Community Hospitals

Jim Shannon Excerpts

Wednesday 3rd September 2014 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to serve under your chairmanship, Mr Owen. The Minister and I have spent a bit of time together in Westminster Hall in the past couple of days, and it is nice to see him in his place. I wish him well. I congratulate the hon. Member for Dover (Charlie Elphicke) on securing this debate, which gives us all an opportunity to participate, and we thank him for that.

I have a deep interest in community hospitals and I therefore look forward to making a contribution. As the Democratic Unionist party spokesperson for health, the issue is of some interest to me. It is not often that we are the second largest party in the Chamber. [Laughter.] With my hon. Friend the Member for Upper Bann (David Simpson) and me, we have two Members, which makes us the second largest party. It is a pleasure to speak on this issue. The local hospital in my constituency of Strangford is in Newtownards. It is a community hospital, like Bangor and Downe, which are in neighbouring constituencies, and all those hospitals feed into the major hub of our hospitals, which is the Ulster hospital. I put on record, because I have to, the excellent staff we have at those hospitals. We are very much indebted to their work, the commitment they give beyond their hours and the quality of their experience.

Community hospitals have a big role to play in our society. Without them, the NHS health system would be under even greater pressure. We have one of the best, if not the best health system in the world, but being the best comes with pressures. Due to the nature of our health system, which entitles all UK residents to health care, delays and backlogs can, unfortunately, arise sometimes. In January this year, the Royal Victoria hospital in Belfast was forced to declare a major incident due to the large number of patients visiting accident and emergency. Health is a devolved matter, and although our Health Minister at home, Edwin Poots, dealt with the issue extremely well, I am under no illusion that the Belfast hospital was alone in declaring itself under extreme pressure. The nature of the NHS means that that happens sometimes, but community hospitals can come in to address that.

I am always thoroughly impressed by the work of staff in A and E departments, because they are often run off their feet, with many people coming in with a variety of problems, but community hospitals play an important role in easing their work. Often, people have injuries that need to be seen to that are not emergencies, and sometimes people have to look at how best to categorise those issues and which hospital to attend. Some people could see their GP at their local community hospital and use the out-of-hours service, rather than attending A and E departments. That is not meant as a criticism; I am always conscious that people respond in the way they see best, but sometimes we need to take a longer look at how things work. Community hospitals can play a greater role.

One thing that we need to do is raise awareness of community hospitals through this debate and look at how best the community and our constituents can respond. The role of community hospitals is to provide accessible health care and ancillary services to meet the needs of defined local populations, particularly in areas remote from district general hospitals. As an extension of primary care, they enable GPs and the primary health care teams to support patients within their own communities. Rehabilitation is a major role of community hospitals, and many offer a wide range of health promotion, diagnostic, emergency, acute and convalescent services, as well as out-of-hours treatment.

Community hospitals provide an undervalued resource, and those wishing to close such hospitals or downgrade them to no longer being community hospitals have often presented community support as irrational, but it is not irrational in my area. The community hospital in my constituency looks after the Ards peninsula. Travel from Portaferry, Portavogie or Kircubbin to the Ards hospital takes 15 to 20 minutes, but travel to the Ulster hospital would take twice as long, because of the traffic. The community hospital has a significant and important role to play, and we must look outside this place, to see what the issues are for my constituents. In the community hospital, they feel like they are treated as people, rather than numbers. That is not a criticism, but it is a reality.

Figures for Northern Ireland show that the waiting times at A and E are extremely good with just 294 out of 62,193 people waiting longer than 12 hours to be treated or discharged. That figure of 294 must also be addressed, but the numbers show the importance of the role that community hospitals play in treating non-emergency injuries, as well as the large-scale rehabilitation programmes that they offer. Community hospitals provide more convenient services, are less costly for the local population to access and are tailored to the local community’s needs. The hon. Member for Dover referred in his contribution to the significant and important role that community hospitals play in that respect. Furthermore, community hospitals provide a range of safe and appropriate services, often with considerable cost benefit to the NHS—minor injuries units being a prime example.

Doctors can be summoned very rapidly to community hospitals, virtually all of which operate without resident medical staff in a satisfactory way. They have proved that they can do the job to a certain level, which is impressive and eliminates the argument that community hospitals do not provide enough of a service, forcing people to district general hospitals when injured or ill through the night. It is a fact of life that such things happen, but that does not downgrade the importance of the community hospital. It would be good, however, to see all community hospitals offering night-time services. In community hospitals, the patient is under the care of their own GP, who will continue to look after them on discharge. The community nursing teams are also able to retain closer links with the patient at community hospitals, which is vitally important for rehabilitation and is why community hospitals are so successful when it comes to patient recuperation

In conclusion—I am conscious that several other Members want to speak—the benefits of having the same doctors and nurses, who know a patient’s case and can get to know the patient, cannot be underestimated. That is why this debate is so important. I encourage the Minister to raise awareness of community hospitals’ work and to encourage people with minor injuries to use their local community hospital instead of A and E departments at district general hospitals. I congratulate the hon. Member for Dover on bringing forward this debate. I look forward to the Minister’s response and to hearing from the third party in the room today when the shadow Minister makes his comments.

Obstructive Sleep Apnoea

Jim Shannon Excerpts

Tuesday 2nd September 2014 Westminster Hall

[Julie Hilling]

Thank you, Mr Havard. I am very pleased to be serving under your chairmanship. You will not be surprised to learn that I first got interested in this subject from a road safety perspective. When a member of the Select Committee on Transport, I received an e-mail from the parents of a young woman who was killed by a lorry driver who fell asleep at the wheel, so I raised the issue on a number of occasions when we were doing different inquiries on things such as freight transportation and road safety. However, as soon as I started to talk about sleep apnoea, I discovered that it was far more common than I had thought—with a number of friends and acquaintances declaring that they had it—and that, in Bolton West, predicted rates of the condition are higher than the national average. I asked for the debate today to coincide with the launch of the British Lung Foundation’s obstructive sleep apnoea health economics report, because an estimated 1.5 million people have the condition in the UK, yet only 330,000 people are currently diagnosed and treated.

OSA affects people of all ages, including up to 4% of middle-aged men, 2% of middle-aged women and 20% of those aged over 70. Although not everyone with OSA is overweight, many are, and with an increasingly overweight and ageing population, it is anticipated that the rates of OSA will increase in the coming years.

What is obstructive sleep apnoea? It is a condition whereby the muscles in the throat relax, causing an obstruction in the airway during sleep, meaning that a person stops breathing. Some people stop breathing hundreds of times a night, and others have periods during which their breathing is restricted. Untreated OSA can have a profound impact on the quality of life of those affected and it has been proven to cause high blood pressure, as well as being associated with a host of other health conditions such as heart disease, heart failure, stroke and diabetes. The life of someone whose OSA is not treated can be dramatically shortened. Correct treatment has been shown to increase the probability of survival of OSA patients by 25%.

There is a strong link between OSA and an increased risk of road traffic accidents, with individuals who have uncontrolled OSA three to seven times more likely than the general driving population to have an accident on the road.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for bringing this issue to the House for hon. Members’ consideration. Many people will look on OSA as something that perhaps is not all that worrying, but from what the hon. Lady has said, it very much is. Does she feel that probably what we, the Minister and the devolved Administrations now need to do is to raise awareness of the condition through GP surgeries, leaflet drops and education?

Aerospace Industry

Jim Shannon Excerpts

Tuesday 2nd September 2014 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure, Mr Hollobone, to serve under your chairmanship. It is equally a pleasure to speak in this debate, and I thank the hon. Member for Mid Worcestershire (Sir Peter Luff) for securing it. He has outlined the case brilliantly, although he did not mention Northern Ireland, so I will do that and correct the balance. That is important, because we have an industrious and successful industry in Northern Ireland that creates many jobs, and I will outline that in my contribution.

As the Democratic Unionist party spokesman for transport, this subject interests me, not only because of its magnitude, but because it creates many jobs in my constituency, both directly and indirectly. It creates jobs directly in the companies, and indirectly through sub-contracting. Many companies come into the engineering sphere because of the good work done through the aerospace industry.

We should all feel immensely proud of the UK aerospace industry, and we have every right to be proud of it. We boast the largest aerospace sector in Europe and we are second globally only to the United States. We should shout our successes, not from the rooftops, because we are not on the rooftops, but in the Chamber. The importance of the continued partnership of the Government and the industry through the aerospace growth partnership cannot be underestimated, as the latest figures from the ADS, which represents the aerospace, defence, security and space industries, suggest. As of 28 August, there was a record backlog of more than 12,000 aircraft and 21,000 commercial aircraft engines orders. With the economy still only making a slow recovery and thousands of jobs not yet secure, that is fantastic news for the aerospace industry and for the United Kingdom overall, with estimates that the backlog will be worth between £135 billion and £155 billion over the next nine years. That is not a paltry sum and it indicates how much the aerospace industry contributes to the economy of the United Kingdom of Great Britain and Northern Ireland.

The aerospace industry is extremely positive. While everything else makes slow and steady progress, the industry has been growing at a pace 10 times quicker than the rest of the economy in the last three years, outstripping many employment sectors. That is another example of the importance of the Government’s partnership with the industry. I am sure that the Minister and the shadow Minister will underline that clearly in their responses. The new orders are simply part of long-term industry growth, with estimates of demand for more than 29,000 commercial airliners between now and 2032, which is in line with the airlines’ desire to carry more passengers and expand their fleets. The future looks positive, and it is positive because of the direct attitude the Government have adopted to the industry, but—as the hon. Member for Mid Worcestershire said—other things need to be done to keep us in a prominent position.

The situation certainly looks promising, and I must admit that I was keen to contribute to today’s debate not only in my capacity as my party’s spokesperson for transport, but also because of the massive contribution that Northern Ireland makes to the industry. The main factory in Northern Ireland is located in Newtownards in my constituency. I am pleased about that, of course, and I can boast of having one of the most technologically advanced and internationally focused aerospace industries in the world right in my constituency, giving job opportunities to many young people.

The hon. Gentleman referred to apprenticeships, as did the hon. Member for Burnley (Gordon Birtwistle), who has commented on the issue before in Adjournment debates and in Westminster Hall, and I am pleased to see such opportunities coming through for people in my area. Bombardier has more than 5,000 highly skilled employees across four sites in Northern Ireland. The site in Newtownards is the biggest, but there are others in Newtownabbey and Belfast. Bombardier promotes many job opportunities, and it is important to see that happening. With first-class capabilities, the site’s operation plays a pivotal role in all of Bombardier’s families of commercial and business aircraft. It also produces and sells components for Rolls-Royce, Airbus and General Electric. Bombardier’s CSeries aircraft has significant UK content, primarily through the advanced composite wings that were designed, and are manufactured, by Bombardier Aerospace in Belfast.

[Sammy Wilson (East Antrim) (DUP)]

The hon. Member for Mid Worcestershire (Sir Peter Luff) emphasised the importance of research and development. One of the ways in which Bombardier has kept its place in the market and, in particular, kept production in Northern Ireland has been through the research and development money made available by the previous Government to ensure that the investment required in Northern Ireland to keep the competitive edge was made. Does my hon. Friend agree with the point made by the hon. Gentleman on the need to think about the long term, because the period of return is long term? It is important to think about long-term research and development incentives if the aerospace industry is to be maintained at its current standard in Northern Ireland and the United Kingdom.

[Jim Shannon]

I thank my hon. Friend for that valuable contribution. He is absolutely right. Sometimes you wonder, Mr Hollobone, whether people have looked at your notes before they make an intervention, because often they raise issues that you were going to come on to. The Northern Ireland Assembly has made a significant commitment to Bombardier—the Minister responsible for that is Arlene Foster—as have this Government and other Governments. We have a huge range of aerospace companies operating in Northern Ireland, including B/E Aerospace, Magellan Aerospace, Goodrich, RFD Beaufort and Thales, to name just a few, so it is perhaps not surprising that one in three of the world’s aircraft seats are manufactured in the village of Kilkeel in Northern Ireland. Look around the world and think of all the planes there are and remember that a third of those seats are manufactured in Kilkeel in Northern Ireland.

Even more good news for Northern Ireland and UK industry was the announcement—this relates to the intervention of my hon. Friend the Member for East Antrim (Sammy Wilson)—of a £6.8 million advanced engineering competence centre in Northern Ireland. That is a commitment to the future and to research and development. The centre will be based at the Northern Ireland Advanced Composites and Engineering Centre in Belfast and will focus on developing innovative solutions in the advanced engineering sector. In other words, it will look at the long-term progression of aerospace, not just in the United Kingdom of Great Britain and Northern Ireland, but in Europe and the rest of the world.

The centre is tremendous news locally, as it will no doubt create more jobs, but it is also brilliant news for the UK aerospace industry as a whole. As opportunities in civil aerospace grow, the UK faces increasing competition from mature and emerging markets, so the new centre will, I hope, develop new approaches for advanced engineering, because being ahead of the competitive market is the only way we can ensure that we remain first in Europe and first in the world. That is the point I want to emphasise. We are aiming at short-term goals, but we are also trying to achieve a long-term strategy.

The figures I gave are testament to just how successful and important the aerospace industry is to the UK economy and our ability to compete globally. That is why I urge the Government to work alongside their partners, not just to encourage technological innovations, which are important, but to lead the way in cutting emissions, reducing fuel burning and increasing aircraft efficiency. Those are important issues that we cannot walk away from, and the aerospace industry is trying to address them. That can be done, and we must do our best in tackling them.

One thing that is close to my heart is my wish to see the Government encouraging students and young people to undertake the necessary courses at universities and technical colleges, as the hon. Member for Burnley said. We need not only aerospace engineers and technicians to replace the current generation—we have to look at that—but staff who can work with new technologies and materials. We need further education at universities and technical colleges to work alongside the industry to ensure that the bright brains of our young people are there to take on those jobs.

I am pleased to learn that almost 70% of UK aerospace companies employ apprentices and trainees. That is tremendous news. Each year we meet some of those trainees here in Westminster, as I did this summer. It was good to meet some of the young men and women who are interested in the industry and looking for opportunities. We have a commitment from Government, both here at Westminster and regionally, to ensure there are apprenticeship opportunities for both genders. This is exactly what the industry needs. Provided we continue to develop and innovate, I believe that the future of UK aerospace is very bright indeed.

[Mr Philip Hollobone (in the Chair)]

I call Sir Gerald Howarth—a qualified pilot.

--- Later in debate ---

[Mr Wright]

The hon. Gentleman is right, and that model works well for the aerospace industry. I certainly want to see that encouraged, because an oversupply of apprentices then cascaded down through the supply chain reassures the primes about quality. It can be a means by which the whole competitiveness of the sector can be maintained and something that we should certainly encourage.

[Jim Shannon]

In Northern Ireland, with Shorts aircraft fitters for example, Bombardier has been anxious and keen to secure recruitment from those in the 50-plus bracket, who perhaps went to another job, but still have the skills. They can come back to do training with Shorts Bombardier. That is an example of where in the United Kingdom that is happening for those over 50, who are not on the apprenticeship scale, but are looking for jobs and have the skills.

[Mr Wright]

The hon. Gentleman makes an important point.

Going back to what the hon. Member for Burnley (Gordon Birtwistle) asked in an earlier intervention, not only with specific regard to particular trades and fitting, but the whole education system, from primary through secondary education and on to further and higher education, the system should be geared up to say, “The aerospace industry: you could have a fantastic career if you choose it.” Going to work in a factory, in particular somewhere such as Airbus in Broughton, is certainly not a sign of failure. I would be absolutely delighted if one of my children won an Airbus apprenticeship. It is a fantastic success story, which we need to encourage. The culture of this country is that we do not make anything in Britain any more, but that is simply not true in practice. What steps are the Government taking on manufacturing in general and aerospace in particular to ensure that that is dealt with?

I mentioned the success of exports for the UK aerospace industry, with 90% of the high-value products made by the sector in Britain exported overseas. However, the industry has told me—the hon. Member for Mid Worcestershire mentioned this—that more support and co-ordination are needed for export sales campaigns. Primes and suppliers have said to me fairly consistently that they would like more advanced information and to be more closely involved when Ministers are travelling on trade missions, or when international delegations are visiting the UK. Will the Minister respond to what seems to be a constant voice?

Mitochondrial Replacement (Public Safety)

Jim Shannon Excerpts

Monday 1st September 2014 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

We have heard many stories today about the potential of mitochondrial replacement for women with mitochondrial conditions, possibly allowing them to have children without these conditions. But the hon. Member for Congleton (Fiona Bruce) and others have put forward the safety issue and the need to make sure that there has been a full investigation. This might seem like fantastic news, but just because the HFEA expert panel has not found evidence to say that mitochondrial transfer is unsafe does not amount to saying that the evidence proves it is safe either, as the potential risks of the techniques required are not yet fully understood.

The controversy surrounding genetically modified food comes to mind: it teaches us a number of important lessons. In a paper submitted to the “Science as Culture” conference in 2008, several academics asserted that

“the GM experience represents a warning, a cautionary tale of how not to assess an emerging technology and allay public concern.”

Clearly, there is some evidence to show that we need to look at this again.

The UK is the only country that is considering permitting these techniques. In the USA, the Food and Drug Administration held hearings where concerns about the safety of the techniques were explored. Some even consider the lack of international consensus as a sign that the UK is moving too quickly, and I must admit that I, along with many others, share that view.

The Government have sought to justify ignoring the clear majority against the techniques on the basis that respondents to public consultations are from self-selecting audiences, but I say to the Government, “Ignore them at your peril.” It would be foolish to dismiss responses to public consultations on any subject in such a cavalier manner, but when we are dealing with concerns regarding the public safety of what is in effect a new biotechnology, and when the memory of the GM food debacle is still fresh in the public memory, the strategy is exceptionally foolish.

It is important that we consider these matters in their full detail. It is in this regard—mindful of the need to avoid at all costs any sense of rushing and of ignoring public opinion post the GM food saga—that difficulties surrounding the approach of the Department of Health are thrown into particularly sharp relief.

According to a poll conducted by ComRes in February, 35% supported the technique and 34% were against it, but in a matter of six months those figures changed to 18% in support and 46% against. That extraordinary loss of support in a very short period highlights that the cavalier approach of the Department of Health is very risky and dangerous.

At the very least, the Government should reassure the public by making it absolutely plain that they will not rush into laying any regulations before this House or anywhere else until all the pre-clinical experiments recommended by the HFEA in its three safety reports to the Secretary of State have been concluded. Only then will we be able to move forward.

Organ Transplants

Jim Shannon Excerpts

Tuesday 8th July 2014 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I am pleased to have the opportunity to speak on this subject. We debated the organ donation register only a few weeks ago, but it is appropriate to highlight the issue in national transplant week. I believe that everyone present is committed to ensuring that organ donation increases throughout the United Kingdom.

I pay special tribute to the hon. Member for Stretford and Urmston (Kate Green), because although I am introducing the debate, I must confess that she asked me to do so. We asked the Backbench Business Committee for an opportunity for this debate, and that opportunity has come this morning. I thank the hon. Lady for giving us all the opportunity to participate, and I hope that the debate will be useful to all involved. I also thank the Backbench Business Committee for giving us the opportunity to speak on this subject in national transplant week. I am passionate about organ donation not just because of the cold facts, but because I witnessed first hand how urgent and important organ transplantation is when my nephew Peter required a kidney transplant.

I was delighted to hear that the latest figures from the British Medical Association show that the number of people who have registered to be an organ donor in Northern Ireland has reached an all-time high of just over 582,000. I checked that figure last night and again this morning because I wanted to make sure that it was right, and it is correct: 582,000 people are registered. That is fantastic news. That all-time high has no doubt been aided by the marvellous work of our Health Minister in Northern Ireland, Edwin Poots, who since 2012 has been dedicated to increasing awareness of organ donation and achieving the desired figures.

That said, much more needs to be done. The UK has one of the lowest rates of organ donor registration in Europe, with 96% of the population supporting the principle of organ donation yet only 30% actually being registered. More than anything else, those low numbers are because the UK population is unaware of and often misinformed about organ donation, how to register, the process involved and how vital transplants are. Many campaigns are under way. I do not often read The Sun, but it is running a campaign on transplants. It pursues many issues, and today it is trying to encourage more people to sign up to the organ transplant list.

Currently, 7,000 people are waiting for an organ transplant, and three people die each week while waiting for organs. That is three people too many: three families left heartbroken by the loss of a loved one who could have been treated if more people were on the list to donate. Just one person can save up to nine lives, so the Government must encourage as many people as possible to sign the register. I know that the Minister is committed and that her response will be positive. With this debate, we want to encourage our nations, collectively, to get involved and sign up.

A third of families refuse to give consent for their loved one’s organs to be donated because they are unaware of their loved one’s wishes. That is just one reason why the Government must consider legislating on the introduction of a “soft” presumed consent system, wherein the families of the deceased can object to donation if the deceased dies without expressly electing whether or not to donate their organs. I strongly believe that people should be on the list as an organ donor unless they opt out. That is very much the soft option. Such a system would undoubtedly increase the number of organs available for transplantation and reduce the number of people dying while on waiting lists.

In 2013, the Public Health Agency in Northern Ireland carried out a survey in an attempt to gauge public opinion about organ donation and came up with some interesting figures. It found that 56% were in favour of presumed consent, just 18% were against it, 8% wanted more information and 18% did not know. A further 62% said that they would not opt out if a soft system was introduced. I believe that there is movement among the people of the United Kingdom of Great Britain and Northern Ireland towards the soft option, which we should consider.

The NHS “Taking Organ Transplantation to 2020” strategy seeks to increase donor rates by 80%, but it does not include or discuss the option of a soft opt-out system. Perhaps the Minister could share her thoughts on that in her response. The lack of mention of a soft opt-out is unfortunate, as the strategy refers positively to the evidence from countries such as Belgium, Croatia and Norway showing

“an increase in donation rates following a move to an opt-out system together with investment in infrastructure and raising public awareness of organ donation.”

It is clear that other nations have made the move and seen the benefits; it is time that our nation moved in the same direction.

The 2013 survey also found that 84% of respondents in Northern Ireland supported the idea of transplantation, but only 32% were on the register. Worryingly, more than a third of respondents were not aware that the organ donor register existed, with that lack of awareness being lowest among 16 to 29-year-olds and people over the age of 65. Perhaps we need to do more to encourage people in those two age categories.

[Ms Margaret Ritchie (South Down) (SDLP)]

The hon. Gentleman is making a compelling argument about the need for organ transplants and has addressed the opt-out system that has only recently been introduced in Northern Ireland. Does he have any suggestions as to the possible reasons why many people do not offer to give their organs for donation?

[Jim Shannon]

I thank the hon. Lady for that intervention. I will come on to address that issue later in my speech, but we can do a number of things. In Northern Ireland, when people apply for a driving licence they must decide whether they want to be on the organ donation list. There is no dispute: they have to answer yes or no. If they answer yes, they are on it; if they answer no, they are not. It is as simple as that. I think that that is one reason why 582,000 people are on the donation list in Northern Ireland. Perhaps the Government here on the mainland can take that approach as well.

I want to highlight a couple of other important points about the 2013 survey. Many of the respondents were wrongly informed on the subject of organ donation—for example, one in five wrongly thought that it was possible for a brain-dead person to recover from their injuries and that only the organs of young people were good for transplants. That shows the need for better understanding of the system, and we should look at how we can educate people through campaigns in schools, TV adverts and in GP surgeries. Maybe we MPs can post on our Facebook pages or websites—not maybe; yes we can. We must encourage people to sign up to the organ donation list.

In Northern Ireland, 78% of people surveyed said that they would accept an organ if they needed one. Some 96% of families claim that if they knew their loved one’s wishes, they would agree to the donation. That shows how important it is for families and friends to discuss organ donation. It should be a subject for consideration. Perhaps a media campaign could be organised and the issue written into the storylines of some of the soaps. That might make it an essential subject matter for discussion around the dinner table.

Several charities have backed this debate, and I would like to mention a few shocking statistics that they have kindly supplied me with. I want to focus on cystic fibrosis; I know that other Members will focus on other things. The chief executive of the Cystic Fibrosis Trust, Ed Owen, said:

“We are delighted to lend our support for National Transplant Week. For many with the life-shortening condition of cystic fibrosis, a lung transplant is the only way to prolong life. Yet it is a tragedy that one in three on the transplant list will die waiting for new organs.

It is vital that more lungs are made available for transplantation. So we strongly support measures to encourage more people to donate their organs in the event of their death—and we continue to support a change in the law to a system of presumed consent to help ensure more people have that vital discussion with their loved ones about their wishes.

Alongside this, more effective action is taken to ensure that a greater number of donated organs are used for transplant with a new national lung allocation scheme and greater use of extended criteria lungs. Our report, ‘Hope for More’, published earlier this year, set out a series of recommendations”.

I want some of those recommendations to be looked at.

Last Saturday, I was judging horses. I do not know very much about horses, but I was lucky; they said to me, “Pick the one that looks the best to you,” which was dead easy. It may not have been the horse the experts thought was the right one, but it was the one that I thought was the right one. At that event, I met a constituent, a gentleman with cystic fibrosis. I remembered him as a healthy, active person, but when I met him on Saturday, he told me that his condition had worsened. I am ever conscious of him and of many other constituents affected by this issue.

In March 2014, the Cystic Fibrosis Trust published the report “Hope for More”, which contained 12 recommendations for increasing the number of successful transplants. Key among them was a call for a national lung allocation system similar to the UK urgent heart system. We have a system in place that works; why can we not extend it to lungs? Regular audits have been key to the success of the urgent heart system. Surely a similar system could be introduced in relation to lung transplants.

In Germany and America, the introduction of a lung allocation system has led to a significant increase in lung transplants and huge decreases in waiting lists. I presume that we could do the same here; there is no reason why we cannot. The current system certainly seems flawed. If a patient in the south of England needs a lung transplant, they must wait for one to become available in their area rather than receiving a lung from the midlands or the north of England. We need some kind of scoring system so that those who are most desperate for a transplant receive one first, and people are ordered from those most at risk to those least at risk.

The Cystic Fibrosis Trust has come up with more ways in which the number of organ donors and therefore transplants could be increased. Although time does not permit me to go into great detail—I am conscious that other Members want to contribute—I believe that those suggestions warrant a committee to consider and delve into the issue. I hope that the Minister will indicate in her response whether she feels that a committee would be helpful in moving the campaign and this debate further on.

Existing lung donor criteria were originally drawn up over 30 years ago. Although they were reviewed in 2001, they have changed little. The criteria place limits on donors according to age, previous health complications and a number of other clinical measures. Although it is important to ensure that only viable lungs are transplanted, those limiting rules mean that lungs from fewer than 25% of brain-dead donors are used in clinical lung transplantation. There are clinically viable lungs among the remaining 75%, and we need to maximise their use. I suggest that we look into that.

On lung resizing, data on organs exported overseas suggest that many lungs from larger donors are not used due to size mismatch. The technology exists to resize organs, and it must be made more widely available. People with cystic fibrosis have smaller than average bodies due to difficulties absorbing nutrients from food.

Extracorporeal membrane oxygenation techniques, which artificially preserve critically ill lung transplant patients and allow them extended time to receive donor lungs, have been developed to prevent death. ECMO is available at eight designated centres in the UK, but guidance is lacking on its appropriate use in lung transplants, where it has been shown to work as a bridge between respiratory failure and transplantation. It is feared that without clear guidance, ECMO will not be used appropriately in such circumstances, leading to adverse outcomes for patients.

The NHS Blood and Transplant 2020 strategy commits to providing

“guidance on levels of acceptable risk in relation to offered organs, particularly from extended criteria donors”.

It notes:

“Clinicians…will use their judgment, based on the current national and international evidence, to draw up criteria for non-acceptance”

and that

“there is variation in acceptance practices throughout the UK.”

Further, the strategy lays out actions

“to improve certainty about organ function”,

including investment in research to identify better biomarkers associated with good or poor function.

The Cystic Fibrosis Trust believes that it is the responsibility of NHSBT to publish guidance that brings together current national and international evidence to provide an up-to-date framework to support and guide clinicians’ judgment. It is a weakness of the NHSBT 2020 strategy that there is no commitment to providing clinicians with such a resource. Since the introduction of a German surgeon, André Simon, as head of transplant at Harefield, transplants have increased by 50%, while outcomes have remained every bit as good. It is ascribed to the culture difference in Germany. André Simon, having transferred that willingness to use extended criteria lungs at Harefield, has had an impact on the transplant programme there.

The 2020 strategy mentions the need for NHS hospitals and staff to be better supported to meet demands. That is welcome, but no mention is made of lung downsizing, and very little is made of extended criteria organs. Elsewhere in Europe, donor lung resizing is commonplace and outcomes are equitable with those of lungs that are not resized. Only three doctors in the UK can resize lungs, so it is a lottery as to whether they may happen to be around when needed. That is not disrespectful to anybody; it is a fact of life. Methods such as those, which involve controlled and safe innovation, are key to improving the likelihood of a lung transplant and go hand in hand with the NHSBT’s aim to

“ensure that transplant centres have the capacity and surgical expertise and other clinical skills to meet the demands for transplantation”.

Innovation has not been addressed in detail in the strategy, but it has been identified as an area on which commissioners must focus in order to make it a reality. Although the NHSBT strategy expresses a desire for a 5% increase in the number of hearts and lungs transplanted from donors after brain death, it is unclear how that will be achieved. We believe that there must be a renewed focus on understanding which lungs are suitable for transplant. There is strong evidence indicating that a new approach is increasing the rates of successful lung transplant elsewhere in the world.

Recent scientific guidance suggests that extended criteria lungs are key to progress in increasing lung transplant rates. Research published over the past 10 years by a range of international centres such as the university of Toronto, Hannover medical school, University Hospital Zurich and the Royal Brompton and Harefield Trust suggests that the use of selected extended criteria lungs may safely expand the donor pool without adverse consequences for lung transplantation. Many lungs designated as marginal by the International Society for Heart and Lung Transplantation criteria are now perceived by experts to be as clinically effective as standard criteria lungs.

Things are changing. Scientific evidence and research shows that more lungs are suitable, and we should be using them. Although the medical evidence is continually evolving, public perceptions are falling behind. We must address the issue of education and perception in the general public. We as MPs, this Government and the House can collectively ensure that that happens.

The charity Anthony Nolan seeks to help people with blood cancer or rare blood disorders who require blood stem cell or bone marrow transplants. The charity has said that despite the fact that there are more than 553,000 donors on the register, there are still not matches for every patient in need of life-saving transplants. Once again, more donors from black and minority ethnic communities are needed, as the only chances of finding a match are among those of similar ethnicity.

The average number of donors per constituency is 796, which is encouraging, but more are desperately needed. In my constituency of Strangford, we have a lot to do, with just 381 donors. I intend to use my opportunities as an MP through Facebook, my website, this debate and the local press to encourage more people to sign up and show the importance of organ donation and transplantation back home, but we must encourage Government to consider new ways of campaigning and raising awareness and new approaches, such as a soft opt-out system and a national lung allocation system.

I have had other correspondence from other bodies relating to organ transplants and blood safety. There are certain risks to organ donors, but they can be monitored in such a way as to reduce safety concerns. Maybe we need to raise the level of awareness and education, so that donors know they are in safe hands. We need to ensure that blood donors and organ transplant patients receiving blood transfusions are as well educated and informed on blood safety issues as they can be.

I am very aware that other Members want to speak and I will give them that opportunity; I also want to give the shadow Minister, the hon. Member for Liverpool, Wavertree (Luciana Berger), and the Minister the opportunity to conclude the debate. I will just give a few figures to put matters into perspective. Since 1 April, 309 people have donated organs; an additional 563 people have donated corneas; 824 people have received the gift of sight; and 804 people have received transplants. However, there are still 6,966 people waiting for the gift of a long and healthy life. Ultimately, choosing whether or not to donate organs will always remain the individual’s right, which is good and proper, but we in this place have a responsibility to ensure that the individual is well-versed in the matter and that the choice they make is an informed one. In organ transplant week, we need to focus on the legislative change that can and will put more people on the organ donor list, so that we can save even more lives. The first stage of that campaign is today in Westminster Hall, and we ask the Minister to respond appropriately.

--- Later in debate ---

[Glyn Davies (Montgomeryshire) (Con)]

I am sorry that I did not give you prior notice that I wanted to speak, Mrs Osborne. Although this is an important issue to me, I did not realise that it was on the agenda and I am grateful for the opportunity to speak. I congratulate the hon. Member for Strangford (Jim Shannon) on introducing the debate. I agreed with a substantial part of his speech, although not all of it. I will come to that point later.

Organ donation and transplantation is one of the most important developments in modern medical science, enabling treatment of patients with failing and damaged organs. Huge advances in transplant surgery and immunosuppression have enabled great advances to be made. Hearts, kidneys, livers, lungs, pancreases, and other organs, are successfully transplanted, but the demand continues to grow. Medical science is enabling more transplantation and we are living longer, but still about 500 people die every year while waiting. We always have to be looking for ways of increasing the levels of donation and transplantation.

My interest in the subject stems from a friend of mine receiving one of the early heart and lung transplants at Papworth, probably about 25 years ago. It was phenomenal at the time, but since then it has become much more common and is more accepted. I have had an interest since that time and that has developed in terms of promoting support for those suffering from kidney disease in my constituency, for example, with the development of a dialysis unit, and it continues here. I am also a trustee of Kidney Foundation Wales, a wonderful organisation promoting transplantation in Wales, although I disagree with it about presumed consent. I have always been disappointed in that regard and somehow feel isolated, because all the other trustees of Kidney Foundation Wales favour a change to presumed consent, which is now a new Welsh law. However, I am implacably opposed to it, because I just do not believe it will work. I will come to that point later, as one of the two points that I want to make today.

We all want to increase the level of organ donation—that is, all those in favour of presumed consent and all those in favour of continuing with informed consent. Providing new life to a fellow citizen is undoubtedly the greatest gift that any of us can give. I have spoken on this issue several times before, but there are two new issues to consider that I want to mention.

First, I emphasise how much amazing success we have had in promoting organ donation. We all owe a debt to the right hon. Member for Kirkcaldy and Cowdenbeath (Mr Brown), who established the organ donation taskforce—in 2005, I think—under the chairmanship of Elisabeth Buggins, an outstanding leader in this debate. That taskforce produced a report in 2008, with a target of increasing organ donation by 50% over five years. That target was met last year. However, it does not stop there. The latest figures show that, after six years, there has been a 63% increase, and it is still rising. We have seen a phenomenal increase as a result of the organ donation taskforce’s recommendations, which did not include presumed consent; in fact, it said that that was not a recommendation. It recommended an increase in the number of intensive care beds and specialist nurses, copying what had happened in Spain, which had delivered great success there in increasing organ donation. It is important to recognise that we can continue to build on the great success that we have achieved.

Secondly, I am disappointed that the British Medical Association takes a different view from me, supporting the introduction of presumed consent. However, it decided to do that on the basis of a show of hands at a conference meeting, and it was the quality of the speakers in the debate that led to that decision. Its decision was not based on a comprehensive report, like that of the organ donation taskforce; it was just a show of hands.

The point that I really wanted to make in contributing to this debate, because it is important and supports my view that no self-respecting surgeon would remove a patient’s organs without the support of their next of kin, is that the Royal College of Surgeons has in recent weeks withdrawn its support for the BMA’s position. The Royal College of Surgeons said:

“Evidence from these countries demonstrates that investment in public awareness campaigns and infrastructure that supports transplantation services, such as the availability of intensive care beds and number of specialist nurses in organ donation, can substantially increase organ donation.”

That is key. It continued:

“It is therefore of profound importance that investment in these areas is increased to support organ donation.”

It also said that

“we believe that there is insufficient evidence that an opt-in or opt-out system increases rates of organ donation. We consider the issue to be a matter for personal ethical and philosophical deliberation. We believe that to improve organ donation rates it is vital that investment in public awareness campaigns and infrastructure that supports transplantation services is increased.”

That is the key point on which I want to finish. There is no evidence that moving to an opt-out or presumed consent system will deliver any more organs. The Welsh Government incessantly repeat that it will, which is why popular support is seen when people are asked about the system. Clearly, if people are told again and again by the Government that the system will increase the number of organs, they will say that they support it. If I believed that it would increase the number of organs, I would support it, but I do not, because it simply will not do that. An important point to remember is that we need to invest in those things that work.

[Jim Shannon]

In my introduction, I referred to three countries that have shown that the soft opt-out option was successful: Belgium, Croatia and Norway. There is evidence and, with respect, the hon. Gentleman cannot deny that.

[Glyn Davies]

I have not studied the situation in Norway, but for many years the example in this debate was always Spain. Spain was the great success story, and it is indeed the best performer in the world. The Welsh Government have recently claimed Spain to be a presumed consent country. The reality is that the law was passed in 1979 and was effectively not followed. It was abandoned in 1980 and remains on the statute book, but it has never been activated. Ten years later, Spain introduced the changes recommended by the organ donation taskforce and had spectacular success. As a nation—I hope the Minister will say that we will carry on doing this—we need to continue doing what we have done, which has produced success: focusing on intensive care beds, specialist nurses and the example that the hon. Member for Bristol East (Kerry McCarthy) mentioned of people telling their next of kin. If all families knew, we could raise the consent rate, perhaps by 20%, to the levels that Spain sees, and we would deliver all the organs we need. The key is people telling their next of kin, so that their next of kin know what they desire. Far more transplants would be carried out and more people suffering would live.

Learning Disabilities (Care in the Community)

Jim Shannon Excerpts

Tuesday 8th July 2014 Westminster Hall

[Norman Lamb]

I am very grateful to my hon. Friend for that intervention. I would be interested to hear further information about the organisation to which she refers. It is clear that sometimes a leap of faith is required to give a person the chance of a better life outside, and the system is horribly risk averse. We know that the main cause of decisions to keep people in assessment and treatment centres is the clinical judgment that the person needs to stay there, so that needs to be challenged. I want to give people the right to a second opinion and I am in discussions with Simon Stevens, the chief executive of NHS England, to give people that right, because we have to find ways of giving a voice to people who hitherto have felt that they are ignored and not listened to and that nothing ever changes.

I pay tribute to the two organisations mentioned by the right hon. Member for Coatbridge, Chryston and Bellshill: Mencap and the Challenging Behaviour Foundation, which have continued to make the case on behalf of people with learning disabilities.

Winterbourne View and the appalling abuse of people there reminded us that there is still a massively long way to go to ensure that people are safe and get the right support—the support that they need. The Government’s review following the Winterbourne View case looked at the systemic issues facing people with learning disabilities and their families. At the end of the review, we published the concordat—the right hon. Gentleman referred to that—bringing together all the national organisations to commit to change. In a way, the most distressing thing is that I felt that organisations committing to the concordat and the change set out in it were doing that with a seriousness of intent that they would deliver on. The lack of change that there has been since then is really shocking, given that they committed to achieving that change. Eighteen months on, we all need to remind ourselves that progress so far has not been nearly good enough and that we all need to continue to work in partnership to deliver on the commitments solemnly made at the start of all this.

I have said recently, and the information that we have shows, that far too many people with learning disabilities are still stuck in hospitals, often hundreds of miles from home and in many cases for years, with serious questions about whether they are getting the right care and support.

I have also met Mike Richards, the chief inspector of hospitals, and Paul Lelliott, the deputy chief inspector for mental health, to ensure that the Care Quality Commission challenges organisations. If someone is living in an assessment and treatment centre, which is there for assessment and treatment, not for long-term living, surely it is not delivering the right model of care. That needs to be challenged by the Care Quality Commission and not simply accepted and tolerated.

Collectively, we need to be honest and say that the system has so far completely failed to deliver on the commitment made in the concordat significantly to reduce the number of people with learning disabilities who are in effect living in hospitals—for whom hospital is their home.

[Jim Shannon (Strangford) (DUP)]

Will the Minister give way?

[Norman Lamb]

I will very quickly; I am conscious of the time.

[Jim Shannon]

I want to say just one thing. Is the Minister saying that this Government are committed to partnership relationships with housing groups and those who are committed to facilitating supported living for people outside these homes? I think that, if he is, he will find that many outside bodies are prepared to take him up on that.

[Norman Lamb]

I very much agree and I am grateful to the hon. Gentleman for that intervention. Providers of supported living care need to be much more central to the task of changing this culture. Indeed, I have asked for a meeting to be arranged that will bring in some of those providers, with Simon Stevens and the chief nursing officer, Jane Cummings, who I am pleased is now in charge of this programme, to demonstrate how they can play a part in effecting change.

I also want to acknowledge the work that has been done from the concordat and what has been achieved by NHS England and other delivery partners.

It is appropriate for us to start by looking at the people who were in Winterbourne View before it closed. I am pleased to report that NHS England’s Improving Lives team, who include senior clinicians, social care staff, third sector partners and family members of people with learning disabilities, have now reviewed the care of all but one of the 47 people who were in Winterbourne View, and the care of the one remaining individual will be reviewed by the end of this week. Those reviews have resulted in some people moving out of hospital into circumstances that are more appropriate for them as individuals.

The Government have provided funding so that the people who were in Winterbourne View can have additional trauma assessments where the need has been identified and they have consented to those assessments. We are providing additional funding to support families through a telephone helpline, regular telephone counselling and family support days. The funding will also support other people with learning disabilities—including the 17-year-old girl whom I visited a fortnight ago—who have experienced institutional abuse, and help their families.

Involving people with learning disabilities and their families is key to ensuring that the work that we are doing means that they have a better experience and better outcomes. We have provided funding to organisations to allow people with learning disabilities and their families to share their views with us, so that we can listen to them and respond to the concerns that they raise.

We have also made progress on other Winterbourne View concordat commitments. For example, guidance has been developed on commissioning advocacy for people with learning disabilities so that, again, they get a voice and they get access to information, advice and support when necessary. It is vital that local commissioners ensure that people have proper access to high-quality advocacy where they need it.

Meningitis B Vaccinations

Jim Shannon Excerpts

Monday 7th July 2014 Commons Chamber

[Geoffrey Clifton-Brown (The Cotswolds) (Con)]

Thank you, Mr Speaker, for giving me the opportunity to raise the important matter of meningococcal B—or MenB—vaccines in this short debate. I also thank the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), for kindly responding on behalf of the Government. I appreciate that I have dragged her to these green Benches at a time when she might well be negotiating with the drugs companies and it might be difficult for her to respond to every one of my points. Nevertheless, she will understand that I must make them on behalf of my constituents and other members of the public.

There will be a number of hon. Members in this House with constituents whose lives have been affected by meningitis B. I have constituents who have had to deal with the suffering and loss caused by meningitis B, which is why I am here today further to raise the need for a national roll-out of the vaccination. My constituents, Dr and Mrs Turner, who are here today, tragically lost their 19-year-old granddaughter on new year’s day this year. As you are aware, Mr Speaker, their granddaughter, Emily, and her parents are constituents of yours. Emily’s uncle is a constituent of my hon. Friend the Member for North Wiltshire (Mr Gray).

Meningitis B is a comparatively rare disease, with about 1,800 cases in the UK each year. According to the charity Meningitis UK, however, many thousands of people die as a result of contracting the illness. The infection progresses rapidly and can lead to permanent disability or death within 24 hours of the symptoms becoming evident. That is sadly what happened to Emily. One in 10 people who contract the infection will tragically die despite the treatment that is available today. Of those who survive, one in five will have devastating life-long disability such as brain damage, hearing loss or limb damage.

Infants under the age of one year are disproportionately affected by meningitis B, with the number of cases peaking at the age of about five to six months. However, there is unfortunately another peak during late adolescence when students mix at university. Those are the two age groups that are most likely to contract meningitis B and the fact that there is another peak later in life highlights the need for a vaccine during infancy to protect people from lifelong suffering from this potentially devastating disease.

Parents up and down the country were given a sense of hope when in January 2013 a vaccine was licensed in the UK as well as in Europe and the US. The Bexsero vaccine was developed by the drug company Novartis and protects against approximately 73% of the different strains of meningitis B with apparently limited side effects. That was obviously very welcome, but there have been extremely long and costly delays in implementing any vaccination programme. The vaccine was turned down by the NHS after being considered by the Joint Committee on Vaccination and Immunisation.

The passion felt by many members of the public that the vaccination should have been implemented straightaway has resulted in various petitions urging the Government to do so. The charity Meningitis Now, which I heartily and sincerely congratulate on its constant campaigning, delivered a petition of 36,000 signatures to Downing street. My constituents organised a petition of around 5,000 signatures and I had great pleasure in presenting that petition to Parliament earlier this evening.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for giving way and for bringing this matter forward for consideration. Meningitis B numbers have halved in the past 25 years, but there is no room for complacency. Some of my constituents have experienced devastating effects from meningitis, so, as the MP for Strangford, my issue is whether the hon. Gentleman feels that the vaccine, when it becomes available, should be available to the whole of the United Kingdom of Great Britain and Northern Ireland.

[Geoffrey Clifton-Brown]

I am grateful to the hon. Gentleman for his intervention. As I shall discuss later, this is obviously a big and costly undertaking for the NHS. As I am sure the Minister will mention later, there are delicate negotiations to be had, but if we start with babies—preferably babies under the age of 12 months—and then roll it out to students, the whole population will eventually have been vaccinated. Perhaps that will take too long, and once we have vaccinated those cohorts of the population, we might be able to find the money later to vaccinate other cohorts, but let us start, for goodness’ sake. In particular, vaccinating young babies would be an important start.

In my view, and in the view of many others, the Bexsero vaccine should have been rolled out immediately. Doing so could have prevented around 600 cases of meningitis B, and the associated 200 deaths between January 2013 and now. Although there have been delays in rolling out this vaccine on a national scale in the UK, it has been available privately since December 2013 for parents able to pay the high price, and it has been used across several university campuses in the United States. I am sure the House would agree that it is unsatisfactory that where a vaccine has been licensed and is available for use, only those who can afford to pay can get it.

Head and Neck Cancer

Jim Shannon Excerpts

Tuesday 1st July 2014 Commons Chamber

[Sir Paul Beresford (Mole Valley) (Con)]

I thank my hon. Friend the Minister for coming. She is smiling slightly, because we have had this discussion on a number of occasions and it will continue, at least until I get my way, if that is at all possible over the coming years.

I must begin by declaring a short list of potential interests. I am still a part-time practising dentist—very part-time. I am also chairman of the all-party parliamentary group on dentistry and the APPG on skin, which has a link to this debate.

In an earlier debate, I focused on oral cancer and, in particular, on the causative role of the human papillomavirus. I have been trying to persuade the Minister to encourage the Joint Committee on Vaccination and Immunisation, or JCVI for short—don’t the medicos always do that?—to broaden its horizons beyond the inoculation of teenage girls against cervical cancer. The results in relation to cervical cancer are very encouraging, but the virus is key to the cause of many other cancers, and that applies predominantly to two variations of it.

In a previous debate, the Minister was very nice, and explained sweetly that I must rely on the advice of the JCVI—or, at least, that she must do so. She explained that the committee was expanding its sights. Although it was enlightening to hear that it would be examining the HPV-related effects of men having sex with men, it did not help me very much because I am looking beyond that. I think that the committee should be looking above the waist, and, more specifically, looking at the trauma of pain, suffering and death—a very horrible death—as well as at the financial costs to the NHS of the existence of the virus elsewhere in the human body. I am aware that the virus plays a part in skin cancer, but I have decided to concentrate on the head and neck.

A quick cruise through the latest papers on head and neck cancer makes for frightening reading. Despite the reduction in smoking, the number of head and neck cancer cases is rising steadily and rapidly. The stark reality is that the number of new cases is growing year on year, at a much higher rate than the experts expected. Some are talking of an epidemic. The problem is now so acute that one form of cancer which falls into the “head and neck” category, oropharyngeal cancer, is the fastest-growing cancer in Scotland, and is a significant and growing problem in the rest of the United Kingdom.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on raising this subject. In the past year in Northern Ireland, 1,218 people have been diagnosed with head and neck cancers, and 64 people die of such cancers every year. Does he think that that is because this is seen as a lesser cancer—if that is the right way in which to put it—than others which seem to catch the eye of the public? If so, does more need to be done to increase the focus on head and neck cancer?

[Sir Paul Beresford]

I am focusing on it, because worldwide it constitutes about 5% of cancers and causes 6% of the deaths, and because, as I think is generally accepted, in a large proportion of cases HPV is a causative agent, or the root cause. There is a way of dealing with that and I think that we ought to adopt it.

In the United Kingdom, the latest findings put the incidence of HPV at 23.5% for oral cancer, 35.6% for oropharyngeal cancer, and 24% for laryngeal squamous cell carcinomas. I have no data for skin cancer, but obviously it applies to head and neck skin. On a personal note, my brother-in-law recently died from a squamous cell carcinoma on his head, which was undiagnosed and untreated, and when it was found it was too late. Head and neck cancers are fifth in the global rankings of cancer incidence, and sixth in the global rankings of cancer deaths.

The cost of oropharyngeal cancer to our health services is enormous. A new report is due to be published following extensive research on the economic cost of head and neck cancer. The findings of the research suggest that the official estimate of the burden placed on the national health service is significantly less than the actual total. The data I have seen of the report that is coming out soon conclude that the cost of oropharyngeal cancer was approximately £115 million at 2011 prices, laryngeal cancer £96 million and oral cavity cancer £98 million. The total at 2011 costs is just under £310 million. We must add that that is almost certainly low because of under-reporting, that we have three years of inflation and, worst of all, three years of increasing numbers of cases. I am not sure, but I suspect that that does not include peripheral rehabilitation costs such as physiotherapy and speech therapy and some cosmetic dentistry in appropriate cases, nor does it cover the unquantifiable cost to quality of life, with the pain and disfigurement that much head and neck cancers produce, and the treatment that is required peripherally for patients.

Perhaps what is most surprising—I have only just discovered this—is that these cancers are more prevalent in men than women at a ratio of approximately two to one. It is common knowledge that the NHS is under immense financial pressure. In fact, demand for access to the NHS is at unprecedented levels. The Government have taken commendable steps towards ensuring that the health service is protected from spending cuts, which have been necessary in so many other areas, but that does not mean budgets have not come under pressure and resources have not been stretched. It is therefore a matter of the very gravest concern that the full economic burden of head and neck cancer, and by extension HPV, is not taken into account. It should be. The whole of the problem of HPV and the way it infects different parts of the body should be addressed by the Joint Committee on Vaccination and Immunisation.

Australia has a policy of vaccination of both males and females. That is producing what is called a herd immunity. Although I am specifically looking at head and neck, with the role of the HPV virus, it is quite clear that there could be a dramatic reduction in a number of cancers, including head and neck cancer, over time with gender-neutral vaccination. Clearly, men currently face a significantly greater, and rising, risk of HPV-associated head and neck cancers.

I therefore again put it to the Minister that it is not fair, ethical or socially responsible to have a public health policy that leaves 50% of the population vulnerable to infection. Such vaccination, combined with early detection and action on smoking and heavy drinking of alcohol, could save a huge number of lives just as we are facing a dramatic increase in head and neck cancer. I hope that the Minister will be able to persuade the JCVI to broaden its horizons and to look at the human suffering, as well as the total costs of HPV to our national health service.

Patient Safety

Jim Shannon Excerpts

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

That is a very good point, and I thank my hon. Friend for welcoming me to Goole hospital; I had a very good visit. That hospital is in special measures but it is making real progress. It was interesting to talk to staff at the front line. I do not know when the hospital will be ready to leave special measures, but the staff on the front line felt that things were changing, and they welcomed that. My hon. Friend is absolutely right that if someone raises a safety concern, it should not be viewed as an HR issue; it is a patient safety issue, and trusts need to treat it as such.

[Jim Shannon (Strangford) (DUP)]

In his reply to the right hon. Member for Leigh (Andy Burnham), the Secretary of State referred to avoiding avoidable harm. Given that Combat Stress has reported the referral of some 358 additional troops for urgent treatment—a rise of some 57%—will he give us some idea of the discussions in which he has engaged with service charities to ensure that that harm can be avoided?

[Mr Hunt]

We have ongoing discussions with the Ministry of Defence about the care and support that we offer to our combat troops, but I can assure the hon. Gentleman that we give them the highest priority.

Melbourne Declaration on Diabetes

Jim Shannon Excerpts

Wednesday 18th June 2014 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to speak about diabetes. I am a type 2 diabetic, so the matter is important to me. I congratulate the hon. Member for Torbay (Mr Sanders) on securing the debate. I know of his passion for the subject, and it is always good to participate in a debate initiated by him. I hope that others will contribute and help him to pursue his ideas. I am fully behind the Melbourne declaration on diabetes. I am delighted at the attention the illness is receiving, and I look forward to great steps being taken to curb the effect of diabetes in our country and the world.

Many people have referred to diabetes as a ticking time bomb. We focus on many diseases, such as cancer and heart disease, in that way. Diabetes is a ticking time bomb because of the numbers of people who have it and do not know, or who will potentially be diabetic in the near future. I am sure that we are all very aware that it is estimated that there are 382 million people worldwide with diabetes, most of whom are aged between 40 and 59. Again, that middle-aged group is where the focus seems to be, and their number is expected to rise to 592 million by 2035. For one second, consider again that the figure will rise from 382 million to 592 million by 2035—another 200 million people will be diabetics by that time.

In 2013, diabetes caused 5.1 million deaths, which is one every six seconds. That is the magnitude of the issue of diabetes and what it is doing and has the potential to do. In world monetary terms, diabetes is taking up some $548 billion in health spending in 2013, right across the world. That is 11% of worldwide expenditure. Those figures get into what it means to be diabetic, and why the condition is a ticking time bomb not only for the United Kingdom, but for the world. The statistics are harrowing. It is an international problem. It is a disease that we are often too blasé about, and we must not let this dire situation continue. We must adequately assess the issue of diabetes and tackle the problem head-on.

I want to mention our colleague, Edwin Poots, the Minister for Health, Social Services and Public Safety in Northern Ireland. He has initiated a programme to bring in 400 insulin pumps to help type 1 diabetics and their families. He has also initiated training along with that, so that people who have the pumps are adequately trained in administering the insulin, and in helping the control of diabetes. Good things have been done in Northern Ireland, but good things have been done in England as well. As the Minister will know, I ask all the time about a strategy, not only regionally, but for the whole United Kingdom.

Obesity and diabetes-related illnesses combined cost the NHS an estimated £15 billion a year, and 80% of the available funding for diabetes is spent on treating preventable complications, because it is not diabetes that will eventually, to use strong terms, kill someone, but the complications. It can affect people’s kidneys, liver, circulation, heart and eyesight.

[Mr Gregory Campbell (East Londonderry) (DUP)]

While my hon. Friend is on the issue of the cost to the NHS and to all of us as taxpayers, does he agree that any additional resource that is deployed in early detection, and in trying to ensure greater awareness in communities across the UK, will vastly be outweighed by the savings, in terms of what the taxpayer would have to pay out otherwise? That has been outlined by both the hon. Member for Torbay (Mr Sanders) and by my hon. Friend.

[Jim Shannon]

I thank my hon. Friend and colleague for that comment. He is absolutely right, and I will come on to some issues that I feel the Government need to address early on. He is correct to say that vast savings will be made if there is early detection. The need for early detection was mentioned by the hon. Member for Torbay, and other Members will make the same comment.

Although it is great that money is available to treat this illness, we must not merely chase after it, putting a plaster on it after it has inflicted damage. That is clear. We need to ensure that money is spent not only on treating it, but on prevention methods—which makes me wonder whether my hon. Friend the Member for East Londonderry (Mr Campbell) was looking over my shoulder at my notes, because he made the next point that I was coming to. We cannot allow ourselves to accept the fact that 3.2 million people in the UK have been diagnosed with diabetes. Again, that is the magnitude of the problem. We must look to the causes and stamp them out at the root.

One thing that we can address is the preventive measures that need to be taken. We have talked many times in the House about the sugar content in food. The right hon. Member for Leicester East (Keith Vaz), who is not here today, introduced a measure, which I was happy to put my name to, addressing the issues of sugar in manufactured products that we eat. We need to take that issue forward, and in the future, I hope we will be in a position to take legislation on that subject through the House with the support of food manufacturers, so that we can address the issue of the food we eat. We do not need all the sugar or salt that is in food. There is a way of addressing issues outside the Chamber—issues that are outside Government control—but something needs to be done at a manufacturing level.

Our annual intake of sugar is 33.7 kg per capita. To put that in perspective, it is equivalent to eating nearly 34 average-sized bags of sugar each year. Imagine if the sugar was piled up on the table here; it would block my hon. Friend the Member for East Londonderry from sight completely. That is how much sugar we are all eating every year, and some people even eat more. Surely when discussing the Melbourne declaration on diabetes, the Government need to take another look at sugar levels in our food. What steps are the Government taking on diabetes prevention to ensure that the next generation is not blighted by diabetes in the way that this one is? Projections show that if current trends continue, in 2025, 5 million people in the UK will have diabetes. Again, the magnitude of the issue is clear, so what are the Government doing to ensure that that does not happen? What preventive measures are they putting in place to decrease that number?

The correlation between weight and diabetes has been made clear: 80% of people with type 2 diabetes are overweight or obese. The Government need to do more to increase education on the danger of being overweight or obese and tighten controls on how much sugar goes into our food. Those are all issues that I feel we need to take on board.

What is so frustrating is that up to 80% of type 2 diabetes could be delayed or prevented. I am not saying that in any judgmental way, because many in the Chamber will be aware that I am a type 2 diabetic, as I declared at the beginning of my speech. The truth of the matter is that I have to blame myself and my lifestyle choices for the onset of the disease. It was the Chinese carry-out five nights a week, with two bottles of Coke—not a good diet for anybody. That is the reason why I was almost 18 stone and had to lose weight very quickly. Aside from that, it was also a lifestyle with high levels of stress. When the two are combined, diabetes will knock on the door of nearly everybody, as most of us know.

While I am on the subject, many people can be diabetic even though they are not necessarily overweight. It can happen through them having a stressful lifestyle. How many others living the same lifestyle are not aware of the damage that they are doing to their bodies in the long term, and how can we do better in highlighting that? I have to take two Metformin tablets in the morning and two at night. That dosage could have to be increased; a doctor could come along, as he often does, and say “By the way, you just need a wee blood pressure tablet now to keep you right as well.” People wonder just how many tablets they will have to take before they reach the age of 65 and retire, if they are spared until that age.

What are the Government doing to diagnose diabetes early and treat it effectively, preventing or delaying the complications that cause so much human suffering, require costly treatment, and reduce life expectancy? Only one in 10 people who are newly diagnosed with diabetes are offered education on how to manage their condition, despite strong evidence that education is a cost-effective way of giving people the knowledge that they need to manage their condition. On managing diabetes, after someone is diagnosed as diabetic, what help is given to them to ensure that they manage that in a sensible way? I accept that the person also needs to acknowledge that they have to manage the condition. I remember Dr Mageean, my doctor, telling me when I was first diagnosed, “Jim, it is up to you what you do.” He was very clear and said, “You must manage this yourself,” but at the same time, I think we need a wee bit of help, perhaps from Government and from the health service in particular, just to ensure that we know what that all means for everyone involved.

It is estimated that in my small Province of Northern Ireland, 80,000 people have diabetes. That awful statistic worries me very much.

[Mr Sanders]

The point about education is interesting. According to the National Audit Office, the estimated amount that the NHS could save annually through people better understanding and managing diabetes is £170 million. That is just from improved awareness and education.

[Jim Shannon]

I thank the hon. Gentleman for his intervention. That reinforces the point made by my hon. Friend the Member for East Londonderry and by me: prevention saves money for the NHS. I accept that the Minister’s budget is restricted, and that we cannot spend outside of that, but if there are ways and means of reducing the money that is spent and ensuring that we can still deliver the NHS that we are all very proud of, we should try to do that as well.

On 12 February 2014, I asked the Minister what discussions had been had with the Health Minister in Northern Ireland on UK-wide strategies for diabetes, obesity, heart disease and rare diseases. The Minister said that there had been no discussions with the Northern Ireland Executive on those issues. I am asking that question again, as she is here. I respect her greatly—she knows that—and I value the work that she carries out in this place, but I honestly believe that a UK-wide strategy is needed. We had one until 2013, but then it was not carried on. I believe that it would be to the benefit of all the regions of the United Kingdom of Great Britain and Northern Ireland if that UK-wide strategy was started again, so I ask the question again.

There is cross-House approval of and support for the Melbourne declaration on diabetes, which pushed for an international effort in the fight against diabetes, and that is what this is all about. Are the Government willing to work with the devolved Administrations of Northern Ireland, Scotland and Wales to use resources wisely and create a UK-wide strategy against diabetes? They have done it before; let us do it again, and do it even better this time.

The director of Diabetes UK Northern Ireland, Iain Foster, has said:

“We are in the middle of a diabetes epidemic…With the numbers rapidly increasing it is now more important than ever that everything is done to prevent serious complications which cost the NHS millions”—

as the hon. Member for Torbay said—

“and are absolutely devastating for the individuals and families involved.”

Let us never forget that it is not just those with diabetes but the families around them who are affected by the debilitating effects of diabetes on the individual.

Will the Government commit to implementing fully the NHS health check, which should be offered to everyone aged 40 to 74, to help identify people at high risk of type 2 diabetes? I say with respect that that programme has been patchily introduced so far, so there could be a lot of improvement. The Government need to do more to ensure that those at high risk benefit from lifestyle interventions to help to prevent the disease. The National Institute for Health and Care Excellence has recommended increasing the proportion of people with diabetes who get the nine annual checks. That should happen as a matter of course when people are in their GP surgery, or in hospital for whatever reason.

Those checks help people to manage their condition and to identify any signs of complications early. However, there is a large geographical variation in the proportion of people getting them. Again, if we had a UK-wide strategy, we could ensure that there were no differences geographically in who gets the nine annual checks and who does not. Will the Government commit to increasing the number of people who receive the checks? That is a positive way forward. It is another way of doing the preventive work that we need, and will ultimately lead to the savings that we need.

In 1922, insulin was discovered by John Macleod, Dr Banting and Charles Best, yet 92 years later, in 2014, we are still fighting against the dreadful disease of diabetes. In the UK this year, 59,000 people will die unnecessarily from diabetes. I strongly urge the Government, in the wake of the Melbourne declaration on diabetes, to take serious strides in the UK in preventing and controlling diabetes.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

Thank you, Dr McCrea. I am aware that some colleagues who would normally be with us for a debate on this important topic have been speaking in the main Chamber. No doubt they will catch up with the debate online, at some point. I thank my hon. Friend the Member for Torbay (Mr Sanders), who opened the debate, and all those who have spoken. It has been another thoughtful debate on a topic that is very important, as he said. I congratulate him on his recent election as the first president of the Global Parliamentary Champions for Diabetes Forum. I am not sure whether he modestly did not mention that, but I give him credit for it. It is a tribute to his effective championing of the issue, and the global initiative is important.

As my hon. Friend said, we must not underestimate the global threat posed by diabetes. Other hon. Members have mentioned the numbers involved; the International Diabetes Federation estimates that by 2035 there will be 600 million people with diabetes worldwide, which is about one in 10 of the planet’s population. I think that the hon. Member for Strangford (Jim Shannon) described that as a ticking time bomb, but the debate has drawn out the fact that for the most part we do not have to accept that as inevitable. There are things that we can do, and it is right that we are beginning to talk about the issue as a global community, in global health terms.

In the UK, 3 million people are affected by diabetes. It is estimated that by 2025 the figure will be 4 million if we do not make progress. We estimate that around 850,000 people have undiagnosed type 2 diabetes. Diabetes is a priority for the Government. We have set clear objectives for the NHS and Public Health England to do more on prevention and to improve the care and management of people with diabetes. I accept that there is a challenge about the need for a national action plan. I have had meetings with Diabetes UK and it is one of the things mentioned in its briefing. We have set up clear objectives for the NHS and Public Health England and we ask them to deliver against those, so my contention is that we do indeed have a national plan, but that we may be carrying it out within a slightly different framework from the one advocated. The degree of priority we give it, and the importance that the Government accord to ensuring that the health and care system work together at all levels to give people with diabetes the care and support they need, should not be underestimated.

I hope that while I have been the Public Health Minister I have reassured colleagues about the personal priority that I give to the issue of diabetes. Indeed, my first public outing, slightly terrifyingly, was to speak to a meeting organised by my hon. Friend the Member for Torbay. Almost certainly, everyone in the room knew more than I did about the subject, but I attended to show, very early in my ministerial role, how important the issue was to me.

I have met the national clinical director. I try to have reasonably regular meetings with him, because the issue is such an important one. I have a continuing relationship with the all-party group on diabetes and the other diabetes campaigning groups and Members in the House. With respect to type 1 diabetes, I met my and other Members’ constituents at the JDRF event, which I have attended several times. It is always humbling to meet those fantastic young people who have learned very young to manage and live with a difficult condition.

What is NHS England doing to improve the management and care of people with diabetes? As I mentioned, I have several times met Professor Jonathan Valabhji, the NHS England national clinical director for obesity and diabetes. He has been generous with his time in attending parliamentary events, and is a great supporter of the work of groups and Members in the House. He regularly attends events focused on diabetes and is focused very much on improving outcomes for people with all types of diabetes.

Earlier this year “Action for Diabetes” was published, which describes the actions that NHS England is taking to improve diabetes care. It covers many areas, some of which have been highlighted during the debate, including developing GP contracts and incentives; working with primary care services to trial and roll out case-finding; and decision-support tools to help to detect and diagnose diabetes earlier. A national conversation is also going on about obesity and taking care of one’s own health. Hon. Members have touched on that with regard to the prevention of type 2. Every member of the public is a part of that conversation. We did not talk much about individuals during the debate, but I think we would all agree that we need constantly to emphasise personal responsibility in relation to preventable or avoidable type 2.

I sometimes worry—I talked about this with the head of Diabetes UK shortly after becoming a Minister—that, because few deaths are recorded as being due to diabetes, rather than its complications, there may be a slightly more relaxed attitude among people who think they might develop diabetes, which they would never in a million years have towards a disease such as cancer, which they would immediately identify as a threat. Through debates such as today’s, and the work that we all do, we can emphasise the fact that, although people may not know many people who can be said to have died of diabetes, they will know many whose diabetes contributed to premature death or a long period of ill health. There is more work for us to do, to get that message out. That is how we can empower people to help themselves.

[Jim Shannon]

The Minister could not have said a truer word, because many people see diabetes as a disease that they can manage—one that is not too bad. However, she is right: the complications are far reaching and can lead to consequences that are final. In my speech I talked about education, because people must manage the condition themselves, but they need to know what they have to manage. That is my point: some people need the information reinforced, with the seriousness that the Minister expressed.

[Jane Ellison]

That is right. We need to make sure of that. People cannot be empowered without information. We also know, having a duty to address health inequalities, that some people and groups in the community find things much harder. I was taken by some of what the shadow Minister, the hon. Member for Copeland (Mr Reed), said about deploying technology more. Work is going on, but I agree with him that we could go further faster with that, to find ways to empower people who may not have a good sense of what to do to take care of their health, and who find it harder than others to obtain the available advice. We must work harder to reach them and I shall talk about NHS health checks in relation to that.

As to the commissioning of integrated care, NHS England is working with other organisations to help to promote services that are integrated around patients’ needs across all settings. There has been much emphasis on that. That body is implementing what it calls a customer service platform to allow patients with diabetes to self-manage, through booking their own appointments, managing their prescriptions, monitoring the care they have received and being able to view their personal health records. That picks up on some of the shadow spokesman’s points.

NHS England has also produced a sample service specification for the management of type 1 and type 2 diabetes that is based on National Institute for Health and Care Excellence standards. It provides a model for commissioning integrated care for those with diabetes, and also highlights the specific needs of those with type 1 diabetes, where they differ from the needs of those with type 2. If the current trial of the service specification is successful, it will be offered as a tool that all clinical commissioning groups can choose to use to deliver high-quality care. That is therefore an important piece of work in progress.

There is always a challenge for any of us in making sure that the rest are as good as the best. Occasionally when we talk about the challenges of our current health infrastructure I worry about the assumption that there is a model out there, somewhere, that would absolutely guarantee the delivery of completely consistent care in a given area, across the country. In a country such as ours it is not possible to give such a top-down guarantee. Yes, we must find a way to drive care from the top, with a clear sense of direction from the strategy and mandate that we have given the NHS and Public Health England, but we must also put the tools in the hands of the clinicians, as I have been discussing. Most importantly, we must empower individuals and patients to know what they can expect and to demand good care. Nevertheless, I genuinely do not think that we could devise any system in which we could just issue a notice from the centre to say exactly how care will be delivered consistently across the country. We must find other ways to do it.

--- Later in debate ---

[Jane Ellison]

I agree. The Government, NHS England and Public Health England are all looking at how we drive that consistency. How do we drive consistent excellence? What tools can we use to do that?

Perhaps it would be helpful if I gave an example. Public Health England is developing a tool to drive improvements in diabetes care and iron out variation. It will be launched later this year, and although I am not able to give much detail now, I am sure that my hon. Friend the Member for Torbay will be interested when it is launched. It will provide a clear picture of how diabetes care and outcomes vary across the country and among practices, which will support decisions on how to make improvements.

The Government have made transparency of data a real priority, and being very transparent about what is being delivered and identifying variation is one of the ways in which we can drive the rest to be as good as the best. I suppose I am trying to explain that, although I could send out a memo tomorrow outlining my national diktat on diabetes, that is not how we drive change. It is crunchy, it is detailed and it is about getting to that local variation and ensuring that we drive up standards in every way possible. That is one of the tools we are developing, but there are others as well.

[Jim Shannon]

In my speech, I called for a strategy that was not just regional but UK-wide, and I hope the Minister can respond to that. Other Members have spoken about the need for an English strategy, but there must also be one for Wales, one for Scotland and one for Northern Ireland. All four must work together so that we can address the issue together. The Melbourne initiative is very much worldwide, so although people refer to England, we must go further. What are the Government doing to initiate a UK-wide strategy?

[Jane Ellison]

As the hon. Gentleman knows, health is a devolved matter. That is not to say that I am not at all interested in what is going on in Northern Ireland—far from it—but it is nevertheless a devolved matter. As I have said to him in other debates, there is clearly an awful lot that we can learn from each other. People can learn from everything that I report to the House on innovation and the progress that we make in England, as well as, indeed, things that other Health Ministers report from other parts of the United Kingdom. Nevertheless, I currently have no plan for a UK-wide strategy because health is a devolved matter.

[Jim Shannon]

Will the Minister give way?

[Jane Ellison]

If the hon. Gentleman does not mind, I am going to make some progress.

Of course, the fact that health is a devolved matter does not mean that we cannot find areas of joint working, and the Melbourne declaration shows us the way forward on that. That is probably where we end up—the fact that it is devolved does not mean that we cannot share learning and knowledge, learn from one another’s initiatives, or operate in that global context.

--- Later in debate ---

[Jim Shannon]

I hope that the Minister will accept that I am not being argumentative, but we had a UK-wide strategy until 2013—last year—so we have shown that we can work together. All I am asking really is: why do we not initiate a similar plan to what was there before 2013—a 10-year plan that started in 2003—and have the four regions work together? That is exactly what the Melbourne initiative is about, and we could do it because we have done it before.

[Jane Ellison]

I will reflect on the hon. Gentleman’s comments and perhaps we will discuss the idea again.

[Jim Shannon]

Thank you.

[Jane Ellison]

I want to discuss another area in which we can make a difference by empowering patients. Colleagues might be interested to hear about the patient experience of diabetes services survey, part of the national diabetes audit, in which I know there is always great interest in the House—we regularly answer a number of parliamentary questions about it. The survey measures the health care experiences of people with diabetes in England and Wales. It collects information online from people with diabetes by asking questions about their care using a short, validated questionnaire, and it is being tested.

Any diabetes service in England and Wales should be able to use the survey to get feedback from patients. We want to publish the first results this month or this summer. That is going to be an interesting extra tool in the box, not only to help to drive excellence and drive out variation, but to empower local services to understand at a local level what is going on and how satisfied their patients are with the service being provided. That can lead only to upward pressure to improve services, not least from patients.

Let me talk a little about the NHS health check programme. Alongside the work being done by NHS England to improve the management and care of people with diabetes, the Government are working on prevention and earlier detection, which all Members mentioned. We are continuing to roll out the NHS health check programme, which identifies those aged between 40 and 74 who are at risk of diabetes and other vascular diseases and helps them to reduce that risk. More than 15 million people are currently eligible for an NHS health check. Our economic modelling has shown that the programme has the potential to prevent more than 4,000 people a year from developing diabetes and to detect at least 20,000 cases of diabetes or kidney disease earlier. It is all about helping people to better manage and improve their quality of life.

In the past year, almost 3 million NHS health check offers were made and almost 1.5 million appointments were taken up, during a time of great change across the health system. We are now looking to challenge the system to go further and faster and to continue to increase the number of people who participate in the programme. I have been out and about and seen some great local initiatives. I visited an NHS health check team in Southwark and witnessed the important conversations they were starting with people in their local area.

Another example is Bolton, where health trainers have worked with 134 people identified as being at risk of diabetes through the NHS health check. The health trainers have supported people to make lifestyle changes such as eating more healthily and increasing physical activity levels, and they have helped almost half the group to return their glycaemic level to normal. That is really good evidence of effective intervention.

In Tower Hamlets, where more than 50% of the population are from ethnic minority groups, the prevalence of type 2 diabetes has been growing rapidly. To help to combat that, Tower Hamlets has incorporated the health check programme into its managed practice network scheme. I have talked to staff about that and heard about how they are approaching it. Tower Hamlets has worked hard to ensure that all diabetic patients have a care plan, and that focus has resulted in a 70% increase between 2009 and 2012. There has also been a lot of focus on the take-up of retinal screening for people with diabetes, and, again, there has been a significant rise.

We are seeing that such local interventions can really work. I firmly believe that a localist approach is important in some of these areas, because there is no one-size-fits-all approach that we can devise in Westminster that will work for every community. Such local innovations are important. I constantly challenge myself to think about how we can ensure that we spread the word about some of this great local action. We have started initiatives in that regard, but Parliament has a great role to play, and I encourage Members to tell us of effective local initiatives, so that we can spread the word.

Research on the NHS health check programme carried out by Imperial college London and Queen Mary university of London is under way. That research will improve our understanding of who is taking up the opportunity, their risk of cardiovascular disease and the incidence of diseases such as diabetes in those groups. When that work comes back, it will help us to understand how we can make those interventions count more.

We have already talked a little about obesity and sedentary lifestyles. Physical activity is a big priority of this Government, and I have had a couple of meetings in the past couple of days alone on the cross-Government action we are taking to try to hardwire physical activity into all aspects of life. We have a long way to go yet because, for too long, physical activity was left in a silo marked “health” when it is more important than that. We know that all parts of local and national Government need to address inactivity; that is one of the factors that can help to prevent diabetes.

I also want briefly to address the responsibility deal. The Government have been working with business—the hon. Member for Strangford mentioned this—on its responsibility to consider calorie reduction and clearer labelling of food. We are starting to see calories and other contents displayed on the packaging of many more foods, as we roll out consistent food labelling on a voluntary basis across the country.

The Change4Life social marketing campaign, which is one of Public Health England’s flagship programmes, is encouraging individuals to make simple changes, and it is trying to work with people in the way that the shadow Minister mentioned. The campaign is trying to talk to people in language that makes it straightforward and easy for them to understand the good choices they can make for the health of both themselves and their family.

The national child measurement programme’s findings on childhood obesity are encouraging. We know that far too many people are overweight and obese, but we are seeing signs of encouragement. In 2012, childhood obesity rates fell for the first time since 1998, so we must not despair over the actions we have all taken and advocated over many years. We are beginning to see that such action can have an effect, but we must never underestimate how far we have to go.

In 2013, the global burden of disease study showed that the UK has the lowest rates of early death due to diabetes of the 19 wealthy countries included in the analysis. The last data on diabetes care showed a 60% completion rate for all eight care processes recommended by the National Institute for Health and Care Excellence, which is a five percentage point improvement on 2010. We see progress, but we know there is much more to do. The Melbourne declaration is a timely reminder of the serious threat posed by the disease across the world, as well as here in the UK. I assure the House and my hon. Friend the Member for Torbay, who led this debate and leads the all-party group in such an exemplary way, that diabetes is a priority on which we continue to work hard. We are pleased to see progress, but we do not underestimate how much more there is to do. Such debates are welcome opportunities to keep the issue firmly on Parliament’s radar.