National Insurance Contributions: Healthcare

Jim Shannon Excerpts

Thursday 14th November 2024 Commons Chamber

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

Thank you, Madam Deputy Speaker. As Members know, I am the last person —when I am called, the debate is almost over.

Will the Minister confirm whether consideration has been given to the fact that the rise in national insurance contributions will not affect the NHS as a whole, as the block grant for us in Northern Ireland will cover it? However, GP practices in my constituency of Strangford will suffer, and unlike high street businesses or manufacturing, they cannot increase prices to cover that impending rise, leaving practices with no option other than to reduce hours in order to stay solvent. Does the Minister agree that this is the last thing already overstretched GP practices need, and will she commit to take this issue back to the Treasury for reconsideration as it relates to healthcare businesses such as GPs, dentists and pharmacies?

[Karin Smyth]

As the hon. Gentleman knows, health and social care is a devolved issue. We will continue to work closely with all the devolved areas, because we think that that is important, unlike the last Labour Government—the last Conservative Government. [Laughter.] I slipped there—I almost got through.

We absolutely understand the precarious nature of general practice and, in particular, I understand the really serious issues around health and social care in Northern Ireland. The hon. Gentleman knows that, and he makes a good case for the sector. We want to ensure that it supports people in Northern Ireland with the good primary and community care they deserve.

Respiratory Health

Jim Shannon Excerpts

Thursday 14th November 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered respiratory health.

It is a pleasure to serve under your chairship, Mr Rosindell. I look forward to hon. Members’ contributions to this important debate, and I thank the Backbench Business Committee for granting it. I was before the Committee a week ago on Tuesday with three requests, and I was well looked after. This is the first of my three debates; the second is on 28 November in the main Chamber, and I am waiting to hear when the third will be. I hope to get more in after that—I will keep at it.

I declare an interest: I chair the all-party parliamentary group for respiratory health, and it is an issue that has affected my family. I became very aware of respiratory health because of how it affected my son. Did I understand it all? Probably not, but I understood it better from interacting with him. He is now 34 years old and married with two children, but he still has issues with his respiratory health.

I am delighted to be able to raise the issue. I look forward to all the contributions, particularly the response from the Minister for Secondary Care. It is always a pleasure to see her in her place: it makes my day and everybody else’s, I am sure. I know that she has a deep interest in the subject, so I am pretty sure that we will be encouraged by what she tells us. I am also pleased to see the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), in his place. He and I have discussed the matter on a couple of occasions this week: we focused on what we would love to see come out of the debate.

This debate is not about us as Members; it is about our constituents and those who contact us. It will be on behalf of all the people in this great nation of the United Kingdom of Great Britain and Northern Ireland. As chair of the APPG, I will cover issues around asthma, severe asthma, chronic obstructive pulmonary disease and silicosis. The APPG has been conducting an inquiry on silicosis in particular. We have had meetings, usually on Zoom, with at least 20 contributors; the hon. Member for Blaydon and Consett (Liz Twist) and I have attended those meetings regularly.

I will frame my comments around the latest initiatives and the current policy direction, but I first want to say a few thank yous. I am indebted to Sarah Sleet and her wonderful team at Asthma and Lung UK for their outstanding help and ongoing support. They have been enormously helpful to me and the APPG and, I suspect, to other Members present. I welcome their latest report, “A Mission for Lung Health”, which was launched on Tuesday. I was there, as were some Members who are here today and many others who unfortunately cannot be.

I met Dr Jonathan Fuld, the national clinical director for respiratory disease, for the first time to get his expert advice and counsel. I had always seen him on Zoom on a laptop, but on Tuesday I met him in real life: we were able to shake hands and say hello. My thanks also go to Dr Richard Russell of the British Thoracic Society for his insights and opinion, and I pay tribute to the ongoing work of our expert stakeholder groups, which comprise senior clinicians, industry professional bodies and other experts. Whenever we have that vast amount of knowledge, experience and input on a Zoom meeting, we learn quickly: I learned quickly what the issues were.

There have been some very welcome developments in respiratory health recently, including the development of a new guideline for asthma, which is due to be launched soon as a collaboration among the National Institute for Health and Care Excellence, the Scottish Intercollegiate Guidelines Network and the BTS. The seasonal flu and covid vaccination programme appears to have been well planned and is rolling out well this year. Great credit and thanks are due to NHS England for its great work. Back home, where this is a devolved matter, I got two injections in one day: one for covid in the left arm and the ordinary one for flu in the right. It was like a conveyor belt: people were getting it every couple of minutes. It really is wonderful to see how well things can work when things go in the right direction.

The battle with smoking-related respiratory illnesses continues. The Government’s plans on smoking cessation, including through the Tobacco and Vapes Bill, are welcome. I understand that the Bill’s Report stage is coming next week, or certainly the week after. We hope that it will have a big impact in more deprived areas and on outcomes. When we were doing our research, having meetings and doing an inquiry into the matter, it became clear that it was more of an issue in deprived areas and areas of disadvantage. I will say a wee bit more about that later.

I hope that this debate will help to highlight World COPD Day, which falls on 20 November. I am sure that the Minister is well aware of the headline figures on respiratory health in the UK. They are worrying. The reason why this debate is so important is that the evidential base tells us that things are not getting better. That is why I look to the Minister for some succour, support and easement of mind.

Respiratory disease is the third biggest killer in England. In the UK, 7.2 million people have asthma, while 3 million are affected by COPD. These are not just figures; they are people, and their families are affected as well. The UK has a higher death rate due to respiratory illness than the OECD average, and the highest death rate in Europe. My goodness! If that does not scare us, it should. Over the past 10 years, more than 12,000 people have died from asthma. All those deaths were preventable. That is another reason why we are having this debate: because if we can prevent deaths, we should. It is important to put this on the record.

[Chris Bloore (Redditch) (Lab)]

Thank you for your chairmanship, Mr Rosindell. As an asthma sufferer, I know that one of the key elements of ensuring that we get the care we need is an annual survey with a clinician or GP about how our symptoms are either deteriorating or improving. I know many asthma sufferers who are not getting that annual review with their doctor. Some are going years without any sort of review of the deterioration of their symptoms. Given the really concerning number of people who die in this country from asthma attacks, is it not time that we did more to ensure that people get the yearly reviews they really need?

[Jim Shannon]

The hon. Member is absolutely right. If there are deaths of people with asthma that are attributable to not getting regular examinations or appointments with doctors or consultants, that is an issue that must be addressed. I am quite sure that the Minister is taking notes and that her civil servants and her Parliamentary Private Secretary will ensure that information is contributed to the debate.

NHS waiting lists for respiratory care have risen by 263% over the past decade. Poorly controlled respiratory disease results in hospital admissions doubling during the winter period. COPD exacerbations are the second most common cause of emergency hospital admissions. These are worrying figures—as worrying as the issue to which the hon. Member for Redditch (Chris Bloore) refers. New research presented at the European Respiratory Society has shown that the biologics uptake for severe asthma is disastrously poor: the national median for patients in England with severe asthma between 2016 and 2023 is 16%. The uptake varied widely among integrated care boards: it was between 2% and 29% against a target of 50% to 60%. These are worrying figures that indicate an unfortunate trend that should concern us all.

The burden of respiratory disease falls disproportionately on the most deprived. Adults in the poorest 10% of the country are more than two and a half times more likely to have COPD than the most affluent. The 10% most deprived children are four times more likely to require emergency admission to hospital due to asthma than the least deprived. Those figures show a fall-down and a need to focus on those areas.

Lung conditions, especially asthma and COPD, cost the NHS £9.6 billion in direct costs this year and every year. That represents 3.4% of total NHS expenditure. Those conditions result in 12.7 million work days being lost every year. The stats indicate a massive problem that needs to be addressed. The illness and premature death associated with them causes reductions in productivity totalling some £4.2 billion a year, and the conditions have an overall impact of £13.8 billion on the English economy.

All these stats tell us that we have a major problem. I ask the Minister that the NHS prioritise the issue. I understand that it was prioritised by the previous Government, but that that was not acted on because of the election, so I ask respectfully that it be prioritised in our strategy for the time ahead. Improving respiratory outcomes will help to achieve the Government’s ambitions to improve the nation’s health, to halve the disparities in health outcomes, to eliminate waiting lists, to break the winter crisis cycle and to enable everyone to live well for longer.

I have a number of questions for the Minister; I think my staff have sent her a draft of my speech and the questions I will ask. Will she confirm that respiratory health will be a priority for the Government? That is my first big ask. The APPG strongly supports the Secretary of State’s three shifts, which were announced following the Darzi report. I very much welcome that report, and the Secretary of State has done extremely well: it was a difficult portfolio to take on, but he has shown that he has the ideas to take it forward strategically. I hope the Minister can provide an idea of how that will happen for those with respiratory health issues.

The Darzi report proposes a shift from analogue to digital. We certainly have to improve the system that is used for our data and for healthcare more broadly, as the Secretary of State has said in the Chamber; I was very encouraged when I heard him talking about that shift. The other two shifts proposed are from hospital to community and from treatment to prevention. Those three should be front and centre, and they all have an important part to play in improving outcomes. The Government are right to highlight the impact of inequalities and deprivation on health. We strongly support their plans to achieve that through the three shifts, with which they have set a strategic course.

The statistics are clear: we have to improve outcomes for the most vulnerable in society. Our No. 1 duty as elected representatives is to look out for our constituents, particularly those who are vulnerable—that is why we are elected representatives. Our duty is to look after those who are less well-off, those who are physically vulnerable, those who are disabled and those who have other issues in their life.

Mortality rates from respiratory disease are higher among disadvantaged groups and areas of social deprivation, higher exposure to air pollution, higher smoking rates, poor housing conditions and exposure to occupational hazards. That has to be a major focus for us all. The trial of neighbourhood health centres could offer a significant shift from hospital to the community; the Government are considering that, and it is a good step in the right direction. We hope that we will enable a better focus for diagnosis and treatment of respiratory health, which could help to reduce inequalities. As the burden of respiratory disease disproportionately affects the most deprived parts of this great country, winter pressures are higher in those areas, so the centres need to be able to match the local challenges. Will the Minister indicate how that will happen?

Part of the challenge relates to the provision of spirometry testing, which is an essential diagnostic tool for asthma and for COPD. Community diagnostic centres currently offer very few spirometry tests; some offer none at all. I ask the Minister to confirm that spirometry will be widely rolled out, especially in deprived areas where we need its use to be widespread in primary care. It would be extremely helpful if spirometry could receive sustainable funding to be equitably delivered. I welcome the Minister’s thoughts.

As the Minister will be aware, the national screening committee has recommended introducing a targeted lung cancer screening programme across the UK. However, the screening programme only explores the possibility of lung cancer; unfortunately, it does not focus on addressing incidental findings of undiagnosed COPD identified during the screening. Including those findings would enable neighbourhood centres to help deliver better care for COPD.

We are aware of some work being undertaken in Hull to roll incidental findings into potential COPD diagnoses. I ask the Minister and NHS England to look closely at the outcomes of that study, which I believe will give some direction on what needs to be done in the United Kingdom. We are deeply grateful to those in Hull who are working on COPD diagnosis.

The national screening committee’s guidance on COPD has not been reviewed since 2019. I ask the Minister whether there are any plans to revisit that and to bring it up to date. It is five years since it was done, and the figures indicate a worrying trend of more disease. We need to have that in place.

Overprescribing of SABA inhalers—short-acting beta agonists—remains a big problem. Guidelines would be of enormous help. I ask the Minister to ensure full support for the NHS to implement new guidelines.

The APPG has been looking at the impact of inequality for some time. We highlighted that at our COPD event in the House at the end of last year. It was a well-attended event with constructive comments. As we always do in the APPG, off the back of that, we are looking forward more strategically, with a number of asks. We intend to hold regional events to enable local clinicians to inform us what more needs to be done. There is nothing better than asking clinicians the best way forward. They know. They deal with patients daily, and we deal regularly with constituents, and that helps us to focus attention, specifically on prevention.

The number of asthma deaths is far too high. They are worryingly high, as the hon. Member for Redditch mentioned. It has to be a priority for us all to reduce deaths as quickly as possible and for that to be an integral marker in the 10-year plan. The Secretary of State is giving us a 10-year plan. Perhaps the Minister can tell us today where the asthma and respiratory health focus is in that 10-year plan. It needs to have that focus, and I hope we get that response from the Minister today.

We are 10 years on from the national review of asthma deaths report and very little has changed in terms of asthma outcomes. A recent study showed that people on lower incomes reported greater use of oral corticosteroids than people on higher incomes. These findings highlight that there may be an increase in OCS prescriptions for people with asthma and COPD in more deprived areas. The study results are similar to those reported in the 2019 survey by Asthma and Lung UK. I again urge the Minister to keep an eye on that study, to see what lessons we can learn. I know the Minister is committed to making things better and we support her in her quest to do so, but I believe there are many who have helpful contributions on how that can be done.

The APPG also welcomes improvements in inhaler technology, specifically the move to combination inhalers, which will ultimately eliminate the use of twin inhalers. That should benefit both asthma and COPD patients and will contribute to the NHS’s net zero targets. There are lots of things that have to be done. We all subscribe to the net zero targets—they need to be addressed—and this is a way of achieving two goals in one.

We welcome the Government’s commitment to increasing the NHS workforce. That is very good news as well. We will see how that looks in the workforce plan next year. I ask the Minister to ensure that with a significant increase in staffing levels in primary care, we will see an end to untrained staff undertaking annual asthma reviews. I do not want to be too critical—that is not in my nature —but when there is an anomaly we have to address, it has to be said.

The APPG warmly welcomes the promise of the outcomes of the 10-year plan, and we will submit our response to the consultation. To have any real impact on respiratory health, though, we believe the plan has to be disease specific and contain suitable outcome measures for respiratory health. Will the Minister confirm whether the plan will include disease-specific measures for respiratory health? Again, I ask the Minister to benchmark metrics at the start of the plan and to factor in regular outcome updates at three, seven and 10 years. If we do that at those points, we can chart the progress, or perhaps the lack of progress, and make improvements. The metrics could include fewer asthma deaths; reduced hospital admissions for asthma and COPD, especially winter admissions; prescription data; and reduced incidence of asthma and COPD in the most deprived areas. Interim data outcomes will enable us to determine whether the plan is on track to deliver the outcomes we all want to see.

The use of biologics is of particular concern to the APPG and features regularly in our meetings. I am sorry to say that figures on the use of biologics in England are simply dreadful. The national median by patients with severe asthma in England between 2016 and 2023 sat at 16%, and the uptake varied widely among ICBs at between 2% and 29% against an uptake expectation within the clinical community of 50% to 60%. It just does not seem to be working. Biologics treatment has been described by our clinical advisers as life-saving for severe asthma patients. There is both wide regional variation in access, and unacceptable delays to the start of treatment. Many patients who need urgent treatment have to wait years to get access to the services that will prescribe biologics to them. That is an inefficient use of NHS resource and means that the health of patients is deteriorating while they wait for the right treatment. I do not want to see that, hon. Members do not want to see that, and I know the Minister does not want to see that either.

We need more easily accessible severe asthma services. Again, I would be much obliged if the Minister could meet us to look at how we can provide better asthma care for those with the highest burden of disease. I hope that the NHS innovation and adoption strategy will put forward solutions to tackle low and variable uptake and the access to innovative treatments, such as severe asthma biologics. The APPG would like to see a funded transformation with the health innovation networks and clinical leadership on the implementation of NICE guidance on respiratory health at neighbourhood level and on the delivery of biologics.

We are being constructive—the Minister knows that I will always be constructive because I believe we need to move forward together and ask the questions. I note the Secretary of State’s recent remarks on data sharing and the call by Asthma and Lung UK for greater data sharing in its report, which urges the Government to

“Improve data collection and analysis across the care pathway to bring together primary and secondary data, and make high quality, publicly available data which will help ICSs target care where it is needed and ensure accountability”.

We fully support that, and I do not think there is anybody in this room who would not support that, because it is absolutely the way forward.

We are also looking closely at the recent increase in silicosis cases around the country, especially in relation to engineered stone. It is something that maybe not everybody is aware of, although I suspect those in this room are. There is a real threat that the rise in what are entirely preventable cases may add considerably to local health pressures. The Secretary of State has been clear that we need to address the waiting lists and take more action to prevent cases, and that is something I have suggested needs to be done as well. There are a number of recommendations in our silicosis report, and a key recommendation concerns wider data sharing between primary and secondary care.

The APPG will hold a roundtable in the new year to ensure a timely discussion to inform the 10-year plan. I ask the Minister if she would be most kind and put it in her diary and come along. We are not here to give the Minister a hard time, but to take her contribution and help us to move forward together. The Parliamentary Private Secretary, the hon. Member for Aylesbury (Laura Kyrke-Smith), is not nodding because she cannot do that for the Minister, but she is indicating—I will send over the date, if that is okay.

Since 2015, 250 to 300 patients have been diagnosed with CF each year. Despite medical advances in recent years, in 2022 the median age of death for those with CF was just 33. Wow—think about that.

The Cystic Fibrosis Trust has called for greater financial support for people with cystic fibrosis for a number of years. In 2023, a University of Bristol study reported that a typical family with cystic fibrosis loses £6,800 a year due to the extra costs of living with that condition. The CF Trust has multiple requests, including for the Government to explore additional innovative market-incentive options to encourage the industry and others to fund research and trials for new antibiotics because of current antibiotic resistance.

I believe we have seen a good and positive contribution to research and development, but we are probably at a cusp where a bit more investment and help would get us over the line. We need to prioritise diagnostics for antimicrobial-resistant infections to prevent further lung damage. The Trust’s final request is to implement an early warning alert system on pollution for people with respiratory conditions.

I am looking forward to hearing what others have to say. The fact of the matter is that we have an opportunity this time because we have a Government who are spending £22 billion on the NHS. That is a massive amount of money. Every person in this great United Kingdom recognises what that means. It is the time to get it right. The Secretary of State has indicated that he is of that mind, and I know the Minister is also of that mind, so we have an opportunity to make effective change to the lives of people throughout this great United Kingdom of Great Britain and Northern Ireland. Some of the £22 billion will come to us in Northern Ireland through the Barnett consequentials, which is good news as well. It means that everybody gains across this great nation.

I believe now is the time to act. We in the APPG want to do all in our power to inform, support and guide the Minister and her Department in effecting change and improving quality of life for those with respiratory health issues.

--- Later in debate ---

[Liz Twist (Blaydon and Consett) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate. We spent many years working on these issues together, when I was in opposition.

[Jim Shannon]

I am still here in opposition, but the hon. Lady is now over there on the Government Benches.

[Liz Twist]

We worked together as part of the APPG for respiratory health. I pay tribute to the work of that APPG’s members, as well as to the clinicians and patient organisations involved, including Asthma and Lung UK and Action for Pulmonary Fibrosis.

Respiratory illnesses have a disproportionate impact on the most deprived communities. In my constituency of Blaydon and Consett, the rates of conditions such as COPD are particularly elevated, and I have seen at first hand in my surgeries over the years how debilitating they can be; they can affect every part of a person’s life, from their mobility to their mental health, and tackling them is key to tackling health inequalities. Deprivation is linked not only to heightened rates of respiratory illness, but to faster rates of progression and poorer outcomes. That is true for terminal diagnoses such as pulmonary fibrosis, which has outcomes similar to common cancers, as well as for more common conditions such as asthma, which has seen a 25% increase in deaths over the past 10 years.

We know that the biggest driver of preventable lung disease is smoking, which is responsible for half of the difference in life expectancy between our richest and poorest communities. I am pleased that this Government are taking the decisive action that is needed to protect future generations through legislation, and I am particularly proud of the work that has been done over a number of years by Fresh, which sees public health and ICBs working together to tackle this issue.

Access to timely diagnoses and appropriate clinical pathways is vital for ensuring that people get the best possible treatment, but such access varies between conditions and areas of the UK. Of about 1.7 million people living with COPD in the UK, 600,000 are undiagnosed. Meanwhile, one person in every three has never heard of pulmonary fibrosis, which can lead to people receiving incorrect diagnoses, such as asthma. Incorrect diagnoses of severe asthma are common among children with the genetic condition primary ciliary dyskinesia. It is not a mild condition. In fact, children with PCD—I am not going to try to say it again—have a worse lung function than children with cystic fibrosis. It is vital that we do what we can to raise awareness of these conditions, including the rare condition of PCD, and their impact, whether they are primarily genetic in nature or driven by preventable causes.

We know that our NHS is in a really difficult place, following 14 years of Conservative mismanagement. We lost 14 years in which we could have made progress to improve the lives of people living with these conditions, but instead, they were left extremely vulnerable to the pandemic, following a decade of under-investment and disastrous top-down reorganisation by the previous Government. That is not the fault of our NHS staff, who are working hard to provide services in very difficult situations—I want to be clear about that—but the state of our health service at present was laid bare in the Darzi report just a few weeks ago. Among many other things, the report specifically notes the poor outcomes for respiratory conditions in people with learning disabilities, as well as the link between the rise in these conditions and the growing levels of damp often found in the private rented sector.

We have a long road to travel to fix the problems we have inherited, but I am proud to serve under a Government who are committed to huge investment in our NHS, and who have already made key steps towards a prevention agenda. Better public health and community care will be really important for tackling respiratory conditions and the shocking health inequalities that follow from them. I know that the Government have a sharp focus on preventive measures, such as those mentioned by the hon. Member for Strangford, and will look at how we can best improve our access to diagnostics and treatments, including biologics, for respiratory health.

--- Later in debate ---

[Jim Shannon]

I thank everyone for their incredibly helpful contributions. It is no secret that I always look for a consensual debate, because that is more positive. That is what we have had today.

We have had the opportunity to discuss many issues. With your indulgence, Mr Rosindell, I will speak to each. Since coming to this House, the hon. Member for Newcastle-upon-Lyme—

[Adam Jogee]

On a point of order, Mr Rosindell. My constituency is Newcastle-under-Lyme, not Newcastle-upon-Lyme as several colleagues have called it.

[Andrew Rosindell (in the Chair)]

That will be on the record.

[Jim Shannon]

I will never get it wrong again. I thank the hon. Member for Newcastle-under-Lyme (Adam Jogee) for his contribution. Air quality has been a massive issue for him since he came to this House; he has reiterated that over and over again. I am hopeful that he will have the success for which he hopes. He referred to deprivation and low incomes as factors. Priority for respiratory health is needed, as the Minister confirmed. The hon. Member for Redditch (Chris Bloore) rightly referred to the need for regular asthma check-ups.

It is always a pleasure to work alongside the hon. Member for Blaydon and Consett (Liz Twist). She and I have talked about this issue over the past five or six years. It was a pleasure to hear her contribution, which included first-hand evidence from her surgery. I agree that we need improved access to diagnostics and medical help.

I thank the hon. Member for Sherwood Forest (Michelle Welsh) for her personal contribution; nothing tells a story better than a personal contribution. As the Minister says, we hope that her family members are able to deal with their issues in a positive fashion, and hopefully the medical care will be there as well. The hon. Lady referred to how the disease drastically changes lives, with some people being unable to walk. She also focused on charity work, which is really important.

The hon. Member for Winchester (Dr Chambers) referred to air pollution, as his party has done for many years. He underlined the problems and the impact on children, and he referred to our old housing stock. These are critical issues. We sometimes forget about farmer’s lung, but those who live in the countryside do not, because it is a big issue. He also referred to RSV, the impact on pregnant women and the importance of vaccination.

The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), reminded us that his first job related to this issue. That has allowed him to make an incredible input into the debate: we thank him for everything that he has put forward. It is fair to say that the last Government had a plan, but a more holistic approach is needed. I thank him for his role on the APPG. Prevention is absolutely the way to go, and data is important. He also mentioned spirometry.

The Minister responded in excellent fashion. I wrote down all the things she said. I thank her for committing to a meeting. I am sure that her colleague the hon. Member for Gorton and Denton (Andrew Gwynne) will be watching the debate and will respond. She referred to her former job and vocation, in which she had dealings with COPD directly. I am also grateful for the roundtable commitment. The Government have committed to a smoke-free society, on which a Bill is pending: that will be important in preventing lung cancer, especially for children. She also referred to damp in homes, an incredibly important issue that comes up all the time in the main Chamber.

The Minister responded very positively, if I may say so, to all the issues on which we required answers, including vaccinations, energy efficiency and fuel poverty. The respiratory network across the nation deals with COPD and major contributors to respiratory health issues, and the Government are committed to it. Respiratory health and biologics are priorities for the Government. It is not often that we have a debate with so much input from everyone, and yet we have a Minister who answers all the questions.

Question put and agreed to.

Resolved,

That this House has considered respiratory health.

Infant Formula Regulations

Jim Shannon Excerpts

Wednesday 13th November 2024 Commons Chamber

[Chris Webb]

I agree. We know from recent studies by the Jamie Oliver Food Foundation and others that this is a serious issue that must be considered urgently.

Last week, the Competition and Markets Authority published its long-awaited interim report on infant formula. The report outlines its concerns about the market, all of which appear to be contributing to parents paying over the odds.

The regulations on the advertising and labelling of infant formula are rightly designed to protect parents and encourage breastfeeding. UK law is informed by, but not identical to, the World Health Organisation’s international code of marketing of breast milk substitutes. Our regulations cover only infant formula intended for babies under six months old. That loophole in UK regulation permits hidden marketing through carelines and the widespread legal advertising of follow-on milk—an unnecessary product that does little more than promote higher sales of a brand’s infant formula. I urge the Government to consider strengthening UK regulations to close the loophole on the marketing of breast milk substitutes, in line with the WHO code.

However, strong regulation should not hinder affordable access to infant milk. Parents are worse off because the current regulations mean that food bank vouchers, loyalty points and store gift cards cannot be used to buy infant milk, and food banks are prohibited from stocking it. As a volunteer for Blackpool food bank for over seven years, I have witnessed at first hand how urgently it is needed. For too long, the third sector and charitable individuals have been desperately scrambling to fill the gap that the previous Government left wide open and allowed families to fall into. When it comes to infant formula, even that safety net has been removed. I recently met Richard Walker, the chairman of Iceland Foods, who shares my commitment to ensuring there is a fair price for formula for parents. Along with over 100,000 signatories to the Metro and Feed UK’s “Formula for Change” campaign, I support the call to allow parents to use food bank vouchers to buy infant milk.

[Jim Shannon (Strangford) (DUP)]

In the last Parliament, I was a member of the APPG on infant feeding and inequalities alongside Alison Thewliss, a former Scots Nats Member. I am very pleased that this issue is being debated, and I congratulate the hon. Member for Blackpool South (Chris Webb) on securing the debate. Does he agree that, while we can all acknowledge the well-documented benefits of breastfeeding, it simply does not work for some mothers, and sometimes the baby does not put on weight? While breast is undoubtedly best, we need to ensure that formula is available and is highly regulated, but not highly costly, in order to provide the best possible alternative. That means not pretending that formula does not exist, but doing all we can to ensure it is the best that we can offer when breastfeeding fails.

[Chris Webb]

I completely agree with the hon. Member. I have seen that with my own son, who would not take to breastfeeding, so we had to resort to infant formula. We need to make sure that all parents have the best product available for their children to ensure they have the healthiest start to their lives.

I ask the Government to examine the fact that food bank vouchers cannot be used to buy infant milk, to ensure the regulations do not punish the very people they are designed to protect.

The CMA report recommends potentially relaxing regulations to permit promotions and price reductions and incentivise competition. However, although discounts would benefit parents in the short term, there needs to be a sustainable solution to permanently lower the price of formula. The infant milk market in the UK is highly concentrated, with just three manufacturers accounting for over 90% of supply. Formula manufacturers have blamed rising costs, but profit margins have inflated beyond them. Those firms pass responsibility to the retailers, who they say ultimately set prices. This is not just passing the buck, but taking it from the pockets of struggling parents to line those of monopolistic multinational conglomerates whose combined annual profits are £15 billion.

Retailers do have their part to play, though. They must do their bit to protect families by capping their prices in line with the CMA report’s recommendations. In the coming weeks, I will meet with three major supermarkets to encourage them to cap prices and follow the lead of Aldi and Lidl in developing a reasonably priced own-brand infant formula. The cost to parents of buying the most expensive brand can add up to £1,000 a year—more than twice as much as using an own-brand infant formula. That is despite the fact that strict regulations ensure that these products are nutritionally equivalent.

Parents naturally want to do the best for their baby, and decisions about feeding are inevitably made at a time when mothers and fathers are at their most vulnerable. The CMA report points out that this can lead to them actively choosing a more expensive product, assuming incorrectly that a higher price means better quality. That assumption is not based on price tag alone, but on decades of brand-building by manufacturers trying to claim the superiority of their products. The important public health message that all infant formula meets a baby’s nutritional needs must be more effectively communicated. The Government must also consider the CMA’s recommendation that they procure infant formula themselves, providing it to parents at a lower price point while putting downward pressure on other manufacturers’ prices.

Prices remain unjustifiably high, but Iceland’s leadership in this campaign has led to a welcome reduction in prices across the sector. Since February, there has been a positive shift, and there are now three formula products available in supermarkets that are affordable with the Government’s weekly Healthy Start vouchers, but those supermarkets are not accessible to everyone. Blackpool has the fourth highest uptake of the Healthy Start scheme, but around 150,000 families nationally who are entitled to access it still do not. There is a clear need for us to ensure that all those who are entitled to Healthy Start vouchers access them, while simultaneously increasing their value from £8.50.

This is a matter of huge importance, and I am pleased to have been given the opportunity to raise it in the House. I urge the Government to consider my points and to work with me and stakeholders to ensure that accessibility and affordability are at the heart of the Government’s policy on infant formula. We must examine the comprehensive recommendations in the CMA’s report and the views of those in public health and the third sector, who understand the urgency of this debate. I invite Ministers to consider the voices of parents in Blackpool, who are at the sharp end of this price crisis, but who are brilliantly supported by our local infant feeding support team.

Raising a child is one of the most challenging and demanding things we will do in our adult lives. The Government’s policy must lighten the load on parents to ensure that it can be one of the most rewarding things we do. We must ensure that every child in this country has a healthy start to life; we cannot allow children in constituencies such as mine to be failed before they have even taken their first step.

Breast Cancer: Younger Women

Jim Shannon Excerpts

Tuesday 12th November 2024 Westminster Hall

[Wera Hobhouse]

The hon. Lady is absolutely right that we need to continue to raise awareness, but I am pointing out that even when young women are aware and go to a doctor, the doctor says, “Don’t worry about it.” However, I agree that we need to continue to make sure that women examine their breasts and are aware of the risks of breast cancer, even when they are young.

[Jim Shannon (Strangford) (DUP)]

I spoke to the hon. Lady yesterday. This is a massive issue for me and my constituents back home, and they bring it to my attention all the time. It was great to attend the Breast Cancer Now “Wear It Pink” event last month to raise awareness of the most common cancer in the UK. Studies have suggested that breast cancer among younger women has a more aggressive pathophysiology, correlating to poorer outcomes compared with those for breast tumours in older patients. Does the hon. Lady agree that consideration must be given to lowering the age requirement for breast screening to ensure quicker intervention for younger women?

[Wera Hobhouse]

I will come to that later in my speech, but I absolutely agree with the hon. Gentleman. We are here to make the case for earlier screening programmes for younger women, because it is becoming such an issue—the rates are increasing. It is because of Lucy’s struggle to get a diagnosis that she felt the need to speak up on behalf of the countless young people who would not question decisions made by medical professionals.

NHS Dentistry: South-west

Jim Shannon Excerpts

Tuesday 12th November 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for securing this debate. Does the hon. Member not agree that the story in the south-west is being replicated across all of the United Kingdom of Great Britain and Northern Ireland? He may not be aware of a survey of almost 300 dentists in Northern Ireland that found that almost nine in 10 intend to reduce or end their health service commitments in the coming year. That could be the end of NHS dentistry. Is he experiencing the same thing in the south-west? If he is, Government must really grasp this issue, and, as the hon. Member for South Devon (Caroline Voaden) said , get it done.

[Richard Foord]

I am glad that the hon. Member for Strangford made that point, because I did not know about the situation in Northern Ireland. It sounds like some regions of the UK are not getting the attention that they require when it comes to NHS dentistry.

I want to share the story of two of my constituents, Mike and Shirley. I have received correspondence from them and many other residents, such as Martin Loveridge, who has had a similar experience. Mike and Shirley are hard-working people. Mike is almost 75 and retired after more than 50 years in horticultural work. Shirley, aged nearly 70, is still taking on part-time cleaning work to make ends meet. In 2023, their dentist in Sidmouth finally went private, driven away by the broken dental contract that we have heard described. The impact of that shift has been devastating.

Shirley developed a dental abscess. Anyone who has had a dental abscess will know what excruciating pain it can involve. Years ago, Shirley suffered from a similar infection, which led to sepsis. This time, instead of receiving urgent care from the NHS, Shirley faced the following choice: either wait in pain or go private. Plainly, this incident is a stand-out case, given that it was crucial that she received NHS treatment for sepsis, but typically, it would cost them £1,200 in dental fees—a sum that is simply unaffordable for people in Mike and Shirley’s position. Mike has not seen a dentist since May 2022 because he simply cannot afford it. Mike and Shirley tried to get NHS dentistry—they went to NHS England, Healthwatch Devon and the complaints department of the Devon NHS—and they had people admitting to them the dire state of the system, but they were offered no real solution. They spent hours on “Find a dentist”, an NHS website just for that purpose, but they were referred to a clinic that was 80 miles away, an impossible journey for them.

Income Tax (Charge)

Jim Shannon Excerpts

Tuesday 5th November 2024 Commons Chamber

[Wes Streeting]

I am grateful for that intervention for two reasons. First, it gives me an opportunity to say to GPs, hospices and other parts of the health and care system that will be affected by employers’ national insurance contribution changes that I am well aware of the pressures, we have not made allocations for the year ahead, and I will take those representations seriously.

Secondly, it gives me a chance to ask the hon. Member and the Opposition: do they support the investment or not? Are they choosing to invest in the NHS or not? They are now confronted with the hard reality of opposition. Just as when we were in opposition we had to set out how much every single one of our policies would cost and how those would be funded, they have to do that now. If they oppose the investment, they have to tell us where they would make the cuts in the NHS. If they oppose the investment, they have to tell us where they would make the cuts in school budgets. Those are the choices that we have made, and we stand by those choices. The Opposition will have to set out their choices, too.

I was told that because the Conservatives had run up huge deficits in NHS finances, I would not be able to deliver the 40,000 extra appointments a week that we had promised. In fact, I was told that we would have to cut 20,000 appointments a week instead. The Chancellor and I were not prepared to see waiting lists rise further. She put the funding in, and an extra 40,000 patients will be treated by the NHS each week. That is the difference that a Labour Budget makes.

[Jim Shannon (Strangford) (DUP)]

It would be churlish of anybody in the House not to welcome the £22 billion that has been allocated to the NHS. Everyone across this great United Kingdom of Great Britain and Northern Ireland will benefit from that.

A number of my GP surgeries have contacted me about their national insurance contributions, which they see as a catalyst to perhaps not being able to deliver what they want to do for their patients. I understand that the Labour party and Government are looking at that in a consensual way. Can the Secretary of State please give me the latest position so that I can go back to my GPs and tell them, “This has been looked at and there will be something coming”?

[Wes Streeting]

I am grateful for that intervention. It is of course for the devolved Administrations to decide how to use the Barnett consequentials that the generous uplift in funding provided by the Chancellor will provide. We make no bones about it: we had to make some difficult choices in the Budget to plug the £22 billion black hole that we inherited, to deliver on our promises and to ensure that we are fixing the foundations of our economy and our public services. We have asked businesses and some of the wealthiest to make a contribution. I say to people right across the House that they cannot welcome the investment at the same time as opposing the means to raise it. If they do, they have to explain how they would find the money.

--- Later in debate ---

[Darren Jones]

My hon. Friend is absolutely right. These were promises made by the last Government that they knew they did not have the money to pay for. This was spending from the general reserve—the money put aside for genuine emergencies each year—that they blew three times over within the first three months of the financial year. Anyone who runs a business, anyone who runs family finances and anyone who is in charge of the country’s finances should know that that is shameful, and the Conservatives should apologise to the country for it. Nowhere is that more true than in our public services, which have suffered as a consequence of the Conservatives’ mismanagement. For example, Lord Darzi’s independent report into the state of our NHS found that the past 14 years had left the NHS in a critical condition.

[Jim Shannon]

We very much welcome what the Government are doing in relation to the contaminated blood and Post Office Horizon scandals, but let ask the Minister a very gentle question—a question that needs to be answered—in relation to the WASPI women? When the right hon. Gentleman was in opposition, we all supported the WASPI women, and now he is in government. I understand that the Government are looking at this issue. What will happen to the WASPI women? Can we expect to have that addressed during this term?

[Darren Jones]

As the hon. Gentleman knows, the ombudsman reported to this House before the election, making a number of recommendations, but did not conclude the basis on which a compensation scheme might apply. Further work is therefore required, which the Secretary of State for Work and Pensions is looking at, but I would point him to the fact that this is a Government who honour their promises. If we look at the infected blood scandal or the Post Office Horizon scandal—an issue that I worked on for many years—we were told by the Conservatives that they were doing the right thing by compensating the victims, but they did not put £1 aside to pay for it.

From education to our justice system, we have inherited public services that are on life support, but I do not need to tell working people that. Sadly, they know it all too well, because the last Government lost control of both our public finances and our public services. This Budget and this Government will get both back under control. I will now outline how we should do that, by focusing on one simple word: reform. Reform is urgent, because we cannot simply spend our way to better public services.

This is a Government for working people, and we are determined that they will get the best possible public services for the best possible price, but public service reform is not just about policy or IT systems or procurement, as important as they are; it is about people. It is about the people at the end of each of our decisions: the patient in the hands of the NHS with worry and hope in their heart; the pupil in a school, college or university with aspirations that should be met; and the pensioner who wants to feel safe walking to the shops on their high street. Behind each of those people is a doctor, a nurse, a teacher, a police officer or a civil servant.

These are public servants who have chosen to work in public service to serve the public, as this Government do. They are public servants and people who today feel frustrated by not being able to access public services and not being able to deliver them. These are public services that, when performing well, deliver a well-functioning state and help keep workers educated, well and able to help grow our economy and protect our country. It is for these people that my right hon. Friend the Chancellor confirmed we will deliver a new approach to public services that is responsible, that looks to the future and that balances investment to secure public services for the long term with reforms to drive up the quality of those services today, and with reform as a condition for investment. From the Attlee Government founding the NHS to the Blair Government reforming poorly performing state schools, reform is in Labour’s DNA.

I now turn to some of the points made by right hon. and hon. Members today, and I begin by congratulating my hon. Friends the Members for Broxtowe (Juliet Campbell), for Sunderland Central (Lewis Atkinson) and for Stourbridge (Cat Eccles), and the hon. Member for Yeovil (Adam Dance), on delivering their maiden speeches.

There were many speeches today, so colleagues will have to accept my apologies for not being able to address all 80 contributions individually. However, I join my Labour colleagues in celebrating this Budget, because building an NHS that is fit for the future is one of this Government’s five missions. That is why we have invested over £22 billion, the highest real-terms rate of growth since 2010 outside of the covid response.

I have also heard the voices of hon. Members from Northern Ireland and Scotland, including the hon. Member for Inverness, Skye and West Ross-shire (Mr MacDonald), who encouraged me so dearly to listen to his speech but has not returned to the House for my summing up. Under this Labour Government, the largest real-terms funding increase since devolution began has been delivered for Scotland, Wales and Northern Ireland. This Labour Government are delivering from Westminster for the people of Scotland, Wales and Northern Ireland, and we will work in partnership with the devolved Governments to deliver the change for which people voted, and which we have now given the devolved Governments the money to deliver.

NHS Dentistry: Rural Areas

Jim Shannon Excerpts

Tuesday 5th November 2024 Commons Chamber

[Sarah Gibson]

I do agree with the hon. Member. The real issue for rural areas is, again, access to public transport. Dental provision might be relatively close in theory, but public transport does not allow people to get to the dentist. The issue of rurality is important and needs to be addressed.

Analysis conducted by the Rural Services Network shows that someone living in a rural area is less likely to be able to access an NHS dentist than those living in an urban area, with 10% fewer dental practices taking on new adult NHS patients in rural areas. The analysis also shows that in rural areas, there are 16% fewer dental practices with an NHS contract per 100,000 people. That again points to the fact that rural areas are definitely in a worse situation than urban ones.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this issue forward; the number of people in the Chamber indicates the interest in it right across the United Kingdom of Great Britain and Northern Ireland. Does she agree that dentistry is on the brink and that the additional national insurance contributions are going to push even more dentists into refusing NHS contracts and taking private patients only? Should not the Government immediately instigate an increase in prices in rural areas, to save the few dentists left who are braving rural isolation and the increased costs of operation?

[Sarah Gibson]

I agree with the hon. Member. The disparity is clear. As he mentioned, rural areas are being hardest hit by our broken NHS dental contract system.

Unfortunately, there does not seem to be much hope on the horizon. Denplan tells me that 90% of dentists plan to reduce their NHS commitment in the next two years and that the UK has the lowest dentist-to-population ratio in the whole of Europe. Although all dentists are dedicated to improving the nation’s health, access to NHS dental services remains a persistent challenge under the current system, particularly in rural areas.

Woman and Equality: North of England

Jim Shannon Excerpts

Tuesday 5th November 2024 Westminster Hall

[Mary Kelly Foy (City of Durham) (Lab)]

I beg to move,

That this House has considered inequalities faced by women in the north of England.

It is a pleasure to serve under your chairmanship, Sirusb Christopher. This debate is about the “Woman of the North” report, published in September 2024 by Health Equity North. I thank Health Equity North for the report and for their support for today’s debate, as well as all those who contributed to that vital research.

Women in the north of England face unequal challenges and inequalities in their lives and their health, compared with the rest of the country. They are more likely to work more hours for less pay and be in worse health. They are also more likely to be an unpaid carer, live in poverty and have fewer qualifications. In fact, the inequality between women living in the north of England and those in the rest of the country has grown over the past decade. It has harmed women’s quality of life and work and harmed their communities and families.

Today, I am going to debate the key findings of the research and highlight the report’s recommendations. The report does not make for easy reading. Even though the Minister, like me, will be all too aware of the impact of austerity on our communities, many of the findings will, I am sure, come as a shock, as they did for me.

I will not be able to cover everything, but I hope the debate will begin a dialogue between the Department and the contributors to this important research.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this issue forward. First, there is an anomaly—there are two and a half times more self-employed men than women, with jobs and opportunities. Women have the skills and the talent, but one of the things that holds them back is childcare. It does not matter where someone is in this great United Kingdom of Great Britain and Northern Ireland: if they do not have childcare, they have nothing—they cannot get the opportunities. Last week on the TV it said that the cost of childcare for some families is as much as the mortgage. That is a massive issue.

[Mary Kelly Foy]

I could not agree more. That is why I am pleased that the Labour Government will be bringing in thousands of new nursery places and breakfast clubs, which will hopefully alleviate some of the problems of childcare. I know that childcare is an issue not just in the north of England but also in the north of Ireland.

I shall begin with employment. Employment rates for women in the north are lower than the national average of 72.2%. In my region, the north-east, the rate is just under 70%; in Yorkshire and the Humber, it is just over 70%; and in the Minister’s region, the north-west, it is just over 71%.

Disability and long-term sickness is a major issue in the north. All northern regions have levels of disability and long-term sickness higher than the national average, and considerably higher than the south-east. The report states that the resulting estimated economic cost is around £0.4 billion per annum. Compounding that is the fact that the median weekly wage for women in the north is below the national average for both full-time and part-time employment. For instance, the average weekly wage for a full-time working woman in the north-east is £569. That is much lower than the national average of £625 and considerably lower than the average weekly wage for women in London, £757. Overall, women in the north could be losing out on around £132 million a week.

In terms of education, the number of women without qualifications is higher in the north than it is in the south and the south-east. That leads to the next point about women and poverty—an issue that is worth its own debate. A higher percentage of families in the north are on universal credit than in regions in the south. In fact, the average number of families on universal credit across the north is 3% higher than in the south. The figure is even higher if London is excluded.

All 12 local authorities in the north-east have rates of absolute child poverty above the English average. By contrast, all 30 local authorities in the south-west have rates of absolute child poverty below the English average.

The north is also the region of unpaid care, with 12% of women in the north-east providing it—just under 2% higher than the national average. Health Equity North estimates that women in the north are providing around £10 billion a year in unpaid care. Harrowingly, it also estimates that, in the last decade, the life expectancy of girls born in the north of England has begun to stall and in some cases decrease. In addition, girls born in the north will not live as long in good health compared with the national average. For older women, menopause is often cited as a potential driver of change in women’s health, which makes it all the more concerning that there are regional differences in levels of hormone replacement therapy, with lower levels of HRT being prescribed in the north of England.

The picture is even more bleak when we consider pregnancy and reproductive health. We have seen the biggest increase in abortion rates between 2012 and 2021, and there has been a demonstrable relationship between austerity, the implementation of the Tory two-child limit and the increased rate of abortions. I should also add that the two-child limit itself affects over a million children in the country, and it impacts over 60,000 babies, children and young people in the north-east alone. Right now, over 25% of pregnant women in the north of England are living in the most deprived 10% of areas, with 40% of pregnant women living in the top 20% most destitute areas. Tragically, stillbirths are the highest in the most deprived communities, and highest among black African and Caribbean women living in the areas of greatest deprivation. Also, women living in poverty are at increased risk of death and depression. Subsequently, babies are at a higher risk of stillbirth, neonatal death, pre-term delivery and low birth weight.

The report also refers to smoking and pregnancy; I am glad to see that the Tobacco and Vapes Bill will receive its First Reading today. It would be good to hear from the Minister whether the Government will continue to fund the financial incentives scheme for pregnant smokers.

Women in the north of England have the highest rates of domestic violence abuse in the country, which is something that many children are exposed to. That also deserves its own debate. When we consider mental health, the report highlights that, in a cohort of over a million women aged between 16 and 65, from 2005 to 2018, the prevalence of mental illness was higher in three northern regions compared with the south of England. With severe mental illnesses, such as bipolar disorder and schizophrenia, the north-west and the north have higher prevalence rates. Lastly, the report covers the reality of marginalised women in the north, which includes a range of areas, from criminal justice to education and health, as well as issues related to homelessness and substance abuse. I do not have time to go into each point, but I encourage the Minister to read that section if he has not already, and I will either write to him about those issues or table parliamentary questions.

The report’s recommendations are spread across multiple departmental areas, so the Minister may want to follow up in writing if he prefers. One key recommendation of the “Woman of the North” report is that central Government should deliver a national health inequalities strategy—one that convenes Government Departments from across Whitehall to put health at the heart of all policies to address the wider determinants of health. Many of the policies announced in the Budget, as well as the Employment Rights Bill, will be welcome, such as uprating universal credit in line with inflation and tackling zero-hours contracts. Of course, we wait in anticipation for the child poverty taskforce strategy next year, and I sincerely hope that we will see an end to the Tory two-child limit. In addition, the report recommends that the Treasury should consider targeted support for pregnant women, as well as improving childcare. When it comes to local and regional government, which I know the Minister has experience in, the report suggests targeted support delivered to 11 to 18-year-olds through careers hubs in the areas of greatest deprivation and a higher level of the adult education budget for the north. Greater support is also required for women navigating the social security system and for social security uptake, and for women to transition back to their families and integrate into their communities after involvement in the criminal justice system.

Finally, with health and social care, NHS England could provide additional support and investment for women’s health hubs, and health services should be supported to collect routine data on ethnicity and other key demographic data. That would help deliver better information for service development and improve our understanding of different health needs. It would also explore the ways in which the services’ work can be adapted to address health inequalities across different population groups, with examples including providing cultural sensitivity training, adopting a trauma-informed approach to care and promoting person-centred approaches.

I have been an MP since 2019 and have spoken about health inequalities ever since I was elected. Today’s debate is not pleasant, but I am genuinely hopeful that we can turn a page under a Labour Government. We have already seen positive measures, such as those in the Employment Rights Bill and the Budget. I look forward to the Minister’s reply and hope to work with him alongside Health Equity North to deliver happiness and dignity for women in the north, which is long overdue.

Cancer Strategy for England

Jim Shannon Excerpts

Thursday 31st October 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

There is hardly a day when I do not make a speech, Mr Betts.

I thank the hon. Member for Wokingham (Clive Jones) for securing the debate and for sharing his personal story. Demonstrating an issue is best done with a personal story, if possible, so I thank him for that—it was incredible. I am minded of his story, and I think of my dad as well. My dad is dead and gone now, but when he was living in this world he had cancer on three occasions. It was many years ago, and the expertise for cancer care and healing were not as good then, but he survived because of the surgeon’s skill and the nurses care, and because he was a Christian and he believed very clearly in God’s help and the prayers of God’s people.

I start by saying how pleased we are to see £22 billion set aside for the NHS. That is constructive and positive and we should welcome it. Within that £22 billion there will be money for radiotherapy, and hopefully for training and bringing staff forward—it is important to have that as well. The hon. Member for Wokingham referred to the Royal Berkshire hospital, and in Northern Ireland we have similar problems.

I am going to tell a story that has been heard often. I am sure that most of us in this House were struck by the candid and very emotional video released by the Princess of Wales to inform the nation that she was going through the valley of cancer. The video was in response to a concerted campaign of disinformation against the princess of my heart, and probably all our hearts. She was disgracefully confronted with that every day. She was forced into a declaration of her intensely private journey with cancer, highlighting the effect on her husband, children and family. That very public declaration and the updates that she has so wonderfully provided have started a wide conversation about the dreaded C-word. We are deeply indebted to the Princess of Wales for that.

We also had the announcement about the King’s health. I was surprised and I immediately prayed for him, as I do every day. But the announcement about the Princess of Wales, a young woman in her prime, goes back to what the right hon. Member for Herne Bay and Sandwich (Sir Roger Gale) said: many people do not see cancer as a disease of younger people. The Princess of Wales, who was apparently so healthy and vibrant, has caused many of our young people to remember that cancer is not a disease that is a respecter of person, age, religion or background. All are brought to their knees by this disease that is ravaging the nation.

In Northern Ireland the target is that at least 98% of patients diagnosed with cancer should begin their first definitive treatment within 31 days of a decision to treat. At least 95% of patients should begin their first definitive treatment for cancer within 62 days. The problem is that those timescales here on the UK mainland and for us back home in Northern Ireland are not always met—indeed, they are rarely met. That means that that first definitive treatment, which is so important, does not happen at the time it should, and the figures are not getting any better. With the £22 billion that has been set aside for the NHS, I am hopeful that, through the Barnett consequential for Northern Ireland, we will get additional money that we can use specifically for cancer treatment.

I want to make a point about research and development and make a plea for Queen’s University Belfast and the partnerships it has with companies. It brings students from all over the world to find treatments and cures for cancer. I know that happens in many other parts of the United Kingdom, which is good. Research and development is so important, so perhaps the Minister will give us some ideas about research and development when he sums up. I am pleased see him and welcome him to his place.

The question should not be about lowering the target, but about how we deliver and meet the target of curing cancer. Having spoken to cancer specialists, I know that the need for more staff in radiology and in labs to provide a quicker turnaround, as well as the need to ensure that there are trained specialist cancer nurses and staff in place, is a long-term issue that needs to be dealt with not with words but with action. We need to spend the budget in a much better way throughout the UK—perhaps the Minister will indicate how that will happen. I believe the answer lies in the recruitment of staff in all facets of the cancer machine—labs, radiology, pharmacy and care. Every area needs specialist training. We need to keep staff in place with better working conditions, rather than the wonderful staff that we have simply burning out due to the pressure.

[Noah Law]

The father of my constituent, Eli Martyr, has been diagnosed with bowel cancer. Despite a difficult time, his father is being looked after amazingly well by NHS staff. If the Government commit to a national cancer strategy, will they ensure that the second biggest cancer killer, bowel cancer, is given sufficient attention? Can we address the staff and kit shortages and ensure that we improve the bowel cancer screening programme to improve the chances of survival?

[Jim Shannon]

I am of an age—I am not sure many others are in this Chamber—where I get a test for bowel cancer every year. A kit is sent out to do the job. Thankfully, every time I have done a bowel cancer test it has come back negative. To be fair, the NHS has a good system for that. When someone reaches 60, they are sent a test. They do the test and the NHS comes back very quickly. If something is wrong, they will hear right away. Although we sometimes criticise the NHS—rightly so—we should always recognise the good things that the NHS does. The hon. Gentleman was right to bring that up; I thank him for that.

The questions regarding cancer care in England are the same as for Northern Ireland: “How can we get the best outcome with what we currently have?” and “How can we plan to do better in the future?” Neither are easy questions, but the fact that some 9,000 new cancer diagnoses are made every year in Northern Ireland—these are drastic figures—in a population of 1.85 million, equating to one in two people developing cancer in their lives, means this issue must be a priority for us all.

I know that in his response the Minister will give us some positives in relation to where we are—I expect that, knowing the nature of the Minister—but it would also be helpful if we could have some idea about how we can better address this issue together, across this whole United Kingdom of Great Britain and Northern Ireland.

Children’s Hospices: Funding

Jim Shannon Excerpts

Wednesday 30th October 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Liverpool West Derby (Ian Byrne) for setting the scene. It is nice see him in his place; he used to be in opposition, and now he is in government. He has been elevated, so well done.

I was saddened to hear about Zoe’s Place in the hon. Gentleman’s constituency having to become a stand-alone charity to encourage investment. There are many children who rely on these services, so it is never nice to hear the sort of news which he has presented today. Our hospices are pivotal within their local communities, so it is great to be here to discuss how to support them further.

It is also a pleasure to see the Minister and the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), and I look forward to their contributions. About a fortnight ago I attended a pop-up hospice charity shop here in Parliament. It was helpful to discuss the funding crisis facing our hospices with other Members and representatives. I also signed an open letter to the Minister of State for Care, and I look forward to hearing his responses in relation to these issues.

Over the years, I have supported the Northern Ireland Children’s Hospice, which holds three or four charitable events in my constituency of Strangford every year. People are very generous and incredibly kind. The money that John and Anne Calvert help to raise through those charity events is something we all appreciate.

To give some background on the situation in Northern Ireland, the Northern Ireland Children’s Hospice is instrumental in providing endless amounts of support for people and is incredibly helpful. Horizon House in Newtownabbey is a seven-bed in-patient centre that aids the local community, including through sibling and bereavement support. It goes beyond what would normally be expected, providing community care alongside hospice at-home and palliative care for 350 babies across Northern Ireland, which is really important.

In February this year, the hospice had to reduce its bed capacity to six due to a reduction in Government funding, with the intention of running six beds from Monday to Friday, and three beds on Saturday and Sunday—a drastic change from the seven beds, seven nights model. Incredibly active fundraisers added a huge £14 million to the four hospice care facilities back home.

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

My hon. Friend is making a fundamental point about the community raising millions of pounds to support hospices, particularly palliative care, across society. Does he agree that that has to be seen, not as a replacement for Government funding, but an addition to it?

[Jim Shannon]

I thank my hon. Friend for that intervention. He is absolutely right. The £14 million raised in Northern Ireland for hospice care is extra money and—I say this very gently to the Minister and those in positions of power—that should not be taken by the Government as, “Well, we can take £14 million off what they’re doing in Northern Ireland because we’ve got £14 million from the volunteers.” That £14 million is vital to ensuring that the care goes forward.

With increasing reports of closures and decreases in some services, there is a clear need for the Department of Health, wholly supported by the Barnett consequentials, to find ways to financially aid our hospice services so that, years down the line, we do not see impending closures. The core priority, I believe, is to protect these vital services that provide so much to families across the United Kingdom of Great Britain and Northern Ireland.

Together for Short Lives revealed that the Northern Ireland’s Children’s Hospice has forecast a budget deficit of £1.46 million for 2023-24. That is due in part to a 6% cut in the hospice’s statutory income. Our hearts— and, most importantly, our thanks—are with the staff of hospice centres who work tirelessly to support those young children and families through that end of life palliative care.

I conclude with this, Mr Twigg—I am trying to keep to time—I strongly sympathise with the hon. Member for Liverpool West Derby and his constituents on what they are going through. I have every hope that the Government can do something to support the devolved nations, and indeed NHS England, in the funding crisis. This is the responsibility of the Department of Health back home, but that must be fully supported by Westminster, right here.