Medical Cannabis under Prescription

Patrick Grady Excerpts

Monday 20th May 2019 Commons Chamber

[Patrick Grady (Glasgow North) (SNP)]

I congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning) and the hon. Member for Gower (Tonia Antoniazzi) on securing this debate, and I thank the Backbench Business Committee for managing to schedule it so that we have enough time for a reflective, open and consensual debate—[Interruption.] So far! I am really looking forward to hearing what the Minister has to say in response.

We are debating an issue whose time has come. The individual cases have come together into a campaign that shows where the consensus is beginning to lie. I want to reflect a bit on that, and to speak, as many others have done, about an individual constituency case. I also want to think a bit more about the consequences of the wider campaign.

At the beginning of the debate, some Members, including the right hon. Member for Hemel Hempstead and the hon. Member for Reigate (Crispin Blunt), talked about the growth of the campaign and of public awareness of this issue. Campaigns such as these can often start with what seem to be quite isolated cases. An individual comes to one of our surgeries and the Member then has the incentive to raise the issue here in the House, after which others join in, saying, “I’ve had that as well.” Then we get the urgent questions and the Back-Bench debates, and the issue becomes much more live and mainstream. Members of the public are encouraged to come forward to their MPs with their individual cases, and the broader public are encouraged to support the overall issues. We have seen this in a number of areas. I am reminded of the WASPI campaign—although that is a completely different situation—because of the way in which it snowballed as people came forward to their individual MPs with their local cases and it built into a positive campaign from there.

The policy environment on medicinal cannabis is ripe for change. We have heard today about the knowledge and experience in other countries as the different kinds of cannabis medicines have been rolled out effectively. In fact, we have heard about that happening here as well, because those people who can afford private prescriptions are feeling the benefit of these medicines. However, it is incredibly frustrating for those who, for whatever reason, cannot access the right kind of medicine privately. The whole point of the NHS is that treatment should be available free at the point of need, and that it should be blind to people’s individual financial circumstances. The progress that the Government have made has to a certain extent been welcome, but the hope that was provided when the reclassifications and the provision for prescriptions from individual doctors were announced has now been dashed.

[Sir Mike Penning]

In the spirit of this cross-party consensus, I say to the hon. Gentleman that this is not a dig. This matter is devolved in Scotland, Wales and Northern Ireland. These medicines have been prescribed privately in Northern Ireland. Progress was made there. Scotland could do this; we could do it; and Wales could do it. I know that discussions are going on within the Department, but we must not take this in isolation. This must happen across the United Kingdom. I passionately agree with devolution, but no child should suffer because one area is devolved and people are playing catch-up with the other parts of the United Kingdom.

--- Later in debate ---

[Patrick Grady]

That is fair enough, and I want to maintain the tone of consensus in the debate. The licensing and classification of drugs remains a reserved issue, and the right hon. Gentleman is right to say that the Governments have to work and move forward together. The Scottish Government have indicated their willingness to do this, and we have to make sure that we move on. Frankly, in Scotland, we are always happy to take on more responsibilities and further devolution and, if we do not see the progress that is being sought, perhaps that is what we should do.

I want to speak about a specific constituency case that I have raised in the Chamber once or twice before. My constituents Laura Murray and John Ahern came to see me for the first time in November 2017, a few months after their beautiful daughter Bláthnaid was born. She has been diagnosed with Aicardi syndrome. With only around 4,000 cases worldwide, it is incredibly rare, but the symptoms are similar to those described by others and include frequent seizures and possible visual impairment. The treatment is limited, and the medicines that she has been prescribed are incredibly powerful, coming with their own debilitating side effects. The hon. Member for Gower made a powerful point about how much money the NHS has been spending—I appreciate that some of this is devolved—on providing emergency treatment and last-minute access to expensive drugs when the parents are keen to try an alternative.

Laura and John wrote to the Secretary of State for Health and Social Care to describe the situation, saying that Bláthnaid

“suffers multiple seizures every day and night which cause her extreme distress. They cause her to scream in pain, cry tears and become highly distressed, which is very distressing for her and us as parents and for her family to witness.

Bláthnaid has been hospitalised due to the severity of her seizures, and whenever she is ill her seizures increase, and she ends up in hospital. This is no way to live for Bláthnaid, to continually suffer and have no quality of life.”

Sadly, we hear about too many similar cases. Bláthnaid’s parents are looking for access to full-extract medical cannabis and will otherwise be at their wits’ end. The situation is particularly galling because, as the wee girl gets older and becomes more aware of what is happening, things become even more frustrating and painful.

I have written to the Health Secretary, the Home Secretary and the Scottish Government’s Cabinet Secretary for Health and Sport. I want to work with people at every level. I will meet with Ministers, with the GMC and with the local health board—whoever I have to meet—to try to secure progress for this individual case, but it should not have to come to that. Almost every Member who has spoken has raised a constituency case or another specific case, which demonstrates that the overall regime has to change. Doctors having to take personal responsibility is a hurdle in several cases. I know that there is provision for second opinions on this side of the border and I want to discover how that can work in Scotland.

I hope that future decisions do not have to come down to individual interventions and that we can have a more permissive atmosphere. I appreciate the point about devolved and reserved matters, but I was a little disappointed simply to be batted to the Scottish Government by the ministerial correspondence unit after raising the issue on the Floor of the House and after including the personal testimony from my constituents. I hope for a little more engagement from the Department of Health and Social Care down here.

It is interesting that the broader campaign is called “End Our Pain” because this does go beyond any one individual case. Dozens of constituents have been in touch in support of the campaign, because they see the benefit to themselves, their families and their friends. They see the benefit to wider society, and they have been moved by the different stories told throughout the campaign. “End Our Pain” refers not just to physical pain or the symptoms that any one individual is experiencing, but the frustration, the delays and the uncertainty. It means the pain of knowing that others are suffering unnecessarily and the pain of knowing that the solution is out there—if they could only get their hands on it.

As I have said, medical cannabis is an idea whose time has come. Public support is there. The evidence from other countries is there. The individual evidence based on when people have been able to access medical cannabis in the United Kingdom is there as well. The Scottish Government stand ready to play their part. I hope that the United Kingdom Government will also take this opportunity to act.

National Marriage and Mental Health Awareness Weeks

Patrick Grady Excerpts

Thursday 16th May 2019 Westminster Hall

[Patrick Grady (Glasgow North) (SNP)]

In some respects, it is nice to have a slightly relaxed atmosphere in Westminster Hall, because that gives us the opportunity to consider issues in detail. I congratulate the hon. Member for Congleton (Fiona Bruce) on securing the debate. It is a happy coincidence of the calendar that Marriage Week and Mental Health Awareness Week have fallen on the same dates, because that allows us to consider how marriage and mental health relate to each other. We should also note the general importance of awareness weeks and the work of the organisations that support them, because they give us an opportunity to raise issues in the House and press the Government on their commitments.

I congratulate the Marriage Foundation on promoting Marriage Week, which I believe has been marked for the past 22 years—not quite as long as the hon. Member for Strangford (Jim Shannon) has been married, but not far off. I also congratulate the Mental Health Foundation, which has worked on mental health issues for more than 70 years. I am actually wearing a tie with the mental health tartan, which was developed by Support in Mind Scotland as a colourful way to promote mental health awareness and understanding.

As we have heard, Marriage Week is all about the ingredients of positive and healthy relationships, which are at the heart of a successful and vibrant society. Families and relationships bring meaning and purpose to people’s lives, and they come in all shapes and sizes, as the hon. Member for South West Bedfordshire (Andrew Selous) said. Governments have a responsibility to support them by providing good-quality public services and fair work practices to ensure that people can live healthy and fruitful lives. When people feel supported by such services and by a positive sense of community, relationships can flourish. That is an ambition of all Governments, no matter what their political character may be or in which part of the United Kingdom they may operate.

It is right to stress that not all marriages are happy or end as happily as they began. It is important to have services and support in place to help those partnerships to move forward as positively as possible. In Scotland, a lot of support is provided to national family support organisations, such as Relationships Scotland and The Spark. As the hon. Gentleman also said, that importance is particularly true in making sure that the support is there for children, whether that is mental health support or mediation.

As the hon. Member for Strangford said, people present at our surgeries and we, as Members of Parliament, have an individual responsibility to signpost people to the right organisations and to be aware of the range of support services available nationally and in our communities.

Marriages come in all shapes and sizes, and Scotland was of course the first country in the United Kingdom to consult on same-sex marriage and subsequently to legalise it, through the Marriage and Civil Partnerships (Scotland) Act 2014. That has been a cause of great celebration, including among close friends of mine.

Not every marriage, however, is made through free choice. That is why we must also recognise the importance of having robust legislation in place to protect against the appalling practice of forced marriage and to ensure that marriage is not a misery or a trap. The Scottish Government introduced forced marriage protection orders to protect people from being forced to marry, or who were already in a forced marriage. In September 2014, that protection was extended to protect those at risk and to make forcing someone into a marriage a criminal offence in Scotland.

By coincidence, there was a particularly high-profile exponent of marriage in the news last week. The First Minister of Scotland, Nicola Sturgeon, gave an interview to her local station, Sunny Govan Radio. She was asked what had surprised her in recent years, and she said her marriage had surprised her:

“I had always been a bit of a feminist and never really considered marriage as an option. When Peter and I decided to get married, it was immediate how much more strong and stable I felt knowing that I had him at my back. His support and the support of my mum and dad give me the resilience and strength to keep going every day and doing my best.”

I hope those are words of encouragement to everyone who is considering marriage. Nobody is an island. None of us politicians is an island. We all have colleagues who have experienced difficulties and intimidation. When you are the one person in a room standing up speaking, that is difficult for any one of us. For most of us, it is the knowledge of the strong relationships in the background, whether marriage or other forms of partnership, or friends and family, that provides that support network that we rely on.

That point links to the importance of Mental Health Awareness Week. The First Minister went on to speak about some of the challenges and stresses that come with life in the public eye, particularly her experience of imposter syndrome. When asked if she ever feels like an imposter, she said:

“Like many women in senior positions, yes I absolutely do. However, I think it gives women a bit of humility too and reminds you that you have to work hard for what you need to achieve. It keeps you grounded. Do I deserve this? Could I do better? It makes you more accountable for your own work.”

That level of self-awareness and her willingness to speak out should be an encouragement for everyone in public life and beyond. It is important to use such opportunities to raise awareness of the issues.

The main focus for Mental Health Awareness Week this year is body image—a subject that has become topical in the last few days with the issues that led to the cancellation of “The Jeremy Kyle Show” and questions about “Love Island” and other reality TV programmes. Sometimes, frankly, this job can feel like a bit of a reality TV programme, though it is less likely to be slated for immediate cancellation. Using the opportunity of awareness weeks to turn the debate on social media around and to try to detoxify online culture is hugely important. We must support people who champion body positivity online and make sure that people who are struggling with those kinds of issue, especially young people, interact with social media content in a healthy way and avoid falling into mental spirals.

The Scottish Government have made several announcements to try to support that this week. They are setting up an advisory group on healthy body image, which will include members from youth, third sector and equalities groups, to identify steps that can improve support for young people and advice for relevant professionals. That will build on a package of measures to improve young people’s mental health, including £90,000 in funding to provide advice on the healthy use of social media and screen time, and a review of evidence on the effects of screen use on sleep and its implications for mental health.

We will continue to drive that forward and, again, I hope there will be lessons that the Governments can learn from each other. The hon. Member for South West Bedfordshire spoke about how such issues can be championed in Government. The Scottish Government have a dedicated ministerial post for mental health. The occupant, Clare Haughey, was herself a mental health nurse and brings significant personal experience to the post. The desire to see mental health issues mainstreamed across the NHS and other support organisations runs right across the national strategy.

Like other hon. Members, I see fantastic examples in my own constituency. The members at Flourish House, part of the global Clubhouse Network, presented me with this tie the last time I met them. They wanted to engage with me on different aspects of how Government and public policy affect people with mental health issues, particularly on questions around welfare reform, but also other aspects of social care and the health services. Flourish House does a fantastic job in reducing social isolation and providing different kinds of activity and engagement for its members. Similarly, the Coach House Trust provides a particular focus on employability and skills. It has been doing so for more than 20 years and has an annual open day that is a highlight of the summer calendar. We are always spoilt for choice with the arts and crafts available for sale that have been produced by their members over the years.

I also pay tribute to a group called Differabled, which was founded by parents in my constituency to provide support for other parents and carers of children and young adults with a range of additional support and mental health needs. I met them during the 2017 election campaign and it was an incredibly powerful experience. The way that organisation has developed is incredibly impressive, and I continue to support it.

The Glasgow Riding for the Disabled Association helps to promote the mental health benefits of physical activity and physical exercise in different ways. It was the beneficiary of the Christmas card competition that I ran in my constituency last year. Last year and the year before, the winners of the competition came from two of the schools that provide support to children with additional needs and mental health issues. East Park in Maryhill has been supporting young people since 1874, and Alexander Houston was a worthy winner of last year’s competition. Abercorn Secondary School, which is supported by the local authority, provides a fantastic supportive environment, and Jack Slavin’s Christmas castle featured on my card in 2017. Kelbourne Park Primary School, in North Kelvinside in my constituency, supports younger age groups in a wonderfully nurturing environment. I use this opportunity to offer them my full support.

There has been a fair degree of consensus in this debate, particularly on the importance of stability in relationships for good mental health, and the benefits that that has for wider society in promoting social justice and tackling poverty, and the many different things that, in our different capacities, we all came into politics to try to achieve. There is a challenge to the Governments in the United Kingdom and the devolved nations to ensure that adequate funding is in place for the different services and that the appropriate legislative frameworks are in place to support families and the various organisations that work with them.

I hope the Chamber will indulge me, because on 1 June, during the recess, I will be attending a wedding of two very good friends of mine, Emma and Adam. I have known Adam Sutherland since we were very young. Of course, people are a bit older when they get married these days, so their chances of being married for quite as long as the parents of the hon. Member for Strangford probably depend on a variety of factors, but the strength of their relationship will be a solid foundation for many long years of happiness, and I hope the Chamber will join me in wishing them all the best.

Access to Medical Cannabis

Patrick Grady Excerpts

Monday 8th April 2019 Commons Chamber

[Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)]

rose—

[Patrick Grady (Glasgow North) (SNP)]

rose—

[Mr Speaker]

Order. It is in the interest of the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) that I call his Chief Whip before him.

[Patrick Grady]

The expectations of too many families have been raised by the Government’s previous announcements. It really is time that they get a move on. I will write to the Secretary of State about my young constituent who has Aicardi syndrome. Her parents firmly believe that medical cannabis would help her symptoms and seizures. What steps is he taking to ensure that those kinds of rare syndromes are taken into account at trial stage?

Services for People with Autism

Patrick Grady Excerpts

Thursday 21st March 2019 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I am sure that the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) would have been very proud of all the contributions to the debate today, and I hope that the hon. Member for Bexhill and Battle (Huw Merriman) will send her our best wishes.

[Patrick Grady (Glasgow North) (SNP)]

On a point of order, Madam Deputy Speaker. Can you advise me, first, how we can get on the record that over 1 million people have now signed the petition calling for the revocation of article 50 as the best way to stop the Brexit madness that seems to be engulfing the country, and secondly, whether you have had any indication from the Leader of the House—she said this morning that if it got to 17.5 million signatures, she would start to consider it seriously, so only 16.5 million more are now needed—that she is planning to make a statement to the House?

[Madam Deputy Speaker]

I thank the hon. Gentleman for his point of order. I have not received any indication from the Leader of the House that she intends to come here today. He will know that, under the e-petitions system, the Petitions Committee will consider any petition that receives more than 100,000 signatures for a debate. It is a matter for that Committee when such a debate is scheduled. I am sure it will be looking at this petition in due course, and I am also sure there will be ample opportunities in the coming days for the hon. Gentleman to make his views known. In the meantime, those on the Treasury Bench will have heard his request.

HIV and World AIDS Day

Patrick Grady Excerpts

Thursday 29th November 2018 Commons Chamber

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

As chair of the all-party group on HIV and AIDS, may I first offer a whole hearted tribute to the bravery, courage and example of my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle)? He has not only shared with us his own very personal experiences in such a clear and honest way that will have an impact in this country and globally; he has also—I would expect nothing less from him—not shied away from the fact that HIV is political. He has mentioned many of the issues still faced by those living with HIV in this country and around the globe, including stigma, discrimination and a lack of access to services. If any message goes out from here today, it should be that we need to continue the fight and end this by 2030, and we can end it. After the example that my hon. Friend has shown today, I am all the more confident that we will do so.

I also pay tribute to my hon. Friend on behalf of other vice-chairs who wanted to be here but could not—Baroness Barker, Lord Black, and my hon. Friend the Member for Stockton South (Dr Williams)—and who are incredibly proud of what he has done today.

As my hon. Friend said, the situation has dramatically transformed since the first World Aids Day 30 years ago. I remember coming to these issues while working in the international development sector for World Vision, Oxfam and others, and I look back at some of the horrific statistics, particularly on young people orphaned or made vulnerable, on those living with HIV and on those dying from AIDS. We saw this as an unreachable mountain that could not be overcome. The progress that has been made over the past 15 years is remarkable, but we must not have a slipping back in that progress.

[Patrick Grady (Glasgow North) (SNP)]

I would like to express, on my own behalf and that of my SNP colleagues who cannot be here, our commendation for the incredibly powerful and moving testimony that the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) has given. The hon. Member for Cardiff South and Penarth (Stephen Doughty) is absolutely correct that that speech will be heard not just here, and not just across this country, but around the world. It provides an opportunity to tackle the stigma that is still associated with HIV in so many parts of the world and that prevents people seeking the treatment, or even the diagnosis, that they need, despite all the opportunities and all the funding that is provided. There has to be a change of mindset as well. So we are thoroughly behind what we are hearing today.

[Stephen Doughty]

I thank the hon. Gentleman for his intervention and completely agree with what he has said.

As my hon. Friend said, access to antiretroviral treatments has revolutionised both treatment and prevention. That has enabled many HIV-positive people to achieve viral suppression where the level of HIV in the blood is so low that it is undetectable and, crucially—we have to emphasise this—untransmittable to others. U=U—undetectable equals untransmittable—is one of the messages that must ring loud and clear from his speech and from this House. It has transformed the medical understanding of HIV from a fatal and emergency disease to one that is chronic and manageable, and where people can live long, happy, healthy lives.

But we must recognise the challenges that exist, particularly internationally, among the world’s 36.9 million people living with HIV. That is still a huge figure. One in four remain unaware of their HIV status. Among those who have tested HIV-positive, 21% globally do not have access to treatment and, of those who have access to antiretroviral treatment, 19% have not yet achieved viral suppression.

I want to turn briefly to some of the key challenges that we face in the UK, which my hon. Friend laid out. Forty-one per cent. of people are still diagnosed late and one in eight people living with HIV do not know their status. In October, we held an event here where we heard from a lady who preferred not to use her real name who had been diagnosed with HIV in her late 50s. She had been left with lifelong physical complications and, tragically, suffered a mental health breakdown because of the extreme stress caused by the diagnosis, the lack of support, the fear, the stigma and the discrimination that she thought she would experience. Holding back tears, she told that room full of strangers that she had been unable to share her HIV status with her friends or family. That shows the courage of the example set by my hon. Friend today. Unfortunately, there are still many people out there, including many I know, who would not have the confidence to do this or even to share their status in private circumstances. We have to turn that around and end the stigma and discrimination.

I absolutely endorse what my hon. Friend said about PrEP. It is simply extraordinary that we are still waiting for the English NHS to make this routinely available. People have told me this week that they want to access PrEP and cannot do so. That simply cannot be the right way forward, from a purely public health point of view, from a rights point of view, and from a cost point of view. In all respects, it is wrong. I hope that the Minister can give us some positive news on that and that we will see the progress that we have seen in the other nations. I pay tribute, as my hon. Friend did, to our Labour Health Secretary in Wales who has shown quite a lot of political and practical leadership, as a Minister, on this issue.

I was disappointed when we had the Department of Health and Social Care prevention strategy last month. there is much in there for us all to agree with, while it failed to mention sexual health at all. That was a huge disappointment because there is a huge amount in the strategy that very much applies to the agenda that we have been talking about today. I hope that the Minister can explain what the Department is going to do to ensure sexual health and HIV prevention are at the heart of that prevention strategy for the NHS overall. I also emphasise what my hon. Friend said about demand for sexual health services rising and the challenges facing particular communities, whether the BME community, the LGBT community, young people, sex workers or injecting drug users. Sometimes we shy away from talking about unfashionable and difficult topics in this House, but we need to have honest and frank conversations if we are going to end HIV and AIDS in this country.

Globally, there are still 15 million people who are not accessing treatment because of inadequate health systems and funding, discriminatory laws, stigma and discrimination, and colonial-era laws that ensure that people do not get the treatment they need. The UK needs to lead the way in ending HIV stigma for good and supporting these programmes through the work of the Department for International Development.

I pay tribute to the Minister of State, Department for International Development, the right hon. Member for North East Bedfordshire (Alistair Burt), who announced at the AIDS conference in Amsterdam an increase in funding for the Robert Carr Fund, for which so many of us have campaigned, and support for civil society organisations to support key populations.

It was inspiring yesterday to hear from not only a young female AIDS activist from Zimbabwe called Audrey, but two former Presidents—the former President of Botswana, Festus Mogae, and the former President of Mozambique, Joaquim Chissano. President Mogae spoke to us in a way that I did not expect. He spoke about all the things that we know we need to do to tackle HIV, but he stood up as a former African leader and said, “We need to address the needs of the LGBT population, the needs of the trans population, the needs of sex workers and the needs of injecting drug users.” That sent an incredibly strong signal to leaders across Africa and the world that we must talk about these issues and take action on them, and I hope the UK will continue to provide that crucial support.

I pay tribute again to my hon. Friend the Member for Brighton, Kemptown for his courage and bravery and the message that it sends. I hope the Minister will have some hopeful words for us about the situation in the UK. I want to end by thanking all the organisations that do so much to support our APPG’s work, including the Terrence Higgins Trust, the National AIDS Trust, the International HIV/AIDS Alliance, STOPAIDS, Youth Stop AIDS, the British Association for Sexual Health and HIV and so many more. I thank all the organisations that are active in our communities and, I am sorry to say, are filling the gaps left by cuts to provision. They are out there making the case, supporting people living with HIV and taking us all down the road to ending this epidemic by 2030.

Oral Answers to Questions

Patrick Grady Excerpts

Tuesday 24th July 2018 Commons Chamber

[Peter Grant (Glenrothes) (SNP)]

9. What steps he is taking to tackle workforce shortages in the NHS.

[Patrick Grady (Glasgow North) (SNP)]

17. What steps he is taking to tackle workforce shortages in the NHS.

[The Secretary of State for Health and Social Care (Matt Hancock)]

We now have more professionally qualified clinical staff working in the NHS: over 41,000 more since 2010, including over 14,000 more doctors and over 13,000 more nurses on our wards.

[Matt Hancock]

It is interesting that the hon. Gentleman asks that question, because it is worth looking at some of the facts. Over the five years to 2017 health spending increased by 20% in England but by only 14% in Scotland. As a consequence, people are 30% more likely to wait 18 weeks for treatment in Scotland than in England, and the increase in the number of nurses and doctors in England has been higher than in Scotland. Perhaps the SNP should look at how we have been performing in the NHS in England and learn from that.

[Patrick Grady]

In that case, perhaps the Secretary of State will join the Royal College of Nursing in welcoming the action by the Scottish Government to enshrine safe staffing levels and ratios in law. Given that there are over 36,000 vacant nursing posts in the NHS in England, when will he follow the Scottish Government’s lead and bring forward legislation on safe staffing levels?

[Matt Hancock]

I have seen what has happened, and maybe the reason why the SNP has had to do that is that in England we have increased the medical workforce faster than in Scotland. When the performances improve in the Scottish NHS, we in England will start to take lessons, but until then I will concentrate on making sure we get the very best NHS right across the country.

--- Later in debate ---

[Caroline Dinenage]

The hon. Lady is absolutely right to raise this issue. Prevention is a key aspect of the new Secretary of State’s focus as the Department moves forward. NHS England will support all CCGs that are in special measures to return to financial balance. It also provides a bespoke package of support, along with a higher level of monitoring and oversight, to ensure that the money is always spent wisely.

[Patrick Grady (Glasgow North) (SNP)]

T2. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Matt Hancock)]

We have proposed £20 billion more funding for the NHS to guarantee its future, and I am looking forward to working with everyone in the NHS and the social care system on a long-term plan to ensure that that money is well spent. Today, we have published for the House the 2018-19 pay settlement for doctors and dentists. It represents the highest pay settlement since 2008. I regard it as a first step and look forward to a wider conversation on pay and improvements to help to make the NHS the best employer in the world.

[Patrick Grady]

Will the Secretary of State update the House on the progress of Baroness Cumberlege’s review of the use of mesh implants? Will he confirm whether the inquiry will liaise with the Scottish Government and whether it will hold any evidence sessions in Scotland? There are plenty of women, including some in my constituency, who had operations in England but now live in Scotland. Their voices must be heard in the inquiry.

[Matt Hancock]

Yes, the hon. Gentleman is absolutely right. We published information on this issue just last week. We absolutely will consult the Scottish Government and all interested stakeholders. It is a very important matter to get right.

ME: Treatment and Research

Patrick Grady Excerpts

Thursday 21st June 2018 Westminster Hall

[Carol Monaghan]

I will come on to the NICE guidelines. They are under review, and all politicians can help with that. I have already written to NICE about the issue and I will ask the Minister about that later.

We now know that 13% of the participants in the PACE trial qualified at baseline as “recovered” or “within the normal range” for one of the study’s two primary measures—self-reported physical function—even though they were classified on the same measure as disabled enough to enter the study. That anomaly, which occurred because the investigators weakened key outcome thresholds after data collection, invalidates any claim that patients recovered or got back to normal. The overlap in entry and outcome criteria is only one of the trial’s unacceptable features.

For patients, the impact of PACE is severe. The recommendation of GET as a treatment for ME has provoked a backlash from patient groups, who report that many people with ME end up more severely disabled after a course of GET than before. I have spoken to people living with ME who have tried to do GET because they are so desperate to get better and have ended up in a wheelchair or bedbound as a result of this programme.

[Patrick Grady (Glasgow North) (SNP)]

I congratulate my hon. Friend on securing the debate. The turnout shows the significance of this issue to all our constituents. Her point about GET is important. It seems perverse that people should be forced to take a course of treatment that patently makes their condition worse. Does she agree that that must be reviewed?

[Carol Monaghan]

Indeed. Many people have written to me about their experience of GET, but some of the most upsetting examples are of children who were forced through a programme of GET and ended up with life-changing disabilities as a result.

Surgical Mesh

Patrick Grady Excerpts

Thursday 19th April 2018 Commons Chamber

[Patrick Grady (Glasgow North) (SNP)]

I congratulate the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) on securing the debate through the Backbench Business Committee. I took part in a powerful debate on the issue in Westminster Hall, and I am delighted that time has now been made available on the Floor of the House. I commend all those involved with the Sling the Mesh campaign and the all-party group, and I commend the hon. Member for Pontypridd (Owen Smith) for the leadership he has shown. This issue is finally getting the attention that it deserves. Like most Members, it was brought to my attention by a constituent who has been affected first hand, and I wish to reflect on some of the experiences and points that she shared with me, as well as considering broader policy issues on which I hope the Minister will respond.

Other Members have already mentioned ventral mesh rectopexy, which has not been included in the UK Government’s proposed audit. Sling the Mesh’s campaign research shows that 7% of its members have been affected by that specific procedure, and there is a certain amount of disappointment that it does not seem to have been included. As the Minister might know, I have written to the Secretary of State about that concern, and asked the Government to think again, particularly given the number of people affected and the devastating effect that this has had on their lives.

I also raised concerns about the need for a hospital episodes code to be allocated to that procedure. Without one, it is difficult to keep track of the number of people affected, and we have already heard about the problems arising from the lack of information about the exact number of people affected by the procedure and the mesh more generally.

There are also concerns that some recent National Institute for Health and Care Excellence guidelines might have been rushed through, partly in response to media attention, which only adds to the argument for a full and comprehensive audit that includes all types of mesh procedure.

The health service is devolved in Scotland, where there is a slightly different situation. In 2014, the Scottish Government requested a suspension in the use of medical mesh by the NHS in Scotland pending safety investigations, and in 2015 the Cabinet Secretary for Health, Wellbeing and Sport, Shona Robison, apologised to women who had been left in severe pain by such operations. Between 2009 and 2016, the number of women receiving mesh surgery in Scotland fell from 2,267 to just 135.

An independent review published in March last year in Scotland made eight recommendations, notably that surgical mesh implants should be used only after all other appropriate alternatives have been exhausted, and—crucially—only when women have given their fully informed consent. Scotland’s chief medical officer accepted the recommendations of that report in full, and has been clear that the requested suspension in the use of mesh implants should remain in place until she is satisfied that all recommendations have been implemented. That means that all women in Scotland who want treatment for urinary incontinence or pelvic organ prolapse should be offered the full range of options available, and they should be fully informed of the benefits and risks associated with those procedures.

Regulation of these devices is reserved, however, and operates at UK-wide level, which is why calls for a UK-wide national clinical audit and database for recording device identifiers are so important. Scottish Government officials are working with UK colleagues to consider the possibility of an automated implant registry, which would allow unique device identifiers to be entered on the patient’s electronic record. As the Minister will know, the now Cabinet Secretary for Health and Sport has written to the Health Secretary to suggest a UK-wide woman’s health summit. That would allow the NHS, and relevant decision makers across the United Kingdom, to work constructively on a range of issues.

I wish to raise other aspects of regulation, and particularly EU regulation on medical devices 2017/745. That will change mesh implants for long-term or permanent use from a class IIB to a class III device, meaning that they are generally regarded as high risk. The regulations will not take full effect until 2020, which is after the Government’s preferred date for Brexit. How will important EU regulations that monitor the use of devices across EU territories be implemented or reflected in UK law and regulation after Brexit? It is important that standards are maintained to the highest possible level.

Campaigners such as my constituent are concerned about the current process of what could be called post-market vigilance, and whether some of the devices are subject to testing that is rigorous enough before they are rolled out to the market. There is a genuine concern that device manufacturers have a profit motive to develop their devices and get them on the market as quickly as possible, although equally, they have a fear of litigation, which is why better and stronger regulation from the start is key.

The risks associated with surgical mesh implants were tragically misunderstood and underestimated by healthcare providers and professionals who provided the treatment, and by patients whose lives have been so badly affected by chronic and debilitating pain. I welcome the conclusions and recommendations of the Scottish and English reviews of this procedure, which must ensure that surgical mesh implants are used only after all other appropriate alternatives have been exhausted and—crucially—only when women have given their fully informed consent.

I hope that Ministers will be willing to work with their counterparts in the devolved Administrations and consider a UK-wide summit on the issue and women’s health more generally. I will finish as I started by paying tribute to my constituent and all campaigners for their bravery and courage in ensuring that this issue has been brought to our attention. It is them we must thank for the small and belated progress that has already been made, and for them we must continue to hope for more and faster progress in future.

Autism

Patrick Grady Excerpts

Thursday 29th March 2018 Commons Chamber

[Chris Stephens (Glasgow South West) (SNP)]

It is a pleasure to follow the hon. Member for Cardiff West (Kevin Brennan). I want first to place on record the fact that many of my constituents have contacted my office and urged me to attend this debate. Many of them have sent emails expressing how much it would mean to them if their Member of Parliament were to attend the debate. I am glad to see so many other hon. Members here as well.

When I was first elected, one of the first things I introduced in my constituency was a surgery specifically for carers. That is important for carers of people with autism, because they often face issues in isolation, including education, social and social security issues. Sometimes, those issues are not faced in isolation; they can become combined. That is why I introduced a specific surgery for carers, so that we could look at all those issues in combination, rather than dealing with them separately.

I want to raise a matter that has not yet been mentioned—namely, the difficulties that those with autism and their carers have when navigating their way through the social security system, particularly the personal independence payment application process. I have a constituent, Mrs Geraldine Lynch, who attended a PIP assessment with her son Jordan, who has autism. Mrs Lynch has said that the descriptions of her son in the reports that came back from the assessment process and the mandatory reconsideration process were unrecognisable. Perhaps they were the wrong files, describing the wrong individual, or perhaps my constituent was misdiagnosed and not given a proper PIP assessment.

My real fear about the PIP process is that far too often there is a lack of specialism among the assessors and a lack of understanding of specific conditions. My experience of my constituency workload tells me that that also affects those who suffer from autism. I encourage the Government to look specifically at ensuring that assessors of PIP, employment and support allowance and other benefits include a specialist on autism and related conditions. That is very important if we are to help those people.

There have been some positive developments in my constituency. One of them relates to my constituents Debbie Elliott and Claire Ellis, who have launched a support group called the Triple A Parents and Carers Support Group in Govan, and I would like to thank the Govan Housing Association for providing free space in its hub to allow the group to organise. It runs a drop-in every Friday. The purpose of the group is to allow parents and carers facing the same issues to share their experiences and to give each other advice, information and support. It is important that carers of those with autism and other related conditions have that kind of support, and the number of support groups is growing in my constituency and elsewhere. They allow support and the sharing of information and experiences, which helps other individuals. Added to that, on the Pollok side of my constituency, Differabled Scotland is organising a parent-to-parent peer support group for parents and carers of children, young people and adults.

[Patrick Grady (Glasgow North) (SNP)]

My hon. Friend has mentioned Differabled Scotland. Some of the people who run that organisation are constituents of mine, and I had a powerful meeting with them during the general election campaign last year. It is clear that the amount of support needed for people with autism is growing, and the work of Differabled Scotland is particularly valuable because it provides a peer support network of parents and carers of children of all ages. It does very valuable work.

[Chris Stephens]

I thank my hon. Friend for that intervention. I, too, met organisers from Differabled Scotland a couple of weeks ago, and it was an excellent meeting. It is quite inspiring that there is peer-to-peer support and that people are sharing their experiences. Both the organisations that have been launched in my constituency are important.

It is also important for people to have access to welfare rights officers, and those officers are in attendance when these groups meet to help people to navigate their way through the various issues that I have mentioned, particularly those relating to social security support. Those groups that are now getting up and running also need funding, and I would like to ask the Minister what kind of funding the Government are planning to put in place to help those peer support groups to grow. What kind of finance will be available to them? I pledge to help them to get the necessary finances, so that they can continue to support carers and parents and help their organisations to grow.

World Antibiotics Awareness Week

Patrick Grady Excerpts

Thursday 16th November 2017 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

I beg to move,

That this House has considered World Antibiotics Awareness Week.

It is a privilege to serve under your chairmanship, Mr Davies. Exactly one century ago, Ernest Rutherford split the atom and humanity entered the nuclear age. The groundbreaking discovery represented a momentous step forward for human progress, but at the same time it unleashed a challenge for those beyond the laboratory and academia—the avoidance of mutual assured destruction. As this debate is about World Antibiotics Awareness Week, some might wonder why I started with the splitting of the atom, but I believe that there is an equally strong argument for the aforementioned period to be referred to as the antibiotic age. It was 11 years after the splitting of the atom that Sir Alexander Fleming discovered penicillin, here in this very city of London.

No one can deny the profound impact of antibiotics on medicine, and their widespread use represents a watershed moment in our evolutionary story. However, as Fleming himself understood, shortly after making his discovery, giant leaps in scientific progress produced wholly new challenges. As antibiotics were readily available, it appeared that we had invented miracle drugs of sorts. The snag is that we now face the real and severe threat of antimicrobial resistance.

Across the globe this week, scientists and healthcare professionals are hosting a wide range of events to make antibiotic resistance a globally recognised health issue. I am delighted that we as parliamentarians are here today to represent the role that lawmakers and Governments will play in facing the challenge of antibiotic and antimicrobial resistance. The week is also intended to raise awareness of the need to preserve the power of antibiotics through appropriate use, to increase recognition that individuals, health and agricultural professionals, and Governments must play in tackling antibiotic resistance, and to encourage behavioural change and convey the message that simple actions can make a difference.

While the threat of antibiotic resistance is often considered a doomsday scenario—one might say a medical Armageddon—we must remember that that menace is all too deadly today. Currently, 700,000 people die each year from drug-resistant infections; the future threat is touted as being so severe and extreme, not because we are not living with the effects today but because of the truly appalling potential scale of the problem if we do not take co-ordinated action. If we do not act now, antimicrobial resistance will be responsible for 10 million deaths per year by 2050. That is more than the number of people worldwide who were killed by cancer in 2015. It is nearly impossible to put a number on the lives that have been saved by antibiotics; some sources put the figure at roughly 2 million, but it is entirely conceivable that we may arrive at a position where the balance tips, and antibiotics pose a greater threat than a remedy.

As I have said previously in this House, we run the risk of returning to a medical dark age, where routine operations such as hip operations cannot be carried out, and infections that are standard today become deadly. This week, the British Society for Antimicrobial Chemotherapy published a report on behalf of the all-party parliamentary group on antibiotics. The report, the briefing for which has been sent to all Members of the House, considers the AMR action plans and strategies set out by the World Health Organisation, the European Union and the UK, and asks, crucially: “Has the world lived up to the challenge?”

The overarching theme of the report is that future strategies to combat antibiotic resistance should incorporate specific, measurable, attainable, relevant and timely—SMART—targets. When the stakes are 10 million deaths each year within four decades, it is easy to become lost in the scale of response that that merits; but as is so often the case, a coherent and clear approach is our greatest weapon. I call on the Government to ensure that all steps are taken to counter AMR and explicitly to incorporate those SMART targets I listed. I believe there is much to be gained from making that standard practice and removing any doubt. I am sure that colleagues will be encouraged to read in the report that

“the UK has taken significant steps to meet the objectives of the EU Action Plan, which in turn satisfies the WHO Europe Strategic Action Plan.”

There are two aspects, however, where our country needs to up its game. First, we need to address education and public awareness, so it is entirely fitting that we meet today during World Antibiotic Awareness Week, an occasion aimed directly at bolstering an understanding of resistance and the threat it poses to humanity. We need to be forthright in promoting the “four rights” when consuming antibiotics: the right drug, the right dose, the right time and the right duration. A survey carried out across Europe in 2016 indicated that knowledge about AMR remains low, and antibiotic consumption has decreased by only 6% over the last seven years. To address that, the British Society for Antimicrobial Chemotherapy advocates the use of simple and clear language in all awareness-promoting material. There is a direct recommendation of

“monitoring the efficacy of education campaigns through online channels.”

Fleming himself was once quoted as saying that the best remedy for a common cold was a dram of whiskey.

[Patrick Grady (Glasgow North) (SNP)]

Hear, hear.

[Julian Sturdy]

I know the Scottish Members would certainly agree with that. As Fleming said,

“it’s not very scientific—but it helps.”

We now need to make the message as clear as day: antibiotics are ineffective when taken unnecessarily and doing so bolsters resistance and endangers mankind.

The second area where significant progress can be made is on the incentives for antibiotic discovery, research and development. It should be noted that the antimicrobial challenge is as much economic as it is medical. We must find an alternative to the reimbursement model, whereby profitability of bringing new antibiotics to the marketplace is linked to volume of sales. That is because we are actually seeking to limit the use of such drugs to preserve their power; to use new drugs as a point of last resort, as it were. To use an analogy, it is almost like the fire service—we need it to be there and to be effective, but we do not want to use it. However, nobody would dispute the necessity of investment and funding for that key emergency service.

To overcome this task, it is essential that measures are taken to co-ordinate a review of progress in new drugs, alongside the activation of research and development by industry for new antibiotics and related products achieved by Innovative Medicines Initiative projects. On the economics, we need to seek innovative solutions, with the pricing conditions and “pull” measures needed for the long-term sustainability of new antibiotic development, so that they are promoted. An example of that is the compact initiative of the European Federation of Pharmaceutical Industries and Associations to promote a sustainable business model and adequate conditions for the introduction of effective new antibiotics.

The O’Neill review, published last year and described last week by a columnist from The Times as

“the best argued and most accessible”

report in his lifetime, was very clear on this matter. Lord O’Neill found that much more needed to be done to close the substantial gap in research and development funding between AMR and the best-funded areas of medical science. The report being launched this week quantifies this further, and states that $40 billion is needed over 10 years, representing about 0.05% of G20 countries’ current healthcare spend. I will not claim that that sum is insignificant, but it is certainly affordable given the magnitude of the threats we face.

For improvement on a global level, the report makes it clear that co-ordinated efforts must be made in the veterinary sector, where I am pleased that tangible progress has been made in the UK. Figures from the Countryside Alliance show that sales of livestock antibiotics across the sector have fallen by an average of 27%—their lowest levels since records began—which is a good start, because a failure to address AMR in livestock has fundamental implications for the treatment of human diseases. For that reason, mirrored co-operation between Government Departments is essential.

While I am delighted that we are joined by my hon. Friend the Under-Secretary of State for Health, this matter also encompasses the Department for Environment, Food and Rural Affairs, the Department for International Development and the Department for Exiting the European Union. We need a clear commitment from the Government that that co-operation is there and that an interdepartmental strategy is on the agenda. Beyond that, we require what Antibiotic Research UK describes as a “grand alliance” to come together, comprising the Government, the pharmaceutical industry, collective medical research charities and academics.

To reduce further the overall use of antibiotics in the veterinary sector, guidelines have been developed for prudent use. The EU road map also proposed the creation of an animal health legal framework, based on the principle that prevention is better than the cure. Take the example of colistin. In 2015, evidence emerged of colistin resistance with the potential for transfer and spread between bacterial species. In order to preserve colistin for human medicine and limit the spread of resistant genes, the European Medicines Agency imposed strict limitations on its use and recommended the withdrawal of marketing authorisations for all oral colistin in veterinary medical products. Professor Galloway, from the Royal College of Physicians and Surgeons of Glasgow, is calling for a full review of the use of antibiotics used in both animal husbandry and human clinical practices, and I believe the Government should actively consider that suggestion.

In the UK, some sectors have conclusively beaten the target set by the veterinary medicinal products directive. Such industries represent very clearly what we are aiming for with the SMART targets I referred to at the beginning of my speech. In many cases, progress has been made through voluntary schemes. I request that the Government look directly into specific sectors in order to investigate best practice and what we can learn from it.

However, we must go further as a global leader and recognise that this is an international challenge. Almost 80% of antibiotics used in the USA are not taken by people but used within the livestock sector, which I find astonishing. In India, people consume an average of 11 antibiotic tablets per year. Only today, data has been released showing that antibiotic resistance is growing in Europe. Progress that Britain makes will be quite simply irrelevant in the absence of a confident international stewardship programme.

The British Government must act as an example in their commitment to tackling resistance head-on globally and, while I recognise it is not in the specific gift of my hon. Friend the Under-Secretary of State for Health to dictate his published ministerial responsibilities, I believe it is timely explicitly to add antimicrobial resistance to those responsibilities. That symbolic act would send a clear message that Britain is committed to remaining at the forefront of the fight against antibiotic resistance.

--- Later in debate ---

[Patrick Grady (Glasgow North) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Davies. At relatively short notice I am standing in for my hon. Friend the Member for Linlithgow and East Falkirk (Martyn Day), who is not very well. I am not certain of the cause of his illness, but I am sure that if he is seeking advice, he will rightly be following the guidance of the theme of World Antibiotics Awareness Week, which states:

“Seek advice from a qualified healthcare professional before taking antibiotics”.

He will also be taking the advice, as I am sure will everyone else, of my hon. Friend the Member for Central Ayrshire (Dr Whitford), who has been impressing on us the importance of the flu jab. I can testify to the medicinal qualities of a hot toddy, from time to time, but in the careful context of appropriate medication with appropriate medical advice.

I congratulate the hon. Member for York Outer (Julian Sturdy) on securing this debate, which gives us an important opportunity to reflect on the issue of antimicrobial resistance and the importance of being aware of the challenges. It is a timely debate, taking place during the World Antibiotics Awareness Week. Any kind of awareness week has a number of important consequences. In this context, improving the understanding of the risks faced, which we have heard clearly from other hon. Members, is key, as is presenting an opportunity to take action in response to the challenges presented.

The challenge is very clear and came through in all the speeches. The right hon. Member for Chipping Barnet (Theresa Villiers) made it clear how difficult it is to overemphasise the scale of the challenge and the risk we face. Some 700,000 deaths a year are attributable to infections from superbugs that are resistant to antibiotics, and that figure is predicted, as we have heard, to rise to almost 10 million in total by 2050.

There are huge challenges in the livestock and veterinary sector as well. I was interested to hear that academics from the University of Glasgow in my constituency are among those taking the lead. I will say a wee bit more about what the university is doing shortly.

As the hon. Member for Stafford (Jeremy Lefroy) has said, the issue also has a big impact on developing countries, where people require access to medicines and the challenge of resistance is huge, and it threatens the progress made in health and tackling poverty. Being aware of the huge risks and then using that as a motivation to action is one of the key opportunities presented by awareness week.

I will reflect briefly on the Scottish Government’s actions. A large amount of health policy is devolved, but there are good examples and good practice on which we can reflect. In March the Scottish Government announced a £4.2 million research grant to investigate the prevention and control of healthcare-associated infections, as well as to research new ways of using existing antibiotics more effectively and efficiently. Some of that funding was provided to a consortium of researchers led, as I have said, by the University of Glasgow in my constituency, working with other Scottish universities to establish a new Scottish Healthcare Associated Infection Prevention Institute, which will conduct important research, bringing together a range of academics, researchers, practitioners and so on.

The Scottish Government have also established the Scottish antimicrobial resistance and healthcare-associated infections strategic framework for between 2016 and 2021. It has a number of aims to do with the containment of antimicrobial resistance; advancing scientific knowledge and innovation; improving efficiency, transparency and accountability; and improved workforce capability. That is important for all environments where healthcare is delivered, such as care homes, community pharmacies and primary care, and for everyone involved in the delivery of care.

There are a number of things we can all do at an individual level. There was a debate in March, I think on the broader issue of antimicrobial resistance, during which we were encouraged to become an antibiotic guardian. In fact, when the sitting was suspended for a Division in the House, many of us signed up online. The number of people signing up to that campaign continues to grow and this is another important opportunity to encourage others to do so. The Scottish Health Secretary, Shona Robison, has pledged to join the scheme and to encourage as many people as possible to do so in order to reach the target of 100,000 people becoming an antibiotic guardian.

This debate has shown that the Government have some challenges and opportunities. Are we ensuring that the right levels of investment are being channelled through the right Departments? The importance of joined-up government across Departments, including DEFRA, DFID and the NHS, has been made clear in this afternoon’s speeches. Towards the end of his remarks, the hon. Member for Stafford touched on the issue of a joined-up global response. There is a sense in some quarters that Brexit might represent some sort of retreat from the world stage. Yet the Government’s response to the O’Neill report in 2016 clearly stated that a global response, including “working closely with Europe”, is required. How do they see that relationship with European institutions in the context of Brexit? How can we be sure that the bonfire of red tape and regulation that so many Brexiteers have dreamed of for so many years will not weaken those efforts? We have already heard about the possibility of chlorine-washed chicken and so on coming into the United Kingdom as a result of potential trade deals with the United States. How can we make sure that meat that comes in as a result of new trade deals is not absolutely overloaded with antibiotics and other treatments that could lead to increased antimicrobial resistance?

In conclusion, this is a significant challenge and awareness is important. Awareness weeks, debates such as this, and the antibiotic guardian scheme play a very important role in tackling some of the challenges. I was interested to hear about the Swab and Send initiative and am keen to sign up to it. I can think of several dusty corners, not just in this Chamber but elsewhere in the Palace of Westminster, where who knows what might be discovered. I think that is a challenge to us all.

We know that there are models out there that can work. The hon. Gentleman spoke about a number of them and some of the many positive actions taken to tackle malaria, as well as the challenges that remain in closing the final gap. The other day I attended an interesting meeting between DFID officials and the all-party parliamentary group on vaccinations for all. We looked at the impact of the near eradication of polio and the challenges that will present for other schemes in the future. Some of the infrastructures that have been built up to deliver that historic achievement of the eradication of polio can perhaps be adapted to meet other healthcare challenges. I am not by any means an expert, but perhaps this is one of those areas.

It is clear from this debate that we can all play our part, and it is also important that the Government lead by example. Once again, I congratulate the hon. Member for York Outer on securing this debate and I look forward to the Government’s response.