NHS Long-Term Plan: Implementation
Pauline Latham Excerpts(4 years, 10 months ago)
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Matt Hancock
I am grateful to the hon. Gentleman for the tone that he takes, and he is absolutely right in his analysis. I know he met the cancer Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy), last week on this point. We absolutely will address it, and we will not miss the less survivable cancers. Indeed, the focus on early diagnosis will of course help survivability, but it is also a focus across all cancers equally, rather than just on those where survivability has improved so much.
Mrs Pauline Latham (Mid Derbyshire) (Con)
This long-term plan for the NHS has been developed by the NHS, not imposed by Government. Does my right hon. Friend agree that this sets the plan apart and means it is much more likely to work for staff and patients alike?
Matt Hancock
Yes, my hon. Friend is absolutely right. The plan is of the NHS by the NHS for the NHS. We in Government will absolutely facilitate it and support it, and of course we are putting in the money, but the NHS as a whole should be very proud of what this plan proposes and the way the implementation is being done in such a rigorous fashion.
Sunbed Use: Health Implications
Pauline Latham Excerpts(5 years, 2 months ago)
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Mrs Pauline Latham (Mid Derbyshire) (Con)
I beg to move,
That this House has considered the health implications of sunbed use.
It is a delight to serve under your chairmanship for the first time, Mr Hosie, and I thank my good friend the Minister for responding to this important debate.
The motion asks the House to consider the health implications of using sunbeds, but I would go as far as calling for a ban. Who needs sunbeds? No one. Many people in the UK believe that they look healthier with a tan, but that could not be further from the truth. Bronzed skin was a trend first popularised by Coco Chanel in 1923, and it has never gone away. From St Tropez to Derbyshire, a suntan continues to be a desired accessory. Over time, people have sought to maintain their tan using artificial means, including the sunbed. In the ’60s, sunbeds were developed for the first time, and in the ’80s they began to be used in large numbers. The industry continued to grow throughout the 1990s and into the 2000s. Today, an estimated 3 million Britons use sunbeds to keep themselves tanned.
According to the World Health Organisation, sunbeds are as dangerous as smoking—many people do not realise that—and in 2009 it classified them as carcinogenic to humans. Worryingly, statistics show that people who have used a sunbed at least once, in any stage of their life, have a 20% higher risk of developing melanoma than those who have never used a sunbed. The first use of a sunbed before the age of 35 increases the risk of developing melanoma by 59%.
Chris Bryant (Rhondda) (Lab)
The hon. Lady is making an important speech. In all honesty, I think of sunbeds as pernicious death machines. They rely on people’s vanity, but we all have elements of vanity in our lives, so let us not decry that. We should be doing far more. One hundred thousand people get a melanoma every year; it is one of the most pernicious forms of cancer, and 10,000 people die. These are death machines, aren’t they?
Mrs Latham
Yes. The hon. Gentleman makes an important point, and we must emphasise the fact that sunbeds are killing machines that nobody needs to use. Nobody needs a tan, and as the hon. Gentleman says, this is purely about vanity. We know there is a lot of vanity in the world, but this is a deadly vanity and it is a waste of everybody’s time and money—sunbeds are also expensive.
Dr Andrew Birnie, a consultant dermatologist and dermatological surgeon, supports the World Health Organisation classification of sunbeds as carcinogenic. He notes that
“it has been shown that the biggest cause of melanoma is high-intensity bursts of ultraviolet light on skin not used to being exposed to UV.”
The World Health Organisations has recommended that countries either ban or limit the use of sunbeds. In reality, there is no such thing as a safe tan unless it comes from a bottle or a can. Indeed, one trainee beautician, Kimberley Platt, said:
“I’m a trainee beautician and part of the course is being taught to spray tan. Our course tutors tell us to steer clear of sunbeds, I wonder why. Has anyone ever looked on Instagram at sunbed burn photos? Horrific. It seems as if to burn, either artificially or in the sun, is somehow a funny thing to do. Dealing with skin cancer is not funny though. Think about the cost of treating skin cancer, not to mention the cost of a life.”
Chris Bryant
Is this particularly an issue in this country because so many people are genetically made for British weather? We have freckles, fair hair and fair skin, which is far more prone to some of the dangers that the hon. Lady mentions.
Mrs Latham
Again, the hon. Gentleman makes an important point. We are not built for the sun; otherwise we would be black. That is why people in Africa do not have the problems that we have. We tend to go on holiday for a couple of weeks, burn like mad, come back and think it is great, but it is damaging to the skin. One need only look at people who spend a long time either on sunbeds or in the sun. When they get older they look like dried-up prunes, and nobody wants to look like a dried-up prune. People think that they are making themselves look healthier, but they are not; they are deeply damaging their skin, and we must try to persuade the Minister that a ban on sunbed use is the only thing we can do.
Frighteningly, over the past 30 years cases of malignant melanoma have more than quadrupled in the UK, and the scary truth is that it is now the second most common form of cancer in those aged 15 to 34. A melanoma is not easy to treat unless caught early. There are around 15,400 new melanoma skin cancer cases in the UK every year—42 every single day. Every 24 hours in the UK, six people die from a melanoma, and in 2016, 2,285 people died of the condition.
In the United States of America, Europe and Australia, combined sunbed use is estimated to have been responsible for more than 450,000 non-melanoma skin cancer cases and more than 10,000 melanoma cases every year. It is no coincidence that the rise in that aggressive form of skin cancer aligns with the popular use of sunbeds. The current updated body of scientific evidence strongly suggests that indoor tanning significantly increases the risk of melanoma. A large amount of data from observational studies provides enough information to infer that sunbed use causes melanoma, using all the epidemiological criteria for causality.
Dr Nicole Chiang, a consultant dermatologist who treats skin cancer patients on a regular basis, has noted that the risk of melanoma more than doubles when sunbeds are used at a young age of below 35 years. Sunbeds cause three times more DNA damage than natural sunlight, and it has been estimated that 20 minutes on a sunbed could be equivalent to approximately four hours in the sun. Just one sunbed session can increase someone’s risk of developing squamous cell skin cancer by 67%, and basal cell skin cancer by 29%. Even more important is the increased risk of melanoma, which is the deadliest form of skin cancer.
I was concerned to learn that data from Cancer Research shows that more than 25% of the UK’s 3 million sunbed users are unconcerned about the dangers that sunbeds pose. Indeed, I was on the radio today and I heard some people talking about this issue. They said, “Well, so what? It doesn’t matter. It will be okay.” I believe it is important to dispel the fake news, often used in the marketing of sunbeds, that they provide a “controlled” way of getting a “safer” tan. Sunbeds are no safer than exposure to the sun.
A 2008 study published in the journal “Pigment Cell & Melanoma Research”—that sounds like something from “Have I Got News For You”—came to the conclusion that to achieve a tan, the skin must be exposed to ultraviolet radiation, and therefore “safe tanning” is a physical impossibility. It is also important to dispel the myths perpetrated by the sunbed industry about vitamin D benefits from sunbeds. Due to the carcinogenic risk associated with sunbeds, their use cannot be justified. We can take a tablet in the winter to ward off vitamin D deficiencies. A further myth is the idea of the base tan—the dangerous and fanciful assertion that getting an initial tan from a sunbed will protect the skin from the sun. Guidelines from the National Institute for Health and Care Excellence explain that getting a tan provides little protection against later exposure to sunlight, and the resulting skin damage outweighs any later protective effect.
Throughout my time in Parliament, I have focused on the prevention and treatment of skin cancer as a result of personal experience. I have had the privilege of working with a cancer charity, Melanoma UK, which I thank for its support in gathering evidence for this debate. I know only too well the devastating effect that that cancer can have on people’s lives. What is most insidious about melanoma in particular is that it is impossible to treat in its late stages, and it often results in a drawn-out, very painful death. Last year I had my own personal scare. I found a mole, which was malignant. After a tortured three weeks waiting for the results I found out that, luckily, the tumour had not spread—but it was malignant. The fear was magnified by the fact that my own brother died from a melanoma when he was only 54. I have therefore always taken a close interest in that type of cancer and its causes.
My brother went to his GP three times in a year before the GP eventually said, “There’s nothing wrong with you, but I will refer you”—just to get him out of his surgery, I think. By that time it was far too late, and my brother died from his melanoma a few years later; but he was never able to work again, because muscle and lymph glands had to be taken away, so he could not do his job. Neither I nor my brother used sunbeds, but given my experience of the awful disease of melanoma I cannot comprehend why anyone would want to increase their risk of contracting it. Research shows that many people who contract it probably would not have done, if they had never been able to use a sunbed.
I want to refer to some case studies highlighting the horrific effect that sunbed use can have on individuals and their loved ones. I thank the House of Commons outreach team for helping me to collate a vast and wide-ranging response, obtained thanks to the power of social media. I am so grateful to those who participated in the initiative. There were some interesting and informative discussions. I was taken aback by the significant number of responses from people who said they regularly used sunbeds in their youth and today have, or have had, a melanoma. One such lady, Jade Luelle Cope, said that she used sunbeds often between the ages of 15 and 32, and was diagnosed with malignant melanoma at 38. She stated that she does not think that it was a coincidence.
Beverley Chesters passionately advocated a ban. Describing her experience, she said,
“without a doubt these killing machines”—
as the hon. Member for Rhondda (Chris Bryant) called them earlier—
“need to be banned in a heartbeat!”
She used sunbeds in her late teens and early 20s, when
“it was the norm for everyone to walk about with the supposed ‘healthy glow’. How very naive was I. I cannot recall ever any health warnings regarding sunbeds, and yes a pair of goggles given for eye protection and that’s it! Now all these years later I have malignant melanoma, first diagnosed last August…since then I have 2 more separate melanomas, and also waiting for results of 2 further biopsies. I would not wish this horrible disease on anyone. If only I knew then what I know now I would never ever have put myself in that position of risking my life, all for a tan. My body looks like a patchwork quilt.”
Similarly, Vicki Brennan noted that she used sunbeds and now has a malignant melanoma. Tragically, she comments:
“If I knew the statistics back then I would have made an informed decision not to use them, it scares me to think how many people are putting themselves at risk. And as for banality...Tell this to the thousands enduring treatment and those who are dying. You don’t just cut skin cancer out and carry on as normal. Please ban sun beds.”
A lady who came to a meeting that I was chairing had four young children, and was only in her 30s. She knew she was not going to survive, because she had a melanoma. She was going to leave the four young children for her husband to bring up, and they would not know their mother at all because they were so young.
The heartbreaking consequences of melanoma, aligning with sunbed use, were highlighted by Elaine Broadhurst. She said she and her brother used sunbeds as teenagers.
“We had one in our own home. There was no legislation or advice on the dangers. My brother was diagnosed with melanoma and died from it two years ago aged 46, leaving a wife and two young children. I’m convinced that the sunbed use contributed to losing my brother to this deadly disease and that sunbeds should be banned.”
Hundreds of people wrote similar testimonials, which illustrate the huge personal impact that the condition has on people’s lives, and the regret that many feel, having used a sunbed repeatedly and contracted the condition as a consequence. I encourage Members to take the time to read through some of the comments on the House of Commons Facebook page.
It is important to stress that it is clear that the majority of people use sunbeds purely for cosmetic reasons and vanity. The significance and dangers of cosmetic tanning are supported by many case studies and scientific research. It is said that people feel more confident, and sometimes even slimmer, when they are bronzed. However, in reality, over time when people over-use sunbeds their skin can age prematurely, making it look coarse, leathery and wrinkled—prune-like. In the worst-case scenario sunbeds can cause burns, scars and ulcers known as basal cell carcinomas. Dr Birnie observed that there has been rising incidence of the condition in younger people, and especially in women who have used tanning beds in their teens and early 20s. I am sure that that is not the aesthetic that young people craving a tan are trying to achieve.
I am particularly concerned to learn of a trend towards sun tanning addiction, where people use the sunbed for a quick and lasting tan. Some research suggests that as many as one in 50 sunbed users are addicted to them. There are stories of people using a sunbed daily for a long period of time. I was on Radio Sussex this morning and a lady said she had for three years used a sunbed at home for an hour a day. She now has a melanoma. That is excessive use, but lower use is still deadly. Scientists from Germany and the US recently published a study showing that almost 20% of indoor tanning users have addictive symptoms.
I would like high street tanning salons that offer sunbeds to raise awareness of the potential health implications of using sunbeds, as happens with cigarette packets. I understand that the British Association of Dermatologists has explained that many tanning salons fail to provide adequate information. However, I should prefer an outright ban to the use of nasty pictures of people with burns.
There is work to be done outside the legislative reach of Parliament. I would encourage the fashion and beauty industry to take an active role in discouraging the use of sunbeds. I commend initiatives previously adopted by the fashion industry, such as when in 2012 Kate Moss and her then modelling agency, Storm, aimed to raise awareness of the dangers associated with sunbeds, to put heavy tans out of fashion. At the same time directors from 11 UK model agencies including Elite, Premier Model Management, Storm and Next signed up to a zero tolerance policy on sunbed use, to protect new and established models from the health and cosmetic effects of using ultraviolet tanning beds. It would be good to see such work continue and perhaps go further. Perhaps there should be more articles in girls’ and women’s magazines to explain the dangers of tanning in that way. We all know that models are generally young and thin—that is another issue—but they do not need a tan to look beautiful. Twiggy, in the 60s, was pretty beautiful, and she has continued to be. I doubt whether she uses a sunbed.
In 2003 the World Health Organisation responded to the serious public health challenge and published a guidance document on sunbed legislation. Since then, a number of organisations and individuals in the UK have called for an outright ban on the use of commercial sunbeds. We should also look at the practice of selling them privately, because there is then no control over how people use them. The Sunbeds (Regulation) Act 2010 banned the use of sunbeds by under-18s, but many people feel that the ban did not go far enough. It was a start, but only an all-out ban is acceptable. That idea is being explored by our European partners. France’s health watchdog says that the risk of cancer from sunlamps and sunbeds is proven and authorities should act to stop people being exposed to artificial ultraviolet rays. France is one of a number of countries that have already limited their use.
I know that many members of the public support the banning of sunbeds. I was very pleased that Melanoma UK’s recent petition to ban sunbeds in the UK received in excess of 15,000 signatures. While I received a mixture of responses on both sides of the argument from the parliamentary outreach exercise, I was struck by the support from some people in the beauty industry. I am pleased that some individuals in the industry have recognised the dangers of sunbeds and champion the safe alternative of a spray tan.
One such example is Tonina Healey, a beauty salon owner who took the decision to ban the use of tanning beds in her salon and instead has promoted a spray tan. She said:
“I have always been very uncomfortable at the use of sunbeds. I took the decision to stop the use of tanning beds in my salon, I think one of the things that should be of major concern to all salon owners, is the issue of control. I have seen articles relating to tanning addiction and of clients going from salon to salon in order to achieve ‘double’ sessions. No one in the beauty industry can legislate for that and I for one, do not want to invite a lawsuit my way—does anyone in this industry really need that kind of hassle? I do believe that that will come one day, a salon in the UK will be sued when someone develops melanoma. I don’t want that on my plate and I certainly don’t want the illness of a client on my conscience. We trained in beauty to make our clients feel good, not to watch them die horrific deaths. We support a ban.”
Brazil and Australia have already banned sunbeds commercially. Brazil was the first to ban sunbeds in 2009, the only exception being where doctors prescribed their use for health reasons. In the same year, the World Health Organisation classified exposure to UV sunlamps, sunbeds and tanning booths as carcinogenic to humans. Australia followed Brazil’s ban in 2013. Annual rates of malignant melanoma in Australia were 10 times the rate in Europe for women, and more than 20 times for men. Professor Grant McArthur stresses the success of the ban in Australia, saying:
“The Sunbed ban in Australia has been highly effective. We estimate that one unnecessary death per week has been prevented by the ban. The greatest burden of deaths from Sunbeds falls in people aged 20-40. I plead that the UK save their young people by banning sunbeds”.
To conclude, it is my view that there should be an outright ban on sunbeds, and I hope I will receive the support of colleagues in that. While the temptation to achieve that sun-kissed glow is understandable, risking contracting such a devastating disease is not. The unnecessary exposure to UV is nonsensical, and I implore anyone to get a fake tan through a bottle or can, not the sunbed. It seems wrong that people should have the option of damaging their health so greatly, purely in pursuit of cosmetic gratification.
The evidence is clear: for over three decades, deliberate sunbed exposure to UV for cosmetic purposes through sunbeds has been driving up the incidence of skin cancers and driving down the age of their first appearance. I stress again the shocking figures that people who have ever used a sunbed are 20% more likely to develop melanoma later in life than people who have never used one, and those who started using sunbeds before the age of 35 were 87% more likely to develop melanoma than people who have never used a sunbed.
I also believe that action needs to be taken to further raise awareness of melanomas and what causes them, including over-exposure to UV through sunbeds. That action should include providing stronger and clearer warnings about the consequences of sunbed usage. Being aware of the possible consequences of the sunbed should lead to a cultural and generational shift, with people avoiding exposing themselves to UV unnecessarily. It is vital that people are conscious of the impact that this awful condition can have on one’s health and personal life—something that I myself have experienced through my own personal circumstances. Please may we have a ban on sunbeds?
Mrs Latham
I thank the Minister for his thoughtful response. I hope that we can get something in the Be Clear on Cancer campaign and the Green Paper, because that would take us to the next stage. If we can prevent melanomas, it will obviously be a good thing. I thank the hon. Member for Rhondda, who talked about killing machines. Unfortunately, he is no longer in his place, as he has had to become a diplomat, educating the Germans to be diplomatic.
I also thank my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant), the hon. Member for Linlithgow and East Falkirk (Martyn Day), and the Opposition spokesman, the hon. Member for Washington and Sunderland West (Mrs Hodgson), who all made thoughtful contributions. This issue does have a very 1980s feel, as the Minister illustrated with the good example from “Only Fools and Horses”. However, it is still happening.
The Minister said that education is very important. I support a campaign for “Sun Safe Schools” in Mid Derbyshire. We had a broadcaster who died in his early 30s from a melanoma—not from sunbeds. A lot of the money raised for him was spent in schools to make them sun-safe schools, where children learn an amazing little song about slipping on a T-shirt, slapping on a hat and slopping on sunscreen. It educates not just the children, but their parents: keep covered up and keep the sun cream on.
That did not happen in my day. When I was a child, there was no sun factor. We just put on Nivea, got burnt and put on camomile lotion after that. Today, there are options for people and it is important that we educate as many children as possible, because they will educate their parents. I actually challenge builders in the street if I see them without a top on, getting burnt, and ask them if they put on sunscreen. They are very polite, usually, about my intervention.
We need to keep talking about this issue, because I passionately feel that nobody should die from a melanoma. There are familial traits, but we need to educate as many people as possible about sunbed use and over-exposure to the sun, whether on the beach, in the countryside or in the back garden. If the Minister could include it in the Green Paper, it would be an excellent step forward.
However, I would still like not only a ban on sunbeds in commercial premises, but a total ban on the sale of sunbeds in this country. I know that is draconian, and I am not a great “banner” of things, but nobody needs a sunbed—they are not necessary to anybody’s life. I thank the Minister for his thoughtful response. I hope that this has moved the debate forward. Since it is 10 years since anything has happened on this issue, let us hope it is not another 10 years before we move forward again on this particular type of cancer.
Question put and agreed to.
Resolved,
That this House has considered the health implications of sunbed use.
Oral Answers to Questions
Pauline Latham Excerpts(5 years, 3 months ago)
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Matt Hancock
Yes. The hon. Gentleman is right: that is absolutely critical.
Mrs Pauline Latham (Mid Derbyshire) (Con)
What advice can the Minister give to elderly and vulnerable people who missed out on the first wave of flu jabs? Are they still available?
Steve Brine
Yes, they are still very much available. People should make an appointment through their GP or their wonderful pharmacist.
Prevention of Ill Health: Government Vision
Pauline Latham Excerpts(5 years, 5 months ago)
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Matt Hancock
I said the opposite actually. There are environmental and economic factors, and they are very important. My point was that having a record level of jobs in this country is a benefit.
Mrs Pauline Latham (Mid Derbyshire) (Con)
In my constituency of Mid Derbyshire, there is an amazing group of community pharmacies that are saving people going into hospital and getting them out quicker. I invite my right hon. Friend to come and see them. He does not need to go to France; he can come to Mid Derbyshire instead.
Matt Hancock
I will actually be in Derbyshire later this month visiting a neighbouring constituency, but it looks like I have just put another stop on the itinerary.
Acquired Brain Injury
Pauline Latham Excerpts(5 years, 10 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
I beg to move,
That this House has considered acquired brain injury.
After the last three hours, I think the expression is—and now for something completely different.
For the past hour and a half, some of us English Members have endured watching the match—Tunisia 1: Spurs 2; I mean, England 2. It is a pleasure to be in the House, and we are very grateful to SNP Members for enabling us to watch the match.
I rise to speak to the motion in the name of my right hon. Friend the Prime Minister. I pay tribute to the hon. Member for Rhondda (Chris Bryant) and my right hon. Friend the Member for South Holland and The Deepings (Mr Hayes) for their persistence at business questions and elsewhere, and for securing this debate in the House. Brain Injury Awareness Week took place last month, which makes today’s debate especially timely.
Let me first recognise the important work of organisations such as Headway and the United Kingdom Acquired Brain Injury Forum in raising awareness and in providing information and support to those living with acquired brain injury and to their friends, families and carers. I know that some of them are with us this evening, and I thank them for their persistence during the family dispute we have had in the Chamber for the past three hours.
Acquired brain injury—ABI—is an injury that takes place after birth in an otherwise healthy brain. It includes traumatic brain injuries such as those caused by road traffic accidents, falls or assaults, and non-traumatic brain injuries related to illnesses or medical conditions, including meningitis, stroke or brain tumours. While prevalence estimates for ABI are quite hard to make, the number living with it is thought to be over 500,000 and could be as high as 1 million people. The total cost of brain injury in the UK has been estimated by our officials to be at least £1 billion per year.
Mrs Pauline Latham (Mid Derbyshire) (Con)
My hon. Friend talks about the cost of brain injuries. My constituent Stuart Tranter asked me to lobby the Government to put more money into brain tumour research, which has been very much the poor relation, and I have been successful. I congratulate the Government on having doubled that money since Tessa Jowell, who used to serve on the Opposition Benches and then went to the House of Lords, died. I am very grateful to the Minister and the Department for putting so much money into that much needed research.
Steve Brine
I thank my hon. Friend. This is the first time I have been at the Dispatch Box since Baroness Jowell passed away. As I said during the debate when she was sitting in the Under Gallery with her lovely family, I did not know her well but the one time I met her I was left in no doubt about her determination on this subject. It is great that we are able to do so much. I pass on my condolences to Jess, her daughter, whom I have got to know a little, and her family. The trauma of the immediate is horrible and it goes on for a long time. Our thoughts are with them. I thank my hon. Friend for what she has said. We will do well by Baroness Jowell, especially through the money that we will put into research to try to instigate new research projects, which have traditionally been thin on the ground in this area. We are hoping to stimulate the research market.
ABI can have a devastating impact on our constituents’ lives; even minor head injuries can cause short-term impairment. Those surviving more severe injuries are likely to have complex long-term problems affecting their cognitive and functional ability, personality, close relationships and ability to return to any form of independent life.
Oral Answers to Questions
Pauline Latham Excerpts(6 years, 2 months ago)
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Mrs Pauline Latham (Mid Derbyshire) (Con)
The Parliamentary Under-Secretary of State for Health (Steve Brine)
It is good to be back.
As I have repeatedly said at the Dispatch Box, pharmacies are a vital frontline service for our NHS, with over 1.2 million health-related visits every day. Community pharmacies have again stepped up during this winter period, and I thank them for their hard work. They have vaccinated more than 1 million people against seasonal flu since October. The Government are committed to ensuring that pharmacies and pharmacists are further embedded in the wider health service.
Mrs Latham
I thank the Minister for that answer. Will he come to Derby to meet a constituent who has pharmacies that are working very hard to keep patients out of hospital, therefore saving the NHS money through their innovative ideas?