Breast Cancer Screening

Stephen Lloyd Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

My right hon. Friend is testing my clinical knowledge here; there will be other people in the Chamber who are better able to answer that question. I am ready to be corrected by eminent experts on this, but my understanding is that, in relation to women in their 70s, for every 1,000 women there are around 12 cancers, and of those 12 cancers, around three are potentially life-threatening.

[Stephen Lloyd (Eastbourne) (LD)]

Let us be clear that this is an utterly desperate situation. We know that some women may well have died who might not have done had they been identified. However, I would like to pay tribute to the Secretary of State’s statement. It was transparent, it ’fessed up and it made clear what the Department of Health and Social Care will be doing to remedy the situation. I appreciate that. What will the Department do to raise awareness of breast cancer screening among women who are not currently registered with a GP?

[Mr Hunt]

That is an important question. We have the Be Clear on Cancer campaign, which is a national advertising campaign but, as my hon. Friend the Member for Lewes (Maria Caulfield) said, it is important for people to recognise that, if we are going to protect them from cancer, they will have to take an active and proactive role in detecting any cancers they might have. Important though the screening service might be, they cannot rely on the screening service, because their own experience of how their own body is functioning is the most important detection method of all.

Bowel Cancer Screening

Stephen Lloyd Excerpts

Tuesday 1st May 2018 Westminster Hall

[Nick Thomas-Symonds]

I absolutely agree with my hon. Friend and I pass on my condolences to him, even though the loss of his father was some time ago.

Along with my father Jeff, my wife Rebecca and my mother’s many friends, I supported her through three arduous rounds of chemotherapy, helping her to achieve her goal of living long enough to meet her grandson, my son William, who was born some three months after she was diagnosed. Owing to the care and treatment she received, her inspirational bravery and her sheer determination, she lived not only to see him born but to see him reach his first birthday in September 2017, and to see her beloved granddaughters, Matilda and Florence, reach the ages of eight and five—precious moments that are now my precious memories.

For families dealing with cancer, time is everything. Those who are diagnosed with bowel cancer have the best chance of surviving—and of surviving for much longer—if they are diagnosed at the earliest stage. This is why screening is so important.

[Stephen Lloyd (Eastbourne) (LD)]

I thank the hon. Gentleman for securing this important debate. I offer him my condolences on his dear mother’s death. He will be aware of the enormous public petition—it has received 446,000 signatures—that was started all those years ago by Lauren Backler, who also lost her mother. I have supported that campaign for a long time. Does he agree that the evidence is clear that we should be screening at the age of 50, so it is surely time for an end to shilly-shallying from the Department of Health and Social Care? Will the Minister agree to at least pilot screening for bowel cancer at 50? It is obvious that the evidence from such a pilot would be irrefutable.

[Nick Thomas-Symonds]

rose—

Oral Answers to Questions

Stephen Lloyd Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Hunt]

I have met the management team for my hon. Friend’s trust and he has talked to me on many, many occasions about that. I hope that he will have a positive answer, and if it is, that will be in no small part thanks to his campaigning.

[Stephen Lloyd (Eastbourne) (LD)]

Bowel cancer remains a major killer in the UK. The National Institute for Health and Care Excellence recognises the new FIT—faecal immunochemical test—to be a far more effective bowel screening process, but there remains a lack of clarity about when it is going to be rolled out nationally. Will the Minister provide that clarity today so that people can be saved down the line?

[Steve Brine]

The UK National Screening Committee has recommended that FIT be the primary screening test for bowel cancer, and NHS England remains absolutely committed to implementing it in 2018-19. We expect to make a decision very shortly on when that will be.

Oral Answers to Questions

Stephen Lloyd Excerpts

Tuesday 6th February 2018 Commons Chamber

[Caroline Dinenage]

Independent living schemes can keep people living healthier, more independent lives for much longer and provide the comradeship and camaraderie that keep people active and healthier. My hon. Friend is right to raise their importance, and the Government very much support them.

[Stephen Lloyd (Eastbourne) (LD)]

With reference to the integration of health and social care, the Minister may be aware that I have two outstanding respite and rehab homes in Eastbourne called Milton Grange and Firwood House. They are both under threat of closure by the county council, which says that central Government are not giving it enough money. Those homes serve a crucial purpose in supporting the local hospital. Will the Minister agree to meet me and representatives from the county council to work out a way to find the funds to keep both those vital homes open?

[Caroline Dinenage]

The hon. Gentleman is absolutely right to stand up for the good-quality respite in his local area. The Care Act 2014 requires local authorities to shape local markets and ensure that they give a sustainable, high-quality local offer. I would be more than happy to meet him to discuss that further.

Social Care

Stephen Lloyd Excerpts

Thursday 7th December 2017 Commons Chamber

[Jackie Doyle-Price]

I welcome the spirit in which the hon. Gentleman makes his comments. It is fair to say that we are hearing exactly the same sort of plea from local authorities, which are at the front end of dealing with this problem. He is absolutely right that we need to separate the short-term pressures from the long term, and we ought to be able to have a more sensible conversation on the long-term pressures. Yes, let us save the politics for the short term and have consensus for the long term.

[Stephen Lloyd (Eastbourne) (LD)]

I appreciate the opportunity to speak, Mr Deputy Speaker, as I missed the beginning of the Minister’s statement—my apologies. I concur totally with what a number of colleagues have said about the issues in the here and now. At the minute, there are significant issues for a lot of councils and a lot of care homes that cannot wait for a few years. The here and now must therefore be the priority.

I have two points to make on that. The first is negative and I would like the Minister to take it back to the Chancellor. I call on the Government to make a public commitment to fund the back-pay bill for sleep-in carers. I do not know how many colleagues know about this issue, but if it is not sorted very soon, a number of very reputable charities and organisations are likely to go bust. On a positive note, I wonder whether the Minister has read the recent BMJ report that indicated how exercise can be a significant miracle cure for older people. May I meet the Minister to share the report with her?

[Jackie Doyle-Price]

I would be happy to meet the hon. Gentleman; I am always looking for solutions. He is absolutely right that if we can look after our own wellbeing—both physical and mental—more effectively, the need for care will diminish. That is another reason why we need to have this public debate. Like the hon. Member for Birmingham, Erdington (Jack Dromey), the hon. Gentleman has mentioned sleep-ins. It is a big issue, but we are working closely with the sector to make sure that we can address it.

Deafness and Hearing Loss

Stephen Lloyd Excerpts

Thursday 30th November 2017 Westminster Hall

[Stephen Lloyd (Eastbourne) (LD)]

It is a privilege to serve under your chairmanship, Mr McCabe. I join other hon. Members in congratulating the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) on securing the debate. I was chair of the all-party parliamentary group on deafness, but was rudely interrupted in 2015 when something else happened. It is a pleasure to be back and to serve as vice-chair of the APPG under the hon. Gentleman’s excellent chairmanship.

I commend the previous speakers’ comments about cochlear implants. I remember 20 or 30 years ago, when they really began to take off. The difference between now and then is absolutely huge. That overlaps with what the hon. Member for Rochester and Strood (Kelly Tolhurst) described of her mother’s experience. I thank her for that moving speech. Her mum will be proud of her, I am absolutely sure of that. I can relate to a lot of the things that her mum went through. I have been deaf for about 50 years of my life.

Cochlear implants have made a huge difference and the improvement is absolutely massive. The Minister is from the Department of Health—he is an old colleague from coalition days; it is good to see him—and I ask him to explore how cochlear implants can be ever more available, because they do much more now and they do it much earlier. They are a game-changer. For many years after they first came out, a long, long time ago, they really did not make that much of a difference. There was vigorous opposition from a lot of the British Sign Language community, and I understand why. That has changed a great deal over the years and cochlear implants are now, in many ways, the future for transforming deafness. I never really believed it in the old days, but now I do, because of the advances.

I would like to cover a few areas, a couple from the UK Council on Deafness angle and a couple specifically because we have a Health Minister here. British Sign Language is a different language. I am hard of hearing and have been since having measles when I was six. Sometimes, people might say to me, “Stephen, are you a member of the deaf community?” and I would say, “No, I am a member of the hearing community. I just don’t hear very well.” That is an important point, because they are completely different. The deaf community is a community. The BSL community is a completely different community, with cultural norms and a different language. BSL is not even a direct translation of my speech; it is different. Sometimes people do not understand that. They would say to me, “Why don’t you learn BSL?” and I would say, “Because I am a member of the hearing community, I just don’t hear very well, and it is a different language.” I am very supportive of profoundly deaf people trying to get BSL as a recognised language, as has happened, I believe, in Holyrood in Scotland.

I remember just before 2015 having meetings with a number of people down from Scotland and we were watching that development with great interest. Once it happens in one legislative House, it is very hard for other legislative Houses not to follow, so I say good luck with that up in Scotland, because it is a game-changer. It will happen eventually in Westminster. When it does, it is not just a label. When a nation says that a language is a statutory language, it means it is accessible and that public bodies have to provide information in that language, and that will make a huge difference for a lot of profoundly deaf people. I will tell hon. Members why and give one very good example.

I have been involved for many years in politics around deafness as a trustee of this or a patron of that, or what have you. I knew a lot of people who are profoundly deaf working in that area, including from the British Deaf Association. I just came from a statement this morning in which the Secretary of State for the Department for Work and Pensions mentioned that about 50% of disabled people are out of work. I tell you what, Mr McCabe, it is a hell of a lot higher than that for the profoundly deaf. I do not have the figures because no one really finds them. The DWP—it used to drive me crazy when I was here before—will not slice the different disabilities up. It just says “problems with deafness and problems with visual impairment”, which completely denies the separateness of deafness. Off the bat, though, I would say that profoundly deaf people have an unemployment rate of around 70%, which is just ridiculous. How can we possibly have 100,000 people—if not more—of adult working age and have such barriers that 70% are unemployed? It is a blooming outrage! Now that I am back in the House, which is wonderful for the people of Eastbourne—I thank them—I am determined to lobby hard to make BSL an accepted language.

I am also keen to join the hon. Member for Poplar and Limehouse in lobbying on Access to Work. The Government have done a great thing with Access to Work—I think it was John Major’s Government that started it. Access to Work is a good thing which has made a huge difference to a lot of people, and I am a big supporter or it, but there is a challenge. It has made a great difference for people who are in work and acquire a disability through illness, a catastrophic incident or what have you—it has been fantastic in helping them to stay in work. I want it to be improved, particularly in the small and medium-sized enterprises sector, so that SMEs understand that they can employ people with disabilities. Access to Work provides a lot of the money that will buy an induction loop, put in a ramp, or do whatever is necessary to help an employer take on a disabled person. That is really important. Corporates kind of get it—they are huge, and they have massive human resources departments and pots of money, so they try to do their best. It is much harder for an SME employing three people. If I were the director of a plumber working seven days a week, and someone with disability came to see me, it would be so much easier to say, “No, no,” and find an excuse not to employ them. Access to Work often provides the money that allows the SME to take on that disabled person.

I will let the House into a vast secret. I say this with authority, because I used to be a consultant in this area for years. If a business employs disabled people, they get lower churn.

[Matt Western (Warwick and Leamington) (Lab)]

rose—

[Stephen Lloyd]

I have seen that in call centres, in businesses and in numerous other areas. I used to be very involved with the Federation of Small Businesses, and I am sure I will be again now I am back. Lower churn is really important for businesses if a lot of their spend goes on employing people. At a later date, I will explain why it leads to lower churn, but it does.

[Matt Western]

Will the hon. Gentleman give way?

[Stephen Lloyd]

Yes, certainly—sorry.

[Matt Western]

The hon. Gentleman is talking about the challenges that SMEs have in employing people with such impairments. Does he agree that it is difficult for many people who suffer from deafness or failing hearing to progress within organisations because of the cap? It is therefore almost self-enforcing that those people are pressed into part-time working.

--- Later in debate ---

[Stephen Lloyd]

That is a very good example. I have no hearing on my left, so I could not hear the hon. Gentleman trying to intervene. Jim knows to punch me.

The hon. Gentleman is right. There are issues to do with Access to Work. As it has expanded and cost a lot more money over the years, the Government—I am not chucking stones, as I know how challenging it is to work within the Budget envelope—have introduced more and more caps. Rather than focusing on different ways of capping Access to Work, I would like the DWP—the Minister can go back and tell his colleagues—to focus on better and more creative ways to use the money. I know from years of experience—colleagues will have to take my word for it—that the majority of disabled people who get into a job, are properly managed and have the right support, stay there for years. That costs much less money than constantly having to re-employ. I thank the hon. Gentleman for the intervention.

I want to talk about two key areas that are specific to the Minister’s brief. One of the things I fought for last time I was here—I am going to do so now as the Minister is in Health—was an automatic invitation for a hearing aid screening whenever someone hits pension age. That would be at 65 or 66, although that was under the coalition—I think retirement age is 150 now. That is significant because something like 50% of people over the age of 65, heading up to 60% as they get older, begin to get age-onset hearing loss. My hearing loss is not age-onset, although I am old enough now—it was measles, as I said—and the hon. Member for Poplar and Limehouse is far too young, so his cannot possibly be age-onset. The thing with hearing loss is that the vast majority of people ignore it for 15 years because it is not a sexy disability. The hon. Member for Rochester and Strood flagged that up, and it is true. People start losing their hearing, they do not admit to it, their husband or wife goes potty, the volume is turned up massively on the television, and eventually their kids drag them to the audiology department, if it is still open—we will come to that—in their mid-70s.

The problem with that—there is significant data to prove this, which I will happily share with the Minister another time—is that the longer someone takes to get a hearing aid, the lower the chance of it working. The difference between a 75-year-old and a 65-year-old in acuity terms is enormous. Hearing aids are not like glasses. If I cannot see properly, I put glasses on and I have 20:20 vision. Hearing aids do not replace lost sound; all they do is amplify the residual hearing. Let me try to explain that to colleagues very quickly. Imagine a radio with a battery that is running down. If the volume is turned up, it makes a lot more sound, but it is very discordant. That is what hearing aids do.

I was pressing very hard for the Department of Health to run a pilot so that all people who get to pensionable age receive an invite to audiology or wherever—it could be a pharmacy, for that matter—to have a hearing test. My rationale for that, which was supported by pretty much every group that could possibly be imagined, including NICE, was that if people get in early, they are forced to accept they are losing their hearing. They get a hearing aid, and ipso facto it is much easier to get used to. My view, which is shared by many others, is that that would be a huge advantage, not least in reducing the levels of dementia. We have discovered that dementia is linked to social isolation, and old people who are deaf or hard of hearing tend to isolate.

The Department of Health agreed in principle to run a pilot. It took me a long time to get that agreement, because the Department did not want to do it. It knew that I was right and all those extra hearing aids were going to cost a lot more money. Then there was a tragedy, colleagues: I lost the election. I was not there to nag like hell, and it sort of disappeared and was put on the back burner. I am delighted to see that my old colleague is now the Minister. I am sure that, now I have put that on the table, he will move heaven and earth to develop it into a pilot. It will make a huge difference to hundreds of thousands of people—I am deadly serious—so I encourage that.

It is easy to cut hearing aids, because it is mostly old people who use them. They are not organised and are not going to complain like hell; they are isolated, anyway. As I said, they are in their mid-70s by the time they go to audiology departments. I am really pretty angry that a lot of CCGs are getting away with beginning to trim audiology services because there are not enough people fighting their corner. I know that CCGs are independent, but the Minister and I also know that there are protocols. In his response, I ask that he make a commitment that CCGs will be told how important audiology and hearing aids are. They must not use the austerity challenges they face to cut audiology. On that note, I again thank the hon. Member for Poplar and Limehouse for securing this debate.

--- Later in debate ---

[Sir Mike Penning]

Governments need to be kicked and beaten up when they get things wrong and praised when they get things right. I was proud that a Conservative Government brought in Access to Work, which is massively important. There will always be examples of abuse in the system and so on, but that does not give the Government carte blanche to say, “No, the only way this can work is with a cap,” particularly if the evidence does not show that a cap will work. The Minister will have looked twice when he came into the Chamber and realised what this debate would mostly be about, which is not his responsibility but the DWP’s. I am more than happy to go across to my old Department and sit with my old officials and explain to them exactly where the evidence is in their cupboards.

Let me touch briefly on two other areas, and then on one thing that has not been touched on at all. I do not understand why, in the 21st century, a recognised language is not recognised in the House or across the country. I really do not understand why, all these years after I made a point of order in the main Chamber in 2005 to complain that a hearing loop was not available for my constituents when they were in the House—even when it was installed, it did not work properly—this is the first time a debate has been signed for our constituents. People will always go on about how that must cost more money. The cost is minimal compared with the benefit to our constituents of being part of the democratic process.

[Stephen Lloyd]

I thank the right hon. Gentleman for kicking off about the induction loop years ago, because I could not function as an MP in the Chamber without it.

[Sir Mike Penning]

The things I do for everybody in this House. It was genuinely embarrassing. I remember it vividly. I said to the Speaker, Michael Martin, “My constituents have come to see this world heritage site and their Parliament at work. I took them on a tour, and frankly they got hardly any benefit apart from visuals, because they couldn’t understand or hear a word I was saying.” I seem to remember that there was the comment, from a sedentary position, “Well, they didn’t miss very much,” but I was trying to get across a point. This is the mother of Parliaments, and as we have heard from colleagues, we are way behind the loop again. I am sorry to use that terrible pun, but we are really behind. I hope that we will have a lurch forward. I have noticed all the Clerks coming in, and have heard that the Speaker will be reported to, and all that, and that is great, but it is absolutely useless unless someone actually does something. Then we can move on. I know this is a trial, but signing should be transmitted live.

Secondly, there should be a GCSE. I find it fascinating: we can see all the different courses that our young people do in schools and colleges, yet they are excluded in this way. If people do not want any more GCSEs, we could drop one of the ones that would not get used anywhere near as much as this. It would make people aware. In my constituency, people who are not deaf or hard of hearing have said to me that they want to be able to communicate like this; they want to do these courses as well. They want to have a GCSE, so that they can chat away with their mates in that sort of way. That is a simple thing, and I cannot see huge cost implications, so it should be moved on, as we have heard this afternoon.

Finally, I will touch on people whose hearing has been impaired by industrial injuries. That has not been mentioned at all in the debate, but not because people think it should not be. It is just one of those issues. People cannot see this type of industrial injury. It is not like the industrial injuries that my hon. Friend the Member for Poplar and Limehouse and I saw in our former jobs as firemen. There is something very wrong about how we measure industrial injuries, and hearing impairment industrial injuries in particular. So many people who have a hearing impairment do not admit it to themselves, their wives and their loved ones, even though their wives and loved ones are probably aware that there is an issue. They certainly do not talk about it to their employer or previous employers.

I can talk about this, because my eardrum is perforated. I did not know about that until I started to miss conversations that I thought I should be picking up. You just do not think there is something wrong. However, when I was a Minister at the Ministry of Defence, I had to have a medical before I was allowed to go into operational fields, and it was obvious that I had a perforated eardrum. It was almost certainly from live firing when I was in the armed forces—the specialists told me that—although it was not picked up then. That is not so important to me, but where industrial injuries are common, it is massively important that there be a level playing field on decibel levels. Completely different levels are used for hearing damage in the armed forces and what I call civvy street, and that cannot be right.

We must encourage people to come forward, not so much so that they can get compensation, but because, as we heard earlier, if we can pick this up earlier, it saves the state and everyone a lot of money, and also makes life much better for that person, who can start to accept the disability that they have and continue to live a happy life.

[Ms Karen Buck in the Chair]

Maternity Safety Strategy

Stephen Lloyd Excerpts

Tuesday 28th November 2017 Commons Chamber

[Mr Hunt]

First, may I apologise to my hon. Friend, because I should have mentioned her in my statement as someone who has spoken very passionately and movingly on this topic in the House? I will take away her point about specialist coroners, because we are now going to have specialist investigators, which we have never had before. I would make one other point. I hope she does not think I am doing down her former profession, but really when people go to the law, we have failed. If we get this right—if we can be more open, honest and transparent with families earlier on—it will, I hope, mean many fewer legal cases, although I am sure that the lawyers will always find work elsewhere.

[Stephen Lloyd (Eastbourne) (LD)]

I welcome the Secretary of State’s statement, like many others in the Chamber. He talked several times about learning lessons. As he knows, a recent report has highlighted that in my own trust, the East Sussex Healthcare NHS Trust, there were 19 stillbirths last year, which is a far higher percentage than in the rest of the UK. In the spirit of learning lessons, will he agree to someone in the Department of Health examining why that is the case?

[Mr Hunt]

I absolutely undertake to look into that case and ensure a proper investigation into what is happening. The hon. Gentleman is right; in the end, we need to be much more open about this data, so I commend the trust for sharing the data publicly. Until we access such data, we will not know where the issues are that we need to solve.

NHS Shared Business Services

Stephen Lloyd Excerpts

Tuesday 27th June 2017 Commons Chamber

[Mr Hunt]

My hon. Friend is exactly right. Of course we welcome the fact that no patient harm has been identified to date. We have to wait until the process of the third clinical review is completed on at-risk patients’ records, which will happen by the end of December. She is absolutely right to say that SBS is no longer performing this contract; it has been taken in-house. Other parts of the SBS contract not related to what we are discussing today were given to another supplier.

[Stephen Lloyd (Eastbourne) (LD)]

Does the Secretary of State agree that this is a very straightforward case? It shows a woeful lack of transparency, is a good example of why so many of us have concerns about too much private sector involvement in the NHS and, bluntly, there is a conflict of interest for the Secretary of State.

[Mr Hunt]

I acknowledged in my statement that there is, or was, a potential conflict of interest when the contract with SBS was in operation, and the National Audit Office talks about that today. In reality, as the National Audit Office confirms, patient safety was always our overriding priority in all the decisions we took. I suggest to the hon. Gentleman, as I do to the shadow Health Secretary, that he would have taken exactly the same decisions had he been in my shoes.