ME: Treatment and Research

Alex Sobel Excerpts

Thursday 21st June 2018 Westminster Hall

[Dr Drew]

I agree, and the hon. Lady makes her point strongly. All I will say is that I will concentrate mainly on the medical side of things. However, everybody needs to be more aware because of the numbers—two in every 1,000 people are thought to suffer from the condition.

We have heard a lot about the PACE trial and the need for NICE to rewrite its guidelines, so I do not really want to labour those points, other than to say that it is not helpful that cognitive behavioural therapy and graded exercise therapy are still suggested as the appropriate way forward after ME diagnosis. We know for all sorts of reasons that that is not so. I am sure the Minister heard that and will want to comment on it.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My constituent was diagnosed with ME but, after going for a private test, it turned out to be Lyme disease. That shows the lack of knowledge and the confusion in the medical profession between those two conditions and others.

[Dr Drew]

If my hon. Friend reads Dr Shepherd’s book, he will see some of the overlap between Lyme disease and ME, as the hon. Member for Glasgow North West mentioned. That is why this whole area needs proper diagnosis and a proper investigation into some of the research implications.

On research, as has been made patently clear by other Members, most of the research is self-help. That is not good enough. This is a major condition that affects lots of our constituents, and yet they are asked to raise all the money for research themselves. That is not good enough, so we clearly ask the Government—as the Minister will have heard—and the research councils to give ME the priority that it deserves.

ADHD Diagnosis and Treatment

Alex Sobel Excerpts

Tuesday 15th May 2018 Westminster Hall

[Jo Platt]

I thank my hon. Friend for that intervention. He is right that we need more awareness of ADHD. I know that people who suffer with ADHD have called for their own Act—something similar to the Autism Act 2009.

In the midst of cuts to school nursing provision, and a school funding and teacher recruitment and retention crisis, the number of school exclusions of pupils with special educational needs is no fault of our hard-working, dedicated and professional healthcare workers and teachers; it is the product of an underfunded and under-resourced health and education system. We cannot go on treating children with ADHD simply as naughty kids, and being unable to afford the time or resources to help them. Instead, we must support those young people and focus their education around their skill set.

The second way we are letting people with ADHD down is through diagnosis. A recent survey with more than 800 responses revealed that 70% of respondents had waited 18 months or more for an ADHD diagnosis, 9% of whom were, shockingly, waiting for more than three years.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

I recently asked three parliamentary questions on waiting times for assessments for ADHD, and for all three the response was that those figures were not collated. We cannot do anything about it until we have accurate data. Does my hon. Friend agree that the Minister and the Department should be collating that data?

[Jo Platt]

I thank my hon. Friend, the vice-chair of the all-party parliamentary group for ADHD, for that intervention. He is absolutely right to mention that the lack of data causes a mismatch and a bit of a postcode lottery, which I will address later.

At a recent APPG meeting, we heard stories of people waiting years for a diagnosis—years battling without the support or guidance they need, falling behind in school, or struggling in their occupation. We heard stories like that of my constituent Mick, whose son has suffered enormously, falling into crime before he was diagnosed, which unfortunately is all too common. About 25% of male prisoners are thought to have ADHD.

Education (Student Support)

Alex Sobel Excerpts

Wednesday 9th May 2018 Commons Chamber

[Karen Lee (Lincoln) (Lab)]

As Members probably know, I was a nurse until last June. I did 12 years in cardiology and almost three in out-patient gynaecology clinics. As an ex-nurse, I could not be any more in opposition to this amendment to nursing bursaries, as I am concerned that it will fail to address the problems with nursing recruitment and will intensify the fall in applications to nursing courses. Overall, applications have fallen by 33% since March 2016, when bursaries were withdrawn. At that time, the Royal College of Nursing, a much respected and non-political body, said the changes were unfair and risky, and the Royal College of Midwives argued that the move threatened the future of maternity services in England.

I hope that all of us in this Chamber acknowledge that there is a workforce crisis across the whole NHS. As the RCN has said,

“plans by the government to remove the NHS bursary for pre-registration students in England must be stopped immediately”.

It goes on to say that

“nurses need bespoke financial support if the government is to meet its commitment to grow the nursing workforce and meet the future population demand for health and care services”.

The National Audit Office has reported that the impact of the EU referendum appears to be driving EU nurses away, and both the Care Quality Commission and the NAO have raised safety concerns relating to nursing shortages—it is not just Opposition Members who are saying that.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend gave many years’ service as a nurse and I am sure she worked with many nurses who came here from abroad. The Migration Advisory Committee has placed nursing back on the shortage occupation list. In the light of that, is not this statutory instrument wrongheaded, as we need nurses to come through all routes if we have a nursing shortage?

[Karen Lee]

I completely agree with that.

There are 40,000 nursing vacancies across the NHS and, for the second year in a row, more nurses are leaving the profession than joining, with one in three expected to retire in the next 10 years. The Government have made much of the nursing associate role and apprenticeships for nurses. Nursing associates provide a support role for nurses, and the RCN feels that diluting and substituting registered nurses with associate nurses has potentially life-threatening consequences for patients. That is the RCN saying that, not me.

This Government also speak in glowing terms about the apprentice nurse role. I do take the points made by the right hon. Member for Harlow (Robert Halfon)—he means well—but it takes four years to train as an apprentice nurse and our health service is, as the RCN says, in crisis right now. Furthermore, this route is not currently providing the 1,000 new nurses per year that the Government planned for, with RCN figures suggesting that there are just 30 apprentice nurses at present—I will give that answer.

I was a mature student. I was 41 when I started my training, and a single parent. We have heard a lot tonight about how we will encourage people who do not want to go down the university route. I worked in Tesco on a checkout. I had been to grammar school and it had failed me, so I had to go to night school to get my A-levels to become a nurse. That took me a year, three nights a week, on top of working. I then worked for three years as a nursing student to become a nurse. I could not have completed my training without a bursary. I also borrowed £5,000 a year from the Royal Bank of Scotland, so I came out hugely in debt, even though I had a bursary, and it took me five years to clear that debt.

Social Care

Alex Sobel Excerpts

Wednesday 25th April 2018 Commons Chamber

[Barbara Keeley]

That is almost the situation we are in at the moment. It is worth thinking about why we seem to have this issue with Allied Healthcare, given that the problem has occurred in the last few days. It was reported that Allied Healthcare’s cash-flow problems had been triggered by increases in the national minimum wage for care staff and by an £11 million bill for back pay owed to sleep-in care staff. However, Allied Healthcare is not the only provider that is facing a large back-pay bill for care workers on shift. Learning disability social care providers have warned that they will have to withdraw services or close altogether to pay the bill for back pay, placing the care of even more people in jeopardy and putting care staff jobs at risk.

This trend of closures and contract cancellations is set to continue. A recent report into residential care by the Competition and Markets Authority painted a bleak picture of the current care home market.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

I recently met Lifeways Group, which looks after thousands of people with learning disabilities and has many hundreds of staff who do sleep-in shifts. It pays above the national living wage and is a good employer, but it cannot afford the back-pay claims if the finding goes against it. Should the Government not provide the funding to support these organisations?

[Barbara Keeley]

It is reported, in fact, that the total back-pay bill across the social care providers that provide sleep-in cover will be about £400 million, so it is not surprising that a care provider such as Lifeways would say that. The Government have to come up with answers for this, because there has been a dragging of heels, the guidance has been very confusing, and it is a serious matter. I understand, too, that the Government have completed two reports, but they have not been made public. Hon. Members and I would certainly welcome having those reports placed in the Library so that we can get that information.

We have seen warnings from the Competition and Markets Authority that care homes would find themselves having to close or move away from local authority-funded care because the funding is now only just covering day-to-day running costs. It is quite clear from all this that there is a growing funding gap in social care that must be filled. The Local Government Association has said that our social care system needs an immediate injection of £1.3 billion to fill that gap, and this is projected to rise to £2.5 billion by 2020, according to the King’s Fund.

In our last Opposition day debate on social care, in October, the strain social care was under—from the weight of growing demand, reducing supply and the lack of funds from Government—was plain to see, but since then the system has cracked still further under the pressure of Government funding cuts.

Privatisation of NHS Services

Alex Sobel Excerpts

Monday 23rd April 2018 Westminster Hall

[Alex Sobel (Leeds North West) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank all those who signed the petition, including the 512 signatories in my constituency. I spoke at a “Save the NHS” rally a couple of weeks ago, and privatisation was one of the top issues for people who attended that rally and spoke to me afterwards. I will make some the points I made when I spoke at that rally.

Week after week, people stop me, come to my surgeries and write to me asking why their local GP has left and been replaced by locum doctors, why A&E waiting times are increasing or why the services they rely on are verging on unsatisfactory and in some cases negligent— I have some negligence cases running. The short answer to those questions is a lack of money in the system. The more complex answer is that the decline in NHS funding has placed strong pressures on healthcare providers right across the NHS to adopt new practices and governance structures. Many of those changes have taken place beyond the public eye and without sufficient scrutiny. The benefits from those changes are far from evident. My hon. Friend the Member for Stroud (Dr Drew) asked many of the questions I had intended to, which will reduce the amount of time I will take in this debate —so I thank him for that—but that allows me to make some broader points. I support all the questions he asked the Minister. However, there is one point, which I will come to, on which I have a slightly different point of view from my hon. Friend.

The Leeds Teaching Hospitals NHS Trust, in an attempt to balance its books, has proposed to take 1,000 NHS workers out of the public sector and place them in a wholly owned subsidiary company. There was a meeting on 29 March to make a decision. After interventions by myself, four other colleagues in Leeds, the trade unions, campaigners and members of staff, there was a stay of execution on that decision and it will be looked at again. Therefore we are not quite in the situation that my hon. Friend has in Gloucestershire, where the change has already happened, but we are approaching it, which makes it all the more important for us to have the debate and to engage with the Department of Health and Social Care and its Front-Bench team. The wholly owned subsidiary company would take staff who have spent their entire career in the public sector and place them in a highly uncertain position regarding their working conditions, salaries and pensions—all points that my hon. Friend made.

A wholly owned subsidiary company structure has already been implemented elsewhere in Yorkshire—in Airedale and Barnsley—and the primary driver is financial. Once the subsidiary company is in place, it can recoup VAT and make significant savings. What is the solution? My hon. Friend suggested that the Treasury close the loophole, but my suggestion is quite different: the NHS, at trust level, should also be able to recoup VAT. Let us create a level playing field in which the NHS has the same rights and benefits as a wholly owned subsidiary company. That would effectively just be a technical change. I hope the Minister will talk to his Treasury colleagues and look at whether those same benefits can be given directly to an NHS trust.

I am not asking for that change for ideological reasons, although I have heard a lot of ideology today. Rather, I am speaking up for the porters, cleaners, lab technicians, receptionists and administrative officers who work in the trust and in other trusts that are considering going down that road or have done so. They tell me that they are motivated to work above and beyond at the trust because they are part of the NHS. They work the hours that they need to work because they are part of a family. They and their colleagues are born of the NHS—an NHS born alongside my hon. Friend the Member for Ealing North (Stephen Pound) in 1948. They do not want to be seen as a moveable commodity. They view themselves as a core part of the NHS, just as much as the clinicians. We need to recognise that.

[Rachael Maskell]

York Teaching Hospital is going down the same lines in creating a wholly owned subsidiary company, yet the staff want to belong to the NHS—that is their ethos and that is what drives them. It is also important for full integration across the whole service, because people who work as porters and cleaners are as much about patient care as anybody else in the NHS. Does my hon. Friend agree?

[Alex Sobel]

Absolutely. When I go into our local hospitals as an MP or as a patient, I see that they are the beating heart of the NHS.

I ask trusts, such as Leeds, that are considering setting up a subsidiary company to put a halt to those plans and to work with their staff, representative trade unions and local MPs prior to making the decision. I ask them to do what is best for all involved, whether patients, staff or the community.

Cost pressures create perverse incentives for people to consider privatisation. We have rehearsed that argument quite well. They affect not just NHS hospital trusts but clinical commissioning groups for primary care services, NHS England and other NHS bodies. We need to take those perverse incentives out of the system so that privatisation does not happen by the back door—instead of being done by the Government through statute—which is what is happening.

Autism

Alex Sobel Excerpts

Thursday 29th March 2018 Commons Chamber

[Paula Sherriff]

I thank the hon. Gentleman for his intervention.

NICE recently recommended the creation of an autism register so that areas where autism may be under-diagnosed can be identified. Following that, the Government committed to including autism in the primary care register. Will the Minister update the House on the implementation plans for this scheme?

We must also ensure that post-diagnosis support is in place. We know that parents have raised concerns about being left with no support during and after the diagnostic process, not being signposted to other advice and help, and not even getting a written report of the diagnosis. Too often, there are significant barriers to accessing the right treatment. In a previous debate, we heard the shocking case of a young boy who was having suicidal thoughts, but was rejected four times for treatment because he had not yet made an attempt to take his own life. The Children’s Commissioner for England confirmed concerns about that issue when she stated to the Health Committee that this type of situation was now “the norm” within children’s mental health services. That is worrying for children’s wellbeing generally, but particularly so for those living with autism.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Does my hon. Friend agree that we need increased support in schools? Nearly 77% of parents say that their child has to wait more than six months for support at school. It is just as important that a child gets support at school as in the health system.

[Paula Sherriff]

Once again, I absolutely agree with my hon. Friend. I will go on to talk about that matter in a moment.

GPs may also need to tailor the way in which they communicate with patients. For instance, they may need to use clear language, or to find ways to communicate with somebody who does not speak. To do that, GPs must be able to access detailed and accurate records about their patients’ needs. Currently, GPs often do not record much information about their autistic patients, and may not even record at all that a patient is autistic. The five year forward view for mental health recommended that NHS England should develop autism-specific mental health care pathways. If the Minister could give us any more information on that I would be very grateful indeed.

As I alluded to earlier, early intervention is key for communication and language skills, which are closely linked to life chances for people with autism. Perhaps the Minister could address the new communication therapies that are being trialled, such as pre-school autism communication therapy, and the pilot studies in Plymouth and Bangor to test new post-diagnosis support programmes. If these programmes are successful, what steps will the Government take to ensure that they are rolled out?

In education, children with autism and other special needs are all too often paying the price for cuts. The first real-terms cuts in school budgets for a generation have put enormous pressure on schools. The vast majority of school budgets are spent on staff costs, and that makes it hard for schools to keep their current staff and maintain the necessary level of pastoral provision. As a constituency MP, I know how the cuts have hit my own borough of Kirklees. The Government’s new funding formula leaves councils needing to take money for central high-needs funding from the amount allocated to schools. That means that schools may now face a cut of up to 1.5% in per-pupil funding.

More than 4,000 children in England with approved education, health and care plans still receive no provision. There was an increase from 1,710 in 2016 to 4,050 in 2017, which was five times the number in 2010. The impact on children with autism was laid bare by the recent inquiry by the all-party group. More than four in 10 families have been turned away when asking for the extra help that their child needs, and 70% of parents said that their child waited more than six months for support at school, with 50% waiting more than a year. I could go on with yet more shocking statistics, but I think the reality is evident. Does the Minister have any response to the all-party group’s recommendations?

If we let down children with autism in education, the impact is felt when they become adults seeking employment, as we have heard from a number of Members this afternoon. In 2015, the Government pledged to halve the disability employment gap, but they watered that down in their 2017 manifesto. Analysis from the TUC found that the Government were years behind schedule on their 2015 manifesto commitment to halve the disability employment gap, and at current rates of progress that would take until 2030 to achieve.

There is an urgent need for improved in-work support for people with disabilities. The Government must act to strengthen and enforce workplace rights, and to improve support for employers to help their employees to stay in work. That would be good for everyone, because a 10% rise in the rate of disability employment would represent a £12 billion gain to the Exchequer.

The autism employment gap is even wider than the disability employment gap. Over the past 10 years, there has been no real change in the numbers of autistic people in full-time work, with the percentage rising from 15% to just 16%. The National Autistic Society found that less than a third of autistic adults were in some kind of paid work, even though more than three quarters wanted to work. There are concerns that this is not even monitored, so perhaps the Minister will address that point. The NAS has also called for an autism employment pathway, an awareness programme for employers and targets for getting people with autism into work. I hope that the Minister can tell us how the Government intend to respond.

Finally, there is the simple question of awareness, which we have touched on a number of times this afternoon, with contributions from my hon. Friends the Members for Bristol West (Thangam Debbonaire), for Cardiff West (Kevin Brennan) and for Coventry South (Mr Cunningham), my right hon. Friend the Member for Knowsley (Mr Howarth), the hon. Members for Luton North (Kelvin Hopkins), for Berwick-upon-Tweed (Mrs Trevelyan) and for Cleethorpes (Martin Vickers), and my hon. Friend and neighbour the Member for Huddersfield (Mr Sheerman). The research shows that only a small minority of people with autism feel that the condition is widely understood. The work of the charities and other organisations in this area is commendable, and hon. Members who have spoken today have done their bit to raise awareness. Will the Minister tell us how the Government will do the same?

The testimonies that we have heard from Members this afternoon starkly show just how crucial it is that more is done on the issue. The power to make meaningful change is in the Government’s hands. I hope that they have listened and will act accordingly.

 Orkambi and Cystic Fibrosis

Alex Sobel Excerpts

Monday 19th March 2018 Westminster Hall

[Ian Austin]

My hon. Friend is completely right. This is what politics is about. What are we here for? We are here to listen to people in our constituencies. It is our job to come here and speak up on their behalf, which is exactly what she has just done.

I want the Minister to look really carefully at the way in which NICE works. This is not a criticism of NICE, the Government or anyone else, but new drugs are being developed and technological changes are happening so rapidly that I want to ask whether the way in which drugs are assessed, licensed and approved still works. My central question is: how are Ministers going to ensure that these ground-breaking drugs and new developments are made available much quicker?

In 2016, NICE was not able to recommend the use of Orkambi due to uncertainty about its long-term value, impact and cost-effectiveness. Vertex submitted a fresh proposal last month. On Friday, NHS England said:

“Following advice from Nice, the NHS has asked this particular drug company to review its proposed pricing. Unless this happens, further progress at this time is frankly unlikely.”

What sort of hope does a blunt statement such as “frankly unlikely” give people with cystic fibrosis? How does it give us any confidence that new drugs such as Symdeko, which is due to have its marketing authorisation confirmed by the European Medicines Agency in the coming works, will be approved as well?

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend is making an excellent speech. A constituent who has two children with cystic fibrosis wrote to me:

“I have lived at first hand now for 42 years in close proximity to this cruel disease…Orkambi, expensive as it is, will offer a possible lifeline to many CF sufferers. On the cost effective side I think it is worth pointing out just how expensive it is to hospitalise and treat CF patients when they are ill, as happens frequently.”

She went on to say that the local facilities are superb, but:

“The cost of any drug that reduces the number of hospital admissions would I am sure, be at least significantly off set by the savings in NHS”.

Does my hon. Friend agree that it should be proved on that basis?

PACE Trial: People with ME

Alex Sobel Excerpts

Tuesday 20th February 2018 Westminster Hall

[Carol Monaghan]

Absolutely. The public perceive it as mere tiredness, but it is so much more than that. The debilitating pain that ME sufferers experience is something that we all should be aware of.

The participants in the PACE trial received a range of different treatments, including cognitive behaviour therapy and graded exercise therapy, where patients were encouraged to become physically active and then increase the activity’s intensity. Unbelievably for a trial this large, none of the groups was given specific medical interventions. The results were published in The Lancet in 2011, with the contentious claim that CBT and GET brought 30% of patients back to normal, while 60% improved. The media reported that all ME sufferers had to do to recover was exercise. However, the report was immediately questioned by the patient community. How could exercise, the very thing that was known to worsen symptoms, actually help?

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My friend Jo from Leeds wrote to me:

“I’ve had CFS/ME for 25 years. I’d had it for 10 years before it was diagnosed. When I was diagnosed in Sheffield I was told there was literally no service they could refer me to and relied largely on a local support group. I was told by a Leeds GP to ‘just get on with life’ despite trying to hold down a professional job and look after a young child.”

That is a typical story of somebody with ME.

[Carol Monaghan]

I thank the hon. Gentleman for his intervention. It is typical, because the PACE trial had such publicity and was lauded by many as the answer. One participant in the original trial has contacted me:

“I was determined to be a part of the...trial because I wanted to get better—so if this ‘treatment’ could make me better I wanted to give it the chance to do so. I was assigned Graded Exercise Therapy. It never occurred to me that it would actually make me more ill. Nor did it occur to me that decline would not be documented, and that despite patients not recovering (or in some cases worsening), they would publish that the treatment was successful...It was stressed that I would only get better if I tried harder, and even though the graded exercise was clearly making me worse, my struggle and pain was dismissed.”

Misuse of Xanax

Alex Sobel Excerpts

Monday 15th January 2018 Commons Chamber

[Bambos Charalambous (Enfield, Southgate) (Lab)]

Until five months ago, I was oblivious to the existence of the drug Xanax. It was only after I was contacted by a concerned mother that I became fully aware of the problem that is going on right under our noses. I am holding the first debate about Xanax in Parliament to raise awareness about a problem that could be widespread.

Xanax, or alprazolam, is a sedative from the benzodiazepine family of drugs. It is physically and psychologically highly addictive. Its sedative effects start 15 minutes after consumption and can last for between 10 and 20 hours. When it is taken with alcohol, the impact is multiplied, and one of the side effects is memory loss.

Xanax is licensed in the UK, but it is not prescribed on the NHS. It can, however, be prescribed privately by a doctor. Unsurprisingly, it is hardly ever prescribed in the UK, but it is widely available and prescribed to treat anxiety and panic attacks in the United States of America. It is reported to be the eighth most prescribed drug in the USA. Popular culture is glamorising the drug and creating curiosity and demand in the UK, and the drug is available online for as little as £1 a pill. It is causing a problem that seems to be spreading. That brings me back to my initial interest, which was the result of some casework I picked up in my constituency.

A concerned mother told me about how her 14-year-old daughter—I will call her Zoe for the purposes of this debate—had become a regular user of Xanax and how this had, in just five months, resulted in a downward spiral leading to Zoe’s permanent exclusion from school. This is Zoe’s story.

Zoe was a bright and popular girl and had a wide group of friends when she started at a local secondary school in 2013. As is sometimes the case with early teenagers, Zoe had some fallings out with her group of friends and was eager to do exciting things. In July of last year, Zoe and her best friend were approached by an older girl at school and introduced to an ex-pupil whom they started hanging out with, together with a group of slightly older people, some of whom were adults. Zoe and her friend started going to private raves with the crowd and to parties in houses across north London where, swept up in the whirl of the excitement of this new lifestyle, Zoe was introduced to Xanax.

Throughout July and August, Zoe and her best friend would be out regularly with this crowd, taking Xanax, mixing it with alcohol, and getting sedated and into a zombie-like state. On some occasions, Zoe would come home from a night out with marks and bruises on her arms and legs, and no recollection of how she got them. At best, she had a hazy notion as to what had happened. One of the side effects of Xanax is amnesia, and there is always a risk that users become extremely vulnerable to abuse when under the influence of the drug, and although there was no certainty about whether Zoe was sexually abused, the concern was there.

Over the summer Zoe had completely transformed. Her mother, like most parents, was absolutely horrified at the change in her daughter since she started hanging around with this new crowd. She started rowing with Zoe. On one occasion, with Zoe under the influence of Xanax, she tried to stop Zoe going out. Another side effect of Xanax is aggressive behaviour, so, in addition to the normal behaviour that teenagers express when rebelling against their parents, in this instance Zoe physically and violently attacked her mother, leaving her with bruises on her arms and legs. Zoe then ran out of the flat. Zoe’s mother was desperate and frightened, and had no option but to call the police to restrain her daughter. At the same time, she rushed out barefoot into the street to make sure that Zoe came to no harm, and watched in horror as Zoe stepped out in front of cars and a bus. The police came quickly and arrested Zoe, which seemed to calm the situation down; no charges were brought. The next day, after spending a night in the cells, Zoe had no recollection of what had happened, nor of her arrest.

The problems continued. Zoe’s mother discovered that Zoe and her best friend were visiting various houses across north London where kids were taking drugs and drinking. Zoe’s mother then found out some of the names of the older people Zoe was mixing with. It transpired that some of those people were known to the police. With the help of the police, Zoe’s mother managed to get abduction warning notices served on six people so that they could be arrested if they were found to be associating with Zoe. An even more worrying discovery by Zoe’s mother were some baggies—small plastic bags used by drug dealers for neatly holding small amounts of drugs—hidden in Zoe’s bedroom. Zoe was now hiding things for her new friends.

In conversations I have had with the NSPCC, its staff have told me that Zoe’s behaviour is typical of someone who is being groomed. Zoe had been cut off from her school friends and had been warmly embraced by this new crowd, who promised excitement. Having been initiated, she was now doing favours for them. Zoe was now at risk of being exploited by people who were drug dealers, whom she regarded as her new friends.

Despite Zoe’s mother’s heroic efforts, Zoe continued to find ways of accessing Xanax. Things took a turn for the worse when, in September, Zoe and her best friend were found to be high on drugs in a zombie-like state, with dishevelled clothes and messed-up hair, on the school premises. As anyone who has a connection to a school will know, being drunk or intoxicated by drugs on school premises leads to a permanent exclusion. Despite this and after being implored not to exclude Zoe, the school allowed her to stay on and some support services were provided for her.

The pressure on Zoe’s mother was unbearable. She was so desperate and struggling to manage that she asked the local council if it could step in and find temporary foster parents for Zoe. Zoe was placed in foster care for just over a week. Although that seemed to shake her up, she was soon back to her old routine when she returned home. Despite Zoe’s mother and the school trying their best to help, Zoe was still able easily to get hold of Xanax, which was being peddled by a dealer from a booth in a McDonald’s restaurant two minutes away from the school. At £1 a pill, it was well within what is affordable to some young people. To make matters even starker, the McDonald’s is next to a police station. All the information that had been pieced together was passed on to the police. Following pressure from the school, Zoe’s mother and me, in December the police arrested three people on drug-related charges. This was not, however, before Zoe and her best friend were found to be drunk on school premises and then permanently excluded from school.

Zoe’s case is not the only one of its kind. On researching the subject, I discovered that on 9 May 2017, some 20 15-year-olds and 16-years-olds were taken ill in Salisbury, Wiltshire and received medical treatment after taking Xanax. A further eight young people were hospitalised in Sussex over the Christmas period after taking the drug, and in Scotland in the past month there has been an unconfirmed cluster of deaths from people injecting Xanax. Since securing this debate, I have been informed by hon. Members of further cases of Xanax abuse that have resulted in the hospitalisation of teenagers. Data about how widespread the misuse is of Xanax is patchy at best.

Last week, I met King’s College London’s emeritus professor of clinical psychopharmacology, Malcolm Lader OBE, who has over 50 years’ experience of working in this field. He told me more about the effects of Xanax. He said that Xanax was a powerful benzodiazepine which, if overused, could lead to a constantly dazed, zombie-like state and cause amnesia, depression, psychiatric disorders, rage and aggression. Taking it with alcohol would result in faster metabolism absorption of the drug and an amplification of the symptoms. He added that it was highly addictive—more difficult to come off than heroin—with prolonged psychological and physical reactions of muscle tensions, tremors, and perception disorders in relation to light, sound and noise. He added that in serious cases of overdose, it could lead to death due to slowing down of the heart and breathing problems.

So why has Xanax become so popular recently? Apart from being cheap—I mentioned that it is being sold for £1 a pill in my constituency—and just a click away on the internet, it has been glamorised in American rap music. The rapper Future has referred to Xanax in songs such as “Xanny Family” and “Perkys Calling”. Lil Uzi Vert has done the same in his song “XO Tour Llif3”, also known as “Push me to the edge”, which, as of today, has been viewed 147 million times on YouTube. The artist 6ix9ine, who has over 1.5 million Instagram followers, often makes references to Xanax in his songs, as does Lil Wayne, such as in his song “I Feel Like Dying”. The list of rap songs mentioning Xanax, or “Xannies”, is endless. I wish to thank my nephew Alex for enlightening me about rap music.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

This is not a new issue. Body Count, rapper Ice-T’s rock band, sang in their 1997 song, “Dr K”:

“Need some (X)anax…want some pills..I want the grim reaper as my guest!”

Ice-T’s social commentary was a way of getting to the heart of the issue 20 years ago. Does my hon. Friend agree that some rappers, like Ice-T, do not glorify Xanax but give the grim reality?

[Bambos Charalambous]

My hon. Friend makes an excellent point. I am about to come on to how some rappers have been dealing with the issue of Xanax in a very different way.

Some rap artists have even allowed themselves to be filmed in a zombie-like state, after claiming to have taken Xanax, before they eventually lose consciousness. But even in the world of American rap, things are changing. On 15 November 2017, American rap artist Lil Peep bragged about taking six Xanax pills on camera. Hours later, he was found dead on his tour bus as the result of an overdose. The clip of him bragging is still available for all to see on YouTube and other social media. Following the death of Lil Peep, the rapper Lil Pump, who previously had a song called “4 Xans” and other songs with references to Xanax, and who had posed for a picture with a Xanax cake to celebrate achieving 1 million followers on Instagram, announced on new year’s day that he would no longer be taking Xanax. Three-time Grammy winning artist Chance the Rapper has also been candid about his addiction to Xanax up until 2014. He told his 6 million Twitter followers—I am paraphrasing—that Xanax was the new heroin and not to be fooled. He has gone on to do interviews where he talks about the damaging effects of Xanax on him and his recovery from addiction.

Whether this is a matter of art imitating life or of life imitating art, the problem is certainly a real one in the UK. Having questioned adults over the age of 30, I found that very few had heard of Xanax, yet those who are younger, ranging from 12 to 24 years of age, had heard of it and would sometimes mock my ignorance and that of their parents. At the older end of the range, users are self-medicating with Xanax to ease their anxiety.

The truth is that there is a cultural and age divide, and whatever the reason, the fact remains that Xanax is certainly the drug of choice for some young people. It may be because it helps to numb the pain, because it is a fashionable drug, or because it is cheap and easy to get hold of—I can only speculate—but what I do know is that not enough is being done about the problem, which I believe is likely to get worse. Xanax is the drug of choice for the young generation. If steps are not taken now to tackle the problem, we will suffer the consequences both in the cost to the NHS and in personal tragedies.

Although it is pleasing to find that Xanax is the No. 1 news item on the Government’s “Talk to Frank” website, which is designed to be accessed by young people, much more needs to done. In the United States of America, abuse of Xanax is endemic and even some of those who were legally prescribed Xanax are dependent on the drug.

There is widespread ignorance of Xanax among the general public. There is very little, if any, research into or data on the misuse of Xanax and the reasons people use it, and very little is being done for those dependent on it. There are also enormous pressures on children’s and young people’s mental health services. There is a mental health crisis in our classrooms, and funding for child and adolescent mental health services has been cut. There is a window for early intervention, and that is key because half of all mental health problems are established by age 14 and three quarters by age 24.

If the Government want to do something about the problem, I would strongly suggest that they do three things. First, they should be running campaigns to raise awareness of the dangers of misusing and abusing Xanax to inform the public. The lack of knowledge about Xanax and its side effects is startling. Secondly, they should be providing more support, via specialist drop-in centres, for young people who develop a dependency on Xanax. They should not be relying on existing addiction centres because adult drug and substance misuse services are not appropriate for young people. Children and young people’s mental health services also need to be better resourced to cover this need. Thirdly, the Government should commission, carry out and publish research into the prevalence of Xanax use and its effects. We do not know how big this problem is nationally, yet we know that young people are attending local A&E units suffering from the effects of Xanax.

Those three actions will go some way to help to alleviate some of the immediate problems caused by Xanax. They will not help Zoe, who has been robbed of six months of her life with potentially life-changing consequences, but they may help others, and that is something that we should all be striving to do.