Oral Answers to Questions

Alison Thewliss Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

I am happy to offer my congratulations, because that is an incredibly important area. We have done really well on clostridium difficile and MRSA infections, but the rates of other infections such as group B strep and E. coli are higher than they need to be. In fact, I am speaking at a conference on infection prevention and control this afternoon.

[Alison Thewliss (Glasgow Central) (SNP)]

Only 57% of maternity units in England have UNICEF baby-friendly accreditation, compared with 100% in Scotland and Northern Ireland and 79% in Wales. What plans does the Secretary of State have to increase UNICEF baby-friendly accreditation to all maternity units?

[Mr Hunt]

Despite the rivalry that sometimes happens between our nations, I actually have a lot of respect for some of the patient safety initiatives in Scotland, and we will certainly look at this. However, we have what we think is the most ambitious plan to improve maternity safety not just in the UK but in Europe. This is one of those areas that the two countries should work together on.

Contaminated Blood

Alison Thewliss Excerpts

Tuesday 11th July 2017 Commons Chamber

[Alison Thewliss (Glasgow Central) (SNP)]

I pay tribute to the hon. Member for Kingston upon Hull North (Diana Johnson) for her sterling work, and to Andy Burnham and so many others who have pursued the issue relentlessly over the years. It is a testament to their commitment that they have kept going, even when all hope seemed to be lost.

I also pay tribute to the hon. Member for Oxford East (Anneliese Dodds) for her excellent maiden speech. I am sure that we share a lot of common ground, and I hope we will work together over the coming months and years.

Before Parliament broke up back in April, Andy Burnham laid a challenge to all the parties to include in their manifestos a commitment to the victims of contaminated blood. I am very pleased and proud that my party saw fit to do so. Our manifesto stated:

“Victims of contaminated blood products deserve answers.”

In 2008, the SNP Scottish Government established the Penrose public inquiry, which reported in 2015. In government we have also worked with stakeholder groups to develop a substantially improved compensation scheme, which is now the best in the UK. SNP MPs will support a full public inquiry for the rest of the UK, and I am very proud to stand by those words today.

I am incredibly pleased and surprised to hear that the Government have changed their stance. When we last met in April it did not feel as though much more was going to happen, so the change in the Government’s attitude is very welcome. I do not want to appear churlish, but the changed numbers in this Parliament mean that some things that seemed impossible before are now open for debate. I am very glad about that.

There has been recognition of the limitations of Penrose and what the Scottish Government could do. We could not compel witnesses to attend and we had a limited remit to consider negligence, so it is good that we now have this opportunity to relook at all the issues. I am also glad to hear the Government commit to working with the devolved Administrations, because we have the experience of an inquiry, limited though it was. I hope to hear more about the ways in which the Scottish Government and victims in Scotland will be brought in as part of the process.

In the April 2016 debate, I mentioned my constituent Maria. I have not been able to reach her to ask for her views, because this debate and the Government’s announcement came so very late in the day, but I want to put on the record again that Maria contracted hep C in 1981 from a blood transfusion following a miscarriage. She did not find out for many years. Even when she sought a diagnosis, it took two years to get it. She would want this House to know that, having lived with hep C for 36 years, she does not want charity. She does not want vouchers or handouts; she wants to be treated fairly and with dignity. That is the very least she deserves from this process.

[Layla Moran (Oxford West and Abingdon) (LD)]

The Oxford haemophilia centre serves my constituents. I thank the hon. Member for Kingston upon Hull North (Diana Johnson) for securing this debate. Does the hon. Member for Glasgow Central (Alison Thewliss) agree that victims want not just transparency but justice, and that if we find evidence of a cover-up, the individuals involved should face the full force of the law?

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[Alison Thewliss]

I absolutely agree. I am glad that the hon. Lady raised that point, which I was about to move on to. Without that justice, the victims will never feel as though they have been well served. They will feel as though they have lost out and there has been no justice.

The inquiry must look at the changing of medical records. Somebody must have issued a clear instruction to do so, because such cover-ups do not happen by themselves. We must find the lines of responsibility whereby people were told, “Delete those records, and don’t tell people about this. Test people, but do not let them know.” All those outstanding questions must be answered, and we must find out what was known, when and by whom. In the search for answers, we must recognise that some questions cannot be answered because the relevant information is held in the United States. Ministers must reach out and speak to their counterparts in other parts of the world to try to find answers. Ways must be found to co-operate with the American Government.

We need to be able to have confidence in our current processes. I understand that the US started screening blood donations in 1983, but we did not start doing so until 1991. Every time I donate blood, I am conscious that the integrity of the system is based on my honesty, at every stage. We must find better ways to ensure that our systems are as robust and secure as possible.

The Government have said that during the inquiry they will reach out to those who receive funds through the current schemes. I hope that that will be done in co-operation with the devolved Administrations where they have responsibility. I encourage the Government to find as many ways as possible to contact people and let them know what is happening. In some cases, the individual concerned may have died and their family members may not be aware of what is going on. We must reach out as widely as possible through advertising, social media and all other means at our disposal to involve as many people as possible in the inquiry.

People must be supported to attend and give evidence to the inquiry. The experience may be very traumatic for some, and they may need counselling or financial support to enable them to attend and to ensure that the required documents reach the inquiry. The Haemophilia Society has said that we must treat such documents with the utmost care and protection. People are, quite rightly, sceptical about how their documents will be treated, and we must enable them to trust that if they submit evidence, it will be not be lost. That goes for Government evidence as well as for private evidence belonging to members of the public.

We have waited far too long for justice on this matter. I encourage the Government to maintain the sense of urgency during the inquiry, to make sure that it is not dragged out over many, many years without the victims receiving answers. The victims have waited far too long for justice, and they should not have to wait much longer.

Reducing Health Inequality

Alison Thewliss Excerpts

Thursday 24th November 2016 Commons Chamber

[Dr Wollaston]

Those are extremely important points. The Government can introduce policies and make sure that there are levers and incentives in the system to make that happen. The drink-drive limit is a very important example.

We are not likely to make a difference to the gap in disability-free life expectancy without tackling smoking, which is a key driver for health inequality and accounts for more than half of the difference in premature deaths between the highest and the lowest socioeconomic groups. Without tackling it, we will not make inroads.

I would like briefly to touch on obesity and on the Government’s obesity strategy, which the Health Committee has looked at. To put the matter in context, the most recent child measurement programme data show us that 26% of the most disadvantaged children leave year 6 not just overweight but obese, as do 11.7% of the least deprived children. Overall, of all children leaving year 6, one in three is now obese or overweight. The situation is storing up catastrophic lifetime problems for them, and we cannot continue to ignore that.

In our report, the Committee called for “brave and bold action”. Although I really welcome many aspects of the childhood obesity plan—such as the sugary drinks levy, which is already having an impact in terms of reformulation—it has been widely acknowledged that there were glaring deficiencies and missed opportunities in the plan.

I would like to have seen far greater emphasis on tackling marketing and promotion. Some 40% of food and drink bought to consume at home is bought under deep discounting and promotion, and that is one of the potential quick wins that I referred to. We often focus in this debate on what people should not do, and this is an opportunity to look at what they should do. Shifting the balance in promotions to healthy food and drink would have been a huge opportunity for a quick win, because one of the key drivers of this aspect of health inequality is the affordability of good, nutritious food. This would have been an opportunity to tackle marketing and promotion, and I urge the Minister to bring that back into the strategy. I also urge the Government to extend the sugary drinks levy to other drinks, including those in which sugar is added to milky products, because there is no reason why it should be necessary to add sugar to such drinks.

I also welcome the mention in the plan of the daily mile, which has been an extraordinary project. I have met Elaine Wyllie, who is one of the most inspirational headteachers one could meet, and she talked about the strategy and about how leadership from directors of public health makes a real difference. I hope that the Minister will update the House on how that will be taken forward. We should think not just about obesity, but about physical activity and health promotion, and about the benefits that they could bring to all our schoolchildren.

The Health Committee stressed in our report the importance of making health a material consideration in planning matters when money is so restricted. I do not think that to do so would be a brake on growth; it would be a brake on unhealthy growth, and it would give local authorities the levers of power when they are making licensing decisions and planning decisions for their communities. That is something that Government could do at no cost, but with enormous benefit.

The Health Committee is actively considering how we reduce the toll of deaths from suicide. The Samaritans have identified that men living in the most deprived areas are 10 times more likely to end their life by suicide than are those in the most affluent areas. Many factors contribute to this—economic recessions, debt and unemployment—but when we try to tackle health inequality, we will not make the inroads that we need to make unless we look at the inequality in suicide, particularly as it affects men. Three quarters of those who die by suicide are men. I hope that the Minister will look carefully at the emerging evidence from our inquiry as the Government actively consider the refresh to the strategy, and that they will do so at every point when they look at how to tackle health inequality.

I would like the Minister to look at the impact of drugs and alcohol on health inequality. The fact that there are 700,000 children in the United Kingdom living with an alcohol-dependent parent is a staggering cause of health inequality, which has huge implications for those children’s life chances and for the individuals involved. Again, alcohol has a deprivation gradient; the two are closely linked.

There is evidence about what works, and we have had encouraging news from Scotland. The Scottish courts, I am pleased to say, have ruled that minimum pricing is legal, although I am disappointed that the Scotch Whisky Association has yet again taken the matter to a further stage of appeal. As soon as those hurdles are cleared, I think it would be a great shame if England undermined the potentially groundbreaking work being done in Scotland by failing to follow suit and introduce minimum pricing at the earliest possible opportunity; if we failed to do so, people would be able to buy alcohol across the border.

[Alison Thewliss (Glasgow Central) (SNP)]

I thank the hon. Lady for giving credit to the Scottish Government for what they have done on minimum unit pricing. I reiterate what she has said: it is disappointing that the matter has been taken to appeal yet again. Does she agree that there is a lot to look at from Scotland in terms of the smoking ban, which England then took up?

[Dr Wollaston]

I congratulate the Scottish Government. It does seem to be the case that where Scotland leads, England will eventually follow. Scotland is particularly good at following the evidence, and I call on us to do likewise. I am particularly concerned that the benefits that will come about when Scotland introduces minimum pricing will be undermined if we do not follow suit here, so I call on the Government to do so as soon as possible.

In summary—I know that many other Members wish to speak—there is a huge amount that we can do, and not all of it has a cost. I urge the Minister, in summing up, to look at all the possibilities. I urge her to stick with the Marmot agenda and to take a cross-Government approach, but to make sure that there is leadership at the highest level. The Prime Minister’s words in Downing Street were hugely encouraging. The Health Committee calls on the Prime Minister to appoint somebody at Cabinet level to take overarching responsibility for health inequalities and to put those fine words into action.

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[Rebecca Pow]

My hon. Friend is absolutely right. Many schools run gardening groups. There is so much to take from gardening, and it can also help the unemployed and other groups. Gardening is physical activity, but watching things grow out of the soil is so beneficial. In fact, Royal Horticultural Society research shows that 90% of UK adults say that just looking at a garden makes them feel better. Doing something in a garden is better, but one can also just look. There were data recently about watching birds on a bird table or hedgehogs. If someone has the chance to watch a hedgehog, that could make them incredibly happy because they are so rare now. I got terribly excited when I recently saw one eating my cat’s food.

[Alison Thewliss]

I do not want to rain on the hon. Lady’s garden as such, but does she agree that there can be a negative impact on someone’s mental health if their surroundings are not good? Some 60% of people in Glasgow live within 500 metres of vacant or derelict land, which can negatively affect their mental health.

[Rebecca Pow]

That is such a good point. We need to be doing something with derelict land as communities. The Woodland Trust has some great data saying that, if someone lives 500 metres from a wood, their health will be better because not only can they go into it, but they can look at it and enjoy it. The mental health charity Mind produced a report called “Feel better outside, feel better inside” that advocates the benefits of ecotherapy. Ecotherapy improves mental and physical wellbeing and boosts people’s skills and confidence to get back into work by taking part in gardening, farming, growing food, exercise and conservation work. Some 69% of people who took part in such projects definitely saw a significant increase in their mental wellbeing and 62% thought that their overall health was improved. The projects helped 254 people find full-time work, which saves the nation money because they no longer need support.

In my constituency, a job agency called Prospects has a contract to get the long-term unemployed back to work. It does gardening with groups of people, but it also does forest walks. I have been out with them in the Neroche forest, which contains a lot of ancient woodland. It definitely helps people not only to engage in nature, but by giving them confidence because they are talking to each other and getting out in a different atmosphere—not an office. Many of those people then have the confidence to apply for jobs and get back into work. There is a clear case for having the prescription of access to green space in the armoury of traditional medical treatments to deal with a range of mental health issues.

We also have physical health to consider. The great outdoors is a vastly underutilised tool, in the wider sense. Many of my colleagues have been talking about obesity and the outdoors can play an important part in our fight against it. Obesity, particularly childhood obesity, currently costs the Government £16 billion, and those living in deprived areas are twice as likely to be obese.

With that in mind, I advocate that consideration be given to green prescriptions. The Local Government Association has recently called on the UK to implement a similar model to that used in New Zealand, where eight out of 10 GPs have been issuing green prescriptions to patients, with 72% of them noticing a change in their health. The LGA is encouraging GPs to write down moderate physical activity goals for their patients, including things such as walks in the park and all-family classes that they can go to. A number of GPs are already using these schemes on Dartmoor and Exmoor, and in one pilot people are being encouraged to visit the national parks, which are beautiful, on their doorstep and free to enter. I am recommending all these things. Councillor Izzi Seccombe, chairman of the LGA’s health and wellbeing board, said that writing such a formal prescription encourages many more people to get out and do the activity. If the doctor says that people must take a pill, they take it, so if the doctor says that they must go out for a walk in the wood, people might do it.

A great many initiatives are already taking place, such as NHS Forest, which aims to improve the health, wellbeing and recovery times of patients and staff by increasing access to NHS gardens—the locations on the doorsteps of the hospitals. As part of the Health and Social Care Act 2012, a statutory duty was placed on local authorities to create health and wellbeing boards. However, the Health Committee has reported that those were not working very successfully and have few powers. Perhaps the Minister might examine that, as they could start to make a big difference in moving this agenda forward.

There was a proposal in 2015 for a nature and wellbeing Act, which was much discussed and debated. That sought to put nature at the heart of all the decisions we make about health, education, the economy, flood resilience and so on. Perhaps, Minister, we could re-examine some of the ideas in there, because some of them are very good. We know that there are links between access to green space and health. It seems a no-brainer to me—if we can improve access to green space and look into the idea of beginning to prescribe these green treatments, we could really make a difference to health and health inequalities.

That would be much easier if we had all the data and we could prove these benefits with those data. Help is at hand, because the Wildlife Trust has commissioned a piece of work; it has commissioned the school of biological sciences at the University of Essex to gather just such data. Once we have some solid facts, we can really move forward. I would like to think that the Minister will consider some of these ideas. When the Cabinet Minister for tackling health inequality is put in place, as was recommended by my hon. Friend the Member for Totnes—or perhaps the Prime Minister could lead on this, as recommended by the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson)—we might be able to add my green points to the agenda and really move forward to a healthier society.

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[Alison Thewliss (Glasgow Central) (SNP)]

I am proud to participate in this debate, and I am glad that the Chair of the Health Select Committee, the hon. Member for Totnes (Dr Wollaston) has brought it before the House today. This debate is an important one, in which I have a considerable interest.

The issue of health inequalities was one of the first that I got interested in as a teenager. Sitting in my modern studies class in Lanarkshire, I could not understand why any Government would allow people in less well-off areas to disproportionately suffer ill health and die prematurely. I was frustrated when I read about the Black report and the inverse care law. I was angry then, and I am angry now that the political decisions taken here are the root cause of that mortality and morbidity that still blights too many lives in our country today. It is unacceptable that male life expectancy in parts of Glasgow should vary by 15 years, between the ages of about 66 and 81. In the case of women, the gap is 11 years. I got interested in politics because I wanted to change that: I wanted to understand why it was, and I wanted to know what I could do to help.

I joined the SNP when I was at school. I know that today’s debate has not been too party political, but I think it is important to put this on the record, because it is important to me. I joined the SNP because I could see that the health of Scotland’s people in particular was not a priority at Westminster. When I was at school there was no Scottish Parliament, and there was no way in which we could deal with the issue ourselves.

The hon. Member for Stockton North (Alex Cunningham) mentioned the Black report. The way in which that report was greeted was quite telling, as is the fact that we are still discussing many of the issues now. The Marmot report has not yet been implemented, and the obesity strategy is still not as strong as it could be. It has not been possible to tackle the underlying causes of health inequality, but I believe that if the Scottish Parliament had all the powers of a normal Parliament, we would be able to deal with them more adequately than they have been dealt with in the past. [Interruption.] Some members may disagree with me, but that is what I believe. It is past health inequality that we are dealing with now, because there is a time lag.

[Alex Cunningham]

I do not disagree with the hon. Lady, but I think she must have misinterpreted my action. It was my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson) who mentioned the Black report, and I was indicating him. No offence was meant.

[Alison Thewliss]

My apologies. I had to nip out to the loo earlier, and I must have got my wires crossed. I thank both Members for raising those issues. It is important for us to think about the context of the debate and where we are going.

I have been reading the report to which the hon. Member for Glasgow East (Natalie McGarry) referred. I pay credit to the in-depth work and dedication of the Glasgow Centre for Population Health. Its director, Dr Carol Tannahill, along with Bruce Whyte and David Walsh, lead much of that work. Along with their team of researchers, they have laid out the history of health inequality in Glasgow and in Scotland more widely. They have done a huge amount of research, and have come up with not only history, but some solutions.

In 2007, when I was first elected as a Glasgow councillor, the centre’s most recent report was “Let Glasgow Flourish”, but since then it has carried out a great deal of research on Glasgow’s “excess mortality”. It is interesting to note that that excess mortality applies across different causes of death, and across ages, genders and social strata, although it is most pronounced in members of the working-age population living in the poorest neighbourhoods, where the impact of alcohol, drugs and suicide, particularly among men, is stark. In comparison with Manchester and Liverpool, Glasgow experienced an extra 4,500 deaths between 2003 and 2007. In Scotland overall, there were an extra 5,000 deaths in each year between 2010 and 2012.

I shall not repeat what was said by the hon. Member for Glasgow East, but it is important to note that Governments knew that that was happening. The impact of their policies was known. Urban change, particularly in Glasgow, was taking place in a noticeably different way from the way in which it was happening in Liverpool and Manchester. It had a disproportionate effect on the population, and we still see the lag of that today. One of the reports produced by the Glasgow Centre for Population Health quotes from a 1971 Scottish Office report called “The Glasgow Crisis”, which noted that

“Glasgow is in a socially…economically dangerous position.”

However, nothing was done at the time. The urban regeneration in Glasgow took place in the shopping centres in the middle of the town, but did not touch the areas that needed it most.

Poverty and health inequality are incredibly difficult to turn around. They cannot be fixed by a sugar tax or any other individual health measure; a wide-ranging approach is required from all levels of government. Glasgow has worked incredibly hard, and has established a poverty leadership panel to examine some of the issues. The Scottish Government have invested heavily, and have set up a ministerial taskforce on health inequality. However, we must keep working harder and working together if we are to achieve a result.

Clyde Gateway is an urban regeneration company in my constituency. Members may wonder whether an urban regeneration company, which builds things and fixes the ground conditions, should be interested in health, but the company has been working for eight years in Glasgow and Rutherglen, and has learnt lessons from previous regeneration efforts. So far, it has managed to lower the claimant count for out-of-work benefits from 39% to 28% and the claimant count for jobseeker’s allowance from 8.6% to 4.8%. That is pretty remarkable in itself, but the company cannot go any further until it starts to tackle the underlying health issues that are keeping people out of work. It is therefore working closely in partnership with local organisations and local people. It is crucial that local people are part of the process and are not having things done to them, as was the case before. They are now part of the solution and the community is a part of what is happening.

Clyde Gateway recently signalled its intention to seek a means of tackling health inequalities. It wants to work to improve diet and cancer screening, which are both factors in the area’s ill health. There is a lot of worrying evidence that people in areas of deprivation are not taking up the screenings to which they are entitled. Those screenings include tests for cancer and free eye tests, which can also be an indicator of other conditions. I spoke to the Royal National Institute of Blind People yesterday about early intervention and the importance of people going for their eye tests. Clyde Gateway also wants to grow jobs in health and social care in the local community to make people working in the industry part of the community as well, rather than having staff coming in from other areas to “do” health to people.

I wholeheartedly agree with the notion that public health ought to be everybody’s business. It is not just for public health officials to do on their own, because the roots of health inequalities are to be found in income inequalities. So in Scotland we are tackling some of the underlying causes. The living wage uptake in Scotland now far exceeds the uptake in other parts of the country. We are supporting families and helping to improve the physical and social environment and housing. We have invested heavily in housing, because much of the ill health was coming from housing that was damp and substandard. Housing was making people ill and was not being tackled.

We have increased free school meals and continued commitments such as free prescriptions, concessionary travel and free personal care. The hon. Member for Bradford South (Judith Cummins) talked earlier about tooth-brushing and the rates of tooth decay. In the mid-1990s, when I was starting secondary school, just under 40% of children in primary 1 in Scotland—those just entering school—had no dental cavities. That figure is now just under 70%, which is pretty good and marks quite a shift, but we need to go a lot further. Initiatives such as Childsmile, through which all children in Scotland regularly get free toothbrushes and toothpaste, are helpful.

As the hon. Members for Totnes and for Congleton (Fiona Bruce) mentioned, a lot of work is being done on minimum unit pricing to reduce alcohol consumption and deal with many of the issues that lead to people buying low-price cheap alcohol, which is killing them. We have reduced smoking rates, too, by bringing in the smoking ban first, and we are doing a lot of work to encourage active living and healthy eating, and investing to improve mental health services.

As chair of the all-party group on infant feeding and inequalities, I want to take this opportunity to speak about breastfeeding and the impact it can have on health inequalities. James P. Grant, executive director of UNICEF during the 1980s, said that

“exclusive breastfeeding goes a long way towards cancelling out the health difference between being born into poverty or being born into affluence. It is almost as if breastfeeding takes the infant out of poverty for those few vital months in order to give the child a fairer start in life and compensate for the injustices of the world into which it was born.”

That is quite a statement.

Sadly, there is a huge inequality in breastfeeding, particularly in the UK. Women in areas of greater deprivation are far less likely to breastfeed. They are then also often paying for expensive formula milk, which will put a strain on their family budget.

I was once told by a Labour councillor in Glasgow that in his experience there was an inverse perverse stigma: if a woman breastfed, it made her look as though she was too poor and could not afford the formula. The cost is a big issue, however, as I highlighted in my ten-minute rule Bill last week.

Families are being penalised for a societal problem: the UK just does not provide enough support, via midwives, health visitors, peer supporters and local networks, to ensure that mums are able to breastfeed for as long as they want to. Some of the economic agenda is having an impact on those important services, and coverage is fraying, as volunteer services find it harder to cope. It is seen as difficult, and there is so much blame and shame for mums, whatever they do and however they feed their children.

Many younger women have never seen anyone breastfeed. There is also interesting evidence from Sally Etheridge that the longer that black and minority ethnic women who have come to the UK from other countries stay here, the lower their breastfeeding rates become as they begin to assimilate into our bottle-feeding culture. I believe that there is a lot we can do to improve this situation and encourage the Government in that regard. I met the Minister earlier this week and am glad that she is listening and keen to address the breastfeeding rates across the country.

The series on breastfeeding from The Lancet and the UNICEF report on preventing disease and saving resources point out that the NHS could save significant amounts of money by investing in breastfeeding services. They reckon that there would be 3,285 fewer hospital admissions for gastrointestinal issues and 5,916 fewer admissions for respiratory tract infections, which could save £10 million across the country. That is no mean feat. There would also be connected reductions in obesity and sudden infant death syndrome, as well as a reduction in breast and ovarian cancer in the mum. Breastfeeding is a significant public health intervention, as the UNICEF call to action has illustrated.

I should like to summarise a few of the suggestions in the Glasgow Centre for Population Health report, as it is the purpose of our debate today not only to look at the problems. Health interventions on smoking, alcohol and so on have helped, but the report has found that the main means of resolving health inequality is not a health intervention but a wealth redistribution. A widening gap in income has been perpetuated by different Governments over many years. Fair and progressive taxation and fair wages would make a huge difference to the gap. Ensuring that all people have a sufficient income is critical, yet this Government continue to slash social security spending, which is making people not only poor but ill.

An NHS Health Scotland report published this month said that a quarter of lone parents in Scotland rated their health as either fair, bad or very bad. Those parents have to look after children. If their health is fair, bad or very bad, they will not be able to be effective parents. The impact of food banks on health is also clear. If people cannot afford to put food on the table, they have to resort to going to a food bank to get canned meals. They do not get fresh food and vegetables; they get something out of a can that they might not even be able to heat. That will have an impact not only on their physical health but on their mental health.

The GCPH report looks at the cost of living and at how we as a society can support people to live with dignity and live a life in which they have choices. Having choices in life should not be a luxury. If someone does not have any control over what happens to them in life, it will have a huge impact on them and their family for years to come. The report also recommends affordable, warm and appropriate housing. As the hon. Member for Hackney South and Shoreditch (Meg Hillier) said, not having somewhere affordable and warm to live can have a huge impact on people. We need to learn from past mistakes and look more widely at the policies we pursue and the things that we in this House think are important, because they can have long-lasting effects, as we have seen in Glasgow.

Most significant to all of this is the adoption of the World Health Organisation’s principle of including health in all policies. This must run through absolutely everything that the Government do, because of the impact on health. Yesterday, the Chancellor failed to address health spending; indeed, he failed to address the question of health at all. He is failing the people of this country by not acknowledging the significance of health to everything else that the Government wish to achieve.

Oral Answers to Questions

Alison Thewliss Excerpts

Tuesday 5th July 2016 Commons Chamber

[Mr Hunt]

I can absolutely assure my hon. Friend on that. I know there are very big national and global events happening right now, but I want to tell the House that over the next month one of my big priorities will be to do something to improve our record on maternity safety. We have made huge progress in reducing stillbirth rates and so on, but maternity safety is still not as good as it should be and certainly not as good as in other countries in western Europe. This is an absolute priority and I hope to be able to inform the House more on this before recess.

[Alison Thewliss (Glasgow Central) (SNP)]

As the chair of the all-party group on infant feeding and inequalities, I welcome the new guidance issued by Public Health England, in conjunction with UNICEF Baby Friendly, on the commissioning of infant feeding services. I welcome in particular the recognition of raising infant feeding at the antenatal stage. Will the Secretary of State explain what resources the Department of Health is putting in to promote the guidance and increase breastfeeding at local levels?

[Mr Hunt]

We already commit huge resources to that, but we can do more. As I just said, we hope to announce something to the House before the break.

Alcohol Consumption Guidelines

Alison Thewliss Excerpts

Tuesday 28th June 2016 Westminster Hall

[Alison Thewliss (Glasgow Central) (SNP)]

It is a pleasure to be able to speak in this debate. I congratulate the hon. Member for Gower (Byron Davies) on securing it.

This debate has highlighted the fact that statistics can be used to prove just about anything. It is important that people out there have confidence in the statistics and the guidance that they are given, and I am concerned that the Royal Statistical Society seems to have a bit of a worry about the guidance that has been put forward—particularly on the issue to do with intake for women and men. There is evidence to suggest that women’s and men’s bodies absorb alcohol slightly differently, and that really ought to be acknowledged so that each individual gets the best advice possible.

The hon. Member for Burton (Andrew Griffiths) talked about the differences between people. My brother is 6 feet 4 inches and his girlfriend is about 5 feet 2 inches, and there are obviously stark differences between them. Having said that, unless people are going to have a personalised alcohol prescription, it is quite difficult to be specific. We have to have general guidelines that give people an idea of what they can expect. People have to know their limits, as the hon. Member for Strangford (Jim Shannon) said. He also said that 60% of alcohol sales are to problem drinkers, which is an issue that we have had in Glasgow and the west of Scotland. As my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) said, alcohol consumption significantly blights families.

Organisations such as the Glasgow Council on Alcohol, through their community work, seek to get people talking about the impact that alcohol has on communities. As the Glasgow Centre for Population Health has found, inequality has a significant effect. In Glasgow, the most deprived communities have five times more of a problem with alcohol than the least deprived communities.

Alcohol guidelines are not just about pubs, as the hon. Member for Gower seemed to be suggesting. I very much support the real ale industry, and CAMRA does really good work and has transformed the way people look at alcohol—they go for quality rather than quantity in some cases—but the fact remains that many people, particularly in deprived communities, are not going to a nice, cosy real ale pub; they are going to the local shop on the high street and buying large volumes of alcohol, which will do them significant damage.

[Andrew Griffiths]

I agree with much of what the hon. Lady is saying. Does she share my concern about telling people that alcohol can cause them to misjudge risky situations, cause accidents and cause them to lose self-control, and giving them advice about drinking alcohol before going up a ladder? That is not the kind of advice about alcohol that people expect, and the risk is that the general public will have no confidence in the guidelines.

[Alison Thewliss]

We need to be aware of the impact of alcohol generally. The hon. Member for Henley (John Howell) spoke earlier about alcohol in the House of Commons, which is still a concern for me. I was at an event earlier celebrating tennis—a nice, healthy activity—and there was booze. I could get a drink at lunchtime. I do not think that is acceptable. The House of Commons should consider whether it is appropriate for people to have a drink with their lunch at events that take place during a working day. I am not convinced that it is.

The Scottish Government have a framework for action on alcohol. We pursued the Alcohol (Minimum Pricing) (Scotland) Act 2012, which, due to the alcohol industry, has been bogged down in a legal dispute. Importantly, it is about trying to cut down the number of people buying large volumes of alcohol. We are trying to change that behaviour and get people to think about how their drinking is affecting their health.

Evidence that organisations such as the Glasgow Centre for Population Health have looked at suggests that we need a change in attitude. There are people who are damaging their health severely every day. This is not about an auntie who drinks a wee drink before she goes to bed or anything like that. It is about people who are drinking more than they should and drinking in unhealthy ways, which has an impact on their health and their ability to go about their business safely.

I saw a study from the Glasgow Centre for Population Health a few years ago that suggested that, in the most deprived areas of Glasgow, people who drink quite a lot end up in hospital more than people who drink an equivalent amount in better-off areas, because their lifestyles and the things around them do not keep them safe. Someone in a well-off area might be having a bottle of wine every night, whereas someone in a poorer area having something else is far more likely to come to harm. There are serious considerations not only about public health but about how we think about alcohol in general, and about the guidelines that are put in place to get people to think about how much they are drinking and what they can do to reduce their intake, be healthy and happy and have a good role in their families and communities.

Support for Life-shortening Conditions

Alison Thewliss Excerpts

Tuesday 7th June 2016 Westminster Hall

[Kirsty Blackman (Aberdeen North) (SNP)]

It is an honour to serve under your chairmanship, Mr Percy. I am pleased that the hon. Member for Pudsey (Stuart Andrew) has brought the debate to the House. I raised the matter at business questions during Children’s Hospice Week, and I am glad to have the opportunity to speak in a debate about it.

There have been many interesting contributions today, and I am pleased that so many people have taken so much time not just to research the matter but to go and meet people, hear their real-life stories and bring them to the House. That is really important; it is not just about numbers, it is about the impact on people’s lives, and the debate has been good at highlighting that.

I thank Together for Short Lives, which prepared a briefing that many of us have seen, and the Aberdeen charity Charlie House, which has provided me with a lot of information in advance of the debate so that I can speak on behalf of families. It is key that we get as much information as possible, including about real-life scenarios. In paediatric palliative care, we are pretty much having to make things up as we go along. That is not any kind of criticism of those who work incredibly hard and do a huge amount of research to try to make lives better, but it is a situation we have not been in before.

The Children’s Hospice Association Scotland produced a report in 2015 that explained that we are seeing an increase in the prevalence of children and young people with life-limiting conditions, which is projected to grow further. As a result, the situation throughout the UK and the world is uncharted territory. We cannot just say, “This is best practice” and lift it, because we are all having to find our way in this scenario. As a result, Governments throughout the UK—the devolved Governments and the Westminster Government—are not necessarily getting everything right, because this is a new scenario for all of us. The best way to ensure that we get this right and provide the best support is to listen and speak to the families and ask them about what they need and the hurdles they are facing.

When a family has a baby with such a condition, it is an unforeseen circumstance. They do not imagine that that child will not learn to sleep through the night, will not learn to crawl and walk and will not go through a weening process and begin to eat solid food. It is an unforeseen and unforeseeable situation. A lot of the conditions that such children have are totally unplanned for and could not have been predicted beforehand.

One thing that has been touched on, but not explored in a huge amount of detail, is the financial impact on families. My hon. Friend the Member for Lanark and Hamilton East (Angela Crawley) mentioned that 25% of families with children with life-limiting conditions live in the most deprived areas of our communities. Those families start from a position of not having a huge amount of money in the bank, and they are then faced with a situation in which more than 60% of mothers and more than 20% of fathers have to stop work. They require support from the Government, because it is impossible for them to survive otherwise.

[Alison Thewliss (Glasgow Central) (SNP)]

My hon. Friend is making an excellent case. I visited the Children’s Hospice Association Scotland, and it said that some of the families that it deals with are not even aware of the benefits they are entitled to and get support on that from CHAS. Could the Government do more to encourage people to take up the benefits they are entitled to for their children?

[Kirsty Blackman]

I absolutely agree; that is something that the Government could do better. Again, that is not just the Westminster Government; it is an issue for Governments across the UK. It is very difficult when a family is suddenly thrown into a situation where they have a child who requires an incredible amount of support. They are trying to find out about children’s hospices and medical support and trying to work out what condition their child has. They are trying to swim through all that while keeping the family financially afloat. If the Government have not been proactive in providing and signposting all that support, it is even more difficult for families already dealing with an incredibly difficult situation. As the hon. Member for Colne Valley (Jason McCartney) said, in a lot of cases they have to do it with next to no sleep. The situation is almost impossible, and it is incumbent on us to ensure that we do all we can to help those families.

I want to touch on a couple of other points that Members have mentioned. The hon. Member for Eddisbury (Antoinette Sandbach) mentioned the importance of families having a break and respite. I underline the point made earlier that children’s hospices are not like adult ones. They provide support from diagnosis, or from the time when it is realised that the child may not survive childhood. Some 75% of the support provided by children’s hospices is through short breaks. We cannot overstate the difference between adult hospices and children’s hospices. There is a requirement that the Government provide them with different levels of statutory support, because they are a totally different kettle of fish.

The children we are talking about have 24/7 care needs, as a number of Members have mentioned. The importance of respite care cannot be overstated. The hon. Lady and the hon. Member for Strangford (Jim Shannon) mentioned sharing the knowledge we have of best practice in the devolved nations and spreading what works. One problem we have in Scotland is the lack of children’s hospice care. We have only two children’s hospices in Scotland, and they have a total of about 15 beds. Families in my constituency have to do a 200-mile round trip to access a hospice, and that is on the weekends that work for the hospice, because there is such a big waiting list. I do not think that is appropriate. We need to work on that. In previous years and decades gone by, it was not necessarily so much of an issue, because there were fewer such children and families. It is now increasingly becoming an issue. That is why Charlie House in my constituency is working hard to get a hospice built in Aberdeen so that there is local access. As my hon. Friend the Member for Lanark and Hamilton East said, the Scottish Government are committed to trying to ensure that we have a geographic spread of services, as well as the spread of services needed for children with all the different conditions.

I appreciate the fact that we have had this debate so that we can discuss these matters, and I appreciate the feeling in the room about working together to try to find a way forward that helps everyone.

One point I will briefly mention, because it has been mentioned a number of times, is the issue of transport for those aged nought to three. That would be relatively easy for the Government to fix and would make a massive difference to the financial impact on families, particularly those who are struggling financially as it is. It would be a massive help.

Thank you, Mr Percy, for your chairmanship, and I once again thank the hon. Member for Pudsey for securing the debate.

Dietary Advice and Childhood Obesity Strategy

Alison Thewliss Excerpts

Monday 23rd May 2016 Commons Chamber

[Alistair Burt]

Tempting though it is to use my temporary position for a whole range of announcements in relation to this area, I think that would be unwise. I can inform my hon. Friend that I have him on an accumulator with my hon. Friend the Member for Bury North (Mr Nuttall); I am not saying who is the final part of it. No, the Government will stick to their declared policy in relation to sugary drinks. Perhaps my hon. Friend might welcome the fact that all the money from that is going into physical activity through sports in schools, which I know he is really keen on as well. Perhaps that mitigates any concern he might have.

[Alison Thewliss (Glasgow Central) (SNP)]

We have heard about the evidence base and the importance of looking at that evidence as we move the strategy forward. May I ask, as I did when this was last debated on 21 January, that the childhood obesity strategy look at the evidence that breastfeeding can contribute to reducing childhood obesity? The evidence is there, and it makes a significant contribution, so will the Minister ensure that it gets prominence in the report when it comes to be published?

[Alistair Burt]

Yes, I am very conscious of the issues surrounding this. The hon. Lady already has a meeting with the Under-Secretary, my hon. Friend the Member for Battersea, when these issues can be taken further.

Contaminated Blood

Alison Thewliss Excerpts

Tuesday 12th April 2016 Commons Chamber

[Alison Thewliss (Glasgow Central) (SNP)]

I am very glad to be able to participate in this very important debate. I thank the hon. Member for Kingston upon Hull North (Diana Johnson) for securing it.

I am slightly sad to have to say this, but it is a shame that the debate is happening at this time of day. I know that constituents of many MPs around the country have travelled a long way to come to Parliament today. Some of my constituents were in the Gallery earlier, having got up at 3 o’clock this morning to come down from Glasgow, but they have had to leave to fly back up and go back to work. [Interruption.] I appreciate that, as the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), says, it was the Speaker’s decision. I am just reflecting on the fact that that is quite sad, and perhaps the procedures of the House should be looked at, particularly when already vulnerable constituents who do not have an awful lot of money have had to travel a great distance to hear what their MPs have to say. I went to join the lobby outside earlier this afternoon and spent a lot of time speaking to people, and their sense of frustration at having to wait so long for justice was compounded by their not being able to stay for the whole of this debate, after waiting for so long for a chance to come to the House to listen to us.

To move on to the more substantive issues, many of us are wearing ribbons given to us by the campaigners, so I will tell members of the public who may be watching at home what the ribbons mean. The red is for sufferers of HIV, the yellow is for people who have suffered from hep C, and the black is to remember those who have died waiting during this process. It is very profound to see the number of people who have lost their lives, over the piece, waiting for justice and for some answers.

The constituent of mine who was here today is Maria Armour. She contracted hep C in 1981 when she suffered a miscarriage in hospital and needed a blood transfusion. She did not find out that she had been infected until she turned about 35; she took ill and had to find out what was wrong. People did not know and could not tell her. She had to wait two years for a diagnosis, when she found out that she had hep C. The treatment that she began at that time further compounded her ill health. She now has fibromyalgia and lupus, and also has issues with her bowels. That causes her great distress. She cannot go out and her life is on hold.

Despite all that, Maria is a very inspiring individual. I spoke to her today. She continues to campaign. She, like many people, has dedicated her life to others, and now wants to be able to spend time with her family rather than having to continue to fight this fight. I asked her what she would like to be highlighted this afternoon in the brief time available to us. She said that she is looking for fair and equal treatment. She does not want to be a charity case—to have to go to funds such as the Caxton Foundation, or send them begging letters for very simple things that most of us would take for granted.

In particular, Maria mentioned that she was turning 50. She applied for funds for a dress to wear to her 50th birthday party, because, unlike many of us, she did not have the general funds to go out to the shop and buy herself a dress. She has to put in three quotes for that dress—they choose which dress she gets—and gets vouchers to pay for it. She mentioned that when, in the past, she has asked for furniture, she had to have vouchers, so she had to go to the shop to buy the furniture and count out all those vouchers in the shop, in front of people, to pay for it. That is very stigmatising. It is unfair that people have to do that, and do not get money, which the rest of us have to go and buy the things we need to make our lives easier. She has a lack of choices in her life. She cannot go on holiday with her grandchildren, as she would like to. She does not have the funds to do all the things she would like.

It would be easier for many people in Maria’s situation if they got the fair funding that they deserve. I am glad that the Scottish Government have recognised that funding should be available at a higher level. It has been said that it is a shame that constituents in England, and the few in Scotland who are affected, will not get that higher level, but that is not an unfairness on the part of the Scottish Government. They have recognised the issue, listened to people, consulted, and done a lot of work, and have decided what they think is fair. The ball is now in the UK Government’s court—they need to decide what is fair.

Some people have waited a long time—in the case raised by my hon. Friend the Member for Caithness, Sutherland and Easter Ross (Dr Monaghan), 42 years—since the initial infection. They need to have what is fair and what is due to them. They are not at fault here. We need to recognise that and find the funds to enable those people to live their lives with dignity as we wish to live our own lives. People should not in any case have to write begging letters to get what they need to live their life with dignity. I commend that point to the House.

End of Life Care

Alison Thewliss Excerpts

Wednesday 2nd March 2016 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Thank you, Mr Deputy Speaker, for giving me the chance to speak on this issue. According to the End of Life Care Coalition, in the 12 months since the “Choice” review was published, almost 50,000 people experienced poor care during the last three months of their lives.

Some right hon. and hon. Members have clearly said that they are speaking from a family point of view, and I heard some of their speeches in the Chamber. Twelve months ago today my father passed away. My dad always wanted to die at home, but that was not possible. He had fallen out of bed and broken his femur. It was quite impossible for my mum to give him the care that he had to have, so he passed away in hospital. I have some experience of end-of-life care in hospitals, and I must say that I commend those involved: first, my mother, who was very loyally and religiously attentive to him, but also the nurses, who particularly helped and were very attentive and caring.

The 2015 report from the Parliamentary and Health Service Ombudsman, “Dying without dignity”, demonstrated the consequences of people dying without access to high-quality care and support. It highlighted cases where people had died in distressing circumstances, which had a lasting impact on their friends and families. That is what we are focusing on today. Unfortunately, research by the London School of Economics suggests that such situations are not as rare as they should be. The people who tend to miss out on palliative care are those with conditions other than cancer, those over the age of 85, single people and people from black and minority ethnic communities. Quite clearly, those are issues.

Research conducted by Ipsos MORI and Marie Curie—many of us met those from Marie Curie in Parliament yesterday—have found that seven out of 10 carers thought that people with a terminal illness were not getting all the care and support that they need. I commend the Marie Curie nurses for the hard and very attentive work that they do. Again, I have experienced that personally because a good friend of mine, Irene Brown, passed away just last week. Marie Curie helped her and her family greatly near the end of her life.

We have had ongoing worries and troubles about care homes in my constituency, with the threat of closures compounding the misery for people who need help the most and who already have to deal with an over-pressed and strained health service. I have to say, with respect, that the fact that such issues are not at the top of the priority list only serves to strengthen the disillusionment with the Government.

[Alison Thewliss (Glasgow Central) (SNP)]

Does the hon. Gentleman share my concern, which was highlighted by some of the Marie Curie nurses I met, that while they very much want to do an excellent job in looking after they people they serve, they cannot do so all week but only on a couple of days, with less experienced staff coming in to fill in the gaps?

[Jim Shannon]

I obviously agree with the hon. Lady. I understand exactly what she says, as I think does everyone in the House. The Marie Curie nurses are special nurses and they do a grand job.

The issue of state-assisted suicide has been mentioned. We have had a debate in the House and a clear decision has been made, by an outstanding majority, that there is no need for it, and we will keep that going. We do not need to discuss the matter, because it has already been decided.

I want to refer quickly to the significant improvements to end-of-life care in Northern Ireland with the ambitious “Transforming your care” plan. Although there is still a long way to go, I ask the Minister sitting on the Front Bench, who is always very responsive, to look at what all the devolved regions have been doing, not least Northern Ireland, to ensure that the best strategy known and available nationwide is being implemented so that the figures I led with are reduced as much as possible and as fast as possible. We all know people or have known people going through this period of their life and, young or old, it is a reality that all of us will face some day. The UK Government and the devolved Governments need to do better on this issue to give ordinary, everyday, hard-working people the treatment they deserve at such a distressing time.

I will conclude on this point because I am conscious that other Members wish to speak. If the Government have been taking action on this issue, they need to make that clear and publicise it, despite the obvious delay. In other words, are the Government giving end-of-life care the focus and money it needs, and are they working with charities and hospices to ensure that it is delivered? It is true that there should be no timescale for coming up with the best solution, but it is equally true that there has been insufficient explanation as to why the timescale has been delayed. I know that the Minister will respond to that. That delay is compounding the misery for people who are affected by this issue and their families. When it comes to end-of-life care, let us ensure that we deliver for our constituents.

Oral Answers to Questions

Alison Thewliss Excerpts

Tuesday 9th February 2016 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

Midwife-led units have increased in number in the past few years, to the great advantage of women wanting a full range of choice when they give birth. That is why we are all looking forward to the publication of the Cumberlege review, which I hope will map out the future of maternity services and show what midwife-led units will do within maternity services in the NHS. I am very excited about that, and I know that my hon. Friend will be, too.

[Alison Thewliss (Glasgow Central) (SNP)]

T7. Ministers will be aware of The Lancet series on breastfeeding and the open letter signed today by a range of organisations in the field calling for concerted action to promote, protect and support breastfeeding. Will the Minister meet me and these organisations to discuss the proposals further?

[Ben Gummer]

I am aware of The Lancet review, which makes some important points. We are not doing well enough yet in England, and it is of note that progress has been made in Scotland, Wales and Northern Ireland that we should be able to copy in England. I know that the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), who has responsibility for public health, will want to hold such a meeting to discuss that. We have made considerable progress, but there is still a differential between rich and poor that we need to fix.