Learning Disabilities Mortality Review

Chi Onwurah Excerpts

Wednesday 15th May 2019 Commons Chamber

[Caroline Dinenage]

The hon. Gentleman has partly tapped into my frustration with the fact that I am here today commenting on leaks of a report that has not yet been published, rather than on the full report, which, when it comes out, will provide clear recommendations as to how we can move forward on this matter. As I have said, we are already writing to reinforce the message that should be self-evident—that learning disabilities should never be a reason for a “do not resuscitate”. When the report is finally published, it will include a very well-considered recommendation as to how we tackle this issue in a way that will ensure that this situation will never happen in future.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

Thank you for allowing this urgent question, Mr Speaker. We should acknowledge that those with learning disabilities have not had their fair share of parliamentary time, and this review into learning disabilities mortality will be a matter of huge concern to them, their friends and their families. The Minister says that resources are going into the review. Will she confirm that a review will be allocated to everybody who has reported a death, and that the impact on access to care for people with learning disabilities from socioeconomically deprived backgrounds is being specifically considered?

[Caroline Dinenage]

The hon. Lady is absolutely right that we need to have much more discussions like this in this place because health inequalities need to be addressed and we need to be outspoken about them. The whole point of asking NHS England to commission this review is to think about how we address the most severe of these inequalities, which is when people die early or in a way that might have been preventable. We want to ensure that every single death of a person with a learning disability—whether or not people regard that it was preventable from the outset—is looked at very carefully. People should always have that reassurance, regardless of where they live and what kind of socioeconomic background they come from.

Oral Answers to Questions

Chi Onwurah Excerpts

Tuesday 7th May 2019 Commons Chamber

[The Minister for Care (Caroline Dinenage)]

Yes. By 2020, we expect all relevant staff to have received appropriate dementia training.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

T4. In the north-east, over half of domiciliary care workers are on zero-hours contracts, 40% have no relevant qualification and, as the recent Low Pay Commission report shows, rates of non-payment of the minimum wage are rising, but enforcement is not. What will the Secretary of State do to improve the pay, conditions and training of careworkers who provide such an essential service?

[Caroline Dinenage]

This is all about getting more money into the system. That is why we have increased spending on adult social care by 9% over the last three years. We are focusing on attracting more people into adult social care, which is why we had the “Every Day is Different” recruitment campaign, to ensure that we get more brilliant-quality staff into adult social care roles.

Oral Answers to Questions

Chi Onwurah Excerpts

Tuesday 26th March 2019 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend is right: cervical screening saves up to 5,000 lives every year, so we cannot do enough to encourage women to take advantage of the screening. It is not the most pleasant experience to go through, but it can save lives. I would encourage everyone to take advantage of the screening, and we will continue to do our best to promote it.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

In Newcastle, cervical screening rates have fallen since 2010: they range from 85% to just 23% and are consistently lower in poorer areas and among younger women and ethnic minority women, and across the UK women are more likely to die in more deprived areas. What specifically is the Minister doing not just to encourage women to attend but to make screening more available at the weekends, out of hours and closer to where people live?

[Jackie Doyle-Price]

The hon. Lady makes some excellent points and highlights those areas of the community where take-up is much lower. We need to be more imaginative about how we promote the need for screening, and in that regard I am very pleased to see the work of Jo’s Trust, and also that of the Eve Appeal to raise awareness. We can all do our bit, and I would encourage everyone to spread the word about the need to get screened.

Oral Answers to Questions

Chi Onwurah Excerpts

Tuesday 15th January 2019 Commons Chamber

[Caroline Dinenage]

I warmly welcome the organisation that my hon. Friend mentioned. There are some outstanding voluntary community-led organisations up and down the country that provide invaluable support for people who suffer from this condition. We know that symptoms can vary and that it can be incredibly distressing, so that support is enormously valuable.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

The effectiveness of primary care in this and many other areas is undermined for the most vulnerable and poorest communities by this Government’s insistence on putting out GP contracts for competitive tender, even when there is no competition to serve poor communities. The Watson review of GP partnerships was published today. Will the Minister commit to reviewing the requirement for competitive tender for GP partnerships?

[Caroline Dinenage]

We do of course support the recommendations that were part of that review. We have announced massive investment in primary and community services and spend on those services will grow as the NHS budget grows.

Oral Answers to Questions

Chi Onwurah Excerpts

Tuesday 24th July 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend has raised an extremely important point. The Home Secretary recently announced a settlement scheme to enable those staff from the European economic area to remain. However, it is also important for us not to scare EU nationals, and to point out that there are now 4,500 more non-UK EU nationals working in the NHS than there were two years ago, at the time of the referendum. There is often a sense that there are fewer, but that is not the case.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

20. The number of vulnerable adults in Newcastle is rising by 20% each year. The over-85 population is set to rise by 60% in the next decade, and additional cost pressures will mean £30 million in extra costs over the next three years. How is Newcastle City Council supposed to meet the adult social care budget, given the cuts that have been made in it? I ask the Minister please not to mention the adult social care precept, because it does not even begin to cover those costs.

[Stephen Barclay]

I would have expected the hon. Lady to welcome the additional funds that have been announced—not just the £2 billion for social care, but the extra £20.5 billion a year, in real terms, that will be delivered through the long-term funding settlement. Instead of criticising that funding, the hon. Lady should welcome the Government’s commitment to increasing funds for the NHS and ensuring that it remains fit for the future.

Oral Answers to Questions

Chi Onwurah Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Hunt]

I thank my right hon. Friend for doing some incredibly important work when he was responsible for this area; he laid some really important foundations. My right hon. Friend is absolutely right: earlier my hon. Friend the Minister for Care talked about the fact that 81% of adult social care providers are good or outstanding, but that means that one in five is not, which means too many people are not getting adequate social care provision. We must put quality at the heart of this, and of course that does link to funding.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

I hope the Secretary of State saw last night’s “Panorama”, which highlighted the link between the low pay of careworkers and the gender pay gap. We all know about the amazing work careworkers do, particularly in difficult circumstances such as when there is severe weather or where there are 15-minute appointments, so what is the Secretary of State going to do to ensure they are properly rewarded?

[Mr Hunt]

I am pleased that the hon. Lady mentioned that, because today is world social worker day. It is a day on which to celebrate the brilliant work done by people working in the social care system, often at low rates of pay. We should also celebrate the fact that, thanks to the national living wage, 900,000 workers have benefited, including through a raise of up to £2,000 a year in the take-home pay for the lowest paid workers.

Oral Answers to Questions

Chi Onwurah Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Dunne]

I can honestly say that the best thing the hon. Gentleman can do to understand what STPs are really all about is talk to the recently appointed chair of the Norfolk and Waveney STP, which covers his local area. He will find that the former Labour Secretary of State, Patricia Hewitt, can give him very good advice.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

14. What steps he is taking to tackle inequalities in the provision of dental health services.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

NHS England has a duty to commission primary care dental services to meet local need, including for the most deprived groups. Nationally, access continues to grow with 1.9 million more patients seen between 2010 and 2016. The Starting Well programme, of which I am sure the hon. Lady is aware, will work to improve the oral health of children under the age of five in 13 high- needs areas. The dental contract reform programme is also working to improve access and oral health.

[Chi Onwurah]

Seven people per day in my constituency are going into A&E because of toothache, and the poorest among us are twice as likely to be hospitalised for dental care. Yet there is no mention of dental care in the “Five Year Forward View”, and funding has fallen by 15% since 2010. Why is the Minister leaving my constituents in pain and overburdening A&E by neglecting dental care?

[Steve Brine]

I am interested to hear the hon. Lady say that, because the January to March 2017 GP patient survey results, which were published in July, show that 97% of those trying to get an NHS dental appointment in the Newcastle Gateshead clinical commissioning group area were successful, compared with the 95% England average.

Oral Answers to Questions

Chi Onwurah Excerpts

Tuesday 4th July 2017 Commons Chamber

[Mr Dunne]

I believe that my hon. Friend is the only dentist in the House, and he still practises occasionally. I would be delighted to meet my hon. and experienced Friend to discuss the issues about dentistry that he raises.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

13. What assessment he has made of the consistency and quality of GP services in (a) Newcastle and (b) England.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

In 2016, 85% of patients surveyed across England reported a good overall experience of their GP surgery. In the Newcastle Gateshead CCG, patient satisfaction is even higher than the national average at 88%.

[Chi Onwurah]

Newcastle has fantastic GPs, but many of my poorest and most vulnerable constituents suffer from GP unavailability and a constant change of providers due to the requirement to re-tender every couple of years to a market that, quite frankly, does not want them because they are too poor or too marginalised to make money from. Will the Minister meet me and my local CCG to find out how we can ensure that those people get the quality and consistency of GP services that they deserve?

[Steve Brine]

I am very happy to do that.

Rare Diseases Strategy

Chi Onwurah Excerpts

Tuesday 28th March 2017 Westminster Hall

[Ben Howlett]

I am sure that the Minister heard that and will pass it on to the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon.

We also saw evidence of poor communication between the organisations responsible for implementing individual commitments and other stakeholders involved in the strategy. What plans does the Minister have to better co-ordinate that communication? Many patients do not have access to the appropriate treatment or information about their condition, and the barriers to accessing information about a condition begin as soon as a diagnosis is made. Unfortunately, that leads to patient care continuing to be poorly co-ordinated.

I know that the Minister is a superb champion for those with rare diseases, and given the rare condition that the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon, has, I hope that he provides more information about the Government’s commitment from last week. Hopefully they can commit to the Department of Health developing a comprehensive implementation plan that describes actions for its arm’s length bodies in particular. An implementation plan would offer direction to bodies involved in rare disease patients’ care, so that they can take action to improve the services that patients need. It would help patients to understand what progress is being made and to ask the right questions when it is not. It would also help to ensure that the needs of rare disease patients and their families are considered in decisions about patient care and access to treatments taken by bodies involved in the strategy.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

I congratulate the hon. Gentleman on securing this important debate. I welcome the recommendations in the strategy, although I am concerned that the recent announcement on capping NHS drug prices will influence implementation. Muscular Dystrophy UK has said that it would have a major impact on drugs for muscular dystrophy and other rare diseases. Newcastle is fortunate enough to be home to the John Walton Muscular Dystrophy Research Centre, but support could be improved further by providing specialist psychological support for people with muscle-wasting conditions. Does the hon. Gentleman agree that such support needs to be an integrated part of service provision for muscular dystrophy and other rare diseases?

--- Later in debate ---

[Ben Howlett]

I thank the hon. Gentleman for his intervention and pay tribute to him for his work on rare diseases over the years. One of the first events I ever went to in Parliament was on rare diseases and was hosted by him. I could not have put it better myself. I will come later to my view that the issue needs to be thought about in a more timely way, potentially in a consultation and through some sort of implementation plan, which has been missing. It will impact not just people with muscular dystrophy, for example, but all those with the different conditions that he has championed in the past.

The four medicines evaluated to date have shown tremendous benefits to patients, and are life-saving and life-extending treatments. They are some of the most powerful and effective treatments for rare diseases ever seen, and the highly specialised technology evaluation committee recommended them for funding in England, but none of those life-changing medicines would have been able to raise the lower threshold significantly, and none would have been approved under the new regime.

If implemented, the plans will significantly affect patients with rare diseases and their ability to access life-changing treatment, at a time when we should be expanding access routes rather than limiting them further. The changes contradict the positive recommendations made in the accelerated access review and will restrict any attempt through the industrial strategy to position the UK as a centre for the development of innovative medicine. England already has extremely slow and limited access to treatments for rare genetic conditions; further narrowing of access routes will shut the door to innovation for our community of patients and families. It is unacceptable to implement such drastically damaging proposals just 18 days after they were announced. I therefore join the sector in calling for a pause in implementing the proposals and for a consultation and impact assessment.

[Chi Onwurah]

I thank the hon. Gentleman for his kindness in giving way once again. The John Walton Muscular Dystrophy Research Centre was named after a peer, now sadly deceased, who also founded Muscular Dystrophy UK and saw over a long lifetime the importance of the UK’s role in innovative science and research techniques, and its economic benefits to the research sector and, more widely, our international reputation. The changes proposed to NHS England will do much to undermine that.

[Ben Howlett]

I think the sector agrees on that point, from patient groups to the constituents whom the hon. Lady represents, as well as all the people with an undiagnosed condition who might access the services of that facility in future and many others throughout the country. The Government need to rethink the implementation and ultimately introduce an impact assessment on that basis.

I know that several hon. Members want to speak, so I will conclude by welcoming the commitment and dedication of this Minister and the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon, in providing a solution to our long-standing problems with the implementation of the rare diseases strategy in England. Following the publication of our report, I hope that the Minister will be able to provide clarity on the questions that I have asked. The UK is doing superb work and leading internationally on rare diseases.

O’Neill Review

Chi Onwurah Excerpts

Tuesday 7th March 2017 Westminster Hall

[Kevin Hollinrake]

That is right. I had a test myself at a drop-in session in Portcullis House that showed me that I was not ill—I did not think I was ill, but they told me that I was not, which was reassuring. Again, we need to ensure that prescriptions are given when they will be effective. One other area that we do not seem to have control over at the moment is the online sale of antibiotics: whether through UK-based pharmacies or those based overseas, it is too easy to access drugs without a proper prescription.

The second key point that the O’Neill review highlights is the need for a global public awareness campaign so that people are aware of the issues. Again on Twitter yesterday, a student who had undertaken some analysis said that 80% of the people she had spoken to had no awareness of antibiotic resistance. We need a significant national and international effort to draw public attention to the problem. As people have already said, we need a reduction of usage in agriculture. That is clearly set out in the O’Neill review as one of the four main recommendations.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

The hon. Gentleman is making an important point about the dangers of antibiotic resistance. Does he agree that as well as not prescribing antibiotics for illnesses, it is important to recognise when there are alternatives that will reduce the use of antibiotics overall? For example, there is research being done at Newcastle University into using antiseptics for urinary diseases.

[Kevin Hollinrake]

Yes, what we need is a mixture of solutions. The UK by its own admission is mid-range across Europe in its use of antibiotics in agriculture. That is one thing, but we have been world leaders on this issue and for me mid-range is not where we need to be; we need to be at the forefront and world leaders in terms of best practice, whatever aspect of this issue we are dealing with.

There are four key recommendations in the O’Neill review’s 10 main recommendations. The last one is on market entry rewards to solve the problem of pharmas not investing in research and development, as well as a possible levy on drug companies that do not invest in research.