Oral Answers to Questions

Chris Bryant Excerpts

Tuesday 5th March 2024 Commons Chamber

[Helen Whately]

I congratulate my hon. Friend on his successful campaigning for healthcare in Northampton, which is, as he says, benefiting from upgrades to the children’s A&E and the main emergency department and will soon have one of our 160 new clinical diagnostic centres. He will know that his local NHS integrated care board will decide whether to fund a new urgent treatment centre, and I have every confidence in his ability to persuade it of doing so.

[Sir Chris Bryant (Rhondda) (Lab)]

It is one of the great successes of the past few years that we now save the lives of a lot more people with an acquired brain injury. Although we might save them in acute and emergency care, however, a national strategy for acquired brain injury is a really important part of ensuring that people have the proper care thereafter. The Government appointed me and the Minister for Health and Secondary Care, the right hon. Member for Pendle (Andrew Stephenson)—he is just passing the hon. Lady a note to inspire her on the subject—to try to publish one. When does she hope that there will be money available to ensure that that strategy is one worth having?

[Helen Whately]

I know that the hon. Gentleman is a great campaigner on this issue; he has worked very hard on it with me in the past, and he now does so with my right hon. Friend the Minister for Health and Secondary Care. I assure him that we are in the process of revising the draft strategy, taking on board feedback from patients, their families, charities and the NHS, and we will publish the strategy in due course. I thank all stakeholders for their continued efforts.

--- Later in debate ---

[Victoria Atkins]

My hon. Friend knows only too well the importance of industrial action and the impact it can have on patients and on the NHS as a whole. I am pleased that the BMA has announced today, following the previous settlement that was narrowly rejected in its ballot, that it has been able to get back around the table with my officials and me. We have been able to find a fair and reasonable settlement that the BMA will advocate for and recommend to its members. We hope that that shows those who are choosing to strike that constructive negotiations, and trying to sort out some of the concerns that we know clinicians have, can be dealt with in a reasonable manner, which is of benefit not just to staff, but to patients.

[Sir Chris Bryant (Rhondda) (Lab)]

How many people were treated for acquired brain injury last year?

[Andrew Stephenson]

The hon. Gentleman has caught me off guard—I will write to him. I am keen to continue working with him on that issue. As he knows, we have already shared draft details of the acquired brain injury strategy with him and members of the all-party parliamentary group, and I am very keen to continue working collaboratively on that issue with him.

Lung Cancer Screening

Chris Bryant Excerpts

Monday 26th June 2023 Commons Chamber

[Steve Barclay]

My hon. Friend speaks with great authority on this issue, and she is right to highlight the importance of mesothelioma. A key theme of the pilots is the importance of convenience of access to screening, and a key part of the programme’s expansion is enabling it to be targeted at those communities that are at highest risk, as we heard a moment ago. I take on board her concerns about some of Medway’s challenges, and I know that she has called for this direction of travel more widely in the past—for the targeting of early detection in the community, because early detection brings far better patient outcomes.

[Sir Chris Bryant (Rhondda) (Lab)]

Screening is obviously important, and early detection is a good thing, but I wish the Secretary of State had not made this announcement today, because it is only a tenth of what we need to do to change things. There is a danger that we will make things worse.

My melanoma was diagnosed late, at stage 3, but my treatment started very quickly, within five days. My anxiety is that if we do not have enough radiographers and radiologists, as my hon. Friend the Member for York Central (Rachael Maskell) said, we will be shifting people from doing one set of tests—those for people who may have a later-stage cancer—to other sets of tests, unless we significantly increase the workforce.

Secondly, as the Secretary of State knows well, the statistics for people starting their treatment when we know they have cancer, because they have been diagnosed, are going in the wrong direction. I wish he had been able to stand at the Dispatch Box today and say, “We are going to have more radiographers and radiologists—I can guarantee that—and we are going to make sure that every single person who gets a diagnosis starts their treatment earlier and on time, otherwise we are failing them.”

[Steve Barclay]

Such is the nature of cancer that it has touched many Members, and I know the hon. Gentleman has taken a long, close interest in this issue. Of course, more than nine in 10 cancer patients get treatment within a month. He is right that it is also about diagnosis, which is why, through the community diagnostic centres, we are rolling out 4 million additional tests and scans, about which I spoke a moment ago. It is also why we have invested over £5 billion through our elective recovery programme, including over £1 billion for the 43 new and expanded surgical hubs. There is additional capacity going in, both on the diagnostic side and on the surgical hub side. We need to do both, and we are making significant progress.

Oral Answers to Questions

Chris Bryant Excerpts

Tuesday 6th June 2023 Commons Chamber

[Steve Barclay]

This is an innovative and exciting development, thinking about how we offer services in different ways and bring those services to patients much more locally. The community diagnostic centres are a huge step forward in that, but we should also be looking at our engagement with employers, at how we use more tests at home and at the successes we have had, for example, with some of the screening programmes in order to offer more services closer to patients.

[Sir Chris Bryant (Rhondda) (Lab)]

The figures on diagnosing people with cancer are certainly improving, but what is getting worse, and has got significantly worse in the last three months, is the starting of treatment for people who definitely have cancer. The figures are now the worst on record, with 19,000 people waiting for treatment, and all the evidence suggests that waiting another week adds 10% to the likelihood of death. Can I please urge the Minister not always to give the rosy, good statistics but to face up to the fact that there are real dangers in the statistics, too?

[Steve Barclay]

I know the hon. Gentleman takes a very close interest in this, and we can all see that there is a shared desire to meet the increasing demand. He recognises the progress on diagnostics. Nine in 10 patients are starting treatment within a month, and the all cancer survival index for England is steadily increasing, but I agree that there is much more still to do, which is why we are investing in diagnostic centres, surgical hubs and the long-term workforce plan. I am very happy to continue working with him and other colleagues as we meet this ongoing challenge.

Recovering Access to Primary Care

Chris Bryant Excerpts

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

I welcome my hon. Friend’s comments. There is £645 million of funding over the next two years to support the expansion of this work through Pharmacy First. As I said a moment ago, the estates programme is more an issue for the integrated care boards. We should not try to determine all the decisions on estates from Westminster; it is right that we let the 42 ICBs have more discretion over what is the right estate strategy in their area. I am sure that his local ICB will hear his representations.

[Sir Chris Bryant (Rhondda) (Lab)]

I completely support the idea of pharmacists being able to do more. For instance, it makes more sense that someone with shingles can go to a pharmacist today to get antivirals prescribed. My fear is that what has been announced today does not fully understand the crisis in primary healthcare. According to the numbers given by the Government’s own Ministers, in September 2015 we had 29,364 fully qualified GPs in England, but last September we had 27,556. By the Government’s own numbers, that is 2,000 fewer. Community pharmacies have gone from 11,949 in 2015 to 11,026—a nearly 10% fall. Do we need to do more to enthuse people to work in our NHS across the whole of primary healthcare? Would it be a good idea to change the model for GPs, so that we have more salaried GPs?

[Steve Barclay]

I have touched on the numbers a few times, but let me give the hon. Gentleman the precise figures. There are 335 more pharmacists than there were in 2010, so it is simply not the case that there are fewer. There are 2,000 more doctors in general practice, and there are also the extra 25,000 in additional roles. As I have said, someone who wants a prescription review should see a pharmacist, and someone with back pain should see a physiotherapist; not everything has to go through a GP, and it is better for GPs’ time to be used more effectively. There are also more doctors in training: 4,000 are receiving training in primary care, as opposed to 2,600 in 2014. So we are seeing more staff, more effort on recruitment, more effort on retention through the pension changes, and better use of the additional roles.

NHS Strikes

Chris Bryant Excerpts

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

In short, the position of the shadow Health Secretary seems to be to deny the vote of his own union, Unison, which voted 74% in favour; to not wait for the NHS staff council to reach its decision; and to unravel to some extent what has been meaningful and constructive engagement with the “Agenda for Change” staff council. My right hon. Friend is right to be confused about the Opposition’s actual position.

[Sir Chris Bryant (Rhondda) (Lab)]

I can see at least two other Members in the Chamber who know from personal experience that early diagnosis and treatment of cancer can save lives. I very much hope that any action taken over the next few weeks will not affect that, because that could mean people losing their lives before their time.

I have two significant worries about the long-term future of the NHS. One is seeing so many people, including those from poor constituencies and poor families, using all their life savings to buy an operation, because they know that that is their only means of getting back to work as there is such a long backlog. That feels like a form of privatising the NHS.

Secondly, there are terrible problems with recruitment and retention, with more than 110,000 vacancies in the NHS. I really hope we will see the workforce paper soon. It has been promised for a very long time, and I suspect “summer” may go on until autumn—it tends to every year, I suppose. It would be good to see that paper soon, because there are so many different parts of the NHS where we need to recruit more people. Everybody in this round is worrying, “Will the NHS be worth working for in 10, 15 or 20 years’ time?”. We can only do this if there is real confidence in the future.

[Steve Barclay]

The hon. Gentleman makes two important points. The workforce plan is critical, and I have referred to that already. He also raises the importance of early diagnosis of cancer, and he is absolutely right on that. He will have seen that the faster diagnosis standard was met in the latest operational performance data for February, which was extremely welcome news. There is obviously more still to do. That is why we are rolling out the programme of diagnostic centres and surgical hubs. We are redesigning patient pathways to streamline those journeys, and we are looking at variation in performance on such things as faecal immunochemical tests. There is a huge amount of work, but I hope he can see some progress in the latest figures.

More widely in terms of elective recovery, we made progress in the summer on the two-year waits, in stark contrast to Wales, which was significantly above 50,000. We got it under 2,000 in the summer. I will update the House shortly on the 78-week waits. We are working through the key actions in our elective recovery plan as we deal with the consequences of the build-up from the pandemic.

Moles and Skin Tags: Testing for Cancer

Chris Bryant Excerpts

Monday 12th December 2022 Commons Chamber

[Bob Seely (Isle of Wight) (Con)]

I am delighted to initiate this debate on melanoma in memory of my constituent Zoe Panayi, after whom “Zoe’s law” is named.

Zoe died of skin cancer in May 2020 at the age of just 26, after having an unusual mole removed at a private beauty clinic. She had trained to become a carer before finding a rewarding role as an assistant to the radiography and CT department at St Mary’s Hospital in Newport, in my constituency. She was the mother of two boys, Theo-Jay and Tobias.

On the night of 3 April 2020, Zoe went home from work feeling poorly. By 11.30 pm she had been admitted back to St Mary’s hospital, where she worked, and it was then discovered that she was in the late stages of cancer. Biopsy results four days later found that the melanoma, which had started in a mole on her back, had spread to her lymph nodes, liver, bone marrow, pelvis, and spleen. Very sadly, after the biopsy Zoe survived for just 55 days.

Over the course of the two years prior to her death, Zoe had raised numerous concerns with GPs about the unusual mole on her back. She had been told on multiple occasions that there was nothing to be concerned about, and after being advised to see a beauty clinic to have the mole removed, staff again raised no concerns about the removal of the mole. Tragically, it was later found that the act of removing the mole probably caused the cancer to grow and spread more rapidly. Zoe’s family, and especially her mum, Eileen Punter, to whom I pay tribute in this debate, have campaigned tirelessly since then to raise awareness of melanoma cancer and to ensure that others do not have to go through the same pain. I will make two suggestions to the Minister in the course of this speech.

By way of background, malignant melanoma is the fifth most commonly diagnosed cancer in the UK, and there are thought to be some 111,000 people living with malignant melanomas in this country. Approximately 16,700 cases are diagnosed every year, and about 2,300 people die every year from this cancer. This should not be the case, because the good news is that since the 1970s, the five-year survival rate for cancers of this type has increased from 52% to about 90%—nine out of 10— especially if they are caught early.

[Chris Bryant (Rhondda) (Lab)]

I congratulate the hon. Gentleman on raising this subject. As he knows, I had a stage 3 melanoma and I was told that I would have a 40% chance of living a year, but the science has moved on dramatically in the nearly four years since then. My biggest anxiety is that we do not have enough histopathologists and pathologists, and that people are getting their results slowly. There are also not enough dermatologists in the country, and lots of GPs are simply not trained in recognising potentially malignant melanomas fast enough. Do we not need to do far more to ensure that this cancer is fully understood, because it can kill, and to ensure that we have enough staff in the NHS to be able to treat it?

--- Later in debate ---

[Bob Seely]

I thank the hon. Gentleman for yet another excellent intervention, and I completely agree. In fact, I will come to those points now.

The Isle of Wight is a specific hotspot for skin cancer. I think it has the worst skin cancer rates in the United Kingdom, primarily as a result of certain factors. First, we still have a very white population, and the paler your skin, the more likely you are to develop melanomas. Secondly, we have an ageing population, and melanomas are cumulative. Thirdly, we have a very outdoors lifestyle on the Island, with golf, sailing, a lot of community activity and a lot of gardening. For the Isle of Wight’s retirement community especially, to be out in the sun aged 60 or 70 doing activities such as sailing, which is very harsh on the skin because of the interaction of sun and water, encourages melanomas. Fortunately, we have one of the best dermatology centres in Britain at Newport’s Lighthouse clinic, and I thank its doctors and staff for doing an excellent job. I have been there myself in the past couple of years, and I know what a great job they do.

In the NHS long-term plan, the Government committed that the proportion of cancers diagnosed at stages 1 or 2 will rise from about half to three quarters of all cancer patients, meaning that some 55,000 more people a year should survive cancer for at least five years after diagnosis.

Pilot schemes in various parts of the country are trying to improve the diagnosis of skin cancers and melanomas. One option to improve this still further is what, on the Island, we call Zoe’s law, but it would effectively be a change of practice within the NHS. Eileen, Zoe’s mum, and her family are doing it in memory of Zoe, and it would require all moles and skin tags removed from the body to be tested for melanoma. I am not expecting an off-the-cuff answer from the Minister on this point, but I would very much like her to write to me so that I can pass on her comments to Eileen and the rest of Zoe’s family. If that cannot be done now, I would like to know why not.

I would also like to know what more could be done in future, because thousands of people are needlessly dying every year. Skin cancers kill more slowly than many other cancers and are certainly more treatable than cancers such as lung cancer and pancreatic cancer. Eileen said Zoe thought of everyone before herself. When Zoe was dying, she said, “The most important thing is that other people do not have to go through this”—she left two young kids.

The idea of testing all removed moles and skin tags is potentially very popular, and a petition started by the family has now reached some 35,000 signatures. Tanya Bleiker, the previous president of the British Association of Dermatologists, recommended that all skin lesions, even if removed for cosmetic reasons, as Zoe’s was, should be sent for histopathological testing to confirm that they are benign—the hon. Member for Rhondda (Chris Bryant) also made that recommendation—because they might be deep rooted in the skin. Mr Ashton, one of our consultant dermatologists on the Isle of Wight, explained to me on Friday that innocent-looking moles can sometimes be the most deadly. They might look benign on the surface, but underneath they are malignant and hide melanoma.

I urge the Government to set out further plans on raising awareness of moles, as this is relatively easy to do. If I understand correctly, including this in nurse training and general practitioner training, especially in sunnier parts of the country along the south coast—places like Cornwall, Devon, the Isle of Wight and Hampshire—could be exceptionally valuable.

[Chris Bryant]

No one can see the back of their own head, but their hairdresser can, and quite often they are the person who can spot a melanoma.

[Bob Seely]

The hon. Gentleman reminds me of what Mr Ashton was telling me on Friday, because it is not only hairdressers but dentists. Dentists spend a lot of time looking at people’s faces, so they could potentially help to spot these things, too. Eileen, Zoe’s mum, spends a lot of her time trying to get this education process going, as she does not want other families to suffer as her family have.

At stage 1, a small and localised melanoma has a 97% five-year survival rate, which is extraordinarily high. By contrast, the five-year survival rate for a stage 2 melanoma is 76%, and it is 58% for a stage 3 melanoma, as the hon. Member for Rhondda had. By the time a cancer has spread from the skin to the lymph nodes, the bone marrow and other parts of the body, the five-year survival rate is only 15%. Sadly, Zoe was one of those who did not survive, because despite her worry, her visits to the GP and the fact that she had it removed, that cancer had been spreading all the time in her body.

I respectfully ask the Minister to write to me on the potential for 100% testing of moles for melanoma, cancer and whether they require further treatment. If there were such testing, some of the 2,341 people who died of the disease last year might have survived, including my constituent Zoe.

I pay tribute again to Zoe’s family, especially her mum for all the great work that she is doing. I ask the Minister to respond not only on the issue of testing for melanomas but on broader education for GPs, hairdressers, dentists and nurses, so that they are better able to spot cancerous moles before they spread.

NHS Industrial Action: Government Preparations

Chris Bryant Excerpts

Monday 12th December 2022 Commons Chamber

[Will Quince]

I do not know where the hon. Lady got the impression that I or anybody else was demonising NHS staff—far from it. The unions have chosen to bring forward this action. As I said, I hugely value and appreciate all NHS staff. That is why we have given them a pay rise this year, on top of the 3% pay award last year, when pay across the wider public sector was frozen.

[Chris Bryant (Rhondda) (Lab)]

I think the Minister knows that there is no clinician in the land who really wants to go on strike. Many clinicians feel that the crisis has been coming for a long time because of the issues around morale and lack of workforce, which I have asked the Minister about on many occasions. He keeps saying that the workforce plan is imminent, but that will not solve the immediate problems.

One nurse said to me the other day that what worries her most is that at any one time, several hundred thousand people in the country are waiting for their test results, particularly in relation to cancer. How will the Minister ensure that people get their cancer results in time to meet all the other cancer plan deadlines?

[Will Quince]

I thank the hon. Gentleman for his question; I know that he has a particular interest in the matter. We are looking to ensure that as many NHS services as possible continue during strike days. On his broader point about pay settlements, the average pay settlements in the private sector are within the range of 4% to 6%.

[Chris Bryant]

Not in the NHS.

[Will Quince]

Within the private sector it is 4% to 6%. The uplifts strike a careful balance in recognising the huge importance of public sector workers while minimising inflationary pressures and, of course, having an eye on managing the country’s debt.

Oral Answers to Questions

Chris Bryant Excerpts

Tuesday 6th December 2022 Commons Chamber

[Will Quince]

We have record numbers going into general practice, which is the remit of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), but part of the plan is to make it more attractive through practice improvement through cloud-based telephony, the additional roles reimbursement scheme, the 24,000 extra staff in primary care, developing multi-function staff so that people can develop their skills and have specialism but still practise as a GP, increasing the use of pharmacy, moving towards more continuity of care and the new GP contract for 2024-25.

[Chris Bryant (Rhondda) (Lab)]

But when are we going to see the workforce plan? The other day I spoke to a radiologist who runs a radiology department. There are meant to be 15, but there are only five and they have not had a single person apply. It needs more radiologists and radiographers. We have a national shortage of dermatologists, which is one reason why skin cancers are not being picked up, and a national shortage of pathologists and histopathologists. We need a dramatic increase in the number of people working in the NHS. When are we going to see that workforce plan?

[Will Quince]

As I said, we have committed to publishing a comprehensive workforce strategy, which, as the Chancellor set out, will be independently verified. That will come soon. We have also set out new pension flexibilities. However, it is important to point out that we have 29,000 more nurses and we are on track to meet our 50,000 target. We have 3,700 more doctors compared with last year, 9,100 extra nurses and 2,300 more GPs.

Ambulance Pressures

Chris Bryant Excerpts

Monday 18th July 2022 Commons Chamber

[Steve Barclay]

I know from conversations in recent days that there has been significant work around dispatch, the assessment of calls and the role of clinicians, particularly in 111. There is further work with frequent callers. I went out with the London ambulance service, and one of our visits was to someone who had had 140 ambulances visit him over the past year and a half. There are initiatives, and work going on, on how we assess calls and get dispatch right, but I am very happy to take forward the comments that my hon. Friend makes.

[Chris Bryant (Rhondda) (Lab)]

I, too, congratulate the right hon. Gentleman on his new post.

The Chair of the Health and Social Care Committee raised the question of what happens when people are ready to go into the community, but there is nowhere there for them to go. There is an even worse example: people who have major brain injuries, for instance as a result of a road traffic accident. The ambulance staff will get them to the major trauma centre, which will save their life, but if they are to get back their life with any degree of independence, they need a prolonged period of neuro-rehabilitation. Some of that will happen in hospital, but across large swathes of the country, there is nothing—absolutely no provision—outside hospital. With any other condition, we would not expect treatment, once started, not to be finished. How can we make sure that neuro-rehabilitation services, which give people back their life, are available across the whole country, and that there is no postcode lottery?

[Steve Barclay]

I know the hon. Gentleman is co-chairing, with the Minister for Care and Mental Health, a strategy board looking at these issues, and I would be very keen to explore that with him in due course. There is an opportunity—not just from a health perspective, but from a levelling up perspective—to look at the pockets where there are gaps in the way he sets out, and to see how we can get better coverage geographically as well as address the very real health needs he identifies.

Draft Mental Health Bill

Chris Bryant Excerpts

Monday 27th June 2022 Commons Chamber

[Sajid Javid]

May I first commend my hon. Friend for sharing his story and for being so open about it? There is no doubt that that will help a great many other people. I am sure he will welcome the Government’s plans for a new 10-year suicide prevention plan. I agree with him about the need to continue to work on improving provision, and I believe I will be having a meeting with him and Mr Starkie to discuss his campaign further.

[Chris Bryant (Rhondda) (Lab)]

I warmly commend what the Secretary of State said over the weekend. Many of us have experienced suicide in our own families, and it is good when people like him can share their experience; I think it helps an awful lot of people around the country.

Can I ask the Secretary of State about brain injury, which he knows I am a bit obsessed with? I visited three units—in Newcastle, Birmingham and Sheffield—the week before last. The big problem is that people are being given what is called a neurorehabilitation prescription, which is very similar to what he has described, but unfortunately, the moment they leave the trauma unit, the services that they require simply are not available in vast parts of the country. There are not enough occupational therapists, speech and language therapists, physiotherapists or psychiatrists to do that work.

The most distressing thing I heard was at the Birmingham Children’s Hospital—it does not have a hydrotherapy pool, which would be useful; nor does any other children’s hospital in the UK—which saw a 70% increase in brain injuries in children during covid from parents attacking their children. How are we going to get the workforce we need in order to make a difference to those people’s lives?

[Sajid Javid]

The hon. Gentleman will know that the investment already going into the workforce is at record levels. As the NHS sets out its 15-year workforce strategy, it will look into acquired brain injury, and rightly so. I thank him for the work he is doing with the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), on the ABI strategy. I understand that the call for evidence has just closed. That process will also help to bring about the change that he seeks.