World Sepsis Day

Debate between Christina Rees and Jim Shannon

Wednesday 13th September 2023 Westminster Hall

[Christina Rees]

I thank my hon. Friend for her important intervention and I am very sorry to hear of her constituent’s loss. My heart goes out to Rick’s family and friends. I will speak a lot about the UK Sepsis Trust, because it helped me enormously and I want to highlight its work in fighting sepsis.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady on securing this debate and for the very personal story she has conveyed to us all—we are very much moved by it. To reinforce what the hon. Member for Feltham and Heston (Seema Malhotra) said in her intervention, sepsis claims some 11 million lives globally each year, or five lives every hour in the United Kingdom. That is more than the deaths from bowel, breast and prostate cancer combined. To give a Northern Ireland perspective, sepsis affects around 7,000 people yearly in Northern Ireland, of whom 1,240 lost their lives to it in 2021. Does the hon. Member for Neath (Christina Rees) agree—I suspect the answer will be yes—that there must be more awareness of the earliest symptoms, to ensure that death from this dangerous and life-threatening disease is reduced as much as possible across all of the United Kingdom of Great Britain and Northern Ireland?

[Christina Rees]

I agree with the hon. Gentleman. He must have seen my speech, because he has quoted some of the stats that I am going to come on to later.

What is sepsis? It is a life-threatening condition that arises when the body’s response to infection causes injury to its tissues and organs. It is a global health concern, but today I will focus on its prevalence, the challenges and some potential solutions in the UK. Sepsis is indiscriminate. While it primarily affects very young children and older adults and is more common in people with underlying health conditions, it can readily occur in those who are otherwise fit and healthy.

Sepsis can be triggered by an infection, including chest and urinary tract infections. It is not known why some people develop sepsis in response to those common infections whereas others do not. Sepsis is often referred to as “the silent killer” because of its ability to strike swiftly and unexpectedly. In the UK, sepsis is a significant public health problem. Each year around 240,000 cases are reported, leading to more than 48,000 deaths.

Sepsis is the leading cause of avoidable death in the UK, claiming more lives than breast, bowel and prostate cancer combined. Unlike data for heart attacks, strokes and cancer, sepsis data is imprecise, because it relies on coded administrative data rather than the granular clinical data of patient-level registries. Moreover, this striking deficit means that not only do we find it necessary to estimate the burden of disease, but we are decades away from precision medicine for sepsis. However, therein lies a paradox, as the UK’s unique healthcare infrastructure means that we are well placed to change that for the world.

Around 40% of people who develop sepsis are estimated to suffer physical, cognitive and/or psychological after-effects. For most people, those will only last a few weeks, but others can face a long road to recovery and develop post-sepsis syndrome. One of the biggest challenges in tackling sepsis is early diagnosis. Sepsis can mimic other common illnesses, making it difficult to spot in its early stages. Symptoms such as fever, increased heart rate, rapid breathing, confusion and extreme pain can be attributed to various conditions. This leads to delayed treatment, which significantly worsens the patient’s chance of survival.

To combat sepsis effectively, awareness is the key. The UK and devolved Governments, healthcare professionals, and organisations such as the UK Sepsis Trust have been working tirelessly to educate the public and healthcare providers about the signs and symptoms of sepsis. Public awareness campaigns and training for healthcare workers have been instrumental in improving early detection. Timely intervention is crucial in sepsis management. The UK Sepsis Trust’s “Sepsis 6” care bundle and treatment pathway includes administering antibiotics, providing fluids and monitoring vital signs, and has been implemented in 96% of hospitals across the UK and in 37 other countries worldwide to ensure rapid and effective treatment. Early recognition and swift action can save lives and reduce the severity of sepsis-related complications, but despite such work, there remain many cases of avoidable death every year.

Careers Guidance in Schools

Debate between Christina Rees and Jim Shannon

Tuesday 11th January 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate and to serve under your chairmanship once again, Ms Rees, renewing the relationship with you in charge and myself making a small contribution, as often happens in this Chamber. I thank the right hon. Member for Tatton (Esther McVey) for setting the scene so well for each and every one of us. I know that the Minister has no responsibility for Northern Ireland; however, I will give a Northern Irish perspective, as I often do, to replicate and support what the right hon. Member for Tatton has said on the importance of careers choice and guidance in schools, and where we want to be on that matter.

It is a pleasure to be here and to participate in this debate. I have stated all too often that children are the future, and I believe that it is our responsibility to ensure that they have the platform and the opportunities to make the most of their lives in terms of employment. I think I recall intervening on the right hon. Lady when she spoke in a Friday debate—while I was in Parliament for my Automated External Defibrillators (Public Access) Bill—to support her as she once again pursued careers guidance for young people.

It is a great reassurance to know that the correct strategies are in place for schools. As the right hon. Lady and other hon. Members have said, it is very important for where we are with our schools and the guidance that they give. The preparing for success strategy, set out by the Department of Education in Northern Ireland, aims to develop more effective career decision makers, leading to increased and appropriate participation in education, training and employment. Schoolchildren in Northern Ireland choose their GCSEs in year 10, when they are 14 or 15 years old. It is fair to say that children are forced—albeit gently—to think about their futures at a young age, so it is essential that the support is in place to enable them to start doing that.

I have served on the board of governors of Glastry College, one of the schools in my constituency for—my goodness; I am just trying to think—more than 30 years. Although I did not attend that school, my boys did. What I have learned from being on the board of governors was that there is a chance to guide young people to where they want to be. Not everybody will be educationally inclined; some are more physically focused and want to work on farms or in factories, and there is plenty of choice for that in my constituency. The main thing is that young people understand the opportunities they have.

There are many schools in my constituency of Strangford that offer sixth-form education. In particular, I would like to mention the South Eastern Regional College in Newtownards, which has countless specialities for teens to take an interest in, whether in mechanics, beauty treatment, working in shops or managing a business—those courses are all there.

Recent statistics have shown that a massive 65% of those studying for a degree admit to having regrets about their academic choice. Further statistics show that two out of five schoolchildren in their final year of school would feel like a failure if they did not progress to university. Not everybody can, should or needs to go to university, but it is good to know that they will have that opportunity if they have the ability to do so. I must say that better careers guidance in schools has the potential to reduce those figures, which I find quite shocking. I have spoken to younger constituents who have said that their schools allocate each of them a careers adviser, with whom they have one-to-one chats throughout the years they are at school. I strongly encourage that not only in schools but in universities and colleges. Some children have little or no idea what they want to do in life, and that is just the way it is, but they do focus. I certainly ended up doing something that I never expected—I always had an interest in politics, but I never thought I would be here—and it is the same for many people.

The lack of careers guidance and support can factor into this. The JobReaders Academy has revealed that the second biggest factor in why six in every 100 pupils drop out of university is poor secondary school preparation. If that is where it starts, that is where things need to start improving. We must remember it is not solely down to secondary schools to teach our young people; the correct careers advice must be readily available in universities, too.

We must ensure that our schoolchildren are encouraged to start thinking about their futures. Yes, it is scary, and I cannot stand here today and say that when I was a wee boy, I was 100% sure what I wanted to be—apart from wanting to be a Royal Marines soldier, a train driver, a shopkeeper, a salesman and ultimately to have my own business. All those sorts of things go through someone’s mind when they are aged nought to 10, or nought to 16, and they may end up somewhere they did not expect to be.

Ofsted has revealed that schoolchildren want to see more information on the full range of courses run by FE colleges and other providers, since not everyone wants to do A-levels and go to university. It is essential that there is the opportunity to do that through careers guidance. We want all young people to have the same opportunities, if possible, but they will go their own ways.

I urge the Minister and the Department to work with their education counterparts in the devolved nations to ensure that children have access to all sorts of careers advice, and so that we can exchange ideas. I am sure that she does so regularly with her counterparts in the other regional Administrations. I believe that careers guidance should start in schools and not stop at university. Many young people from Northern Ireland end up at universities here in the mainland. Guidance should be available inside and outside education settings, and we must not let our youngest be hindered from reaching their full potential because they did not have the means to get there in the first place.

[Christina Rees (in the Chair)]

I am sorry, but we will have to go down to three and a half minutes.

Surgical Fires in the NHS

Debate between Christina Rees and Jim Shannon

Thursday 16th December 2021 Westminster Hall

[Christina Rees (in the Chair)]

I remind Members that they are expected to wear face coverings when not speaking in the debate. That is in line with Government and House of Commons Commission guidance. I also remind Members that they are asked by the House of Commons to have a covid lateral flow test twice a week if coming on to the parliamentary estate. That can be done either at the testing centre on the estate or at home. Please also give each other and members of staff space when seated and when entering and leaving the room.

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the matter of preventing surgical fires in the NHS.

It is a joy to see you in the Chair, Ms Rees, for the third time this week, and to be here myself to make a contribution to the debate. I am pleased that other hon. Members are present: the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar); the shadow Minister, the hon. Member for Ilford North (Wes Streeting); and the Minister. It is no secret that I am very fond of the Minister. She and I have worked together in the House on many health issues, and I very much look forward to her response. This topic is of significant importance, so I am glad to see other Members in the Chamber to make what I am convinced will be significant contributions.

As Members are aware, health has been my portfolio in this House for quite some time—almost 10 years—which means I have been exposed to some of the more challenging issues to face the healthcare system across the United Kingdom. Today’s discussion is about one of those: surgical fires in operating theatres. It is certainly one of the most concerning issues that I have come across in my time in this House. Did I know much about it? I probably did not, but once it was brought to my attention in this place and back home in Northern Ireland, where it is a devolved matter and the responsibility of a Minister in the Assembly, I became aware of it.

I spoke to the Minister present before the debate, and she has some of the questions in my speech from my staff and others. I very much look forward to her response to the questions that I will pose today. First, however, I pay tribute to the work of the expert working group on the prevention of surgical fires, who brought the matter to my attention and whose report on the prevention and management of surgical fires I recommend to the Minister and all Members of the House. It is a thorough and detailed report, which encapsulates the issues that we will discuss in the debate and gives the Minister and her Department the opportunity to respond, I hope in a positive way.

I had the pleasure of chairing the parliamentary launch of the working group’s report in November last year. I am sure that their report and campaign will feed into much of the debate—it certainly will through my comments, and I am pretty sure it will through those of other hon. Members as well.

I want to underline what we mean by surgical fires and the serious dangers they pose to patients and clinicians alike. A surgical fire is a self-descriptive name: it is a fire that occurs during surgery in an operating theatre. In order for a surgical fire to occur, three elements must be present: the ignition source, the fuel and the oxidiser. Ignition sources include electrosurgical units, fibre-optic light sources and lasers. The fuels regularly include alcohol-based skin prepping agents that have been used in excess or applied inappropriately. The oxidiser is simply an oxygen-rich environment in which nitrous oxide is present, alongside the oxygen. Those are the three ingredients, or the three elements that are the reason for surgical fires. I do not believe that it is impossible to address the issue, through the Department and the Minister’s response, so that we can ensure that such fires do not happen.

The statistics, which the people working in the background have gained from across the whole United Kingdom, highlight just how worrying this matter is. The report states:

“Injuries caused by a surgical fire most commonly occur on the head, face, neck and upper chest.”

By and large, that is where operations focus on, and a fire can leave victims with debilitating pain and lifelong physical and psychological scarring—I will later give the example of someone whom I met in this House at a presentation that we did some time ago. A surgical fire can also cause harm to operating theatre staff, who are exposed to similar risks. It can affect not just the patient on the table who is having the operation, but the staff, so there is a dual responsibility for safety—obviously for the patient, but also for the staff.

Like so many members of the public and those of us present for the debate, I had absolutely no idea that surgical fires posed a threat to patients across the United Kingdom, and I was unaware of the extent of the injuries that they can cause, so I am extremely pleased that this subject is being debated, even though we are in the graveyard slot. We are going into recess after today, so most Members have probably left. That is unfortunate, because others had wished to participate but could not stay. The omicron variant has also been part of the problem, and that is perhaps the case for the shadow Minister who was originally going to participate in the debate but could not do so. We are ever mindful that although we may be small in number, the debate is none the less important, and we want to put that on the record.

Today’s debate is about raising awareness about the seriousness of surgical fires and pushing for the next steps to ensure that they no longer happen. Ultimately, that is the goal of the debate—to ensure that precautions are taken so that surgical fires do not happen. What I will outline in my contribution will helpfully enable the Minister and her Department to take the necessary action.

I am sure that many Members will be asking the same question that I did when this issue was first brought to my attention: how common are surgical fires? That is a question that many of us ask. The reality is that nobody knows entirely, but the expert working group sent out a freedom of information request to trusts, health boards and relevant bodies across the United Kingdom. Although there were significant discrepancies across all organisations, the NHS England acute trusts and Welsh health boards stated that they recorded some 96 surgical fires between 2010 and 2018. The report states:

“A search of the National Reporting and Learning System (NRLS) data from between 2004 and 2011 identified just 13 reported surgical fires.”

The important point is that, by comparison,

“NHS Resolution claim to have been notified of 631 clinical negligence claims relating to surgical burns to patients”

between 2009 and 2019. NHS Resolution also claims to have paid out £13.9 million

“in damages and legal costs on behalf of NHS organisations.”

The data that some of the trusts and health boards hold as their evidential base indicate to me that the issue is bigger than many people thought. The fact that some £13.9 million has been paid out in damages and legal costs emphasises that point with a strong evidential base. I am sure that the figure is still a stark underestimate of the scale of the problem, and not all incidents will have been recorded. I suspect the number of claims could be bigger than 631, and that does not even account for all the near-misses that may have occurred in operating theatres across the United Kingdom.

According to a survey by the Association for Perioperative Practice, which is one of the largest membership organisations for operating theatre staff, almost half of its members have personally witnessed a surgical fire—again, an evidential base to prove that this issue is like picking at a scab, because the evidential base and examples are far-reaching and quantitative. There is no question but that there is a clear and obvious discrepancy in how surgical fires are reported, which raises questions about the true number of such incidents.

One of the key questions is what reason is behind the large discrepancy in reporting and why the number of surgical fire incidents that occur each year cannot be accurately quantified. The answer is quite simple: it is not mandatory for trusts to report these events when they take place. I am astounded that that is the case. There is evidence to show that £13.9 million was spent in pay outs for damages and legal costs, and that there were 631 fires. How can it be possible that it is not mandatory to report when someone is set alight during surgery? It is bound to be a fairly dramatic situation. These figures do not even cover the near-misses that must occur on a regular basis.

As the Minister may know, over the past year I have tabled a few parliamentary questions, asking the Government to provide an answer about the number of surgical fires that occur every year, but each time they have been unable to do that. I find it concerning that the Government accept that surgical fires are an issue within the NHS but they still do not know the true scale of the problem. Such is the magnitude and severity of this issue that I would have thought the Government might respond. I say that very respectfully, which is my way of doing things, Ms Rees; when I ask questions, I ask them both to get the answer and to improve the situation. That is probably why I always see the glass as half full, rather half empty. I look to the Minister for a response on that.

The Government are still not monitoring or reporting issues that threaten the safety of patients in the UK. This is also a structural problem that requires proper education and training, and puts in place the necessary protocols to mitigate and reduce the risk as much as possible. One would assume that trusts across the country all have protocols in place to prevent such fires from occurring, but I am sad to report that that is not the case.

According to research by the expert working group, which examined specific protocols and training programmes addressing surgical fires in local NHS trusts, only a limited number of trusts across the UK actually have surgical fire protocols. I think it is vital that they should have them, but many rely on general fire safety guidelines, where there is often no mention of surgical fire risk and prevention processes. Again, I look forward to the Minister’s response about what protocols and safety measures can be put in place.

According to a survey by the Association for Perioperative Practice, over half the respondents reported not having surgical fire protocols to date, while almost two thirds reported that their organisation did not provide training courses or education for operating theatre healthcare professionals on preventing surgical fires. Again, there has to be a clear change of focus among healthcare professionals to ensure that this issue is addressed.

A third of respondents reported receiving training and education, and that training included both high-risk management courses and more generic fire safety training, which was more reactive than preventative. I am a great believer in early diagnosis and preventative measures, rather than reactive measures, so I hope that as a result of this debate we will have measures put in place to address those issues. The training is clearly not adequate for the seriousness of the danger at the moment. The lack of prevention and management protocol is completely unacceptable and represents a clear and present danger to all patients who undergo surgery in the NHS.

It is truly astonishing that surgical fires are already recognised as a safety concern in other countries. I will give examples of those, because if other countries can see the risk, difficulty, impact and severity of this, then I know that our NHS, which we all treasure and love, can deal with the issue equally well, if not better. Yet there is insufficient guidance about how to prevent and manage surgical fires in the UK.

In the United States, the Food and Drug Administration already provides a list of specific recommendations on reducing the incidence of surgical fires. These include conducting a fire risk assessment at the beginning of each surgical procedure, which seems to be logical. Again, maybe the Minister can give us some indication of whether that is a procedure that the NHS will adopt. Those recommendations also include additional safety procedures such as planning and practice on how to manage a surgical fire, including how to use carbon dioxide fire extinguishers. Are those things available in the NHS? They should be, so if not, is there an intention to put them in place? As a result of introducing the necessary protocols, educational tools and reporting systems, the number of surgical fires in the United States has dropped by 71% since 2004. By putting the right strategy and safety measures in place, we reduce the threat. That is my goal today, and that is the approach we should be trying to emulate within the NHS.

The expert working group’s report made a number of recommendations on the prevention and management of surgical fires. I do not intend to read out the entire report—even though I have three hours, I do not want to put people to sleep when they want to go home—but I want to highlight four of its key recommendations. First, professional associations should explore the value of a national awareness campaign for healthcare professionals. Secondly, education on surgical fire prevention should be mandated in the surgical and perioperative education and training syllabus. Thirdly, NHS England should explore how to evolve the procurement process for sanitation products, in order to reduce surgical fire risk and encourage procurement of proven surgical fire-safe technologies. Fourthly, NHS England should explore the development of a standardised patient safety alert system that aligns the processes and outputs of all bodies and teams, and ensure that they set out clear and effective actions for providers to take on safety-critical issues. If I were to ask for nothing else today, I would ask for those four recommendations to be acted on, because that would be a massive step forward.

It is clear to me, as I hope it is clear to other Members, that effective education and training are the primary means of preventing the incidence of surgical fires. Despite some form of fire safety training being mandatory for all NHS staff during their induction and ongoing employment, that training does not address the unique features involved in preventing or extinguishing a surgical fire. The response to different kinds of surgical fires can differ, as can an individual’s role, depending on who is present at the time. I know that the past year and a half—almost two years—have been extremely difficult due to covid, and that the NHS, the Minister and the Government have other priorities, but this is about prevention. It is about making sure that surgical fires do not happen again, and it is logical to try to do so: it would have stopped that £13.9 million from being paid out in damages and legal fees. Meanwhile, preventative measures and effective management strategies require additional education and training, and the absence of such training currently acts as a barrier to eliminating incidents of surgical fire and ensuring an appropriate response.

As I have highlighted, providing detailed guidance and encouraging the individuals who constitute the perioperative team to consider their role in surgical fire prevention has led to a statistically significant decline in the incidence of such fires in the United States. Their incidence has fallen by 71%—wow! I did not do the mathematics, but if we brought that 631 down by 71%, it would be approximately three quarters of that number. It is clear to me that surgical fire training should be made mandatory across the NHS and the private sector, and should be updated at least every two years. Again, I refer to those four asks: we need to make sure that those matters are taken on board, so that we have a proper system in place for the future as well.

Despite education being an essential method of preventing surgical fires, it is no use if it is not mandated, and if we still fail to tackle the institutional failure to truly record the scale of the problem. Following discussions with the expert working group and others, I call on the Minister to instruct the Centre for Perioperative Care to investigate the possibility of making surgical fires a never event, meaning that they never happen again. We would like to see surgical fires made a never event as part of the CPC’s work on redeveloping the national safety standards for invasive procedures to ensure they remain fit for purpose.

Classifying surgical fires as a never event would require mandatory reporting of incidents or near misses, while also mandating essential education for surgeons and other perioperative staff across all NHS trusts. Even without knowing the details of surgical fires, the name itself suggests they should be a never event. The concept of a surgical fire is terrifying enough that if we asked a lay person whether it should be classified as a never event, they would likely agree that it should never happen—indeed, they would probably be astounded that it even did. Only by classifying surgical fires as a never event can the national safety standards continue to be fit for purpose.

I have been paying keen attention to some of the Government’s responses to my questions about surgical fires over the past year. I realise that the Government have previously stated that they have no plans to classify surgical fires as a never event. Again, I urge the Minister, in the light of the evidential base we now have, to do just that. I note in the latest response to me that the Minister says that it is not possible to make surgical fires a never event because

“there is currently no national guidance or safety recommendations to prevent surgical fires in operating theatres”.

I say respectfully that we need to do that. If we can do that, we can move forward.

I have good news for the Minister—I always try to bring good news, and not just because it is Christmas. The expert working group has already developed national guidelines. Its report made safety recommendations for perioperative staff, and the group is waiting for them to be adopted. What the expert working group has done could be a template for exactly what the NHS needs to do. It has informed me that it is more than willing to pass on its hard work directly to Government. If the Minister is agreeable, I would be happy to have a meeting to exchange those views, and those papers as well, with the Centre for Perioperative Care expediting the process. I believe there is now no reason not to classify surgical fires as a never event.

We should not forget the most important impact of surgical fires: the human impact. As I mentioned earlier, I had the pleasure of chairing the launch of the report last year. During the event, I also had the pleasure and the privilege of listening to a patient who had experienced a surgical fire. He explained to us the impact that the incident had on his life. What happened to this gentleman is quite tragic. I will quote his story, but I will not name him, and I will be careful what I say in relation to him.

He told the group that he had visited the hospital for a routine procedure, but that when he woke up the staff informed him that his body had been set alight during surgery. He told us how he had been burnt on the left side of his chest and upper arm, and of the impact that this trauma had on him. He was not aware of the fire because he was under anaesthetic having an operation. He went on to explain how it had prevented him from continuing his career in social care, which he had been in since the age of 16, because he was disabled as a result of the incident. He explained how it had left him physically and psychologically drained, and how it had left him in pain, unable to carry out simple household tasks such as making a cup of tea—he did not have the stretch or lift in his arm any more. He told us of the impact that the fire had on his family. His partner became his carer and he could no longer spend time with his granddaughter. Having five grandchildren—three girls and two boys—I know how much I enjoy spending time with my grandchildren.

That is a jarring story—one that is all the more shocking and disturbing the more details that are revealed. I am not going to name him because there are legal discussions going on with the trusts involved and because he has nothing but praise for the nurses who have cared for him since the incident. He understands that nobody set out for it to happen, but it happened, and it happened because the precautions were not in place, because there was no safety measures and no training. The so-called never event happened.

He is a very kind man—a gentleman. However, no matter how good the nurses have been to him, it would be remiss of me not to mention how inadequately his situation was addressed. To cause severe harm to a patient is beyond the pale; it is against every medical principle that exists. The NHS and all its staff are tasked with saving life, and that is what they do to the best of their ability. We must not forget the impact on the operating theatre staff, who may also experience a psychological cost from these experiences. It is equally essential that surgeons learn how to give both physical and emotional support to the victims of surgical fires. They are the ones who have suffered most, and surgeons must be empathetic to them and their needs.

What is also concerning is that, despite this serious incident taking place, the hospital appears not to have made the appropriate changes to its systems and protocols. We all learn lessons—every day of my life, I learn lessons; I am not so proud that I do not learn from all those around me and those who I speak to. The patient required follow-up treatment in the same hospital and, on inquiring what had been done to prevent the incident from happening again, was told that nothing had changed; there had been no updates. How disappointing.

As I mentioned, I cannot name the patient, but I pay tribute to his bravery and his determination to prevent this from happening to another person. That is one of the reasons why he told us his story. He wanted to provide us with the evidential basis for what had taken place and to ensure that it did not happen to somebody else. He is truly an admirable person. I thank both him and his partner for sharing their story with me and, ultimately, with everyone in the House and Westminster Hall and with the Minister and her Department.

I am coming to the end of my speech, Ms Rees. I will begin summing up, so that we can also hear from others. I look forward to hearing some thoughtful and insightful contributions from the shadow Ministers and, specifically, the Minister. As I have stated, I hope this debate will bring greater attention to the issue of surgical fires and shine a spotlight on this danger. It is clear to me, from reading the expert working group’s report and patients’ testimonies and from listening to expert guidance, that more needs to be done to prevent surgical fires. That is why I am so pleased to play my part in today’s debate in support the aims of the expert working group.

I hope that in the short time—it feels like a long time perhaps, Ms Rees—that we have been making the case today that it is clear that we are supporting the aims of the expert working group. There needs to be mandatory reporting of both surgical fires and near misses, because until we can effectively quantify the scale of the problem, we cannot effectively address it. Similarly, we need to introduce effective and mandatory education for all surgeons and perioperative practitioners in order to prevent surgical fires from occurring and to ensure that they are effectively managed when they do occur. This can also be done by classifying surgical fires as a never event. NHS operating staff are already aware of the threat of surgical fires, but they have not received the proper support and guidance to ensure that these incidents are prevented.

I therefore hope that our actions today will start the necessary change. Whether we are talking about simple steps such as introducing a checklist to ensure the taking of appropriate preventive measures, such as using the correct antiseptic skin solution, or ensuring the presence of the appropriate tools and equipment for the management of fires, which we should have as a precautionary measure in all operating theatres, these are all necessary steps to ensure the safety of patients and operating theatre staff alike. This is about the patient; it is about the staff; it is about getting it right. If we do not, we will have to confront the reality that many more people will be harmed by our failure to act. Classifying surgical fires as a never event is, I believe, the only way to effectively prevent patients and NHS staff from coming to harm.

I thank hon. Members for attending the debate and ask them to consider the reaction of their constituents if they were asked about surgical fires. If a Member here were asked about this matter, what would he or she want done in relation to it? They would surely all agree that such fires should never be allowed to happen. Making them a never event is the common-sense option, and I hope that others will join me in urging that that rational action be taken on this issue.

The people to whom I have referred, including the gentleman who made his own personal submission, are real human beings. They are people who have gone through operations and been confronted with the reality of this issue. We know about 631 of them in the United Kingdom, and we believe there are more. Addressing this issue would put an end to the need for the £13.9 million of damages and legal charges. We live in an age in which we must also be careful with the money we spend. If we are not, things may happen that cost the NHS money. People have been affected by this issue, and people will continue to be at risk until we act. I therefore invite the Minister and other hon. Members to join me in what I believe is a very worthwhile campaign to make surgical fires a thing of the past—as I said before, a never event.

Education After Covid-19

Debate between Christina Rees and Jim Shannon

Tuesday 23rd March 2021 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate. I thank the hon. Member for Isle of Wight (Bob Seely) for setting the scene so very well —we appreciate that. It is good to see the Minister in his place. I think he has always been there—at least it seems like it. That is not a bad thing, by the way. We very much look forward to his response.

Obviously, education is a devolved matter in Northern Ireland, so the Minister does not have any responsibility for it, but I wanted to feed in to this debate and give the perspective of what it is like in Northern Ireland. I know that what we have experienced in Northern Ireland is the same as what other hon. Members have experienced across the whole of the United Kingdom.

I have had many fears for our children during the outbreak. I think education probably features fairly high on the constituency problems page. I have fears for children’s paths of learning, fears for those who have not been able to learn online, fears for their mental health, fears for their social skills—so many fears. The question is: what will we in this House do to support them through those fears?

Today’s papers, which I read on the way over—the local and provincial press—were full of photographs of the Education Minister back home meeting some pupils in schools. There were also pictures of the pupils with absolutely glorious smiles. In some cases, they had ice-creams—I am not quite sure if it was 9 o’clock in the morning. The teachers, principals and classroom assistants were all responding very positively, and the hugs that they were giving the children told the story.

We have seen that online learning has a role, but there is nothing that beats physical presence in schools. I have spoken to GCSE teachers recently, and they are very concerned that many children will not go on camera, and they do not know whether they understand the work. They have said that there is nothing like walking around the room to see the children working through, and checking for understanding. That underlines my view that we can incorporate more online, but we cannot and must not imagine that it can replace what teachers are gifted at doing. Teachers get to know their pupils and what works for them. The personal, face-to-face contact really motivates the child individually whenever they are falling behind.

I am given to understand that parents have been given access to teaching staff during the pandemic, allowing greater communication. It has been wonderful to build up relationships. That, I believe, should continue when we get out of the pandemic, but with appropriate guidelines that allow teachers to have their evenings off without being bombarded. All staff in every job, when they finish their day’s work, should have a balance with their home life. There is pressure on pupils, teachers and classroom assistants.

The lessons that we can learn are clear: there is a role for technology and for face-to-face, and there is also a place for greater home-school co-operation. In all this, there is a need for real investment in our education system to ensure that children have access to technology, and that parents are aware of what is happening in their children’s lives. I understand that some parents may not have as big a role in their child’s life, but they need to do that.

I again thank the teaching staff, the pupils, the teachers, the classroom assistants, and everyone in schools who went above and beyond, and who have sourced technology and contacted parents with concerns above and beyond their hours. We are determined to do all we can to get our children back to where they should be, with no one left behind.

[Christina Rees (in the Chair)]

I thank all the speakers for staying within the time limit. I call the Opposition spokesperson, Toby Perkins, who can have an extra minute.

Employment and Support Allowance and Universal Credit

Debate between Christina Rees and Jim Shannon

Thursday 17th November 2016 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this important debate. I thank the hon. Member for Airdrie and Shotts (Neil Gray) for setting the scene so well. Right hon. and hon. Members across the Chamber have made marvellous contributions. I have the pleasure of speaking on behalf of the DUP and am happy to have the same attitude as others on the right way forward.

ESA is a complex, complicated benefit with many different aspects. Like many other MPs, I have a full-time member of staff dedicated to working with people to help to calculate their benefits and fill out the confusing, complicated forms. She works some 37.5 hours a week—sometime more in her own time—and always has a waiting list of people to see her. That is how it is in my office, and I suspect it is the same in others. On my constituency days, I also take on the benefits problems, while the admin staff in my office handle the day-to-day queries. A lot of our time is spent trying to help people, which is why today’s debate is so important to my constituents and to me. I watch the struggles that people go through and wonder how these vulnerable and ill people can go through more.

[Christina Rees]

Further to the point about employing full-time caseworkers to deal with the issues that the hon. Gentleman has just mentioned, the caseworker I employ is passionate about helping my constituents in Neath, but the toll on him is great, and he is under strain. We are passionate about what we do, but the workers in our offices are passionate about what they do, too, and we must give credit to them.

[Jim Shannon]

The hon. Lady is right. Our staff are compassionate on behalf of our constituents—in many cases, they themselves are our constituents—and they understand the issues very well. When it comes to explaining ourselves, let us make sure that that point is highlighted.

National Arthritis Week

Debate between Christina Rees and Jim Shannon

Thursday 20th October 2016 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered National Arthritis Week 2016.

It is a pleasure to serve under your chairmanship, Mr Betts. I am delighted that today, for the first time in five years in this House, there is a dedicated debate in Parliament examining the impact of arthritis. It is a privilege to speak in this House; that opportunity is not something we take for granted. It is good to come along to expound and inform on an issue that is so important. I am very pleased to see the Minister in his place. I think he and I will be in this position many times, debating health issues that interest us. It is good to see right hon. and hon. Members here. I know they will all make significant contributions.

Arthritis, along with musculoskeletal conditions, has a massive impact on people’s everyday quality of life. While I am disappointed that we have not spoken sooner in the past five years about this topic, I am pleased that time has been allocated today by the Backbench Business Committee, which I thank, for such an important debate that enjoys cross-party support. Opposition Members seem to be well balanced, and I am pleased to see the hon. Member for Congleton (Fiona Bruce), who is always here; I thank her for that and look forward to her contribution.

I should make it clear at the outset that the title of this debate is a slight misnomer, as the National Arthritis Week campaign has been replaced by the “Share Your Everyday” campaign, led by Arthritis Research UK, which is encouraging the public to share their stories of living with arthritis so that research is better targeted at the issues affecting most people with arthritis. We need to break the stigma of talking about pain and loss of dexterity and mobility, so that we can help to alleviate it. I urge Members to show their support for the campaign by sharing their own stories. I know there are Members here today who will do so, and that will be a very effective way of underlining this issue.

We should begin by discussing arthritis, because the burden on the individual is clear and substantial. It brings pain, isolation and fatigue and stops people doing the things that matter to them, keeping them from the world of work, from enjoying leisure time and from spending time with their families. Those are all key issues. I want to thank Arthritis Research UK—some people from it are in the Gallery—for supplying us all with notes and information to help the debate develop. We thank it for the hard work it does.

Arthritis should not be seen as a by-product of old age. For some it is, but for others it is not. The examples that I, along with others, will give show that arthritis is not only an elderly person’s ailment. It affects thousands of young people and millions of working-age people. One in five people over 50 have osteoarthritis in their knee. There is a young girl in my constituency who I went to appeal with several times. She suffers from chronic inflammation of the bowel—a by-product of severe arthritis, which led to her being medically retired at the age of 28. This is not an elderly person’s disease by any means.

The burden of arthritis on society warrants greater debate. Arthritis has an impact in a number of ways, particularly on our health and care system. Each year, 20% of the population consults a GP about musculoskeletal problems. The NHS spends £5 billion per year on arthritis— its fourth largest programme budget. That puts into perspective the enormity of what we are looking at today. I was struck by the stories shared on the Facebook page set up for this debate, so many of which are genuinely heart-breaking. One that stood out was that of a young girl of 27 who is waiting for a hip replacement, having suffered from arthritis since she was 20. That underlines, again, that this is not an old person’s disease. It knows no barriers, no age restrictions and certainly no class or creed barriers.

There is also the issue of workplace absence, with 30.6 million working days lost to the economy each year. The indirect cost to the economy of arthritic conditions is £25 billion. We do not necessarily want to focus on the financial aspect, but we can look at the figures as an indication of how important it is to address this issue and to raise awareness through this debate.

The scale of the burden is growing, with an ageing and increasingly physically inactive population. The numbers are sure to rise in the coming years. I briefly want to describe some of the characteristics of arthritis. When we talk about arthritis, we are talking about a number of different musculoskeletal conditions within the categories of inflammatory conditions, joint conditions and fragility falls and fractures, which are key factors.

The first group is inflammatory conditions, such as rheumatoid arthritis, where the immune system rapidly begins attacking the joints in the body. Those conditions affect around 1% of the UK population, including people of all ages, and have serious consequences. The second group is a range of conditions that cause musculoskeletal pain, the most common being osteoarthritis. Some 8.75 million people have sought treatment for osteoarthritis, with the true number of sufferers likely to be even higher. As is often the case, we are just scratching at the surface. The gradual onset means the condition mainly affects the elderly, but 2.36 million working-age people in the UK have sought treatment for knee osteoarthritis. Lower back pain, the most common form of disability in the UK, also falls into this group of conditions.

The final group is osteoporosis and fragility fractures. Osteoporosis is a silent and painless disease, but it causes fragility fractures after falls from standing height that afflict mainly but not exclusively elderly patients. The disease causes weakening of the bones and some 300,000 fragility fractures in the UK per year, of which 89,000 are hip fractures. The impact of those fractures on elderly, frail patients can often be severe, taking away their mobility, independence and, in some cases, their lives. We have to consider that.

Arthritis is not inevitable. Preventive measures must be the focus in tackling it. We need to address the risk factors for arthritis and musculoskeletal conditions. Links between being overweight or obese and long-term conditions such as heart disease, cancer and diabetes are well known—I declare an interest, as a diabetic. I am glad to say that I am almost back to the weight I was before I got married, which is quite something. I am trying to keep off all the sweet things, if I can. However, being overweight or obese is also a major risk factor in various forms of arthritis. It is the single biggest avoidable cause of osteoarthritis and increases the likelihood of developing inflammatory conditions such as rheumatoid arthritis.

Every one of us, as an MP, is aware of these issues because our constituents come to see us. In many cases, we deal with related benefit issues, and that is how we come into direct contact with people affected by arthritis.

[Christina Rees (Neath) (Lab/Co-op)]

I am grateful to the hon. Gentleman for securing this really important debate. These conditions cause not only physical but psychological problems. A girl came to see me, aged 19. She said:

“Arthritis is unpredictable. It flares up suddenly. Medication problems make it difficult for me to manage. It is hard to explain to my friends why I cannot do something I could do last week, because I look so normal.”

Does the hon. Gentleman agree that we have to look at the damage these problems are causing youngsters in their everyday lives, including in how they associate with their friends?

[Jim Shannon]

I thank the hon. Lady for her intervention and for outlining how arthritis can affect people at the age of 19. I am aware of a constituent who is even younger, which really surprises me.

Rising levels of obesity, combined with our ageing society, could lead to a near doubling in the prevalence of osteoarthritis in the UK by 2035. The Government need to make sure that musculoskeletal health is always included in assessment of the population’s health locally and nationally; that the benefits of physical activity for people with musculoskeletal conditions are emphasised in health promotion messages; and that, when programmes targeting lifestyle factors such as obesity and physical inactivity are being designed and delivered, their impact on musculoskeletal health should be explicitly included. So there are many things the Minister could respond to, and I look forward to that.

Above all, the Government need to make sure that effective physical activity services are available locally. This is crucial, and I hope colleagues from all parties will join me in calling for a National Audit Office review of physical activity services for people with osteoarthritis so that services help people across the UK to maintain good musculoskeletal health. We need to address that.

I want to speak about benefits as well. I know about osteoarthritis and rheumatoid arthritis because I have sat across a table from a person helping them fill in disability living allowance forms, now personal independence payment forms. People tell me their story, because we need to know their story when we help them fill in the forms. We need to know what they have done and what they have discussed with their GPs and consultants. The issues are very clear. I know that the Minister is not responsible, but for the record I implore the Department for Work and Pensions to make sure that, when it comes to filling in PIP forms, people have their full medical story told. They need an understanding person at the other end of the phone. I am not being disrespectful to anybody, but sometimes when we phone up about PIP, the person at the other end of the phone does not understand the medical details. I respectfully and gently say to the Government that we need someone on the phone who understands the medical condition and understands the issues and can therefore empathise with the person who does their 10-minute interview at the first stage of their PIP form before they do the full form. I think every MP would recognise that particular issue.

As I mentioned earlier, falls and fractures are a pressing public health issue among older people. Falls are the second greatest contributor to the burden of disability in the UK and a major cause of mortality. Around 300,000 fragility fractures occur each year in the UK, including some 89,000 hip fragility fractures, with 1,865 cases submitted to the national hip fracture database in Northern Ireland. Hip fractures are the most common cause of accident-related death in older people, resulting in some 14,000 deaths in the United Kingdom every year. We know that 20% of hip fracture patients die within four months of their injury and 30% within a year. This is a growing problem. Projections show that by 2036 hip fractures could account for 140,000 hospital admissions in the UK each year, with care and treatment costs rising to £6 billion. Let us put that into perspective and do the sums. Let us address the issue early on and do away with the cost impact further down the line.

We need more joined-up treatment in such cases because, once a first break occurs, it is vital that a second break is avoided. A fracture liaison service, the FLS, which provides targeted assessment and treatment for those with fractures, is widely regarded as the best way to address the problem of preventing future fractures. It is both a clinically effective and a cost-effective solution. Despite this, only 37% of local health services in England have a fracture liaison service. We need local commissioners to ensure that a fracture liaison service is linked to every hospital and held to account for commissioning fracture liaison services that cross the boundaries between health and social care so that the two marry. It is important that it does so. Arthritis may not kill, but it attacks what it means to live. The normality of life will never be the same with arthritis.

The condition limits people in doing the things that matter to them, but with greater personalisation and help in managing their condition, the NHS, care services and our welfare system can help people push back the limits of their condition. Too few people with arthritis currently have a care plan. Many people cannot quickly access physiotherapy without a GP referral, and people with arthritis need more help so that they can be in work, which is where most of them want to be if only that was possible. People with arthritis know how their condition affects them better than anyone else. Personalised and person-centred healthcare is therefore essential to move forward.

Care planning is an approach that people with long-term conditions can use to manage their health and wellbeing. It is based on a two-way conversation with a healthcare professional where goals are shared and actions agreed. If we could arrange that, we could help them. A better system should be in place to make sure that that happens. This can offer important benefits to people with arthritis, yet only 12% of people with arthritis currently have a care plan. If it is only 12%, there is something wrong and we must address that. That number needs to increase if we are to enable more people to manage their condition.

There are other tools that health and care services can use to enable people with arthritis to manage their conditions more effectively. Physiotherapy is a clinically effective therapy that can substantially reduce pain and restore movement for people with arthritis. Again, is it available for everyone? If it is not, it should be. I gently ask the Minister how can we make that happen. I look to the Minister, as I always do, for a sympathetic and understanding response.

Self-referral to physiotherapy is a system that lets people go directly to an NHS physiotherapist without a GP referral. This system is associated with improved health outcomes and patient experience. It is good that it is cost-effective and reduces the burden on GPs. All people with arthritis in Scotland and across much of Wales can already access physiotherapy directly. We have many friends and colleagues here from Scotland, and I know that they will make contributions that I suspect will indicate what is being done in Scotland. I must say I am envious of some of the things being done there. I would love to see those things in place in Northern Ireland and across the whole of the United Kingdom.

In the rest of the UK, for example, only a third of clinical commissioning groups in England offer self-referral and it is still only being piloted in Northern Ireland. That needs to change. When inflammatory conditions such as rheumatoid arthritis strike, delay can be a major risk factor and the clock starts ticking once symptoms develop. Early identification and treatment is needed rapidly to control disease, minimise long-term joint damage and avoid lifelong pain and disability, but the NHS does not currently assess people with rheumatoid and other forms of early inflammatory arthritis—EIA—quickly enough, and national guidelines are not being met. Again, I gently say to the Minister: if the guidelines are not being met, what are we doing to improve that?

A recent clinical audit by the British Society for Rheumatology found that only 20% of people who see a GP with suspected rheumatoid arthritis or EIA are referred to rheumatology specialist services within three days, and only 37% of people referred with suspected rheumatoid arthritis or EIA are seen by a specialist within three weeks. Again, that needs to be addressed and I again look to the Minister for a response on that. Local commissioners across the UK need to achieve earlier diagnosis of inflammatory conditions. Arthritis and other musculoskeletal conditions are the most common diseases in our working population, and as the population gets older, an even greater proportion of workers will have conditions that include osteoarthritis and back pain. Those workers want to keep working, so we have to improve the system of healthcare to enable that.

Many people with arthritis want to work, and they can with the right support. However, only two thirds of working age people with a musculoskeletal condition are currently in work, compared with 74% of those without health problems. What is more, the rate of employment for people with arthritis is 20% lower than for people with no condition. We need better support to enable people with arthritis to work and we need to promote the Access to Work scheme that is in place, which pays for practical support and equipment. It is good that we have such a system, but I want to see better utilisation of it and fiscal incentives for employers to provide health and wellbeing initiatives that promote musculoskeletal health.

It is vital that more is known about people with arthritis so that research can be targeted at what matters most to them, but, worryingly, key data are not being collected. Arthritis Research UK is working to increase the quality and availability of data about the experiences of people with arthritis and about the public services that improve their quality of life. Arthritis Research UK and Imperial College London have developed a model for estimating prevalence using the existing NHS data currently available in England. I encourage all Members for English constituencies to visit the Arthritis Research UK website to get access to the data, which I understand will soon be available in Scotland, and later in Northern Ireland and Wales. We have a lot to do to catch up.

However, not enough data on people with arthritis are being collected, and that limits our understanding of the prevalence of the condition and action that can be taken in response. Moreover, data that are collected are not uniformly classified across the system. Definitions of musculoskeletal conditions used in other national data sets, such as those for benefits, are inconsistent. National survey content may need greater co-ordination. Again, I say gently and with respect that it is a question of how to do things better. I am speaking very quickly, Mr Betts, because I am conscious that other Members want to speak. I am probably rushing faster than usual, but I hope everyone can follow what I am saying.

A pivotal issue is the need to protect and build the UK’s excellence in medical research, so that researchers can continue working on a cure for arthritis. How important it is to find a cure. The centres funded by Arthritis Research UK have been at the forefront of research aimed at improving the lives of people with arthritis in the UK. It is marvellous and encouraging that they have uncovered breakthrough treatments that push back the limits of the condition. In the 1990s, centres supported by Arthritis Research UK—it has given us all the information—discovered that a molecule called tumour necrosis factor was causing the disruptive auto-immune inflammation of joints. The anti-TNF therapy that they developed has freed millions from the pain and disability caused by rheumatoid arthritis; it was also an inspiration for the field of biologics, medicines that use the body’s own molecules to combat diseases. It is crucial that that work, and the work of all medical research charities, should be supported by the Government in the long term with a real-terms increase in science spending. It is not something for the Minister to respond to, but I would seek his assistance and support on that point.

Within the life sciences sector, substantial investment by medical research charities drives improvements in health and generates wider societal and economic benefits. In 2013, medical research charities invested about £1.3 billion in UK medical and health research, which represents more than a third of all publicly-funded medical research in the UK. The Government have recognised that our science base is a vital national asset— a view that I and all Members present, including the Minister, subscribe to—and they have reaffirmed their intention to make Britain the best place in the world for science. We all support that ambition. It is crucial to uphold that commitment, through a real-terms increase in science spending over the long term.

That would include bolstering the charity research support fund, which provides an uplift to support charity-funded research in universities. It is a marvellous asset, investing a lot of money in research. That joint funding of research ensures that charitable donations are invested directly in research that meets the needs of people with medical conditions. In 2013, the Government’s £198 million investment through the CRSF leveraged some £833 million of investment by charities in English universities. That is a significant, marvellous, gigantic sum of money to help to find cures. When the House debates rare diseases—and we do our best in these matters—we often refer to the good work done by charities, universities and the relevant partnerships.

[Christina Rees]

rose—

[Christina Rees]

My arthritis is in many ways self-inflicted; it comes from a lifetime of playing sport. I have no cartilage in my right knee, which is severely arthritic. Then there is my lower back—I do not think anything much works any more. Does the hon. Gentleman think that there should be more research on people who have played sport and become arthritic? In this day and age we advocate participation in sport, without really looking at the long-term consequences.

[Jim Shannon]

The hon. Lady is right and I think many of us recognise what she says. We encourage people who are obese to do more sport. We encourage young people, rather than playing on computers and laptops, as they so often do, to take part in more physical activity. However, we must consider the side-effects of that as well, and ensure that we help with them. I hope that what I have said about responding early has been taken on board. With an early response to signs of deterioration, the hon. Lady might not today be in as much pain; although I can tell hon. Members that I have seen her moving around the House, and she moves at some rate. The hon. Lady is obviously not completely restricted, and I say well done to her.

Without the CRSF there would be less funding to invest in world-class research. The UK’s medical research landscape is currently undergoing major change with the formation of UK Research and Innovation through the Higher Education and Research Bill. I expect that the whole House would agree that is crucial that the CRSF should increase in line with charitable investment, within the new research funding system, to safeguard research in the long term.

I look forward to hearing the remarks that will follow in the debate, including the personal experiences of arthritis of Members’ constituents—and perhaps also those of Members themselves. Much more can be done to improve the quality of life of people with arthritis, and to push back the limits of that worrying condition. We have an opportunity in Parliament to play a huge part in ensuring that our constituents get a better quality of life. I look forward to hearing the speeches of the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), and of the Minister.

UK Steel Industry

Debate between Christina Rees and Jim Shannon

Monday 29th February 2016 Commons Chamber

[Christina Rees (Neath) (Lab)]

Steel and the steel industry are vital to Wales, particularly to south Wales and my constituency of Neath. The Tata steel plant in Port Talbot is in the neighbouring constituency of my hon. Friend the Member for Aberavon (Stephen Kinnock) and the Trostre plant is roughly half an hour away in the constituency of my hon. Friend the Member for Llanelli (Nia Griffith). Both Aberavon and Llanelli are places where hundreds of my constituents from Neath work every day.

The fact that, this year, 1,050 jobs have been lost in the UK steel industry, 750 of which are in Port Talbot, shows the Government’s complete lack of action in saving the UK steel industry. Time and again, the Government have been dragged to the House by the Opposition to answer urgent questions on their plans to save the steel industry, but all they have offered are warm words, which are of no help to an industry that is in desperate need of action.

Many options are available to the Government, including a large amount of readily available EU funding to shore up the industry. The Government could also take action against the large amount of Chinese steel being dumped on to UK markets.

[Jim Shannon (Strangford) (DUP)]

Does the hon. Lady agree that, although we must express real concern about the job losses and the impact on the UK economy, we must also express concern about the quality of the imports. For instance, when it comes to the defence industry, the plate that comes from China is not of the same quality. How can we leave our defence forces at such a disadvantage when it comes to our submarines and ships?

[Christina Rees]

The hon. Gentleman makes a very good point. Chinese steel is far inferior to UK steel.

The Government could also take action against the large amount of Chinese steel being dumped on to EU markets, yet, again and again, they have left all such options to the side. The statistics speak of the importance of the steel industry in Wales. There are more than 6,300 jobs in Wales, over 4,500 of which are in Port Talbot and Trostre. Of that 4,500, almost a quarter are filled by people who live in my constituency of Neath. At this time, my constituents still do not know who will lose their jobs. For many, the plants in Port Talbot and Trostre are a way of life and have been for generations. Not knowing whether they will have a job in a month or two is absolutely unbearable for them. I know personally of the community that has grown up around the plants. My father worked at the Abbey, which later became the Steel Company of Wales and then Tata. When I was a schoolchild, I played hockey for the steel company. It was the centre of the community; SCOW put food on our plates at home and contributed enormously to our social and sporting lives. The same sense of community applies today to the 4,500 workers and their families that still work at and depend on the plants. The threat of the closure of Trostre and Port Talbot is more than I can contemplate, given the devastating effect that it would have on communities.

The Minister insists that the Government are doing all they can to help the industry, but that requires action rather than the warm words that they are offering. There is so much that the Government can do, especially about the dumping of Chinese steel on the market. The prospective change in dumping calculation methodologies away from the analogue method towards local Chinese prices and costs could result in the direct loss of at least 310,000 jobs in EU industries already badly hit by dumped Chinese exports. That is in addition to the hundreds of thousands of indirect jobs that would be at stake. Surely, rather than the Chancellor moving ever closer to the Chinese, he should not grant market economy status to China until it fulfils all five EU technical criteria and not before a thorough EU-wide impact assessment, including a full public consultation.

It is important to tackle the dumping of steel because our current anti-dumping measures cannot counter the massive blow caused by Chinese steel import surges. Lifting the lesser duty rule would remove the cap on anti-dumping and anti-subsidy levels, simultaneously bringing the EU in line with everybody else, but the Government have chosen to be the main player in blocking those changes. Will the Minister assure the House that the Government are doing all they can, including reversing the decision to impose low-level duties on Chinese rebar and supporting the steel industry by supporting the lifting of the lesser duty rule? Even the former European CEO of Tata agrees. He has said that as long as trade defence protections are not introduced, the dumping of steel below its cost of production will continue.

The UK steel industry had 280,000 jobs in 1970, but now it has only 30,000. That is 250,000 jobs lost in less than 50 years. When will the Government wake up and pay attention? Will they pay attention before it is too late? EU options are also available to us. Why are the Government not moving forward and allowing the modernisation of EU trade defence instruments that would stop it taking a year and a half from complaint to definitive anti-dumping measures?

Many regions in the world are more effective at providing a level playing field for their industries and deploy trade defence tools faster and more effectively. As a consequence, dumped goods find their way on to the European market much more easily. The Government would prefer to argue with themselves over the issue of the EU than to use our membership of it to save the UK’s steel industry and the jobs of my constituents in Neath.

The president of the European Steel Association, Eurofer, has said that if we do not use the trade defence instruments available to us there is a substantial risk we will see more plant closures and job losses. Given the wide number of options available, why are the Government not standing up for UK steel in the EU and arguing for modernisation? Over and over again the Government have missed their chance to save the UK steel industry. The Minister for Small Business, Industry and Enterprise has told the House that the steel industry is vital for the UK, yet the Government are treating it with contempt and playing fast and loose with the livelihoods of the tens of thousands of workers in the industry.

The Welsh Government are doing all they can within their power to help the affected communities in Wales. They are working tirelessly to provide support to the industry, but, as the First Minister has said, the fundamental question facing steel production in Wales goes far beyond the devolved responsibilities of the Welsh Government. He has said that the UK Government must step up and play their part.