Oral Answers to Questions

Debbie Abrahams Excerpts

Tuesday 5th December 2023 Commons Chamber

[Priti Patel (Witham) (Con)]

7. What funding her Department is providing to help tackle health inequalities in Essex.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

9. What steps she is taking to help reduce health inequalities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

I am pleased to reiterate to my right hon. Friend the Member for Witham (Priti Patel) that Essex is receiving funding from the National Institute for Health and Care Research, which is funded by the Department of Health and Social Care, to promote research into health inequalities and support better health outcomes for her constituents and all residents in Essex.

[Victoria Atkins]

I thank my right hon. Friend very much for her kind words. She will remember how much I enjoyed sitting on the Front Bench alongside her when we were in the Home Office. In terms of her work in Essex, she is a formidable campaigner and she will know that the decision on such a healthcare centre lies with her integrated care board, to which the Government have given some £183 million of capital funding between 2022 and 2025. I am sure she will make a compelling case to the ICB for such a centre in her constituency. Interestingly, the Mid and South Essex integrated care board is one of seven sites receiving additional support and funding from NHS England to address health inequalities, and I know she will pay close attention to how that is spent.

[Debbie Abrahams]

There were multiple warnings from experts such as Professor Sir Michael Marmot of the widening health inequalities that started in 2015. Covid just exposed and amplified those inequalities, so that in the north there were 17% more deaths, or more than 2,500 avoidable deaths. While I welcome the new Health Secretary to her post and I welcome her announcement this morning, what else is she going to do to address in particular the socioeconomic inequalities that drive those health inequalities?

[Victoria Atkins]

I thank the hon. Lady for her welcome. Having grown up in Lancashire myself, I very much understand why she is speaking up on behalf of her constituents. There are many different ways that we deal with this, but let me use a couple of headline points. First, we are increasing the public health grant to local authorities, providing more than £3.5 billion this year, so per capita public health grant allocations for the most deprived local authorities are nearly two and a half times greater than for the least deprived.

There is also interesting work going on with family hubs. Indeed, the Under-Secretary of State for Health and Social Care, my right hon. Friend for South Northamptonshire (Dame Andrea Leadsom), who has responsibility for start for life, is leading on that. The family hubs and start for life programme will deliver a step change in outcomes for babies, children and parents in 75 local authorities in England with high deprivation. We believe strongly that if we can give the best start in life to our babies and children, it will bode extremely well for their future years.

Oral Answers to Questions

Debbie Abrahams Excerpts

Tuesday 11th July 2023 Commons Chamber

[Neil O’Brien]

I know how intensely my hon. Friend is campaigning on this issue. The amount of NHS dentistry being delivered has gone up by a fifth over the last year, partly as a result of the reforms we are already rolling out. He will have seen in the workforce plan that we are going to increase training places for dentists by 40% so that we have the NHS dentists we need. However, that is not all we will do, and our forthcoming dental plan will take further steps.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

We have known for a while that our life expectancy is shorter than it was in 2010. However, we are now seeing impacts on children in the UK, who are about 7 cm shorter at five compared, for example, with the children of our neighbours in Holland. What is the Secretary of State doing on this issue, and will he support the all-party parliamentary group on health in all policies in assessing the impacts on health and health inequalities?

[Neil O’Brien]

Of course we are taking action to improve public health, and that includes children’s nutrition. That is why we are spending £150 million on healthy food schemes, such as the school fruit and vegetable scheme, the nursery milk scheme and Healthy Start. It is also why we are investing £330 million a year in school sport and the PE premium and a further £300 million through the youth investment fund. We will continue to take action on this key issue.

Draft Tobacco and Related Products (Amendment) (Northern Ireland) Regulations 2023

Debbie Abrahams Excerpts

Tuesday 11th July 2023 General Committees

[Neil O'Brien]

We have driven down smoking rates in England to a record low—from about 40% in the 1970s to about 20% in 2010 and down to a record low of 13% today. We have done that partly by doubling excise duties and partly by introducing a minimum excise on the cheapest cigarettes.

We continue to move forward in our efforts to cut smoking. I recently set out plans to give all women who smoke during pregnancy new incentives to quit smoking, and plans to give 1 million smokers help to “swap to stop” with free vaping kits. The Government are taking determined action to drive down rates of smoking, and we will keep all measures about comparability between Northern Ireland and the rest of the UK under review.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

The Minister has not responded to the point made by my hon. Friend the Member for York Central.

[Neil O'Brien]

Which point?

[Debbie Abrahams]

The point about the inequalities that there will be between Northern Ireland and the rest of the UK, and whether there has been an assessment of them. I gently remind the Minister that it was a Labour Government that introduced smoke-free zones and ensured that people were protected from second-hand smoking. The Government need to recognise that.

[Neil O'Brien]

We keep all those things under review. Flavourings in heated tobacco are a relatively niche issue, but of course we will look at the regulation of those things. The mainstay of our policy is raising tax on cigarettes, which has driven down smoking rates, and using vapes, but not heated tobacco, as a potential substitute to get people off smoking.

I commend the draft regulations to the Committee.

Question put and agreed to.

NHS Long-term Workforce Plan

Debbie Abrahams Excerpts

Monday 3rd July 2023 Commons Chamber

[Steve Barclay]

The hon. Lady raises a fair point. It also applies to the issue of stroke. The elderly population has increased in many coastal and rural communities. That has created significant pressure: for legacy reasons, services are often in other parts of the country. We have five new medical schools in place, and we have looked at those parts of the country where it is often hard to recruit. Part of the expansion will be to look further at what services are needed in different areas. The hon. Lady’s point also speaks to that raised by the Chair of the Health and Social Care Committee. By giving greater autonomy to place-based commissioning through the integrated care systems, we will enable people at a more local level to design the services and the workforce that they need, and that includes the flexibilities required to retain local staff.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I welcome the workforce plan. Given that it has taken 13 years, one tends to wonder why it has taken so long, but then of course we remember that there is a general election on the horizon.

Page 121 sets out a labour productivity rate of 1.5% to 2% per year. That has never been achieved by the NHS or any other comparable health system, so what assumptions is the Health and Social Care Secretary making in relation to achieving that?

[Steve Barclay]

First, this is a plan developed by colleagues in NHS England, so these are assumptions that have been agreed by those who lead within the NHS. It is about ensuring that people operate at the top of their licence. It is about having new and expanded roles, such as advanced practitioners and associate roles, that allow people to progress in their careers and, in doing so, freeing up capacity for senior clinicians, who often spend time doing things that do not need to be done by people in those roles.

Of course, there are also rapid changes in technology. We often talk about the developments in artificial intelligence, and I have touched on developments in the life sciences industry. I have also mentioned advances in screening and genomics. All those developments will in turn help us to prevent health conditions, and treating those conditions early will be not only better for the patient, but better value for money for the taxpayer.

Mental Health Treatment and Support

Debbie Abrahams Excerpts

Wednesday 7th June 2023 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

As we have heard from colleagues from all parts of the Chamber, we are in a mental health crisis. Unfortunately, it is becoming increasingly endemic. I pay tribute to the work of our offices, including my own team, who regularly deal with critical cases of mental ill health, including suicide calls, for which we have had to put on special training. That was happening before the pandemic too, and we need to recognise that.

Recent figures show that seven out of 10 secondary school children are expressing mental health distress. That should worry us. It has already been mentioned, but we know that there are risk factors and risk conditions that can contribute to the onset of a mental health problem. I will speak about the importance of early intervention a little later.

Oldham has the 37th highest prevalence of mental health disorders in the country. That puts it in the highest 20% in the UK; for reference, the Prime Minister’s constituency is in the lowest 6%. On the other side of the coin to this higher prevalence is our reduced funding. Research from the Children’s Commissioner found that child and adolescent mental health services in Oldham received over £100 less in spending per child from the Government than those on the Isle of Wight. Similarly, in 2019 The Guardian reported that London had nearly double the number of psychiatrists in the north of England. As I have mentioned, it is true that things have got worse since the pandemic, but that is not just a consequence of the pandemic.

I want to focus on what needs to happen, because we need a serious plan, and I am not from the Minister’s speech that the Government recognise that. The Opposition want to recruit thousands of new mental health professionals, which will go some way to addressing the lack of parity of esteem between mental and physical health services. That needs to be reflected in the Government’s NHS workforce plan. We have waited ages for the Government to produce that and it makes the partygate report look quite prompt. As the Government sit on their hands and fail to produce a plan, the crisis continues to get worse. That is why we will commit to the biggest expansion of the NHS workforce in history. We must also look at the metrics we use. For example, we would guarantee treatment within a month. That would make such a big difference to all those people stuck on what feel like endless waiting lists in Oldham, Saddleworth and across the country.

Finally, I am pleased to see our party committing to a paradigm shift from the medical to the social model of health, focusing on prevention in communities as well as treatment. The Leader of the Opposition has committed himself to that in Labour’s health mission, and we have also pledged that there will be a mental health hub in every community. We will go further than that: our commitment to addressing the rampant health inequalities across our country includes tackling the inequity in mental health. As we develop national policy from education to transport and finance, we will consider the impacts on health and health inequalities, including mental health. This is the difference a Labour Government will make. The next Labour Government have a plan that is both radical and credible, and for my constituency and for our country, it is long overdue.

[Mr David Davis (Haltemprice and Howden) (Con)]

On a point of order, Madam Deputy Speaker. You will be well aware, because you have chaired many of the debates, that there has been a campaign in this House for over a year to stop SLAPPs—strategic lawsuits against public participation—which are used by very rich men to oppress free speech in this country. Just in the last hour or so, the High Court has ruled one of those SLAPPs cases out of order: the case of Mr Mohamed Amersi against the ex-Member of this House Charlotte Leslie has been struck down. In my view, that is a great victory for free speech. Because it is so important, I give notice that I will be raising the matter on the Adjournment.

Oral Answers to Questions

Debbie Abrahams Excerpts

Tuesday 6th June 2023 Commons Chamber

[Neil O’Brien]

My hon. Friend is quite right that we absolutely need to go further. That is why, through the primary care recovery plan, we are taking some of the pressure off general practice, investing £645 million in the new Pharmacy First service, which will free up about 10 million GP appointments a year. That is why we are investing about £60,000 per practice in new IT and modern online systems. None the less, he is totally right: we need those doctors in general practice. We have about 2,000 more now than we did in 2019, but we will go further. We have already increased GP training and we are looking at building on that further.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Can the Minister clarify when Oldham will receive its share of the 6,000 additional GPs that were promised in the Conservative 2019 general election manifesto? Today we are running with fewer GPs, and that is not helpful to anyone.

[Neil O’Brien]

I have already noted that we have increased the number of doctors in general practice by nearly 2,000 since 2019 alone. The number of direct patient-facing staff in general practice is 50% higher in total than in 2019, and that is up right across the country. However, of course we will go further and grow the number of clinicians in general practice, building on what we have already done.

Recovering Access to Primary Care

Debbie Abrahams Excerpts

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

My hon. Friend has a great deal of experience, and he is right to focus on the amount of clinical time often spent on non-clinical issues. Sending reminders through the NHS app will reduce non-attendance. We are also looking at the key interface between secondary care and primary care, as well as considering which appointments can be done elsewhere, such as through pharmacies and the additional roles. The online booking system can better triage people to the right place, and there will be some self-referral in order to take pressure off GPs—not for things that carry a clinical risk, such as internal bleeding, as the Opposition suggest; but for things like hearing aids. If a person has taken a hearing test, they will not need to clear an appointment for a hearing aid through their GP.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I reinforce what colleagues have said. This is a step in the right direction, but it fails to grapple with the grave situation in which there has been a threefold increase in waiting lists since 2010, including a twofold increase since 2019, before the pandemic. In Oldham we have fewer GPs and more patients with increased acuity, so when will we get our fair share of the promised 6,000 GPs?

[Steve Barclay]

I have recognised throughout that demand has increased. Primary care is treating 10% more patients than before the pandemic, with around 1 million appointments a day. There is more demand, not just because of the pandemic but, as I said in my opening remarks, because we have a third more people over the age of 70, and they are five times more likely than younger people to go to their GP. That demographic change, the impact of the pandemic and a change in public expectations of advances in medicine are all creating additional pressure, which is why it is right that we use the full range of additional roles and that we invest in technology, in addition to the 2,000 more doctors in general practice.

Cancer Care

Debbie Abrahams Excerpts

Tuesday 14th March 2023 Westminster Hall

[Nicola Richards (West Bromwich East) (Con)]

I beg to move,

That this House has considered the future of cancer care.

Cancer will affect every single one of us here today, and every single person in this country, in some way. Statistically, half of us will get cancer in our lifetime. When that happens, both we and our families should expect the best possible care and support from our health service. This time last year, my family and I were coming to terms with losing my mum to secondary breast cancer that spread to her liver. She passed away in April 2022, only six years after her younger sister passed away with the same diagnosis. Their brother, my uncle, has since bravely fought cancer too, and I am pleased to say—not least because he tells the worst dad jokes known to man—that he is doing well.

My family know all too well what the statistics mean in real life. I would like to think that I am one of the few to have lost their mother at an young age, but that is not true. A member of my team, Bradley, reminded me that his mother, Sharon Langer, would have been 58 today. She died in December 2018 from lung cancer.

Thanks to our health and care services, we have taken great strides in improving cancer survival rates. Over the last 40 years, the survival rate has doubled in this country, and now half of the people diagnosed with cancer in England and Wales survive their disease for 10 years or more. However, the number of cancer cases will only rise in the years ahead. Modelling by Cancer Research UK suggests that cases will rise by around a third, with as many as 506,000 people being diagnosed with cancer between in 2038 and 2040. That is not wholly because of a growing and ageing population, as incidence rates are also due to rise, meaning that individuals will be more likely to be diagnosed with cancer than they are now.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

My condolences to the hon. Lady on the loss of her mum, which must have been horrendous. One of my constituents, Jo Taylor, has received an advanced breast cancer diagnosis; hon. Members may have seen her on social media. She is campaigning to make sure that secondary breast cancer, as it is also known, is counted, because currently we only estimate the number of women—and men—with secondary breast cancer. We know that figures drive care. Does the hon. Lady think that that is something the Government will take on board?

[Nicola Richards]

I totally agree. Any statistics and data that we can gather will help us to improve services and understand the landscape when it comes to who is affected and when cancer can recur, and it is important that we take all that into account. It is important to have a long-term plan for making our cancer services fit for what is to come. They need to cope with the increased demand, and deliver the world-leading outcomes that patients deserve.

Last year, the Government declared war on cancer. They announced a 10-year plan to ramp up our cancer services and make them the world leader that they ought to be. However, we now know that our plans for cancer care will become part of the five-year major conditions strategy. Although it is clearly important to take a holistic approach to caring for people with life-threatening diseases, there is no killer like cancer. We must ensure that our strategy addresses the key elements of what would be a world-leading cancer care system: research, prevention, diagnosis, treatment and care. I will first discuss one of the most important elements that we need addressed in the strategy: diagnosis.

Finding cancer early and commencing treatment is key to survival rates. For instance, 90% of people diagnosed at the earliest stage of bowel cancer will survive for five years or more, compared with just 10% of those diagnosed at the latest stage. Furthermore, almost everyone diagnosed with breast cancer at the earliest stage can receive treatment and live for five years or more, whereas only three in 10 women diagnosed at the latest stage survive for more than five years. The picture also varies by region. Unfortunately, if someone lives in the west midlands, they are statistically less likely to survive for five years or more after being diagnosed with lung cancer than those across England on average, and all combined mortality rates are significantly higher than average, too. Those stark figures hammer home the need to make sure that we detect cancer and commence treatment at the earliest opportunity.

I welcome the commitment from the Secretary of State for Health and Social Care that the strategy will shift our model towards the early detection and treatment of diseases. I also welcome the ambitious target set to diagnose 75% of cancers early by 2028. I look forward to reviewing how the strategy will address the need for greater capacity in the breast screening programme, ensure that all women at elevated risk of breast cancer are included in the national breast screening programme, and raise the proportion of all cancers that are diagnosed early; at present, just under 60% are.

Of course, it is not enough to detect cancer in its earliest stage. We also have to make sure that people receive treatment promptly, especially after urgent referrals. Much work still needs to be done in that area. Only 54.5% of people starting their treatment after an urgent referral do so within the 62-day target, and around 2,100 people have waited more than 104 days to begin their treatment. In my constituency of West Bromwich East and the wider Sandwell area, there is a mixed picture when it comes to meeting those important targets. It is welcome that our local health service met the two-week target for referring urgent suspected cancer cases to a specialist. However, like much of the rest of the country, other targets, including the 62-day standard, were not met. When I compare those statistics with the survival rates that I mentioned, it is obvious that we have to do more to ensure that people start treatment as early as possible. A critical element of that is ensuring that cancer services are sufficiently well staffed.

It would be remiss of me not to honour the people who work day in, day out, providing care for cancer patients across the country. We have all relied on them to care for us and our loved ones, in sometimes the most desperate circumstances, and to provide comfort for us in our time of need. I put on the record my thanks to the Mary Stevens Hospice in the constituency of my hon. Friend the Member for Stourbridge (Suzanne Webb); it looked after my mum in her last days, and held a last-minute wedding blessing for me and my now husband at my mum’s request.

We need to address the shortfalls in the workforce that are affecting our success in improving cancer outcomes. We have a shortfall of both clinical oncologists and radiologists, who are vital to the effort to diagnose and treat cancer patients in the earliest stages. It is so important to tackle the workforce issues with long-term plans to recruit and train the staff we need to tackle cancer properly. I welcome the Government’s NHS long-term workforce plan, which commits to addressing those and many other issues across the NHS workforce. I ask the Government to ensure that the necessary funding is provided to meet those commitments.

On the major conditions strategy, I hope that the Government will take into account the wealth of views expressed by Cancer Research UK and other key organisations in the cancer community in last year’s call for evidence, and ensure that the strategy lays the groundwork for a longer-term strategy on cancer that also tackles inequalities.

Oral Answers to Questions

Debbie Abrahams Excerpts

Tuesday 24th January 2023 Commons Chamber

[Helen Whately]

I thank my hon. Friend for her excellent and important question about her local share of the £750 million of extra funding for discharge this winter. I can tell her that, in Worcestershire, money is already going into extra placements in homecare, community care and care homes, and into providing practical support to help people when they get home from hospital, in partnership with the voluntary sector. I assure her that we will publish the spending plans for her area and the rest of the country shortly.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

8. What assessment he has made of the implications for his policies of the number of excess deaths in 2022.

[Alex Cunningham (Stockton North) (Lab)]

13. What assessment he has made of the implications for his policies of the number of excess deaths in 2022.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

Excess deaths data are published on the gov.uk website, which was most recently updated on 12 January. They show that causes of death from conditions such as ischemic heart disease contributed to excess deaths in England in the past year.

[Debbie Abrahams]

The UK’s all-cause mortality for working-age people was 8.3% above the average for the previous five years and the fifth highest in Europe. On top of that, excess deaths are disproportionately experienced by the most deprived and by people of African, Caribbean and Asian descent. Given that these figures are driven by structural inequalities, and that those inequalities are getting worse—the richest 1% have bagged nearly twice as much wealth as the remaining 99% in the past two years—does the Minister think that it is appropriate to recommend that people pay for their GPs?

[Maria Caulfield]

The Government are not recommending that people pay for their GPs. In fact, we are investing more in primary care than ever before, unlike the shadow Secretary of State who wants to dismantle the GP system and privatise the healthcare system as well. I think the hon. Lady needs to have a conversation with those on her own Front Bench. Not only did the shadow Secretary of State insult primary care teams for running up their vaccination programme, calling it “money for old rope”, but we are the ones who are investing in primary care services and making them more accessible to people.

Sudden Unexplained Death in Childhood

Debbie Abrahams Excerpts

Tuesday 17th January 2023 Westminster Hall

[Kwasi Kwarteng (Spelthorne) (Con)]

I beg to move,

That this House has considered sudden unexplained death in childhood.

It is a great honour for me to give my first speech as a Back Bencher in about six years on this vital subject. We are here to discuss something that is incredibly difficult to deal with, emotionally very taxing, and one of the most serious medical phenomena in our country—something that has not had the public attention it deserves: sudden unexplained death in childhood, or SUDC.

This vital subject was brought to my attention while I was still in Government. Julia and Christian Rogers came to see me at the beginning of October, when I was still Chancellor of the Exchequer. In that role, I would not have been able to raise this vital subject personally. I pay tribute to my constituency neighbour, my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), for his diligence in pursuing the subject while I was still in Government. Luckily, as a matter of privilege to me, I can now raise it myself. I cannot think of a better, more urgent subject to raise in my first Back-Bench debate for many years.

When Julia and Christian came to see me in October 2022, they told me the story of their son, Louis, who tragically passed away in 2021 before he reached the age of two. Julia and Christian lived with Louis in Shepperton in my constituency, and they loved their little boy with all their hearts. Of course, no occurrence is more tragic than the death of a small child. It was particularly disturbing that they knew very little about the illness that took away Louis’ life. One can only imagine the horror of discovering one’s child lifeless, and the sheer bewilderment of trying to understand the causes of that tragedy.

Julia and Christian introduced me to other bereaved parents who had gone through this heart-wrenching occurrence. The national charity SUDC UK does vital work to promote more understanding and sensitivity around a subject that, as I said, has drawn too little attention in the past. SUDC is among the leading categories of death in England and Wales for children aged between one and four. As a community, we have to engage more vigorously with this phenomenon.

Technically, SUDC is the sudden and unexpected death of a child between one and 18 years of age. Those deaths, by their definition of sudden and unexpected, often remain unexplained after a thorough investigation, including a post-mortem. This is one of those areas that modern medical science has still not really got to the bottom of, despite the great advances we have made.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

It is good that we can unite and collaborate to address some of the issues raised by SUDC. Christian’s aunt is my constituent, so I learned about Louis from her. Many of us here are parents, and this issue is deeply worrying. Like the hon. Member for Runnymede and Weybridge (Dr Spencer), I was a public health consultant and have come here from working in the NHS. This issue has not had the profile it needs—just 50 research papers, compared with 12,000 on sudden infant death syndrome. I hope we can do some joint working on the issue to raise the profile of risk factors and so on.