Baby Loss and Safe Staffing in Maternity Care

Guy Opperman Excerpts

Tuesday 25th October 2022 Westminster Hall

[Jill Mortimer]

He was a whopper; he still is a whopper. It caused long-term damage to my pelvis but, worse, he has had to battle his entire life with learning difficulties caused by a lack of oxygen at his birth. He was a floppy, quiet baby, and at 18 months he was diagnosed with, among other things, hypertonia. All his development was delayed, and he did not walk or speak until he was nearly two. I worked with him, and I am so proud that he kept battling on learning how to learn. Today, at 27 years old, he is training to be a nurse. [Hon. Members: “Hear, hear!”]

It was only during my third pregnancy that I experienced continuity of care, which was wonderful. The ability to build a relationship with my midwife, who stayed with me throughout my pregnancy, labour and beyond, was invaluable. I did not have to go through my story with new people all the time and had someone I came to know and trust by my side. I was lucky enough to experience that and wish more women had that chance.

Despite the benefits of continuity of care, I look back on the pregnancy and birth of my daughter with mixed emotions, because there should have been two of them. Very early in that pregnancy I again started to bleed. I bled with my first son and ended up spending a week in hospital, with people saying to me, “Don’t worry, it’s very early on; you’ll have another baby.” I lay still for a week, I did not breathe, and I kept him. But this time I started to bleed again, and I miscarried my daughter’s twin. I did not know how to feel or how to grieve, while having to put all my efforts into sustaining my pregnancy, fearful every day that I would lose the baby I still carried. I was lucky that my beautiful daughter was born safe and healthy, but that loss never goes away. With each milestone, I reflect on how they should be celebrating together. There should be two of them.

[Guy Opperman (Hexham) (Con)]

Grab a breath for a second. First, I congratulate my hon. Friend on bringing forward this vital debate. The House is joined with her in supporting the cause that she is espousing. Does she agree with me—this is something that I certainly have suffered from—that the concept of the take-home child is something we all need to come to terms with? I have had three children, but I have been able to take only one home. For my hon. Friend, it is unquestionably the case that she loves and adores her daughter, but never forgets those who came along with her but did not make it in the end. Is that a fair description of the situation?

[Jill Mortimer]

It is, Guy. Now you have made me feel more upset.

[Guy Opperman]

I was trying to help!

[Jill Mortimer]

You have done. Yes, that loss never goes away. I still feel guilty, because it was so early; I did not go through what people such as my hon. Friend have gone through.

--- Later in debate ---

[Guy Opperman (Hexham) (Con)]

I thank my hon. Friend the Member for Hartlepool (Jill Mortimer) for bringing forward this debate. This is my first Westminster Hall speech in seven and half years; it is an honour and a privilege to speak on such an important matter.

I have had three children, but was able to take only one home from hospital. Teddy and Rafe came and went in the summer of 2020—briefly—and were loved all too shortly. I welcome the work led by the teams at Oxford and Leicester to ensure that there is clear advice to support health professionals in assessing and documenting signs of life in extremely difficult pre-term births. That is what I want to focus on.

I should put on the record, as I am sure many will, the amazing charities such as Sands and others who work in this sphere and who have helped me get over the trauma, loss and bereavement, as have the Northumbria NHS trust in my constituency and St Thomas’s, where my children were born. I thank my constituent, Sarah Richardson, and all the teams at Hexham Queen’s Hall and Hexham Abbey for their support for baby loss awareness.

Consistency across the NHS is key. People will lose children; that is a fact of life. Pregnancy is, as we all discover, more complicated than we imagined it would be—even in 2022. There is work to be done on the improvement of midwives and maternity staffing levels, but the key for me is a consistent approach across all NHS trusts up and down the country. Why does that matter? Because there should not be a postcode lottery in which a parent in trust A is treated differently from a parent in trust B, and poor souls go on the internet and find out that in trust A they would have been treated in one way, but in trust B in another way.

We all have to accept that mistakes are made and that giving birth is a fragile process, but we should expect the NHS and our Government to promote consistency of approach in dealing with the individual issues that mums and dads have.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Does the hon. Member agree with me that the principle that he correctly outlines should also apply to the nations of the United Kingdom, and that equality of service should apply right across Great Britain?

[Guy Opperman]

It is a perfectly fair point that there is a difference of approach in the different countries of the great United Kingdom, and I utterly agree that if someone lives in the United Kingdom, they should have a consistency of approach. There should be a coming together of the various professional boards to drive forward consistent standards. I will give one specific example.

[Alicia Kearns]

Will my hon. Friend give way?

[Guy Opperman]

My hon. Friend will take my time, but I will give way very briefly.

[Alicia Kearns]

Before it even gets to treatment, a big problem is the way we assess the safety of a pregnancy, which is the same as it was in the 1960s. It has not changed. There is a new AI programme—the Tommy’s app—that could be rolled out across the entire country to ensure that technology is used to assess the vulnerability of pregnancies. Does my hon. Friend agree that that sort of tool is what we need rolled out to ensure consistency of diagnosis and safety in pregnancy, and not just treatment?

--- Later in debate ---

[Guy Opperman]

I endorse what my hon. Friend says. It helps doctors. Doctors and midwives are not the villains here; they all try very, very hard. It is easy for politicians to say, “This trust is not doing the right thing,” or, “This team is not doing the right thing,” but that is genuinely unfair. We have to shy away from being so critical.

This is about trying to provide the cover and approach so that clinicians are better able to deal with particular scenarios and situations. That is genuinely possible. There is good evidence that, on occasion, parents have been told that their child was stillborn when it should have been determined to be a neonatal death. That has consequences, because, as some will know, coroners can investigate neonatal deaths but not stillbirths. There is some evidence—only some; this is very much anecdotal and I do not want to start hares running—that a trust seeking to improve its figures would say that more births were stillbirths rather than neonatal deaths.

We have to be honest about the process and start from a position of generosity of spirit towards the doctors and clinicians who all try their hardest. If nothing else emerges out of today, driving forward a consistency of standards on how deaths are treated is vital.

I have one final comment. My second child came and went in one very long day at St Thomas’s, over the road from this place. The fact that his was a neonatal death meant that the trust attempted to save his life for a period of time and we were able to spend time with him, which is something that I will always treasure.

--- Later in debate ---

[Dr Johnson]

I will not, because I have a lot of questions to get through in a really short time.

Many hon. Members talked about bereavement. In the difficult scenario of baby loss, we understand that bereavement care for women and families is critical. We continue to engage closely with the bereavement sector to assess what is needed to ensure that bereaved families and individuals receive the support that they need. This year we have provided £2.26 million of national funding to support trusts, expand the number of staff trained in bereavement care and directly support trusts to increase the number of days of specialist bereavement provision that families can access.

In the women’s health strategy, which hon. Members mentioned, published earlier this year, we discussed the introduction of pregnancy loss certificates for England. This will allow a non-statutory, voluntary scheme to enable parents who have experienced a pre-24 weeks pregnancy loss to record and receive a certificate to provide recognition of their baby’s potential life. The certificate will not be a legal document, but it will be an important acknowledgement of a life lost, and we hope that it will provide comfort and support by validating a loss.

We understand the impact of pregnancy and childbirth on mental health, especially for those affected by the loss of a baby, and we are committed to expanding and transforming our mental health services so that people can receive the support that they need when they need it.

As part of the NHS long-term plan, we are looking to improve the access to and quality of perinatal mental health care for mothers and their partners. Mental health services around England are being expanded to include new mental health hubs for new, expectant, or bereaved mothers. These will offer physical health checks and psychological therapy in one building.

[Guy Opperman]

I accept that my hon. Friend has many things to cover today. As a former Minister, may I advise her that she might want to be encouraged to write to everyone with detailed answers from civil servants to the points raised?

Does my hon. Friend agree on one key point—that the collation of data and the consistency of approach must be nationwide? While we have many wonderful trusts, that has to be driven by the NHS, for which she is a Minister.

[Dr Johnson]

I absolutely agree with my hon. Friend.

Going back to the issue of perinatal mental health, we have previously funded Sands, the stillbirth and neonatal death charity, to work with other baby loss charities and the royal colleges to produce and support the roll-out of a national bereavement care pathway to reduce the variation in the quality of bereavement care provided by the NHS and ensure that, wherever a woman and family are being cared for, they get a high standard of care. The pathway covers a range of circumstances of baby loss, including miscarriage. As of April this year, 78% of trusts in England had committed to adopting the nine national bereavement care pathway standards.

The hon. Member for North Ayrshire and Arran (Patricia Gibson) talked about pre-eclampsia. NHS England is establishing maternal medicine clinics. These are specialist networks across the UK, which will manage pre-conception, antenatal, post-natal and medical issues in women, and reduce long-term morbidity, thereby improving outcomes for those women who have co-existing medical conditions.

My hon. Friend the Member for Macclesfield (David Rutley) spoke about the maternity unit in his constituency. I know that he is a doughty campaigner for that unit. I will write to him with further information on progress in that area.

The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) talked about the Scottish health service and how it is performing in relation to maternity care. It is, of course, a devolved issue in Scotland, but I was moved to hear about what is happening in areas of the north of Scotland near Elgin. I would encourage the devolved Scottish Administration to consider carefully what is going on there and to see what they can do to improve care. It seems unacceptable for women to travel 102 miles to give birth.

The NHS in England has a medical education reform programme, co-sponsored by NHS England and Health Education England, to direct investment for specialty training for population needs back towards smaller and rural hospitals. That programme entered its implementation phase in August 2022.

Hon. Friends mentioned The Lancet recommendations. While the pregnancy loss review will be published shortly, I am not in a position today to commit to what it is going to say, but we will consider it carefully.

Human Fertilisation and Embryology

Guy Opperman Excerpts

Tuesday 3rd February 2015 Commons Chamber

[Luciana Berger]

I thank the hon. Gentleman for that clarification.

Many concerns have been raised, the first of which is that this process is being rushed through. Anyone who has been involved in the development of these techniques would disagree that this has moved quickly. Professor Doug Turnbull and his team at the university of Newcastle have been researching this for 15 years. It was over six years ago, back in 2008, that the Human Fertilisation and Embryology Act 1990 was amended to introduce the powers to allow regulations that would enable mitochondria replacement to take place to be brought forward. It was back in 2010 that researchers at the university of Newcastle developed the techniques to avoid diseased mitochondria being passed from a mother to her children. After another three years of consultation and review processes, the Government announced in July this year that they would be bringing forward the regulations to enable mitochondrial donation techniques to be used, and that is what we are voting on today.

[Guy Opperman (Hexham) (Con)]

The hon. Lady and I both attended the meeting last night, which was very productive and helpful. Does she agree that this is about choice for the families? I have constituents who have this particular disease and constituents who work at Newcastle university, and what we are trying to do is provide a scientific way forward, under a highly structured and licensed regime, to alleviate these particular families’ suffering.

Oral Answers to Questions

Guy Opperman Excerpts

Tuesday 21st October 2014 Commons Chamber

[Dr Poulter]

During this Parliament we are set to improve efficiency in the NHS and make £20 billion-worth of efficiency savings. There is much more that we can continue to do on improving hospital procurement practices, sharing business services across the NHS, and freeing up surplus land—which, as my hon. Friend the Member for Enfield North (Nick de Bois) outlined, is happening at his hospital. That is what we need to focus on in freeing up money for the front line.

[Guy Opperman (Hexham) (Con)]

Hexham hospital is outstanding but was built under a very expensive Tony Blair PFI. Does the Minister welcome the fact that Northumbria NHS trust is the first in the country to buy out the PFI and put it into public ownership, thereby putting millions more into front-line care?

[Dr Poulter]

My hon. Friend makes an important point. The PFI schemes negotiated by the previous Government were, quite frankly, disastrous for many hospitals. His hospital has seen that the way forward is to buy out the PFI and free up more money for front-line patient care. We will support as many more hospitals in doing that as can be achieved, because this is about making sure that we deliver more money for NHS patients.

Hospital Car Parking Charges

Guy Opperman Excerpts

Monday 1st September 2014 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend has put a very important point on the record. It illustrates again that when management thinks about patients rather than managing the accounts, it can come up with solutions that are good for the patient.

We have all had many representations from individual patients about the costs they have incurred personally. We have also heard from pressure groups. In particular, Macmillan has highlighted that cancer sufferers have found parking charges to be a very costly element of their treatment, adding significantly to the financial strain for people who are going through prolonged periods of treatment. As I have said, some of them are losing considerable amounts of earnings during that process. We need to be making it easier for them to get better and overcome their debilitating illness.

[Guy Opperman (Hexham) (Con)]

I congratulate my hon. Friends the Members for Thurrock (Jackie Doyle-Price) and for Harlow (Robert Halfon) on securing this debate. Of course, it is patients and their families who are the main people affected by this particular issue, but does my hon. Friend the Member for Thurrock agree that surely it is wrong that NHS staff, who do such an amazing job in all our hospitals, are in many cases, particularly in my area, required to pay for the parking in the area where they work, thereby reducing their own salary?

[Jackie Doyle-Price]

My hon. Friend raises a very important point. One objection to our campaign on parking charges is that somehow the money would be taken away from health care, but I do not believe that is the case at all. He mentions staff. In order to get the best conditions for care, we need to make it easier for people to go out and work, and access to cheap parking is very much a part of that.

--- Later in debate ---

[Guy Opperman (Hexham) (Con)]

Like my hon. Friend the Member for Worcester (Mr Walker), I would like my trust to review its approach to parking charges at Hexham hospital and in the region.

I will start my short speech by pointing out that I have probably spent more time in hospitals as an acute patient than virtually any other Member of the House, and I have certainly had my life saved on two separate occasions. More particularly, I have seen on the many occasions that I was visited by family and friends the degree of worry in the wards that I was in, whether with a brain tumour or as an injured jockey. The last thing people need at such times is to worry about parking and similar matters. That is not the right approach, and it is wonderful that the House is debating the issue today—as always, full praise is due to my hon. Friends the Members for Harlow (Robert Halfon) and for Thurrock (Jackie Doyle-Price).

The direction of travel is clearly good, with the Secretary of State’s announcements over the summer, today’s discussion, and the sharing of innovative ideas. The hon. Member for Solihull (Lorely Burt) made a fair point about the alternative ways that such issues can be approached, and we all agree that at times our trusts seem not to talk to each other to develop an alternative way forward.

Northumbria NHS Trust is an outstanding trust with exemplary staff and quality service, and Hexham hospital charges are well below those of many trusts. There is free disabled parking and concessions for some patients and visitors. It has got rid of the dreaded ParkingEye that so many people complained about, but problems still remain and there are complaints not only from individual constituents but from the staff who are effectively required to use the hospital car park if they wish to get to their job. That cannot be right. I endorse all the comments about how we need to review that and change the system.

In Northumberland, we have managed to remove local authority parking charges, so a visitor to Hexham is entitled to free parking. As a consequence, the one argument the town centre hospital had for charging has disappeared. We therefore have the bizarre situation where it is free to park in the town, but expensive to park at the hospital. The Network Rail station, Marks & Spencer and the hospital are the only three organisations charging for parking in the local area, whereas in the town it is now free.

Sadly, the trust is not prepared to reduce or cancel the parking charges. We can all understand why parking charges should be imposed where a hospital is in a town centre and where, sadly, members of the public would use free parking to avoid a Northumberland county council car park or alternative private cark park—there is ample evidence for that—but we need to balance the two arguments to ensure a flexible approach. Then we can have an individual policy for the town.

In rural Northumberland, well over 90% of journeys to the hospital are made by car. Mr Deputy Speaker, you have kindly granted me a debate on rural transport in Northumberland, so you know that I shall be raising the absence of bus, train and alternative provision to Northumberland town centres this Wednesday evening at 7.15 pm. Currently, however, the harsh fact is that those journeys have to be made by car. As I have indicated, we have received many complaints from members of staff and constituents, and I endorse the favourable comments about the Macmillan report on the treatment of cancer patients and the findings of the charity Bliss which my hon. Friend the Member for Harlow outlined so eloquently.

There is a cost to this process, but if we all stopped using hospital car parks, hospitals would not benefit from the charges, so, bizarrely, unless the trusts act, all of us will attempt to boycott them and use alternative means, in which case they will be the ones facing the costs. Trusts need to review this policy in the light of their individual circumstances—town centre parking and other parking facilities in their areas—and ultimately change it, because this policy is wrong.

Mitochondrial Replacement (Public Safety)

Guy Opperman Excerpts

Monday 1st September 2014 Commons Chamber

[Fiona Bruce]

I can respond in this way. In the general science, concerns have been referred to. A mismatch between nuclear and the mitochondrial DNA could cause severe health problems in children conceived with this technique: problems such as infertility, reduced growth, impaired learning, faster ageing and early death. Are those not sufficiently serious for us to be extremely concerned?

[Guy Opperman (Hexham) (Con)]

I support the work to combat this terrible disease, some of which is being pioneered by my local university, Newcastle, and I will be urging the Government to proceed with the trials, but the question is this. The new IVF technique that has been pioneered at Newcastle has proved to be successful in the laboratory, but the current law prevents it from being tested in a clinical trial or used in clinical practice. That is what we need to change. Without those clinical trials, we cannot progress and deal with this terrible disease.

[Fiona Bruce]

That is very interesting but the point I am making is that at the moment such clinical trials would involve children. Two peer-reviewed articles in Nature have suggested that mitochondrial transfer is inherently risky, one of them citing a figure of 52% of embryos created through MST having chromosomal abnormalities.

Patient Safety

Guy Opperman Excerpts

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

I pay tribute to my hon. Friend’s campaigning on mental health issues, which has done a huge amount to raise the profile of the subject. Let me reassure him that the information that we are publishing on the website today includes staffing data for all the mental health trusts. We completely recognise the parity issue, at least in what we are doing today.

[Guy Opperman (Hexham) (Con)]

In my previous job, before I entered the House, I conducted dozens of clinical negligence cases. Almost every defending trust was obstructive, defensive and reluctant to admit blame, even when patently culpable. I strongly welcome the changes that are being brought about. Does my right hon. Friend agree that greater transparency and whistleblowing will bring about the safety changes that we all want to see?

[Mr Hunt]

I very much agree with my hon. Friend, and he will know that one of the things we have introduced this year is the duty of candour, which makes it a legal requirement for trusts to be honest with patients and their families when harm or avoidable death has occurred. He is absolutely right that we have to tackle this, and he will also know that when trusts are open and transparent, relatives are less likely to sue, because they recognise the good will and spirit involved.

Severe Eating Disorders (North-East England)

Guy Opperman Excerpts

Monday 23rd June 2014 Commons Chamber

[Chi Onwurah]

My hon. Friend makes an excellent point. Again, the testimony of those most intimately involved speaks to the excellence of the unit and the concern of people in Tyneside.

[Guy Opperman (Hexham) (Con)]

I congratulate the hon. Lady on securing this debate. Like her, I have had many letters of support from constituents who have been helped by the Richardson eating disorder service, and also from individual nurses and doctors, such as Dr Caroline Reynolds, the consultant psychiatrist at REDS, who have provided assistance to people with this terrible disease. Does the hon. Lady think it would be right for the mental health trust and NHS England, together and collectively, to review their decision and, going forward, address how they will recommission the service when the present contract ends?

[Chi Onwurah]

The hon. Gentleman makes an excellent point, and I certainly believe that the decision should and must be reviewed. It is clear that a number of hon. Members have been contacted by concerned constituents. Indeed, the right hon. Member for Berwick-upon-Tweed (Sir Alan Beith), who cannot attend this debate, asked me to say that he also had constituents who are affected.

Given that admissions in the north-east are 30% above the national average, and that the Royal College of Psychiatrists recommends that six beds per million of the population are needed for average admission rates, the north-east’s 2.8 million people need 23 beds. I will return to that figure, but first a word about the threatened unit that hon. Members have already referred to.

The Richardson eating disorder service is operated by Northumberland, Tyne and Wear NHS Foundation Trust. It is in the centre of Newcastle, with excellent transport links. It is acknowledged to be an outstanding unit, rated excellent by the Royal College of Psychiatrists and the Care Quality Commission. It has just won Beat’s clinical team of the year award. A stable, vastly experienced staff has been treating adult in and out-patients since 1997, and it has saved many lives. One sufferer said:

“I have suffered from anorexia nervosa for over 12 years and unfortunately during that time I have required many admissions to medical and eating disorder units”.

She names a number of them before going on to say:

“The admission to the Richardson was by far the most successful. I made such huge strides towards recovery and was the healthiest I have been since this all began.”

[Chi Onwurah]

My hon. Friend makes an excellent point. Indeed, if the criteria on which this decision was made were publicly available, we could perhaps tell which models NHS England considered and what it hoped to achieve. Unfortunately, there is no transparency, which is one of the key issues.

Problems started in 2010, when commissioned adult eating disorder in-patient beds were tendered and the contract was awarded to Tees, Esk and Wear Valleys NHS Foundation Trust, although it did not then operate an in-patient unit. It quickly established a 10-bed unit in Darlington, but on a site with poor transport links to the north. For clarity for those Members who may not be familiar with the north, Newcastle is to the north of Darlington.

The award was a shock to many people, not simply because of the result, but because of the lack of consultation. I should like to ask the Minister a specific question: against what criteria were proposed services considered to be better than award-winning ones already on offer in the Richardson? If he does not know, I hope that he will promise to find out. Was cost the driving factor? What was the evidence basis for the centralising of these critical mental health services?

The National Institute for Health and Care Excellence guidelines specifically state that for severe eating disorders patients should be treated near their homes, with the support of family and friends. These are often young, vulnerable people, who are not yet independent of their family, either financially or emotionally. As one told me,

“Seriously ill anorexics are often cognitively impaired as a result of severe starvation and separation from loving support, together with that the challenge to dangerous and entrenched behavioural traits is often too much to bear.”

Given the lack of consultation, the north-east specialised commissioning group was instructed to strengthen its relationships with stakeholders and report any other substantial changes or developments to the NHS scrutiny committee.

NEEDAG, formed by carers and patients concerned about the threat to the Richardson, hoped that at least five of the beds in the Richardson would continue to be used by those in the north of the region, given overall regional demand. However, in April 2012, the commissioner increased the number of beds at Darlington to 15—again, without any consultation, scrutiny or performance data by which to make judgments. When challenged, I am told that the commissioner said they were not obligated to consult anyone. I hope that the Minister will correct them on this point. It is possible that the top-down reorganisation of the NHS instituted by this Government may have led to them forgetting their obligations under the NHS constitution.

When Darlington was full, commissioners started sending very ill patients out of the area, instead of to the Richardson, saying that every commissioned bed in England, no matter where it was, had to be filled before a patient from Tyneside could be sent to Newcastle. That is how we have arrived at the ridiculous and tragic situation of our national health service sending vulnerable Tyneside patients to Glasgow, Norwich and London when there are empty beds in the Richardson unit in the centre of Newcastle.

The impact on vulnerable young people of being separated from their families undoubtedly makes it more difficult to recover—hence the NICE guidelines. The cost of visiting for families is enormous, both financially and emotionally. One parent wrote:

“This will then have an effect on our family’s mental health as we are all struggling to come to terms with the condition and to help M recover. I would refuse to let M be admitted so far away from home and would rather give up my full time job to look after her in the familiar and safe surroundings of home.”

Another parent who fought to win a place for their daughter at the Richardson said:

“We were very angry to have been put in the position of having to fight for a bed for our dangerously ill daughter at a time when all our energy was needed to comfort and support her through a very difficult time. The added pressure and anxiety it caused the whole family was dreadful.”

It has been announced that the unit will be closed down, because it was said—cynically and cruelly—that it was not being used locally. If it was not being used locally, it was because NHS England was sending local people hundreds of miles away. Freedom of information requests submitted by NEEDAG show that Darlington’s 15 beds are full; that there are eight in-patients from the north-east in London, Sheffield, Leeds, Glasgow and Norwich; and that five patients have managed to win beds in the Richardson.

[Guy Opperman]

We all understand the need for and importance of centralised specialist services, whether they be stroke services or those under discussion, but given the number of people per capita in the north-east who suffer from this terrible disease, is there not a genuine case to be made for the two services to co-exist?

[Chi Onwurah]

The hon. Gentleman makes an excellent point. That is indeed the case. The number of in-patient admissions in the north-east as a result of severe eating disorders is 30% above the average, which suggests that about 23 beds are required. It would be possible to meet the NICE guidelines and retain the services in Darlington and in Newcastle, yet not meet the increasing demand for in-patient beds. There are a total of 28 in-patients from the north-east, but NHS England says that only 15 beds are needed; that clearly goes against the 23 calculated in accordance with guidelines.

NHS England argues that it is investing in the north-east, and that it is opening an intensive day unit in Newcastle that will reduce demand for in-patient care, but it has provided absolutely no evidence to support its claim. One parent said:

“For my daughter the thought of going back to the local community mental health teams fills her with dread.”

A day centre does not address the issues of isolation and support when in-patient care is needed.

Patients are so worried that two of them have decided to take both the trust and the commissioners to judicial review, based on the lack of consultation transparency. They are applying for legal aid, so we will be in the ridiculous situation of spending public money to both defend and attack a decision taken without the most basic public consultation.

Having written to the Minister of State, Department of Health, the hon. Member for North Norfolk (Norman Lamb), on the subject in the past, I know that he is sympathetic to the plight of sufferers of severe eating disorders and their families and friends. Both he and the Secretary of State have criticised sending patients hundreds of miles for treatment. I want the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), to answer the questions I have already asked and the following two in particular.

First, does the Minister support the concentration of mental health services? In the case of heart surgery for children, we are told that concentration saves lives, because surgeons must be operating on many patients to retain their skills, but the mind does not physically work in the same way as the heart. Does he believe that there is something to be gained from making mental health into a production line? Why is it not possible to maintain beds in Darlington and Newcastle? Why is NHS England not following NICE advice? If the aim is to save money, is this truly a cost saving, or merely moving costs from the NHS to the sufferers of this terrible condition and their family and friends? Is it not outrageous that NHS England should be moving costs on to the most vulnerable and risking lives by doing so?

Secondly, on transparency, how can the Minister possibly support a process whereby there is no consultation on decisions that are so important to the lives of patients and their carers? Is that not in itself a reason to reverse the decision, given that the commissioners did not consult the people to whom they are accountable and in whose interests they are paid—and often paid very well—to commission services?

I will leave the last words to someone more intimately concerned with this than I am, who wrote to me:

“My friend’s beautiful and talented daughter has battled this terrible condition for many years with the help of the Richardson and the support of friends and family every single day that she has been in there. I truly believe that if the unit near to home closes and she feels far from this lifeline of support, she will give up her fight and that could be the end not only of her dream to take up her place at University but possibly, it’s not too dramatic to say, her life.”

Pancreatic Cancer

Guy Opperman Excerpts

Tuesday 4th March 2014 Commons Chamber

[Eric Ollerenshaw]

rose—

[Guy Opperman (Hexham) (Con)]

I congratulate my hon. Friend on securing the debate and endorse what he says entirely. Does he agree that perhaps we should also consider going commando this Friday to raise male cancer awareness and show our general support for all cancers that people are struggling with today?

[Eric Ollerenshaw]

I am grateful for those well-timed interventions from my colleagues across the frontier.

What I am trying to get on the record is the fact that those two more months are critical in this particular cancer. Our worry is that two more months might not look good enough when the judgment is made, but for pancreatic cancer it is a massive improvement.

I also want to put on the record two other emerging possibilities. A useful and emerging new technology is NanoKnife. It carries out a process called irreversible electroporation, which destroys parts of the tumour while avoiding damage to vital tissue nearby, such as blood vessels. The process shrinks the tumour to a more manageable size, which might then allow more permanent surgical solutions. NanoKnife is currently available only through the private sector at one hospital in London.

A company called Novartis, has a treatment for neuroendocrine pancreatic cancer that is currently funded via the CDF in England. Although it is welcome that patients can access treatment via that route, we continue to argue for a long-term solution. In that context, we are worried about Andrew Dillon’s statement that, under the new system of value assessments that NICE is due to introduce in the autumn, only six out of 20 treatments assessed by NICE in the past year would be approved. A 30% approval rate is clearly not the long-term solution expected from the original concept of value-based pricing. In 2013, I understand, not one new cancer drug was approved by NICE. That issue, perhaps, is for a wider debate, but I hope the Minister understands that those arguing on behalf of pancreatic cancer patients are extremely worried about ever getting the new drugs on to the system and available for wider use across, hopefully, the whole United Kingdom.

Minister, this debate has been an unashamed appeal for support—from the charities concerned, the all-party group, the survivors and all those who have been affected by pancreatic cancer through the loved ones they have lost. We do not want others to go through our tragic experiences.

Oral Answers to Questions

Guy Opperman Excerpts

Tuesday 25th February 2014 Commons Chamber

[Dr Poulter]

Group B strep is an important issue. I have seen in my clinical practice the devastating effect that the disease can have on newborn babies and on families, so we are doing all that we can to support work on it and ultimately to develop a vaccine to prevent the condition. I would like to correct the hon. Lady on the record. I met Group B Strep Support with the Chief Medical Officer and we undertook to investigate the applicability of the test. The clinical evidence unfortunately does not support its introduction, and we have to be guided by clinical evidence.

[Guy Opperman (Hexham) (Con)]

17. My hon. Friend has visited the Hexham midwife-led maternity unit, which provides exemplary care. Can he update the House on what steps the Department of Health is taking to prevent excessive screening of pregnant women away from midwife-led units? Surely health care is about choice, not diktat.

[Dr Poulter]

My hon. Friend is right. It was a pleasure to visit and open the new facilities at his local birthing unit. He has been a tremendous champion for the midwifery-led unit in his constituency, and I pay tribute to him for that. He is right that it is important that women have choice. These are local decisions by local health care commissioners, but I hope that it will give him some reassurance that the number of midwifery-led units has increased from 87 in 2007 to 152 in 2013 precisely because of the investment that the Government are making.

NHS

Guy Opperman Excerpts

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

My hon. Friend puts his finger on it. There are families who are choosing between eating, heating or other essentials, such as prescriptions. That is the reality for many families and it is having an impact on their health. For those on the Government Benches not to recognise that that is the reality of life for many people, I fear for the state that we are in. They have been shouting at me for the past few minutes about scurvy. I can tell the hon. Member for Taunton Deane (Mr Browne) that the number of admissions has doubled. There are a relatively small number of cases, but they are on the rise. He really should not sit there barracking and dismissing the whole problem. He would do well to look at the facts.

Today, the Secretary of State says that the NHS got better in the past year. He should say that to the 131,000 people left waiting on trolleys for more than four hours. He should say that to the people finding it harder to get a GP appointment under his Government, left ringing the surgery at 9 am to be told that nothing is available. He should tell that to the families of children who have suffered a mental health crisis, but are told that there are no beds available anywhere in the country and end up being held in police cells. The truth is that the Government have failed to get the A and E crisis under control and it is threatening to drag down the rest of the NHS. In the past 12 months trolley waits are up, waiting times are up, emergency admissions are up, cancelled operations are up and delayed discharges are up, too. That is the reality of what is happening in the NHS.

One of the main reasons for the intense pressure on A and E is the collapse of social care in England. In December, a report from the Personal Social Services Research Unit found that, due to local government cuts, social care support in the home has been withdrawn from about 500,000 older and vulnerable people. These are people who were receiving support in the home, but are no longer getting any help. Even for those people still receiving some support, we continue to hear stories of corners being cut: slapdash 15-minute visits where staff have to choose between helping people wash or helping people eat. If we carry on like this, our hospitals will become more and more full of older people. A and E will be overwhelmed by the pressure and that really is no answer to the ageing society. That brings me to the second part of our debate today: the solution.

What is clear to most people is that there will not be a solution to the sustained pressure on A and E without better integration of hospital services with social care, primary care and more collaboration between the two. What is also clear is that there is now great frustration among people working in the NHS that they are being prevented from developing solutions to the A and E crisis by a large barrier standing in their way: the Health and Social Care Act 2012. This Government like to talk about integration, but the fact is that they have legislated for fragmentation. Under this Government, market madness has run riot throughout the NHS and is now holding back solutions to the care that older people need.

[Guy Opperman (Hexham) (Con)]

Will the right hon. Gentleman welcome the exact example that he so urgently seeks: Haltwhistle hospital in Northumberland? It is currently being built and I have been around it. It is integrated, with the local authority on the top floor and the NHS on the bottom floor. That is surely the model and the way forward.

[Andy Burnham]

I agree with the hon. Gentleman. There are examples of good practice out there, but I suggest that he speaks to chief executives of clinical commissioning groups and trusts. They are telling me that the competition regime introduced by his Government is a barrier to that kind of sensible collaboration. The chief executive of a large NHS trust near here says that he tried to create a partnership with GP practices and social care, but was told by his lawyers that he could not because it was anti-competitive. Does the hon. Gentleman support that? Is that what he thought he was legislating for when he voted for the Health and Social Care Act? People are being held back from doing the right thing for fear of breaking this Government’s competition rules.

Recently, we heard of two CCGs in Blackpool that have been referred to Monitor for failing to send enough patients to a private hospital. The CCG says that there is a good reason for that: patients can be treated better in the community, avoiding costly unnecessary hospital visits. That is not good enough for the new NHS, however, so the CCG has had to hire an administrator to collect thousands of documents, tracking every referral from GPs and spending valuable resources that could have been spent on the front line.

--- Later in debate ---

[Mr Hunt]

I want to make some progress, but I will give way once more.

[Guy Opperman]

Does my right hon. Friend agree that it is the right policy to highlight trusts such as Northumbria, which is leading the way on integration between hospice care and local authorities, and which is also assisting another trust, in this case North Cumbria, which is presently in special measures and which we hope will come out of them very soon?

[Mr Hunt]

Absolutely. One of the most encouraging developments in the last year was the setting up of buddying systems so that hospitals in difficulty such as North Cumbria—where I think there was a pay-out of £3.6 million to just one person under the last Government because of some utterly appalling care—are given help by a hospital that is being run well.