Tobacco and Vapes Bill

Jim Shannon Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Victoria Atkins]

To be clear, is my right hon. Friend suggesting that we repeal the Misuse of Drugs Act 1971, under which cannabis is prohibited? Although I have no experience of it, I understand that the consumption of marijuana also involves the consumption of tobacco and cigarette papers. The point is that we are trying to move away from the idea that current youngsters will be able to buy their cigarettes legally in shops from the age of 18 in 2027, precisely because we want to ensure that they can lead longer, healthier lives. In a moment I will come to some of the myths that the tobacco industry has put around about the impact of introducing age restrictions on cigarettes, which will be interesting evidence for those who are concerned about that.

[Jim Shannon (Strangford) (DUP)]

First of all, I commend the Secretary of State and the Government for bringing forward this legislation. I support it because I believe it is right, but I have been contacted by vaping groups. My right hon. Friend the Member for Belfast East (Gavin Robinson) and I met some last week. They sent me a small comment, and I want to ask the Secretary of State a quick question about it, so that we move forward with consistency to try to achieve something.

Those groups referred to the impact assessment report by the Department of Health and Social Care, and said that it fails to consider potentially detrimental effects of restricting vape users and smokers looking to switch. I think we all try to be helpful and constructive in our comments in this Chamber, so being constructive, they requested a vape retailer and distributor licensing scheme in the Bill. The industry has developed a comprehensive framework for such a scheme, which is designed to deal effectively once and for all with underage and illicit vape sales—a situation that could get worse. Does the Secretary of State intend to develop a vape retailer and distributor licensing scheme?

[Victoria Atkins]

I am extremely grateful for the hon. Gentleman’s support. We understand the level of lobbying that has been undertaken by both the vaping industry and the tobacco industry. We know that the vaping industry has pushed that as one of its lines. In the current vapes market, when walking into a local shop or a newsagent the vape products can be seen on sale next to the till, often next to the sweets—the part of the shop that children will be very attracted to, if my experiences are anything to go by. The industry markets them in very cynical ways. We are saying that it is already unlawful to sell vapes to under-18s, but we want to take the powers in this legislation to consult on flavours, design and so on, to ensure that vapes are sold as they are intended—to help adult smokers to quit, because no child should ever vape.

Health Services: Cross-border Co-operation

Jim Shannon Excerpts

Tuesday 16th April 2024 Westminster Hall

[Virginia Crosbie]

I thank my hon. Friend for his intervention, which gives me the opportunity to thank him for his hard work in fighting not only for his constituents, but for everyone across Wales. They deserve a better service than they are getting, and it is only by working together that we can get action, so I am delighted that he is here today. He is a doughty campaigner and a doughty champion for his constituency.

[Jim Shannon (Strangford) (DUP)]

The Northern Ireland-Republic of Ireland cross-border initiative was officially closed in December 2020 due to the withdrawal of EU funding. It was a scheme that many of my constituents bought into and did well out of, getting their operations down south before coming back to Northern Ireland, thereby skipping long waiting lists.

The hon. Lady is absolutely right to ask for better cross-border health co-operation between Wales and England, and I understand the reason that she does so, but I believe that there is an argument to be made for a scheme across the whole United Kingdom of Great Britain and Northern Ireland, because I think that there are cross-border opportunities that we can all take advantage of. Although she is asking specifically about Wales and England, the title of the debate, if she does not mind my saying so, is “Health Services: Cross-border Co-operation,” and that is something that we can all ask for.

[Virginia Crosbie]

I thank the hon. Member for his intervention, and in particular for that feedback on how cross-border co-operation actually works. Of course I am focusing on Wales, but he quite rightly highlights that this is the United Kingdom. By working together, we can solve these issues and provide a collaborative approach to healthcare for people across the UK.

I also wanted to add to my list of failures the near-collapse of local NHS dental services. I could honestly stand here and reel off story after story of lives drastically and sometimes irreversibly impacted by the failures of BCUHB. In Holyhead, the largest town in my constituency, two GP practices were merged during the pandemic into Hwb Iechyd Cybi, or Cybi Health Hub. That practice has suffered a series of problems, including twice facing the threat of having no GPs—and that is in Holyhead, the largest town in my constituency.

One of the main things that would make a difference to Hwb Iechyd Cybi and the people it serves would be to co-locate the two original practices. Proposals have been made for that and, in the longer term, for a state-of-the-art healthcare centre for Holyhead. The co-location project would deliver economies of scale that would vastly improve the service that the practices can deliver and, therefore, patient outcomes. The project was allegedly given the go-ahead two years ago, but it has stalled and stalled in BCUHB’s hands, and now it has completely stagnated. Likewise, the integrated health centre has been under discussion for years, but it remains under discussion, with no progress likely. Lack of funding is the problem that is generally cited.

Hwb Iechyd Cybi serves 9,000 patients, and there are around 15,000 people in its catchment area. Holyhead is not a minor backwater in north Wales; it is a large town, yet it has no integrated healthcare. It has an A&E that is 25 miles away across a bridge that closes in high winds, and it has a massive shortage of doctors. I have launched my own petition to raise awareness of this issue and to call on BCUHB to proceed with the co-location project, as well as starting work on the new health centre with urgency. I recognise that the NHS faces significant pressures across the UK, but people are actually moving out of my constituency to live in other parts of Britain because they are scared of becoming ill in north Wales.

There are too many stories of avoidable death and harm. Unfortunately, it is almost impossible to compare the situation across the devolved nations in order to see just how bad it really is, because the Welsh Government produce different data from that produced by the UK Government. That makes it almost impossible to compare patient outcomes across borders.

What we do know are facts like these. In 2023, over 22,000 paramedic hours were lost in Wales just waiting outside A&E. In January 2024, more than 3,000 people in north Wales waited for more than 12 hours to be discharged from A&E, and nearly 60,000 BCUHB patients had been waiting for more than 36 weeks to start treatment; six years earlier, that number was just under 10,000. Over 57,000 people across Wales have been waiting for more than a year to start treatment, with 24,000 patient pathways waiting more than two years. Since 2010-11, the Welsh Government have increased health spending by 30.6%, well short of the UK Government’s increase in England of 38.9%.

We have asked the UK Government for help on behalf of our constituents. Last year, the then Secretary of State for Health and Social Care, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), wrote to the Welsh Government to offer a right of access to NHS services in England for people in Wales. Unfortunately, the Welsh Health Minister claims not to have the additional budget to facilitate that proposal, despite the clear benefits it could offer our constituents. The Welsh Government can, however, find an estimated £100 million to increase the number of Senedd Members from 60 to 96; £4.25 million to buy a farm that it now cannot develop; and over £30 million to implement the much-derided default 20 mph speed limit.

The Welsh Government approach is also highly inconsistent. Take the covid pandemic. The Welsh Government seemed to be unaware that they would have to provide their own response to the threat, despite having been in charge of healthcare in Wales for years. They prevaricated and created different measures and responses, but they want to be part of the UK covid inquiry rather than holding their own. They seem to think they can pick and choose when they are accountable. It would be fantastic to see the Welsh Government prioritising health as the UK Government are doing, for example by enabling pharmacies in England to prescribe medication for common conditions such as earache and impetigo. It is challenging to be a UK MP in Wales when a matter such as health is devolved. Many people do not realise that it is devolved and blame Westminster for failings.

Cass Review

Jim Shannon Excerpts

Monday 15th April 2024 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I do not want to say that the Secretary of State could ever be wrong, but on her last judgment I have to say that the show is never over until the hon. Member for Strangford (Jim Shannon) has spoken.

[Jim Shannon (Strangford) (DUP)]

You are most kind, Madam Deputy Speaker. I know that I have now caught the Secretary of State’s eye.

May I thank the Secretary of State for her fortitude and determination, and Dr Cass for all her endeavours? Both ladies—honourable ladies, I believe—have been incredibly impressive and capable. We should be taking on board Dr Cass’s report in Northern Ireland. Indeed, I will make it my business to ensure that the Minister in Northern Ireland takes this in, so I shall be sending him a copy of the report. What help and support is available for all those patients who have been in the Tavistock since its inception? Importantly, what steps can be taken by the Government to stop this malpractice and to stop the movement of the vulnerable—some have called this tantamount to abuse—into privately funded abuse? How quickly can that protection be put in place?

[Victoria Atkins]

Let me offer the hon. Gentleman my sincere apologies; I am out of practice and should have known that his would be the last question.

I genuinely look forward to working with my Northern Irish counterparts on this, as we have already worked together on other matters. The hon. Gentleman makes a point about private practices. That is one area that I am working on at pace. What we do not want is to have any idea forming that somehow people can get round the strict rules that the NHS is setting the system to get these drugs to young people and children. I promise to come back and update the House when I have more news on that, but the hon. Gentleman is right to identify that issue. It shows the complexity of the matter and the real need for a very clear, detailed and principled approach to help reform our NHS so that we make it faster, simpler and fairer.

Defibrillators

Jim Shannon Excerpts

Wednesday 20th March 2024 Westminster Hall

[Jonathan Gullis]

I could not agree more with my right hon. Friend about the need, which I will come to later, to ensure that devices are registered. Having visited AEDdonate myself, I can say that it is made up of fantastic custodians working incredibly hard, not just in rural Staffordshire and Stoke-on-Trent but across the country, to make sure there is access. I know that my right hon. Friend is a doughty champion for its cause, as well as for the community he serves in ensuring access to these lifesaving devices.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Member for Stoke-on-Trent North (Jonathan Gullis) for bringing this subject forward. Many in the House, and others, will be aware that I brought the Automated External Defibrillators (Public Access) Bill to the House in 2020. The Government at the time accepted the necessity of having defibrillators in schools, and that was a fantastic milestone in this campaign, which the hon. Gentleman has taken further. Does he agree that it is one thing to have defibrillators installed, but that more must be done to educate people in schools, such as teachers, and teachers’ associations, to use defibrillators properly and make the most out of them, thereby saving more lives?

[Jonathan Gullis]

I thank my hon. Friend for that intervention. He is a great champion for the people of Strangford and it was an honour to visit his local community with him and see the fantastic work that he is doing there. That Bill still has my full support. I will come to the importance of improving education, so that it is not just a one-off. It needs to be repeated year in and year out, so that children in particular are immune to seeing what will be a distressing scene but, most importantly, have the muscle memory and are able to put that lifesaving support into action. The Minister himself is regularly saving lives, not just in his constituency but across his wider region, with the work that he does, so I am sure that he will understand the importance of persistent and regular education and training.

In September last year, I was pleased to see the Department introduce the community automated external defibrillator fund. This £1 million investment will help to increase access to these lifesaving devices and put an extra 2,000 defibrillators on the streets. That is an important step forward by the Department, but I urge the Minister to do far more to address the clear imbalances that I outlined.

The APPG on defibrillators and I have concluded that there is no co-ordinated national strategy to ensure that defibrillators are placed in areas with the highest need. With previous research illustrating that cardiac arrest is more likely in deprived areas, the Government must ensure that those areas have better or at least equal access to lifesaving equipment to more affluent areas. At this moment in time, that is simply not the case.

With over 30,000 out-of-hospital cardiac arrests in the UK each year and a survival rate of just one in 10, it is crucial that bystanders and emergency responders can locate and access the closest defibrillator immediately. The British Heart Foundation, NHS England, St John Ambulance and Resuscitation Council UK provide the NHS with vital information about the location of defibrillators. The Circuit is a nationwide, data-led map of defibrillators in the United Kingdom. Currently, over 86,000 have been registered, but it is estimated that tens of thousands are still unaccounted for.

Health and Wellbeing Services: Essex

Jim Shannon Excerpts

Tuesday 12th March 2024 Westminster Hall

[Priti Patel (Witham) (Con)]

I beg to move,

That this House has considered health and wellbeing services in Essex.

I am grateful that you are chairing the debate, Mr Henderson, and pleased to see that my right hon. Friend the Member for Pendle (Andrew Stephenson) is the Minister responding. He has been very good on many issues that I have taken to him thus far. I will cover a wide and diverse range of health-related issues affecting my constituents and people across Essex. I appreciate that some of those issues fall outside of the Minister’s portfolio, but I know he will take them on board and will feed back to colleagues. He is an excellent Minister, and I know he will respond in a helpful way. I am particularly pleased to welcome to the debate colleagues from neighbouring constituencies, my right hon. Friend the Member for Maldon (Sir John Whittingdale) and my hon. Friend the Member for Colchester (Will Quince), because we care about the provision and quality of health and wellbeing services. It is important to our constituents, and it is important that our constituents know we will work together as neighbouring MPs on some of the issues.

As the Minister and colleagues will be aware, just over a year ago, in March 2023, we were in this very Chamber having a similar debate with a similar title—I think we stretched it to the east of England last time round—and this debate follows on from that one. Everyone here will know that Essex is an amazing county. Our residents, businesses and communities are hard-working, resilient, entrepreneurial, ambitious and aspirational. They obviously back all the Conservative values around lower taxes, being a county of entrepreneurs and the engine of economic growth. We are net contributors to the Exchequer. I never tire of saying that because, as net contributors, we in Essex do not always get our pound of flesh back from the Exchequer when it comes to investment in our public services. It is fair to say that our constituents expect that from the Exchequer, particularly the fact that we should be supported when it comes to our public services, including the NHS, but also wider health and wellbeing services that do not always require medical interventions or diagnostics.

Parts of our county—mid-Essex in particular—have experienced considerable population growth and demographic changes, and that covers the constituencies of Colchester and Maldon. For clarification, we share district boundaries, so our council boundaries are intertwined—we are effectively three integrated MPs, I think it is fair to say, on many of the issues that we stand up and speak for. Those living within Essex County Council’s boundary totalled more than 1.5 million at the 2021 census, up by more than 100,000 people on the 2011 census, which is more than 7% and above England’s average of 6.6% at the time. That includes areas such as Southend and Thurrock. When we include those areas, our county population totals just under two million, at 1.9 million. We are one of the fastest-growing counties in the country, and growth in the city of Colchester, which covers parts of my constituency, continues to grow. With that, demand on public services continues to grow. We see from the census that we have over 300,000 people aged 65 or over, which is 21% of our population. That is higher than the average in England of 18.6% and, by 2035, that number will grow by up to 27%, so just under 400,000 people in Essex. The number of those over 85 will rise by 60%, so we can see that the numbers are growing. We are an ageing not just county but country and, that impacts on the working-age population of 18 to 65-year-olds which, by contrast, is set to rise by only 4%.

We can see the counter-cyclical issues resulting from the fact that a greater part of our population will be elderly. Interestingly enough, with that ageing population we are seeing increasing numbers of young families coming to Essex, which will mean more house building. Our schools are rated good and outstanding, and we are commutable territory, so our towns are thriving and growing.

As I said in the debate last year, there are pressures on social care which have had a very significant impact on the integrated care systems that have been introduced, with further integration taking place. In particular, those pressures have had an impact on spending at the county, district and city council level. We have a number of integrated care boards that cover Essex: NHS Hertfordshire and West Essex; NHS Mid and South Essex, which predominantly covers mid-Essex; and NHS Suffolk and North East Essex, covering Colchester and Tendring.

We also have a number of hospitals, the biggest being Broomfield Hospital, Colchester Hospital, the Princess Alexandra Hospital, Basildon University Hospital and Southend University Hospital. Our emergency services are provided by the East of England Ambulance Service NHS Trust, and the South Essex Partnership NHS Foundation Trust provides mental health services. I am shortly going to discuss those areas, and those trusts in particular.

As hon. Members have heard, we have a range of trusts, hospitals and challenges in Essex. When I was first elected we had the old-fashioned primary care trusts and strategic health authorities. Those were deeply unpopular, hugely problematic and bureaucratic and massively resource-intensive, and the changes in structures we have seen now provide greater integration. What really matters to all my constituents and residents across Essex is not so much the configuration and structure of services, but how those services work together effectively to deliver what those people and their families need: primary care, appointments and access to health services.

[Jim Shannon (Strangford) (DUP)]

I commend the right hon. Lady on the debate. It is clearly about health services in Essex, and is therefore not to do with Strangford. However, to add my support to what the right hon. Lady is saying, I note that the problems in Essex she has outlined are replicated across my constituency as well. They include the closure of the local minor injuries unit, which is integral to the local community. That means that constituents have to travel further to get their healthcare—the very thing that the right hon. Lady is referring to. Does she agree that health bodies must focus more on community health and wellbeing to ensure that all constituents have the local access they deserve to efficient health and care services? Again, I commend the right hon. Lady on introducing the debate.

Parents and Carers of Infants: Support

Jim Shannon Excerpts

Tuesday 12th March 2024 Westminster Hall

[Sally-Ann Hart]

I agree with my hon. Friend. The wonderful thing is that we have so many voluntary organisations that do amazing work helping young mothers and parents with breast and infant feeding. Our family hubs focus on that, as does the Start for Life programme. It is not just one organisation; there are lots of services out there that can support parents doing this.

The Bill will achieve its aims by ensuring that local authorities publish a Start for Life offer on their websites and via other means they consider appropriate—for example, by providing physical as well as digital copies of their offer. A Start for Life offer is information on services that a local authority is aware are available in its area for infants, parents or carers of infants, or prospective parents and carers, that are provided by or on behalf of public authorities.

In particular, the Bill focuses on services that support the physical and mental health and development of infants, and that support parents and carers, or prospective parents and carers, in providing support to their infants. The services named in the Bill that local authorities will be under a duty to publish information about are maternity services, health visiting services for current or prospective parents or carers of infants, services promoting positive relationships between infants and their parents or carers, mental health services, and breastfeeding and other infant-feeding services. Local authorities will be able to provide additional information on other services that they consider it appropriate to include information about.

The Bill also includes a regulation-making power so that the Secretary of State may ensure that information on other services provided by or on behalf of a public authority that are likely to support infants, parents or carers of infants, or prospective parents or carers, are included in a Start for Life offer in the future. The Bill introduces a further duty on the Secretary of State to publish guidance to local authorities relating to those duties. It is important that parents receive evidence-based support and are provided with information that is backed by research and proven by parents, such as that of the Start for Life programme.

While I understand that guidance on Start for Life offers already exists, I know there will be a huge amount of learning from the Government’s family hubs and Start for Life programme that could be considered and taken on board as part of new statutory guidance. A duty to consult on the statutory guidance will ensure that local authorities and bodies the Secretary of State consults will have the chance to have their say on what will most help them to fulfil that duty and support families locally.

Finally, the Bill requires the Government to publish an annual report that sets out information about support that is being provided in England for infants, their parents and carers, and prospective parents and carers. The report will also include information that the Secretary of State considers appropriate to include, such as information about the impact of support on outcomes. That is very important as it will create further transparency for prospective parents, and for parents and carers of infants, so that they can understand the support available as they navigate the joys and the challenges of raising a new baby.

I will say a few words on the family hubs and Start for Life programme. Family hubs offer early support to families and young children to help them overcome difficulties and build strong relationships. East Sussex County Council was one of the trailblazers benefiting from the £300 million investment up to 2025. It is leading the way and supporting other local authorities to improve services that are offered to families so that they can be rolled out more widely across the country.

We have three family hubs in Hastings, offering support including maternity and health-visiting services, breast and infant feeding, parenting programmes, budgeting, employability and many other things. I pay tribute to East Sussex County Council’s director of children’s services, Alison Jeffrey, who is soon to retire, for all her dedication, determination and service to all families across East Sussex—especially to ensure that children’s life circumstances are not life sentences.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady. When it comes to the issue of childcare or support available for parents and carers of infants, what she is saying is really important. Just to give a quick point of view from Northern Ireland, there has been an increase of some 14% in the price of childcare—which is part of this topic—in Northern Ireland as of 2021. My party has long pushed for an increase in the tax-free childcare allowance beyond 20%.

The pressure on working-class families cannot continue. More needs to be done to support them financially with childcare, so that they can go out and work and, as a result, make ends meet at the end of the month. The hon. Lady is right to raise this matter. I would press the case of working-class families who are under extreme financial pressure.

[Sally-Ann Hart]

I thank the hon. Gentleman for his comments. The Bill is not specifically to do with childcare; it is also to do with the information given to parents and carers and prospective parents and carers of babies and infants. However, I do take on board his point about childcare. I think the hon. Gentleman will be aware that people who are in receipt of universal credit get free childcare, to some extent. That is worth noting, is it not? I thank him for his intervention.

Strong families are at the heart of communities. It is so important in Hastings and Rye to have high ambitions for and expectations of our families, because supportive families make for more stable communities, better outcomes for children and happier individuals. Investing in families and making sure they get the support they need from birth through to adulthood helps with children’s educational attainment, wellbeing and life chances, while improving wider outcomes such as poor mental health and unemployment. That is why funding allocated to family hubs must continue beyond 2025, and further funding should be allocated to extend the scheme to all local authorities in England beyond the 75 pilot authorities.

My Bill is scheduled to have its Second Reading on 15 March—this coming Friday. I hope it will be successful and that we can work together to ensure that every baby has the best start in life.

Dementia Care in Hospital

Jim Shannon Excerpts

Wednesday 6th March 2024 Commons Chamber

[Theresa Villiers]

Those are very valid points. It is important to keep people out of hospital for as often as possible, but that is particularly the case with dementia patients, given the dislocation and insecurity that comes with moving them to a different environment. Measures to keep people healthier for longer and to deliver care via the primary care system rather than in acute hospitals are an important way to address some of the problems I am outlining.

[Jim Shannon (Strangford) (DUP)]

I commend the right hon. Lady for raising this issue. Over the past couple of years, I have dealt with a number of incidents similar to the one she refers to. Does she agree that, for those with dementia and Alzheimer’s, the emotional upheaval of being taken from a safe place where they feel comfortable can often lead to incredible distress, which can, in turn, result in aggressive behaviour? I know of one young nurse who had her arm broken in two places. It was not the patient’s fault, as he was simply beside himself and could not let go of her. Does the right hon. Lady agree that there must be enough staff in place to ensure that one young nurse should not be left screaming in pain, with no one there to help her? Does she also agree that that patient deserves compassion and understanding for their outburst?

[Theresa Villiers]

The hon. Gentleman makes an important point. One problem that emerges from some of the cases I will talk about tonight is that disruptive behaviour by patients with dementia, including shouting, can often be just an attempt to communicate. It is vital that staff understand that. Of course, I agree that it is essential that we have sufficient numbers of staff to ensure that they can give appropriate attention to patients with dementia in these circumstances.

The father of Carer 2 died a month after being admitted to Barnet Hospital. This constituent reported that food and drink was often just left in a tray, with little apparent effort made by staff to feed her father. He was left all day in a chair or in bed, with no attempt made by the staff to encourage him to walk. He was not supported while in the toilet, and when that led to distressing and undignified consequences, including the soiling of his clothes and hands, he was not washed until the following day.

Carer 3 told me that her husband’s condition deteriorated significantly during a stay in Barnet Hospital. Apparently, the nurses complained and said that he screamed all night. My constituent explained to them that that meant he wanted to get up to go to the loo but was prevented from doing so by the side bars on the bed. He was simply calling out for help. She often found food left untouched, yet no one seemed to note that her father had stopped eating. The catering staff just took the uneaten meals away. His medication was also stopped without his family being told, which led to a worsening of his symptoms and his anxiety.

Carer 4 told me about her partner, who has early onset Lewy body dementia and was admitted to Barnet Hospital in April 2022 after a fall. Apparently, until that point he was walking, climbing stairs and coping fairly well at home, albeit that he was a little wobbly on his feet. But the last time he ever walked was when he arrived at the Barnet accident and emergency department.

My constituent was initially restricted in visiting hours and had to fight to be allowed to stay in the hospital outside those times. She felt that the staff, especially some of the agency workers, did not understand her partner’s care needs. She was given the number for the specialist dementia nurse covering the hospital trust, but the phone was never picked up, no matter how often she rang. During his stay in the hospital, her partner deteriorated far more quickly than he had before. He was kept in bed constantly and lost the ability to walk—he is only 55. At one point, after undergoing an MRI scan, he was left distressed and confused in a cold hospital corridor, wearing a hospital gown damp with urine after radiographers had removed incontinence Conveen equipment. After he got out of Barnet Hospital, he said he would never, ever go back, no matter the circumstances.

Carer 5 told me about her father, who was admitted to Barnet Hospital with pneumonia in November 2021. When an ambulance was sent to pick him up, he was able to walk downstairs without assistance and climb into the back. Throughout his stay, it was extremely difficult for my constituent to get to speak to any doctor or nurse about his care.

--- Later in debate ---

[The Minister for Social Care (Helen Whately)]

I sincerely thank my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) for securing this Adjournment debate, and for her powerful speech. She really brought the subject to life through the examples from her constituency of people’s experiences in hospital. They were very difficult stories to hear, and I am very sorry to hear of times when it sounds like the care for people’s loved ones has fallen short.

My right hon. Friend made some powerful points that I want to address, starting with the fact that, as she said, there are many thousands of people living with dementia, and the number is only expected to increase; indeed, there will be more than a million by 2025. Many people with dementia will also be living with other health conditions. At the moment, it is estimated that around a quarter of the beds in hospitals are being used by patients with dementia, so ensuring that people receive the right care when they are in hospital with dementia is really important, as is doing our utmost to avoid unnecessary admissions and ensuring that people are discharged from hospital on a timely basis.

It is really worth emphasising the point that my right hon. Friend made about dignity, and the fact that every single person counts, at whatever stage of their life. There are challenges to ensure that people living with dementia have that dignity, particularly when they are in hospital. I, too, pay tribute to the many unpaid carers who are looking after their loved ones with dementia. I know what a huge burden and challenge that can be. However much someone loves somebody, there is a huge demand on them when they are caring for somebody with dementia. It can be very difficult, very distressing and absolutely relentless, however much they love them. I pay tribute to all carers who are doing that.

My right hon. Friend spoke first about Lisa Rutter, who very sadly lost her mother, who was living with dementia, during the pandemic—in hospital, if I heard my right hon. Friend correctly. I thank Lisa Rutter for the work that she is doing as the founder of Dementia Club UK. It is fabulous to be supporting other people to look after loved ones with dementia, or indeed those with dementia themselves. My right hon. Friend talked about the time Lisa’s mother spent in hospital, and how, for instance, Lisa knew what her mother needed but felt that she was not listened to, and that it may have contributed to her mother’s death. My right hon. Friend also talked about the visiting restrictions during the pandemic. I will talk about those in a moment.

My right hon. Friend talked about another constituent, whose wife was in hospital. She rightly talked about the importance of mobilising somebody with dementia, and how her constituent’s wife was nearly given the wrong medication, which could have been fatal. She spoke about the importance of his intervention. She also spoke about a constituent who was a carer for their father, and the importance of mobilisation, and some of the communication challenges for somebody with dementia.

My right hon. Friend talked about one person who had been screaming all night, as described by the staff. Actually, the family member who knew them understood that they were calling for help, as they needed to go to the toilet. That brings to life how difficult it can be when somebody has dementia and is not necessarily able to articulate their needs and what they want. Those who know them well will often know what they are trying to say or communicate, but that can be difficult in hospital when they may be being looked after by staff who simply do not know them well enough to know what they mean.

My right hon. Friend talked about food being left uneaten. If somebody is not eating in hospital, clearly they are likely to lose weight and their condition may deteriorate. She also talked about medication being stopped, and she talked particularly about somebody whose partner had early onset dementia, and had been coping fairly well at home. He walked into A&E, and that was very sadly the last time he walked. That emphasises the challenge of keeping people moving and maintaining their ability to be mobile during a hospital stay. She also described the fight to visit outside visiting hours.

I very much hear my right hon. Friend’s asks on visitor access, volunteers being trained in dementia care, as well as staff training, and avoiding discharge delays, among other things. I will pick up on some of those.

First, on the challenge of caring for people with dementia when in hospital, many hospitals have worked hard to do better for patients with dementia, for example creating dementia-friendly environments by changing the colour and lay-out, ensuring that staff are trained in dementia, and having dementia leads and dementia-lead nurses, as well as having training for volunteers. Standard training in caring for people with dementia is available through NHS England for staff and volunteers.

Clearly, my right hon. Friend the Member for Chipping Barnet described examples where care fell short. I have no doubt that across the NHS, with the work already taking place, we can go further. I will raise the points that she made about secondary care with my colleague, the Minister for Health and Secondary Care, so that we can work together on ensuring that care is right in hospitals. He also has oversight of workforce, and we should focus on whether the training that I know is available is being taken up by enough staff, considering the number of people in hospital with dementia.

On visiting, my right hon. Friend spoke about a subject that is close to my heart. Having been involved in some of the decisions about social care visiting restrictions during the pandemic and knowing how hard those decisions were—weighing up the infection control concerns and ensuring people could spend time with loved ones—we have been putting in place changes to Care Quality Commission regulation to make visiting a fundamental right, a fundamental part of care and a fundamental standard of care to ensure better access for loved ones to their family members in care homes and in hospitals. I know in particular how important that is for people with dementia, among others. The CQC is consulting on the implementation of the regulatory change, which will be live shortly. I believe we have taken a significant step to address concerns expressed about visiting.

Another thing my right hon. Friend spoke about was faster discharge. I am very alert to the risk of patients deconditioning in hospital, particularly patients with dementia. That is why over the past year or so, we have worked hard with the NHS to get better at identifying patients at greater risk of deconditioning, in particular those with dementia, on their admission to hospital. We have done earlier discharge planning and have been getting care transfer hubs established all across the country, which will do the work on more complex discharges. Often someone with dementia may need more access to social care. We may need to increase the access to, availability and supply of social care, so that it is there for those who will need it when they leave hospital. We have made some real progress on that over the past year.

[Jim Shannon]

Will the Minister give way?

[Helen Whately]

I have very little time, so I am afraid I will not give way.

My right hon. Friend the Member for Chipping Barnet talked about the social care workforce, another subject close to my heart. We have a strategy for the care workforce. We are building care as a career, in particular to boost recruitment and retention among our home-grown workforce. We recently published the first ever national career structure for care workers, and we are launching a new national qualification to boost the supply of care workers.

Avoiding admission is another priority for me. Clearly, some people should be—absolutely must be—in hospital for the treatment they need, but we know that patients with dementia in particular can deteriorate in hospitals, so we are doing more work with the national health service and social care to avoid admission when it is not truly necessary by putting in place alternatives or, at the other end, supporting earlier discharge through the roll-out of the Hospital at Home initiative, or virtual wards, under which we committed to at least 10,000 hospital-at-home beds or equivalent as part of emergency care recovery plans. The NHS has over-delivered on that, so we now have more than 11,000 Hospital at Home beds, which help people who would otherwise be in hospital receiving acute care. They receive that care and are able to recuperate at home, avoiding the risk of a longer hospital stay and deconditioning.

My right hon. Friend talked about dementia research and the new treatments coming onstream. The Government have committed to doubling our investment in dementia research during this Parliament, and we are on track to do that with our dementia mission. We are also working very closely with NHS England to be ready for the breakthrough treatments lecanemab and donanemab coming onstream. I should be clear that we know very well—I have received clinical advice on this—that those treatments have quite significant side effects, so they will not be suitable for everybody and I put a note of caution there. We are waiting to hear whether they are approved by the Medicines and Healthcare products Regulatory Agency and the National Institute for Health and Care Excellence. In the event of approval, NHS England is taking steps to be ready to put in place the levels of diagnosis required to be able to support those treatments.

That goes hand in hand with the work that we are doing with NHS England to improve the diagnosis rate for dementia. We have a target dementia diagnosis rate of 66.7%. That dropped during the pandemic because dementia services and assessment had to be closed, but it has been gradually building up, and I expect NHS England to get back up to that level during the course of this year. That is really important, because having a diagnosis helps people—the individual with dementia and their carers, for example—to access the support and back-up that they should be receiving.

I am conscious of the clock ticking, so I have tried cover some of the territory that my right hon. Friend set out in her speech, which I thought was very powerful in raising these significant issues for those with dementia receiving care in hospital, their carers and loved ones. I completely agree about the importance of dignified treatment and treating those with dementia with dignity at all times. I know that that can be particularly challenging in hospital, but we have to ensure that that is the case.

We will ensure that we get all the necessary care in place outside hospital, which avoids unnecessary admissions; support people to be discharged from hospital quicker; get ready for the arrival of new dementia treatments; and raise awareness about the significant proportion of dementia cases that can be prevented or at least delayed by looking after our health. In fact, the risk factors for dementia are similar to those for heart disease and other things, and there is relatively low awareness of that. We will see more people with dementia in the years ahead, but we can do more to raise awareness of how people can maintain their health and stave it off.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 5th March 2024 Commons Chamber

[Helen Whately]

Across the country, ambulance response times have come down by a third. We have worked very hard, particularly with areas that face greater challenges, including Shropshire. I have spoken to leaders in the local health system about the ongoing challenges. We are learning lessons about what has worked over the past year, and from where we have not made so much progress, to ensure that we do better in areas such as the hon. Lady’s over the year ahead.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her positive answers; they are really appreciated. Bearing in mind the pressure that GPs are under, which is leading to more pressure on emergency provision, what steps are being taken to provide greater incentives for medical students to take on positions in GP surgeries? That would make a big difference.

[Helen Whately]

The hon. Gentleman is absolutely right to talk about the whole health system. One thing we are doing as part of our work on urgent and emergency care is preventing people from being admitted to hospital unnecessarily, or from being brought to A&E in the first place. Primary care is part of that. In our investment in expanding medical school places, we are particularly encouraging medical schools, such as the new Kent and Canterbury Medical School near me, to train students to work more outside hospitals, including in primary care.

Tackling Obesity

Jim Shannon Excerpts

Tuesday 27th February 2024 Westminster Hall

[Sir David Evennett (Bexleyheath and Crayford) (Con)]

I beg to move,

That this House has considered the matter of tackling obesity.

It is a pleasure to serve under your chairmanship this afternoon, Mr Dowd. I am incredibly grateful to be able to raise the important subject of tackling obesity, which I believe is vital to our country’s future. I am grateful to see colleagues here from both sides of the House, as tackling obesity requires a cross-party approach. I particularly welcome my right hon. Friend the Minister, who is also a personal friend. I have worked closely with her in the past, and I know how interested in and concerned about this issue she is.

Obesity is a major public health problem and a global concern. According to the World Health Organisation, worldwide obesity has nearly tripled since 1975. Most of the world’s population live in countries where issues associated with being overweight or obese kill more people than issues associated with being underweight, and 39 million children under the age of five were overweight or obese in 2020. These are quite shocking statistics. However, the problem is of particular concern in the United Kingdom, where we have the third highest obesity rates in Europe, behind only Malta and Turkey, and where we have the third highest in the G7, behind only Canada and the US. Almost one in three adults here is now classified as obese, a dramatic increase from the one in 10 adults in 1970. The increase in this country has been much greater than in other western European countries, such as France, Germany and Italy.

The health survey for England monitors trends in our national health and care. It found that a higher proportion of men than women were either overweight or obese—69%, compared with 59%. The highest rates of obesity were found among the lowest socioeconomic groups. Almost 70% of people in the most deprived quintile of English localities are classed as living with obesity or being overweight, compared with 59% of those in the richest.

[Jim Shannon (Strangford) (DUP)]

I commend the right hon. Gentleman on securing this debate and apologise to him in advance: but for an AGM that I am attending at five o’clock, I would have participated in the whole debate.

According to the Department of Health back home, 65% of adults in Northern Ireland are obese, which is quite a shocking figure. There are now plans for a consultation, which highlights the need to make healthier food more affordable. Does the right hon. Gentleman agree that this must be a priority for every region of this great United Kingdom of Great Britain and Northern Ireland, and that that must be done in partnership with our own agrifood sector? It has a role to play—maybe a financial role, as much as a role in guidance. When it comes to the Minister’s reply, does the right hon. Gentleman agree that partnership with the Department for Environment Food and Rural Affairs might be advantageous?

Heart and Circulatory Diseases: Premature Deaths

Jim Shannon Excerpts

Thursday 22nd February 2024 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Member for Watford (Dean Russell) for setting the scene today. We have spoken many times on this issue. It is a real pleasure to see him back to health and strength, and working very effectively in this House.

The rates of premature death from heart and circulatory diseases do not make for easy reading. The British Heart Foundation has been clear about how stark the situation is. As the DUP’s health spokesperson, I try to involve myself in all health matters—whether they be in ministerial questions or in debates—in this Chamber or in Westminster Hall, because that is part of my duty.

The number of people dying before the age of 75 from heart and circulatory diseases has risen to the highest level in more than a decade. Waiting lists for heart operations and other heart procedures are nearly 100,000 higher than they were a year ago. Those figures are stark and worrying.

I am very pleased to see the Minister in her place. We all have great respect for her. Although we do not want to burden her with questions, we do need to ask ourselves why these figures are so high and what is being done to reduce them. Worryingly, there are more people over the age of 75 waiting over a year for treatment—the rate is 140 times higher than before the pandemic began.

Latest figures show that, in 2022, more than 39,000 people in England died prematurely of cardiovascular conditions, including heart attacks, coronary heart disease and stroke—an average of some 750 people each week. Again, worryingly, that is the highest total since 2008. What is being done to address those issues?

This backwards trend—because that is what it is—has been broadly mirrored in age-standardised premature death rates, which account for changes and differences in population sizes and demographics. Before 2012, the number and rate of deaths from these conditions under the age of 75 were falling, in part thanks to decades of medical and scientific breakthroughs.

But after nearly a decade of slowing progress, recent statistics show that the rate of premature deaths from cardiovascular disease has now increased in England for three years back to back. This is the first time that there has been a clear reversal in the trend for almost 60 years. Again, the question must be: what has brought that about and what has been done to stop it.

The British Heart Foundation has said:

“The reasons for the rise are multiple and complex. While increasing pressure on the NHS and the covid-19 pandemic have likely contributed in recent years, the warning signs have been present for over a decade.”

If those signs have been present for over a decade, the question we must all ask is: what steps have been taken to slow the trend that has been there for some time.

I know that there will be many in this Chamber with opinions as to the cause. I do not hold a medical degree. I am a very simple person, but I do have an interest in health and I do ask the questions. The fact is that the sharp rise needs to be better managed. I can quickly give some examples of what we are doing back home in Northern Ireland. We have a developing plan with the Irish Football Association that includes more defibrillators and CPR training, which is really important. Many people who are fit and healthy—the hon. Member for Watford referred to this—have had heart attacks on the football pitch. Those are things that we need to address. May I commend the Chest, Heart and Stroke charity back home for all that it does?

This month in Northern Ireland, 340 people will die from heart or circulatory disease, around 90 of whom will be younger than 75 years of age. Some 225,000 people are living with a heart or circulatory disease, 320 hospital admissions will be due to a heart attack, 130 people will die from coronary heart disease, and 13 babies will be diagnosed with a heart defect this year. Those are the figures for Northern Ireland. The statistics are shocking, especially given the small size of Northern Ireland. There are an estimated 225,000 people living with heart and circulatory diseases in Northern Ireland. An ageing and growing population and improved survival rates from heart and circulatory events could see these numbers rise still further. It is clear that this really is a ticking timebomb and therefore we do seek some help from the Minister here.

I can see the Minister formulating her response. Both she and I are glad to see that the Northern Ireland Assembly is up and running. As health is a devolved matter, may I ask her in a genuine fashion, as I always do, whether she can indicate what discussions will take place with the Department of Health in Northern Ireland.

We in Northern Ireland are in the situation in which every region of the UK finds itself: there is not enough funding, not enough staff, and not enough support. Across the United Kingdom of Great Britain and Northern Ireland, we need to address the growing problem with solutions, which can only come about with reasonably paid staff and a better system. Let us exchange our thoughts and ideas, and move forward together towards a system where we can help each other. An overhaul of the system is needed, and we look to the Minister for a plan of action, beginning here in this place and extending through the NHS and across the United Kingdom of Great Britain and Northern Ireland.

You told me to finish within a certain time, Madam Deputy Speaker; I have just done it.