Covid-19: Effect on People with Learning Disabilities

Jim Shannon Excerpts

Tuesday 15th December 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Ms Ghani, it is obviously a pleasure to serve under your chairmanship—sorry, I think “chairship” is the right word in this PC age we live in. It is always a pleasure to follow many other hon. Members. Some of the speeches so far have been incredible, and we thank the Members for them. It is a pleasure to follow the hon. Member for Sheffield, Hallam (Olivia Blake). We seem to spar with each other here. In our first debate, we were of the same mind. In the second debate, we had different opinions. And now we are back together again to support the same thing on this issue. The hon. Member for City of Chester (Christian Matheson) always brings to the Chamber, with compassion and understanding, points that certainly I and, I think, many Members can subscribe to and are very pleased to be part of.

During lockdown, I experienced teachers and parents alike expressing grave concern for the children who need this specialised additional help, who thrive in specially designed schemes and education, and whose parents could see the adverse effect of their not being able to follow their routines and get the external help and support that they needed. Particularly for disabled children and children with educational challenges, it is so important to have a routine in place. From my constituency, I can easily call to mind two cases of children with special needs who required emergency day placement at their school during the initial lockdown period in order to give them some of their routine back. I want to express my thanks to Longstone and Tor Bank, which filled the breach; those are two of the special schools back home in Northern Ireland.

Children with special needs saw an impact on their entire routines, starting from the change in their at-home morning routine of getting up and getting ready for school. Then they were not collected as usual by their school bus. They did not have the presence of their teacher, assistant and peers in their daily lives. And they were restricted in their daily movements by not being able to go out and about. One child was unable to be taken as usual to the local playground to get the sensory stimulation that he needed, as it was locked for an extended period.

This was not the fault of any Department or person, but the fact is that the ramifications of the lockdown and subsequent extension of holidays and so on are still being felt even now by some of the most vulnerable in our society. As schools have closed and additional support has been halted, respite and rehabilitation services have been withdrawn. These are all the complications that we see.

In particular, parents of children with autism were on their own each day in their homes with no specialist assistance, and they reported that dealing with their child’s needs impacted on the family. Some reported that they felt at breaking point because of having little or no support while their children’s special needs schools were closed. I deal with parents of autistic children nearly every week in my office—my staff do as well—and I know the particular issues for those with autism. Support workers were unable to enter the family home, and tutors who provided one-to-one tuition to statemented children were unable to visit them, so their education was interrupted. If an autistic child’s routine is changed, that makes life extremely difficult for the child and for the family as well.

The pandemic has seen an attainment gap result from the isolation of the children from their teachers and peers. Continued schooling for children with a statement of special needs, which typically represents those with severe needs, was provided in some cases, but that was not universal by any means and did not cover all the additional support. I understand that the Minister does not have responsibility for Northern Ireland, but I want to tell the story, because I think it is replicated across the whole of the United Kingdom of Great Britain and Northern Ireland. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), whose speech will follow mine, will probably confirm that. The gap in schooling can also be expected to make the full return to school and subsequent social interaction more challenging, especially for children with anxiety problems.

The economic impacts of the pandemic have been felt directly by those who had special educational needs in childhood. We see that in the use of food banks. Between March and September of this year, we had 180 families who were experiencing financial, social and emotional pressures, but the food bank in Thriving Life Church in Newtownards was able to help.

Since the onset of the pandemic, more than 70% of the youth who study or combine study with work have been adversely affected by the closing of schools, universities and training centres. Programmes such as STRIDE—support and training to realise individual development and employment—aimed at training and integrating vulnerable youth into the workplace, were halted because they are based in specific cafés and factories and those were closed during the pandemic. Right away, those people, who needed the daily routine of work, were not getting it, so things were quite difficult. Those programmes impart important social and educational skills and, where the young people make progress through routine and socialisation with members of the public and peers, their progress was impacted by the closure of the services.

I will conclude with this point. The most vulnerable have felt this pandemic more than anyone else. Now is the time to rebuild and restore their wee lives and the support for the families who have been left so alone. We in this place can make a difference with innovative programming and considered funding, and now is the time to take steps to make that difference.

Covid-19

Jim Shannon Excerpts

Monday 14th December 2020 Commons Chamber

[Layla Moran (Oxford West and Abingdon) (LD)]

I would like to start by remembering all those in my constituency, in Oxfordshire and across the country who have tragically lost their lives. The number of people dying at present is thankfully fewer than it was before—it is in the handfuls—but for every single one, there is a family who has lost someone just before Christmas. It is right to start by remembering them.

I am sure I speak for many when I say that I cannot wait to see the back of 2020. It has been the most ridiculous year in so many ways, but it has also given us glimpses of hope and positivity. In Oxford West and Abingdon, there are so many people to thank, because they deserve it and they are working so incredibly hard, but I will just name a few. I think of the Abingdon Bridge, a group that works with deprived young people who often have nowhere else to turn. Other Members have spoken about mental health, which affects all parts of society, but I am particularly worried about our young people right now—their loss of chances for the future and their feeling of despair, with many feeling that they have nowhere to turn. It is an incredibly difficult time.

It is a difficult time, too, for families. Furlough has, of course, been welcome, but far too many businesses are on their last legs. They tell me that if Oxfordshire goes up from tier 2 to tier 3 or, even worse, if there is a spike and we go into a national lockdown in January, they will have to close. The very last of their resilience is nearing its end, and those families are finding themselves relying on food banks such as the Cutteslowe Larder, the Botley Fridge and the Oxford Food Bank more than they ever have before. We must thank those volunteers, but we must also make the case for a sustainable way through this crisis. That is what those businesses crave—the stability. They tell me that they would prefer to stay in tier 2 longer than to open up too quickly and risk a spike, which is what we are seeing in some parts of the country now, sadly.

I am proud that many of the scientists who work as part of the Oxford Vaccine Group with Sarah Gilbert and her cohort live in my constituency. They are nothing short of heroes. When the vaccine is approved, as I am sure it will be, they will save lives, and not just in this country. Because this vaccine does not need to be stored in extraordinarily sub-zero temperatures, it will save millions, if not billions, of lives across the globe. Those scientists all deserve extraordinary thanks.

There are others who deserve our thanks. Oxford United have given facemasks not just to their fans, but to the wider community. I have never been more grateful to our local papers, including the Oxford Mail, and to our local BBC networks for covering these extraordinary moments of heroism locally. It has made me and, I am sure, others really appreciate the value of our local broadcasters.

I would be remiss not to mention organisations such as the Children’s Air Ambulance, which has helped some of those most vulnerable families during this time. Of course, I also thank our local NHS teams, GPs, those who work in our care homes and our teachers, who have stuck on the frontline through thick and thin, and are desperate to be included in the first roll-out of the vaccine. That is my ask of the Minister: please encourage the Government to include teachers in that first wave of the roll-out; they desperately need it because they have been there throughout, looking after the children so that others could go to work.

Let me turn to the sustainable way out. It is not fair to say anything other than that the vaccine is the light at the end of the tunnel. It is what we all want to get to, it is how we are going to eliminate this virus. It is the way out, but as miraculous as the vaccine is, we are a long way away from that point. When the Government started hyping up the vaccine, I was disheartened to see in my own area—other Members may have seen this too—that people were thinking, “Oh, it’s around the corner. People are going to get it in December and January, not appreciating that the scale of the task means that in reality we are not going to get there until Easter at the very earliest, and probably much later than that.

Let me tell the House a story from the Oxfordshire trusts today. GP surgeries in north Oxford were lined up to vaccinate the over-80s. They had called people and said, “Come—here’s your appointment.” But at the 11th hour, NHS England contacted them to say, “You haven’t quite got the right information in the right place. Computer says no. Stand everyone down.” The disappointment among my constituents was palpable. There was frustration in the clinical commissioning group and the GP surgeries, which had worked through the weekend and overnight to ensure that the vaccine was available. I say this not to apportion any blame, but to point out that these kinds of mistake will happen. There will be hiccups on this road. We cannot assume that this will be over quickly.

[Jim Shannon (Strangford) (DUP)]

Does the hon. Lady agree that over Christmas there is an onus on us all, in and outside the House, to follow the rules of hands, face and space, not to invite extra numbers to our Christmas dinner, and to wear a mask and keep our distance when we go shopping? If we do all those things, then with the vaccine we can beat the virus.

--- Later in debate ---

[Tim Farron (Westmorland and Lonsdale) (LD)]

Point taken, Madam Deputy Speaker. Thank you very much for calling me.

This has been the most peculiar of years. When we look at the media coverage of where we are with the virus, the vaccine, all the political issues that go alongside that, and the challenges over how the Government are handling things—well, badly or indifferently—many of us overlook what an appalling tragedy this has been and continues to be. Sixty-four thousand people in this country have lost their lives. Around 600 people or more in my county have lost their lives, and I knew dozens of them. One thinks about those people for whom Christmas will be not just lonely, difficult and challenging because of the restrictions we are all under, but a time of deep distress because they have lost someone close to them in the last nine months. When we see debates about the necessity of lockdown or restrictions of one kind or another, we need to remember what it is we are seeking to do: it is to save lives, and it will continue to be to save lives.

The tragedy that has hit my community, as it has every other community, feels almost too much to bear. We are a community where the average age is 10 years above the national average age in the United Kingdom. We are an area that, after London, is the next most visited place in the United Kingdom—the Lake district. Arguments are made about whether that meant that we had a higher than average incidence of the virus early on. We do not know that; what we do know is the way in which communities have responded to the virus.

In community after community, whether in our large town of Kendal, in Windermere, Grasmere, Ambleside and Sedbergh or in smaller places like Dent, Coniston, my own village of Milnthorpe, Arnside and Grange—everywhere I could mention in my patch, which is bigger than Greater London, and by the way I could mention another hundred—people have stepped up to take responsibility and have been desperate to meet the needs of their neighbours, though their own needs may be very significant. I pay tribute to every single one of them. I am proud to represent the south lakes and to represent those communities. Diverse though they are, they are also utterly determined to support one another.

There are so many within those communities who deserve our thanks and support, such as those working in care homes. I talked to one lady who worked in a care home, and not even a particularly large one, in my community. Back in April, on one night she saw nine residents lose their lives—in a single night. That was a tragedy for every single one of those people and every single one of those families. What does that mean? What does it feel like to be somebody who works in a place like that, administering love, care and concern for people as they go through their last moments? What is the cumulative impact on the mental health and wellbeing of people working in those communities?

We say thank you very often, and it is right that we do so in this place, but I want people who work in care homes, personal carers and those who work in the health service to know that we are not saying it glibly—we really, really mean it. We are utterly in their debt for the way they have cared for people at their moment of greatest need.

I think also of another group of people in a community like mine, where unemployment has gone up nearly sevenfold over the period of the pandemic: people who work for the Department for Work and Pensions in the jobcentre. They are people who serve people—people who perhaps were living in a state of relative comfort back in February or March, and then discovered that everything had collapsed around them. They are there for people at a moment of desperate need. They are not the only people, but I just want to draw them to the front of our attention. I thank those people on the frontline who have been supporting others who found themselves in need of benefits when they never thought in advance that they would.

I could say so many things about those who have stepped up to the mark at this time, but I also wish to pay tribute to those who have ensured that we have got to a stage where a vaccine is imminent—it turns out that we do need experts, after all. I am utterly indebted to those people, be they in this country or elsewhere, who have used their expertise and brilliance to do in 10 months what we would normally expect to take 10 years. Here is the thing that concerns me: we are close, potentially, to seeing light at the end of the tunnel and we can almost sense people beginning not to dip for the tape but to just let their guard drop. On behalf of everyone in this Chamber and beyond, I just want to say that this is the moment for utmost vigilance.

My dad was sharing that very thought with me the other day and he made the analogy with those tragic people who fell in the hours before the guns stopped on 11 November 1918. What a particular tragedy it was to be those who died at the end when the end was in sight. That is what we have ahead of us now, which is why if we need to tighten up restrictions over Christmas, miserable though that may be, we must think, “For pity’s sake, don’t we want our loved ones to see summer? Aren’t we prepared to make some restrictions now?” We know we are not going to have to live with this for years and years. We know that the light at the end of the tunnel is now visible. That is a glorious thing we can cling on to, but it is not an excuse to let our guard down—in fact, it is the opposite of that.

I want to encourage Ministers to think carefully about how the vaccine is administered. Of course, it should go first to those who are the most vulnerable, and those working in care homes and in the national health service. I have talked about the scale of my constituency, so it is great that we are likely to have a centre in Kendal and in Windermere, and we are looking at centres being rolled out through the primary care network, through GP surgeries and the like. I encourage the NHS within Lancashire and south Cumbria to ensure that there are centres in places such as Grange-over-Sands and Sedbergh, and other more rural, remote parts of Cumbria, so that this is not hard to access, particularly for people who are older and more vulnerable.

A community such as mine, which relies so heavily on tourism, with half the workforce working in tourism, has been deeply hit by the coronavirus. We operate on a feast and famine basis in hospitality and tourism, with the winter famine and the summer feast, and then back to the winter famine. The problem for us is that we have had three winters in a row. The Government’s investment in hospitality and tourism early on was of real benefit. Those £10,000 grants ensured that many businesses that would have failed were able to take advantage of the unlocking through the summer, so July and August were not a bad couple of months for hospitality and tourism in the lakes and the dales. I suggest to the Government that their failure at this point to repeat that grant support on that scale risks throwing away all the advantages they got from supporting hospitality and tourism in the early part of the year. What is the point of investing billions into it only to let those companies die in the next couple of months, so that when we are able to get back to some kind of normality, rather than having a hospitality and tourism industry ready to fight back and bounce back, we may have a bunch of dead businesses? So I encourage the Government now to repeat those £10,000 loans, to support hospitality and tourism.

I also encourage the Government to recognise the challenges faced in areas such as mine, which have been in tier 1 and are now tier 2, and are adjacent to tier 3 areas. The Lake District and Yorkshire Dales are in tier 2, but our neighbouring huge communities, the big population centres, are tier 3 So we are not compensated in the same way as businesses in tier 3 are, but we are massively affected by the fact that people in tier 3 cannot travel to take advantage of the wonderful facilities available in south Cumbria. I encourage the Government to consider making sure that support is provided.

[Jim Shannon]

With the advent of the vaccine for covid-19 almost here, does the hon. Gentleman feel that an extra push at this time for the goal of being covid-free should be what we all focus on? If we do that—collectively, singly and all together—we can make it happen, and that should be the positive message we are trying to send out from the Chamber tonight.

[Tim Farron]

I am grateful to the hon. Gentleman for his intervention. The fact that we know that the vaccines are now on their way surely changes how we look at all this. It means we now know we are not throwing billions and billions into a pot where we will never see the bottom. We know some kind of end is in sight, so what a terrible waste of tens of billions of the public’s money it would be, were we to be penny pinching in the last part of this pandemic. That is why we should back hospitality and tourism, which is the fourth biggest employer in the country and the biggest employer in Cumbria. It is essential to our economy as a whole and is worth £3.5 billion to the Cumbrian economy every year. This is the point; to invest in hospitality and tourism to see us through to the end.

In my community, there is a preponderance of businesses afflicted by having been excluded from support. Something like 4,000 people in my constituency alone were given no support. We are often talking about people who became self-employed in the past 18 months or so—the directors of small limited companies, hairdressers, personal trainers, taxi drivers and the like—but got nothing throughout this period. People on maternity leave have had their support cut at one end or the other. Often, these are the people—the entrepreneurs—who we will desperately rely on to build back our economy once we are through the coronavirus. Not only is it lacking in compassion for the Government to not back those people who have been excluded, but extremely stupid when they are the engine of our recovery, or at least they would be, if only the Government would help them.

A source of employment and a very important sector within my constituency and constituencies like mine is the outdoor education sector. It has been overlooked in many ways, although I am pleased to be part of the all-party group that the hon. Member for Aberconwy (Robin Millar) chairs, which is looking at how we can support outdoor education.

It is worth bearing in mind that about 15,000 people work in outdoor education around the country, and 6,000 of them have lost their jobs already, largely because residential stays have effectively been banned by the Department for Education under advice from the Department of Health and Social Care. I understand that, although I would argue that residential stays at outdoor education centres are at least as safe as children going to school in the first place.

It is important that we save our outdoor education centres, which are hugely at risk at this point, not only because it is right to save them, but because this is the moment to deploy them. I and others in this Chamber have talked about the impact this period has had on the mental health of young people and their disengagement with education. Those children have lost three months at school, but some of them went back two years as a consequence of all this. In our outdoor education centres, we have the skill and talent to engage young people in learning, to foster a love of learning, to improve their mental health and wellbeing and to engage them with the education process again. Will the Government bring forward a specialist package, as they have in Scotland, to make sure that we lose no more outdoor education centre jobs and protect all our outdoor education centres?

Finally, I will say a couple of words about health in general, but in particular mental health. In my constituency, we saw the closure of our adult mental health ward, the Kentmere ward, at Westmorland General Hospital for covid reasons. We understand why that is the case, and we are pleased that the foundation trust is now putting £5 million into redeveloping that service and opening again within the next year. I encourage Ministers to put pressure on the Lancashire and South Cumbria NHS Foundation Trust to make sure that happens as soon as possible, and also to ensure that it remains a site to support people of all ages and all genders with mental health problems. It is incredibly important that we do not end up at the end of all this with a more exclusive and less accessible mental health service available in South Lakeland.

Finally, cancer. We have learned during this period that there is a backlog in cancer treatment of around 100,000 people. Cancer Research UK estimates that 35,000 additional deaths may happen as a consequence of covid through people dying as a result of cancer. We believe that for every four weeks’ delay in diagnosis and, indeed, in treatment starting, we see a 10% drop in the likelihood of surviving that cancer. I want to encourage the Government to look carefully, if belatedly, at the comprehensive spending review submission that the all-party parliamentary groups on cancer, including the radiotherapy group that I chair, put to the Treasury, but which the Government did not match or fund. That proposal would allow us to massively expand radiotherapy, which would be a way not just of treating people who would normally expect to get radiotherapy but of ensuring that we substitute for those other treatments that are not possible due to covid-19. It would be an absolute tragedy if we ended up losing tens of thousands of people to cancer through this period because the Government did not catch up with cancer when they had the chance to invest and to do so.

Covid-19 Update

Jim Shannon Excerpts

Monday 14th December 2020 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his update to us on what is happening with covid. As a type 2 diabetic, I will take my vaccine when the time comes for me to take it. We will make sure that others get it before I do, but will the Secretary of State outline the response from the medical community about the reactions to the vaccination and the safety of the drugs for those who feel, in some cases, that it has been rushed through?

[Matt Hancock]

On the contrary, all the safety checks that are necessary have been carried out and we continue to monitor the roll-out of the vaccine throughout the UK. The Medicines and Healthcare Products Regulatory Agency has done a terrific job on that and continues to do so. For instance, my team and the MHRA were having an update assessment on Saturday morning to check the progress of the first week’s roll-out, and I am delighted to say that we are able to keep doing that. I say to the hon. Gentleman and everybody else who wants to see the impact of the vaccine: look at the faces of those who have had their first dose, and how pleased they are to have it and to be able to get that step closer to protection from this awful disease.

Covid-19: Vaccination

Jim Shannon Excerpts

Monday 14th December 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to speak on any issue in Westminster Hall, Sir David, but my mailbag has been full of points of view about this issue. I agree with some of those points of view, and have questions about others.

The hon. Member for Carshalton and Wallington (Elliot Colburn) set the scene exceptionally well. The purpose of the debate is to say that those who are convinced to have the vaccine should do that—I am one of them—and that those who have questions should have those questions answered. That is thrust of where the hon. Gentleman was coming from, and it is exactly what I would wish to see being done. I thank him for setting the scene and bringing forward the debate.

As some hon. Members will know, I lost my mother-in-law to covid about seven weeks ago. The effect of the covid-19 outbreak was particularly relevant to my family. At the time my mother-in-law had covid-19, she had underlying issues, so, unfortunately, when covid-19 struck, her time in this world was always going to be difficult. The doctors thought they might be able to do the plasma test with her, but they quickly realised they could not do that, because her kidneys would be unable to take it. Therefore, it was basically palliative care.

It was terribly sad, because she was on a ward on her own in the Ulster Hospital and none of us could go and see her. We all wanted to, but we could not. Her daughter —my wife’s sister—was in the ward across from her in the intensive care unit, with covid-19 as well, at the same time. She could not even go the distance from where the hon. Member for Carshalton and Wallington is seated to where I am now to see her mum, because it was not allowed. My wife and my father-in-law were self-isolating. My wife’s aunt and uncle both had covid-19 at the same time. My wife’s uncle Frank was on oxygen in the ICU of the Ulster Hospital, as was her sister-in-law. They are all better today.

My 11-year-old granddaughter also had it at about the same time. I can never understand how covid-19 can take this person and not that person. At 11 years of age, my granddaughter is very strong and fit and able to combat it. It did not affect her mummy, daddy or sister, who did not have it, so it is sometimes a bit hard to understand. But when I talk about this disease and the e-petition, I have personal knowledge of how it affects families.

Also, I had two very good friends. Norma McBride, a lady who looked after our Soldiers, Sailors, Airmen and Families Association coffee morning every year, had underlying issues and did not last long. Here is a story. Two sisters, one of whom works in my office, came together for a family reunion in February this year. Betty from my office and Norma both drank from the same bottle of water. Norma took covid and died, and Betty did not. One would think that the chances of getting covid after drinking from the same bottle as one’s sister, who went on to get covid, would be fairly strong. That would have been my opinion, but Betty did not get it. I also lost a good friend, Billy Allen, one of my constituents. He lived most of his life in England but then came back home to Newtownards, and I knew him quite well.

We have had some difficult times, but I am very aware of the need for a vaccine to combat the virus and to give people the best opportunity to win the battle against covid. I am a type 2 diabetic, unlike the hon. Gentleman who introduced the debate. When it comes to handing out the vaccine, I will probably fit into a priority category, but I want to say this: come to me after everybody else in the priority list has had it, because I do not want to be ahead of anybody else. I want it, I know I need it, and I have no doubts about it whatsoever, but I wish to make sure that we follow the order that the Government and the regional Governments have set out, and at some point it will come to me as a type 2 diabetic. I urge everyone to take the covid-19 vaccine and to be safe.

I am not a medical professional so, in preparation for this debate, I have been in contact with several medical professionals, including a GP, a pharmacist and an intensive care doctor. I raised with them issues that have been highlighted to me, such as concerns about women’s fertility, which is an issue when it comes to the Government giving the vaccine to pregnant ladies, for instance. The long-term effects are a concern. The outcome of those discussions have meant that it is likely that I, as a diabetic, will take the vaccine probably between now and the summer, if we go down the priority list of networks.

In the past, vaccines were taken by some because they felt that it was a risk they should take, whereas others were not sure. The eradication of some of the world’s diseases, as the hon. Member for Carshalton and Wallington set out, should be an evidential base for what we should do. Many people, whenever they saw that past vaccines were successful, were convinced that they could take it and not die as a result, so I think there is every merit in making sure that we do that as well, as the hon. Gentleman referred to. It was a salient point and a key issue for this debate.

Queen’s University Belfast and other universities across the United Kingdom of Great Britain and Northern Ireland have formed partnerships to investigate and try to find a cure for diabetes, cancer and heart disease, and also for dementia and Alzheimer’s, and for those who have vision problems. If we did not have these pioneering investigations, examinations and medical tests going on across the United Kingdom of Great Britain and Northern Ireland, we would be unable to find the things that are important for the cures that I believe can happen.

I want to put on the record that I think I should have the vaccine, because I want to have it, and I believe it is right to have it. I thank the Minister—I have said this in the Chamber and now say it here—for all the hard work that he and his team have done. We owe him a debt for his leadership through this difficult time, because things were so uncertain back in February and March, when we did not know the answers, because we were all learning as we went along. What joy it brought me and many others across this great nation when it was announced that a vaccine had been found.

Vaccinations should be strongly encouraged, and I encourage people to take up their flu jab, the measles, mumps and rubella vaccination and others, and to take this covid-19 vaccine when it comes as well. However, it must be a matter of personal choice, and I in no way support punishing those who do not choose to take this vaccine, ever mindful that I want them to take it. I wish that they would, and I hope that we can convince them. The hon. Member for Carshalton and Wallington set the scene in his excellent contribution. It is our job to convince, and I look to the Minister for that purpose. How can we convince others who may be unsure or doubtful as to the best way? The debate centres around the fact that there must be an element of choice, and while the Government have said that vaccination will not be mandated at present, responses such as

“the Government will carefully consider all options to improve vaccination rates, should that be necessary”

may pose a question in the minds of some people about whether they will be made to take it. I do not think that they will be, but I will listen to the arguments.

When I was much younger, as a councillor in a previous life, I had a fairly black-and-white opinion of things. Over the past 30 years of married life, my opinions have changed greatly and I see things in a much wider and more general way than in the past, which I believe allows me to be persuaded by those who have an evidential base and who can persuade me that something is right and that I should do it. That is what I am asking the Government to do. Many people need their concerns addressed and fears dispelled, and I believe this debate is the time to ensure that one option is not enforced vaccination, or a penalty for not being vaccinated, or even a curtailment of activity. Again, it is a point of persuasion. While I am aware that other nations may consider immunity passports alongside vaccination, it is my fervent belief that we must not penalise people who remain unconvinced.

Those who have questions should have them answered. I am awaiting answers to questions I asked of SAGE—asked through the Prime Minister’s office, by the way—regarding constituents’ concerns. That is what we do: we ask questions on behalf of constituents. When I get those answers, as I know I will, I will be happy to pass them on. Many of my acquaintances are happy to take the vaccine, but some wish not to, or they wish to wait—that might be a better way of putting it. Medical professionals and others advise caution, and like much of the coronavirus pandemic, both sides, whatever they may be, should be understood as valid.

I also express my concern over some of those on the internet and social media who promote the opinion—I will be careful how I put this—that the vaccine could be harmful and would be detrimental to health and wellbeing. I gently suggest that we need to listen to the scientists who have the evidence and the knowledge and who can deliver the convincing evidence necessary for people to understand that there should not be a fear. I caution the internet and social media users against the drive that there seems to be to do that.

I understand that there must be a decent uptake for this vaccine to be effective, but I also understand that those who have questions must have the opportunity to discuss it, and that that discussion must be with our medical professionals, many of whom feel ill-informed at this stage to recommend the vaccine. Reliable information and all the necessary evidence must be made public, so that everyone can weigh up the risks and benefits for themselves. That freedom must be the cornerstone of any discussion of the vaccine.

Let me be clear that I will take the vaccine when my time comes. I am not good with needles, but I do take my vaccines—I take the flu jab, and a while ago I had a tetanus injection after cutting my hand. Those are things I had to do. I trust those with whom I have spoken who know more than I do, but I uphold the right of those who are uncertain at this time to hold back. That is freedom.

I have heard the hon. Member for Wycombe (Mr Baker) talk about freedom many times in a genuine way. I hope that we will not be too far apart in what we say in our speeches. I understand the point that he has made. In this House we must protect our people. I want to protect my constituents. I want to ensure that they are safe. I believe that they need the vaccine in order to be safe, but on behalf of those who have signed the e-petition, I believe we have a job to do. Sir David, I have gone on too long.

--- Later in debate ---

[Patricia Gibson]

Yes, I agree. The reason why I have talked about Qantas is that I do think that it is a knee-jerk reaction. People are afraid. I think that, as the vaccine is rolled out, as there is more information and as they see that more and more people are taking up the vaccine with no ill effects, the concerns that both business and the general public might have will all start to dissipate. Perhaps I am just the eternal optimist, but I genuinely believe that that will happen, because vaccinations are not new.

What I have heard from constituents and what I have read is that the overwhelming majority of people want to stop having to worry about this virus. They want an end to the restrictions that we face as soon as that is safely possible. They want a vaccine to help put this dark time behind us, and they want these things to be delivered as soon as that is possible.

Many have contacted me—I am sure that I am not alone in the Chamber in saying this—to ask whether, in the roll-out of the vaccine, we could include, as a priority, those who are living with a terminal condition, which makes their vulnerability to the virus very concerning. I share the view that those who are living with a terminal condition ought to be prioritised for receiving the vaccine. I throw that in, because it is important at this point, when we are talking about concerns about the vaccine, to say that there are also concerns about groups who feel they may be excluded from being prioritised, which is very important.

[Jim Shannon]

The hon. Lady has outlined a concern on behalf of those who have terminal illnesses. The families want to enjoy that bit of time with their loved one as well. We can never ignore their feelings and input into this, either.

[Patricia Gibson]

Yes. I would expect and hope that anybody whose immune system was compromised would be prioritised in the roll-out. That is important, because those people have to be able to enjoy whatever time they have.

There is a minority—I believe it is a minority—of people who are concerned about the vaccine’s safety and/or efficacy. As we have heard, there is a job to do in convincing them that the vaccine is safe—that the vaccine is the work of top scientists and experts in the field and is as safe as the vaccinations that they have had and that have been administered, with their consent, to their own children when they were but babes in arms. Yes, we have a vaccine for covid-19 that has been delivered at breath-taking speed in scientific terms. However, that should not be a cause for concern or alarm; it should be a cause of pride. It should be the cause of a great sense of achievement that wonderful scientists and dedicated teams have worked flat-out to deliver this vaccine, and have rigorously tested it by undertaking mass trials with thousands of human volunteers to ensure that the vaccine is safe and effective.

The higher prevalence of covid-19 in the population, compared with other viruses against which vaccines have been developed, has led to a much faster rate of infection in respect of test/control groups, meaning that conclusions about efficiency were faster. In addition, the funding for this vaccine has enabled its rapid development, as there has been no delay due to financial considerations. Add to that the advances in technology to enable the mass manufacturing of huge quantities of the vaccine, alongside a global effort involving almost every scientific research institute, global health organisation and country, bringing together global, state and private power, as opposed to relying on a handful of scientists working for a small number of private companies. If we take all of that into account, we can appreciate how this vaccine has been delivered in record time. That is the message and information that need to be relayed again and again, to allay the fears of those who are concerned about the safety and/or efficacy of the vaccine. However, that may not always be easy, with disinformation and conspiracy theories thriving on the internet. I had no idea there were so many self-styled experts without any medical or scientific expertise expounding their view that the vaccine is not safe, but that is not surprising, given that they are probably the same people who, throughout this entire pandemic, have been perpetuating the myth that the covid-19 virus is some fictional, mythical dark conspiracy. We know that those who expound these bizarre theories are in the minority, but they manage to reach and even convince some people, and they frighten people. As such, the job for every Government and for all of us is to expound the positives of this game-changing vaccine, which will allow us to resume some kind of normality and save lives.

The roll-out of this vaccine is a good-news story: in fact, it is the best news story this year, if not this decade. It is a story that should be told with joy, pride and relief. We all have a duty to tell this story in our own way, and I know the Minister will be very keen to share in the telling of that story. Vaccines have protected us from birth to old age, and have saved countless lives. They are nothing short of a medical and scientific wonder, so I hope and believe that as this vaccine is rolled out, we will all be reminded of that fact, and the overwhelming majority of us will avail ourselves of this vaccine, which could save our lives.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Business, Energy and Industrial Strategy (Nadhim Zahawi)]

It is a pleasure to serve under your chairmanship, Sir David. I congratulate my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) on his leadership of this important debate on e-petition 323442. Over 300,000 people have signed the petition, including 641 in his constituency.

I am grateful to the hon. Member for Strangford (Jim Shannon) for his very moving speech, and I am deeply saddened by the loss of his mother-in-law and the infection of his wife, other family members and friends. As the shadow Minister rightly pointed out, the hon. Member for Strangford brought home that each and every statistic is a person, with a family and people who love them very much.

I will hopefully address the excellent—as always—speech by my hon. Friend the Member for Wycombe (Mr Baker). I am grateful to the hon. Member for North Ayrshire and Arran (Patricia Gibson) both for her excellent speech and for her clear confirmation that neither the Scottish Government nor the United Kingdom Government will mandate vaccination at all. I congratulate her chief medical officer, as well as the chief medical officers in Northern Ireland and Wales, who worked together so that we could all start to vaccinate on the same day, last Tuesday. I am grateful, Sir David, for the opportunity to speak on behalf of the Government this evening.

[Jim Shannon]

We in Northern Ireland were first.

[Nadhim Zahawi]

I hear the hon. Gentleman; Northern Ireland was first by a few minutes.

Last week was a most important week across the United Kingdom, because we began vaccinating people against covid-19, and that, I hope, has started to turn the tide on this virus. The pandemic has forced the Government and our devolved Administrations to take steps that are truly unprecedented in peacetime. They are steps that no democratic Government would wish to take unless they were absolutely necessary. At each point in the pandemic, every decision we have taken has been with the utmost consideration for its impact on our personal freedoms. As hon. Members have brilliantly highlighted this evening, and as my hon. Friend the Member for Wycombe rightly reminded us, the petition that we are debating is a matter of great legal and ethical complexity.

Before I address some of those complexities, I will set out the facts. First, there are currently no plans to place restrictions on those who refuse to have a covid vaccination. As my hon. Friend the Member for Carshalton and Wallington reminded us, we have no plans to introduce so-called vaccine passporting. My hon. Friend the Member for Wycombe was slightly nervous about that, quite rightly, as when I did my first interview about the issue—with the BBC, I think—I was asked about some of the technological challenges and I may have mis-spoken. I was grateful to The Spectator and TalkRadio, which allowed me to explain myself.

Mandating vaccinations is discriminatory and completely wrong, and, like my hon. Friend the Member for Wycombe and others, I urge businesses listening to this debate to not even think about that. I will explain in further detail why that is the wrong thing to do. I put on record my thanks to Professor Karol Sikora, who has many hundreds of thousands of followers, who quoted me and said I eloquently dealt with the issue. We have absolutely no plans for vaccine passporting.

Secondly, cards that were issued after people got their first covid-19 vaccination have been mentioned on social media. Among other details, they contain the date of their second vaccination. That record does not constitute a so-called vaccine passport. It does mean anyone is immune. As we know, the vaccine is given as two injections, 21 days apart. The second dose is the booster dose. I am sure hon. Members will forgive me for repeating the message that patients must return as instructed for their second dose. Without the second dose, the vaccine will not be effective. That is a really important message, and I am grateful to all hon. Members who are repeating that to their constituents.

Thirdly, on completion of both vaccinations, patients will be issued with a vaccine record card, much as they are for other vaccination programmes, so there is nothing different in the way we are dealing with this vaccine. Again, that does not constitute a so-called vaccine passport; nor can it be used as a form of identification. That would be absolutely wrong. Colleagues will appreciate that the careful and accurate recording of vaccination status is an important part of a public health effort. It supports patient safety during probably the largest and most challenging vaccination programme in British history.

Fourthly, in addressing the many who signed the petition, I want to underline one key fact, which we have heard over and over again from hon. Members: vaccines work. It is really important that we send that message from this place. After clean water, they are the single greatest public health tool in the history of mankind. My hon. Friend the Member for Carshalton and Wallington reminded us of Edward Jenner. It fills me with great joy that the Jenner Institute was one of the first to stand up and say, “We can do this.” I hope that, after a rigorous study by the Medicines and Healthcare Products Regulatory Agency, the Oxford-AstraZeneca vaccine will be in place as soon as approval comes through. Obviously it is up to the regulator to deliver that.

Vaccines, as we have heard, have ended untold suffering for millions, if not billions, of people around the world. When our turn comes and our GP gets in touch, we all have a duty to heed that call. It is how we will be able to protect ourselves and the people around us—our friends and family, the people we love. Months of trials, involving thousands of people, have shown that the vaccines we are using are effective. They work. In answer to my hon. Friend the Member for Carshalton and Wallington, they have been tested on between 15,000 and 50,000 people. There were no shortcuts or quick fixes by the MHRA; it has followed exactly the same process as usual. The difference is that instead of waiting for phase 1 to finish before doing phase 2, and then phase 3, the studies were in parallel; hence we were able to develop the vaccines rapidly.

Fifthly, and equally importantly, each covid vaccine will be authorised only, as I have said, once it has met robust standards of effectiveness, safety and quality. As we have heard, vaccines authorised by our independent regulator, the MHRA, will be assessed for clinical safety and effectiveness through a robust review. The vaccine is free to everyone eligible across the UK. There is really no excuse for someone not to take it when their turn comes.

Sixthly, although we know the vaccine protects individuals, we do not yet know its precise impact on onward transmission. My hon. Friend the Member for Wycombe made that point brilliantly himself, and by quoting the Secretary of State. In answer to the hon. Member for Nottingham North (Alex Norris), we will not know where the point is that he mentioned until we scale up the vaccinations. We will continue to monitor the impact on transmission through the Test and Trace system. As my hon. Friend the Member for Wycombe said, we do know that the vaccine protects people, which is the important thing. That is why I encourage everyone to read, read and read again—or to ask, ask and ask again, to quote the hon. Member for Nottingham North.

The full impact on infection rates will not become clear until we get to those large numbers, so we are monitoring that carefully. Hon. Members will understand that without our knowing that, it would be irresponsible for anyone to declare that they are immune. The Qantas question is therefore completely wrong, because it is impossible for anyone to say that. The science does not yet support that conclusion. Even if people are vaccinated, they must continue to follow the rules where they are, and keep taking the common-sense steps that are now so familiar to us—washing our hands, covering our face and making space.

Hon. Members have raised many questions about the World Health Organisation and the required international response. The United Kingdom Government have led the way. We could do even more. Next year, the UK will take up the presidency of the G7, as the hon. Member for Nottingham North mentioned; we will need to deal with anti-vaxxers nationally and internationally. We look forward to working with many nations on that challenge.

I will turn to some of the hon. Gentleman’s other questions. On GPs and the additional 15 minutes, that was the further guidance from the MHRA after two cases in which people with a history of severe allergies had an allergic reaction to the Pfizer-BioNTech vaccine. That is why there was a change to the process. On the roll-out today to primary care networks and the question about caseloads, it is brilliant that GPs have come together with primary care networks. For example, in an area of 50,000 people and five practices, they have come together and agreed that one would lead on the vaccination while the other four continued to support the community and deal with caseloads. On his question about care home staff who continue to be prioritised, I am happy to take that offline with him if he has a particular case or details.

The petition that we have debated is of profound importance. I urge anyone who is considering refusing a covid-19 vaccination to ask and ask again. Not only is the vaccine effective and proven to be clinically safe, but the quicker we are able to vaccinate people, the quicker we can bring forward the date when we can begin to lift the oppressive restrictions that were put in place with a truly heavy heart. I came from a world of entrepreneurialism, of unleashing people’s ingenuity, energy and passion. I did not enter politics to restrict people’s freedoms, which I profoundly believe in. In the meantime, we all have our part to play. We must continue to respect the rules to ensure that the efforts succeed and can be our shared success, so that we can all have a more joyous 2021. If I do my job properly, we will all be back in this Chamber celebrating, I hope, without the restrictions that we have today.

Ockenden Review

Jim Shannon Excerpts

Thursday 10th December 2020 Commons Chamber

[Ms Dorries]

I thank my hon. Friend for her pursuance, her persistence and her dedication, both to her constituents and the hospital as a trust. I would also like to mention, as my right hon. Friend the Member for South West Surrey (Jeremy Hunt) did, the parents of Kate Stanton-Davies and Pippa Griffiths, who have been instrumental in getting us along the pathway to where we are today. Yes, my right hon. Friend commissioned the report, I pushed for it to happen now, and my hon. Friend has been pushing also, but it is down to those parents and their commitment. It should not have to be like this. Parents should not have to go through what they have gone through to get to where we are today.

As my hon. Friend is aware, I have visited the trust myself and have been round the midwifery unit and the consultant-led unit, and I think there is an anomaly there. Should we have a midwifery unit and a consultants’ unit? Is that not where the problem is, with two separate disciplines not working together? Should there not be just one delivery unit? Does the culture not start there, and should we not look at how it works?

However, my hon. Friend has my absolute 100% assurance that, for as long as I am in this post, I will be driving forward the recommendations and findings of this report.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her understanding and compassion on the findings of the Ockenden report. With other right hon. and hon. Members, I wish to express my deepest sympathy to those families who have been grievously damaged by the failings of the Shrewsbury and Telford Hospital NHS Trust.

But will the Minister underline that sympathy alone is not necessarily what is required? What is required is action, and an undertaking to review procedures not only in this trust, but UK-wide, to ensure that the Ockenden report recommendations are implemented in all maternity wards. Will she give a guarantee that that will be done?

[Ms Dorries]

I thank the hon. Gentleman for his question; he is absolutely right, of course. The findings will be put in place, and in many trusts they already are. I was just looking for my data on the Morecambe Bay investigation, which I believe my right hon. Friend the Member for South West Surrey (Jeremy Hunt) also commissioned. If we look at the Morecambe Bay trust investigation, the predecessor to this, it is quite commonplace to say—I hear it all the time—“Well, we had Morecambe Bay and nothing has happened: the recommendations haven’t been implemented there.”

Actually, the Morecambe Bay investigation made 44 recommendations, 18 of which have been completed within the Morecambe Bay trust. There were 26 wider NHS learnings and recommendations, of which 14 were accepted nationally and 11 are being worked on now in the Department, to be rolled out nationally. I use that as evidence that reports such as this have consequences: actions that are implemented and make a difference in maternity units.

Covid-19 Vaccine Roll-out

Jim Shannon Excerpts

Tuesday 8th December 2020 Commons Chamber

[Matt Hancock]

Well, I very much hope so, but there is some time between now and then, so we have got to temper our joy and enthusiasm at today’s announcement with the need to keep on keeping each other safe between now and then. Let us not blow it, since we can see that the answer is on the horizon.

I reiterate the point that my hon. Friend made about the team in the Department, because my civil servants and special advisers have been amazing during this year. They have worked so hard—seven days a week, often 18 hours a day—and they deserve enormous praise, because this is a team effort and nobody can do this sort of thing on their own.

[Jim Shannon (Strangford) (DUP)]

First, could I say what a positive news story it was this morning when Margaret Keegan got her jab, followed by a fellow called William Shakespeare, which I thought was quite interesting? I thank the Secretary of State and all those who have made this happen, because it is really good news. Will the Secretary of State outline whether he has liaised with the Treasury to secure the funding needed to roll out this vaccine in the devolved nations, bearing in mind that we are behind on our flu vaccine roll-out and both cannot be carried out at the same time? Further, what discussions have taken place with the Secretary of State for Defence to provide trained military assistance in the devolved regions to make it happen?

[Matt Hancock]

This year, I have sometimes turned for inspiration to the bard:

“If you prick us, do we not bleed?”

So it was a delight and a coincidence to find that Mr William Shakespeare of Stratford-on-Avon, a constituent of the vaccine roll-out Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi)—by coincidence; Members should not get any ideas—was called forward to be the second person to be vaccinated by the NHS. It is absolutely terrific to see that people right across this United Kingdom are being vaccinated right now according to need, and I hope it can bring us all together.

Coronavirus Vaccine

Jim Shannon Excerpts

Wednesday 2nd December 2020 Commons Chamber

[Matt Hancock]

Yes, I am very happy from this Dispatch Box to remind the supermarkets of their responsibilities to follow covid-secure guidelines and ensure that they are in place for their customers and staff. I pay tribute to my hon. Friend for standing up for the small businesses of Ashfield. It is tough in Ashfield at the moment—I get that. We have the restrictions in place only because they are absolutely necessary. I know that he understands that. He is a strong voice in this Chamber for all the small businesses and residents of Ashfield.

[Jim Shannon (Strangford) (DUP)]

What a joy it was at 7 o’clock this morning to see this news being broken, and to see the Secretary of State as well. I put on the record my thanks to the Secretary of State and all his team for making this happen.

Is the Secretary of State aware that there are still those who are unable to access their flu vaccine? What steps have been taken to ensure that the flu vaccine roll-out is completed before the corona programme begins? What discussions has the Secretary of State had with the Northern Ireland Assembly on providing vaccines and, more importantly, on the roll-out for our vulnerable and our frontline key workers?

[Matt Hancock]

I am grateful to the hon. Gentleman for his kind words. It has been a big team effort. I echo his thanks to the whole team.

We have a further tranche of flu vaccines ready to go; that is just about to be rolled out. Making sure that flu vaccines are available right across the UK is very important. It is an issue that Robin Swann—my opposite number in the Northern Ireland Administration—and I have worked on extensively. He is incredibly diligent in ensuring that we get the flu vaccines rolled out to Northern Ireland. There is an interaction between the massive flu vaccine roll-out programme, which the NHS does every year but which this year is bigger than ever, and at the same time having to do a covid vaccine roll-out. We have taken that into account in the plans. In fact, before the announcement at 6.30 this morning, I was talking to Robin Swann on the phone, which shows how hard-working he is.

Covid-19: Access to Cancer Diagnosis and Treatment

Jim Shannon Excerpts

Wednesday 2nd December 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Westmorland and Lonsdale (Tim Farron) on securing the debate and setting the scene, and all hon. Members on their incredible contributions. I look forward—I said this yesterday and need to get away from saying it again—to the Minister’s response and the contributions of the shadow Minister and the Scots Nats spokesperson.

I have been contacted by many constituents asking me to attend and speak in this debate, and as my party’s health spokesperson I am very happy to do so. One of the heartbreaking stories I have heard in the past couple of difficult days is a widow saying:

“my husband only died of cancer—he isn’t important”.

I honestly could have cried when I heard those words, because I believe that she genuinely felt that no one cared, and that is what she told me. I felt that hardness; I had a compassionate understanding of what she was saying.

We are in unknown territory and undoubtedly we are distracted. How can we save people from contracting covid? How do we treat those who have it? How do we keep people in contact with others for their mental health? How do we ensure economic viability to pay for the future health needs of this nation? We are distracted, but when we have widows and cancer patients telling us how left behind and unimportant they feel, we know that in our distraction we have got this wrong. It pains me to say that.

Throughout this pandemic, I and others have lost loved ones. Two of the girls in my office have lost loved ones: one lost a sister and the other lost two uncles. We know the devastation, but we have all lost loved ones to cancer too. It is not that one is less important than the other, so that is why this debate is so important. I am thankful for this debate, which allow me to come alongside my colleagues and friends—that is what they are—to discuss how better we can do this together.

I was contacted by a radiotherapist who highlighted the massive problems they are dealing with daily. There are two main radiotherapy centres in Northern Ireland. I know this is not the Minister’s responsibility, but I am saying this to give some context to the debate. One is in Belfast, and the other is the newer, smaller North West Cancer Centre at Altnagelvin. I am told that the main issues in radiotherapy are the result of the lack of investment and funding. There are major problems as a result of staffing—doctors, therapy radiographers and physics—including recruitment, training and retention. That has a knock-on effect on service delivery, development and research. Investment is needed to replace old radiotherapy treatment machines.

Northern Ireland would like to feel more connected to mainland UK radiotherapy, through sharing best practice, training support, data sharing, peer review and so on, and that is what we are asking for. It is important that we take an holistic approach to this across the whole of the United Kingdom of Great Britain and Northern Ireland.

The covid problems found also included more patients having their treatments disrupted in many centres in the United Kingdom and a higher proportion than average reporting a poor or very poor experience. That also worries me greatly. We have members of the all-party parliamentary group for radiotherapy in the Chamber today, and I know that every one of us understands these issues, including the hon. Member for Westmorland and Lonsdale, who set the scene. One hundred per cent of responders said they were treating patients who would usually be having chemotherapy or surgery. The additional referrals were for a range of cancers, including oesophagus, lung, breast, head and neck, upper gastro- intestinal and bladder, and also included palliative cases.

I want to speak about one specific cancer, pancreatic cancer. It has been highlighted that there was already an emergency before covid-19. This was a critical issue back in March and it is even more critical today, in December. Surgery is the only potential cure for pancreatic cancer. Before the pandemic, only one in 10 people received surgery. With pancreatic cancer, a six-month delay to surgery means a 30% reduction in survival and a three-month delay a reduction of over 17%. Unfortunately, that sets the scene, with pancreatic cancer progressing from a curative to a non-curative disease while treatment is delayed. Surgery, for some, is no longer an option. That is greatly disturbing.

Reports of service restoration are encouraging. We hear from clinicians that, in most parts of the UK, surgery and treatment are now back up and running at near normal levels, but for so many people with pancreatic cancer and their families the damage has already been done. For those diagnosed in the future, the continued delays to the restoration of clinical trials are stunting crucial improvements in treatments and outcomes.

People with pancreatic cancer have also experienced an information gap, with 40% of patients who were impacted by the pandemic reporting having received insufficient information and support about treatment, symptom management or palliative care. We have had multiple reports of people being sent home from hospital with a new diagnosis without any further information on the disease, their prognosis or treatment options. Anyone facing something incredibly dark such as pancreatic cancer at an advanced stage will want the person opposite them to tell them what is wrong and give them some light on a way forward. All of us in this Chamber today, and all of us outside it, have been touched by cancer. For every two people we meet, one of them, or someone in their family, will have had it. Unfortunately we are continually confronted by this, each and every day.

Calls and emails to Pancreatic Cancer UK’s support line nurses have been up 58% on the normal weekly average, and there has been a 34% increase in the number of people being supported each week. Again, I think those figures are the critical factor in where we are on this. Pancreatic Cancer UK has also been contacted by a larger proportion of palliative patients than normal, because that is unfortunately what pancreatic cancer often leads to. If people do not get an early diagnosis and early surgery, they are confronted with end-of-life care. For families, that is incredibly difficult and complex, and a very difficult time in their lives. People with pancreatic cancer have reported feeling forgotten and isolated, at a time when they are also unable to see friends and family due to the risk of covid-19 transmission.

We are all heartened by the tremendous news today that we are going to roll out the covid-19 vaccine late this year and into next, given the time it will take to get to everyone. That is good news, but we have to address the issues for those with cancer now. I believe we need to do better, and the changes must be implemented from here at Westminster and across the whole of the United Kingdom of Great Britain of Northern Ireland. On behalf of all those cancer patients—all the ones who have contacted us, and all those facing an incredibly difficult time—I look, as I often do, to the Minister for a response. I know we will get that, but we really do need to be reassured. We need early diagnosis and extra care, and we need to show compassion in this place for those outside.

[Esther McVey (in the Chair)]

We now move to the Front Benchers.

Cancer in Teenagers and Young Adults

Jim Shannon Excerpts

Tuesday 1st December 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the matter of raising awareness of signs and symptoms of cancer in teenagers and young adults.

It is a pleasure to have this debate, and I thank the Backbench Business Committee for making it possible. I have a number of debates lined up with the Committee, and it asked me the week before last which debated I wanted to do. That is a very difficult question, because there are others that have been lined up since April or May, so I said, “I can’t make my mind up. I will leave it to you.” The Committee chose this subject, and I am very happy to speak on it.

I am my party’s health spokesperson, and this issue is very close to my heart. That is perhaps because, over the years, as an elected representative, I have had the opportunity to speak to constituents who are very clear about what the issues are for them. Cancer in teenagers and young adults is very important because sometimes children have been healed, and sometimes they have not.

Far too often, young people are forgotten when it comes to the conversation around cancer. Today’s debate offers a great opportunity to highlight the issues young cancer patients face, helping us all to explore how we can increase the understanding of signs and symptoms of cancer in their age group, and how to support their specific needs, experience, survival and recovery from cancer.

The importance of the debate was made clear to me the Teenage Cancer Trust, a charity that is very close to my heart and that I have supported frequently over the years. The Teenage Cancer Trust is the only UK charity dedicated entirely to improving the quality of life for 13 to 24-year-olds with cancer. It helps the seven young people who are diagnosed with cancer every day of the year, supporting them through treatment and beyond. The Teenage Cancer Trust has specialist units in NHS hospitals and provides dedicated staff, including specialist nurses and youth support co-ordinators. It is important to have specialist nurses and youth support co-ordinators in place to offer that umbrella of support when it is needed. The charity has 28 units across the United Kingdom of Great Britain and Northern Ireland, and uses the charitable funds it raises to provide over 90 specialist staff posts.

This year, after noticing the worrying drop in cancer referrals across the first lockdown, the Teenage Cancer Trust ran the “best to check” campaign, which was supported by a large number of MPs, on social media. Many MPs in this House and many Members of the devolved Administrations were involved in that social media campaign. The aim of the campaign was to highlight the specific signs and symptoms of cancer in young people and, importantly, to encourage young people to speak to their GPs or other healthcare professionals if they were concerned, with the message that, if in doubt, it is best to check. It is a good campaign, because it highlights the issues well.

An important point to raise today is that young people with cancer are different from children and older adults. While, fortunately, cancer in teenagers and young adults is rare, compared with cancer in older adults, it is still the biggest killer of young people by disease. This week in Westminster Hall and in the Chamber, we will have a number of debates about cancer, which is something we have highlighted over the last period.

It is always a pleasure to see the Minister in her place, because she has personal experience, but also a knowledge of the subject matter, and I look forward to her response. I also look forward to hearing from the shadow Ministers and from other hon. Members today.

It is always important to remember that cancer is still the biggest killer of young people by disease, because we focus very much on older people in our constituencies who come to see us. My father had cancer on three occasions; the first time, the specialist told my mother, “Go home and get your affairs in order,” yet he survived that. I have a similar outlook in life, both spiritually and in understanding, to my hon. Friend from the Scottish National party, the hon. Member for Glasgow East (David Linden). We believe in prayer. At that time, prayer was a big thing, and I believe it changed the outcome for my father. It was the skill of the surgeon and the care of nurses along with the prayers of God’s people and others that brought him through. He lived 34 years after he was first diagnosed. For a man who was told that his life was over, it is clear what happened. He had two more bouts of cancer and survived them too.

Young people experience a pattern of cancer types distinct from those faced by children and older adults. Typically they are the types of cancer that are considered rarer than those we are most used to hearing about in older adults. It is important that we focus on that. These cancers include the lipomas, the leukaemias, the sarcomas and the germ-cell tumours that are often harder to diagnose than the cancers faced by those in older age groups. We regularly see on television adverts from Great Ormond Street children’s hospital, and when I see young children suffering from cancer at a very early age, it always make me focus on the young people who have to deal with the disease. For example, a couple on television this morning told a very personal story. The case of children who have not had the chance to see all of life resonates very much with us and is close to our hearts.

Alongside that, it is important to recognise that young people with cancer have a distinct and highly significant set of social and emotional needs. Perhaps they do not always understand what has happened to them. They depend on the love of their parents and their families, and the skill of the nurses and their love as well. The normal challenges facing all adolescents and emerging adults still have to be faced by a young person with cancer. Along with the changes that they face, they have to deal with some of the bigger issues.

Young people are at a stage when their brain is still developing. That means that they will interpret and manage their diagnosis and the treatment of cancer differently. Experiencing cancer at the same time as puberty can have an effect on the physical transformations that are taking place. Cancer can have a number of unique physical and social impacts on a young person, and that can affect their identity, sense of self and body image. As the father of three young boys growing up, I was very aware of the difficulties and changes in children. Now I have the pleasure of having grandchildren and watching them growing up. All the things that I did not do right for the children I can perhaps get right for the grandchildren. My wife might say, “That’ll be a big thing for you,” so we will see how it goes.

Cancer can disrupt young people’s attendance at school, their romantic relationships and their interactions with peers at a crucial time in their development. The Teenage Cancer Trust funds youth support co-ordinators who are specialists, who help young people through all aspects of their care.

Young people with cancer face many barriers when needing a swift and accurate diagnosis. An issue both before and during the coronavirus pandemic is the challenge of getting age-specific data on cancer referrals. That is one of the things that we perhaps have not been able to do accurately. I understand the pressures that Ministers and Departments face, but data are not just figures. Data enable us to look at trends and to focus on them. It is important that we have age-specific data.

Statistics on cancer waiting times are broken down by trust and cancer type, but not by age, which is rather unfortunate. When the Minister replies, perhaps she will give us an indication of how improvements can take place. If we had such improvements for age data, we could focus our efforts on how best to address the issue. It is difficult to understand the full impact of coronavirus on access to the system for young people with cancer, but there is no benchmark for comparison in the first place. We cannot even compare with what happened before because the statistics are not in place. It is important that we get them.

Data from the national cancer patient experience survey in 2018 showed that young people were the group most likely to sit on concerns about their body for more than 12 months before presenting to a doctor. We have to address that. If young people are not sure what is wrong and what the changes in their bodies are, they need to be encouraged to speak to their parents and their GP and to feel free to do that, just to check and be sure. I will shortly give one example or perhaps a couple of examples of where doing things that way probably saved people’s lives.

Data from the national cancer patient experience survey and surveys conducted by the Teenage Cancer Trust also show that, compared with older adults, young people with cancer are the group most likely to have to present to GPs or healthcare professionals three or more times before they end up getting a referral and a diagnosis. How many times have we heard that people have gone to see their GP and presented their case, but the GP—I am not being critical—has never been able to indicate exactly what is wrong at an early stage, when the symptoms are perhaps clearly saying it? That is why people go back perhaps two or three times.

As I said, I will give an example of one young person, and I will give just her first name. The Teenage Cancer Trust hears these stories frequently. In June 2019, a young person named Alex was diagnosed with acute lymphoblastic leukaemia. She was 13 years old. Her symptoms started as back pain. When she presented her symptoms to the GP, she was told to take paracetamol and ibuprofen and to keep an eye on it. A week later, she was still having persistent severe back pain, but she had also developed a rash and unusual bruising. Luckily, her GP told her to go to the A&E department for a test, and that was probably what saved her life. Following that, Alex was told that she had cancer.

Alex is now on maintenance treatment and wants to share with other young people the message that if they go to their doctor once and something still feels wrong afterwards, it is important to keep going and asking for help. It might seem silly to do that, but it is essential. If someone has a persistent pain or problem, they must go back to their doctor. What made young Alex persevere was knowing that she would be able to stop guessing once she found out what was wrong. Alex’s story is one of many with a similar message.

Studies such as that by Herbert et al in 2018 have shown that GPs are often not familiar with cancer in teenagers and young adults because of its relative rareness, so their suspicion is low. I know that GPs are confronted every day with different issues, and I understand that, sometimes, with the rapidity of issues, it might not always be possible to know exactly what the problem is. It is often thought that young people are too young to get cancer. No, they are not. It is important that that is said today.

Interestingly, the BRIGHTLIGHT cohort study has highlighted that sociodemographic factors and tumour type significantly influenced primary care referral rates and time to diagnosis. BRIGHTLIGHT has done excellent work, and it is good to have that on the record.

Following on from that, it is timely to raise the issues that coronavirus has caused for teenagers and young adults with cancer. At the height of the coronavirus pandemic, around the time of the first national lockdown, cancer referrals from GPs dramatically reduced for all age groups. It would be great to think that that was just because cancer problems and the need for diagnosis had dropped, but that was not the reason. Cancer referrals were down by as much as 75% across all age groups—adults, young adults and children—as people stayed at home to prevent the spread of coronavirus. People were obviously afraid. They would think, “If I have a chronic disease and I go to the hospital or my GP, I might find that I have coronavirus as a result of that.”

There are potentially thousands of undiagnosed people who otherwise would have been diagnosed, and I think that other debates this week will indicate that as well. There is concern, too, about the particular challenges from the increased demand during the winter period. We cannot ignore that, because the winter period will bring its own problems as it always does. As one who had the flu jab back in September, I understand how important that is. I was never convinced at the beginning that it was really important, but as a type 2 diabetic, I now understand that there is a purpose to it. I have no doubt at all that the flu jab has helped me and many others.

As I said, there is concern about the particular challenges from the increased demand during the winter period. We also have to look at wider access to services for young people with cancer and at how that can work and how we can do it better, because it is important that we do so. Much of the support for young people with cancer has had to move online during the pandemic. That suits some people, but not everyone. While there has been some excellent adaptation and innovation, it cannot fully replace one-to-one support. While online is important, it is not the answer to it all.

It is encouraging to see the pick-up in referral rates across age groups in the latter part of the year. The NHS Help Us, Help You public awareness campaign is welcome. Some of these campaigns are really important, and we have to thank the Minister and the Health Department for campaigns that raise awareness. It is important that that happens.

During the first lockdown, the Teenage Cancer Trust found that young people with cancer found that accessing members of their treatment team much more challenging, particularly for rehabilitation and emotional support. We often say this—there are not many debates when we do not—but the issue is not always the physical part; it is also the mental and emotional wellbeing, the social interaction and the help of families. My goodness, how much we depend on our families for support as well. The trust’s findings show that 69% of young people were seeing their physiotherapist less frequently than usual, and 53% of young people were seeing their psychologist less often than normal. Those figures tell their own story of the fall-downs.

For many of these young people, the impacts of covid-19 and cancer are a massive double whammy. For those in treatment, coronavirus has exacerbated what is already a horrible situation and made it even more isolating and scary. Those young people who do not have the support of family and friends find it a very lonely road to chart a way down. I hope the Minister will give us some ideas in her response about how we can help these young people with their emotional and wellbeing.

For those at the end of treatment, coronavirus has extended some of the most difficult pressures of cancer treatment, which they thought they were finally breaking clear from, such as missing friends, family work and education. I support the Government’s campaign here and in Northern Ireland, where the issue is devolved, to have children at school. It is really important to do that where possible. We can probably do education at home and online by Zoom, but there is not the contact. I watched a TV programme last week where four children from a school back home were asked how important interaction in class was to them. They all said the same thing: they need that social contact. That is very important to have a normal life.

Another young person, Darcy, was diagnosed with skin cancer in February this year, at the age of 21. Her diagnosis came after her mum noticed a mole on her collar bone that was growing and getting darker. Like Alex, Darcy was originally turned away by her GP, who thought the changes were nothing to worry about. That is not a criticism; it is a reality. Luckily, because Darcy knew that something was not right, she decided to go back. She was persistent, and her mother was persistent as well. Her mole was removed and tested, and Darcy was diagnosed with skin cancer.

Coronavirus changed Darcy’s experience of cancer, as the UK entered lockdown soon after her diagnosis. She was one of the fortunate ones who had a diagnosis early and was treated before coronavirus came in. Coronavirus has amplified the issue of young people being forgotten in the conversation about cancer. Due to infection control restrictions as a result of coronavirus, many young people with cancer have to face treatment without someone there with them.

We have had many such debates in Westminster Hall and in the main Chamber. We had a Westminster Hall debate about month ago about miscarriages and losing young babies and children. It was a very emotional debate, full of raw emotion from all those who participated with personal stories. One person in particular—I do not think I will ever forget her contribution—told her story for the first time. Her story was that she had lost her child during the coronavirus pandemic, and it had happened only three months previously. She told the story, from that chair, not so long ago. It told me how important it is to have someone there. Because of the coronavirus, she had not seen her mother since she lost the baby. The special contact that mothers have with daughters was lost for a period of time, so it is important to have that in place. The restrictions are there, of course, in the interests of safety and stopping the spread of virus, but young people with cancer report that they are increasingly struggling with the impact of having to face some of that treatment alone. I underline that again, as it is really important.

It is important to raise several other issues faced by young people with cancer, one of which is access to clinical trials. Perhaps the Minister will agree that we should be trying to address that. Access to clinical trials can improve survival rates, outcomes and quality of life. Teenagers and young adults are, however, significantly under-represented in cancer research. We do need to do something in that department, and it is important that we do that. If young people are involved in clinical trials, we can improve cancer research, thereby improving the results. Recruitment rates in the UK among 15 to 24-year-olds are between 14% and 30%, compared with a rate of 50% to 70% in paediatrics. That tells me something. Those facts are stark, and we need to address that.

Another key issue is the impact that cancer can have on the mental health of a young person. I said it earlier on and I say it again. CLIC Sargent’s 2017 “Hidden Costs” report on young cancer patients showed that 70% had experienced depression, 90% had experienced anxiety and 42% had experienced panic attacks during treatment. Despite that, many young people with cancer cannot access the psychological support that they need. Research by the Teenage Cancer Trust in 2018 showed that only 61% of young people said they had access to a psychologist or a counsellor throughout their cancer treatment. That figure fell to 44% after the treatment had finished. We really need to do something with that sector. It is crucial that every young person with cancer who needs it gets support from a mental health professional, from diagnosis through treatment to aftercare: from the beginning of the process to its end.

Cancer in young people may be rare when compared to cancer in adulthood, but it is still the biggest killer of young people by disease. Cancer awareness now forms part of the health education curriculum in schools in England. That is welcome, but education about lifestyle choices to prevent cancer in adulthood does not go far enough to help young people to understand the signs and symptoms of cancer in their own age group that are not down to lifestyle. It is important that we realise that. Cancer can come and strike hard when it is least expected. Young people with cancer need to be equipped with knowledge about the signs and symptoms of cancer in their age group, and empowered to visit a doctor when they think that something is wrong. Perhaps the Minister can give a follow-up in her response on how that education programme is going. It is a good idea, by the way. It is fantastic, and I highly welcome it, but I think, ever more mindful of the difficulties in education due to coronavirus, that the follow-on is important. Hopefully life will change in the new year, when the vaccine is more available and we have a better opportunity to take advantage of it. I am not quite sure what the new normal will be, but we do look for some sort of normality for the future. More widely, young people with cancer are consistently forgotten in the cancer conversation, so it is important that awareness of the issues faced by young people with cancer is raised. If data on referrals and diagnosis risks by age is not publicly available, however, difficulties in knowing where to effectively target interventions will continue. The specific needs of young people with cancer must be considered. Public awareness activity on cancer needs to include reference to the specific types of cancer that are more prevalent in young people. If we can focus on cancers that are more prevalent, we can give advice, raise awareness and encourage young people to act at an early stage.

Finally, general practitioners and healthcare professionals should be encouraged to refer young people who present possible cancer symptoms for tests, even if the suspicion is on the lower side. If they are in any doubt whatsoever, it is always better to check this to just sit on it. Thank you for this opportunity, Sir Christopher. I look forward to hearing contributions from right hon. and hon. Members, who have plenty of time to do so.

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[Wendy Chamberlain (North East Fife) (LD)]

It is a pleasure to serve under your chairmanship, Sir Christopher, and I congratulate the hon. Member for Strangford (Jim Shannon) on securing this very important debate.

I will use my time today to highlight the work of a charity in my constituency, based in Cupar, that is focused on childhood and teenage cancers, called Toby’s Magical Journey. The “Toby” in Toby’s Magical Journey is Toby Etheridge, who was diagnosed with acute lymphoblastic leukaemia as a child, back in 2014. Together with his parents, Richie and Alison, he raised over £50,000 for charity during the two years of his treatment: £50,000 that would help provide toys, games, gifts and experiences to children and young people who were being treated for cancer and their families, both at the Royal Hospital for Sick Children in Edinburgh—which is where 90% of child and teenage cancer sufferers are treated in Scotland—and to families across Fife.

After Toby’s treatment was, thankfully, successfully completed in 2018, which was fantastic news, Toby, Richie and Alison decided to keep going with that amazing work, and set up Toby’s Magical Journey as a result. I have seen first hand the support that Toby’s Magical Journey provides, both to those being treated and to their siblings and parents. It is doing absolutely amazing work, helping people at what is an incredibly difficult time. When restrictions were eased earlier this year, I spent a morning sorting toys and craft gifts for Halloween, and saw the consideration and co-ordination that goes into the purchases it makes. I am looking forward to hopefully joining its team again in the run-up to Christmas.

One of the key issues that Alison, Richie and Toby have raised again and again—indeed, all Members so far have highlighted this—is the challenges that children and young people face in getting a diagnosis in the first place. This was not actually the case with Toby, but for many parents of children and young people with cancer, achieving diagnosis is often an arduous first step. The pandemic has created added difficulties: coronavirus is now a complicating factor, and that is why debates such as this are so important. Thirteen children and young people are diagnosed with cancer in the UK every single day, and of those 13, three will sadly die. That is a huge number of families every year, and it is therefore so important that we as a society do all we can to raise awareness of the symptoms of cancer, and to support those families who have children and young people being treated for cancer.

We have had Breast Cancer Awareness Month, and we have just finished Movember. These campaigns do a great job of raising awareness of the symptoms of breast cancer and testicular cancer. We need to better promote Childhood Cancer Awareness Month each September, in order to raise similar awareness of the symptoms of childhood cancer—symptoms that are not well known, which means that diagnosis can sometimes come too late. That means for many children, the chance of survival is greatly reduced, and as the hon. Member for Strangford has said, cancers in young adults and their symptoms are even less understood.

As I touched on earlier, this problem has definitely been exacerbated by coronavirus. In Scotland, general practitioners’ surgeries are still not seeing patients, which means diagnosis over the phone. As we have heard, that is a real problem when it comes to the often obscure symptoms of childhood and teenage cancer. It is important that these young people can have a face-to-face session with a doctor. I hope the UK, Welsh and Scottish Governments will commit to this as an absolute priority, especially given the mass expansion of testing we are seeing and the prospect of future vaccinations. Thankfully, at the Royal Hospital for Sick Children in Edinburgh, those crucial treatments are still going ahead. Children are being covid tested, and one parent is allowed in—usually, that would be two. I pay tribute to the team there, who do such important, life-saving work.

I also pay tribute to Alison, Richie, Toby and their wider family, because childhood and young people cancer impacts the whole family, and to all at Toby’s Magical Journey—volunteers, etc.—for the support they provide to children and families, but also for the way they have adapted the support they provide during the period of restrictions. Where they would be holding craft activities for family groups, they are now buying the same supplies and posting them to families, and doing sessions remotely. They are still sending gifts to children in the ward at the Royal Hospital, and I am pleased to say that Father Christmas will be doing socially distanced visits and meetings.

It is a very challenging time and as with many other charities, fundraising has been limited by covid. There are a number of factors, but one that I want to highlight is that people are using cash far less than they were at the beginning of 2020—I know that certainly I am. We need to think about how we can enable charities to continue to best collect donations in an increasingly cashless society.

Without child and teenage cancer charities such as Toby’s Magical Journey, the experiences of families being treated for cancer would be far worse than it is. They provide vital support, but equally important is the voice that they provide to families and parents. Without parents like Alison and Richie, who have direct lived experience, child and teenage cancer services would be much the poorer.

Like the hon. Member for Strangford, I commend the work of the Teenage Cancer Trust. In Scotland, it contacts all children weekly by text, and young people can respond via coloured love heart emoji, depending on how they are currently feeling.

We should be aspiring for a system far better than the one we have: one in which parents not have to fight for their child or young person to receive a diagnosis or treatment. We can do much better than this. The work that people such as Toby, Alison and Richie are doing has hugely improved services and will continue to improve those services in the future. They are amazing, but they should not have to be amazing in some respects. They should not have to step in to advocate; we should be getting the system right in the first place. I am sure all Members here aspire to that.

[Jim Shannon]

On the issue of charitable giving, the Government have made it possible through gift aid that for every pound given, they will give an extra 25%. Does the hon. Lady agree that this could be raised better, to ensure charities receive that extra bit of money? Sometimes when giving money, if a person knows they will get more for it, it is a bit like investing money for the future as one pound is actually worth £1.25.

[Wendy Chamberlain]

I agree that is arguably one of the opportunities of a more cashless society. If people are making a payment, the gift aid opportunities are potentially easier to access than with putting money in a box.

I appreciate that healthcare is a devolved matter, but I am still looking forward to hearing the Minister’s response because I am sure these challenges exist throughout the UK. Indeed, that is why the hon. Member for Strangford is the person who has secured this debate. We can also achieve much by pooling our healthcare expertise across the four nations. We should be making sure that in Scotland, Wales, Northern Ireland and England that we are following the best possible practice, which means raising awareness of symptoms, enabling swift diagnosis and ensuring that children, young people and their families are properly supported.

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[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate. He works hard through the Backbench Business process to get important debates either on the Floor of the main Chamber or here in Westminster Hall. I think he has chosen very wisely in this one.

I know that all Members in the room have a personal commitment to this issue. My childhood experience of cancer was the death of my father just before my third birthday, and that stays with me and my family, 33 years on. I am here to speak up for my community, but also to fight on this issue so that across the country, there might be fewer families like mine. We are well served in that regard with the Minister, and her personal commitment to this issue is something that we all look to.

Similarly, when it comes to the Scottish National party, it always great to see the hon. Member for Glasgow East (David Linden) in his place. We always learn from his contributions, and also from those of his colleagues, such as the hon. Member for Central Ayrshire (Dr Whitford); with her enormous professional experience, she always adds to the debate. The hon. Gentleman mentioned his colleague and friend the hon Member for East Dunbartonshire (Amy Callaghan). I am sure she is watching, and I know the hon. Member for Glasgow East will pass our best wishes on to her. We can see that across this Chamber, there is a high level of commonality in our views about what must be done for young people. Between us, I am sure we can move forward on this important issue and make an impact.

I agree with so much of what the hon. Member for Strangford has said that throughout my speech, I will be reiterating the points that he made. Unlike him, I did not have a point to make on schooling, which is very important. Whatever challenges our children face in their lives—because of their socioeconomic background, their health, or whatever makes them different from their peers; everything makes a child different in some way—we must ensure that we are no less ambitious about their educational outcomes. We must meet their health needs in the short term, and then be ambitious about their futures so they can reach their potential. That is a cross-party theme; no one has ownership of it. It is important that we remain ambitious about the broader outcomes of children and young people who are suffering from cancer, so that—fingers crossed, and all that wonderful support willing—we can help them to resolve their health challenges and they can go on to live really full lives.

I refer to the poignant personal experiences described by the hon. Member for Wakefield (Imran Ahmad Khan). If he is still in touch with Daniel’s family, I hope that they can take comfort from the fact that Daniel’s story has been heard and his life recognised. The hon. Gentleman’s moving contribution will stand as a testament to Daniel in Hansard for centuries, and I hope that the family get to see it. I agree with what the hon. Gentleman said about early diagnosis, and I will refer to that theme shortly.

On covid-19, the hon. Gentleman said that the cure must not be worse than the disease. I understand that, but if we do not put restrictions in place and we do not control the virus to the degree to which we are able, our NHS will not be able to do anything else because it will be overwhelmed. I do not think that treating cancer and treating covid are in tension, and I hope we do not lose sight of that in the debate that we will have later today.

The hon. Member for North East Fife (Wendy Chamberlain) made points about cashlessness. We are all looking at how covid will change British life and our own lives. I was thinking about cashlessness only this morning as I beeped on to the tube. I have had the same £10 note in my wallet for months, and it is hard to think when we will use cash again. I have to say that such change makes me a little anxious—that might just be something in me—especially when I think about my constituents. For me, beeping in is great and doing stuff on apps on my phone while watching the telly is brilliant, but for lots of people in my community, cashlessness would be their worst nightmare. We tend to think about it in those terms, but the hon. Lady talked about how we might embrace the opportunity to get better outcomes, and how we might all take into these new times the spirit of putting money into charities’ collection boxes. Those points were well made. Importantly, I am sure that those whom she works with at Toby’s Magical Journey will have seen that their contributions and their wonderful work have been recognised today. I will come back shortly to the point about getting an early diagnosis.

I have spent eight months as shadow public health Minister, and it has has been a non-stop procession of virtual calls. The fact that it has been eight months may remind you that it feels simultaneously as though this pandemic has been going on forever, and as though it only started yesterday. The sense of time and space is strange. Sometimes, the virtual meetings can blend in together—I think I can say that without that sounding rude—but one really stood out, and that was when I was lucky enough to meet the Teenage Cancer Trust youth advisory group. I heard from four incredible people who had all experienced cancer at a young age, and they shared with me their unique and personal experience of this horrific disease. What they said was eye-opening and quite hard to hear at times. It was so inspiring that those four young people, who have fought or are fighting cancer, have chosen to use their experiences to fight the greater fight for others like them. That has had a great effect on me and informed my work.

Those young people talked about the scale of the problem that we are dealing with. We know that every year, 2,200 15 to 24-year-olds will be diagnosed with cancer. Lymphoma will be the most common—about a third—the next most common will be carcinoma of the thyroid, cervix, ovary, bowel or breast, at a little bit less than that. Survival rates are improving. That is something we should recognise, and we should be pleased and optimistic about it. We know that 82% to 85% of teens or young adults diagnosed with cancer will now survive for at least five years, but that is still in the context of the fact that nearly once a day a young person will pass away from cancer. That is the level of seriousness of this debate. Cancer in young people is rare, thankfully, but it is the biggest killer by disease, and the 2,200 15 to 24-year-olds diagnosed each year face mammoth challenges. We in this place cannot make that go away, although we wish that we could, but we have a responsibility to make sure that the best services are in place to meet their health needs directly and to provide support. I know that we are all committed to that.

The hon. Member for Strangford talked about the wide variety of challenges our young people face; everyone goes through them, even if they do not have to deal with this disease. I am just about young enough to remember some of them, whether social, emotional or physical. The idea of combining them with the physical and mental burdens of dealing with cancer is quite unimaginable. As we know, the normal challenges faced by young people are not sidelined in that situation; dealing with cancer just adds to and compounds them.

The experience that the TCT youth advisory group shared with me highlighted one of the biggest issues that young people with cancer face, and that is diagnosis. As multiple hon. Members have said, that is something that those young people face before they even know they have cancer. Cancer is often not the first, second or even third suggestion for what their healthcare challenges might be, and we know that young people are the most likely age group to present three or more times before they are diagnosed. That is backed up by studies that show that rarity can lead to doctors being unfamiliar with some of the symptoms that are presenting. A compounding factor is that, as the hon. Member for Strangford said, this age group is the least likely to take to a doctor concerns about their bodies. That can often go on for more than a year. Although the challenges that we face are understandable, we should not accept them. Rarity is not an excuse for us to not be really focused on the issue, and to want to do something about it.

I know the Minister will want to do that, and I look forward to hearing her contribution. I hope she can address a couple of issues. I am particularly keen to understand what steps the Government can take differently to increase awareness of cancer, not just among young people, but also among healthcare professionals, doctors and the wider healthcare system. We know those people are doing their best, so what can we do better to make sure they have the right information and awareness to recognise it more quickly? The hon. Member for North East Fife mentioned Childhood Cancer Awareness Month, and I think we could all do more during that month.

I am keen to hear the response to the question asked by the hon. Member for Strangford about what can be done to get waiting time statistics broken down by age, and I will explain in a second why that is particularly personal. The current situation masks the true extend of the problem and restricts our ability to understand it.

That leads on to my point about the impact of the coronavirus. I have raised this at three of the last four Health questions. Dealing with the cancer bubble of delayed diagnosis and delayed care is critical to improving our health services and making sure we do not add to the terrible loss of life from covid a series of other lives lost to cancer. Young people are particularly at risk in that regard.

In the short term, I cannot even imagine how scary it must be to deal with cancer at a young age during this period of time, because all the support systems that would normally be there are more difficult to access, and they must be accessed virtually rather than person to person. That is really challenging. The long-term issue is around waiting times. In the first lockdown, referrals dropped dramatically, as people stayed home to protect themselves and others. That means that lots of undiagnosed cases of cancer are out there, many of which will be among young people, who were already less likely to seek medical attention or be diagnosed quickly. That is a potential added factor that may make outcomes for young people worse. As cancer services are restored, we really need a sense of what we are doing differently to deal with the bubble for young people in relation to those extra factors.

[Jim Shannon]

The hon. Gentleman is making some important points. There is a build-up of young people, children and young adults who have not had a diagnosis or the chance to get treatment because of covid-19. Does he think that in the Government’s policy and strategy decisions, resources must to be set aside to address the long list of people who need diagnosis and treatment, and that resources must be in place for staffing as well?

[Alex Norris]

I agree with the hon. Gentleman. We will have to do something differently to catch up. When we talk about restoring cancer services, that does not mean restoring them to how they were in January. I know there will be a debate tomorrow morning on ways in which we can make those treatment pathways better. I think the wise thing to do is to focus on those groups on whom the impact is worse, and young people are one of those groups. Before I finish, I ask the Minister for her assessment of what the second lockdown has done to referrals and waiting times. When that was discussed at Health questions the week before last she was relatively optimistic about it, but I would be keen to know more. Particularly, we had a period between lockdowns where services will have been getting back to normal. Do the Government feel that we have learned any lessons from that about restoration of services, particularly for young people?

I want to conclude by saying, as have all Members who have taken part: if any young person, or indeed anyone at all, who is watching this is worried about possible symptoms, such as hacking cough, blood in the stool, or a lump or bump that they do not recognise—whatever it is—they should please not think that we are distracted by fighting the coronavirus and that they should therefore not present in the normal way to the health services. Do it—ideally this morning, or, if not, this afternoon or tomorrow morning. Whatever the earliest opportunity is, please do it, because the services will be there for you.

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

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the hon. Member for Strangford (Jim Shannon). I congratulate him on securing the debate and on the sensitive way in which he always approaches these subjects.

Someone once said to me, “You don’t choose it. It chooses you.” That is the challenge with cancer. People have very little control over when or if they have to make that journey. However, it is a matter of making sure that we have the services in place and can have early diagnosis, and that we never take our foot off the pedal in getting the right workforce and making the pathways simple. People are understandably discombobulated when they are told; it is a tsunami of emotions. I would gently say that in the case of someone’s child, the wave is even higher. I could not imagine the pain of being told that.

On that point, I thank the hon. Member for Strangford for talking about Alex. I thank my hon. Friend the Member for Wakefield (Imran Ahmad Khan) for his tribute to Daniel and to Ellis Price. I thank the hon. Member for North East Fife (Wendy Chamberlain) for giving us a little hope and showing us that Toby’s Magical Journey was a way those parents, through the most appalling circumstances, could turn their love of their child into something incredibly productive that is now helping parents who are going through the same thing.

As many hon. Members have said, the issue is a cross-party one. I was so pleased that the title of the debate was about raising awareness, because that is something that we can do in this place no matter what divides us about our other politics. We can raise awareness, and the issue of health is very much one that joins us, although the delivery of it is separate in the devolved nations that we belong to.

I thank those who have made contributions and want to add my good wishes to the hon. Member for East Dunbartonshire (Amy Callaghan). When I noticed that she had become the chair of the all-party parliamentary group on children, teenagers and young adults with cancer, I looked forward to perhaps being able to discuss things with her. As hon. Members have said, the ability to bring personal experience to this place—in the sphere of health, business or anything else—gives debates a power that is sometimes otherwise lacking. In these covid-tinged times, debates in this place have changed, but our ability to do things together—to raise awareness and make sure that people’s voices are heard—is still very much in our control.

We have discussed the fact that cancer is no respecter of anyone. I have two young friends who have been through the challenge of teenage cancer—and it is challenging. One was just a teenager and the other was just exiting that period of life, which, as everyone has said, is one with an awful lot going on, emotionally and in a person’s maturity. We have not talked about ensuring we get the transition right, but speaking to people from the Teenage Cancer Trust or young people who have had cancer, we know that ensuring we get them in the right place in the system is important, so that as they move into adulthood they are not on a ward with very young children and vice-versa.

We have talked about the challenges posed by covid-19. In phase one of the pandemic we stopped services, but as soon as we could push the recovery button, we did. I have focused, along with those leading the drive in the NHS—Cally Palmer and Peter Johnson—to ensure we do not do that again. It is important that people can access other treatments. As the hon. Member for Nottingham North (Alex Norris) said, if covid-19 overwhelms the system, all the other areas we so passionately debate will become secondary and access to those services will become more difficult. We should all be aware, however, of the ambition to be tough on this disease.

We will get into calmer waters. When we do, we need that long-term plan and personalised care interventions, including a holistic needs assessment, health and wellbeing information and support, and end-of-treatment summaries. We need to identify and address the more psychological, psycho-social and emotional needs from diagnosis onwards, and to inform GPs about what is happening to a patient and their ongoing needs. A patient’s journey in hospital is often quite short, so those other medical professionals need help and assistance to access the information they need in their training.

As several hon. Members pointed out, childhood cancer is thankfully rare. That offers professional challenges in ensuring the diagnosis is as early as we would like. We heard from my hon. Friend the Member for Wakefield about the short window between Ellis’s exhibiting symptoms and being in hospital. We often find that in young children; it feels as if the change happens in a week or so. That is a challenge for the profession, but one it is up for. It is incumbent on me to outline to everyone that, thankfully, these cases are rare, but that makes it challenging for doctors when they are looking at a set of symptoms.

In the light of phase one, we have set up the cancer recovery taskforce, which includes children and young people’s cancer charities, to ensure that their voice is heard. It is important that, as we are recovering, we ensure that individuals from across the cancer family have their voice heard, because no two journeys and no two individuals’ needs are the same. That is a challenge. We are focusing on early diagnosis, workforce, treatment pathways, data and support. We are addressing system recovery, urgent referrals and screening, and ensuring the right communication is in place.

I know personally—like all of us—of the devastation this disease causes and the pain it brings to individuals and their families, but the impact on a young person is particularly heartbreaking. We know that cancer is rare among teenagers and young adults, who account for less than 1% of all diagnoses. Approximately 2,200 cancers are currently diagnosed for patients between 15 and 24. However, today’s debate has provided an important opportunity to raise awareness and shine a light on young people’s specific needs, experiences and recovery from cancer.

One of the positives of covid is that many more cancer treatments have become more patient-friendly and less impactful on the individual; that relates to the point made by my hon. Friend the Member for Wakefield about the treatment not being worse than the disease. Therefore, as treatments progress and with genomic testing coming along, it is important to make sure that we target the disease and not the healthy part of the body, so that we get the most positive outcomes for individuals that we can.

[Jim Shannon]

In my speech, I referred to clinical trials and the need for young people to be part of them. That will improve the data and the end results. Perhaps the Minister is about to come to that point and I apologise if she is, but has she any thoughts on how we can do that?

[Jo Churchill]

I thank the hon. Gentleman; if he will give me a second, I will come to that. Like him, I believe that research is the way to unlocking some the problems.

Awareness of teenage cancers in schools is important. Education from an early age on the causes and symptoms of cancer has been mentioned. I was pleased to see that this year’s curriculum for religious, sex and health education means that children are being taught about some of the signs and symptoms of cancer. In particular, that includes skin cancer, the link between smoking and lung cancer and ensuring that people keep a healthy weight. All these things help young people to become more aware of themselves, their bodies and their health outcomes. I hope that will encourage someone to pick up the phone and take steps towards discussing their health if they are worried about it.

As the mum of four daughters and, like my hon. Friend the Member for Wakefield, as the friend of parents who have been in this situation, raising awareness in a sensitive manner especially when the risks are low is something that we should all work on. Cancer is a frightening subject at any age and I pay tribute to the cancer charities that specifically deal with young people. As many Members have said, they do an amazing job not only to support people but to promote cancer awareness. For example, the charity HeadSmart helps to improve the understanding and awareness of the symptoms of brain cancer. The Teenage Cancer Trust, CLIC Sargent and Teenage and Young Adults with Cancer are also in this space, and the hon. Member for North East Fife pointed out that many local charities, such as Toby’s Magical Journey, do good work right across the country.

There is another debate in the conversation about moving to a cashless society and understanding how charities will probably have to reframe their work. In my constituency only last month, a small team of three raised more than £400,000 in an online auction. Things will have to move in a different direction when traditional collections cannot take place. We saw that with the Royal British Legion’s poppy collection, which was severely impacted. Like the hon. Member for Nottingham North, I am aware that if we are not careful, we will create a two-tier society because many people in all our constituencies still want to use cash. We could probably be smarter, but that is an issue for another day.

On the learning in school guidelines, we will keep an eye on how the research develops and feed that in. I will have further conversations with my colleagues at the Department for Education to understand how we look at the curriculum and what more we can do.

I turn to research. Only by understanding the data can we understand the treatment pathways and cohorts. I want to make a point about those carrying the BRCA gene, who tend to be much more at risk. A young friend with BRCA in their family recently had a double mastectomy. She wrote to me about the support that she had had from a charity and she mentioned raising awareness.

Understanding the data is really important. The National Institute for Health Research is leading a multi-stakeholder strategy with NHS England and NHS Improvement, cancer charities, teenage and young adult cancer patients and clinicians, focused on increasing the participation of teenage and young adult patients in research, as set out in the recommendations of the independent cancer taskforce in 2015 to improve outcomes. I regularly meet Cally Palmer. Our focus last week was on teenage cancers, because it is a challenging area where we know we have to do better. The collection of data is very important, as is the participation in clinical trials.

The NIHR clinical research network has funded specific teenage and young adult research and also nurse posts in its 15 local clinical networks, and has instituted measures to identify all teenage and young adult cancer patients participating in the NIHR portfolio research. It is also taking a lead role in an international initiative to remove artificial age barriers that prevent adolescents and young patients from accessing clinical trials.

There are some challenges around data protection and various other things that make the collection of age data a little problematic, but my offer to the hon. Member for Strangford is to take that away and further discuss with colleagues how we can do it. Although things often seem simple, they sometimes are not, and we have to consider the unintended consequences of collecting vast amounts of data. For example, who do we allow the data to be shared with? We can depersonalise it for research purposes, but very often people want it personalised because they think that perhaps the school should know or whatever. All these things are very sensitive and need handling in the correct way.

The long-term plans states that we will

“actively support children and young people to take part in clinical trials, so that participation among children remains high”

and rises to the 50% that the hon. Gentleman mentioned by 2025. However, it is a challenge. Clinical trials need to be more representative across the board. We often find that they are particularly skewed towards males, but that is for another debate. Pharmacology and treatments act differently across genders and age boundaries, so making sure we have the right participants is important.

More effective consent processes for using data and tissue samples will contribute to improving survival outcomes. We will seek the views of patients aged under 16 to ensure that the NHS continues to offer the very best services for young people, which is where the cancer patient survey is most important. That will be used alongside other data to inform service design and transformation.

It is a given that we all want to do more, but making sure that the ambition for the future of cancer diagnosis and care is foremost is something that I am particularly focused on.

I am pleased that we have delivered on our commitment of September 2019 and that all boys aged 12 and 13 are being offered the vaccination against human papillomavirus-related diseases such as oral, throat and anal cancer. That builds on the success of the girls’ programme, which has already reduced the prevalence of the main cancer-causing types of HPV, 16 and 18, by more than 80%. There is also prevention here, which is very important. Ultimately, that will reduce cervical cancers and other cancers as people go through their lives.

Our aim is to drive more personalised treatments for patients, but particularly children. From last year, we have targeted the use of whole genome sequencing, which will enable more comprehensive and precise diagnosis and access to personalised and less invasive treatment. Cancer treatment is often challenging, and the personal approach reduces medications and interventions that may be harmful to healthy parts of the body.

We also support increased access to clinical trials, making sure we have diverse participation across age, genders and ethnicities. Following from that commitment, we made available treatments targeting neurotrophic tyrosine receptor kinase gene fusion solid tumours earlier this year, following the National Institute for Health and Care Excellence appraisal. Further guidance that has been issued by NHS England and NHS Improvement prioritises the delivery of the long-term plan commitments that support the recovery of services.

The ambitions include improving survival rates and early diagnosis. In March, we had 17 live rapid diagnostic centres. However, since October we now have 45, and I hope the fact that, even during the pandemic, the cancer workforce have stood up a further—I will do my maths very quickly—28 rapid diagnostic centres shows that commitment. Continuing the accelerated roll-out of places where people can be swiftly diagnosed is vital to getting on top of this disease.

I know hon. Members have raised concerns about the impacts on services through the second wave. As I said at the start, we must protect NHS capacity for non-covid services such as cancer. We expect cancer services to be maintained, with the redeployment of staff or blanket decisions to postpone services made only as a last resort and only at the behest of the clinicians involved in the treatment of others in their local area.

I have been meeting regularly with the national cancer director, Cally Palmer, and this week NHS England issued its latest guidance on maintaining cancer recovery throughout the second wave. It is important to continue to advise children and young people and their parents, as several hon. Members have done, to contact their GPs if they are worried about any sign of cancer. It is far better to pick up the phone and ask and to have their worries allayed than to think that maybe they could have rung before.

Referrals in September were running at 102% against referrals last year, but we do have a backlog to make up, and we still have some challenges in some of the pathways, which I know the workforce are addressing as swiftly as they can. We saw 199,801 urgent referrals, which, as I say, was 102% of the normal rate year on year; in April it was at 40%. That gives hon. Members some idea of the differential that we have to drive forward. We intend to ensure that we get education right for professionals and that we maintain a patient-centred approach.

I would like to conclude by wishing all those young people the best for their treatment and a fervent hope that they get to ring the bell. At the end of treatment, in most wards, there is a bell that young people get to toll, which marks out that they have finished what is a pretty gruelling episode of their life. I would like to hear that bell ring out for every family. While I know in reality that that is not possible, with good attention to research, by ensuring that we collect the data appropriately, and with all of us focused on raising awareness, I hope we will hear those bells ring out much more regularly.

[Jim Shannon]

I thank the Minister for the wee reminder of that TV programme. We have seen the adverts for Great Ormond Street Hospital—and other hospitals as well—where, when the child has finished their treatment, they ring the bell. That is an incredible finale. It is a wee salient reminder to us all that we have a wonderful NHS—a wonderful health service—and that it can make changes in the lives of young people.

I thank all hon. Members for their contributions and personal stories. Everyone has a personal story and everyone has shared their story with us today. It reminds us all of the heartache that others go through, even though we, personally, are fortunate not to have travelled that road. I believe that we, as elected representatives, have a responsibility and a duty to deliver on behalf of those people. I thank each and every Member for sharing their wonderful stories—what a reminder for us all.

I also thank Members for raising awareness, which we will continue to do. The Minister and every hon. Member is right to continue to do that. The hon. Member for North East Fife (Wendy Chamberlain) is absolutely on the ball on the issue of charities and how we can help them.

I welcome the Minister’s commitment to the review of clinical tests. I understand the reasons in relation to personal data. I also welcome her other comment on being able to pick up the phone and get reassurance—it is so important that people do that.

I look forward to working together. I have said often, and I think we all agree, that the House always shines better when we agree on the subject matter. This morning, we have all agreed on the matter and are all very pleased at the Minister’s response. I am not just saying that; I really think that her response was excellent.

Question put and agreed to.

Resolved,

That this House has considered the matter of raising awareness of signs and symptoms of cancer in teenagers and young adults.

HIV Commission

Jim Shannon Excerpts

Tuesday 1st December 2020 Commons Chamber

[Steve Brine]

I most certainly would. As a Health Minister I travelled around the world to G7 and G20 meetings. The NHS and what we do within it, as the Health Secretary has said many times, is so well respected around the world that we often set the tone and the lead. Yes, this is a plan for England, but I hope it will work across the devolved nations of the UK. I hope that we will set the standard around the world, as we have in so many areas of public health policy, so that others will then follow. I take the hon. Gentleman’s point exactly.

[Jim Shannon (Strangford) (DUP)]

First, I congratulate the hon. Gentleman on securing the debate. I just want to add my support for the HIV Commission project. I spoke to him beforehand. It is important that we put on record the hard work that has been done by so many people, including by those in my constituency. The Elim Church’s missions have helped to address HIV in Swaziland. Over the years I have known them and what they have done, they have been instrumental—it is a wonderful thing—in assisting the Swazi Government to reduce the number of adults who have HIV from 50% to 27%. A programme of education and medical support has helped. Does he agree that what they have done in Swaziland could enable us, through the House of Commons, to deliver that to the rest of the world as well?

[Steve Brine]

Yes. The faith element is very important. We have done very well on driving down the numbers, but we have to do even better, and it will get harder as we get closer to the goal. Reverend Steve Chalke, a Baptist minister and the founder of the Oasis Charitable Trust, was one of our commissioners. He provided a very important element and the hon. Gentleman’s point is very valid.

Why do I say that this is scientifically possible? A HIV diagnosis is a notification of a serious condition, but these days, thank goodness, it is not the death sentence it once was and many understand it to be. An end is therefore in sight. Treatment has come such a long way. People on the right treatment have their viral load suppressed, meaning that they cannot pass on HIV. That, frankly, was a game changer. Overwhelmingly, people in England and the UK now know their HIV status. Of the 106,000 people with HIV in our country today, 94% know they are HIV positive, 98% are on treatment, and nearly all are virally suppressed and therefore cannot pass it on.

In addition, we have a wonder drug, PrEP— pre-exposure prophylaxis—which is taken by people who are HIV negative. It stops transmission during sexual intercourse. The PrEP impact trial data comes out in the new year, but we know already that it is a massive success—I hope I am proved right in that assertion. The Secretary of State made the drug readily available, free on the NHS—that was important. That took a little longer than it might have done but, legal challenges notwithstanding, let us not dwell on old ground. Let us ensure that all communities that can benefit from it know about its virtues and its availability.

If we are to get the benefits of PrEP to all who need it, HIV testing is needed in GP surgeries, pharmacies—I refer the House to my entry in the Register of Members’ Financial Interests—termination clinics, gender clinics and much more besides. Then, PrEP prescribing powers need to be given to each of those bodies. Again, it can be done—we need the will to do it. I commend the PrEP Protects campaign, focusing on black African women and men. If we can get take-up in other communities as there has been with gay and bisexual men, we will be changing lives and saving money. So thank you to the Terrence Higgins Trust, the National AIDS Trust, I Want PrEP Now, who lobbied me heavily as a Minister, and PrEPster for their amazing campaigns on the issue.

--- Later in debate ---

[Matt Hancock]

The cross-party nature of the support for this work could not be better demonstrated than by the fact that when our colleague from the Scottish National party, the hon. Member for Glasgow Central (Alison Thewliss) intervened, she anticipated my very next sentence, and so has the hon. Gentleman. I wanted immediately to turn to the global matters, because no one is safe until everyone is safe. If we have learned anything this year, we have learned that. We also need to work on shared solutions together and across the world, and we as a country will lean into the global efforts to tackle HIV and AIDS, as we have done under Governments of all persuasions over the past three and a half decades.

[Jim Shannon]

In my intervention on the hon. Member for Winchester (Steve Brine), I referred to the good work that has been done in Swaziland. From a global point of view, I just wonder whether the Secretary of State will be able to make contact with Swaziland and see how it has reduced the numbers.

[Matt Hancock]

I would be very happy to ensure that that happens and to work with the hon. Gentleman on a subject that I know is close to his heart. I reiterate that over the past three and a half decades, here in the UK we have played our part in supporting efforts right around the world. I am proud that we are the world’s second-largest donor to the Global Fund, which is reallocating up to $1 billion to support the prevention and treatment of HIV and other threats to global public health during the pandemic. We have to make sure that work goes on, even in the clutches of another public health emergency. It is absolutely critical that we do not let up, because we cannot let one virus undo the progress we are making in fighting another.

Today is a day to look back and remember those we have lost to HIV. It is a day to look back and acknowledge the progress we have made, but it is also a day to look forward and together reaffirm our resolve to keep working towards that goal of no new infections in 2030, because HIV is a virus that has taken too many people before their time. We should all redouble our efforts to make it a thing of the past.

Question put and agreed to.