Diabetes: Tailored Prevention Messaging

Debate between Jim Shannon and George Howarth

Thursday 24th October 2019 Westminster Hall

[Jim Shannon]

Like my hon. Friend, my wife is younger than me. It must be a Northern Ireland DUP MP thing—we look for younger wives to keep us young. I am not sure if that is right or wrong, or if it is politically correct to say that, but my wife is nine years younger than me. She understands the issue of me and diabetes.

Some 10% of people with diabetes have type 1 and 90% have type 2. I will refer to both throughout my speech, and I encourage hon. Members to do the same and to acknowledge the different factors at play with each. We can manage type 2 with medication, provided we control what we eat and what we put in our bodies. Of those living with diabetes, we have the broadest cross-section of society. The condition affects all genders, ages, ethnicities and financial situations. However, too often I see that policy makers and clinicians fall into the trap of treating people with type 1 or type 2 diabetes as homogenous groups that will respond to the same approach and message, but they respond in different ways.

During this debate I want to focus on four things: the primary prevention of type 2 diabetes; the need to offer different messaging to ensure that the support is appropriate for each individual living with diabetes; the necessity of preventing the complications of all forms of diabetes; and innovations in technology—there is marvellous technology —and patient pathways that can improve outcomes for people living both type 1 and type 2 diabetes. I wish that I had known 12 months before I was diagnosed that the way I was living—the lifestyle, the stress—was putting me at risk. We all need a bit of stress; it is good and keeps us sharp, but high stress levels with the wrong eating and living habits is harmful. I do not drink fizzy lemonade any more because it was one of the things pushing me over the edge. That was probably why I lost most of the weight fairly quickly.

Let us talk about prevention. Today more than 12 million people are at increased risk of type 2 diabetes across the UK. More than half of all cases of type 2 diabetes could be prevented or delayed. If I had known a year before my diagnosis, I could have stopped the downward trend in my health, but I did not know, and I wish that I had done. Many in this House offer leadership on type 2 diabetes prevention; the right hon. Member for Leicester East is certainly one of them. England is a world leader on this front, having recently committed to doubling its national diabetes prevention programme.

I was pleased to attend a roundtable discussion last summer, chaired by the hon. Member for Enfield, Southgate (Bambos Charalambous), at which we considered the link between obesity and diabetes and the importance of tailored messaging for the different subsets of the population. During the discussion I met the inimitable Professor Valabhji, the national clinical director for obesity and diabetes at NHS England, whose leadership in this space should be celebrated. I put that on the record because his knowledge and help for those around him, and his research into and development of how we deal with diabetes, are incredible.

For people with type 2 diabetes, there is the additional aspiration of achieving remission. I echo colleagues’ congratulations to the deputy leader of the Labour party, the hon. Member for West Bromwich East (Tom Watson). We watched him almost shrink. One day I stopped him and said, “Tom, is everything all right?” He was losing so much weight, but it was his choice to diet as he did. He is an inspiration for many people because of what he has done, and I commend him for it. The concept of remission can be alienating, however, because it is not possible for every person with type 2 diabetes.

Central to the effectiveness of all types of support for the individual and the wider population is the messaging used, which is what this debate is about. Tailored messaging should be developed for the sub-groups most at risk of type 2 diabetes. For example, those in the most deprived areas of the country are nearly 50% more likely to be obese and have type 2 diabetes than those in the most affluent areas: there is type 2 diabetes in areas where people do not have the same standard of living.

Obesity is responsible for around 85% of someone’s risk of developing type 2 diabetes. Additionally, south Asians are six times more likely to develop type 2 diabetes than Europeans are. It is a well-known cliché that men are not so open or proactive—I can say this is true—about their health needs, and men are 26% more likely than women to develop type 2 diabetes. I am willing to speculate, as one who fell into that category, that that is in part due to messaging not being in a format that reaches men. I did not know what it was, did not know what it meant, did not know what the symptoms were, but it was happening.

We need to focus some of the messaging on the importance of prevention and the risk of type 2 diabetes for men. Will the Minister commit to ensuring that all messaging to support those with type 1 and type 2 diabetes, as well as for type 2 diabetes prevention, is tailored to the relevant sections of our society?

I have to manage my diabetes every day. I take my tablets in the morning and at night. I am careful about what I eat. By and large, I manage it. I check my sugar levels every morning. The doctor tells me to check and I do it every day so that I know where I am. I am a creature of habit; I do it all the time so that I know exactly where I am. Some days it is out of kilter, probably because I transgressed and had a cream bun when I knew it was the wrong thing to have. None the less, we do such things.

On self-management, the average person with diabetes will spend just three hours a year with a healthcare professional. That means that they will spend most of their time managing the condition themselves and will need appropriate education. The right hon. Member for Leicester East chairs the all-party parliamentary group on diabetes. He organised a seminar where we looked at healthcare professionals and how people manage their own condition and therefore need appropriate education. The current delivery of structured education does not reflect the varying needs of each individual living with diabetes. We are all different.

The best efforts of healthcare professionals and those who provide education often focus on perfect self-management or no self-management at all. In reality, the daily struggle of living with a long-term condition means that every marginal improvement should be seen as a true achievement. We have to manage it and encourage ourselves as we move forward. We have to make sure that by moving a step forward we can then move forward again. There has been an admirable drive to increase the uptake of education, but education alone will not help an individual manage the ups and downs of living with the condition. They need the tools and confidence, as well as the education, necessary to manage their condition.

When I speak to people in my constituency who live with diabetes, they often highlight the feeling of isolation. I am sure we can all agree today that there is a need to provide each of those individuals with the support they need to take away the isolation. Being a diabetic can be lonely if someone does not know how to manage it. They might think they are doing the right thing when they are not. Issues have been highlighted to me about the delivery and format of education programmes. Digital solutions and coaching services should be explored. The Minister referred to that in a conversation that we had prior to this debate. I look forward to her response. We always get something positive from her, and we will certainly get something positive today.

Will the Minister commit to ensuring that the delivery, format and content of structured education programmes is improved through the use of digital solutions, and that national guidelines are adapted to accommodate that? Health apps could also be used to refine and augment diabetes training programmes by enabling clinicians to learn from patients about what motivates them and therefore what support to provide.

I want to congratulate the hon. Member for Wolverhampton South West (Eleanor Smith) on her leadership on how health apps can be used to improve care and patient self-management. Many MPs in this House are diabetic or have an interest in diabetes. That is why we are here today. We are either diabetic or interested in the matter and here to make a contribution. I commend and thank right hon. and hon. Members for their commitment.

Will the Minister commit to undertaking an extensive public engagement and education programme, using digital platforms where appropriate, to showcase effective and evidence-based health apps and encourage their wider usage? Support needs to be tailored to individuals’ particular needs, in recognition that no single solution works in self-management for everyone. Everybody’s needs are different. I was the first diabetic in my family. When the doctor diagnosed me as a diabetic he asked me about my mum and dad and my wife’s mum and dad, and whether there was anybody in my family tree with the condition, but there was no one there. Unfortunately, my condition was caused by my diet and my lifestyle, so I created the problem. It was not hereditary, but it is how we deal with such things and tailor our responses that matters.

I have recently been convinced that health coaches—the Minister will comment on this—can play a key role in this space. Coaches can bring a distinct non-clinical skillset that poses questions for patients to help them devise the solutions that work for them, to help build their self-confidence and self-motivation—in stark contrast to the more prescriptive approach taken in clinical settings. Coaching needs to be clearly defined, and the full range of support that coaches can provide to support tailored prevention messaging needs to be identified. I look to the Minister’s response, because I believe it will have some positivity in relation to what we seek and what will happen.

It has been brought to my attention that the health service may ultimately need to decide whether to adopt a population-based approach to support improved outcomes across the entire population, or a more targeted approach aimed at those facing the greatest barriers to effective self-management. Will the Minister ensure that the health system explores the full range of ways in which health coaches can support people living with long-term health conditions, as well as carers and family members, through the development of an NHS definition of health coaching? Does she agree with me—and I hope with others in the House—that the UK has an opportunity to be an exemplar in the use of health coaches? It is an excellent opportunity and I hope that through the Minister we can make those changes.

I want finally to discuss the potential of innovations and technology in addressing issues related to self-management. That is what I do—I self-manage my diabetes. A flexible approach to the provision of structured education is vital to support self-management. Once equipped with the information and skills necessary to self-manage, people must have access to, and choice from, a range of proven technologies to help them manage their condition in everyday life. There has been a big investment in technology recently in the NHS.

We welcome the Government’s commitment to the extra spend on health, which we talk about regularly. All us in the House are particularly appreciative of the Government commitment. People with type 2 diabetes are now provided with glucose monitors; my hon. Friend the Member for South Antrim (Paul Girvan) referred to those in an intervention. However, people are offered little education on how to use them appropriately. There may be something more that we can do about that. It is good to have the technology, and to be taking steps forward, but it is also good for people to understand how to use it appropriately for management.

The level of investment in innovative hardware for people with type 1 diabetes is substantial and should be commended. However, individuals can be left lost if timely support is not available to help them to interpret and utilise those tools as a means of preventing complications. Many people with type 1 diabetes choose not to access the technologies now available to them. Why is that? I do not know the reason, but it is a question we must ask. I believe that it is partly because of a lack of individual awareness. In the case of my diabetes, that would be right. It could, potentially, be linked to a lack of information. If information is not being provided, I should hope that something could be done about that.

Later in the month an event is being held in Parliament, chaired by the right hon. Member for Knowsley (Sir George Howarth). The event, held in partnership with the type 1 diabetes charity JDRF, is to do with the development of a new report on access to technology for people with type 1 diabetes, “Pathway to Choice”. I look forward to reading the report when it is published, and I know the Minister will be keen to read it.

All of us with an interest in diabetes—and that is why Members are here for the debate—will be interested to read it. Can the Minister inform colleagues here today what measure will be introduced to ensure that all people living with either type 1 or type 2 diabetes can access the latest proven technologies that are right for their situation?

[Sir George Howarth (Knowsley) (Lab)]

The hon. Gentleman has highlighted two important themes: self-management and knowing how to go about it properly; and the more recent theme of the potential of technology to achieve good control. He knows I am keen on both. However, does he accept that artificial intelligence can never replace the human element of having someone to talk to, who can give good, accurate information about how to deal with the condition?

[Jim Shannon]

The right hon. Gentleman is absolutely right. Artificial intelligence is beneficial: it can help where it can help. However, it is better for people to have the chance to talk to someone who can instruct them. I think probably we all want to talk to someone face to face, so we can understand the issues better.

An event that I attended here—with the hon. Member for Heywood and Middleton (Liz McInnes), I think—was about diabetes and also bariatric surgery. It may have been in the Thames Pavilion. I mention it because sometimes bariatric surgery may be the only way to reduce weight and enable someone to get to the other side, to address the issue of diabetes. That, as the right hon. Member for Knowsley said in his intervention, is something that people need to talk about. It needs to be discussed so they know what the options are. It is not for everyone, but it is for some people. A number of my constituents over the years have had that surgery and it has always been successful. It has reduced their weight in such a way as to control their diabetes. They are fortunate. Not everyone would have been able to have that surgical operation, but bariatric surgery is important.

To conclude, there is no one solution to diabetes prevention or management. Sometimes, no matter how well informed we are, diabetes can present new and potentially insurmountable challenges. I have some recommendations for the Minister. Primary prevention of type 2 diabetes should take a broad population approach, while ensuring that there is a range of programmes, including digital ones, so that no groups are excluded. There should be someone to speak to—access to someone to converse with who can advise and take things forward. Messaging should be varied and regularly re-evaluated, to ensure that there is engagement from those subsets of the population at the highest risk of type 2 diabetes. We cannot ignore the issue of obesity and diabetes. That was referred to at business questions and will probably be referred to during Health questions on Tuesday.

Finally, a holistic approach should be taken to diabetes care both to ensure value for the individual and to maximise the benefits to the NHS. When we are dealing with the NHS we must look at the money we have to spend, and how to spend it better. Prevention and early diagnosis are among the ways to do that, and the area of type 1 diabetes technology is important. Over the years I have had a number of constituents under the age of 10 who had early-onset type 1 diabetes. I can picture some of their faces, as I speak. They will always have to manage their diabetes. Mine came about through bad diet and bad management, but for some people it is hereditary. I ask the Minister to ensure that the Department for Health and Social Care will continue to focus on the important issue of messaging, in relation to diabetes.

Diabetes: Artificial Pancreas

Debate between Jim Shannon and George Howarth

Wednesday 12th December 2018 Commons Chamber

[Mr Howarth]

I am grateful to my hon. Friend for that intervention. I am aware of the #WeAreNotWaiting group and as recently as earlier today I had an email from one of them. I will not name them, because I do not have permission to do so.

[Jim Shannon (Strangford) (DUP)]

Will the right hon. Gentleman give way?

[Mr Howarth]

I will give way in a moment. I just want to finish answering the point made by my hon. Friend the Member for Birmingham, Selly Oak (Steve McCabe).

The email reads:

“As someone who has built an artificial pancreas using the open artificial pancreas system and is reaping the rewards from this technology, I just wanted to wish you good luck with this evening’s Adjournment debate. Having been a type 1 for 38 years, I can confirm that this is truly life-changing.”

Before I give way to the hon. Member for Strangford (Jim Shannon), I want to say a word about those who are manufacturing their own artificial pancreases. In some respects, we should celebrate that there are so many young people out there who have the ability to build what is in effect an artificial pancreas, while, at the same time, writing their own algorithms to link them together. That is truly amazing.

I have a background—this is a long time ago—in engineering and I cannot even conceive of doing that, so it is very encouraging that people are doing it. On the other hand, I worry. I have spoken to clinicians and one said to me, “I’ve looked at some of them and they are viable devices, but I worry about people building something that is not reliable and then relying upon it. There could be serious consequences down the line.” But this does show what is possible when people—in their bedrooms or in their mum and dad’s garage—are effectively able to control their own diabetes.

[Jim Shannon]

I congratulate the right hon. Gentleman on securing this debate on using modern technology to deal with diabetes. I declare an interest as a type 2 diabetic. I know other Members in the Chamber have similar ailments.

Northern Ireland has some of the highest levels of diabetes in the whole of the United Kingdom. We have the highest level of type 1 diabetics among children in the whole of the United Kingdom per head of population. That gives an idea of the importance of this debate.

I am very interested in the success of the artificial pancreas given to a teenager in Leeds. Does the right hon. Gentleman agree that this revolutionises both treatment and quality of life, but that it must be available throughout the whole of the United Kingdom of Great Britain and Northern Ireland? It must not be a postcode lottery. This must be available as a matter of course for those who fit the protocol. Will the Minister tell us how we can do that across the whole of the United Kingdom of Great Britain—Scotland, Wales, England—and Northern Ireland?

[Mr Howarth]

I am grateful to the hon. Gentleman, who must be psychic, because that is the very next point I was going to make.

There have been, as the hon. Gentleman says, postcode lottery-style problems with accessing the technology. For example, with FreeStyle Libre, a flash glucose monitoring device, patients in Liverpool are able to get it on prescription if they meet the criteria. That is very welcome, but many patients from outside the area cannot get one, as up to 30% of CCGs do not fund them. There needs to be more work done on that and I know the Government have made an announcement, which I will refer to in a moment.

Thanks to Diabetes UK’s campaign on 14 November, World Diabetes Day, NHS England announced that from April 2019 the FreeStyle Libre will be made available to all who meet the clinical criteria regardless of where they live. That is a very welcome development. I do not think it will apply to Northern Ireland, but I hope a similar policy is adopted in Northern Ireland. Innovation in diabetes technology is evolving rapidly in exciting ways.

--- Later in debate ---

[Mr Howarth]

The right hon. Gentleman is right, and it was an omission on my part not to have acknowledged that. Any parent of a diabetic child has to experience the disease—at second hand, but in very important ways. The younger the child, the more responsibility parents have to take, so that is important. By the way, training and other support for parents needs to be built into the system.

[Jim Shannon]

I just want to reinforce what we do for diabetics in Northern Ireland. The surgery that I belong to, in Cuan in Kircubbin, holds diabetic classes twice a year. The staff there do tests on all the diabetics—type 1 and type 2—including for their blood pressure, feet, eyes and all the other things they need to test in the clinics. The surgery then reports back on those tests. For instance, patients will get an eyesight test a month after they have been to the clinic. That shows that there are ways of dealing with this. I am not sure whether surgeries on the United Kingdom mainland do something just as good, but perhaps they should.

[Mr Howarth]

There are centres where people can access a lot of services in one place in a similar way to what the hon. Gentleman describes as happening in Northern Ireland.

I attended an interesting conference in Vancouver three or four years ago. I found out—the Minister or one of her colleagues might want to investigate this a bit further—that some of the smaller island states tend to provide all the services in one place because they do not have the capacity or resources to do anything else. It is an accident of geography that they are forced to do that, but it seems to work very well, particularly in some of the Pacific island areas, where there is a massive problem with type 2 diabetes.

Infection Prevention and Control

Debate between Jim Shannon and George Howarth

Tuesday 15th May 2018 Westminster Hall

[Jim Shannon]

The hon. Gentleman is absolutely right; we have got to get it right in our own hospitals and across the NHS and the whole United Kingdom of Great Britain and Northern Ireland, and then we can look further afield to other countries. He reminds me that last year I had occasion to be in hospital three times for various operations. I never had any infections. I had nothing but the best care. The surgeon’s knife went in the right direction and removed what had to removed. It was important to do that. The important thing is that we have hospitals and an NHS that are excellent. When the NHS works well, it is the best in the world, but sometimes we need to think about things.

The cost of infections to the NHS includes the immediate costs of treating patients in hospital, bed-blocking and so on. There are also issues with hospital capacity, which has reached 100% in some cases. The World Health Organisation estimates that 50% to 70% of hospital-acquired infections are transmitted by hands, so improving hand hygiene must play a central role in any strategy to reduce hospital infections. It would be remiss of me not to note the work carried out by the Secretary of State to improve patient safety in the NHS—let us give credit where credit is due. In November 2016, there was a commitment to halve gram-negative infections by 2020. The Secretary of State announced he would appoint a new national infection prevention lead, Dr Ruth May. Both are important steps in bringing down infection rates and show a commitment to do so.

Given that 50% to 70% of hospital infections are transmitted by hands, I was encouraged to see alongside those measures a commitment for the NHS to publish staff hand hygiene indicators for the first time. If hand hygiene is done—it should be, and perhaps there are indications of places where it has not been—then publishing hand hygiene indicators will allow benchmarking between hospitals and help drive up standards of hand hygiene. If we can have a system that can help drive hand hygiene, we should have it. Perhaps the Minister can respond to that point in his summing up.

The policy should not be implemented by weighing or counting cartridges used in hospital hand sanitiser dispensers. If it is done by the number of cartridges used, we might be under the impression that things are going the right way, but there has to be a wee bit more to it than that. Without factoring in patient bed numbers and staffing levels, the information is, I gently say, somewhat meaningless in showing hand hygiene compliance levels. The intention is right, but other factors need to be looked at.

The Secretary of State is a strong proponent of the use of reasonable technology in the NHS. Like me, he believes it has the power to radically change how we deliver care. Electronic monitoring technology can monitor hand hygiene to deliver real-time, accurate data to drive behavioural change. We want to see behavioural change where staff are not as active on hand hygiene as they should be.

Electronic monitoring is an innovative practice that is used internationally. Studies from a hospital in the US have shown that following the adoption of the technology, hand hygiene compliance improved by 30%. If we use that methodology, hopefully we can replicate what has happened in the US and reduce infections. That 30% increase corresponded with a 29% decrease in the number of MRSA infections, saving that one hospital more than $400,000. Here in the UK, electronic monitoring is being piloted at a number of hospital trusts in what the Care Quality Commission describes as “outstanding” and “innovative” practice. It goes back to what my hon. Friend the Member for Upper Bann (David Simpson) said in his intervention: where we see good things happening, we should be doing those things across the whole United Kingdom. My hon. Friend the Member for East Londonderry (Mr Campbell) also referred to that.

If the results from the US are replicated here in the UK—they can be—the national adoption of electronic monitoring technology could see 30,000 fewer infections, saving the NHS more than £93 million. More importantly, it would mean less infection, fewer people staying in hospital and fewer deaths. Dr Ruth May, the national infection prevention lead, said that,

“the collection, publication and intelligent use of data…will ensure organisations improve infection control and help…poor performers get the support they need”.

Those are very wise words. While I welcome the announcement of the hand hygiene indicator policy, it appears that progress on its implementation has stalled. I suppose that is the point I am coming to and the reason for this debate. The Department of Health and Social Care has missed its own deadline to publish the data by the end of 2017. Data is so important in drawing up a strategy, policy and vision of how we can address the issue.

We have been collecting mandatory data on the number of healthcare-associated infections, such as MRSA and Clostridium difficile, since 2004. When hand hygiene is so critical to reducing the number of healthcare-associated infections, it is difficult to see why it has taken more than 14 years to publish data on staff hand hygiene—data that we are yet to see. I find that incredible. I spoke to the Minister last night, so he knew I would raise this issue. The key issue for me is how we use the data we have to make a policy and a strategy from which we can all benefit. To mark World Hand Hygiene Day, the World Health Organisation is calling on Health Ministries worldwide to make hand hygiene a marker of care quality. If we do that right, we will be going in the right direction.

Will the Minister consider making hand hygiene a national marker of care quality? Will he, on behalf of the Secretary of State, outline who is responsible for the implementation of the policy? Will he set out a clear timeline for the collection and publication of this data, which is critical to driving up hand hygiene standards in hospitals? Someone walking through the door of any hospital will always first notice the smell. They will probably notice the warmth of the hospital, because it is there to care for patients and those who are ill. They will also see nurses running about with their gloves on. Hand hygiene is important for them, but we need to drive it a wee bit harder from the ministerial point of view and the local hospital point of view, to ensure that it happens.

Publishing data on hand hygiene compliance is a simple first step in improving hand hygiene, which is essential to raising standards of infection prevention and control in the NHS. It will save lives and money, and we cannot afford further delay. The UK and the NHS have been at the forefront of worldwide infection prevention and control strategies since the early 2000s. While a good deal of progress has been made since then—we welcome that progress, some of which has been significant—there is much work to be done to realise the Secretary of State’s ambition: that the NHS will be the safest health service in the world. We should strive to be the best. In many cases, we are the best, but we can certainly do better. The role of good hand hygiene in reducing hospital-acquired infections and improving patient safety cannot be overstated. We must also acknowledge that the current method of direct observation in monitoring hand hygiene in hospitals is no longer fit for purpose, and that technology can and should play a role in changing behaviours.

I look to the Minister for his response. I thank all Members for taking the time to come to Westminster Hall on a Tuesday morning to make a contribution. We look forward to those contributions.

[Mr George Howarth (in the Chair)]

I do not propose setting a time limit on speeches. It might be helpful by way of guidance to suggest that if everyone speaks for no more than 10 minutes, it should be possible to accommodate everyone who has indicated that they want to speak.

Cable Standards: Fire Safety

Debate between Jim Shannon and George Howarth

Monday 26th March 2018 Commons Chamber

[Mr George Howarth (Knowsley) (Lab)]

I will try to live up to your splendid introduction, Mr Speaker.

Last year’s Grenfell Tower tragedy was, without doubt, one of the most shocking and disturbing building safety failures in living memory. As we know, the likely cause was a shocking failure of our building control regulations, and as a result, the Government established an independent review of building regulations led by Dame Judith Hackitt. A long-overdue national debate about buildings and safety has been taking place alongside the review. In her interim report, Dame Judith rightly stated that Britain’s building regulations are “not fit for purpose”.

I would like to place on record my thanks to the Safer Structures campaign, Electrical Safety First, the Association of British Insurers, the Fire Brigades Union and the Merseyside fire and rescue service for providing me with a briefing for the debate.

The focus for Grenfell Tower is on the specification and installation of the cladding used on the building. This debate concerns the need to eradicate substandard cabling from the market, because there is an overwhelming argument that our existing regulation is too weak and, as a consequence, exposes structures and those who live and work in them to unacceptable levels of risk.

[Jim Shannon (Strangford) (DUP)]

I congratulate the right hon. Gentleman on securing this salient debate. Does he agree that, with electrical fires being the cause of 20,000 fires in United Kingdom homes per year, we have a duty to ensure that people are able to check their cabling and understand how to do so to ensure that it is safe, for not only the people themselves but the councils, which have responsibility?

[Mr Howarth]

I am grateful to the hon. Gentleman for his intervention, and I will be giving some statistics that exemplify what he just said.

According to the Approved Cables Initiative, more than 27% of all electrical fires are attributable to faulty wire and cables, and there are serious concerns about the risks in our built environment that need to be urgently addressed.

A related concern is that current regulation is not being sufficiently well enforced. For example, in October 2017 the BBC published evidence from an investigation it carried out which exposed the fact that a now-defunct Turkish cable manufacturer, Atlas Kablo, has sold 11 million metres of cable to the UK that pose a deeply concerning fire risk. The Health and Safety Executive, which labours under severe resource restrictions, decided against a compulsory recall of all 11 million metres of that cable. Consequently, as far as I am able to ascertain, so far only 7 million metres has actually been recovered. That poses a real fire safety threat in cases where that cable is still being used.

Interviewed by the BBC, Sam Gluck, the technical manager at the electrical fire consultants Tower Electrical Fire & Safety, said that this approach had

“planted a bomb in the system”.

Mr Gluck added that

“if it overheats, it will ignite anything that touches it. If it’s against a plasterboard wall that will ignite”.

Dr Maurizio Bragagni, chief executive of Tratos—it has a factory in my constituency—and a founder of the Safer Structures campaign, added that

“it could be in any shopping centre, any venue, any building”.

Even where cable regulation is properly enforced, the standards are too weak. By way of background—the Minister will be aware of this—on 1 July 2017, the European Union introduced the construction products regulation. As a result, all cables sold in the EU now have to adhere to common standards, which should result in safer, more consistent building regulations and much improved public safety. The EU, however, has not been prescriptive in specifying which classification of cable performance should be used for buildings and infrastructure in each country. Instead, it is the responsibility of each EU member state’s regulator to decide this, and in the UK, this is the Ministry of Housing, Communities and Local Government.

At present, the Department has not specified which class of cable should be used for buildings, and instead requires all electrical installations in buildings to comply with British standard 7671—a minimum requirement equivalent to European class E. This means that flames can spread through a cable to 3 to 4 metres in under five minutes, and the fire will continue to propagate at the same rate, while at Euro class C, for example, the fire growth rate is limited to below 2 metres. On the range of Euro classes A to F, the A standard is virtually fireproof. Adoption of a higher standard at Euro class A, B1, B2 or C would lead to much greater resistance for permitted cables. In short, it would mean much improved levels of fire safety.

The official statistics on domestic fires make for sober reading. In 2016-17, 14,821 primary fires were caused by electrical distribution, space heating appliances and other electrical appliances. These three categories resulted in 44 fatalities and 1,353 non-fatal casualties. Another cause for concern is the electrical safety of white goods such as dishwashers, tumble dryers and fridge freezers, which are a major cause of electrical fires. In 2016, 1,873 fires were caused by domestic electrical white goods.

As you will recall, Mr Speaker, on 1 November 2017 there was an excellent Westminster Hall debate on the subject of product safety and fire risk in residential premises, led by my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick). I will not go over that ground again, other than to say that this is a serious problem and it needs to be addressed urgently.

Analysis by the Fire Brigades Union indicates that the number of fires and fire deaths is increasing. In the year ending September 2017, there were 346 fire-related fatalities compared with 253 in the previous year, which is a 37% increase—and it was even up by 9% if the tragic deaths at Grenfell Tower are not included. An improvement in standards must, by definition, lead to reduced fire deaths, less property damage and lower demands on already overstretched fire and rescue services. We should bear in mind that, since 2010, more than 11,000 firefighter jobs have been cut across the UK, and that represents one in five frontline firefighter jobs.

There are, as I have highlighted, genuine concerns about buildings such as Grenfell Tower and fire safety. I also have serious concerns about the growing private rented sector, which is far too lightly regulated. Electrical Safety First recommended that properties in the private rented sector should be subject to mandatory five-year checks and the fitting of residual current devices. This would enable substandard cabling to be identified, rather than, as at present, leaving it undetected until it causes serious property damage, injury or even death.

The post-Brexit landscape for regulation and compliance must, at the minimum, maintain the current protections afforded to consumers. There should be no deregulation of the product safety standards currently implemented. Following our exit, the UK should continue working closely with European friends to ensure that products entering the UK market are safe, and dangerous products are intercepted and reported.

One further point I want to make before I move to a conclusion concerns regional variations. Merseyside had 53% of its fires recorded as being electrical in origin, which is below the national average. During the same time, Manchester had 61%, and Norfolk, the Isle of Wight and Cornwall had in excess of 70%, of dwelling fires recorded as electrical. Of the 628 incidents defined as electrical fires on Merseyside, 133 were deemed to be “structural/fixtures/fittings”, and cables would fall into that category.

To conclude, I ask the Minister to consider the following questions. First, Dame Judith Hackitt’s review of building regulations must inevitably go through all the evidence thoroughly, and I accept that that will take time. However, in the case of cabling, would the Minister consider introducing immediate measures to properly regulate cable standards along the lines I referred to? The evidence is already there.

Secondly, will the Minister consider providing the resources to enable the Health and Safety Executive to identify the remaining 4 million metres of Atlas Kablo cable so that it can be recalled? Thirdly, will she undertake to see what further action can be taken on white goods to more fully identify the risks and any action that could be taken to eradicate those risks?

Fourthly, will the Minister carry out a review of the regions most prone to electrical fires to identify the common characteristics and what more can be done to deal with the problem? Finally, following our exit from the EU, will she commit to ensuring that there is no deregulation of cable standards in the UK?

I hope the Minister will accept that this is a very serious issue and that it is in need of urgent attention from her Department. I hope she will inject some energy into the work the Government need to do to combat it.