National Health Service Funding

Debate between Jim Shannon and Margaret Greenwood

Tuesday 22nd November 2016 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

It is not often that the people who come last get more time to speak, so thank you very much for that, Madam Deputy Speaker.

The speeches by right hon. and hon. Members from all parts of the Chamber have been exceptional. We should focus on the good things in the NHS, which everyone in this Chamber acknowledges. The passion that we hear in debates like this often comes out of what our constituents tell us.

[Margaret Greenwood]

Does the hon. Gentleman share my concern about the introduction of ACOs through the STPs, which come from America and are often used in insurance-based models of healthcare? Because people here do not pay for healthcare, except through direct taxation, but do pay for social care, there is a lot of concern about the blurring of the boundaries and a worry that we will wind up with people being asked to take out health insurance.

[Jim Shannon]

I agree wholeheartedly with the hon. Lady. Madam Deputy Speaker mentioned how fast she speaks; perhaps she is trying to take away my record. The hon. Member for Vauxhall (Kate Hoey) says that I do more words to the minute than anybody else in the House. Perhaps the hon. Member for Wirral West (Margaret Greenwood) is trying to take that mantle, but we will see.

I am the health spokesperson in the House for the Democratic Unionist party. It is a portfolio that needs to be balanced, and we should look for the greater good at every stage. In my opinion, it is the most difficult portfolio for anybody to hold. I am glad that I am not in the position of the Secretary of State for Health, because I would find it difficult to say to a person, “We cannot supply the drugs that you need to prolong your life, but we are hoping to save the life of the person beside you. We need the money to save, rather than prolong, life.” The hon. Member for Monmouth (David T. C. Davies) referred to sofa-surfing and the lottery for those who need access to drugs. Although I do not envy the Government in having to make such decisions, I cannot sit back and not highlight the difficulties that exist within Government funding and the fact that the NHS must have more designated funding to keep it running.

I read with interest the briefing provided by Macmillan. It sent chills down my spine. By the end of this Parliament, about one in every two people will be diagnosed with cancer in their lifetime. I look around the Chamber today and remember that those statistics include us and our loved ones. Indeed, there are some Members in the Chamber who have experienced cancer and are survivors. My own father battled and won against cancer three times. I am aware of what that battle entails, and how much of it is based on the right diagnosis and treatment, the availability of that treatment, the skill of the surgeon’s knife and the prayers of God’s people—those are all very important. It is clear that improvements in diagnosing and curing the disease mean that more people surviving it are living for longer with it; some 2.5 million people are living with or beyond cancer in the UK today.

In my opinion, more must be done to help those with rare diseases and rare forms of cancer. Will the Minister give us an indication of what funding and resources will be set aside for them? Those rare diseases and cancers are increasing. Put together, those conditions affect a large number of people. I know that funds are not infinite, but we must focus on those with rare diseases and with rare forms of cancer.

I will mention a tremendously courageous lady—I hope she will not mind me mentioning her name in this Chamber—who works in my constituency, called Aundrea Bannatyne. She watched her son battle cancer and triumph, only to be told that she had pancreatic cancer and that there was no treatment for it in Northern Ireland. The help she needs will cost up to £100,000 and the people of the area where she lives, Dundonald, have dug deep to help fund that.

That lady’s story could be replicated in the constituency of every Member in this Chamber, across the whole of the United Kingdom of Great Britain and Northern Ireland, but the postcode lottery says that she cannot have treatment because she lives in Northern Ireland. However, she would be able to access it in other counties on the mainland, which is something that the hon. Member for Monmouth referred to. That lottery is not what is needed. We need treatment in all areas. That must be addressed by additional funding. Aundrea needs more than us wringing our hands and being sympathetic. She needs practical, physical help. That is the only thing that can change her hopes for her future and her son.

Macmillan has said that one in four people living with or beyond cancer face disability or poor health following their treatment. That can remain the case for many years after the treatment ends. It is vital that they can access the best care—the care that is right for them—when they need it. The NHS must be able to meet the changing needs of cancer patients. That would not only increase the quality and experience of survival, but ensure that resources are invested in the most effective way. That is key, given that the five year forward view projections indicate that expenditure on cancer services will need to grow by some 9% a year, to £13 billion, not to get ahead but simply to stand still. That level of spending is likely to yield outcomes that continue to be below average when compared with similar international healthcare systems. We must therefore act now to ensure that the money is spent as effectively as possible, to give England and the United Kingdom of Great Britain and Northern Ireland a better chance to achieve world-class cancer outcomes and deliver the Government’s manifesto commitment.

The health service currently spends more than £500 million a year on emergency care for people with the four most common cancers alone. If we are spending £500 million on emergency treatment for cancer, there is something wrong with the system that we have to address effectively. Emergency care should be a last resort for people living with cancer. Such a vast amount of emergency care spending is symptomatic of a system that is not geared towards helping people take control of their health.

I am conscious that the hon. Member for Bury St Edmunds (Jo Churchill) is waiting to contribute, so I will conclude with this comment. Let us make the right decisions to sustain the NHS as it is—never mind give more, which is what people actually need. If that means taking simple things such as paracetamol off the prescription list, to save £80 million, let us do it.

Let us look at real issues that can make a change. Let us do the simple things for the greater good, and let us determine to be more efficient where possible and cut unnecessary red tape rather than services. Let us ensure that our NHS can withstand not only the surge of cancer diagnoses but the surge of diabetes—other Members have referred to that—heart disease, and all other major illnesses, which are only worsening. I do not envy the Minister’s task, but we have to make hard choices. We have to get the funding in the right place, and make decisions that take away bureaucracy and restore funds where they are needed—to cancer, rare diseases and rare cancers.

Cockling: Dee Estuary

Debate between Jim Shannon and Margaret Greenwood

Tuesday 19th July 2016 Commons Chamber

[Margaret Greenwood]

That is an interesting point. I certainly know that a number of families in my constituency have been involved in cockling for a great many years.

My constituents feel that the Environment Agency is not representing them adequately, and that, as Natural Resources Wales is an agency of the Welsh Administration, its responsibility is obviously to people in Wales rather than those in England. They have spent months making requests for access to the accounts showing the fishery costs, which have been released in a piecemeal fashion. They have made repeated requests to see the full accounts, but have been provided with only a summary, which has led them to conclude that the fishery is not being managed properly.

My constituents believe that they are being overcharged for their licences because Natural Resources Wales is not acting in a cost-conscious or effective way. They are concerned about the lack of scrutiny of NRW by the Environment Agency and the lack of attendance by EA representatives at meetings, and that is clearly an issue. After submitting numerous freedom of information requests, they were given sight of a document: references from the minutes and papers of the partnership board meetings to Dee Services and transfer of functions. The Partnership Board executive summary of 6 October 2015 states:

“NRW are under pressure from fishermen (who fish the Dee River Cockle Beds), for a meeting. NRW would like EA representation at this meeting but local EA staff are unwilling.”

The Environment Agency apparently pays £18,000 a year to Natural Resources Wales to manage the cockle fishery, but, according to my constituents, that figure never appeared in the accounts before 2015. I should like the Minister to tell me exactly how much the Environment Agency has paid Natural Resources Wales in each year since 2012, and how much scrutiny the Environment Agency is giving to how the money is being spent. The lack of oversight of the way in which money is spent is of real concern.

Last year I asked the Minister what enforcement measures the Department had undertaken in relation to illegal cockling on the River Dee, how many prosecutions for illegal cockling had been brought in each year since 2010, and how many prosecutions had been successful. The Minister replied:

“All cockle fisheries within the Dee Estuary are controlled via the Dee Estuary Cockle Fishery Order 2008. Enforcement of the Order is a matter for Natural Resources Wales (NRW) as grantee of the Order.

Defra does not have information pertaining to the specific enforcement measures taken by NRW on illegal fishing occurring within this fishery.”

My follow-up question is this: why does Defra not have that information? It is paying NRW to manage the fishery, so it should have some interest in how the money is being spent.

More importantly, not only are my constituents paying for bailiff activities via their licence fee, they have also been told that it will pay towards unsuccessful prosecutions. I have asked the Minister how much the Department has spent on the management and enforcement of cockling rights in each year since 2010 and what information the Department holds on equivalent spending by the Welsh Government. The Minister’s response was to state:

“DEFRA does not hold this information.”

Why does it not hold this information? Last year the cockle beds were closed for quite some time, so I ask the Minister what discussions have taken place with the Welsh Government on, first, the management of fish, mussels, cockles and other seafood stocks in the river estuary; secondly the reasons for the closure of the cockle beds in the estuary; and, thirdly, the projected date for the reopening of the cockle beds?

[Jim Shannon (Strangford) (DUP)]

The cockle industry is also important in my constituency. With advances in technology and environmental science there is great potential, but does the hon. Lady agree that ensuring that the jobs of local fishermen continue must be the priority for future legislation?

[Margaret Greenwood]

I thank the hon. Gentleman for his intervention and he makes a good point: it absolutely is important that we protect the jobs of those currently engaged in the industry, as they have been for generations.

To return to the Minister’s response, he stated:

“Fisheries is a devolved matter, and the Dee Estuary is a cross border fishery which is managed by the Welsh Government and Natural Resources for Wales for the Welsh part of the estuary. For the English part of the estuary, fisheries management is covered by my Department, the Environment Agency, the Marine Management Organisation, and the North West Inshore Fisheries and Conservation Authority.

However, Natural Resources for Wales (NRW) has responsibility for managing the cockle fishery in the Dee Estuary (on both the Welsh and English sides) as grantee of the Dee Estuary Cockle Fishery Order 2008. NRW has taken the decision to not open the fishery this year due to insufficient stocks. It has suggested that it may be opened in July 2016 should sufficient stock be available. I have not had any direct dealings with counterparts in Wales within the Dee Estuary fisheries management context or specifically in relation to the closure of the cockle beds.”

Does the Minister believe it is fair for NRW to charge cocklers the full licence fee for a season when that season amounts to only a few days? Cocklers are not doing this as a hobby; this is their livelihood, and if they are unable to access the beds they have no income. The cocklers are concerned that under the bird food modelling system used by NRW, a closed season will become the norm but they will still be expected to pay for a full licence and eventually be driven out of business by this cost.