Oral Answers to Questions

Baroness Berger Excerpts

Tuesday 25th November 2014 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

The Minister talks about parity of esteem, but it is under this Government that mental health budgets have been unfairly cut, and 1,500 beds and 3,300 nurses have been lost. He has already received a damning Select Committee report on child and adolescent mental health services. Ill people are being locked in police cells, or are travelling hundreds of miles to find a bed. The Minister could not have brought about more disparity if he had tried—and now we hear that there is to be yet another review. He is the Minister in charge. I ask him again: what action is he going to take today?

[Norman Lamb]

Inexplicably, when the last Labour Government introduced access and waiting time standards, they left out mental health. That was an extraordinary decision, and it drives where the money goes. The introduction of mental health waiting time standards next year, for the first time ever, will help to achieve equality for mental health. We have also published a vision of the next five years explaining how we will secure genuine equality for mental health, which is something that the last Labour Government did not achieve.

Physical Inactivity (Public Health)

Baroness Berger Excerpts

Tuesday 18th November 2014 Westminster Hall

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship again, Mr Weir. I congratulate my hon. Friend the Member for Blaenau Gwent (Nick Smith) on securing this debate and all colleagues across the House who supported the application for it. We have heard some important contributions by hon. Members from all parties.

I should like to take this opportunity to thank the many organisations that are doing an important job to get Britain moving—hon. Members mentioned many of them—including ukactive, Sustrans and StreetGames. I had the pleasure of joining Living Streets on a walk to work back in May, to celebrate national walking month and the benefits of walking to work, so I have seen first hand the fantastic work that it does. I also thank my hon. Friend for mentioning pedometers. Many hon. Members measure their steps on a daily basis. I am just on 2,000 already today and on my way to securing my 10,000 a day.

I share hon. Members’ concerns about the place of physical activity in our society. Just a few generations ago, physical activity was an integral part of daily life, yet today it is becoming ever less a part of our daily routines. The opportunity to move and be active in modern life has declined dramatically: advances in technology mentioned by hon. Members, the rise in passive entertainment options, community safety concerns, roads that are not safe for pedestrians and cyclists, and limited playgrounds and green spaces are just a few of the reasons why.

We have heard the statistics, but they are worth reiterating. In some parts of the UK, more than 40% of the adult population is classed as inactive and a quarter of all adults in England are failing to do enough physical activity to benefit their health. Nearly half of all 11 to 25-year-olds in England—more than 4.5 million individuals —fail to achieve the chief medical officer’s recommended levels of physical activity. This is deeply concerning. Our nation’s children and young people are not getting the activity that they need to stay strong, fit, healthy and happy, which is something that will inevitably affect them in later life.

As we heard, insufficient levels of physical activity are estimated to cost more than £7.5 billion nationally. Other figures have also been mentioned. That sum is broken down to just over £1 billion in the NHS, £5.5 billion in lost productivity and £1 billion in premature mortality among the working-age population. My hon. Friend the Member for Easington (Grahame M. Morris) also mentioned the staggering 16 million days lost in the workplace, which we must be concerned about and take action on.

More than 1 million children are classed as obese and a third of children leaving primary school are classed as obese or overweight. We know that the status quo is not working. If we are to make the NHS financially sustainable in the 21st century, it follows that we need to have the most ambitious plans for physical activity, to contend with those lifestyle diseases that the NHS is increasingly responding to.

We know that physical activity is the simplest and cheapest route to good health and staying well. Moving from inactivity to activity is one of the easiest first lifestyle changes to make. This has been looked at academically and found to be easier than altering diet, stopping smoking or reducing drinking—and it can cost next to nothing, too. However, the issue is about more than health; it is also about people fulfilling their potential and making the maximum contribution. We know that children who are more active are more likely to achieve better exam results and earn more throughout their lives. I echo the concerns of my hon. Friend the Member for Blaenau Gwent about lower levels of physical activity in more deprived communities. I should be keen to hear the Minister respond to that issue.

Put simply, physical activity and sport builds strong people and strong communities. Yet for an activity that brings such universal health benefits, there seems to be very little centrally driven support for its promotion. We have neither a way of accurately measuring the physical activity people take, nor consistent messages about what level of physical activity people should be taking. Until recently, the guideline for adults was for them to take 30 minutes or more of physical activity of moderate intensity on at least five days a week. That is a minimum of two and a half hours of physical activity per week.

In 2008, the health survey for England measured physical activity among adults by means of a questionnaire. Some 39% of men and 29% of women reported that they met the recommended minimum level of physical activity. However, when accelerometers were used on a group to measure their physical activity objectively, the real percentages were actually 6% and 4%. That was complex enough, but to make things more challenging, in 2011 new guidelines were produced by the UK’s four chief medical officers that are particularly complex—I shall not read them out; I struggle to understand exactly what the recommendations are.

There are other issues to consider, too. The active people survey does not actually measure activity and does not include recreational walking or recreational cycling. We no longer even have a way of measuring children’s participation in school sport, because the school sports survey, which measured the proportion of pupils receiving two hours of curriculum PE and the proportion participating in at least three hours of “high quality” PE a week, was scrapped in 2010. So, too, were the regulations that previously tracked schools’ travel patterns. Will the Minister share with us any plans to clarify this confusing picture and introduce a more consistent way of measuring physical activity? Are there any plans to reintroduce the school sports survey and school travel survey?

Again I share concerns raised by hon. Members about the Olympic legacy in our country, despite the huge progress made under the previous Labour Government. In 2002, just 25% of children undertook two hours of PE and sport in school, but by the end of the previous Labour’s Government time in office this had been raised to 93%. The previous Labour Government also created 422 school sports partnerships and 2,300 school sport co-ordinators, covering every school. It was my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown) who promised a “golden decade of sport”, kicked off by the Olympics and Paralympics in 2012. Yet a series of decisions has meant that these ambitions have not quite been realised under this Government.

The school sport partnerships—the local networks of schools and PE teachers—which had quietly been achieving notable success in getting students across England to be more physically active during school hours, have been abandoned; playing fields in some areas have been sold off; and school sport targets have been removed. We heard earlier this month that the borough that hosted the Olympic games is the least physically active in England.

[Grahame M. Morris]

Will my hon. Friend acknowledge the impact that cuts in local government have had, particularly on youth services? In national youth week last week, a number of youth clubs, including in Peterlee in my area, were reporting that they may have to close because of funding cuts.

[Luciana Berger]

I will move on to that point in a second. I was interested in the remarks made by the hon. Member for North Swindon (Justin Tomlinson). I have seen first hand some young people in my constituency who have taken part in the national citizen service, but that is just a few young people. At the same time, throughout the country, we have seen devastating cuts to our youth services. I want all young people to have access to good services. In a moment, I will mention my concerns about local authority cuts.

I should be interested in hearing from the Minister what work the Government are doing to mobilise all the different sectors, industries and organisations that have a role in getting Britain moving. My hon. Friend the Member for Easington mentioned people with dementia. We need particularly to pay more attention to and focus more on older people.

I am keen to hear what the Government are doing to encourage councils, which have the delivery system, to open up their parks, improve access to leisure centres and swimming pools, and make walking, running and cycling a key consideration of developments. However, I echo the concerns of my hon. Friend the Member for Easington about cuts sustained by local authorities throughout the country. My own area in Liverpool has had its budget cut by 56% and it is struggling to do all those things well.

We know that small adjustments to workplaces can make active travel or exercise before or after work a much more realistic option. What work are the Government doing with employers so that workplaces can become more physical activity-friendly? I have asked a number of questions about the health at work programme, and I was disappointed to learn from a parliamentary question that no records are being kept of the number of businesses that are becoming good health at work employers. That is a key issue, which needs more attention and resource directed towards it.

What work are the Government doing with sport governing bodies to ensure that the great success we have enjoyed at the elite level is matched with the same success at grass-roots level? I, for one, enjoyed taking part earlier this year in the “Back to Netball” programme, and I would like to hear about more projects like that that the Government are encouraging across the country—not only for young people, but for adults.

There is a particular concern and challenge around young people at college or university and the differing costs of accessing physical activity and organised sport in places of higher and tertiary education. In the absence of school sport partnerships and compulsory minimum numbers of hours of physical education in schools, how will the Government ensure that sport and activity are a feature of every school, with quality sports coaching and provision in all schools?

I echo the concerns raised by my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) and the hon. Member for Romsey and Southampton North (Caroline Nokes) about female participation in sport and physical activity. We know that there is a gap between the number of men and the number of women who take part, and I would be keen to hear from the Minister what the Government are doing in that area. Finally, what action are the Government taking to promote active travel and create environments where people are more likely to walk or cycle for short journeys?

With the right support and direction from Government, getting Britain moving is a single, simple, positive goal that the whole country can get behind—a goal that has the potential to shift our national culture. The issue is not about finger-wagging or telling people they cannot do something they enjoy; it is about promoting a positive activity that people can feel good about and an affordable route to good health and well-being for the whole population. It is the most cost-effective way of making our public services and our NHS sustainable now and in the future.

Oral Hormone Pregnancy Tests

Baroness Berger Excerpts

Thursday 23rd October 2014 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I thank my hon. Friend the Member for Bolton South East (Yasmin Qureshi) and the other sponsors of the debate for ensuring that the House discusses an issue that has been ongoing and unresolved for 40 years. I greatly admire my hon. Friend for her tireless campaigning on behalf of the families, who have never received the answers they deserve. I thank other Members for their thoughtful contributions, which are testimony to how much the issue has moved those in all parts of the House. I also pay tribute to Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Testing, who has never given up what has been a real struggle to get to the bottom of what happened and why. I had the privilege of meeting Marie and hearing her own story.

Today I speak not just on behalf of my party’s Front Bench and as a member of the shadow health team, but in my role as a local constituency MP. I was visited in Liverpool by my constituents Pat and Terry Hughes, who told me their story, which I have their permission to share with the House. Pat had taken the oral hormone pregnancy test, primodos, in 1971, and her daughter Katherine was born by caesarean in October of that year. When Pat came round from the operation, she was told that something had gone horribly wrong. Katherine had been born with no gullet and no back passage. She had kidney problems and disfigured feet. Very tragically, Katherine survived for just two hours. Pat and Terry never had the opportunity to see their baby. I was incredibly moved to hear that story about Pat, Terry and Katherine’s experience, and about Pat and Terry’s immense bravery, but also about their determination to find out why Katherine was born the way she was.

As we have heard, Pat and Terry Hughes are not alone. Many hon. Members in all parts of the House have shared their constituents’ stories. It is worth reminding the House of how many stories we have heard. We heard from my hon. Friend the Member for Bolton South East about Nichola Williams. The hon. Member for Aberconwy (Guto Bebb) told us about his constituent Mrs Roberts and her son Garry. My hon. Friend the Member for Makerfield (Yvonne Fovargue) shared the story of Mr and Mrs Tilly and their son Stephen. My hon. Friend the Member for Coventry North West (Mr Robinson) talked about Christine Pettifer. The hon. Member for Enfield North (Nick de Bois) spoke on behalf of his constituents, Chris Gooch and her daughter Emma-Victoria. My hon. Friend the Member for City of Durham (Roberta Blackman-Woods) spoke on behalf of Mr and Mrs Chapman and their daughter Margaret. The hon. Member for Romsey and Southampton North (Caroline Nokes) talked about her constituent Vicky. My hon. Friend the Member for Hayes and Harlington (John McDonnell) spoke on behalf of his constituent Kulvinder Sidhu. My hon. Friend the Member for Airdrie and Shotts (Pamela Nash) spoke on behalf of her constituent Mrs Rose Stallard and her daughter Elizabeth.

Those are just some of the many hundreds of individuals and families who have endured for more than 40 years not just the disabling physical conditions but an overriding sense of injustice. We are here today to determine whether there is a case to answer, whether there are unanswered questions, and whether there is information out there that might help fill in the gaps. I think that the case is clear.

Let me summarise the points we have heard. We have heard about the drug itself. Like the hon. Member for Enfield North, I am not a medical professional, but we do not need to be doctors or scientists for alarm bells to ring when we hear that a drug that was approximately 40 times the dosage of a contraceptive pill prescribed today was then prescribed to be taken by pregnant women twice within the course of 12 hours.

We have heard about the many women who took the pill at the time and who went on to suffer instant miscarriages. Thousands more gave birth to babies with missing limbs, abnormalities in their internal organs, brain damage, and heart defects. Many of those children died before reaching adulthood. Of course, many mothers who have not taken this pill also gave birth to babies with disabling conditions such as these, but the scale of the proportion of women who had taken the drug and who experienced complications gives rise to some serious questions. There were between 500 and 700 UK members of the Association for Children Damaged by Oral Hormone Pregnancy Tests, although it is thought that the true number of alleged victims may be in the thousands. The Government have estimated the number to be 3,500. In Germany, where a primodos equivalent was distributed, another 500 families are fighting for their claims to be heard.

We have heard about the studies on the drug that were undertaken at the time. In 1968, the Royal College of General Practitioners sent a letter to Dr Inman of the Committee on Safety of Medicines stating that 10% of abortions recorded after primodos were unlikely to be due to chance. The committee received a letter from the Usher Institute of Public Health in Edinburgh, which had concerns about its study on rats and abortions. It stated:

“Primodos should be withdrawn from use.”

In 1968, the drug company’s lead UK scientist wrote to the parent company in Berlin:

“it is extremely disturbing that the results of statistics, human studies and other studies all point clearly to the possibility that Primodos may interfere with a pregnancy.”

Those are just some of the studies and warnings that were received throughout the 1960s and early ’70s, and we have heard from many hon. Members on both sides of the House about further representations and studies that were done at the time.

That takes us to the crux of the debate: the significant delays in communicating those warnings. By the early 1970s, primodos was no longer authorised as a pregnancy test. In fact, it contraindicated for use in pregnancy, meaning it was declared that it should not be taken during pregnancy. Despite that fact, primodos continued to be used as a pregnancy test until 1975, when the Committee on Safety of Medicines finally wrote to doctors to warn them that the drug “may cause congenital abnormalities”. A warning was placed on the packet, saying it was

“not to be used during pregnancy...may cause congenital abnormalities”,

but it was not until two years later, in 1977, that the committee wrote to GPs stating that the “association has been confirmed”. In 1977, there were 7,038 prescriptions of primodos to pregnant women. A 1975 paper for the World Health Organisation questioned why research on such a critical issue, published in the late 1960s, was not followed up for many years.

It is worth reiterating that the authorities in Sweden, Finland, Germany, the USA, Australia, Ireland and Holland issued warnings and took action on hormone pregnancy tests as early as 1970, five years before any warning was issued in the UK, despite the fact that the Committee on Safety of Medicine was the first medical authority to know of the hazard.

Let me be clear: the point today is not why this drug was ever allowed to be prescribed in the first place, although there are some very serious questions hanging over that. No one is questioning the GPs who prescribed the drug. Why would they question the safety of the medicines and drugs approved by the Committee on Safety of Medicines? The problem is why, after so many warnings, and after it lost its licence to be given to pregnant women, there were so many delays in communicating that information to GPs. It was that delay that meant that so many women continued to take the drug long after it was known to be unsafe. Had the drug been withdrawn when the warnings become clear in 1970, my constituent Pat Hughes would not have taken it in 1971.

Why are we here? Why has this case not been resolved before now? We have heard from many Members that an opportunity the group had to mount legal action—which was supported by Lord Ashley, the then Labour MP for Stoke-on-Trent South—against the pharmaceutical company Schering had to be abandoned before it got going, when the Legal Aid Board said it could not continue to provide public funding because it felt the weight of the argument was in favour of Schering.

That case, however, was more than 30 years ago. Just because the evidence we have knowledge of is insufficient does not mean there is not a case for investigating the issue further and trying to find out more. That is why we are here: to call for the full disclosure of all the documents held by the Government relating to this drug.

There are real challenges in obtaining scientific proof of a causal link, but the facts that we do have are incredibly compelling. The drug has been withdrawn, so it cannot be tested on women, and those women who were affected have gone back to their doctors for their records, only to find that they are no longer there, as my hon. Friend the Member for Makerfield has said. I will not speculate on why the records are not there any more—I will leave it to Members to draw their own conclusions—but I understand that the BBC has made a documentary to expose that particular issue.

The situation leaves us with a real problem, and not just for those families affected: this is a matter of principle about the integrity of how we do things in this country. Marie, the chair of the Association for Children Damaged by Hormone Pregnancy Testing, explained to me that whenever she visits a doctor now, she questions everything that is prescribed to her. She has lost trust. These families want to prevent this from ever happening again.

The primodos case also raises wider questions about the safety of medicines. It is not acceptable to have such a shadow of doubt hanging over the impact of a drug that was licensed, prescribed and taken by women without due and proper process. If there are documents relating to this drug, it cannot be right that they are not made publicly available.

I want to finish by coming back to Marie Lyon, my constituents Pat and Terry Hughes, and all the other families who are still looking for answers. Feelings of guilt and injustice have followed them throughout their lives. They had 40 years of grieving for the children they lost, or of caring for those who survived. As my hon. Friend the Member for Airdrie and Shotts said, these families are getting older. The parents are now heading into their 70s, and they are worrying about who will take care of their children when they are no longer here.

The families still do not have any answers. This cannot be right. They need answers not just for themselves, but to ensure that this can never happen again. The petition signed by hundreds of people, which has been handed in to No. 10 Downing street, shows that that goal is supported by people across the country. Today’s debate has demonstrated that Members from both sides of the House are clear about what needs to be done to achieve it. It is a very reasonable request. It is important that the documents are released and that they are reviewed by an independent panel. I wholeheartedly urge the Minister to commit to making that happen. I look forward to his response.

Oral Answers to Questions

Baroness Berger Excerpts

Tuesday 21st October 2014 Commons Chamber

[Norman Lamb]

Yes, I agree that it is totally unacceptable for patients to be sent a long way away from home. In children’s services, we are investing £7 million extra this year to produce 50 more beds, and we are holding NHS organisations to account to ensure that they provide beds locally so that people do not have to travel long distances.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

Research published yesterday by the Centre for Mental Health and the London School of Economics shows that perinatal mental illness is costing our economy more than £8 billion each year. Does the Minister think it is acceptable that half of mums do not have access to a service, are being separated from their babies, are being forced to travel hundreds of miles for a bed, or are not getting any help at all? What is he going to do about it?

[Norman Lamb]

The position has actually improved significantly. Last week, I visited a fantastic perinatal mental health service in Torbay where mums are getting support locally, as, indeed, they should be. I totally agree with the hon. Lady that it is unacceptable that people have to travel long distances, but across the country things are changing, and changing rapidly.

Foetal Alcohol Syndrome

Baroness Berger Excerpts

Tuesday 14th October 2014 Westminster Hall

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Turner. I congratulate my hon. Friend the Member for Sefton Central (Bill Esterson) on securing this debate and on his powerful speech. I am delighted that hon. Members have had the opportunity to debate an issue that is often overlooked.

I pay tribute to those organisations that continue to campaign tirelessly on this issue. We have heard a number mentioned today, but they are worth reiterating: the FASD Trust, NOFAS UK, Alcohol Concern and Drink Wise North West, which has engaged with me in my role as a constituency MP. We have also heard a lot about the former Children’s Commissioner, Sir Al Aynsley-Green, who is the incoming president of the BMA, and Lord Parry Mitchell, who have both done significant work on raising awareness of the issue.

I recently had the privilege of joining a conference organised by Drink Wise North West on the issue, where I heard not only about the vital work done by those organisations but about what needs to happen to improve diagnosis of both FAS and FASD and to improve support for children and adults who experience that and for the families who care for them. Most importantly of all—the issue that is the crux of this debate—I heard about what we can do to prevent it in the first place. I will deal with each of those subjects in turn.

On improving diagnosis, we have heard from a number of Members about the wide range of symptoms that people with FAS or FASD can experience. The difficulty in diagnosis means that we have no official understanding of the scale of the problem, with many cases misdiagnosed as ADHD, bad behaviour or autism. It is estimated that around one in 100 children are born every year in the UK with some form of the condition. Figures I uncovered through a parliamentary question reveal that the number of finished admission episodes where there was either a primary or secondary diagnosis of foetal alcohol syndrome are up 37% in England since 2009-10, with 252 episodes in 2012-13. As many hon. Members alluded to, those figures are only the tip of the iceberg.

[Kelvin Hopkins]

I remember a report from the Home Office in the 1970s that showed that the rate of alcohol consumption in Britain was among the lowest in Europe; the only country where it was lower was Ireland. It would be simple to compare the number of birth defects in that period of time with the number now, to see the effects of alcohol consumption among women.

[Luciana Berger]

My hon. Friend’s remarks lead me to the challenge that the Government themselves admit in their alcohol strategy. They say:

“We do not have good information about the incidence of FASD, so it is likely that significant numbers of children are not diagnosed.”

In the response to my parliamentary question, there was no information about what action the Government intend to take to address that information deficit, so will the Minister confirm whether she has any plans to commission a much-needed prevalence study of FASD and foetal alcohol syndrome in England? Will she share with us her plans to improve diagnosis across the country?

[Bill Esterson]

Will my hon. Friend give way?

[Luciana Berger]

Forgive me, but I will not: we must allow the Minister to respond, and we have just 10 minutes.

I move on now to improving support both for people who have a diagnosis and for their families. Many sufferers have special needs that require lifelong help, yet slip under the radar either because they are not diagnosed or because there are no services in place to support them. Lack of diagnosis for those who do not exhibit physical signs means that those children often receive no additional help from support services or at school. I recently met a head teacher, who said she did not have a single student in her school who had been formally diagnosed, but she was sure that some students were affected.

There is no systematic record of the needs of children with FASD and no official guidance on best educational strategies, as my hon. Friend the Member for Sefton Central said. There is just one specialist FASD clinic in the whole of England, which is run by Surrey and Borders Partnership NHS Foundation Trust. It is one of the few places that can confidently diagnose the disorder. It is a national clinic, supposedly serving the entire country, yet it is not commissioned by NHS England. Out-of-area patients must be paid for, and with a cost of £2,500 per patient, many local clinical commissioning groups refuse to refer. Worst of all, I understand that the clinic is not due to be commissioned beyond April 2015. What does the Minister intend to do to ensure that NHS England commissions services and that plans are in place to improve provision and to increase both the number and the spread of specialist FASD clinics? Without specific support, people who are affected are at higher risk of developing mental health problems, getting into trouble with the law, dropping out of school and becoming unemployed. That may come at massive personal cost and in turn produce a tremendous cost for society. The crux of this debate is how to prevent that.

I have highlighted how we need to improve diagnosis and support services. Let me reiterate a point that has been made several times today. FASD is entirely preventable. It is caused by drinking during pregnancy, but the information about the risks of drinking during pregnancy is wholly inadequate. The guidance is inconsistent and confusing, and women receive mixed messages. The Department of Health recommends that pregnant woman should avoid alcohol altogether, but that if they opt to have a drink they should stick to one or two units of alcohol once or twice a week to minimise the risk to the baby. The National Institute for Health and Care Excellence advises women to abstain from alcohol completely during the first three months of pregnancy because of the risk of miscarriage. It then refers to the number of units that they should or should not drink subsequently.

People struggle to use units as a way of monitoring their alcohol consumption. Research from the Joseph Rowntree Foundation found that very few people use units as a way of measuring their drinking or of monitoring their health. Is it any wonder that women are confused? What is the Government’s official advice and what plans does the Minister have to improve much needed awareness throughout the country?

It is not just expectant mums who are not being given the information they need. The hon. Member for Chatham and Aylesford (Tracey Crouch) referred to health professionals and my hon. Friend the Member for Huddersfield (Mr Sheerman) referred to GP training. Earlier this year, I asked a parliamentary question about midwives, but the reply did not fill me with confidence. The issue involves not just women who have mental health or substance misuse support requirements, as the reply suggested; it involves all women, but the Government’s 32-page alcohol strategy makes just one reference to FASD, and that is not good enough.

Voluntary organisations do fantastic work and some local authorities—just some—are raising awareness locally. Some include FAS in their joint strategic needs assessment, but that is far from commonplace. What will be the Government’s concerted and co-ordinated response and where is their national drive? I struggled to find any information on the website of the Department of Health and I found nothing on the website for Public Health England. I would be delighted if the Government pointed me in the right direction.

We have heard a lot this afternoon about alcohol labelling. There is no legal requirement in the UK to display proper warnings about the harm of drinking alcohol during pregnancy. We have heard many references to Lord Mitchell’s Alcohol Labelling Bill, which sadly did not progress beyond the Lords. Today, it is still left to businesses to decide whether to display warnings.

As part of the Department’s responsibility deal, alcohol retailers and producers have made a voluntary commitment to put an agreed warning or a pregnancy warning logo on 80% of labels on bottles and cans. In June, the Minister responded to me saying that an independent market survey is under way to measure compliance. I am keen for an update on how that survey is going.

Many hon. Members on both sides of the Chamber have said that the logos are very small, if they are there at all. They are difficult to see because they are just a few millimetres high. They go unnoticed by many people and fail to convey the seriousness of drinking during pregnancy. Many countries prescribe warning labels about pregnancy on all alcoholic beverages and we have heard about them this afternoon. They include Colombia, South Korea, France and South Africa. I would like to hear from the Minister when the UK will follow suit.

We have heard about other countries that are leading the way. Canada was held up as an exemplar for what it is doing on diagnosis, treatment and specifically prevention. It is spending millions of dollars, because it believes that that will not only prevent something that is very difficult for many people, but comes at great cost to society. It believes that preventing FAS in just 10 babies saves enough to fund all the comprehensive services that it provides.

Very few disabilities are preventable, but FASD is. The message about the risks must be loud, clear and consistent. No woman wants to harm her child, but we know that lack of knowledge about the dangers of drinking during pregnancy can have a devastating impact. The Government’s response to the problem must be thorough, coherent and carried through into effective action. I look forward to hearing the Minister’s response and what more the Government will do to address this serious issue.

Oral Answers to Questions

Baroness Berger Excerpts

Tuesday 15th July 2014 Commons Chamber

[Norman Lamb]

I completely agree with my hon. Friend. It seems to me to be inherent in the nature of therapy that people go into it willingly. The idea that we could frogmarch them into therapy against their will simply would not work. We could end up with a dangerous and costly tick-box exercise that achieved nothing, so there is no plan to introduce compulsion to access therapy.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I listened carefully to what the Minister said in answer to the Chair of the Health Committee, the hon. Member for Totnes (Dr Wollaston), but will he confirm that there is no truth to reports that the Government are considering plans that would mean that people with mental illness would have their benefits stopped if they refused treatment? Rather than people refusing treatment, are not the increasing shortage of beds and ever longer treatment delays under this Government the real reasons why people are not receiving the help that they desperately need?

[Norman Lamb]

I can confirm, as I already have done, that there is no truth in the rumour. Indeed, in August we anticipate publishing the start of trial programmes to bring together IAPT—improving access to psychological therapies—with Jobcentre Plus. The idea of ensuring that people who are out of work and have mental health problems get access to psychological therapies is incredibly important, and I am very excited about the pilots that we will launch in August.

Organ Transplants

Baroness Berger Excerpts

Tuesday 8th July 2014 Westminster Hall

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

It is always a pleasure to serve under your chairmanship, Mrs Osborne.

I thank the hon. Member for Strangford (Jim Shannon) for a debate on such an important issue. In his opening remarks, he alluded to others who have encouraged him, so I thank them, too, and the Backbench Business Committee for granting the debate. I thank all hon. Members who have contributed; they have shared their personal connection and the case studies of their affected constituents. Our discussion today is most timely, given that we are in the midst of national transplant week.

Sixty years ago this year, the world’s first successful kidney transplant was performed by Dr Joseph Murray in Boston, Massachusetts. Dr Murray broke new ground when he and his team transplanted a kidney from Ronald Herrick to his dying twin brother, Richard, which saved his life. Today, kidneys are the organ most commonly transplanted, with about 2,000 transplants each year in the UK.

Organ donation is without doubt one of the great success stories of the latter half of the 20th century. This debate and national transplant week provide the opportunity to celebrate such fantastic achievements, to debate the challenges facing organ transplantation and to increase awareness of organ donation. It is welcome to see so many hon. Members showing their support for the campaign.

Over the past century, organ transplantation has overcome some major technical limitations to become the success that it is today. Breakthroughs include developing surgical techniques to manage the immune response and devising preservation solutions to enable prolonged periods of ex vivo storage. The results of organ transplantation continue to improve as a consequence of such innovations and of improvements in peri-operative and post-operative management.

Major progress has been made with the infrastructure and organisation of organ donation, which has led to a significant increase in donation rates. I am extremely proud of the fact that, in 2001, the previous Government said that we would double the number of donors from 8 million to 16 million by 2010; we achieved that a year early, in 2009. The 19.7 million of us on the NHS organ donor register are testament to the changes made at every level—from hospitals to the critical care and emergency department staff committed to donation. Most of all, there is the generosity of donors and their families.

Despite all those astounding achievements, many challenges persist, most notably the shortage of suitable donor organs. We know that the number of potential donors is declining because people are living longer and fewer are dying in hospitals in circumstances where they could donate. Every year in the UK, about 1,200 people die after death has been diagnosed on neurological criteria, with a further 3,000 people dying after the withdrawal of treatment in circumstances where donation is possible.

The hon. Member for Romsey and Southampton North (Caroline Nokes) highlighted the particular challenge of finding suitable child and infant donors. That makes it more critical than ever to increase the pool of willing donors and to encourage more people to join the NHS organ donor register, which includes engaging with parents to consider the gift of life at a time of child death tragedy.

As many Members have said, market research carried out by NHS Blood and Transplant highlights that, although 51% of the population definitely want to donate their organs and 31% said that they would consider it, only 31% have actually signed the register. Twenty years on from the launch of the NHS organ donor register, people may sign up in many ways, such as through an online form, a 24-hour donor line, a text message, the GP or even a driving licence application. I did so when I signed up for my Boots advantage card. Surely even more mechanisms could be used to sign people up—the hon. Member for Strangford mentioned a debate we had on the issue only a few weeks ago, when I suggested supermarket cards. What more could we be doing to encourage people, particularly young people?

A current campaign, led by the Anthony Nolan trust, goes into schools to encourage 16 to 18-year-olds to consider signing up to the bone marrow register. What more could we be doing across all schools?

[Jason McCartney]

The hon. Lady has just raised the campaign by the Anthony Nolan bone marrow trust—it is called Register and Be a Lifesaver. As the hon. Member for Stretford and Urmston (Kate Green) pointed out, there is still an issue when it comes to different ethnic backgrounds. As the bone marrow register has been mentioned, I want to point out that northern Europeans have a 90% chance of finding a bone marrow donor, but that figure falls to just 40% for people from black, Asian and minority ethnic backgrounds.

[Luciana Berger]

I was just about to come to the specific challenges of regional differences and of people from different communities having access to organs. To finish my point about the important campaign by the Anthony Nolan trust, as part of that campaign the organisation wrote to all MPs to encourage us to write to schools in our constituencies to inform them about the opportunity to have the Anthony Nolan trust come in and inform 16 to 18-year-olds about the chance to be a life saver. I want to put on the record that I strongly encourage other Members to write that letter if they have not already done so—I sent mine off only last week—because it is something that we can do as MPs to encourage people locally to get involved.

In response to the hon. Gentleman’s point about specific communities, the challenge, as we have heard from a number of Members, is not simply getting more sign-ups to the register but targeting specific communities and areas that we know are losing out from the stark inequalities in our system. In the north-west, for example, where my constituency is situated, patients are waiting longest for a transplant and we have the highest death rate among those who are waiting: 62.2% of patients in the north-west wait more than six months for a transplant, compared with an average for England of 47.3%. Some 23.2% of patients in the north-west have waited more than 18 months for a lung transplant, compared with an average for England of 15.8%. We need to take regional differences into account.

Many Members have referred to lung donation. My hon. Friend the Member for Bristol East (Kerry McCarthy) referred to the zonal lung allocation system, an important issue that I will focus on in more detail. The Cystic Fibrosis Trust has raised legitimate concerns about that system and is concerned about equity in lung allocation.

Currently the allocation of lungs to transplant centres operates on a rota system. When a donor becomes available, the organs are offered to the closest transplant centre if a matching recipient has been identified. If no suitable candidate is found, the organs are then offered to the next centre, as per the pre-agreed rota. The likelihood of getting a lung transplant and the time frame for the procedure will therefore vary according to where an individual is listed. A donated organ will not currently always reach the candidate most in need anywhere in the country. Will the Minister give her view on the zonal lung allocation system? Does she have any plans to develop a more needs-based system?

It is not just where someone lives that can affect their chance of having a transplant operation if they need one. People from BAME communities are up to three times more likely to need a transplant than others, yet, because organ matching is likely to be closer when the ethnicity of the donor and the recipient are the same, they have to wait much longer. For example, on average a person from a BAME community will wait a whole year longer for a kidney transplant than other patients.

The #Spit4Mum campaign to find suitable stem cell donors for a woman called Sharon Berger—I am not related to her—highlighted the specific challenge of finding suitable donors for members of the Ashkenazi Jewish community. I am a member of that community and I have done my bit to contribute to that specific campaign. But we know that there are many different ethnic minority communities that struggle to find donors of organs and stem cells.

Such inequalities are not acceptable. We cannot accept that some of our citizens will be far more likely to die than others because of where they live or their ethnic background. Will the Minister address that point specifically and outline what concerted action the Government will be taking to tackle it?

Many Members on both sides have raised their concerns about what more we can do to support families in honouring the wishes of their loved ones. It is very difficult when someone passes away, but we know that in 2011-12, 125 families overruled an individual’s intention as recorded on the NHS organ donor register to become an organ donor. Many people do not realise that if they have not made their donation decision clear, their family could be asked to agree to a donation taking place. Nobody wants to leave their family with such a burden, so it is vital that we encourage and support families in having those conversations earlier. The theme of the current national transplant week is “Spell it out”. Will the Minister outline what she is doing to promote that message further? There is a great disparity between those people who sign up and share their intentions with their families and those who do not, and there can then be issues with vetoing.

I will touch briefly on the issue of the opt-out or presumed consent system, which was raised both by my hon. Friend the Member for Bridgend (Mrs Moon) and by the hon. Member for Montgomeryshire (Glyn Davies). There are many obvious advantages to the system. I return to the point I made earlier: there is a gap between the 51% of the population who definitely want to donate their organs, the 31% who would encourage it and the 31% who have actually signed the register. The system will be introduced in Wales in 2015. Any change in legislation will need to take into account the impact of the system in Wales and must have the backing of the public. What consideration is the Minister giving to learning from the introduction of the system in Wales and to introducing a similar system in England?

[Sandra Osborne (in the Chair)]

Order. I am sorry to interrupt the hon. Lady, but I ask her to be mindful of the fact that the Minister has many points to answer in the debate.

[Luciana Berger]

My hon. Friend the Member for Bristol East referred to the international comparison that suggests that there is room for improvement in ensuring that we are making the most of donor organs. The Cystic Fibrosis Trust has pointed out that a large number of donor lungs are never used, despite consent from the next of kin. Lungs from fewer than 25% of brain-dead donors are utilised in clinical transplantation. The need for suitable organs must be balanced against possible risks to the recipient, such as transplanting an organ that does not work properly or transmitting a serious disease from donor to recipient. However, I echo the concerns raised by my hon. Friend the Member for Stretford and Urmston (Kate Green) on donor lungs: there are clinically viable lungs within the 75% that are not used and more can be done to address the issue.

Anxiety over the likely function of an organ largely explains why it is only in a minority of cases that all possible solid organs are used. The Government strategy for organ donation and transplantation, published last year, highlighted that sometimes actions that could be taken to improve the function of a retrievable organ are not taken and the organ is declined. On other occasions, organs declined on the grounds of poor function should have been accepted and implanted. What steps are the Government taking to ensure that we are using as many donor organs as possible? I also echo and reinforce the points made and questions raised about supporting patients who are waiting for organs to ensure that, when the time comes, they are psychologically prepared.

This issue is important to all Members, across the political divide. Anyone in this room could one day need an organ donation or have a loved one who does. We are making progress but we must maintain our momentum. I welcome the Government strategy for organ donation and transplantation set out last year. I am happy to work with the Minister and do all I can to promote efforts to improve organ donation and transplantation, to ensure that anyone who needs an organ transplant has one. I look forward to the Minister’s response.

Organ Donation Register

Baroness Berger Excerpts

Tuesday 17th June 2014 Westminster Hall

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank the hon. Member for Burton (Andrew Griffiths) for calling a debate on such an important issue, and for his passionate reflections on organ donation and on the fact that the chance of life for one person can often come at a time of trauma for another family. There were also emotional and personal contributions from the hon. Members for Strangford (Jim Shannon), for Montgomeryshire (Glyn Davies) and for Foyle (Mark Durkan).

Organ donation is surely one of the great success stories of the latter half of the 20th century, not just for science, but for humanity. It is a precious thing: there can be few greater achievements than to have given life to those who were on the verge of death. Fewer than 5,000 people each year die in circumstances in which they are able to become a donor. Despite the sadness of the moment, the act of organ donation can become a major comfort to bereaved families as time passes.

There have been major improvements to the infrastructure and organisation of organ donation over the past few years. Those improvements have been reflected in donation rates, which have increased significantly. I am extremely proud of the fact that in 2001 the previous Labour Government said that we would double the number of donors from 8 million to 16 million by 2010, and achieved that target a year early, by 2009. That was thanks to an enormous effort from large numbers of people.

The recommendations from the organ donation taskforce in 2008 set in train many of the reforms that NHS Blood and Transplant has made. It laid the path for many of the improvements we have seen, such as, for example, the creation of a network of specialist organ donation nurses—already referred to in our debate—who support families in considering organ donation at a difficult time.

As we have heard, over 20 million of us are on the NHS organ donor register. Again, that is testament to the changes that have been made at every level in hospitals, to the commitment of critical care and emergency department staff to donation, and most of all to the generosity of the donors and their families.

We cannot be complacent, however. As we have heard in the debate, we have lower registration rates than some of our European neighbours, and too many people still die while waiting for a donation—three people every day, which is three too many.

We need to raise awareness, and hon. Members have been right to emphasise the need to raise more awareness of the importance of joining the register and supporting our families and friends when they do so. This year marks 20 years since the NHS organ donor register was launched, and there are now many ways in which people can sign up. There is an online form and a 24-hour donor line. People can register through a text message, at their GP’s surgery, or when they apply for their driving licence. I signed up through my Boots advantage card. Yet we still have more to do. Are there any more ways in which we can ask people to sign up? Boots advantage cards are disproportionately owned by women. There are ways in which we can target men; many supermarkets have cards. Should we be thinking about that? I would welcome the Minister’s thoughts on the different ways in which we can encourage people to sign up.

We know from market research carried out by NHS Blood and Transplant that 51% of the population definitely want to donate their organs, and 31% would consider it. Only 31%, however, have actually signed the organ donor register. The question of how to bridge that gap is vital. As MPs, we will all have received e-mails telling us that national transplant week runs from 7 to 13 July, and that is a great opportunity for us all to raise the profile of the issue. Will the Minister share with us the Department’s plans to mark national transplant week and encourage more people to sign up to the register?

As the hon. Member for Burton mentioned, we need to get more people on the register from specific communities. The challenge is not only getting more sign-ups to the register, but targeting specific communities and areas that we know are losing out from the stark inequalities in the system. My constituency is in Liverpool, in the north-west, where patients are waiting the longest for a transplant. We also have the highest death rates among those waiting. In the north-west, 62.2% of patients waited more than six months for a transplant, whereas the average for England is 47.3%; and 23.2% of patients waited more than 18 months for a lung transplant, whereas the average for England is 15.8%. Those long waits are themselves concerning, but where some people are waiting longer than others for a life-saving operation purely because of where they live, it is something we need to address urgently.

It is not just where someone lives that can affect their chance of getting a transplant operation. As we have heard, people from black, Asian and minority ethnic communities are up to three times more likely to need a transplant than others, yet because organ matching is likely to be closer when the ethnicity of the donor and recipient are the same, they have to wait much longer. On average, a person from a BAME community will wait a year longer for a kidney transplant than a white patient. Many die while waiting for an organ to become available, and the Government must urgently tackle that situation.

The debate this morning has centred on organ donation, although Members have referred to bone marrow donation, which is an important area for us to reflect on, and an area where we should look at lessons that we can learn. More than 90% of white patients in need of a bone marrow transplant find a match, but for the BAME population the matching rates can be as low as 40%, which is a difference of 50 percentage points. We need to look at that. I am of Ashkenazi Jewish descent, and I joined the bone marrow register because I know how hard it is for people from my community to find a donor.

A number of campaigns have led to a massive increase in the number of people joining that register. The Berger family—no relation to me—led the campaign #Spit4Mum. A woman called Sharon Berger had a very rare blood disease. She was of Ashkenazi Jewish descent, but she needed to find a match in a hurry. Her children, Jonni and Caroline, started the #Spit4Mum campaign, which has raised awareness among all BAME communities and had a high press profile. There was a 1,700% increase in Jewish people joining the bone marrow register in the year that they ran that campaign. We need to see that happening in all communities right across the country, and it needs to extend to organs as well.

We cannot accept that some of our citizens will be far more likely to die than others because of where they live or their ethnic background. Will the Minister address that point specifically and outline what concerted action the Government are taking to tackle it? In particular, what will the Government do to improve the diversity of the organ donation specialist nurses? Another Member raised that issue.

We need to ensure that the wishes of those on the register are granted, and we must do more to support families in that. In 2011-12, 125 families overruled the individual’s intention, as recorded on the NHS organ donor register, to become an organ donor. Of course, that is understandable. The decision to allow their loved one’s organs to be used is incredibly tough for a family to make when they are in the throes of grief. We know, however, that many family members were unaware that it was what their loved one wanted and found it difficult to come to terms with such a decision at such an awful time of loss. That is why it is vital that we encourage and support families in having conversations about organ donation. Family consent rates have been static at around 55% to 60% over recent years, but that shoots up to 95% when those family discussions take place. NHS Blood and Transplant is taking steps to address that, so I would welcome an update from the Minister on its progress.

Finally, I want to touch on the opt-out or presumed consent system. We have heard some Members’ positions on that, but if more Members had been in the debate, we might have heard a wider variety of views. Some professional groups, including the British Medical Association, consider the system to be the most effective solution in addressing the shortage of organ donors. The system has advantages. To return to an earlier point, there is a gap between the 51% of the population who definitely want to donate their organs and the 31% who have actually signed the register. We would, however, have to consider carefully the safeguards the system would need and continue to review the evidence from countries that already have it in place. Wales will be introducing the system later this year. Any change in legislation would need to have the backing of the public. Whether we agree with assumed consent or not, I hope we can all agree that it is time we started a major public debate about how we can best tackle the shortage of organ donors in this country. What steps is the Minister taking to start that national conversation?

In conclusion, this issue transcends party politics and is important to all Members. We are making progress, but we need to maintain our momentum. I welcome the Government’s strategy for organ donation, which was laid out last year. Its first goal is as follows:

“action by society and individuals will mean that the UK’s organ donation record is among the best in the world and people donate when and if they can.”

I would be very happy to work with the Minister to continue to build awareness of the importance of joining the organ donor register, and to work towards achieving that critical goal.

Oral Answers to Questions

Baroness Berger Excerpts

Tuesday 10th June 2014 Commons Chamber

[Norman Lamb]

I thank my hon. Friend for that question, and it is a legitimate one. A lot of work is being undertaken by NHS England and the national clinical director Geraldine Strathdee, a highly regarded individual, to strengthen the quality of commissioning of mental health services. It falls short in many areas at the moment and it is essential that it is improved.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

Ministers say that they are committed to parity of esteem between mental and physical health, yet we have already learned from an NHS England report that three quarters of children with anxiety or a diagnosable depression are not receiving the treatment they need. This is plainly unacceptable. It would not happen to children presenting with a broken arm or asthma, so can the Minister please tell the House when he will translate his rhetoric into reality?

Cervical Cancer Screening

Baroness Berger Excerpts

Thursday 1st May 2014 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I thank my hon. Friend the Member for Liverpool, Walton (Steve Rotheram) and the other hon. Members who supported the application for this debate to ensure that the House can discuss such an important issue. I also thank hon. Members for their thoughtful contributions throughout the debate, which are a testament to how much the case of Sophie Jones has moved Members on both sides of the House. Not only across this House, but across the country people have reacted with shock and sadness at the death of a young woman that might have been prevented. We need only consider the number of people who signed the petition calling for the Government to look again at cervical cancer screening to appreciate the depth of feeling surrounding this issue. As we heard, 321,956 people signed it, which is more than three times the number required for it to be considered for a debate in this House. As my hon. Friend the Member for Liverpool, Walton said, that is the largest number for any of these petitions.

I would like to take this opportunity to pay tribute to Sophie Jones’s family and friends for their courage, spirit and strength in driving forward this campaign and for their determination to ensure that what happened to Sophie does not happen to another young woman. I am speaking in this debate not just as shadow public health Minister, but as a constituency MP representing Liverpool, Wavertree. My constituency is close to that of my hon. Friend the Member for Wirral South (Alison McGovern), where Sophie Jones lived, and this tragic case has affected people right across Merseyside. I have heard from a number of constituents who have read about Sophie’s story and were very keen for me to participate in this debate.

I was very privileged to meet Sophie’s family with my hon. Friend the Member for Wirral South and hear from them about what a remarkable young woman Sophie was. She was active, well-liked and so positive, and I was so moved hearing about her bravery and positive outlook, even as her cancer took hold—it really is a true inspiration to us all. I am glad that the House has had the opportunity to hear about Sophie’s case, to examine policy on cervical cancer screening and to debate ways in which we can do so much more to ensure that such a tragedy does not happen again.

Cervical cancer is the most common cancer in women under 35 in the UK and although deaths from cervical cancer have plummeted over the past 30 years, about 970 women died from it in 2011 in the UK—that is more than two women every day. Cervical cancer is not normally associated with younger women—as we have heard from a number of hon. Members, it is extremely rare in under-25s. There were 47 cases in women aged under 25 in England in 2011, which was less than 2% of all cases. The House has heard today many good reasons why routine cancer screening is offered when women turn 25. I will not go through them in detail but I will touch on them briefly.

We have heard today, including from my hon. Friend the Member for Liverpool, Walton, about evidence showing that screening all women under the age of 25 can lead to some harmful investigations and treatments. I listened to what the hon. Member for Cheltenham (Martin Horwood) said and I will be interested to hear the Minister’s response and whether she believes that that evidence needs to be reviewed. I am grateful for the opportunity I have had to speak to experts in this field, including at the Liverpool women’s hospital, in preparation for today’s debate. I have heard that there are problems involved in screening under-25s and that young women often undergo natural and harmless changes in the cervix that a smear test would identify as abnormalities. Screening young women would involve putting these women through further tests and investigations they would not otherwise have gone through when, in most cases, the abnormalities would have sorted themselves out without any need for treatment. I understand that the decision for routine cervical screening to begin at 25 was taken after a thorough review of the evidence by expert clinicians and scientists. That decision was reviewed in 2009 by the Advisory Committee on Cervical Screening, which at the time voted unanimously to keep the age at which screening starts at 25, reaffirming the earlier conclusion that the harms of screening women under 25 outweighed the benefits.

The point in the cases of Sophie Jones and of all the other people we have heard about today is that there is heartbreaking proof that, though rare, cervical cancer in the under-25s can happen. We must get better at spotting the signs of the disease and diagnosing it earlier.

I wish to cover three main areas for improvement to which I hope the Minister will respond. First, we must increase awareness of the symptoms not just among women so that they can spot the signs and go to their doctor at an early stage, but among doctors and nurses so that they understand that young women can develop cervical cancer. Secondly, we must ensure that once cancer is diagnosed, women are swiftly referred for treatment. Finally, we must do more to prevent cervical cancer from happening in the first place. We can do that by ensuring high levels of coverage among girls of the human papillomavirus vaccination programme and that eligible women attend their cervical screening appointment.

The cervical screening programme is highly effective at detecting early stages of cancer or pre-cancer, but it is not the best tool for diagnosing cervical cancer once symptoms are apparent, as they were in the case of Sophie. We know that detecting cancer early can make a real difference. The earlier that cervical cancer is diagnosed, the better the outcomes are likely to be. As we heard from the chair of the all-party group on cancer, the hon. Member for Basildon and Billericay (Mr Baron), it is so important that women are made aware of the signs and symptoms of the disease.

I echo the point made by my hon. Friend the Member for Wirral South; it was refreshing to hear a man—my hon. Friend the Member for Liverpool, Walton—listing the different symptoms experienced by women. I will not read them out again, but encouraging women to visit their GP if they have any concern or are showing any of the symptoms is such a simple message that could make a really big difference. Men, as fathers, partners and siblings, can also play a part, by being aware of the symptoms.

The tragedy in Sophie’s case was that she did visit the doctor on a number of occasions, but tragically was not diagnosed accurately. The Government must do more to ensure that GPs are getting the support and the training they need to help them identify cancer signs and symptoms, and that needs to be done during initial training and ongoing professional development. Clinical commissioning groups have a role to play, too. Crucially, we must make doctors aware that, although rare, young women can suffer from cervical cancer.

As much as these improvements at the first point of contact are needed, they are not enough if, once cancer is suspected, people are not seen quickly enough by specialists. We have heard from Members about how important early diagnosis and treatment are. NHS England’s figures on cancer targets for the last three months of 2013 reveal that 4,500 people waited more than two months for treatment after an urgent GP referral, which was in breach of the Government’s own target. That is not good enough, and the Government must urgently get to grips with the failing.

If we are to win the battle against cervical cancer, we must do everything possible to prevent it from occurring in the first place. I am proud of the fact that it was the previous Government who, in 2008, introduced the HPV vaccine, which immunises teenage girls against the majority of the high-risk strains of HPV that are associated with cervical cancer. My hon. Friend the Member for Liverpool, Walton highlighted the very high risks connected with the HPV virus and cervical cancer. All 12 and 13-year-old girls are now being offered the vaccine through their secondary schools. From September 2012 to September 2013, 86.1% of 12 to 13-year-old girls in England went on to receive all three doses of the vaccine. There is room for improvement here, and the Government must do more to encourage girls aged 12 and 13 to participate in the HPV vaccination programme.

As my hon. Friend the Member for West Ham (Lyn Brown) outlined in her contribution, the HPV vaccination alone will not prevent every case of cervical cancer. Alongside the HPV vaccine, the best preventative measure is for eligible women to attend their routine cervical screening appointment. We know that cervical screening saves around 5,000 lives every year in the UK, but, despite that, around 3.7 million women are currently overdue for a smear test. Shockingly, that has increased to 11% since 2009-10.

One challenge is around access to GPs. A YouGov survey for Jo’s Cervical Cancer Trust found that of the women of screening age who have missed or delayed appointments, almost a third of them said that it was hard to book a screening at a convenient time, and 35% said that if GP surgery opening times had been more flexible it would have encouraged them to attend their appointments. As my hon. Friend the Member for Wirral South said, we should do all that we can to encourage and provide the opportunity for women to take up their invitation for a smear test.

I wish to finish by coming back to Sophie and her family. As Sophie's mother, Peri Cawley, said:

“If we can do something to make sure this doesn’t happen to someone else, then Sophie's death will not have been in vain.”

The petition under discussion had hundreds of thousands of signatures, which shows that people across the country support that goal. As today’s debate has shown, Members of this House are clear about what needs to be done. We must increase awareness of the symptoms among not just women, but men and all GPs to ensure that they understand that younger women can develop cervical cancer and are able to spot the signs. We must also ensure that we do more to prevent cervical cancer from occurring in the first place by encouraging girls to have the HPV vaccine and women to attend their cervical screening appointments. We now look to the Government to take the action that is needed to make progress on those counts and to ensure that there is no repeat of the tragedy that happened to Sophie Jones. I look forward to the Minister’s response.