Oral Answers to Questions

Margaret Ferrier Excerpts

Tuesday 8th June 2021 Commons Chamber

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

What steps the Office for Health Promotion plans to take to promote mindfulness in supporting good health.

[The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries)]

Work on the scope and organisation design of the Office for Health Promotion is ongoing. We will present more detail on our plans for the OHP in due course. Public Health England’s “Better Health—Every Mind Matters” social marketing campaign aims to inform and equip the public to look after their mental health. Its NHS-endorsed website offers guidance on the actions that people can take to improve their mental wellbeing, including by practising mindfulness and reflection.

[Margaret Ferrier [V]]

Research shows that mindfulness training can contribute to improvements in obesity, eating behaviours, addiction and mental health and wellbeing. Will the Minister ensure that the Office for Health Promotion looks at the evidence of how mindfulness can help with how we all manage our health?

[Ms Dorries]

There is emerging evidence on the mental health benefits of mindfulness, which can take the form of meditation or wider approaches that incorporate a mindful approach. As the hon. Lady may be aware, I have been particularly concerned that we separate out mental illness and wellbeing and mindfulness. We should focus on mental illness, which needs intense clinical intervention in NHS services, but also look at mindfulness and wellbeing. That is why I mentioned “Every Mind Matters”: the facilities are there.

Covid-19

Margaret Ferrier Excerpts

Monday 28th September 2020 Commons Chamber

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP)]

It is a pleasure to follow the hon. Member for Tonbridge and Malling (Tom Tugendhat). I start by paying tribute to all NHS key workers and volunteers in my constituency for their care and commitment over the past seven months.

I will focus my comments on the economic health of my constituents this evening. For many months now, my constituents have been contacting me to express their fears and concerns about the end of the furlough and self-employed income support schemes. They told me how they were at serious risk of redundancy, and they are worried that their livelihoods will be at stake if the scheme ended prematurely. The Chancellor’s announcement last week simply does not do enough to support those people whose jobs are at risk due to the pandemic. Dropping the Government contribution from 80% of wages to 22% of wages in the transition from furlough to the job recovery scheme means that firms that could still be viable but are not yet able to resume business activity now face the awful choice of closure or mass redundancies.

Scottish Government analysis suggests that this move could result in the loss of 61,000 jobs in Scotland when compared with an eight-month extension to the previous furlough scheme. This kind of extension would place Scotland on a similar footing to the French and German furlough schemes if it had the power to extend furlough in its own right. The same considerations apply to the self-employed income support scheme, for the cut from 70% of average earnings to 20% of average earnings does not reflect the reality of many self-employed constituents who contacted me to say that their work is not picking up at a high enough level to survive without the support offered by self-employment income support.

Unfortunately, the Chancellor’s announcement comes far too late for some of my constituents. Tom, a sales rep from Blantyre, was placed on furlough at the end of March, but his company made him and 45 colleagues redundant as a result of restructuring due to the pandemic. He cannot get support through the jobs recovery programme, and there is not an option for him under this scheme to retrain, unlike in Germany, where Kurzarbeit would give him that opportunity to obtain new skills. Kurzarbeit has been established for more than a century in Germany, and it is a great example of using preventive spending to create a safety net during tough economic times.

When recessions have hit the German economy, the Germans have been able to keep skills within the workforce for when times get better, adapting the scheme to reflect the prevailing economic circumstances. As much as the Chancellor would like to think that his jobs recovery scheme achieves similar outcomes to those of the Kurzarbeit scheme, the design of his scheme still makes the inherent assumption that if a job cannot be sustained at a minimum of a third of the hours at this point in time, then it is not possible to retain that job at all. Given that some sectors, such as the events industry, are continuing to rely on furlough because they cannot reopen substantially, cutting the support available to them risks mass lay-offs and will trigger a loss of skills in those industries, which will be felt for years to come.

I think we have to ask ourselves at this moment in time whether the UK Government have truly done everything they can to avoid mass redundancies due to the coronavirus pandemic. Given the history and experience of the 1980s, I believe that this Tory Government will again fail my constituents and fail communities across Scotland by drastically cutting back the levels of support that were offered by the furlough and self-employed income support schemes. That will only strengthen the desires of the people of Scotland to have the powers needed to support our economic recovery and avoid a lost generation.

Covid-19 Update

Margaret Ferrier Excerpts

Thursday 17th September 2020 Commons Chamber

[Matt Hancock]

That is an important question. It is a very difficult balance, because often informal childcare is grandparents looking after children and older people are, of course, the most vulnerable to the disease. That is the balance that we need to strike. I always keep an open mind and I am very happy to talk to my hon. Friend about getting the balance exactly right in his area.

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP)]

The Government’s plans for mass testing have been criticised for placing their faith in technologies that are yet to be fully validated scientifically. The Prime Minister himself acknowledged that we are some way off the widespread use of pregnancy-style covid-19 tests. Given the well documented issues with capacity in the UK testing system at the moment, does the Health Secretary accept that we need to focus on ensuring that the existing system works before trying to shoot for the moon?

[Matt Hancock]

We need to do both. I would just ask the hon. Lady to look at the work the SNP Scottish Government are doing. They are themselves employing and deploying some of the new technologies.

Coronavirus

Margaret Ferrier Excerpts

Wednesday 17th June 2020 Commons Chamber

[Matt Hancock]

Yes, I will do absolutely everything I can. I did not know that my hon. Friend’s wife suffered from cystic fibrosis. I am absolutely determined to make this happen. I worked really hard with the CF community to land Orkambi and I was very proud when we managed to do that. Thank goodness we did that before coronavirus struck, because for many who caught coronavirus it was literally a lifeline. Trikafta has great promise: it promises to be able to treat almost all CF sufferers, as opposed to the approximately half that Orkambi successfully treats. I have been working on that even during the crisis and I really, really hope we can make some progress.

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP) [V]]

On 5 May, the first trial of the NHS covid-19 app started on the Isle of Wight. Since then information on the app’s development has been scarce. It has been beset by delays, with media reports suggesting that the app has some technical problems with accurately estimating distance between phones. That is worrying because the app is intended to expand contact tracing in England. When will the Health Secretary publish the results of the pilot and outline his plans for a wider roll-out of the app?

[Matt Hancock]

Those reports were wide of the remark and the app does not have a problem with the measurement of distance. But I will come forward with an update very soon.

Oral Answers to Questions

Margaret Ferrier Excerpts

Tuesday 21st March 2017 Commons Chamber

[Nicola Blackwood]

As I mentioned, we will be publishing the reformulation baselines against which all future success will be measured. They will include measurement across all industry targets. In addition, we will of course have the voluntary healthy rating scheme for primary schools to recognise and encourage their contribution to preventing obesity.

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

As part of our ambition to make the NHS the safest healthcare system in the world, I will today be speaking at the largest ever conference on learning from avoidable deaths and what we can do to improve care in the future. As part of that, I can inform the House that the NHS Litigation Authority will radically change its focus from simply defending NHS litigation claims to the early settlement of cases, learning from what goes wrong and the prevention of errors. As part of those changes, it will change its name to NHS Resolution.

[Margaret Ferrier]

My constituent Pauline Cafferkey was cleared of misconduct last September, following a very public case surrounding her return from Sierra Leone and her contraction of Ebola. Will she receive an apology from Public Health England and will it reimburse her legal costs?

[Mr Hunt]

With respect to Pauline Cafferkey, who is a very brave lady and who gave very good service to this country and the people of Sierra Leone with her work during the Ebola crisis, the hon. Lady will understand that disciplinary procedures are an independent matter. They are not dealt with by the Government. They have to be done at arm’s length and we have to respect whatever is said or done.

NHS Shared Business Services

Margaret Ferrier Excerpts

Monday 27th February 2017 Commons Chamber

[Mr Hunt]

I am very happy to follow my hon. Friend’s advice in that respect. I think we all know that although the proper use of electronic records creates huge opportunities, we have to carry the public with us and make sure they are confident that the data will be held securely. That is why we have introduced the new post of a National Data Guardian, Dame Fiona Caldicott, who is the patients’ watchdog in this area.

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP)]

NHS Shared Business Services Ltd exists for one reason only, which is to deliver £1 billion in savings by 2020. The results of this Government’s ideological obsession with savings and austerity have surely now been laid bare for all to see, and we are quite lucky that this did not, quite literally, kill anyone. Will the Secretary of State agree to meet the Chancellor urgently to discuss increased funding for a health service that is being starved of the resources it needs to run effectively?

[Mr Hunt]

The result of our “ideological obsession” with savings and austerity is that we have increased spending on the NHS twice as fast in England as the hon. Lady’s party has in Scotland.

Oral Answers to Questions

Margaret Ferrier Excerpts

Tuesday 20th December 2016 Commons Chamber

[Nicola Blackwood]

Yes.

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP)]

Certain supermarkets persist in placing less healthy foods on promotion near the entrances to their stores, where they are unavoidable. Does the Minister agree that it is not just at checkouts that healthy options should be promoted, and that retailers should exercise more responsibility?

[Nicola Blackwood]

I absolutely agree that putting healthier options near checkouts and helping people to make healthier choices are part of retailers’ responsibilities. What has been notable in my discussions with retailers is that the penny is starting to drop that this is the direction of travel and what the public want, and I think we are going to start seeing a real sea change in the way retailers are advertising.

Land Registry

Margaret Ferrier Excerpts

Thursday 30th June 2016 Commons Chamber

[Chris Stephens]

The hon. Gentleman makes an excellent point, and I will come on to that. The New Economics Foundation states in its research that only an in-house Land Registry can continue to deliver a quality, trusted and impartial public service while fairly bringing in new revenue. In the research, the foundation also revealed that the Government’s assurances about the service are meaningless, because no risk assessment has been undertaken; and that a private company, naturally seeking to maximise profits, would inevitably put up fees to achieve an increased profit margin. There are also risks in the proposals to all users of the system, to any future Government planned infrastructure build, to the housing market, to the wider economy and to the national interest as increasing amounts of land are sold off, all too often to unknown overseas individuals and companies, as has been said.

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP)]

Just last week, it was announced that the Ministry of Defence is set to privatise the repatriation and burial of war casualties—an idea that I find abhorrent. Does my hon. Friend agree that that is a clear sign that the Government’s privatisation agenda is ideological?

[Chris Stephens]

It is quite clear that we have an ideological Government, and they will be debating among themselves how far that ideology will take them.

As many hon. Members have pointed out, if the Land Registry is privatised, it would not be subject to freedom of information requests or the Freedom of Information Act, and it would be easier to conceal information on that basis. There is also the issue of local land charges. In 2014, the Land Registry added to its scope additional services such as land charges. The Land Registry is looking at the rules, and it concerns me that its consultation on the matter contains only a passing reference to privatisation plans and no mention of what impact they would have on local land charges or the local land charges service. Local land charges service providers have seen their business removed and nationalised, and now it may be sold off to a large conglomerate before the nationalisation has even taken place.

In the words of the former chief land registrar, John w, the Land Registry is

“highly regarded by those who depend on it as a provider of trusted, prompt services. Land registration is not an activity that any responsible Government can transfer to the private sector.”

I urge Ministers to abandon these damaging plans for the Land Registry service.

Oral Answers to Questions

Margaret Ferrier Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Jane Ellison]

Absolutely. My hon. Friend again highlights where we are investing, upgrading machines and putting in money, effort, people and resources to make sure that we can achieve world-class cancer outcomes. As I say, we are on course for record outcomes in terms of patients surviving 10 years beyond a diagnosis. However, we always want to do better, so I applaud the local efforts that she has highlighted.

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP)]

I would like to reiterate what the Minister said. As I sure my hon. Friends would agree, our thoughts go out to everybody in Brussels at this time.

Will the Minister please inform the House of what consideration has been given to bringing the bowel cancer screening age into line with that in Scotland—at 50 rather than 60—following the recent Westminster Hall debate on this subject?

[Jane Ellison]

We had an excellent debate. An extraordinary number of colleagues turned up in Westminster Hall, a debate of just half an hour, demonstrating how many people are interested in this important subject. I outlined in my response to the debate the fact that we have the bowel scope screening programme and the bowel cancer programme in England, which complement each other. The result, particularly of bowel scope screening, is that we can actually make a huge impact on mortality rates for people who are caught. I went into that in more detail in my response to the debate, but that is the key to making sure we identify more people and stop them dying from this dreadful disease.

Bowel Cancer Screening Age

Margaret Ferrier Excerpts

Tuesday 8th March 2016 Westminster Hall

[Caroline Ansell (Eastbourne) (Con)]

I beg to move,

That this House has considered bowel cancer screening age.

Bowel cancer is second only to lung cancer for the number of lives it takes. Across the country, 165,457 people have signed a petition to bring down the bowel cancer screening age in the UK in a bid to hit this devastating disease.

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP)]

It is extremely unfortunate that bowel cancer— screening is available only in England, Wales and Northern Ireland from the age of 60. Would the hon. Lady’s welcome the Scottish Government’s approach of screening people from the age of 50 being taken up across the rest of the UK? That would surely give many individuals an early diagnosis and a higher chance of survival.

[Caroline Ansell]

I thank the hon. Lady for her intervention. I recognise that earlier screening in Scotland and would certainly welcome it.

The petition that I mentioned has been well supported; in fact, it has had 500 new signatories this very day. The originator of the petition, Lauren Backler, has travelled from Eastbourne to be with us today in Westminster. May I at this point pay tribute to her courage and endeavour? For anyone hearing the news that they or a loved one have been diagnosed with bowel cancer, it will be simply earth-shattering, as Lauren knows. She writes:

“On 2nd December 2014, my Mum Fiona Backler was diagnosed with bowel cancer, at Eastbourne DGH’s”—

Eastbourne District General Hospital’s—

“Accident and Emergency and was told a few days later that the cancer was terminal. She started palliative chemotherapy within a week, but despite us being told that potentially she could have up to 2 years to live, she passed away on 28th March 2015, just under 4 months after diagnosis and a week after her 56th birthday. Before she was diagnosed, she had been back and forth to her GP with vague symptoms, and had even had an endoscopy about a year and a half beforehand, which she had been told was all clear. When she was diagnosed, her consultant told us that the cancer had possibly been missed at that stage.

Bowel cancer screening can often pick up abnormalities in people who have no symptoms at all, and so I believe that if the screening age was lowered to 50 it would give thousands of people a fighting chance of beating the disease.”

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. The quite extraordinary level of participation in this half-hour debate speaks volumes about the level of interest in and engagement with this issue from parliamentarians. I congratulate my hon. Friend the Member for Eastbourne (Caroline Ansell) on securing the debate. I am grateful that I had the opportunity to speak to Lauren at the Beating Bowel Cancer reception here in the House in January and to have heard her story in person. My officials and I enjoyed that conversation. As my hon. Friend said, she is a remarkable young woman.

Bowel cancer is one of the most common types of cancer. The statistics around the number of people who die from it each year have been eloquently explained. We accept that we as a country want to do better. That is why, looking at cancer in the round, NHS England set up the independent cancer taskforce, which produced the new strategy “Achieving world-class cancer outcomes”. That was widely welcomed when it was published last July. The Government are committed to implementing the recommendations of the taskforce, and that will see improvements right across the cancer pathway, including in screening. The strategy sets a clear ambition for a further improvement in survival rates. They have improved, as my hon. Friend said, but we want to go further.

Today’s focus is very much on screening, which is a crucial part of diagnosing bowel cancer early. We know that outcomes are significantly better for people diagnosed at stages 1 and 2 as compared with stages 3 and 4. When deciding whether to undertake bowel cancer screening, we have to remember that it is a choice for each individual, so it is important that people are provided with the information they need to make an informed decision. I will go on to talk a little about how many people either decide not to do it or do not get round to doing it. Screening is a significant challenge, and I welcome attention being given to it.

On the advice of the UK National Screening Committee, the expert body that advises Ministers and the NHS in the four UK countries about all aspects of screening policy, bowel cancer screening using the faecal occult blood self-sampling test is offered in England. The bowel cancer screening programme offers screening using the kits every two years to men and women aged 60 to 74 who are registered with a GP. Men and women aged over 74 can self-refer for screening every two years if they wish. People eligible for screening receive an invitation letter explaining the programme, along with an information leaflet explaining the benefits and risks of bowel cancer screening. By the end of January 2016, nearly 29 million men and women in England had been sent a home testing kit and more than 17.5 million had returned a kit and been screened. More than 24,000 cancers have been detected, and nearly 70,000 patients have been managed for high or intermediate-risk adenomas, or polyps, including polyp removal.

The age issue has been the focus of much of the comment today. The NHS bowel cancer screening programme began in 2006, with full roll-out completed in 2010. The programme initially offered screening to men and women aged 60 to 69 because the risk of bowel cancer increases with age. More than 80% of bowel cancers are diagnosed in people aged 60 or over. In the pilot, which was conducted in Coventry and Warwickshire and in Scotland in the late 1990s and early 2000s, more than three times as many cancers were detected in people aged over 60 than in those aged under 60, and people in their 60s were most likely to use a testing kit. Only 47% of men aged 50 to 54 completed a kit, compared with 57% of men aged 60 to 64.

There are also issues of capacity, particularly for endoscopy services, as has been mentioned. The roll-out of screening required that the NHS bowel cancer screening programme take into account and help balance the increasing workloads and pressures placed upon services providing diagnosis and treatment to all people with bowel cancer, not just those found through the screening programme. I emphasise that point to the House, because it is important. The latest routes to diagnosis figures from Public Health England show that in 2013, only 9% of bowel cancers were diagnosed through screening. That 9% is important, but it compares with the more than 50% of bowel cancers that were diagnosed following a GP referral. Sadly, 25% were diagnosed via emergency routes, and those have very poor survival rates because the cancers tend to be at a later stage. The programme has to be able to respond. The skills and the clinicians we need to respond to those GP referrals have to be available, so there is always a difficult balance in terms of the resource we need.

The programme was also required to consider possible changes to it. One such change—this is an important point that has not quite come out in the debate so far—is bowel scope screening, also known as flexible sigmoidoscopy, for people in their 50s. It is a one-off examination that is an alternative and complementary bowel screening methodology to the self-testing kit. It aims to find polyps before they turn into cancer, so it actually prevents cancer ever developing. Evidence has shown that men and women aged 55 to 64 attending a one-off bowel scope screening test could reduce their individual mortality from the disease by 43% and their individual incidence of bowel cancer by 33%.

In 2011, the UK National Screening Committee recommended offering bowel scope screening for bowel cancer. The NHS bowel cancer screening programme is currently rolling it out to men and women around their 55th birthday. They will be invited to take part in the self-testing part of the programme from age 60. Although Scotland is piloting bowel scope screening for some people in its programme, England is the only UK country committed to a full roll-out. Some 77% of bowel scope screening centres in England are currently operational. The Secretary of State is committed to rolling out bowel scope screening to all screening centres in England by the end of 2016, and we are on track to deliver that commitment.

As of the end of January, more than 230,000 invitations had been issued and more than 85,000 bowel scope screening procedures performed. Although that is very good, Members who can do the maths quickly will realise that uptake is currently running at 44%, compared with nearly 60% for the self-sampling part of the programme. If, on the back of this debate, Members can do anything to raise awareness in their constituencies and to empower men and women to make informed decisions about taking up these free tests, I encourage them to do so.

[Margaret Ferrier]

Will the Minister give way?

[Jane Ellison]

I am afraid that I cannot take any interventions because there were so many in the opening speech. I do apologise, but I really want to get through my response.

So far, nearly 3,500 people have attended colonoscopy following bowel scope screening, with 125 cancers detected, and 1,688 people with high or intermediate-risk polyps and 1,270 people with low-risk polyps have had them detected and managed or removed.

Delivering the bowel scope screening programme will obviously place huge demands on endoscopy services, but it can be safely delivered by members of the hospital team other than trained doctors, such as nurses. That is why we announced in September last year that Health Education England is developing a new national training programme for an additional 200 non-medical staff to get the skills and expertise to carry out endoscopies by 2018. The first cohort began training at the end of January. In addition, NHS England’s sustainable improvement team is working intensively with trusts that have significant endoscopy waiting lists, in order to improve performance. That learning will then be shared widely. NHS England is also exploring ways to improve endoscopy performance through pricing changes.

I have already mentioned low uptake rates. We know uptake is lower in more disadvantaged groups, in men—as has been referred to—and in some black and minority ethnic groups. Public Health England is providing support and technical advice to its partners in the NHS on reducing the variation in coverage and uptake. Local screening providers are working with commissioners to address that, which is really important, because some of the variation in these important programmes is astonishing. Again, if any Member can do anything to reduce the variation, it would be greatly appreciated.

The Independent Cancer Taskforce has also recommended an ambition for 75% of people to participate in bowel screening by 2020. To facilitate that change, it recommended a change to a new test, the faecal immunochemical test—FIT—which is more accurate and easier to use than the current FOB test and also improves uptake. I encourage Members with an interest to compare the two tests and try to understand how different they are and why they are likely to have such different effects.

My hon. Friend the Member for Eastbourne will be aware that in November last year the UK National Screening Committee recommended that the FIT test should be used as the primary test for bowel cancer screening instead of FOB. We are currently considering that important recommendation. If it is accepted, it is worth remembering that it will be a major change to a programme that saves hundreds of lives, so we will have to ensure that it is rolled out in a safe and sustainable way, which will include the procurement of cost-effective kits and IT systems.

In any debate about cancer screening it is important to underline the difference between population screening programmes and people going to see their GP with the symptoms of cancer. Information for the public on the signs and symptoms of bowel cancer is available on the NHS Choices website. The Department advises people who are concerned about their risks to speak to their GP. Many of the cancers we have heard about in the debate were found at a very late stage. It is probable that there were some symptoms that could have led to a GP referral.

Since 2010-11, the Department and Public Health England have run 10 national “Be Clear on Cancer” public awareness campaigns, including two national campaigns to promote the early diagnosis of bowel cancer. The first campaign ran from January to March 2012, raising awareness of blood in poo as a sign of bowel cancer. It was the first ever national TV campaign to raise awareness of the symptoms of this cancer and to encourage people with relevant symptoms to go to their doctor without delay. A second campaign ran later that year.

The National Institute for Health and Care Excellence has guidelines on the recognition and referral of suspected cancer, which were updated in June 2015. That is important because in updating them NICE urged GPs to lower the referral threshold when they are assessing whether a referral is appropriate and to think of cancer sooner when examining patients. Switching the way we think and lowering the referral threshold is a critical change that NICE estimates will save many thousands of lives. Of course, professional advice is also available through the various expert bodies.

I emphasise that all screening programmes are kept under review, and the UK National Screening Committee will always look at new evidence. I will of course make sure that our expert advisers are aware of the significant parliamentary interest that has been demonstrated today. In responding to this short debate, I have been trying to illustrate the interaction between the two different parts of the programme—bowel scope screening and the original screening. I have also been trying to underline the point about take-up. Of course it is about individuals making an informed decision, but beyond rolling screening out to different ages, we must ensure that people in the highest risk groups, particularly the over-60s, are aware that they can choose to be screened. Many lives could be saved, so it is really important that we get that message across. We can do more.

In conclusion, I thank my hon. Friend the Member for Eastbourne again for securing this debate and drawing the important issue of bowel cancer screening to the attention of the House. I assure her and the families of all those affected—including, of course, Lauren, who started the petition—that preventing premature death from cancer is of the utmost priority for the Government. I hope I have set out how we are responding to that vital challenge.

Question put and agreed to.