Children with Life-limiting Conditions

Mary Glindon Excerpts

Tuesday 29th January 2019 Westminster Hall

[Mary Glindon (North Tyneside) (Lab)]

It is an honour to serve under your chairmanship, Ms Dorries.

I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate. He and I are both members of the all-party group for muscular dystrophy, so I know that his commitment to the issues being discussed this morning is genuine.

Following on from my hon. Friend the Member for West Ham (Lyn Brown), I will talk about Spinraza, because nothing is more fundamental for anyone with a life-limiting or life-threatening condition, or their families, than to have access to treatment that will give the chance of a better quality of life and, possibly, some chance of longevity.

As my hon. Friend said, one of the rare conditions that until the last few years has had no proven treatment is SMA. There are four types, and the most severe is type 1. Infants diagnosed with that have a life expectancy of no more than two years. The condition affects the lower motor neurones in the spinal cord, leading to loss of mobility and eventually of the ability to breathe and swallow.

The drug Spinraza, which was developed and marketed by the pharmaceutical company Biogen, is the only treatment that has proved successful for children with SMA. Spinraza was granted a marketing authorisation by the European Medicines Agency more than 18 months ago. It is available in 24 European countries including Scotland, as has been said, but not in other parts of the UK.

The APPG, which I chair, has supported the work of our excellent secretariat organisation, Muscular Dystrophy UK, and other groups to press for Spinraza to be approved by NICE. Many MPs across the House with constituents who suffer from SMA feel the frustration of families waiting for Spinraza to be approved. So far, however, progress has been slow. That is largely due to the fact that Spinraza has been assessed by NICE under the single technology appraisal, or STA, route, which is not appropriate for such a rare condition. That route is normally used for more common conditions, and it is now a year since the assessment began. Also, in August, when NICE published its initial decision on access to the drug, it did not recommend Spinraza for use on the NHS. That was a bitter blow for all the families, including the family of young Sam McKie from North Tyneside, who has the condition.

Biogen opened an expanded access programme globally in 2016, as an interim solution for patients with infantile-onset SMA. In the UK, the programme was extended to support continued access for those patients until NICE completed its appraisal. To date, more than 80 eligible children in the UK have received the drug free of charge. Under the timeframes provided by NICE, the final appraisal document was scheduled for last November; therefore, disappointingly, Biogen closed its access to the EAP for new patients.

Since August, the APPG has been active in pressing NICE, NHS England and Ministers to be flexible in finding a way forward, and I raised the issue at Prime Minister’s questions in September. There is an impasse, because NICE continues to require that Spinraza should be cost-effective through the STA route, but Biogen has pointed out that, given the smaller patient population in rare diseases, it is inappropriate to expect treatments to achieve the same cost-effectiveness thresholds as medicines in disease areas that have much larger patient populations.

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 19th June 2018 Commons Chamber

[Mr Hunt]

Yes, I can.

[Mary Glindon (North Tyneside) (Lab)]

11. What recent discussions his Department has had with representatives of NICE on increasing the capacity of the highly specialised technologies evaluation process.

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

My officials have regular discussions with the National Institute for Health and Care Excellence, of course, but we are clear that there is no fixed capacity in NICE’s HST programme. The number of drugs that it evaluates each year is driven by the pipeline of drugs expected to come to market, and we will refer any suitable drugs to it for evaluation.

[Mary Glindon]

There is a risk that new treatments for life-limiting conditions, such as Duchenne muscular dystrophy and spinal muscular atrophy, might not be approved by NICE, so will the Minister meet me and Muscular Dystrophy UK to discuss ways to facilitate access to treatments, as highlighted by the charity’s FastTrack campaign?

[Steve Brine]

NICE has recommended the drug Translarna for use in the treatment of Duchenne muscular dystrophy; it is now routinely available on the NHS. It is a disease that I grew up with—the friends that I grew up with did not, and I did, and this is a timely reminder of how terrible this disease can be. I would be really pleased, therefore, to meet the hon. Lady and the charity that she mentioned.

Neuroblastoma

Mary Glindon Excerpts

Tuesday 23rd January 2018 Commons Chamber

[Steve Brine]

I am glad that the hon. Gentleman is here. He raised the same point last week during the Westminster Hall debate on blood cancers, to which I responded. As he had to leave before I did so, I will repeat what I said then. Obviously, once devolved government returns to Stormont and there is a Health Minister in the Northern Ireland Executive, I shall be happy to meet him or her, and I am sure that the hon. Gentleman would like to be involved in that meeting. We shall then be able to talk about some of the successes that we have had in England and some of the things that I am sure we can learn from Northern Ireland.

An even more precise form of radiotherapy that can be used in neuroblastoma treatment is proton beam therapy. It sounds like something out of the future, and in many ways it is, but the future is coming. In 2012, the Government provided some £250 million for the building of two PBT centres in England, at University College Hospital here in the capital and at the Christie cancer centre in Manchester. I had the privilege of visiting the Christie last year—I happened to be there in the autumn, for some reason—to see its new PBT facilities, which are incredible and which will be providing treatment for patients later this year. As a result, the NHS will no longer need to send young patients to the United States—which has caused great upheaval to patients and their families, has had an impact on patient outcomes and has, of course, involved huge expense to the families and the NHS—for this cutting-edge treatment.

My hon. Friend the Member for Spelthorne spoke about guidance from the National Institute for Health and Clinical Excellence. We want the very best new innovative treatments, such as the promising antibody therapy we have heard about today, to be available on the NHS. NICE is the independent body that provides guidance on whether drugs and other treatments represent a clinically effective and cost-effective use of resources in the NHS—a publicly funded health system. I am advised that NICE is currently considering two antibody-based treatments for neuroblastoma. It is appraising Dinutuximab-beta for use in high-risk neuroblastoma, but the appraisal has been delayed as NICE awaits additional evidence from the drug company. Final guidance on the use of any drug can be issued only after careful consideration of all the available evidence and extensive engagement with stakeholders. That has to be the right approach, however frustrating it is. Another drug used in the treatment of high-risk neuroblastoma is dinutuximab or Unituxin. NICE’S appraisal of this drug, which is in the same family as Dinutuximab-beta but is distinctly different, has also been suspended as demand for the drug in the United States has exceeded expectations and is outstripping the company’s ability to meet global need.

I stress that just because drugs are not routinely available to patients on the NHS that does not preclude their use. Clinicians can make a case on a patient’s behalf for exceptional funding if they believe a particular treatment would deliver the best clinical outcomes. I understand that Alfie’s consultant is looking at doing that. Individual funding requests made by a supporting clinician are always a potential route for access to treatments that are not currently commissioned by the NHS. NHS England is not aware of any IFR in Alfie’s case, but I will be happy to make it so, working with my hon. Friend, following tonight’s debate.

Despite the strides we have made in increasing overall cancer survival rates, we recognise that there are some cancers where progress has been far too slow. That is why our focus for these cancers is on research and innovation, and ensuring that proven innovations, once they are discovered, are adopted swiftly across the health service in England. I am pleased to say that the Government are fully supportive of the Less Survivable Cancers Taskforce, which I launched last summer here in the House, specifically to address the survivability gap between the least and the most survivable cancers. I met the taskforce just before Christmas to discuss how we can work together to raise awareness of the symptoms of cancer and how we can ensure that less survivable cancers have better access to research funding. That is a promising workstream. The taskforce is a cutting-edge group and I look forward to working with it.

Cancer Research UK is also funding research to better understand childhood cancers such as neuroblastoma. In September 2016, the Government announced the largest ever investment in health research infrastructure—£816 million over five years from April 2017 for 20 National Institute for Health Research biomedical research centres in England. That was a big step, and I am sure hon. Members recall the Prime Minister’s announcement. That includes £61.5 million in the biomedical research centre at the Royal Marsden Hospital here in London and the Institute of Cancer Research. The NIHR spent £137 million on cancer research in 2016-17—an increase from just over £100 million in 2010-11. That investment in cancer research is of huge importance and constitutes the largest in a disease area.

[Mary Glindon (North Tyneside) (Lab)]

I am not sure whether this has any bearing on the subject of the debate, but will the accelerated access review help to bring some of these potential new treatments forward more quickly?

[Steve Brine]

The accelerated access review is an important piece of work, and I will be happy to write to the hon. Lady in more detail than I have time to go into now. It is about bringing treatments quickly to the market for patients’ use once they are approved, instead of having to take a rather arduous and tortuous route.

I want to put on record that we want the NHS to be the best in the world at treating childhood cancers and all cancers. We can only imagine the pain that Alfie’s family are going through, and they have our prayers and our support. I hope my hon. Friend the Member for Spelthorne will agree that the Government are working hard, even in difficult economic times, to implement the cancer strategy, to invest in research and to continue the investment in cancer treatment to ensure that we can lead the world in the fight against cancer and make this a reality by making life better for people like Alfie.

Question put and agreed to.

Drug Addiction

Mary Glindon Excerpts

Wednesday 22nd November 2017 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gapes.

Let me start by thanking the hon. Member for South Thanet (Craig Mackinlay) for securing this important debate, and for his excellent opening speech, which laid out all the human and associated monetary costs that drug addiction costs society and indeed the Exchequer. His figures are even greater than the ones I will be citing in my contribution, which is perhaps because he included all classes of drugs. I will only be citing figures for class A drugs, but that shows the enormity of the costs that we are dealing with today.

While there is a very important debate going on in the main Chamber, it is welcome to see the number of MPs here today to discuss this important issue. We have had many excellent contributions to the debate, including from the right hon. Member for North Norfolk (Norman Lamb), the hon. Members for Reigate (Crispin Blunt), for Inverclyde (Ronnie Cowan) and for Henley (John Howell), and the hon. Member for Glasgow East (David Linden), who is the Scottish National party spokesperson; he made a pertinent and moving speech, and I commend him for that. They all made strong and thought-provoking speeches, and we have had some excellent interventions. I thank all Members for taking the time to set out their positions and thoughts on drug addiction and the costs to society.

As we have heard, drug addiction is one of the most deeply concerning issues we face today. Drug addiction, in its many guises, can blight communities and the lives of so many people, which is why it is vital that policy is developed to significantly reduce the harm that addiction can inflict on individuals and communities. According to Home Office figures, the number of people taking drugs has fallen significantly over the past decade. That is to be welcomed. Reducing the number of people taking drugs is a step in the right direction to not only improve the health of the nation but reduce crime and pressures on our public services.

Sadly, if we scratch the surface, we unveil more uncomfortable truths that the Government must face. In 2016, there were a total of 2,593 drug misuse deaths involving illegal drugs—the highest number since comparable records began in 1993. That trend in avoidable deaths is reflected across both genders. However, for men the drug misuse mortality rate has jumped sharply over the last three years and reached a new peak of 67.1 deaths per million people—another high since records began in 1993. The female rate is less pronounced but is also at an all-time high.

Across Europe, it is estimated that a total of 8,441 deaths occurred due to drug overdose in 2015, mainly from heroin or other opioids. Here in the UK, we come out on top with the highest percentage of those deaths, at 31%. That is absolutely damning, especially when the Advisory Council on the Misuse of Drugs stated in a report last year that England alone saw an increase of 58% in opioid deaths between 2012 and 2015. Much of that is put down to ageing users of heroin and opioids, which gives rise to the question: what are the Government doing to address the often complex social care needs of drug addicts?

It is not only the deaths that occur from drug misuse and addiction that are concerning, but the costs to society in general, as we heard from the hon. Member for South Thanet. In terms of monetary costs, it is estimated that class A drugs such as heroin and crack cocaine cost us £15.4 billion a year, which is £44,231 per problematic user. Broken down, that figure is roughly £13.86 billion on social and economic costs, £535 million on drug arrests and £488 million on the NHS dealing with mortality and morbidity and providing acute treatment and support for mental health and behavioural disorders associated with drug misuse. As I said, that is just for class A drugs. When we include all classes of drugs, the sums increase substantially, as has been set out in detail.

[Mary Glindon (North Tyneside) (Lab)]

Does my hon. Friend agree with the drugs, alcohol and justice cross-party parliamentary group that, to reduce alcohol and drugs-related deaths and illnesses, a co-ordinated harm reduction strategy needs to be prioritised?

[Mrs Hodgson]

Yes, I do agree.

It is no wonder, when we go off all these figures, that earlier this year the UK was deemed the overdose capital of Europe and is now seen internationally as having serious shortcomings when it comes to addressing addiction and drug misuse. What are the Government going to do to address these problems? I am sure the Minister will cite the recent publication of the drugs strategy in the summer. As he will know, Opposition Members welcomed the strategy, but it left us wanting. There is much to be welcomed in it, but it is clear that what was announced has not moved us on any further from what was happening in 2010 and now works within a seriously reduced financial envelope due to short-sighted cuts to public health budgets.

The Minister knows all too well that public health budgets have been decimated, with an estimated £800 million expected to be siphoned out of local budgets by 2021. That has meant drug rehabilitation services being closed and budgets to tackle drug abuse cut, all against a backdrop of an NHS under significant pressure. Labour’s analysis of figures published by the Department for Communities and Local Government shows that this year we will see 106 councils reduce drug treatment and prevention budgets by a total of £28.4 million; 95 councils reduce alcohol treatment and prevention, at a total of £6.5 million; and 70 local authorities reduce drug and alcohol services for children, at a total of £8.3 million. That works out at a total reduction of £43.3 million imposed by the Minister’s Government on a whole host of services created to prevent and treat addiction problems. Those figures are unavoidable and shameful. We should be putting greater emphasis on the radical upgrade in public health and prevention promised in the “Five Year Forward View” in 2014.

The Minister cannot come before us today and honestly say that his Government are improving services and seriously addressing this issue when they are overseeing such significant cuts that are rolling back provision on addiction services. It is not just me or Labour making that case, but the likes of the chief executive of Collective Voices, Paul Hayes, who said earlier this year:

“The more we disinvest in treatment, as we are doing at the moment, the more we will put increasing numbers of people at risk of early avoidable deaths.”

The Minister has the power to go back to his Department and ensure that these avoidable deaths are avoided and the unnecessary losses of life halted.

The Government’s failure to seriously get to grips with the issue of drug addiction and the sad outcomes associated with it is shaming us across the world. Yasmin Batliwala, chair of the Westminster Drug Project, was recently reported as saying:

“We once had services that led the way.”

She went on:

“We now need to do a lot to catch up with countries in the developing world that are doing a lot more for their service users. The sign of a civilised society is how it cares for its most vulnerable.”

The Minister needs to acknowledge that his Government are overseeing such a negative and backwards approach to prevention, instead of taking radical steps to address and prevent drug addiction.

It is high time this Government seriously came to terms with the actions they have taken over the last few years on public health and rethink their short-sighted approach. Otherwise, we will see the figures that I quoted at the beginning of my speech become ever worse under their watch. The people who struggle and battle with addiction deserve and need our support, not just for them, to improve their lives, but for the rest of society, so that we can finally ensure that no one’s life is blighted by drug addiction.

Abortion Act 1967: 50th Anniversary

Mary Glindon Excerpts

Monday 6th November 2017 Commons Chamber

[Jackie Doyle-Price]

Central to this is that Parliament needs to be satisfied that the regime is safe for women. The law has been on the statute book for 50 years, and until Parliament decides to change that, that is the law that I will implement as safely as possible. I hear many polls quoted but, frankly, when it comes to this issue, on which people have very strong views, we need to ensure that we maintain the law with integrity.

Thanks to the dedication, hard work and expertise of the doctors and nurses working in abortion clinics, termination of pregnancy is now an extremely safe procedure. In marked contrast to some of the statistics before the Act, which the hon. Member for Kingston upon Hull North outlined, data for 2016 show a complication rate of just one in every 630 abortions, which is substantially lower than just 10 years ago, when the rate was one in 500. The choice of early medical abortion, which is less invasive than a surgical procedure and does not involve use of anaesthetics, has helped to increase the overall percentage of abortions performed at under ten weeks gestation from 68% in 2006 to 81% in 2016. Clearly, the more we can encourage that, the better it will be for the welfare of women undertaking terminations.

[Mary Glindon (North Tyneside) (Lab)]

I congratulate my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) on securing the debate. The Minister is talking about what happens to women during the procedure and about how much care should be taken. However, does she share my concern that, as the report “Abortion and Women’s Health” from the Society for the Protection of Unborn Children highlighted last week, counselling and support for women who suffer mental distress after they have had an abortion is seriously lacking in this country?

[Jackie Doyle-Price]

At the risk of being really controversial, I think there are lots of elements of counselling for women that are seriously lacking. That possibly reflects the fact that decisions about the welfare of women have generally been taken by men. It is great that there are now lots more women in this House able to influence exactly that.

Tobacco Control Plan

Mary Glindon Excerpts

Thursday 19th October 2017 Commons Chamber

[Mary Glindon (North Tyneside) (Lab)]

It is an honour to follow my friend the hon. Member for Colchester (Will Quince). He highlighted, importantly, the dangers of pregnant women smoking, and he was very supportive of women who find themselves smoking during pregnancy. I congratulate my right hon. Friend the Member for Rother Valley (Sir Kevin Barron) on securing this Back-Bench debate. The knowledge he brought to his opening speech set the tone for the debate.

I am pleased to take part in the debate because I am a member of the all-party group on e-cigarettes, and I believe that vaping is a safe and popular alternative to smoking. I have never smoked or vaped. I am the oldest of five siblings, and none of us has ever been a smoker. I put that down to the fact that both my parents smoked all their lives, and smoking never held any charm or attraction for me or my brothers and sisters when we were young people.

Because my parents, other relatives and friends smoked, and I am married to someone who started smoking at the age of nine, I think I understand why people smoke and the impact it can have on their lives. When my parents started to smoke in the 1940s, people were not fully aware of the dangers of smoking. Now, we all know that smoking can kill or cause serious lifelong illness. It makes me so sad to see so many young people starting to smoke.

The hon. Member for Harrow East (Bob Blackman) mentioned mouth cancer. That reminded me that I lost a colleague, who was in her early 60s, to mouth cancer, and only a year before she had seen her son, aged in his 40s, die of the same horrible disease, so I know how awful it can be.

Vaping is important as a safe alternative to smoking for people of all ages. I am pleased that for the first time the tobacco control plan focuses on vaping as a viable alternative to cigarettes. As my right hon. Friend the Member for Rother Valley has said, independent studies by Public Health England and the Royal College of Physicians have recognised that vaping is at least 95% less harmful than smoking, and research by the University of St Andrews has found that the cancer risk from vaping is only 1% of that of smoking. Many other valid statistics from various bodies now support vaping as a safe alternative for smokers, as has been highlighted in the debate.

I am pleased to say that many of my family and friends, including my husband, have all stopped smoking and now use vape products, and although many people so dear to me tried to give up smoking and always returned to tobacco, I am sure many others across the country are as happy as I am that relatives and friends have made this choice on vaping.

The commitment to support stop-smoking services is commendable, but in my experience—I undertook training to run smoking cessation sessions some years ago—it is very difficult for people diagnosed with diseases that might be smoke related to give up smoking. We all know that ill health can increase stress levels, so reliance on the habit at such a time can increase and it can be really tough to give up. Being able to switch to vaping for people in such situations is very welcome. I wish I had been able to recommend people, such as those who had had a heart attack, to switch to vaping when I was trying to help them to stop smoking, because those were difficult times for them.

I believe that the promotion of vaping and e-cigarettes is key to the Government achieving their vision of a smoke-free generation as part of the tobacco control plan. I support the view of the UK Vaping Industry Association that article 20 of the tobacco products directive, which conflates vaping products with tobacco products, should be reviewed, and that restrictions on advertising, packaging and product size should be lifted.

I do, however, have a warning for the Government. Much of the attraction of vaping is that, after the initial outlay for equipment, it proves a much cheaper way to enjoy the habit than smoking. I seek an assurance from the Government that they will ensure vaping always remains affordable, and that they will not be tempted to impose an excise tax that would force up prices and give smokers less reason to switch. Finally, I agree with colleagues that the Government must put their money where their mouth is if the tobacco control plan is to succeed.

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 10th October 2017 Commons Chamber

[Steve Brine]

The Government are already investing £16 billion in public health services over the spending review period. We made it a condition of the public health grant that local authorities have regard to the need to improve the take-up and outcomes of their drug and alcohol services. Local authorities are best placed to make those decisions. The investment in effective services means that the average waiting time is just three days and, according to our monitoring systems, treatment outcomes in Greater Manchester are generally better than or in line with the rest of England.

[Mary Glindon (North Tyneside) (Lab)]

10. What discussions he has had with the Secretary of State for Education on promoting improved education in schools and youth settings to tackle the stigma associated with mental health.

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

Ahead of our autumn Green Paper on children and young people’s mental health, we are having productive discussions with the Department for Education on the vital role that schools can play in tackling both mental health problems and the stigma surrounding them.

[Mary Glindon]

The YMCA and NHS’s #IAMWHOLE campaign, which was launched this morning, shows that young people seeking help are often dismissed by those around them, largely due to a lack of understanding of mental health difficulties. Will the Secretary of State meet the YMCA to discuss what can be done to combat the stigma?

[Mr Hunt]

I am more than happy to meet the YMCA. I also want to point out the amazing work done by the “Time2Change” campaign. I was at an event to mark its 10th anniversary, and I heard from young people who have spoken up about their mental health conditions, which takes a lot of courage. Things are changing, and we can draw a lot of hope from what is happening on the ground.

--- Later in debate ---

[Steve Brine]

I thank my hon. Friend for that. We expect the first launch to be the bilateral UK-China partnership £10 million fund, which we expect to go live early in 2018. Further information on the calls for the remaining £40 million will be announced in due course.

[Mary Glindon (North Tyneside) (Lab)]

T10. In the light of the latest statistics from the Office for National Statistics showing a record number of drug-related deaths registered in England and Wales, will the Minister meet members of the drugs, alcohol and justice parliamentary group to discuss this issue and see how it can be addressed?

[Steve Brine]

I am very happy to meet the group, and the hon. Lady should contact my office. The Home Office is the lead Department for cross-governmental drugs policy, and we obviously released the new cross-Government drugs strategy earlier this year. However, this cannot all be about drugs services and picking up the pieces after things have gone wrong; it can also be about prevention. We should, as somebody once said at this Dispatch Box, understand a little more and condemn a little less.

Agenda for Change: NHS Pay Restraint

Mary Glindon Excerpts

Monday 30th January 2017 Westminster Hall

[Andy Burnham]

My hon. Friend the Member for Foyle (Mark Durkan) said that this is a pay cut. We should not call it a pay freeze because it is, in fact, a pay cut. The Government have manipulated the figures in this area. Let us call it what it is: a pay cut that has now been sustained over a number of years.

People are at their limits. They cannot carry on having their pay cut every single year while they face other pressures and rising costs, such as accommodation costs, without there being a consequence. The consequences will be for their own sense of wellbeing, their own mental health or, indeed, their children’s quality of life. Nurses are now saying, in large numbers, that enough is enough.

[Mary Glindon (North Tyneside) (Lab)]

Further to what my right hon. Friend just said, does he agree that there is a culture under this Government and the previous coalition Government of devaluing the whole of the public sector? This is one stark example of what is happening across the public sector.

[Andy Burnham]

That is how it begins to appear. The Government are pushing people beyond their limits. There was the attempt to introduce regional pay, and there was the attempt to cut what is called the unsocial hours payment—there has been a whole series of initiatives that try to strip away support for the profession. It begins to feel like an attack on the profession. That is certainly how junior doctors felt, and I think GPs feel the same. The nursing profession is making clear today that it feels the same too.

As I said, this is a false economy. As well as damaging the good will and the extra hours that people were willing to offer before, it has also, as my hon. Friend the Member for Foyle indicated, pushed people into the arms of private staffing agencies. That, in the end, is another false economy for the national health service. Over recent years, we have seen the bill for private staffing agencies in the NHS increase year on year, to the point where it is now in the region of several billion pounds every year. Many trusts are in the grip of the private staffing agencies. That, of course, is also a factor in the cuts to nurse training that we have seen in recent years.

Breast Cancer Drugs

Mary Glindon Excerpts

Thursday 26th January 2017 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I thank my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) for securing this debate, following the very sad news that her friend Samantha Heath, who had been receiving this life-extending treatment, had heard from NICE that it was being taken away from her. I am pleased that she was able to secure this important debate through the Backbench Business Committee.

I also thank all colleagues who have attended the debate and made excellent speeches, sharing with us their experiences and thoughts, including the hon. Members for Milton Keynes South (Iain Stewart), for Portsmouth South (Mrs Drummond), for Louth and Horncastle (Victoria Atkins) and for Wycombe (Mr Baker), my hon. Friends the Members for Torfaen (Nick Thomas-Symonds) and for Wythenshawe and Sale East (Mike Kane) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who spoke for the SNP. I am sure that the Minister has been given lots to think about, and I look forward to her response shortly. I also thank Breast Cancer Now for its work campaigning on this matter, along with Breast Cancer Care for its continued dedication and its support and advocacy for individuals with secondary breast cancer.

In my contribution, I will first briefly establish the documented and perceived benefits of Kadcyla, and then, building on that, discuss the broader issues around the provision of off-patent drugs, before moving on to present the problems with determining the funding of a drug based principally on its cost-effectiveness as judged by NICE.

Kadcyla’s continued funding through the cancer drugs fund in 2015 was a great success for patients and patient advocates. At the time, the value of the drug was recognised and the concession was made that, despite its high cost, its positive impact was worth the funding it needed. Yet just over a year later, the alterations to the cancer drugs fund have prevented the future funding of this drug, along with, potentially, that of a number of other secondary breast cancer drugs such as palbociclib and Perjeta—I hope that I pronounced those correctly—as it moves towards becoming a funding mechanism for under-researched but innovative drugs with cost and value as a principal driver, and away from its original principle, which was to finance drugs that were too expensive to be recommended by NICE but proved effective in treating cancer patients.

We can all agree that patients have benefited significantly since the introduction of the cancer drugs fund, but the progress that has been made in recent years in improving access to cancer drugs is now at risk. That is unsurprising, given the cash-strapped state of the national health service—we have discussed that in the House recently in the past few weeks—which faces pressures to provide these costly drugs that are developed by large pharmaceutical companies, and is forced to consider costs rather than clinical need. I hope that the Minister will tell us whether those concerns have been assessed, and how she plans to address them. We have heard a number of good suggestions today about how funding may be redirected.

[Mary Glindon (North Tyneside) (Lab)]

Is not the situation made all the more poignant by the fact that since 2001, the incidence of breast cancer has been rising by 9% every year?

[Mrs Hodgson]

That is a very good point. It may be that more and more people are coming forward and being diagnosed, but, as my hon. Friend says, this will clearly become more of an issue, not less of an issue, in the years to come.

As we have heard today, it is estimated that Kadcyla benefits 1,200 women every year in England alone, and that on average it can increase the length of a woman’s life by six months, although reports suggest that in the case of some women that can stretch into years. Even if it is measured in months, however, the extra time is surely priceless to the women and families involved. I speak from personal experience, as I lost my mother-in-law to secondary breast cancer 20 years ago this year, when my children were very small. I know that she fought for every extra week and day in the end, and that she would have given anything for an extra six months to spend with her grandchildren. We all wanted that little bit longer for her. For all those 1,200 women, that extra time is time with their families. It means seeing their children reach perhaps one more milestone: starting school or university, getting married, or even giving them a grandchild. What is the cost of such moments, such memories, which are so precious and which help families so much with what, ultimately and inevitably, will follow?

North East Ambulance Service

Mary Glindon Excerpts

Wednesday 4th May 2016 Westminster Hall

[Mrs Hodgson]

I thank my hon. Friend for that very sad example, which I fear and predict will be one of many—perhaps not all with such a tragic ending—that we will hear this afternoon.

The correspondence I have received about ambulance waiting times in my constituency makes it clear this has been a persistent problem since 2012. I was first told about the problem with waiting times by the league chairman of the Wearside football league after he raised concerns with the North East Ambulance Service directly about numerous incidents. In his correspondence, he said that waiting times for football players who had broken their leg had continually gone over 70 minutes. In one case, after a player broke his leg, the league chairman called 999 at 11.40 am, but he was called back and informed that no ambulance was available and that he should take the player by car. He rang 999 back and complained that that went against what trained first aiders were told about not moving people with broken bones. An ambulance then arrived at 1 pm—80 minutes after the initial call—and the young man was taken to hospital.

Ever since that case, I have received a range of correspondence from other constituents highlighting failures and shortcomings in ambulances going out to emergencies. An issue particular to my local area—I do not think it is replicated in other parts of the region, although we may hear differently when other colleagues speak—is that ambulances struggle to get to certain parts of my constituency due to confusion in finding the address. That has been repeatedly brought to my attention by my constituent, Mr Walker, who for the past two years has highlighted the difficulty that ambulance crews have getting to the Usworth Hall estate in Washington. When a shocking murder took place in the area in 2014, the ambulance did not arrive for more than an hour and the man died.

An example of that failure happened when a woman was in labour and her sister-in-law had to deliver the baby because the ambulance went to the wrong street. The children of the woman in labour had to search the streets for the ambulance. When they found it, they guided it by foot, as they were not allowed on board, for more than a mile to where it should have been.

I could give many other examples. It has been a persistent issue for the residents of Usworth Hall, who, through Mr Walker, have highlighted their concerns and their exasperation at those problems. On each occasion, I forwarded their concerns to the North East Ambulance Service, which looked into each issue. To its credit, it has tried to address them. That was highlighted in a letter to me in July 2014, in which it explained that it had set up an electronic flag system for all residents in Usworth Hall and had a duty manager from its control room go out and survey the area for problems. However, Mr Walker contacted me again at the beginning of April and informed me that an ambulance was parked outside his house one evening. When he went out to speak to the staff, he found that they were lost and supposed to be in another street.

Paramedics understandably do not have the local knowledge that residents have, but sat-nav equipment is provided to help ambulances get to the right destination at the right time.

[Mary Glindon (North Tyneside) (Lab)]

Does my hon. Friend think that those delays could be because of the shortage of paramedics and the fact that, as the service has admitted, it uses volunteers and private contractors to provide ambulances? That exacerbates the problem of people not knowing how to get to where they need to be.

[Mrs Hodgson]

My hon. Friend makes a very good point. I will come on to the shortage, which is running at about 15%, and the stress on paramedics, to which she alluded.

If the sat-nav equipment continues to fail, and if my interventions on behalf of my constituents and the ambulance trust’s action do not rectify the situation, there needs to be a serious investigation into what is going wrong. We cannot have our ambulances driving round lost on estates looking for the right street.

My most recent piece of casework is from February and is deeply concerning. It concerns my constituent, Mrs Ellen Sherriff. I feel that using the words emailed to me by my constituent’s husband, Mr David Sherriff, can help to highlight the situation and the distress that can come from having to wait hours and hours for an ambulance to arrive. I hope that you will allow me a moment to read out Mr Sherriff’s words, Mr Bailey. He said:

“Ellen became unwell at 10.35am yesterday morning with severe head pain on the right-hand side. She felt like she was going to pass out. I checked her blood pressure which was very high, so phoned 111 at 11am and spoke to a call handler who told me he was sending an emergency ambulance and not to be worried if it arrived with blue lights.

Two and a half hours later no one had come. Ellen remained unwell and could not stand any light.

I phoned 999 and was told the ambulance that was coming had been diverted to Cramlington but that we would be next unless a more urgent call came in.

At 2.40pm, a patient transportation ambulance arrived with two ambulance men. I asked why it had taken so long. They said given the circumstances Ellen should have been seen earlier. They had no equipment, not even a blood pressure machine. They said they couldn’t risk moving Ellen in case they caused the bleed in her brain to become life threatening and they would send for a paramedic. They would also remain here till he arrived. They also complained to the control room regarding the wait.

They sat outside until 5.30pm, 6 and a half hours after I first phoned. When the paramedic first arrived he examined Ellen and said she should have been in hospital 5 hours earlier.”

It was not until 6 pm, more than eight hours after the initial phone call, that my constituent, Mrs Sherriff, was admitted to hospital, where it was discovered that she did indeed have a bleed in the brain and that she should have been there much sooner.

Until Friday, Mr Sherriff was still awaiting a response to his complaint, which was sent in February. Perhaps the prospect of this debate ensured that he eventually got it. The trust has admitted errors in the handling and categorising of Mrs Sherriff’s condition, meaning that it was continually not treated with the urgency required. The trust has apologised and said that a “reflection and learning session” has been given to the original call handler, but this case could easily have had a tragic ending.

--- Later in debate ---

[Ian Lavery (Wansbeck) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Bailey. Great credit must be given to my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) for securing this timely debate.

The North East Ambulance Service is not creaking at the seams; it is totally and utterly broken. It is in meltdown, and that causes great concern. As has already been said, there is a total lack of any confidence at all in the North East Ambulance Service among the residents. It is failing people of all ages in their time of most need. As my hon. Friends have said, we must place on the record our thanks for the commitment and passion of the workforce in the North East Ambulance Service.

Unfortunately, there is a staff shortfall of between 10% and perhaps 15%, which has been mentioned. That puts huge stress on the remaining individuals, who must make up for the shortfall. My hon. Friend the Member for Washington and Sunderland West suggested that 64% of people have complained about stress. There is a high rate of people employed in the service who cannot go to work any more because of stress; and is it not really alarming that one in four people has considered taking their own life: paramedics—people working in the ambulance service, who we are terribly proud of? We urgently need to look at the situation.

There is a complete lack of staff. The service is undermanned and underfunded, and we have not got the resources we need for the situation we have in the north-east. We have to ask why there is a shortage in the first place. I believe that the wages in the North East Ambulance Service are the lowest in the country. That is one factor. We do not have the resources to pay even on a par with the counties next to us. The wages, terms and conditions are much lower than those of other ambulance services.

Like all the other hon. Members who have spoken I want to mention a few instances. My hon. Friend the Member for Washington and Sunderland West mentioned a young fellow playing football, who broke his leg on the pitch. Now, you would expect an ambulance to come and pick you up, wouldn’t you? Is that too much to ask if someone is lying in agony with a broken bone from playing football on a cold Saturday afternoon? Of course they would want an ambulance. We cannot just push people to the side and wait, and explain to them, “There’ll be somebody coming shortly.”

That is not even the most important example. Everyone who has spoken has given examples of what has been happening—mainly to elderly people. There are lots of elderly people in my constituency—Mrs Robson, for one. She is 78 years old. She slipped on a pavement in the middle of winter. She had to wait one hour and 40 minutes for an ambulance; but the message that comes is: “I’m sorry; you’re going to have to wait, because it is not at crisis point. You are not an emergency.” Of course she is an emergency. If a 78-year-old lady is lying on the floor crumpled in absolute agony, that is an emergency; but on paper—“Sorry, you’re not an emergency.”

I will tell hon. Members what happens. Someone rings up, and they have got a crib sheet in the central office. My hon. Friend the Member for North Durham (Mr Jones) mentioned that if someone is unconscious or has got pains in the chest, the service will come to them. The first question is “Are they conscious? Are they breathing?” “Yes.” “Right. Are they bleeding?” “No.” Then, if they are conscious and not bleeding, they are put right down the pecking order. Quite frankly, it is simply not acceptable.

[Mary Glindon]

Does my hon. Friend agree that the morale of the call centre staff has been lowered? They can no longer care when they talk to people, but are like call centre handlers, with things being very automated; and they do the minimum to reassure patients because everything is down to time and hitting targets. They are no longer people dealing with callers who are in distress. They are not able or allowed to show any emotion or any support, because they simply have to deal with the call as quickly as they can, to get on to the next one.

[Ian Lavery]

What I am saying is not meant to be any criticism of the people in the call centre, either—because if they veer from the crib sheet they have got, they are in trouble; but it shows how bad the whole situation is.

I want to mention Mr Taylor. I must say that he is a relative of my wife, who waited 11 and a half hours for an ambulance to arrive. He was really poorly. Plenty of people came from the NHS and said, “He needs an ambulance”—and then someone says “He doesn’t” and someone says “He does,” and someone else says “He doesn’t”. When he actually got the ambulance, at 1.45 in the morning, he was in a coma. That was seven months ago, and he is still lying in a coma as we speak. If that ambulance had turned up before, he might not be.

I will not dwell on that point other than to say that that brings me on to the complaints procedure, because MPs have complained, as well, about what happens to our constituents. We get a chronological list of what happened, and why the ambulances could not come, because they were diverted to other more serious incidents. That is not good enough. It is not good enough for me to say to one of my constituents, “Your mam couldn’t get an ambulance because somebody else was more important”—when she was lying suffering. Or if someone has a terminal disease and is desperate, or someone has a chest disease—it is not good enough; and the complaints procedure is not good enough. They are not treating people like human beings.

I have got lots to say and not a lot of time to say it, but I am going to reiterate the fact that these delays are utterly unacceptable and we cannot continue on this basis with the North East Ambulance Service operating as badly as it is. Someone mentioned that the service will be fully operational in 12 months. I have heard that before. It is not good enough for the people who will trip, fall and stumble. It is not good enough for elderly people, or young people playing football.