Hospital Building Programme

Mike Penning Excerpts

Wednesday 3rd November 2021 Westminster Hall

[Sir Mike Penning (Hemel Hempstead) (Con)]

It is a pleasure to serve under your chairmanship, Mr Sharma, as was alluded to by my hon. Friend the Member for Crewe and Nantwich (Dr Mullan). This debate is enormously important. Hospitals are often the heart of our communities. The staff in our hospitals, whatever job they do, do a fantastic job, and it is right and proper that we pay tribute to them. But the environment that they work in is also vital to them.

To give a little history lesson from Hemel Hempstead and South West Hertfordshire, which is my part of the world, we had three hospitals—three acute hospitals—until just over 20 years ago when St Albans was closed as an acute hospital. The promise was made at the time that the emergency facility would be picked up by Hemel Hempstead and partly by Watford. That promise was made and then, sadly, Hemel Hempstead was closed—I am not going to get into party politics, but it was by the previous Administration—and we fought tooth and nail, as most constituency MPs would, to save it. Now we have partly elective surgery for non-emergency care at St Albans and I have a clinic—there is no other way I can describe it—at Hemel hospital. Three quarters, if not more, of my hospital is boarded up or vandalised on a site worth hundreds of thousands or millions of pounds.

I was thrilled—absolutely thrilled—when the Prime Minister announced at the general hospital in Watford, which is the only acute hospital we have left in our part of the world, that we were in the top six to get a brand-new hospital. That thrilled us not because we wanted suddenly to bring back our hospital—we understand the restrictions on doing so and what a modern hospital needs to provide for a community—but within hours of the Prime Minister announcing that we were in the top six and that there was the funding, unlike what it sounds as though the management did in my hon. Friend’s constituency, the management ruled out a new hospital on a greenfield site.

As for many of my colleagues, the population in my part of the world on the edge of London is booming. We have a thriving economy, and we have more jobs than we actually have people to fill them, even after the pandemic. The population is growing massively, and I have 20,000 homes coming to my own constituency in the next 15 years. The logic of not building a new hospital on an available greenfield site is confusing to everybody, especially to those who know that Watford hospital is a Victorian hospital next to the Watford Football Club ground in the middle of a Victorian town. All we have been offered is a refurbishment of Watford and a running down even more of the Hemel site.

What fascinates me is that the West Hertfordshire Hospitals NHS Trust seems to be completely unaccountable to the politicians who are giving them the money to look after care in our constituencies. I know that the Health and Care Bill going through Parliament at the moment is going to address that going forwards, but it does not address the historical problem going backwards. The trust spent millions of pounds proving that we cannot have a new hospital on a greenfield site, rather than actually spending some of its consultancy money proving that we could have it on a greenfield site.

My constituents had been campaigning to save the Hemel hospital long before I was around, and there is cross-party support in our part of the world for saying, “Watford is not the right place, and it is not a new hospital. It is a refurbished hospital in completely the wrong place. Please see sense.” I fully understand that Watford constituents are worried they might lose their hospital, but they will not lose it because nothing is going to close until the new one opens. However, we have already lost ours, and the largest town in Hertfordshire has a clinic, with proposals for no intermediate care beds whatsoever and with pathology being taken away as we speak.

The point I want to make to the Minister is that, when we look at the bids that come in, we have to be careful that trusts have done what they were supposed to do, which is to look at the best possible options for the community they are supposed to serve, in the same way that we are serving them, rather than be blindfolded by the situation. In my case, the trust seems fixated with one site in the middle of a town and next to a football stadium, which by anybody’s logic would seem to be ludicrous.

I wish Watford every success—they may well stay up again this season. I am not a Watford fan, although most of my constituents are. I am sad to say I am a Spurs supporter, and that comes with a lot of problems, as we know. However, when Watford play at home, there is a massive knock-on effect on the hospital next door. Believe it or not, but the trust gives up some of its parking spaces to the football club, which is an historical agreement.

I can give an instance of when an ambulance was turned away from the route it would normally take into the hospital because Watford were playing at home. I am not blaming Watford and I am not blaming the police for this; it is just a logistical problem. The ambulance was turned away and sent on a different route as the road was closed because of the home game. I said to the police officer in charge, “If one of your officers had been injured, what would you have done? Would you have allowed that ambulance through?” He said, “Of course, we would have done.” The guy in the back of the ambulance that was trying to get to hospital had had a heart attack; fortunately he survived.

That is the sort of illogical thinking that is going on in some of the trusts, though clearly not in that of my hon. Friend the Member for Crewe and Nantwich. In my trust, its unaccountability to do what is right for the people it serves seems to be blindfolded. I politely ask the Minister, as he knows I have been pushing on this for more years than I can remember, please do not trust the management of my trust to give the full information. We want a new hospital on a greenfield site. I have letters showing that there is £590 million available for that, but not for refurbishment.

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[Justin Madders]

My hon. Friend probably needs to direct his pleas to the Minister more than me—at this stage, of course—but I would be delighted to visit the facility with him. I am sure that he will make a strong case for investment, as other Members have done. There is an issue with how the interplay works between some of the competing bids for what is obviously a very competitive process, which I will return to later. Like the hon. Member for Eddisbury (Edward Timpson), my hon. Friend the Member for Weaver Vale (Mike Amesbury) has shown that there is cross-party support for the case for a new hospital that was made by the hon. Member for Crewe and Nantwich, who also set out why this is good for patients. He talked about some of the issues around privacy, dignity and infection control, and he said that a new build gives us an opportunity to invest in modern digital infrastructure. Of course, he also mentioned important stuff to do with COP26 and the energy efficiency of a new build. Those were all well-made points.

We also heard from the right hon. Member for Hemel Hempstead (Sir Mike Penning), who made a persuasive and passionate case as to why the current plans need to be reconsidered. He made a very interesting point about the accountability of trusts. He is probably not aware that the Minister and I have been debating this issue in Committee for a number of weeks, and it is fair to say that we have differing views as to how accountable the current system is and whether it will actually change at all when the Health and Care Bill receives Royal Assent. There is an issue with how large trusts have their own priorities, which are not necessarily in tune with the rest of the wider population and healthcare system.

The hon. Member for North West Norfolk (James Wild) made a very strong case for the Queen Elizabeth Hospital in King’s Lynn; he highlighted the critical nature of the maintenance issues there, which are clearly having an effect on patient care now. The Minister will not be surprised to know that I will be referring to the maintenance backlog during my comments today. The hon. Member also set out very well how new builds can not only improve infection control, but enhance the patient experience. We should always remember that the patient journey is central to these things. A new hospital always has to have the interests of patients, and their perspective, at the heart of its plans.

The hon. Member for Keighley (Robbie Moore) made a strong case for why a new hospital is needed in Airedale. Again, it is a building that is past its original lifespan; it has critical infrastructure issues. Describing it as the “leakiest hospital is the UK” is not something the hon. Member will want to repeat for much longer. It shows again that many of these issues have been building up for some time.

I was very interested in what the hon. Member for Hartlepool (Jill Mortimer) said about health inequalities; it was an important point, and perhaps a broader one than some of the others that have been made. She is absolutely right that the pandemic has shone a light on the existing health inequalities in this country. I agree that if we are serious about levelling up, reducing health inequalities has to be central to any policy.

The right hon. Member for Basingstoke (Mrs Miller) made a compelling case about how investment is needed for her new hospital, and how the change and growth in local population has created additional demand. It is an important point that, because of the way that her town has built up, there is more demand from an increasingly ageing population.

All the Members have made very good cases today; if it was based on the commitment and passion of individual Members, the Minister’s job would be quite straightforward. However, I know there will be many other demands on the departmental budget. There is a serious point here. We need to have transparency on the criteria that will be applied when the decisions are made. It would be fair to say, if we look at levelling-up bids, there has been some consternation that the decisions are not always made on the merits of the case. It is important that the Department is crystal clear on why particular projects are getting the go-ahead, and why others may have to wait a little longer.

I am sure that the Minister would be disappointed if I did not make a reference to whether the Prime Minister’s claim to be building 48 new hospitals is in fact an accurate one. We take with a large pinch of salt the definitions from the Department’s playbook that the following count as a new hospital: they say this includes

“a new wing of an existing hospital (provided it contains a whole clinical service, such as maternity or children’s services).”

They also say this includes

“A major refurbishment and alteration of all but the building frame or main structure, delivering a significant extension to useful life which includes major or visible changes to the external structure.”

That may well be investment in buildings—which is of course welcome—but it stretches credibility to say that those are new hospitals. I will not repeat the whole debate again on whether those descriptions can be classed as new hospitals, except to say that the Minister will no doubt rely on his VAT notices to reach that figure of 48: we will rely on the good sense of the British public to judge whether a new hospital is indeed a new hospital. When we get to 2030, we will see how many new hospitals we actually have—although it is possible that both the Minister and I will have moved on by that point.

Let us return to the present day, move away from the headlines and the spin, and ask some specific questions about the programme. I will start with the cost issue. It is my understanding that the projects identified in phase 1 have been promised a total of £2.7 billion, although some reports suggest that a £400 million price cap is being applied to each scheme, even though some of the published plans for those schemes have exceeded that limit already. Could the Minister comment on whether there is in fact an upper cash limit on particular projects, and whether it is indeed £400 million?

Almost exactly a month ago, the Prime Minister made an announcement on round 2 of the health infrastructure plan, in which, incidentally, only three out of the 25 hospitals are in the whole of the north of England. I think that says something about the Government’s commitment to levelling up and bolsters the case made by the hon. Member for Crewe and Nantwich to push forward for a new building in Crewe. Could the Minister advise what period and how much of the total programme the £3.7 billion mentioned in that announcement covers? Could the Minister also advise if the £4.2 billion, announced in the spending review last week in relation to new hospitals, is the same money as the Prime Minister announced on 2 October or is in addition to that? If it is additional, what period does that £4.2 billion cover? We want a little clarity on how much has actually been allocated and the period that it covers. I am sure the Minister realises that, even if we add up all those figures, it would not be the total cost of all those projects moving forward to 2030.

We have had three separate announcements over the last year. I make that point because the foreword to the health infrastructure plan talks about ending the “piecemeal and uncoordinated approach”. We have an investment plan spanning a decade, but the necessary investment has been announced for only the first half of that decade, at best, to come out in dribs and drabs. I suggest that the Minister might need to read the foreword to the plan again to see whether the ambitions set out there are being met.

NHS Providers has said that the actual cost of the planned building projects would be around £20 billion, most of which will need to be found in the next few years. Even building an average-sized new hospital costs around £500 million, which rather puts the spotlight on the supposed £400 million cost limit I referred to earlier. I wonder if the Minister could put a total cost—

[Sir Mike Penning]

I think we have to be slightly careful when referring to costs such as that £500 million. Built into that is inflation, because of the way the Green Book works, because of the risk. I had to deal with this on the roads programme as roads Minister: what happens is that a figure is set out, but it is not the same as the actual cost of the build project. That is probably where some of that cost anomaly comes from. The Treasury Green Book insists on inflation of that price when the build price is much lower; in my case, £500 million was £420 million in the Birmingham build. We have to be careful of trusts that do not want to do that; for example, my trust—the West Hertfordshire Hospitals trust—inflates the cost into £600 million because it does not want to do it.

[Justin Madders]

I will reflect on the right hon. Gentleman’s comments. That leads on to another point I wanted to raise with the Minister: we are aware that the economy is currently in something of a flux in a whole range of sectors, in terms of finding the right people and the right skills, and construction is not immune to that. Do the plans include any wiggle room to take account of the fact that the cost of labour and materials is unfortunately going up quite rapidly at the moment?

NHS Providers said that

“there are still significant questions on whether the NHS will be able to meet the government's manifesto pledge to upgrade 70 hospitals and build 40 new ones given the lack of clear, long term, funding commitments beyond 2024/25.”

It also said that it awaits

“confirmation of the money that will be available to providers to tackle the £9.2bn maintenance backlog that has built up.”

The Minister will know that that has shot up in recent years, leading to cancelled operations and a 23% increase in treatments being delayed or cancelled in the last year because of infrastructure failures, and yet we are hearing very little on what is being done about that. I think the hon. Member for Eddisbury mentioned something in the region of £400 million being identified as the maintenance backlog costs at Leighton Hospital alone. We have also heard from other Members on infrastructure issues causing difficulties in their own trusts.

These problems are not new; they are the result of a decade of underfunding on both capital and revenue, with the Health Foundation reporting that

“the UK is investing significantly less in health care capital as a share of GDP compared with most other similar European countries.”

Of course, we have also seen frequent revenue raids on capital in the last few years. If these plans are to be successful, those raids must stop. I hope the Minister will be able to guarantee that there will be no revenue raids on capital for this programme in the next decade. I would also be grateful if he could set out the Department’s plan to tackle the maintenance backlog.

A few moments ago, I mentioned the interplay between large infrastructure projects and other capital requirements at a system level, particularly around how we get capital investment into primary and community care. Taking my own patch, Ellesmere Port, which I know best, we have several GP premises in the town centre that are past their best—past their useful life, perhaps—they are not really suitable in these covid-conscious times. We are not short of more modern, available premises in the town centre, where there might even be greater potential for integration with other services

However, these projects take time and money, and some decision must be taken at a system level to prioritise them. I think that would be an important step forward for improving access in my community and dealing with some of the health inequalities we have talked about. I recognise that sometimes it is a fact of life that the bigger players—the acute trusts—will always be higher profile than individual practices for attracting funds and investment. In many ways, this is an echo of the debate that the Minister and I have had in recent weeks on the Health and Care Bill Committee. I mention it again because, particularly with capital investment, there is a danger that primary and community services will struggle to have their voices heard against some of the bigger players in an extremely large integrated care system.

I will end with a few comments from stakeholders regarding the Chancellor’s statement last week. The King’s Fund said that

“the real game changer would have been clear funding for a workforce plan. Chronic workforce shortages across the health and care system heap further pressure on overstretched staff who are exhausted from the pandemic. Yet despite pledges, promises and manifesto commitments, the government has failed to use this Spending Review to answer the question of how it will chart a path out of the staffing crisis by setting out the funding for a multi-year workforce strategy.”

The Health Foundation said that

“new money for technology and buildings, although vital, is of limited value without additional staff. A workforce plan backed by investment in training are critical and we await details of both so that the NHS’s recovery can be secured.”

The Nuffield Trust said:

“It is striking that there is a lack of strategic workforce investment alongside this boost in funding for facilities. Staffing is recognised as the number one issue for the sustainability of the health service. Recovery from the pandemic not only rests on investment but on hard-working staff as well.”

Finally, the NHS Confederation said that

“to ensure the extra money delivers for the public, a strong and supported NHS workforce is needed. This is why training and increasing the supply of doctors, nurses and other health and care professionals is so important at a time when public polling recognizes that staffing is the biggest problem facing the NHS.”

While we welcome the investment in new buildings, we hope that none end up being a white elephant, because the elephant in the room is that we could find ourselves in the remarkable position by 2030 that brand new hospitals, extensions, or refurbishments are delivered, but are not fully operational because of a failure over the preceding decade to tackle the workforce crisis. That is here and now, and it needs to be tackled in the short, medium and long term. That is the final plea I make to the Minister: these investments are welcome, but we must ensure that we have a plan so that these buildings are fully staffed when they are up and running.

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[Edward Argar]

I am grateful to the hon. Gentleman, who quite rightly never misses an opportunity to champion his constituents’ interests.

Hon. Members will be aware that the interest around the country is significant. A significant number of expressions of interest have been submitted, so whittling them down will be a competitive and challenging process, but we undertake to be as clear and transparent about that as we can be. I suspect that, when the final list is announced, if I do not come to the House with a statement, the shadow Minister may well UQ me, to give colleagues an opportunity to say they are very pleased or to ask why their hospital is not on the list.

Let me turn to points made by other hon. and right hon. Members. My right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) will not be surprised that I will not be drawn on the specifics of the internal politics and the plans for his trust at this point. However, he quite rightly made the extremely important point that when trusts develop their plans and bring them forward, they need to carry the communities they serve with them and genuinely reflect on stakeholder input from elected Members and others, rather than—I am not saying that this is or is not the case with this trust—automatically having a preconceived idea of what the right answer is.

[Sir Mike Penning]

rose—

[Edward Argar]

I may regret this, but I give way to my right hon. Friend.

[Sir Mike Penning]

The Minister might not be willing to say that my trust has preconceived the decisions it was going to make; I will, because it made its mind up long before the latest announcement. However, we are in a slightly different position from other colleagues here. We are in HIP 1—part 1 of the health infrastructure plan—and we do not want that money to be wasted. We do not want a sticking plaster; we do not want a refurbishment in the middle of Watford. The community in my part of the world is absolutely solid on that, and if that meant that we slipped out of HIP 1 into HIP 2—I will put my neck on the block—I would be happy with that, as long as we get the right facility on a greenfield site, rather than the wrong facility as a refurbishment in the middle of Watford next to a football ground.

[Edward Argar]

I did not regret giving way to my right hon. Friend quite as much as I feared I might, although he may yet come back to me. As ever, he makes his point powerfully and clearly, and I suspect that, as well as my having heard it, his trust will also have heard it.

As the shadow Minister said, my hon. Friend the Member for Hartlepool (Jill Mortimer) made broader points, in addition to points about her local hospital and trust, about health inequalities and the role that the right infrastructure and staff—the right people in the right place—can play in tackling that. I have to pay tribute to her. Within a day of her arriving in this place following her fantastic by-election victory, she had pinned me down so she could come and see me and talk about Hartlepool and health services there. Her constituents are extremely lucky to have her. She hit the ground running and has not stopped working since on behalf of her constituents.

My right hon. Friend the Member for Basingstoke and I, as she alluded to, have spoken a number of times about her trust. How can I not accept her kind offer of going to the site and seeing her in her constituency? I have known her for a long time, so it is a pleasure to say yes. I would like to go there and do that, then perhaps we can discuss the plans further. She and I have met on several occasions. She is a great champion for the new hospital in her area, so I am grateful for the invitation.

My hon. Friend the Member for Keighley—I almost said “my hon. Friend the Member for Airedale”, given the frequency with which, he raises and champions in the House at every opportunity the need for a new hospital at Airedale—is right to highlight the challenges that his trust faces, as he has done on many occasions, particularly in the context not only of the needs of his population, the challenges of an old building that has long exceeded its intended lifetime, but also the RAAC plank issue. I know that his trust is keen to be one of the eight. I will only say to him, I am afraid, what I said to my hon. Friend the Member for Crewe and Nantwich, which is that the bids will be considered very carefully. I know that he will continue making the case, as he has done in the past.

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[Edward Argar]

I am grateful to the hon. Gentleman, who raises a couple of points. Yes, roofs are a factor. In some cases—my hon. Friend the Member for Keighley talked about Airedale—there is a flat roof, which is vulnerable to heat and water, and aerated concrete planks, which is extremely challenging.

The hon. Gentleman mentioned cladding. I might be slightly out, but from memory I think that there are no hospitals with cladding in need of remediation. We put a programme in place following the Grenfell findings. Off the top of my head, I think every hospital trust has either had it removed or been assessed by the fire brigade as not having a risk. If I am wrong about that, I will of course write to him to correct the record.

[Sir Mike Penning]

On the point the Minister has just made, Natalie Forrest has taken on her new role. I notice that the Minister said she has been in communication with the trusts, but she has not been in communication with the MPs who have emailed her and asked her to respond to them, including me. My hospital action group and I met her predecessor and had very fruitful discussions, and Natalie Forrest would be very welcome to have a discussion with me.

[Edward Argar]

I am grateful to my right hon. Friend. Understandably, the approach we take with right hon. and hon. Members is that correspondence is replied to by Ministers. Occasionally it is a little belated, but that is the conduit for responses.

On meetings with senior officials, I am always happy to facilitate that. Normally, the approach is that I would attend as the Minister in order to reflect the respect that I have for right hon. and hon. Members—and I suspect that he may be about to ask me whether I will therefore do that.

[Sir Mike Penning]

The Minister is being very generous in giving way again. Yes, that would be great. However, I did meet Natalie Forrest’s predecessor without a Minister present, and I just want an email back to say, “I acknowledge you.” That might be quite nice.

[Edward Argar]

I suspect that the Department will have heard my right hon. Friend’s point.

Covid-19 Update

Mike Penning Excerpts

Monday 6th September 2021 Commons Chamber

[Nadhim Zahawi]

The hon. Member raises important points from the industry and we will always make sure that we look at them. One piece of feedback from our earlier consultation was that to be able to check IDs, for example, we would want to make this process equally straightforward for the industry.

[Sir Mike Penning (Hemel Hempstead) (Con)]

I completely support—the whole House will concur—the fantastic work that the NHS has done through the vaccine programme. It is great news that they are coming forward and are ready, but the army of volunteers I saw and worked with in my constituency are exhausted. They need to know up front how often and when they will be needed, because the programme cannot happen without not just vaccinations from the NHS, but the army of people who come forward and put their own lives at risk so others can be safe.

[Nadhim Zahawi]

My right hon. Friend raises an incredibly important point that we look at every single day. In my ops meetings, we have a section dedicated to the workforce and specifically to the volunteers, so that we can make sure that they are put on notice of where and when we think we will need them. The only caveat that I would add is that we have built a very large infrastructure, but it has to flex depending on the advice from the JCVI, the MHRA and, of course, our chief medical officers.

Medicinal Cannabis

Mike Penning Excerpts

Monday 6th September 2021 Commons Chamber

[Christine Jardine (Edinburgh West) (LD)]

It is in some ways a pleasure to speak in this debate, but in others it is a huge disappointment that we are still debating this issue years after we thought it was in fact settled. I go back in this issue to my first face-to-face meeting with my constituent, Karen Gray. It was in London, curiously—not Edinburgh—in the pouring rain. We were meeting to hand in a petition to Downing Street calling for the legalisation of medicinal cannabis. I had been in touch with Karen and her son, Murray, before that day and was aware that Murray had a rare form of epilepsy that was blighting his childhood, with multiple seizures, hospital admissions and missed school days; his parents feared for his life.

Since then, my team in the constituency have experienced all the ups and downs of the journey with Murray and Karen—the hope, the frustration and the disappointment, but always, always optimism that the medication that he needs will be there and available on the NHS. We thought the job was done in November 2018 when, after a powerful public campaign in which the right hon. Member for Hemel Hempstead (Sir Mike Penning) played a pivotal role as a Health Minister, the then Home Secretary, now Health Secretary, the right hon. Member for Bromsgrove (Sajid Javid) made medicinal cannabis oil—the substance on which so many were pinning their hopes—legal.

[Sir Mike Penning (Hemel Hempstead) (Con)]

With your permission, Mr Deputy Speaker, I will elaborate later in a speech, but the crucial thing about when the law was changed was that it was about the prescribed medical use of cannabis oil by a specialist consultant, not a GP. It was not about a spliff behind the bike sheds or anything like that; it was prescribed medical use that saved children’s lives. I agree with the hon. Lady that it is a disgrace we are still here today, debating it.

[Christine Jardine]

I thank the right hon. Gentleman for his intervention, and I share his frustration and annoyance. The measure was specifically designed in the way that it was, and it had the support of the Government at the time. The Home Secretary, the Prime Minister and the whole Department for Health team were behind this move, which we thought would change so many children’s lives. Sadly, the job was not completely done, because Murray is still unable to access that life-changing treatment on the NHS. His family have to find the money themselves every month. It is not just Murray; it is not just about his case and his life; it is not a one-off. I stand here tonight for him, and also for all those who know exactly what that feels like.

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[Christine Jardine]

The hon. Member makes exactly the point that I would make. I think we all appreciate that the Government do not have the power to make the medical profession do anything, but they can be encouraged to put their shoulder to the wheel and get behind this cause.

[Sir Mike Penning]

I thank the hon. Lady for being generous. Fortunately, we have time to debate this massively important subject this evening, which is what it deserves. The point made by my hon. Friend the Member for South Leicestershire (Alberto Costa), who co-chairs the all-party parliamentary group that I used to chair, is that specialist medics out there are writing the prescriptions, but they are being blocked and regularly threatened by other senior people in the medical profession. They are told, “Even though you are the expert and that would save a child’s life, if you do this, we will stop you.” It is right that it is not a politician’s job. The will of the House is very important, as I will come to in my speech, but if the top-expert clinicians are writing prescriptions, some of which are honoured by the NHS—I will also come to that—and they are being blocked by other medics, somebody has to step in and sort the mess out.

[Christine Jardine]

The right hon. Gentleman makes an excellent point. We do have that overwhelming body of observed evidence of the efficacy of cannabis oil. I have seen at first hand the difference that medicinal cannabis has made to Murray Gray’s life—it has transformed his life. When his mum, Karen, first came to see me, he was a very unwell wee boy who was, as I mentioned, constantly in and out of hospital with dozens of seizures a day, and his family were worried that they could lose him. Since being prescribed cannabis oil, he is seizure-free and a happy youngster who plays football with his dad. When he came to visit me in my office, he explained everything I have ever need to know about dinosaurs. It was a joy to see him so happy. The medication has given him a life that he may not otherwise have had.

It is time for the Health Secretary—just as he did when he was Home Secretary—and his team to intervene to make the case that the medical profession should put its shoulder to the wheel. It is time to close the huge gulf between what the Government promised—and, I believe, wanted—and what has been delivered.

[Christine Jardine]

I agree 100% with the hon. Lady that we need action now—it is actually overdue—and that the Secretary of State for Health and Social Care is the very person who can give us what we need.

Because this is not a political football kicked between party politicians—it never has been and never should be; we have always resisted that—a little over a year ago, more than 100 MPs across the House from the Liberal Democrats, Conservatives, and Labour and Green parties wrote to the former Health Secretary to demand action.

[Sir Mike Penning]

And the DUP.

[Christine Jardine]

And the Democratic Unionist party; I do beg your pardon.

Nor is the debate any longer about the proper use or otherwise of cannabis oil. As I have said, the evidence that it is life-changing for those in need is already overwhelming. So it appears that the debate comes down to the willingness of the medical profession. The clock is ticking, however. There are currently only two physicians in this country prescribing the medication, and one of them retires shortly. Add to that the fact that for many families, the Grays included, there will come a time when they cannot afford the medicine their loved ones need and will no longer be able to raise the money. We cannot wait for the creaking bureaucracy of the medical profession to turn.

As we have said, when the current Health Secretary was at the Home Office, he responded to the parents’ appeals, listened and made medicinal cannabis legal. Now the ball has once again found its way into his court and he can help, so my appeal is straightforward. I know a little of it personally: I have had a seizure— I have come to and seen the fear and the relief in the eyes of loved ones—and it is terrifying. What it must be like for a child I do not know. Until a more widespread solution for prescribing can be agreed, and it must be, the Government should save these families the pain of paying for prescriptions. Surely, when the quality of life for a child—so many children—is on the line, it is the right thing to do. I have always been optimistic, and I have confidence that I am right to have optimism and belief that this Health Secretary will take this opportunity.

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[Sir Mike Penning (Hemel Hempstead) (Con)]

As I said earlier, is it not great that we have a couple of hours to debate this subject, which is so important to the family and loved ones of the children who have suffered so much, and we can do something about that? But is it not a crying shame that we have had this debate not just in this Chamber time and again, but in Westminster Hall as well? It was there that I responded to the debate as the police and counter-narcotics Minister, when I actually said on behalf of Her Majesty’s Government that the Government were willing to look at the prescribed medical use of cannabis for certain treatments, particularly for seizures in children with the very rare form of epilepsy that some have.

There are myriad other illnesses, which we might get to, that cannabis could help, but this is about the closed mind of some members of the medical profession—these so-called experts who took an oath to protect lives and to protect the human beings they are responsible for—who are blocking other medics. As we just heard, fewer and fewer medics are able to prescribe, frankly because in many cases they have been scared off and threatened, or are now coming close to retirement. So what will these parents do? I ask hon. Members in the House this evening what they would do if they were a parent of one of these children. God forbid.

I remember so well Hannah Deacon bringing Alfie Dingley in to see me. Alfie was having in excess of 100 seizures a week. I think the figure was actually greater than that, but that is the figure that sticks in my head. Every time he had a seizure, Hannah and her husband did not know whether he was going to come through it, because all the other medication they were giving him was not working. We have heard this story from constituents around the country, but if I may, I will just concentrate on Alfie for a second. He was given products off-label that were never designed for children to try to help him. Doctors were willing to do that with products that were never ever medicated, designed or regulated for children, but because they were off-label, GPs could write a prescription and they did that on the NHS—trying to keep him alive in that way, while in others blocking the help he could have had.

I praise the End Our Pain campaign of Peter Carroll and his team. They have worked tirelessly over the years, and I will give him a name-check because it is very important that people understand that he has never taken a penny for running such campaigns. There is all the media coverage we have had from lots of famous people, but at the end of the day it is his team who have pushed this. There is the bravery of the parents of these children—some out of desperation. But now, as hon. Members will hear in my speech, they want to make sure it does not happen to other families and other children who are desperate to make this change happen.

I made that speech in Westminster Hall with the full permission of the Home Secretary at the time, who then became the Prime Minister—my right hon. Friend the Member for Maidenhead (Mrs May)—and we started that process. The process then progressed because it was nothing to do with the Department of Health at that stage; this was a Home Office matter. I remember going to No. 10 with Alfie, and he was his usual naughty self, which was fabulous because that is how we want our young children to be to experience life. We were due to meet at No. 10 the police Minister at the time and some of the experts, and my right hon. Friend the Prime Minister came into the room, sat with Alfie and his mum and dad, and talked to them. She said, “We will do something about this: we will change the regulations and the law,” and to her credit, that is exactly what she did. With the help of the Home Secretary, who is now the Health Secretary, we changed the law.

The bit I am so upset about is that if we had not changed the law fully to move this into the Department of Health, other children would be getting the prescription that Alfie and some of the others are getting. They were not given that prescription free on the NHS by the Department of Health; they were actually given it by a committee in the Home Office. We had not moved it across through the legislation, so it was done by that committee, based on evidence that it was going to save the life of this little boy and the lives of subsequent other little boys and girls.

Then we got this impasse. The children got the prescription for free—there are not thousands of children out there; this is a really very rare condition—but when this moved across to the Department of Health, it stopped. They carried on getting their free prescriptions, but even though prescriptions were being written, they could only be written as private prescriptions, and we have heard about the cost of medication for families trying desperately, from all means, to raise the money to get this prescribed medical use of cannabis. There are different types and we could go into the different mechanisms and what is in them, but at the end of the day that is a medical or doctors’ decision, not a politicians’ decision.

Believe it or not, I had to phone the Home Secretary several times and say that there was a family at Stansted airport, at passport and customs control, who were having the medication taken away from them even though it was perfectly legal in this country to have that product. Parents had raised the money and they went to Holland—most of them went to Holland—and saw the specialist, went to the pharmacist and brought it back, and then had it taken away from them. Believe it or not, when we eventually got the authorities to agree to let them have it, they tried to charge the parents for the transport cost of moving the product back to the family. That is ignorance, a lack of knowledge, but we are beyond all that now.

We are now in this situation for the families. I spoke fairly recently to Hannah Deacon, the mother of Alfie. Alfie is what we would expect a boy of that age to be—he can ride a bike and he can have a relationship with his sister that he has never had before, and vice versa. At times he is a naughty boy; hey, that happens. Is that not what we want for our children? Yet families are still in this limbo situation of having to raise money—beg, borrow, I am not going to use the word “steal”, but all of us in the House this evening know where I am coming from; they have to desperately try to raise money. The Government could use their power to buy this product so the families would not have to pay £2,000 for it; if the Government bought the product it would be vastly cheaper as it would not cost the NHS £2,000 per prescription.

[Adam Afriyie]

My right hon. Friend is making a powerful and passionate speech, and I thank him for his work in the Home Office and in pushing this through. Does he share my frustration that in many other countries around the world, including Germany, manufacturing is coming up to speed and producing well-defined products that could be exceptionally helpful, but because of the impasse we have here among the medical profession it will prove almost impossible to introduce those products here even though, based on the evidence we have, they are perfectly safe?

[Sir Mike Penning]

We are not reinventing the wheel, as my hon. Friend says: we started this but are now lagging behind the rest of the world. The product is slightly different—the oil has different forms of THCs in it. The Minister used to be my Parliamentary Private Secretary all those years ago—how the mighty fall, and how the mighty have risen up the greasy ladder—and she is passionate about trying to help on this, but it is not about Epidiolex; it is about the particular product being prescribed actually working, and it is normally to do with the levels of THCs.

I think this problem might be to do with the terrible word “cannabis” that we use in this country. This is not anything to do with cannabis, really; I wish we could invent another name for it and just say “oil with TCHs in it”, because that would eradicate much of the fear that there is at present—and it is not just fear, it is dangerous to the argument.

[Ronnie Cowan (Inverclyde) (SNP)]

I feel a little sorry for the medical profession, because a slight correction should be made. Fifty years ago in the Misuse of Drugs Act 1971 we pretty much classified cannabis as a poison. That is why the medical profession has not felt confident enough to use it, test it and research it; it simply could not. Now we are saying, “You guys have got to catch up and catch up quick,” and the Government have a role to play in facilitating that. Research is kicking off now, which is great, but although some say the medical profession should have been doing that for all these years, it could not do so because this place stopped it. On the right hon. Gentleman’s last point, let us call it “medical hemp”.

[Sir Mike Penning]

I completely agree on the medical profession and know exactly where the Home Office stood when I was at the Department. I would love to say that the whole of the Home Office and my civil servants in the narcotics part of it were thrilled by what I said in Westminster Hall all those years ago, but I can assure colleagues that they certainly were not, to say the least; fortunately, I had covered my back with the Home Secretary.

We need to move on from this, however. This is not about reform of the 1971 Act. It is about whether there is a group of children who we know get benefit from this, and whether, as we all know from our constituency postbags, there are other conditions that could also benefit from this type of oil with a THC product in it. That is where we are struggling.

We need to roll back this debate and talk, as I did at the start of my speech, about children—children who deserve the best possible start in life and just happen to have been born with a medical condition that the medical profession, in its infinite and great wisdom, has not quite got an answer for. This product is part of the answer, although it only alleviates the condition. As parents have said to me on many occasions, it does not take away the condition but it does let the children live a life as close to normality as possible; it is not normal, because it involves dropping oil on a little boy or girl’s tongue on a daily basis, but it is as normal as we can get.

[Tonia Antoniazzi]

It was a pleasure to serve with the right hon. Gentleman as co-chair of the all-party group on medical cannabis under prescription. On the point he makes about children, we have Bailey Williams in Cardiff, a constituent of my hon. Friend the Member for Cardiff West (Kevin Brennan), and that case highlights that these children are no longer classified as children after four years; they become adults. Bailey Williams is now 18, and the question arises of how things will change for him in a different health system with different rights. What would the right hon. Gentleman say on that?

[Sir Mike Penning]

The hon. Lady was a brilliant co-chair with me for all those years; we agreed on most things even though there is a tiny number of things we do not agree on. The hon. Lady is absolutely right. I have a constituent who has now turned 18, although it is not the THC but another medical component that particularly helps her. People come out of the care of one part of the health service and there is a little bit of a transition period but there is very little research on the evidential base going forward, and we need to do that research.

Let me touch for a second on what has been said to me by senior medical people in the Department of Health and Social Care. They said, “We need to do trials, Mike. We need to use placebos. We need to find out whether this actually works or whether it doesn’t work.” What parent on this planet is going to take their child off a medication that actually works, with the risk that they may get a placebo, have a seizure and die? Is that where we are in the 21st century, really and truly?

We had a statement earlier from the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi). We are a world leader in doing medical things. We have done things in this country around the vaccines that no one dreamed possible, yet we are talking about giving placebos—and those people were serious. I can tell the House that the parents were very serious, too. I cannot repeat some of the comments I got from some of the parents, but they quite rightly said—I will speak politely on their behalf—“Not in a million years.” Let us put it in those terms.

I know that the Minister will do her level best, but this is not about the Government taking over Epidiolex. Yes, they need to pay for research—I absolutely agree with the hon. Member for Inverclyde (Ronnie Cowan) about that—and research in this area could change the whole way that pain is addressed and perhaps get us away from using so many opioids, but this is actually just about having trust in the expert who has written the prescription for a child who may well die if he does not get that oil with the THC component on prescription.

[Tonia Antoniazzi]

I am sorry for intervening on the right hon. Gentleman again. The NHS keeps asking experts, but those experts are not experts in medical cannabis; they are experts in the condition of epilepsy but have no insight into that. Where is the foresight and vision to help these children with intractable epilepsy?

[Sir Mike Penning]

I alluded earlier to the narrow-mindedness of people who have taken an oath to protect people and protect children. No one, I would have thought, goes into the medical profession to hurt people, but at the end of the day, we have a group of children—not thousands, but a small group—whose parents are crying out, “Please listen to my specialist. Please listen to me, as a parent trying to save my child’s life.”

[Alberto Costa]

I thank my right hon. Friend for the good work that he did as my predecessor on the APPG. Does he agree that, given that there is such a small number of children across the country who suffer from severe forms of epilepsy, a temporary measure would be for the Government to be bold and simply cover the cost of private prescriptions until we develop the proper framework, along with the science that demonstrates conclusively the efficacy of this medicine?

[Sir Mike Penning]

I could not agree with my hon. Friend more strongly. That was what we did in the Home Office, which is why Alfie and some of the other children got their prescriptions paid for by the NHS. We set the committee up and we did it. I say again that I feel personally guilty, because we worked in all good faith to get the issue across to the Department of Health and it still has it, and those parents feel guilty, because they feel that other children should be having the benefits that Alfie is getting.

Surely, given the will of this House, the will of the Government, the will of previous Prime Ministers, the cross-party support, the fact that the previous Health Secretary came and met the parents here in the House and made them a commitment, and the fact that the Home Secretary who changed the legislation is now the Health Secretary, it must be a no-brainer. Let us look after these kids.

--- Later in debate ---

[Jim Shannon]

The hon. Lady is absolutely right: we do have to move forward, and that is the message from us all in the Chamber tonight. I know that Robin, on behalf of Jorja, and Darren and Danielle, on behalf of Sophia, tried almost every other thing that they could before they came to medicinal cannabis, and they have seen the difference almost right away.

[Sir Mike Penning]

I am sorry to come back in because I did speak at length, Mr Deputy Speaker. Some of the medics have tried all the other medications. Many of those, as I alluded to in my speech, are completely off-label, were never intended for this and have not worked, but they are willing to block the medical use of cannabis oil with THCs. Why?

[Jim Shannon]

I bow to the expertise of the right hon. Gentleman and I wholeheartedly agree with him.

We need the Government and the Minister tonight to give us an assurance that they will cover the prescription beyond September. The letter I referred to asked the Government

“to clarify the guidance which enables children…to continue to receive this vital treatment”

via their GP

“under guidance from a specialist and funded by the NHS.”

The clinical trial for a treatment manufactured by MGC Pharma, which is due to begin in the autumn, was also referred to. Until that happens and until those trials are completed, we really need to recognise the proof that each of us as MPs have, on behalf of our constituents, and confirm that medicinal cannabis improves quality of life.

I also want to mention my sister and her son, Jake. Jake never had medicinal cannabis when he was young. I wish he did, because I tell you what: I can see the improvement that he would have had at a very early stage, which he does not have today because of all those years of epileptic fits. It grieves me greatly to realise that the opportunity that Sophia and Jorja had was something that wee Jake did not. If we had had that years ago, perhaps his improvement would have been much greater.

I support the hon. Member for Edinburgh West tonight and the right hon. Member for Hemel Hempstead and everyone else who will speak afterwards, including in interventions—I thank all those who have intervened. We are all united tonight on retaining medicinal cannabis for our constituents. We as MPs, on behalf of these parents and children, can see the evidential base, and what an evidential base it is. We always say, “Let’s have the evidence.” Well, we have the evidence. We have it individually and on behalf of those families, and tonight, I look to our Minister to give us the reassurance that we need on behalf of our constituents back home.

--- Later in debate ---

[Crispin Blunt]

I wholly agree with the hon. Lady, whose leadership of the all-party parliamentary group on access to medical cannabis under prescription, along with that of my right hon. Friend the Member for Hemel Hempstead, adds to the whole discussion and illuminates the fact that our drugs policy is in a serious state of strife. It is not based on evidence, and we have to drag it in that direction. Behind the hon. Lady sits my friend the hon. Member for Manchester, Withington (Jeff Smith), with whom I have the honour of co-chairing the all-party parliamentary group for drug policy reform. We took over from the hon. Member for Brighton, Pavilion (Caroline Lucas) and from Paul Flynn. My objective, as the first Conservative to take his place, was to drag this conversation into the mainstream, which is where it belongs.

However, we need to remember just what got this over the line in the first place. The Dingley family behaved perfectly within the rules. They made applications and everything else, and indeed we had an urgent question on the subject. I remember my right hon. Friend the Member for Hemel Hempstead interrogating the then Policing Minister, who had taken on the responsibility, about when this was going to happen, particularly for Billy Caldwell.

What got this over the line, however, was the fact that Bill Caldwell’s mum, Charlotte, was brave enough to obtain the medicine in north America, present it to customs and have it confiscated. Her son was then hospitalised and was fitting, and within three days the overseeing consultant was on the steps of the hospital saying, “I do not care about what is going on here; it is unbelievably cruel to take a medicine that works away from a child.” The following day, the then Home Secretary—now, wonderfully, the Health and Social Care Secretary: what a brilliant repositioning that is—authorised the return of Billy’s medicine, or at least some of it, from customs so that he could receive his treatment.

[Sir Mike Penning]

While we are name-checking colleagues, we should mention one chap who is not here because he has left the House, and that is Frank Field. My hon. Friend referred to Frank—[Interruption.] Oh, he is in the other House now, is he? Lucky fella! Frank and I were absolutely adamant that the following day, we were going to go to Holland and come back, and that unless a change to the legislation had been indicated the following day, we would be arrested. But what a great reason to be arrested, trying to save someone’s life! It was Frank’s idea, and I jumped on with him—we should also acknowledge other people including Billy Caldwell’s family and Alfie’s family; I completely agree with that—but without Frank jumping in as well, we would really have struggled.

[Crispin Blunt]

This is where we come to the cost, to which the hon. Member for Gower (Tonia Antoniazzi) drew my attention. In order to get Alfie Dingley’s prescription over the line, it would have taken £5,000 for the person who was going to make the application, who happened to be on holiday in the Galapagos Islands and who then had to be interviewed by Home Office officials before he was allowed to make the application; £5,000 for the pharmacy to get a licence to bring it in; £5,000 for the pharmacy then to hand it out to the doctor; and then £5,000 for the licence for the prescribing doctor. I mean, I ask you! It might have been possible to pay in that case, but behind the case of Alfie Dingley, there is not just a score of epileptic children.

--- Later in debate ---

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

First, I congratulate the hon. Member for Edinburgh West (Christine Jardine) on securing this debate. I agree with colleagues’ comments: it has been incredibly helpful to have time to talk about this issue. As I sat on the Front Bench, the debate highlighted to me, first, the needs of these children and their families, and secondly, the complexity of the whole situation. We can make statements, but there are no easy solutions. This issue involves the medical profession, licensing and trials.

Let me thank all those who have contributed to the debate. In no particular order, so as not to upset anybody—I have met many of those who have contributed on numerous occasions—I thank my hon. Friends the Members for South Leicestershire (Alberto Costa) and for Windsor (Adam Afriyie), and the hon. Members for Strangford (Jim Shannon), for Gower (Tonia Antoniazzi) and for South Antrim (Paul Girvan).

I thank my right hon. and learned Friend the Member for Kenilworth and Southam (Jeremy Wright), who is not in his place but with whom I have met. As is the constituency MP for Hannah Deacon and Alfie, he has contacted me and spoken to me on several occasions.

I thank the hon. Members for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) and for Inverclyde (Ronnie Cowan), to whom I shall not forget to wish a happy birthday.

As my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) said, we have known each other a long time and I have carried his bags on more than one occasion—

[Sir Mike Penning]

Not no more!

[Jo Churchill]

Not no more, but I understand where his passion comes from.

I can also see in their places the hon. Member for Manchester, Withington (Jeff Smith)—we have spoken about this matter—and my hon. Friend the Member for Reigate (Crispin Blunt).

At the heart of this debate for me are Alfie; Billy; Eddie Braun, who was not mentioned; Murray; Jorja; Maya; Bailey Williams, mentioned by the hon. Member for Gower; Sophia; and others. It is about those children. I have personally met several of the families and heard at first hand how it feels not to be able to have anything more. To be honest, as a mum of four, I can say that sympathy feels a bit useless when it comes to a mother who, in some cases, can watch their child fit 100 times a day. They have explained to me the relief that applying Bedrolite under the tongue brings to their children. They have spoken about the financial challenges, but I would like to use the time available to go over some of the challenges that I am trying to wrestle with to get to a solution.

We have had an accordion debate tonight. Initially, the hon. Member for Edinburgh West said that this debate was about access to NHS prescriptions. However, many others also spoke about how much this might benefit multiple sclerosis sufferers and those with chronic pain. Indeed, Lord Field in the other place has written to me on this subject and spoken about the relief of chronic pain that I think he himself gets from using a cannabis-based product. However, there does have to be an evidence base that is more than observational.

--- Later in debate ---

[Jo Churchill]

I understand that point and I have said to those parents that I would struggle. In fact I would probably find it impossible to offer my child something else when they were already gaining relief from something. However, as we have debated here today, there are probably two issues here: the treatment of those children who are already on Bedrolite; and the need for an evidence base, particularly when we start to talk about expanding the use of cannabis medicines for those suffering from a large range of other medical issues, be it MS sufferers and so on. This is where the challenge comes. Clinicians rightly want to prescribe based on the evidence so that they do their patients no harm. Many people have said that this is the place of last resort for these parents, but we have this difficulty.

[Sir Mike Penning]

rose—

[Jo Churchill]

I will go on to explain why after my right hon. Friend’s intervention.

[Sir Mike Penning]

I have two points. The first is that it is not all Bedrolite. A lot of these parents do not have Bedrolite. There are myriad specialist ones with different THC levels, but they have been prescribed by a consultant. I know what my hon. Friend said, but these are consultants, and they do want to prescribe the drug and they have prescribed it, but they are not allowed to put it on an NHS prescription unless you are Alfie, Billy or any of the others. It just does not make sense.

[Jo Churchill]

I agree that there are other medicines, but one of the challenges is how we treat people with ongoing needs as their conditions vary, if we do not have the ability to understand how the body is responding.

I will push on a little bit. Let me provide an update on Bedrocan oils from the Netherlands. As stated previously, the commercial agreement between Transvaal Apotheek and the UK special medicines manufacturer, Target Healthcare, is progressing. The Medicines and Healthcare products Regulatory Agency and the Home Office are working with those companies to ensure that all regulatory standards for manufacturing these medicines in this country are met. We continue to work closely with the Dutch Government, Transvaal, the Home Office and the MHRA—which I have met with and which says it will look at the international evidence—to ensure continuity of supply until domestic production has been established. We have had movement; I can sense the frustration in the House tonight, but we are moving forward. I will continue to keep the House informed of progress.

On the main topic of the debate, it is undeniable that it is incredibly hard for many of the patients and their families. As many Members have said, the challenges have done nothing but worsen during the covid-19 pandemic. The Secretary of State for Health and Social Care, my right hon. Friend the Member for Bromsgrove (Sajid Javid), when he was Home Secretary, changed the law to allow unlicensed cannabis-based products for medicinal use to be prescribed by doctors on the General Medical Council’s specialist register. This removed legislative barriers to legitimate use as a medicine. However, there is still caution across specialists in their ability and willingness to prescribe. [Interruption.] Indeed. However, with respect, if the prescribing of these medicines by a clinical specialist was that seamless, we would have more of it, but we do not.

The whole thing comes back to the fact that clinicians want to rely on an evidence base, and that includes clinicians in Scotland. We recently received a letter from the Scottish Government, outlining that Dr Rose Marie Parr, former chief pharmaceutical officer, had chaired a teleconference with key paediatric neurologists from specialist centres. The clinicians had a clear and united view that, following the GMC and British Paediatric Neurology Association guidelines, they would be unwilling to prescribe CBPMs containing THC, including Bedrolite, until there is clearer, published evidence available following a clinical trial.

--- Later in debate ---

[Jo Churchill]

I am going to make a little progress, because at this rate we will go up to the end of the time. I will come to my right hon. Friend the Member for Hemel Hempstead.

While saying that it should remain a clinical decision for doctors—indeed, that was very much what I took from the hon. Member for South Leicestershire, because it would be inappropriate for Ministers in Whitehall or the Scottish Government to influence individual prescribing decisions—with the exception of three licensed medicines, cannabis-based products for medicinal use are not first-line medicines and are not routinely funded. Most cannabis-based medicines are unlicensed medicines, and that means they are yet to have their quality, safety or efficacy assured by regulators here or, indeed, anywhere else around the world. Nor has their cost-effectiveness been decided by the National Institute for Health and Care Excellence, which is how we administer medicines. Those are the foundations of NHS decisions about routine funding. The cost of treatments sought privately remains the responsibility of the patients, and I am not cloth-eared to how difficult that is and why we need to try to find a solution.

[Sir Mike Penning]

rose—

[Tonia Antoniazzi]

rose—

[Jo Churchill]

I will give way first to my right hon. Friend.

[Sir Mike Penning]

The Minister is being very generous, although we have plenty of time. I think we have until half-past 10, Mr Deputy Speaker, should we or you wish. I have two questions. The hon. Member for Gower (Tonia Antoniazzi) asked a specific question: how is it safe on the NHS for three prescriptions to be given to three children, paid for by the NHS, but not any others? Is it safe, or is it not? The Minister referred earlier to clinicians not having the confidence to give the prescriptions. Is she aware that one of the clinicians was reported to the General Medical Council for writing a prescription and was exonerated? That is why they are scared; they are scared for their careers. How can it be safe for three children, but not the other children whose lives can be saved?

[Jo Churchill]

I thank my right hon. Friend. I have met clinicians, as well as the families. Like just about every other area of medicine, there is divergence in how they approach it. There are those who prescribe and those who do not. I have also spoken to Alfie’s general practitioner, who was very articulate in describing the benefits that Alfie saw from taking medicinal cannabis. However, it is still fundamentally the decision of the clinician who has the child as the patient. One thing that has been said to me is that it is important, as we try to move forward and do better, to ensure that private specialists also have conversations with those who are treating the children for other issues in their NHS care, because of contraindications and so on, as was referred to earlier.

Independent Medicines and Medical Devices Safety Review

Mike Penning Excerpts

Thursday 9th July 2020 Commons Chamber

[Ms Dorries]

I thank my hon. Friend—I do regard her as a friend because she is such a principled campaigner on issues such as this. I hope she does not mind my saying that I know that her mother gave evidence to the review and went along to one of the hearings. I thank her for that, because it was a very brave step to take. This is not an easy thing to talk about, so that was incredibly brave of her. We owe her for her bravery in coming forward, and I thank the hon. Lady for mentioning that.

I completely agree with the hon. Lady. I cannot comment on the specific point about individual doctors with expertise because work has to go forward on removals of meshes and on where we go in the future. However, on specialist centres—I think she is aware of this—NHS England is assessing bids from NHS providers to become specialist centres and to provide treatment for women with complications from mesh inserted for urinary incontinence and vaginal prolapse. Following the covid-19 pandemic, during which some of this work has unfortunately been halted, every effort is now being made to finalise the centres quickly. Stakeholders will be kept up to date with progress, but we do want to see more of that work.

[Sir Mike Penning (Hemel Hempstead) (Con)]

In October 2017, I stood in this very spot with the report in my hand, and it was a whitewash. It was disgusting to the victims—we have not heard that word yet today, but they are victims—of what has gone on in these three terrible cases. In particular, the Primodos victims were shown no compassion in the report and were in many ways blamed for what had happened to their children.

The new report is completely different. I apologise to my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who was the Secretary of State, because I was critical of the three problems being put to Baroness Cumberlege in one inquiry; I thought it would be much better if each was looked at individually. I apologise to Baroness Cumberlege, because I said that to her as well as to the then Secretary of State, and I was wrong. This report is probably the best report on what has gone wrong inside the NHS that I have ever seen.

The NHS does wonderful things, but it gets things wrong. We all praise the NHS. We stood outside last weekend—I hope people did—and praised the NHS on its 72nd anniversary. But when it gets it wrong, it gets it seriously wrong. In 1967, it knew that Primodos was a danger: the company knew and the NHS knew. Young women went to their GP, and said, “I think I might be pregnant”. Very often, no prescription was issued. There were no warnings and no concept of what could happen to their foetus if they were pregnant. The drawer was opened and the tablets were given to them. Those tablets were given by the drug company to the GP, who in many cases did not even issue a prescription.

Today, we have the report, with nine recommendations, but how are we going to compensate those families? It is not just for the women, but for their families, including the men who have stood next to them, such as Marie Lyon’s husband, who has been with her all the way through. How are we going to compensate those who lost their baby, who were told to abort their baby or who had a stillbirth? How are we going to compensate and help those families when the loved ones, the mums and dads of the survivors—they have terrible disfigurements, and they did brilliantly well to give evidence for the report—are no longer with us and the survivors need such support afterwards? While we must make sure this never happens again, we must also make sure that we look after those families and that the drug companies pay for what they did to those families.

[Ms Dorries]

My right hon. Friend makes an impassioned and compassionate contribution, and he should be recognised for his long-term campaigning and his advocacy of the people he mentions who have suffered as a result of what has happened. I cannot comment on the individual points he has raised, particularly on Primodos, because there is legal action pending, but I hear everything he said and others will hear his comments too.

Acquired Brain Injury

Mike Penning Excerpts

Thursday 6th February 2020 Westminster Hall

[Chris Bryant (Rhondda) (Lab)]

I beg to move,

That this House has considered acquired brain injury.

In 1980, I woke up in the middle of the night on a train from Barcelona to Madrid. All I could sense was the world moving in and out. It was not the worst headache that I had ever had or anything that could even be described as a headache; it felt as though my brain was struggling to burst out of my skull. As it turned out, I had viral meningitis. In the end, I was fine after a lumbar puncture and treatment in Madrid, but I feel very lucky, because many people who have had meningitis—with that precise feeling of the world going in and out as the brain pushes against the meninges and the skull—now have permanent brain damage.

Because of the work that I have done on the issue over the last couple of years, I am very conscious that there are some phenomenal people working with those who have brain injuries. Last year, I spent a beautiful day with the Children’s Trust in Tadworth, where a third of the children have had a haemorrhage of some kind, while others have been in road traffic accidents. The trust does phenomenal work to rehabilitate those children—restoring in them a sense of themselves—and to get them back into the education system.

I spent a day with the National Star College near Cheltenham, which does phenomenal work teaching many of these youngsters skills that they can take into the work environment. I saw people whose injuries put them in a challenging position learning to socialise again, and to understand their personal lack of inhibition and its impact on other people. Professionals working in south London explained to me the difficulty in moving people out of hospital and into other forms of community support, especially when families may have been broken up by, for example, the same road traffic accident that led to the injury.

Whether in Norwich, Lincoln, Birmingham or Manchester, the most extraordinary people are doing what looks like miracle work. They can take somebody from needing five or six people just to be able to clean, feed and clothe themselves during the week to the point where, after a year or two of neurorehabilitation and care and support of every different kind, they can do the vast majority of those things more or less on their own, relying perhaps on only one person. The narrow-minded might say, “That is a great success, because it means that the state will not have to spend so much money on them,” but it is a miracle to see such a transformation of those people’s lives. It is also depressing to see, for example, a young lad who has been sitting in an east London hospital for far too long because there is nowhere else for him to go that is safe and can provide the right kind of care.

In Cardiff, I met a young lad for whom we recently held a fundraising dinner at the football stadium—he is a magnificent chap. He had to go all the way to Tadworth because it is the only place in the country with residential neurorehabilitation of that kind for children. I want to that care to be provided closer to home so that parents do not have to make enormous journeys and children do not feel discombobulated and uncertain about their role in the family and how their life will proceed.

The Disabilities Trust has done amazing research—partly in Cardiff prison, but in other prisons, too—that the Government now wholly accept as factual and as the basis on which we should proceed. Who would have thought, even five or 10 years ago, that analysis of both male and female prisoners arriving in prison would show that more than half had sustained a significant brain injury at some point in their lives? The Government’s website states that someone who has suffered a significant brain injury is twice as likely to commit a serious crime. There is perhaps not just a correlation between the two, but a causal link. Maybe this is not, as some of us have said, a hidden epidemic affecting 1.3 million people across the country, but something much more systemic. If we can spot those who need support, ensure that they get it and deal with brain injuries sooner, so many other societal issues might be addressed.

Work with young offenders in my patch of south Wales, where we have a very good co-ordinated approach, made it clear that a child from a poor background is four times more likely to suffer a brain injury under the age of five, with similar figures for teenagers from poor backgrounds. Those ages are both important developmental periods for the brain, which is a soft organ inside a hard, craggy shell, and is therefore extremely vulnerable if pushed around or jarred. In my patch, three quarters of the youngsters in the criminal justice system who caused the biggest problems were those who had suffered significant brain injuries that had been left largely untreated. If we had dealt with those injuries in the first place, we might have been able to help those children in the education and health systems long before they entered the criminal justice system. That would have meant a much better outcome for those individuals, their families and society, and a much greater saving to the public purse.

Members will know that a brain injury can come about for all sorts of different reasons: a traumatic incident, such as a fall or a crash, or just a single punch. I can remember so many horrific incidents in my constituency, outside pubs and so on, where somebody has been punched in a fight. That punch, or the individual hitting the pavement or the wall, may lead to an injury that completely changes their life. The cause of a brain injury could be that, or it might be a haemorrhage, an aneurism, a tumour or carbon monoxide poisoning. Carbon monoxide poisoning can particularly affect people in rental accommodation, and we have to make sure that landlords properly test all the equipment in the house to ensure that a faulty boiler or heating system does not poison those who live there. We now have a much better understanding of carbon monoxide; not only can one big exposure to it do damage to an individual, but even relatively low levels sustained over a period of time can damage the brain in the same way.

Hypoxia is another cause of similar problems, as is stroke. I am quite conscious of this issue, because quite a lot of people have got in touch with me and said, “Why don’t you talk more about stroke?” It is not because I do not understand the problems in relation to stroke and brain injury—many of the issues are exactly the same; it is an injury, just by a different means—but because there are organisations specifically dedicated to stroke, such as the Stroke Association, which have been dealing with it. We in the all-party parliamentary group on acquired brain injury have tended to leave that to one side. But when we bring it all together, we realise that we still have a limited understanding of how to look after, treat, care for, provide for and protect the part of our body that we think of as the place where our personality resides, and therefore as the bit that is most intimate to us as human beings.

It is only recently that people at the Ministry of Defence have started to think that perhaps some people who have been diagnosed with post-traumatic stress disorder actually had brain injuries that were not treated and that led to all the other issues.

[Sir Mike Penning (Hemel Hempstead) (Con)]

I congratulate the hon. Gentleman on securing the debate. As other Members want to speak, I will not intervene for long. A lot of diagnoses were not made at the time, sometimes because the symptoms were just not there. There needs to be an understanding, not just in the Ministry of Defence but in the medical profession—I will come on to social services—of what a brain injury is. A brain injury does not necessarily show itself straight away, and it does not necessarily have physical symptoms; it is inside this little cocoon that we rely on so much.

[Chris Bryant]

Perhaps we have thought, “Well, a little blow to the head is okay; we don’t mind and we’re not going to worry about that.” The right hon. Gentleman is right; perhaps we have been a bit blasé about it, and perhaps even more so in the armed forces, where people want to show that they are tough and can carry on.

Incidentally, the appearance of symptoms some time later is equally an issue in education. A child might come back to school wearing a bandage, at which point everybody is warm, friendly, loving, caring and supportive. Nine months later, when the bandage is gone and everyone presumes that the child is getting on with their life, the child may start becoming difficult in class, finding it difficult to concentrate and falling asleep in lessons. They may be less in control of their inhibitions, and all the rest of it. The teacher may not recognise that as part of what happened nine months before.

Unless teachers and the whole education system are trained to understand fully the concept of neurocognitive stall, there is a real danger that the child will end up becoming increasingly difficult because they do not know anything else; they get shouted at, which sends them into panic rather than making them say, “Please, Miss or Sir, I need some support and help.” Then the child ends up getting excluded and falling into the criminal justice system. If the support had been sustained from day one for at least a year, and if we had made sure that all the teachers in the school understood those issues, we might have been able to save that person’s education.

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[Sir Mike Penning (Hemel Hempstead) (Con)]

It is a pleasure to take part in this debate. I campaigned for free car parking with my right hon. Friend the Member for Harlow (Robert Halfon), and I completely agree with what the hon. Member for Mitcham and Morden (Siobhain McDonagh) said about it. Perhaps the Minister cannot commit now to abolishing car parking charges, but I am sure that the Government will do so because we campaigned for that all the way through. No distinction should be made between one type of case and another; people who need to be by their loved one’s bedside should not be paying car parking charges. The NHS was designed to be free at the point of delivery, and that includes car parking for people in that position.

The hon. Member for Rhondda (Chris Bryant) is right in most, if not all, of what he said. His personal experience has given him an outlook that someone like me could not possibly have. Interdepartmental work is the only way to take this forward. Like my right hon. Friend the Member for South Holland and The Deepings, I have been a Minister—in my case, in seven Departments, before I managed to upset the last one and came to the Back Benches. This will only work if the Prime Minister says that there will be an interdepartmental group that will meet regularly and will be chaired by so-and-so—probably the Deputy Prime Minister, as it was then, or the Cabinet Office—and that they will report back what each Department is doing.

As we have heard, nearly every Department will be affected, from the Department for Digital, Culture, Media and Sport—the hon. Member for Airdrie and Shotts (Neil Gray) has alluded to football, and I will declare an interest about rugby and boxing in a moment—to the Department for Work and Pensions, which deals with how personal independence payment is assessed, and where I used to be a Minister. As I said earlier, because of the nature of the injury, it is not always visible; very often, it is inside.

I will touch on some other points. I understand exactly where the Scottish Football Association is going in looking at the issue of younger people and heading, but if those young people go on to play professional football later, they will head the ball. The rest of the world of football must take a leaf out of rugby’s book—particularly rugby union. I declare an interest: I stupidly started playing rugby when I was 11, and I am still playing now. I will be playing against the Welsh Assembly at Richmond in a couple of weeks’ time; that game might be slightly more interesting than the England-France one was.

Perhaps because we have seen some shocking injuries and we know what is going on, the game has changed, not just in that we now pull people off the pitch to be assessed, but in how we tackle. To be fair, a lot of that has to do with American football, where they used to lead with their head because they had the protection of the helmet, and because of machismo. Women’s rugby is the fastest-growing female contact sport in the country, and it has been for years; quite right, because it is brilliant to watch. However, in women’s rugby as well as men’s rugby, the game had to change to protect the players—those going into the tackles as much as those coming out of them.

[Neil Gray]

Like the right hon. Gentleman, I declare an interest in view of my past, rather diminished career as a rugby player. Football certainly has a lot to learn from rugby, not least when it comes to what he is saying about the contact area. The enforced absence of a player from the pitch for a period of time following a concussion diagnosis is also important, and it is something that football needs to learn from.

[Sir Mike Penning]

I could not agree more, and I was just coming on to that point. The Football Association and FIFA do not need to reinvent the wheel. We need to take time to assess whether a person has been concussed and, if so, they should not play the following week or the week after that. Those assessments have to be done by professionals, away from the pitch, and sometimes with scans.

Rugby has led the way. I watched a rugby league match this weekend—I have a rugby league team in my constituency, even though I am deeply in the south. Some of the tackles just would not be allowed in rugby union any more. As far as I could work out, they were old-fashioned spear tackles—the player is allegedly going for the ball, but they catch their opponent around the top of the neck, and that causes damage to the brain, which rattles around inside the piece of bone that protects the brain. It is plainly obvious that we needed to change, and it has taken time—probably too long—but it has happened.

Boxing also has to change for the better. I declare an interest, in that I boxed for many years. I am talking not just about the terrible things have gone on in the ring, as a result of which people have died for a sport that they love and want to be involved in, but about what happens to people years later. I will not name names, but I know several former world boxing champions who now suffer the consequences of the brain damage that they incurred. They can be read about in the papers. I do not need to name them, and it would be improper to do so.

This is not just about concussion. People in this situation have gone through clinical depression, and their injuries affect them and their loved ones for the rest of their lives. We must support more awareness and encourage the sport to do all it can to open up. We do not need to reinvent the wheel, but we must learn from other sports. I wish the hon. Member for Airdrie and Shotts luck in Scotland on Saturday, and I hope that England play somewhat better than they did against France. Let us hope that there are no injuries like some of the ones we have seen in the last couple of weeks. There was a neck and spinal injury at the Saracens-Worcester game the other week, and it was spine-chillingly horrible. People want to play the sport and it is their passion—stupidly, I still play—but we have to make sure that we protect them.

I want to touch on long-term care and the assessments that are carried out when people with a pre-existing brain injury of some description get dementia. Continuing healthcare is an absolute minefield. I have heard about this from too many of my constituents, and from colleagues in the House over the years. Even though someone who is going into care has a medical condition—a brain injury—before dementia comes on, that seems to be put to one side when the panel look at continuing health provision for them. That is fundamentally wrong.

Just because someone develops dementia or Alzheimer’s, it does not mean that their other medical conditions have vanished off the face of the earth. They have not. But time after time, I have had to help individuals and their families to go to appeals and tribunals to get something that they would probably have got if the individual had not got dementia, but that that they do not get because they have dementia alongside the pre-existing injury. It sounds very complicated, but it is actually very simple. If someone has a medical condition, such as a brain injury, that brings on dementia—we do not really understand that, and I was reading some research last night on the reasons for it—surely, the medical and nursing care that they needed for that brain injury should not be put to one side when they go for an assessment if they have Alzheimer’s or dementia.

I give praise where praise is due. I was a shadow Health Minister for four and a half years when the last Labour Government were in power, and they started the major trauma centres. The debate started with them, and they progressed it. The issues with major trauma centres are about where they should be, how quickly people can get to them and whether enough people are using them to make them viable, given the required expertise. To be honest, it is the same old story as with A&Es. Major trauma centres are not A&Es; they are specialist units for people who need specialist care. People who need to go to A&E should go to A&E, and people who need to go to a minor injuries unit should go to a minor injuries unit. It is about making sure that people go to the right place.

With major trauma, the decision is made for people. All the major trauma centres have helipads now. I truly hope that as they develop as centres of expertise, we will recognise that people need travel to the right place to see the specific consultant specialist who can save their life. That may not be the centre that is just down the road or the one in London—for my constituents, such things often involve coming into London—but it might be one that is 20 minutes away by helicopter ride. That is absolutely right, if that is where the expertise is. The time when people need to be closer to home, and to the support of their loved ones, is when they come out of major trauma centres and into rehabilitation.

Public understanding about major injuries is better these days. I was a fireman for many years and, sadly, I went to too many road traffic incidents. People are increasingly surviving major road traffic incidents or collisions. We tend not to call them accidents these days, because they are not accidents—they are preventable—and victims feel very strongly that we should not call them accidents. I understand that view. I made a big booboo as road traffic Minister when I talked about road traffic accidents. I did so because that is what firefighters did, but I respect the point: every accident is preventable, and these are collisions in which people’s loved ones are involved.

Today’s survival rate has a lot to do with the manufacture of the vehicles, airbags and how crush plates work inside vehicles. Those things mean that more people are surviving, but with very serious injuries. As I alluded to in my intervention, some of those injuries are physical and show themselves there and then, but a lot do not show signs until much later—sometimes nine weeks or nine months, or sometimes many years later.

That brings me to my final point, which is about our armed forces. We send our armed forces around the world. They work in a very dangerous occupation, and we try to make it as safe as possible. Sometimes, there are injuries in training. We sadly lost one of our Royal Marines only the other day; he was doing the job he loved and training to do something he was passionate about. Our thoughts and prayers are with his family, friends and loved ones.

We must look after our armed forces personnel after they are injured. I can remember so many incidents around head injuries when I was a squaddie, and there was no way that I would have gone down to the medical officer the day after a head injury with a headache. The barrack room humour would have been all about, “Get on with it. You are supposed to be robust.” I have been the Minister for the Armed Forces, and I think we are getting there, but the way forward is to improve public awareness. That involves debates such as this, and perhaps an overall Government body that can look at the issue in general terms. I hope we do not need too many of these debates—I have been around a long time—before we get to a better position in Government.

--- Later in debate ---

[Caroline Dinenage]

I will certainly seek to get that in writing for the hon. Lady.

My right hon. Friend the Member for Hemel Hempstead spoke about continuing healthcare. I know that that is a concern for many people, but what concerns me is that actually, CHC is needs-based, not diagnosis-based, so eligibility should be assessed by looking at all of an individual’s needs and considering their nature, complexity, intensity and unpredictability. If he wants to drop me a line about an individual case that he is concerned about, I will be more than happy to look at it.

[Sir Mike Penning]

It might be a lot of cases; I think the Minister will have had a lot of cases from across the House. I completely agree that that is what the principle should be. In practice, however, I ask her to look at the amount of appeals that have taken place, and she will realise it is not quite working.

[Caroline Dinenage]

I will very much take that on board.

The hon. Member for Washington and Sunderland West asked me a number of questions. I may not have written them all down, but she asked about workforce. We have the people plan, which Baroness Harding has been working on, which will be released later this year. It will look at all forms of medical professionals, but also the allied health professionals that the hon. Lady mentioned.

The hon. Lady asked what conversations I had had with the Department of Education. That Department is currently undertaking a review of special educational needs and disability, which will look at all aspects of supporting young people through their education. We are playing a key role in that SEND review. She also asked what conversations I had had with the Department for Work and Pensions about training. Case discussions about claimants with ABI now form part of a new entrant training for all healthcare professionals undertaking work capability assessments, and they all have access to a learning module on ABI, which was updated in 2018 and has been quality assured by Headway.

I hope that today’s debate has continued to demonstrate how seriously the Government take ABI. We are committed to ensuring that people get treatment, care and support when they need it.

Health and Social Care

Mike Penning Excerpts

Thursday 16th January 2020 Commons Chamber

[Matt Hancock]

I am, because Milton Keynes’s new MP has already been working with me to bring this concern to light. I can inform him that the new cancer unit will be handed over to Milton Keynes hospital at the end of next week. That problem is indeed temporary and it is being resolved, very much thanks to the hard work of the new MP for Milton Keynes.

[Sir Mike Penning (Hemel Hempstead) (Con)]

I thank the Secretary of State for his meeting the other evening. I am sure my right hon. Friend the Member for Harlow (Robert Halfon) is thrilled that he is one of the six to get a brand-new hospital.

In south-west Hertfordshire, as the Secretary of State knows, we are not happy about having a hospital in the middle of Watford, next to a football stadium. It is not right for my constituents or for many constituents of Members in the Chamber today. The Secretary of State has committed to me privately to look at whether we can have a new hospital elsewhere, and I know there is a review going on about the funding and how much that would cost. Would he like to reiterate that at the Dispatch Box?

[Matt Hancock]

Yes, we are doing that work to make sure that, as we pump hundreds of millions of pounds into Hertfordshire to improve its healthcare, we get the exact locations right. I look forward to working with my right hon. Friend on that.

--- Later in debate ---

[Sir Mike Penning (Hemel Hempstead) (Con)]

When I sat in the Chamber earlier, I was not certain that I was in the right place. As you will know, Madam Deputy Speaker, we are not used to so many people listening to speeches—and what brilliant speeches they have been, particularly from the new entrants in the House. I say to newly elected Members of Parliament: this will not last. As we get further into the Session, trust me, it will not last.

I thought back to my maiden speech in 2005, when I made a promise to my constituents that I would go on and on and on about the acute problems at the hospital in my constituency. There was a bit of politics. I am not making a maiden speech, so I can be a little more controversial than some of my colleagues here today. The Labour party made the decision—in those days it was the Minister’s decision—to close the acute facilities at Hemel Hempstead Hospital. Acute facilities at St Albans had already been closed, and promises were made that those facilities would always be looked after at Hemel Hempstead Hospital, which was fairly new. We are a new town, so this was not about dilapidation. It was a fairly new hospital, but the decision was made to move those facilities to the centre of Watford, next to Watford football club.

I have nothing against Watford football club. As you may have heard, Madam Deputy Speaker, I am an ardent Spurs supporter, so this weekend will be very difficult for me as the Spurs play Watford. I want every success for the local clubs, but we have a Victorian hospital next to that football club, in a very difficult traffic area of Watford, and it is well over 100 years old. In the modern world we live in, would we dream of building a hospital in the middle of a town, next to a football club? Of course we would not. So I was simply thrilled—this is where I am going to get controversial on my own Treasury Front Bench—when it was announced that in south-west Hertfordshire, in my part of the world, we would get one the first six new hospitals—six new hospitals were announced; five new hospitals and one refurbishment—guess where, Madam Deputy Speaker: next to Watford Hospital.

We can moan and moan at Ministers, but the difficulty these days is that we have devolved so much power to local health authorities. That sounds good on the tin, but having oversight from local, democratically elected people is really very difficult. The clinical commissioning groups should listen and in our community they are not particularly listening. West Hertfordshire Hospitals NHS Trust is absolutely determined that this is where they want to build £400 million of new facilities: in the middle of Watford, nowhere near the community it should be serving—apart from the people of Watford, to be fair.

We continue to campaign. We have not given up. We do not want to reopen the facilities at Hemel Hempstead Hospital and we do not really have the land available in St Albans. What we have said is this: let us build a new hospital for south-west Hertfordshire. That is what we would do today; that is what the money in the new hospitals plan would do. To be fair, the Secretary of State has seen me and he has asked his officials to look into what the cost-evaluation would be. We have had costings of £1 billion for a greenfield site put out on local radio, interestingly by the Mayor of Watford, and we have had costings from other parts of the country as low as £375 million. So something is seriously going wrong between the costings.

We have got into a situation where the only way we can fight this, believe it or not, is to take the trust to court. There is a lack of accountability—I have called for debates in this House on that for years now. The only way we can fight the fact that the trust has only put in a bid for refurbishment of the Watford site is to take it to court and challenge it under judicial review. I have a fantastic community. We have raised the money. We will go to court. But is it not crazy that here I am praising, and I will be voting for, the Queen’s Speech and against Labour’s amendment, when I am saying that the £400 million being offered by the Government is going to the wrong place?

I listened deeply to the former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), when he said that we have to admit it sometimes when we make mistakes in the NHS, whether they are clinical mistakes, mistakes on Primodos—another thing I like going on about in the Chamber, although I do not have the time to do so this evening—or the fact that we do not have prescribed medical cannabis free at the point of delivery to our children when a consultant says it should be prescribed. The only way we can fight this at the moment is to go to the courts. I am pleased with the Secretary of State on this, and I know that this will all be fed back. There was supposed to be a letter to me in the last couple of days from the people looking at the funding. That has not arrived yet, so—hint, hint, Front Bench—let us get the letter to me.

I do not want to go to court and the community do not want to go to court, but I was sent here to fight for something. The biggest issue in my constituency is the future of my hospital and the future provision of care in my constituency. We want a new hospital on a greenfield site. This Government, I believe, could fund that.

The National Health Service

Mike Penning Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Jonathan Ashworth]

I completely agree, and I pay tribute to my hon. Friend and to hon. Members such as the right hon. Member for Hemel Hempstead (Sir Mike Penning) who have led the charge in this debate. If medicinal cannabis has a medicinal, therapeutic value, it should be allowed. If there are issues in the bureaucracy that are slowing it down, and if that needs legislation, we will work with the Secretary of State to get it through, if that is where the blockage is. If the blockage is in some other area and he needs our co-operation, we will co-operate with him. We need to resolve this, because too many young people are going without the help they need.

[Sir Mike Penning (Hemel Hempstead) (Con)]

The shadow Secretary of State is being very generous, and I thank him for his comments—the families, who are the most important people, will be very conscious of what he has said—but we have to be very careful when describing this: we are after the medical use of cannabis on prescription. The medical use of cannabis often relates to cases where people have felt they would take it in other ways. We are not talking about the casual use of cannabis, about a spliff in the armchair. I will raise this with the Secretary of State when he is on his feet: we are saying that where a qualified consultant feels that cannabis on prescription would benefit the child, particularly if they have epilepsy and fits, it should be available free on the NHS. I think that is what the hon. Gentleman is saying.

[Jonathan Ashworth]

Absolutely. There appear to be blockages in the system, however, and my offer to the Secretary of State is this: if those blockages are there because of legislative or regulatory issues that need resolving in this House, I will co-operate with him to get those resolved. If it is not about regulatory issues in this House, I will continue to reinforce the issues that the right hon. Gentleman is putting to him and urge him to intervene using his good offices.

Many vulnerable people are waiting longer for treatment or being denied treatment, sometimes, sadly, with devasting and tragic consequences. The standards of care enshrined in the NHS constitution are simply not being delivered. A&E waits in September were the worst they have been outside of winter since 2010. Our hospitals have just been through a summer crisis, and with flu outbreaks in Australia expected to hit us here, our NHS is bracing itself for a winter of enormous strain yet again.

Last year, 2.9 million people waited beyond four hours in A&E. Since 2010, over 15,000 beds have been cut from the NHS and bed occupancy levels have risen to 98% under this Government. The number of patients moved from cubicles to corridors and left languishing on trolleys has ballooned under this Government. When Labour left office, around 62,000 patients were designated as trolley waits, which was unacceptable, but today under this Government that number is 629,000.

What about cancer?

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[Matt Hancock]

My right hon. Friend’s mind is so aligned with my own that that is the very next line in my speech. What of GPs, dentists, opticians and pharmacists? They are all privately provided into the NHS, and they have been since Bevan, but this hard-left amendment would nationalise them.

I like the hon. Member for Leicester South. He is a good and sensible man, so I can only assume that he has been captured by the militant hard-left within his party, whose aggressive proto-Marxist ideology I know, deep down, he has little sympathy for. He is far more right-wing than the right hon. Member for Islington North (Jeremy Corbyn), and I know it because we have it on the record. He used to say that

“there has always been a private element of health provision in this country.”

That is what he really thinks, but he is hostage to the hard-liners and has been captured by Corbyn.

[Sir Mike Penning]

My right hon. Friend knows full well what I am going to raise with him in my intervention, which is the prescribed medical use of cannabis. In my speech later, I will talk about the privatisation that took place under Labour, with the Darzi clinics, polyclinics and the PFI schemes. There is something we could do today for families who are desperate—families who are willing to go on hunger strike and sell their homes because they cannot afford the medication, which this Government have allowed to be prescribed for children who have severe forms of epilepsy and seizures. I know that a lot of work is going on, but these families are desperate. There will be hunger strikes soon and people are selling their homes. We must give them that opportunity to protect their children.

[Matt Hancock]

Yes, I entirely understand where my right hon. Friend is coming from, and he has been a tireless campaigner on this issue. On this point, I also want to welcome the cross-party approach set out by the hon. Member for Leicester South. This is an important thing to get right. Of course each decision for an individual patient has to be clinically-led; we cannot have MPs calling for specific clinical interventions, and I think my right hon. Friend and everybody else recognises that. But there is a problem in the system here, and I have asked the medical director of the NHS to lead the work to resolve the problem. We are working on it, and I look forward to meeting my right hon. Friend and others with an interest in this soon.

The National Health Service

Mike Penning Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Dr Whitford]

Okay; I welcome that. However, I would suggest that the Healthcare Safety Investigations Bill is about looking at mistakes after they have happened. I invite the Secretary of State again to look at the Scottish patient safety programme, which is more than 10 years old and has reduced hospital deaths, including post-surgical deaths, by over a third because the aim is to prevent harm in the first place.

I welcome the Secretary of State’s reference to whistleblowers, but it is not just about having guardians in hospitals. It is critical that the Public Interest Disclosure Act 1998 is reformed. Only 3% of employment tribunals are successful. All Members who have dealt with any cases on this issue will know that the wreckage of whistleblowers’ careers acts as an absolute brake on people coming forward. You can say what you like, but they are faced with the question, “Do I speak up and risk my career, my family income and my home?” It is not just a matter of paying lip service to this issue; we actually need change.

I welcome the ending of the private finance initiative, which was originally brought under a Conservative Government, but was really accelerated, I am afraid, under Gordon Brown. We are now facing the fact that £13 billion-worth of hospitals in England will have cost £80 billion by the time they are paid off. I call on the Secretary of State not just to end the PFI going forward, but to look at whether these contracts could be ended and renationalised to avoid another £55 billion having to be paid over the next 30 years. This problem is UK-wide, so we were saddled with these contracts in Scotland as well. There are health boards across England that are spending up to 16% of their income on their PFI contracts, and that obviously undermines patient care.

[Sir Mike Penning]

The hon. Lady is making a perfect point. I had the honour of being the roads Minister, and I desperately asked my officials to look at the PFI contracts on motorways around the country, including the M25. They found that the cost of coming out of these contracts is so formidable—simply because these companies’ lawyers were frankly a lot better than Gordon Brown’s lawyers when the contracts were written—that no Government would do it, so we are trapped. Some trusts—not least the trust in Romford, which also has a polyclinic—are trapped in debt from the private sector, which makes them completely inefficient.

[Dr Whitford]

I thank the right hon. Gentleman for that point. Of course, Governments can borrow at a much lower interest rate than any private business. Money is being sucked out of the NHS through the PFI across the UK, but there are also other ways in which money is being sucked out of the NHS, particularly NHS England—for example, through outsourcing under the Health and Social Care Act 2012. Private companies have to make a profit. Their chief executive is bound to make profit for the shareholders. They are not bound to deliver quality of care. We have seen clinical commissioning groups get trapped in this way. Six commissioning groups in Surrey tried to bring community care back into the NHS—they were not breaking a contract—but Virgin did what Virgin always does if it does not get a franchise renewed. It sued the CCGs. It is all hidden behind a commercial veil, but we know that at least one of those commissioning groups paid over £300,000 to settle out of court, and six groups together means that the figure was likely to be well over £2 million.

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[Sir Mike Penning (Hemel Hempstead) (Con)]

It is a pleasure to follow the hon. Member for Huddersfield (Mr Sheerman). I fully agree with many of the points that he made, and I think that everyone in the House would agree with them.

I am not usually confrontational politically, so I will do only a tiny bit of that. This fear thing that is being thrown around about a privatisation of the NHS is very damaging. It is not particularly damaging to my party, but it is damaging across politics. I was at the Opposition Dispatch Box as a shadow health Minister for four and a half years, and during that time all those PFIs went through. Under the private finance initiative, private companies were being paid for surgery that was not even carried out. They were contracted for 1,000 knee operations or 1,000 hip replacements which did not take place, and they were still paid. That is what happened under the previous Labour Administration.

We need to admit that we make mistakes when we are in government. We have made mistakes before. I made mistakes as a Minister when I was in seven different Departments—it will probably not be eight now. Governments sometimes make mistakes for the best of reasons. One of the great mistakes was that era of privatisation, with PFI deals that were off the balance sheets, and Darzi clinics. Lord Darzi was a great surgeon, a great medical man; I just happened to disagree completely with many of his proposals which were implemented by the Government, and which, frankly, have not worked. There are still many clinics out there to which trusts have to pay huge amounts of money, not to get out of their contracts but just so that they can carry on. That is something that we need to admit. So, in this House, let us admit that Governments make mistakes and that the PFI privatisation carried out by the Labour party was wrong, although it was probably done for the best of reasons. A PFI hospital was promised to my constituents; it never came even though the Labour party closed the A&E at Hemel Hempstead hospital, in the largest town in Hertfordshire. We were promised that that would be looked after, because St Albans had had its hospital closed. However, it was closed and the whole thing moved to a Victorian hospital in the middle of Watford, which cannot cope today and has not been able to cope since then.

Adding little bits to hospitals, as the hon. Member for Huddersfield (Mr Sheerman) said, and putting a new A&E on the front can sometimes work, but when there is serious funding around, which is what we are talking about now, a modern, new, environmentally proper hospital that can actually have sufficient footfall to enable the medics to work in their specialties is what we need.

I am one of the few Conservative MPs to have been offered the £400 million for a new hospital. I have said to the Secretary of State and to my trust that it is not a new hospital; it is a refurbishment of a Victorian hospital in the middle of Watford next to a football ground, and my community does not want that. The people of Watford might, but if they thought outside the box—I am not being rude to them—I am sure they would agree that it would be better to have a brand spanking new hospital that looks after the communities of Watford and the surrounding areas of Hemel Hempstead and St Albans in that massive growing area just north of the M25.

So I do not want my old hospital reopened. It is still sitting there boarded up; it is just sitting there like a running sore in my constituency. It was a wonderful new hospital when the new town was built, but there she sits now with two wards, out-patient facilities and a minor injuries unit that does not even open for 24 hours even though we were promised it would.

What we want is a tiny bit more money—the Secretary of State knows this; I am not saying anything to the Minister that he does not know. We should not keep frightening people by saying it will cost £750 million or £1 billion to build a new acute hospital on a greenfield site, because we know it will not. We have the experts working for the new hospital action group and I am going to meet the experts in the Department in the next couple of days. So I am saying to the Department, “Hold back for a second on this new hospital for us, because if you hold back a second, we might get a completely different result.”

[Barry Gardiner (Brent North) (Lab)]

The right hon. Gentleman is speaking very candidly and with great integrity. My mother died in the Hemel Hempstead hospital that he speaks of many years ago. He talked about PFI and some of his remarks are absolutely spot on, but does he now recognise that the money owed on the PFI liabilities is actually £9 billion, as opposed to the £11 billion, which is the backlog of what hospitals are paying to the Department itself because of the borrowings they have had to take out as a result of the financial problems they are facing?

[Sir Mike Penning]

As was said in debate with the Scottish National party spokesman earlier, the Government can borrow money much cheaper than any private organisation.

I am thrilled that there is some honesty in the Chamber, because we have argued about PFI for donkey’s years; it was a way of getting things off balance sheet, and let us move on from that. There is no more PFI—we can all agree on that—but actually we are not privatising the NHS, as everybody with an ounce of common sense knows. The NHS is perfectly safe; it has been safe under this party for the majority of its time since inception, and it will stay perfectly safe. There are massive demands on it, however, and I cannot allow all this money—taxpayers’ money—to be put into a Victorian hospital next to a football stadium in the middle of Watford. Anybody who knows our part of the world knows that Watford football club is in the premiership. It might be struggling a little bit at the moment, although it did very well against Spurs the other evening. Let us pause, get the experts around the table and stop scaring people with costs that are completely unrealistic—new hospitals were built in Birmingham for £425 million and a new one can almost certainly be built in Harlow for similar amount. Let us have a 21st-century hospital. Let us be honest with each other and move that forward.

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[Alex Norris]

Having had a long four-and-a-bit hour vigil in the Chamber, I have not had chance to see that, but I certainly will. That is the picture up and down the country, including in Nottingham. The key thing is that as well as being absolutely dreadful for the individuals affected, it is terrible for the system not to have those good, often early, interventions on drugs and alcohol. If we let those things spiral, the impact on the individual and the costs related to the system grow exponentially. These are really bad value choices and we could do much better on public health.

I will finish with a point about cannabis on prescription. We have had important conversations on this today, and it is good that both the right hon. Member for Hemel Hempstead (Sir Mike Penning) and my hon. Friend the Member for Gower (Tonia Antoniazzi) are here. Their leadership on this has been absolutely crucial. I heeded what the right hon. Gentleman said about how to describe it, and I changed my speech from saying “medicinal cannabis” to “cannabis on prescription” as a result. I have had a case in my constituency, as many have, with a very, very frustrated parent who could not understand why their child did not fit the criteria.

[Sir Mike Penning]

The hon. Gentleman is making a really important point, and I thank him for changing his speech slightly. The reason why it is so important is that we need the observational trials. We need to know about the THCs and the chemicals that come from the cannabis oil; we need to know the strengths and what it is. That is why talking about the prescribed medical use of cannabis oil is crucial when we make this argument; otherwise, we will lose the public will.

[Alex Norris]

I am grateful to the right hon. Gentleman for improving the quality of my speech by adding that to it. I am very confident about this matter, and this afternoon has only increased my confidence. He will have heard the shadow Secretary of State say that if primary legislation is needed—

[Sir Mike Penning]

It’s not.

[Alex Norris]

Clearly not. Whether it is regulations, or whatever, we are very capable in this place of having a grown-up conversation on this and finding a solution. That is what my constituent and her mother are desperate for us to do.

We are very grateful in Nottingham for our excellent health and social care staff. They do an incredible job, keeping our communities going and bringing hope and enjoyment of life to many people struggling with profound challenges, but they want us to do better. The social care Green Paper would be a good chance to do that, and I hope we can do it quickly. Integrated health and social care promises many virtues. We just need to get around the table and have a proper conversation about it. I hope we can do that.

[Mark Pritchard (The Wrekin) (Con)]

I don’t know about you, Madam Deputy Speaker, but I am delighted that the age of austerity is over. We have heard from the Government today a commitment to record investment in the NHS. In my political lifetime, I cannot think of any Government of any political colour that was so committed to the NHS or a Prime Minister and Secretary of State similarly committed. And of course that must come on the back of a strong economy, not the magic money tree we hear about so often in politics.

I am also delighted that we are talking about something other than Brexit. I hope that we can get the withdrawal agreement and Bill through so that we can pass the Queen’s Speech and legislate to make sure that these improvements to the NHS actually take place.

I want to go local for a moment and thank the Minister and all the team at the Department for ensuring that Shropshire and the borough of Telford and Wrekin have not lost out in this record investment in the NHS. In fact, in Shropshire we are seeing the largest investment in the NHS in its 70-year history: £312 million. That is fantastic news. What does it mean locally? For my constituents, it means that most of the planned surgery—the majority—will take place at the Princess Royal University Hospital in Telford. My constituents will no longer have to take a journey to Shrewsbury for the majority of their visits to their local hospital trust. That is good news.

There is a debate about the accident and emergency award, but I am delighted that today we have heard from the Secretary of State that the A&E has been saved at the hospital in Telford. In fact, it will be the very latest in modern thinking on how A&E services are provided, under the banner of “A&E local”. Of course, some cynics say, “Maybe that’s ‘A&E lite’”. Well, it will not be as long as I and my hon. Friend the Member for Telford (Lucy Allan) are on the case, working in tandem for local people to ensure that we have an A&E that provides what local people need.

I am glad that the Secretary of State, in releasing the £312 million to Shropshire and the borough of Telford and Wrekin, said it was conditional upon the A&E at the Princess Royal University Hospital being adequately run and sufficiently resourced, with the right staffing levels and expertise and with the clinical and medical cover it requires to service the people of Telford and Wrekin. I and, more importantly, my constituents welcome that commitment.

I am also delighted that new services will be coming into the hospital. There is a lot of doom and gloom in some parts of the local media in Shropshire, which one would expect from Opposition voices in other parties, but the good news is that we are going to see a new cancer unit; the good news is that we are going to see a new MRI scanner; the good news is that we are going to see an extra £7 million spent on a completely modernised radiology service; the good news is that we have just recruited 180 nurses to the trust; the good news, further to that other good news, is that we have now recruited 17 extra A&E doctors to the trust.

May I digress for a moment and raise the issue of recruitment, which overlaps with that of social care? I hope that the Ministers will work closely with Home Office Ministers on the points-based migration system to ensure that we attract not just highly skilled doctors from around the world, but others with fewer qualifications and skills— whether it be from India, the Philippines, or other Commonwealth and non-Commonwealth countries —so that we can provide that expanded social care service. Indeed, I hope that we will continue to retain and recruit the very best from the European Union, when we cannot recruit domestically.

Many positive developments are resulting from the Future Fit programme in Shropshire. Let me also say briefly that I am delighted by the Secretary of State’s announcement today of the immediate provision of an additional £400 million, which will enable us to expand our women and children’s unit and ensure that we have a high-quality, modernised, midwife-led unit. That is good news as well.

Finally, let me issue an appeal to Ministers on the subject of mental health, which I raised earlier today. Can we ensure that veterans who are leaving the military and making the transition into civilian life have a pathway of care?

[Sir Mike Penning]

My hon. Friend has touched on an issue that I did not have time to raise because of the time limits which, understandably, have been imposed. The danger of putting ex-military personnel into one box is that, as I mentioned earlier, some will react almost immediately to what they have seen and done, while it will take others years and years. I have close friends who fought in the Falklands war and who are only now being diagnosed with post-traumatic stress. It is important that in local communities around the country, and particularly in The Wrekin, the NHS understands the mental health needs of those who may have served in the armed forces many years ago

[Mark Pritchard]

My right hon. Friend is absolutely right to underline that. He has served in the armed forces himself, and has been a shadow Health Minister and a Minister in many other Departments. I also think that serving doctors should be given more encouragement to go into the reserves to help to stop this problem. As my right hon. Friend says, if post-traumatic stress is not dealt with by means of early intervention, it can turn into the much more difficult and complex condition of post-traumatic stress disorder.

I am sure that my right hon. Friend will, like me and like other Members on both sides of the House, pay tribute to Combat Stress, which has a unit in my constituency and which does a great job, and to Help for Heroes, whose current campaign is intended to ensure that people who are leaving the military under medical discharge with mental health conditions in particular, but with other conditions as well, have the pathway of care that I mentioned through local NHS trusts in all our constituencies.

This is good news for Shropshire. There are still some battles with the Minister ahead, and I will fight those battles with my hon. Friend the Member for Telford, but overall, this is good news.

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[Tonia Antoniazzi]

I thank my hon. Friend; I look forward to keeping on working with him.

It has been an uphill struggle. While thousands of people across the world have access to medicinal cannabis, the law was preventing patients in the UK from accessing it.

We have worked with the amazing families of the End Our Pain campaign, spearheaded by the amazing Hannah Deacon, who is mum to Alfie Dingley. Hannah’s campaigning meant that she got a special licence for Alfie to continue to use the cannabis that had transformed his life in the Netherlands. Then Sophia Gibson and Billy Caldwell were given prescriptions for medical cannabis. The highlight came last year, on 1 November, when there was a change in the law to reclassify cannabis so that it was available for medical use.

At the time, we thought that would mean that the children who were suffering would be able to have cannabis prescribed by specialist consultants. It turned out that that was not the case, so many other children were not given access to this life-changing medicine. Children from all over the UK continue to suffer because the Government are dragging their feet. The medicine is proven to work for many types of sufferers, but children are still being pumped full of steroids and unlicensed drugs that leave them severely impaired. The effect on the families has been terrible—on the children, the siblings and the parents. It is just not fair.

No one claims that this is a miracle drug. It is not a cure for epilepsy, but it does make a huge difference to the quality of children’s lives. Everyone has a right to live their best life.

I have worked closely with the parents of Bailey Williams from Cardiff, Rachel and Craig. I have seen at first hand the difference that this medicine has made to their son. When I called at their house one evening, Bailey got out of the chair, picked up a bunch of flowers and brought them to me. I actually cried to see a child who previously could not get out of bed get up out of a chair and give me a gift of thanks.

A lot of other children have the same story. Alfie has been riding a bike and a horse—something that would never have happened when he was on his previous drugs. The problem is that Alfie is getting to a point where the efficacy of this type of medicinal cannabis is dulling. As with all long-term medication, he needs a review and to be put on a new strain. However, the strict restrictions mean that even Alfie will not be able to access a new strain. As his tolerance to his medication builds, he is beginning to have more seizures. What next for Alfie? What will the Secretary of State do?

As we approach the anniversary of the law change, I want to reflect on what has happened to the lives of the families I have worked with, as co-chair of the all-party group on medical cannabis under prescription along with the right hon. Member for Hemel Hempstead (Sir Mike Penning). At the End Our Pain campaign event on 19 March, the Secretary of State told the families that he would make sure they got the medicine they needed. However, more than six months on from that promise and nearly a year on from the law change, not one new NHS prescription has been made, not one child has benefited from medical cannabis, and not one family have been able to move on with their lives.

[Sir Mike Penning]

Will the hon. Lady give way?

[Tonia Antoniazzi]

I will give way, but I will not take the extra time.

[Sir Mike Penning]

This issue shows the House how people from different parties, with very diverse views on politics, can work together for the good of children. There are children who are getting medical cannabis on prescription, but their parents or grandparents are paying for it. The NHS is free at the point of delivery. Surely that is how it should be.

[Tonia Antoniazzi]

I absolutely agree with the right hon. Gentleman.

I made a personal choice to go to the Netherlands with some of the parents to pick up the cannabis they need for their children—parents such as Emma Appleby who has a prescription for her daughter, Teagan, that costs thousands of pounds. She can afford to fly to the Netherlands to get the prescription because it costs less over there. The Government have created a two-tier system. Parents are forced to fundraise for medicines. One mother has put her house up for sale to pay for the next round of drugs. These families have run out of time, run out of money and run out of patience. All 20 families will go on hunger strike because they are at the end of the line.

I will move on swiftly. On 19 September, six months after the Secretary of State had made his promises, the families were continuing to fight for their kids. They took a bill to the Secretary of State showing the money they had spent on their private prescriptions, and they have delivered letters to the Prime Minister begging him to do something, but they have been ignored. They have not had a response, and that is absolutely disgraceful.

These families are being pushed to the end of their tether, and I honestly believe that it is time for the Secretary of State either to consider his position or to get this sorted. As a mother, if I was faced with this inaction, I would be fighting and fighting to get these life-saving drugs from the NHS—for free. I would be doing everything I could, and that is why I will continue to do everything I can to help these children who are needlessly suffering. I will raise this at every opportunity, and I will not stop until we have the good news that we need.

Health Infrastructure Plan

Mike Penning Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

The hon. Gentleman is understandably and rightly fighting the corner for his local trust and local hospitals, but I am sure he would none the less welcome the huge investment by this Government in our NHS that this announcement amounts to. On delivering on these commitments, we are clear: we want to see these hospitals built as swiftly as possible. Unlike the Labour party, when we say we will do it, we get on with doing it.

[Sir Mike Penning (Hemel Hempstead) (Con)]

As the Minister knows, in his short time in office I have been pinging his ear, as I did his predecessor’s, over the investment we need in west Hertfordshire. The Secretary of State kindly took a call from me at the weekend. Now £400 million is welcome, but not if we are going to chuck it into Watford Hospital, which is a Victorian hospital that took all the work from Hemel Hempstead Hospital when Labour closed our acute hospital. Hemel Hempstead is the largest town in Hertfordshire. We welcome the money, but we would like a new hospital where we could look after St Albans, Hitchin and Harpenden, Watford and Hemel Hempstead in the 21st century—we do not want to plough this into a Victorian hospital.

[Edward Argar]

My right hon. Friend rightly campaigns vociferously for his constituents in Hemel Hempstead, and I know he has spoken to the Secretary of State about this issue on several occasions. No formal decision has been made on the detail. He will know that his hospital trust has a view. I hope he will continue to engage with the trust and with us Ministers, and that he will put the points that he just put to the House to us in a meeting.

Cystic Fibrosis Drugs: Orkambi

Mike Penning Excerpts

Monday 10th June 2019 Westminster Hall

[Paul Scully]

My hon. Friend makes an interesting point. Clearly, a portfolio of drugs is coming through the system. The original drugs treated only 5% of cystic fibrosis sufferers, but now the figure is 50%. The triple therapy that is being researched can benefit up to 90%, and clinical trials show an increase of 10% in some people’s lung capacity in a single week of using the drug. It is disappointing that Vertex has not included the triple therapy in its negotiations about the portfolio. None the less, my hon. Friend is right that the NICE system needs to be reviewed to take an interesting and innovative approach to drug research in future.

[Sir Mike Penning (Hemel Hempstead) (Con)]

There are those who are listening to the debate but are not experts like the families who live with this every day, but lung transplants are a common procedure. The lungs fill up and do not function, and lung transplants are often the only option. How does NICE take that into consideration? It cannot do so when it is looking at the viability and cost-effectiveness of Orkambi.

[Paul Scully]

My right hon. Friend makes a really interesting observation. This morning I saw a number of people, some of whom have had a lung transplant. Orkambi was able to get them to the point where they could have a lung transplant in the first place. I spoke to most of the people via video link, because they could not be in the same room as me due to the risk of cross-infection and aspergillosis hitting their lungs. Aspergillus gets in our lungs, and most of us just bat it off and do not have an issue with it. However, it can adversely affect these people’s lung functions, or even be fatal. That is how debilitating the disease is. What struck me about all this are the mental health issues behind it, which I will come back to later.

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[Sir Mike Penning (Hemel Hempstead) (Con)]

We all hoped that we would not be in this debate again, a year on from the last one. It is a tribute to the House that we have come together, from across the House, for a debate, which probably should take place in the main Chamber, about what is in my opinion an immoral situation, frankly: families are still waiting for a drug that we know can extend lives and prevent a serious need for invasive and very painful surgery. The situation causes a lot of worry among extended families.

Across the Irish sea in the Republic of Ireland—a country that is poorer than us in GDP terms—and in other countries that are also poorer than us, the deal has been done. It is not just a shame but a blight on our proud NHS that we have not come to an agreement one way or the other with Vertex and that we have not made a decision about whether we will go down the Crown use licensing route if Vertex cannot do a deal with us. We could have started that way back—they said it would delay everything, but we are here now, and there are patents being developed around the world. The situation is not of benefit to Vertex—we have heard about its shares—because it has not been able to sell its product in a country with a prominent number of CF sufferers.

Why is this happening? Is it just about cost? Is it just because civil servants and Vertex do not care about the lives of those wonderful people and their children? Is it about greed, or is it about how we procure drugs, as we have heard? When NICE was brought in, it took the politician, quite rightly, out of the decision making. But we cannot be outside it, because we are here as representatives of people who are suffering in constituencies around the country. We are here to be their voice. They have done fantastically well—the campaign group is brilliant: one of the top campaigns out there—but we do not seem to get anywhere. We have to look at how NICE looks at whether something is value for money. How can we value someone’s life? How do we value someone having a lung transplant later in life? What if they are not well enough to have that lung transplant, and they die early? What about the cost on not only physical health but mental health?

Let me stretch the House’s imagination a little. I used to be the roads Minister. Understandably, everybody wants roads—they want bypasses here and there. I had a simple way of looking at them: we would look at the benefit-cost ratio and say, “If we put money into that pot, what is the benefit to the community?” It would be £1 billion for a bypass, but the community benefit would be £3 billion, for example. Clearly, the way that NICE is looking at this drug is that there is not a good cost-benefit ratio, even though we know how much benefit there would be. NICE needs to look down the other end of the telescope.

Things have changed since NICE was set up—medicine has changed and drugs have changed, as the Chair of the Health and Social Care Committee, the hon. Member for Totnes (Dr Wollaston), mentioned. There are generic drugs coming down the line that are fundamentally targeted at certain illnesses, particularly ones that people inherit and are born with. Those drugs can turn off that switch and make the situation better, but NICE was never set up to deal with them. I was a shadow Health Minister for four and a half years; we looked at how NICE could develop and where to go with it. NICE is quite fixed, but because we politicians tell it to be. The House set up NICE—those with a long enough memory will remember when we did—with the Department of Health.

The key is for NICE to look at this issue differently. We can set up trials and we can find out why Scotland has an interim agreement, but the trials are there now. How immoral is it that someone was put on Vertex and their life expectancy got better, but it was removed? We are not talking about millions of people—surely, Vertex could have addressed that. We cannot sit here or in the main Chamber next year debating exactly the same thing that we debated last year. I do not care what colour the Government are: if there is a change of Government tomorrow morning, the issue will be exactly the same. Minister, for the sake of humanity, and families and loved ones, we have to do something about this, and we need to do it now.