Independent Medicines and Medical Devices Safety Review
Nadine Dorries Excerpts(3 years, 10 months ago)
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The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries)
I am today informing the House of the publication of the report of the Independent Medicines and Medical Devices Safety Review, chaired by Baroness Cumberlege.
I would like to thank Baroness Cumberlege for her dedication to listening to the experiences of patients and their families. She has acted with compassion and thoroughness and gone to great lengths to ensure that those who have felt unheard have had a voice. She has also been diligent in looking across the system at possible improvements.
The Government also thank those very same patients and their families who have contributed their time and energy to the review. We know that in some cases it has been a physical and psychological challenge to attend the meetings that the review set up.
The review was commissioned by the Government in February 2018 and its terms of reference required it to explore how the health system responds when patients and their families raise concerns about the safety of treatments.
While the review has progressed, the Government and the NHS have already taken a number of steps that are relevant to the issues the review raises. However, there is always more we can do more to make the NHS systems more responsive to peoples’ concerns when they are first raised.
It is imperative for the sake of patients that we now give the recommendations from this independent review the full consideration they deserve.
I can assure you that patient safety remains a key priority for the Government and we are committed to the NHS being the safest healthcare system in the world.
I will give an oral statement in Parliament.
A copy of the report will be placed in the Libraries of both Houses.
[HCWS347]
Oral Answers to Questions
Nadine Dorries Excerpts(3 years, 10 months ago)
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Tim Loughton (East Worthing and Shoreham) (Con)
Giles Watling (Clacton) (Con)
The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries) [V]
Departmental officials have been working with NHS England and NHS Improvement to establish means of specialist support for those women requiring it. NHS England is in the process of commissioning a number of mesh removal centres, which it hopes to be operational later this year. We urge anyone who has concerns about their treatment to speak to a clinician.
Giles Watling
I thank my hon. Friend for her answer, but I understand from constituents that many women have to travel miles for their operations in great discomfort, and that when they get there, they are told they are not eligible. As the Minister said, the mesh recovery centres have not yet been opened. I have met women who are going through utter pain and torment as a result of surgical mesh surgery. There are concerns that English and Welsh patients do not get the same monetary help as their Scottish counterparts. What is the Minister doing to address these issues?
Ms Dorries
On access to services, NHS England advises that it is aware of the negative impact that covid-19 is having on patients during what is a very challenging period. As a result of my hon. Friend’s question, I will ask officials to look into why women may or may not be eligible for services during this time. As healthcare is devolved, the Scottish element of his question is a matter for the Scottish Government. I would advise anyone who intends to make a claim for compensation or is having difficulty seeking services to seek independent advice or see a clinician. It is important to reiterate that NHS England is currently in the process of commissioning those specialist services for mesh removal, which it hopes will be operational later this year.
Craig Williams (Montgomeryshire) (Con)
Covid-19
Nadine Dorries Excerpts(3 years, 12 months ago)
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The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries) [V]
Coronavirus presents the most serious public health emergency that our nation has faced for a generation. I thank Members for the many contributions made in this debate, which have showed vividly the impact that the pandemic has had on our constituents and our country as a whole. Today, on the international day of the nurse and as a former nurse myself, I echo the sentiments of Members and express my gratitude for the crucial work and commitment to duty shown by our nurses everywhere in all that they are doing to care for others at this important time.
With regard to the devolved Administrations, we have taken a four-nation approach and have worked closely with the devolved Administrations every step of the way, but, as the Prime Minister set out, part of that four-nation approach will be acknowledging that the virus may be spreading at different speeds in different parts of the UK. I assure the House that at all times we will be guided by the science, which the hon. Member for Leicester South (Jonathan Ashworth) has himself just mentioned.
On the science, my right hon. Friend the Member for Chingford and Woodford Green (Sir Iain Duncan Smith) queried the 2-metre distancing rule. Modelling data supports the view that large droplets expelled during breathing and talking, which are the main droplets associated with respiratory viruses, in the main drop to the ground within a 2-metre radius of a person. The distribution of droplets is influenced by a very large number of factors, including humidity, temperature, ventilation, velocity, size and composition of the droplets. There is general agreement that large droplets are unlikely to spread beyond 2 metres.
Members have raised the benefits for the green economy and our environment and the increase in wildlife and cleaner air. As people return to work, we have encouraged flexible working. We have asked people to work from home if they can, and to get to work by foot or by bicycle, which is a greener way to travel.
Several hon. Members have raised the impact of coronavirus on BAME communities. It is critical that we find out which groups are most at risk so that we can take the right steps to protect them and minimise that risk. We have commissioned Public Health England to better understand the different factors that may influence the impact of the virus on these communities.
We have also heard widespread support from across the House for our care sector. We have overhauled the way PPE is delivered to the care sector, ensured that residents and staff are tested and have supported local authorities with £3.2 billion of additional funding to help frontline care services.
Another common theme during this debate was the supply of PPE. It is important to recognise that there have been real challenges in this area, given the sudden and high global demand for those products and the need to establish new supply chains from scratch. Despite that, since the beginning of the pandemic, we have still managed to deliver more than 1.2 billion items of PPE. We are continuing to source more PPE through our new Make strategy, which is headed up by Lord Deighton.
We also heard several contributions about testing. The Government’s ultimate goal remains that anyone who needs a test should be able to access one and we will continue to expand our capacity until that is achieved. As our capacity has continued to increase, we are now able to test all essential workers and those who are unable to work from home and everyone over 65 and members of their households, if they have symptoms. We are also ramping up testing for NHS staff and patients and social care staff and care home residents, both with and without symptoms.
Some have suggested that Public Health England should have involved private testing companies earlier. Unlike some countries, we did not enter this crisis with a major private diagnostics manufacturing industry to call on. However, over a very short period of time we have seen our life science companies and pharmaceutical giants step up. Working with our world-leading but smaller diagnostic companies, they have built an impressive British diagnostic industry at scale.
Some Members asked about the transparency of scientific advice. At all times during this pandemic, we have been consistently guided by the scientific advice. All advice put to the Government by SAGE has been published online and the membership has also been published online.
Members asked about returning to school and pay for key workers. I note that that will be covered in a debate tomorrow. However, there are ongoing discussions on the issue of schooling. We will be setting out detailed guidance on that shortly. Regarding pay for key workers, we are incredibly proud of our social care workers and are determined to do everything we can to show them that they are valued. The national minimum wage and living wage apply across social care, and we expect local authorities to work with providers to determine a fair rate of pay.
The healthcare situation regarding non-coronavirus patients has been raised. Thanks to the efforts of NHS staff and the success of social distancing, the NHS has not been overwhelmed. We have been able to start the reopening of several important NHS services, for example fertility services. I would like to take this opportunity to encourage anyone who needs urgent care to seek help as they normally would do. If you experience chest pain, feel a lump or have any health worry whatever, please come forward and seek help.
Members paid tribute to the NHS workers who lost their lives. Nothing can replace the loss of a loved one, but we want to do everything we can to support families who are dealing with this grief. We have recognised the sacrifice that health and care workers are making by setting up a life assurance scheme for NHS and social care frontline colleagues who contract coronavirus during the course of their work.
Members rightly stressed the need to avoid a second peak of cases. The Prime Minister reiterated that we will not make major changes to the lockdown rules until we are confident that we can avoid a significant second peak of infections.
Members raised the issue of support for the charity sector. Last month, the Chancellor announced that charities would receive a £750 million package of additional Government support.
Every single Government Department is engaged in tackling coronavirus. As the Minister with responsibility for mental health, I would like to take this opportunity to thank all mental health trusts. The Government recognised the mental health impact of covid-19 very early in the pandemic and the support has been there for those affected, including the rapid establishment of 24-hour open access telephone lines for those in need of urgent support, and, in addition to that, a confidential helpline to support the health and wellbeing of frontline workers who have also been affected. The NHS is there for everyone and continues to provide the very best care for all.
This has been an important debate that starkly confirms the impact of coronavirus on all our lives. I am grateful for all the points raised today. I can assure the House that the Government are committed to defeating this invisible killer once and for all.
Mr Speaker
Before I put the Question, I remind hon. Members that the Question is to be decided by a remote Division in accordance with my provisional determination announced earlier. There is therefore no need for me to collect the voices or for Members present in the Chamber to shout Aye or No. The Clerk will initiate the Division on the MemberHub and Members will be invited to record their votes using the remote voting system. Hon. Members will have 15 minutes to record their votes.
Question put.
The House proceeded to a remote Division.
Paterson Inquiry
Nadine Dorries Excerpts(4 years ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)
The report of the independent inquiry into the issues raised by the former breast surgeon Ian Paterson was published on 4 February 2020. It describes significant failures in the ability of the healthcare system to detect and protect patients from the consequences of Paterson’s malpractice.
The report contains 15 recommendations, some of which go to the heart of our regulatory system and the performance management of healthcare professionals. Government Ministers undertook to study these recommendations in detail and provide Parliament with a full response within a few months of the report’s publication or indeed within three months if that was appropriate.
Our action to tackle the covid-19 crisis has unfortunately diverted resources from this work which has had to be put on hold for the present time. This will inevitably lead to a delay in the Government’s formal, written response.
I would like to assure Parliament and the public that we will resume our focus on the Government’s response as soon as these unprecedented circumstances are behind us. Also, that we remain committed to implementing considered and effective improvements in the areas set out in the inquiry’s recommendations.
In the meantime, we will continue to talk to NHS England and NHS Improvement and Spire Healthcare about the current and ongoing care of patients treated by Paterson.
[HCWS208]
Health and Social Care
Nadine Dorries Excerpts(4 years, 1 month ago)
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Ms Dorries
I thank my hon. Friend for that intervention. I will go on to talk about waiting times, but he is absolutely right. It is a trial that we have rolled out to ensure that, across the country, anybody who presents with a serious first instance eating disorder is seen within one week and routine cases are seen with specialist help within four weeks. That has been rolled out and tested across the country by NHS England, and I am incredibly impressed at some of the statistics that I am hearing; I thank the hon. Member for Worsley and Eccles South for citing her own constituency.
This is a trial and, as we know, everybody has yet to meet the standards; that is the responsibility also of the clinical commissioning groups, because this is quite complicated.
[Official Report, 5 March 2020, Vol. 672, c. 396WH.]
Letter of correction from the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries).
An error has been identified in the speech I made on Thursday 5 March 2020.
The correct statement should have been:
Ms Dorries
I thank my hon. Friend for that intervention. I will go on to talk about waiting times, but he is absolutely right. It is one of the first trials that we have since rolled out to ensure that, across the country, anybody who presents with a serious first instance eating disorder is seen within one week and routine cases are seen with specialist help within four weeks. That has been rolled out and tested across the country by NHS England, and I am incredibly impressed at some of the statistics that I am hearing; I thank the hon. Member for Worsley and Eccles South for citing her own constituency.
As we know, everybody has yet to meet the standards; that is the responsibility also of the clinical commissioning groups, because this is quite complicated.
Ms Dorries
We are continuing the investment in mental health services through the NHS long-term plan, as I think most people know. The £2.3 billion is with NHS England, which has a long-term plan to deliver on mental health and is moving at incredible pace. Even today, although it is not relevant to the debate, it announced the opening of gambling clinics across the UK. Community services are being rolled out across the UK so that people in mental health crises do not end up in casualty. It is an incredibly impressive roll-out of mental health services across the UK, including for eating disorders.
[Official Report, 5 March 2020, Vol. 672, c. 399WH.]
Letter of correction from the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries).
An error has been identified in the speech I made on Thursday 5 March 2020.
The correct statement should have been:
Ms Dorries
We are continuing the investment in mental health services through the NHS long-term plan, as I think most people know. The £2.3 billion is with NHS England, which has a long-term plan to deliver on mental health and is moving at incredible pace. Even today, although it is not relevant to the debate, it announced the opening of gambling clinics across the UK. Community services are being rolled out across England so that people in mental health crises do not end up in casualty. It is an incredibly impressive roll-out of mental health services across England, including for eating disorders.
Ms Dorries
Let me just go on to the point made by my hon. Friend the Member for Broxbourne (Sir Charles Walker) about diabulimia. It is also of course the point that the right hon. Member for Knowsley raised repeatedly. We are absolutely committed to ensuring that people with diabulimia receive the treatment that they need. That is why NHS England announced in February 2019 the piloting of services. The services are being piloted on the south coast and in London, and NHS England will evaluate and monitor the pilots and take the learning from them. I will raise what the results show, if the results are through yet from the pilots, and what learning there has been and how it will apply across the UK.
[Official Report, 5 March 2020, Vol. 672, c. 401WH.]
Letter of correction from the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries).
An error has been identified in the speech I made on Thursday 5 March 2020.
The correct statement should have been:
Ms Dorries
Let me just go on to the point made by my hon. Friend the Member for Broxbourne (Sir Charles Walker) about diabulimia. It is also of course the point that the right hon. Member for Knowsley raised repeatedly. We are absolutely committed to ensuring that people with diabulimia receive the treatment that they need. That is why NHS England announced in February 2019 the piloting of services. The services are being piloted on the south coast and in London, and NHS England will evaluate and monitor the pilots and take the learning from them. I will raise what the results show, if the results are through yet from the pilots, and what learning there has been and how it will apply across England.
National Guardian’s Office: Annual Report
Nadine Dorries Excerpts(4 years, 1 month ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)
The Government are committed to supporting the right of staff working in the NHS to speak up and raise concerns. This is a vital step towards ensuring patient safety and improving quality of services. It should be routine in the NHS. Our interim NHS people plan reinforces this commitment, setting out a vision to make the NHS the best place to work—a place where everyone feels they have the power and freedom to speak up.
As a Government we take the issue of speaking up extremely seriously and have introduced several sources of support for staff to help them raise concerns when they think something is not right.
In 2016, we established the independent national guardian to help drive positive cultural change across the NHS and make speaking up business as usual. As well as leading culture change, the national guardian also provides support and leadership to a network of over 500 local guardians—in every trust.
Today, I am laying in Parliament, on behalf the national guardian, the national guardian’s annual report for 2019. The report sets out the improved culture in the NHS, as well as the positive influence that the national guardian and the network of local freedom to speak up guardians are having. However, it also shows that there is still more to do. Copies are also being deposited in the Libraries of both Houses.
We are committed to ensuring our NHS staff are encouraged and supported to raise anything that is impacting on their ability to provide the best possible care to patients, and the healthcare system is a place where concerns are valued, listened to and acted upon.
As a Government we will continue to work with the national guardian and others to do all we can to support NHS staff to raise concerns and make the NHS the best place to work.
[HCWS164]
Eating Disorders Awareness Week
Nadine Dorries Excerpts(4 years, 2 months ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)
It is a pleasure to serve under your chairmanship, Mr Rosindell. I congratulate the right hon. Member for Knowsley (Sir George Howarth) —my right hon. Friend, if I may call him that—on securing this important debate on eating disorders awareness during Eating Disorders Awareness Week.
This is a subject close to my heart; it is a subject that we talk about frequently over at the Department and it is on the desk. It is so important because, as I think the hon. Member for Worsley and Eccles South (Barbara Keeley) mentioned, the morbidity rates among young women suffering with eating disorders are the worst of any mental health issue. It is the most serious of all mental health issues that children and young people, and indeed adults, can suffer from. That is why it has such a high priority within the Department.
People with eating disorders often suffer in silence, but Eating Disorders Awareness Week brings this important issue out into the open and provides information and advice for those who seek help. I pay tribute to all those who are working hard to raise awareness of eating disorders, in particular the charity Beat, which hon. Members will know is supported by the Government and does so much to support young people through its helplines and support groups. I have met with Beat and I am incredibly impressed by the charity. It does incredibly good work.
We also have passionate and committed individual campaigners such as Hope Virgo, who has been mentioned a couple of times today. They are also doing much to raise the profile of eating disorders and to show people who are suffering from an eating disorder that, as hard as that is, it is possible to fight them and to get well.
As I have said, eating disorders are serious and life-threatening conditions; they can be devastating for those who are suffering, their family members and the people around them. That is why we want to ensure that people have access to the right mental health support in the right place and at the right time. Improving eating disorder services is a key priority for the Government, as I have said, and is a vital part of our work to improve mental health services. We know that the earlier an intervention is made and treatment provided, the greater the chance of recovery.
Alexander Stafford (Rother Valley) (Con)
The waiting time figures for child eating disorder appointments in London show 97.1% of urgent cases being seen within one week and 92.8% of routine cases being seen within four. In my constituency, the figures are 78.6% and 78.3% in the same circumstances. Does my hon. Friend the Minister agree that, as part of our great levelling-up agenda for this country, the young people in my community in Rother Valley and across South Yorkshire deserve the same waiting times for eating disorder services as Londoners currently enjoy?
Ms Dorries
I thank my hon. Friend for that intervention. I will go on to talk about waiting times, but he is absolutely right. It is a trial that we have rolled out to ensure that, across the country, anybody who presents with a serious first instance eating disorder is seen within one week and routine cases are seen with specialist help within four weeks.[Official Report, 19 March 2020, Vol. 673, c. 12MC.] That has been rolled out and tested across the country by NHS England, and I am incredibly impressed at some of the statistics that I am hearing; I thank the hon. Member for Worsley and Eccles South for citing her own constituency.
This is a trial and, as we know, everybody has yet to meet the standards; that is the responsibility also of the clinical commissioning groups, because this is quite complicated.[Official Report, 19 March 2020, Vol. 673, c. 12MC.] I will go on to talk about that, but I am actually impressed even with those statistics, considering what it was like before. I am pleased to hear the figures that my hon. Friend the Member for Rother Valley (Alexander Stafford) quotes for his constituency, but they do have to be, to quote a phrase, “levelled up” along with everywhere else.
We know that the earlier an intervention is made and treatment provided, the more successful it is. One of the services in our mental health profile, which is not focused on eating disorders but which I am particularly impressed with, is the trailblazer schemes that we have rolling out into schools. Staff working on the schemes can pick up young people’s eating disorders at the very first signs. Outcomes are promising if they intervene at that very first stage, because the pattern of behaviour does not become established or embedded. They can intervene very early on.
On the point from my hon. Friend the Member for Rother Valley, we set up the first standard to improve access to eating disorder services for children and young people to ensure that, by the end of 2021, 95% of all children and young people with an eating disorder will receive treatment within one week for urgent cases, and within four weeks for routine cases. We are on track to meet that commitment, and figures I have seen today suggest that we may be on track to meet it early, which would be fantastic.
The number of people seeking treatment for eating disorders is sadly rising—or maybe it is a good thing, because people are not so stigmatised, are aware that help is there and are seeking it. However, that rise makes even more encouraging the corresponding increase in the number of patients who actually receive the care that they need. In-patient treatment should be a last resort, which is why in 2014 the Government announced a £150-million investment to expand community-based eating disorder care. We are making good on that promise, and as a result, 70 dedicated new or extended community services are now open or in development.
Indeed, I visited one myself and met the amazing staff who work there—it takes incredible skills to work with people who suffer from eating disorders—and some of the sufferers, and saw that work taking place. People who go into these units are usually there for quite a while; it takes some time to work through this. However, the outcomes looked incredibly promising, particularly for the young women I spoke to. The fact that we have 70 of those dedicated units open now, or about to open, across the country is an incredible step forward in addressing this problem.
That has led to sufferers receiving swift access to treatment within the community, because it is important that they receive treatment near to where they live, close to their families, schools and friends, and that their treatment causes as little disruption to their lives as possible. By improving care in the community, we can improve outcomes and recovery, reduce rates of relapse and prevent eating disorders continuing into adulthood, which is really important.
Caroline Nokes (Romsey and Southampton North) (Con)
I thank the Minister for giving way; there is nothing more aggravating than somebody coming very late to a debate, but I have been in the International Women’s Day debate all afternoon. On relapse or eating disorders continuing into adulthood, does she agree that we have made massive strides forward in treatment for young people, but that there remains a problem of transition when sufferers turn 18? For those who develop an eating disorder slightly after their teenage years, or even well into adulthood, there is still a challenge in accessing services for those not eligible for children’s services.
Ms Dorries
My right hon. Friend makes an important point. That is why we invested £2.3 billion in mental health services, which, as I always say, is more than half the entire prison estate budget. We are focusing on young people and young women in this debate, but funding for mental health services is growing faster than the overall NHS budget. That funding and the development of community services is there to pick up exactly the cases she cites.
No mental health service, other than the very extreme, is better delivered in a hospital than in the community, whether for children, young people or adults. Despite that investment in community mental health services, our challenge is unprecedented, and our challenge is about workforce—it is about attracting people to work in this arena and to help us develop the community services that we need to provide treatment for adults and young people. That is the challenge we have taken on, and it is a challenge that we are meeting and moving forward with. It is our ambition and my absolute hope that children, young people and adults, regardless of their age—this illness is severe, whether in adults or children and young people—receive the treatment they require, when they require it.
Jim Shannon
These plans will require a close working relationship between the Department of Health and Social Care and the Department for Education. I am sure that that is what the Minister refers to, but will she confirm that that is the case?
Ms Dorries
Absolutely, and the Green Paper, which I am sure the hon. Gentleman will be aware of, references the mental health of young people in schools. However, it is also about the trailblazer schemes, peer support workers and other people who go into schools who specialise in how to identify this and pick it up. Teachers have a huge job, and I think if we were to say that they needed to pick up when someone is suffering from an eating disorder, they would probably throw their hands up, because it requires specialised training. It is a skill, and it takes careful handling when identifying someone who is suffering from an eating disorder. So yes, of course we work across Departments, but it is those specialised and trained mental health workers in schools who will pick this up.
Barbara Keeley
We have a few moments left, so I refer the Minister back to the point I raised about relapse. We are largely talking about adults, and there is a mismatch between the average duration of an adult eating disorder—a large number of patients have severe and enduring illnesses—and the shortness of the therapies that they get. Professor Janet Treasure told me that a solution could be to increase the knowledge and skills of patients with those long, enduring conditions and their carers, so that they can self-manage the illness in parallel with clinical care. She is working on a pilot of that. I do not know if the Minister has heard about that, but I wanted to raise it as something that we ought to give attention to.
Ms Dorries
That is incredibly interesting. I had not heard about it, but I am sure that my officials will take note of it. We have an open door for anything that we can identify that helps us in targeting and providing services. We are looking for solutions to the problem. As I said, the money is there. Claire Murdoch, who I mention in almost every debate, and Professor Tim Kendall are rolling out mental health services across the country via NHS England. They have probably heard of it and are probably looking at it, but I am sure that we will take note and check if that is the case.
Although eating disorders are commonly first experienced by people when they are young, they can continue into adulthood. Following a report on how NHS eating disorder services were failing patients, NHS England convened a working group with Health Education England, the Department of Health and Social Care and other partners, which goes to the point that my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) made. We are working in collaboration to address the report’s recommendations and to take them into account when planning for improvements to adult eating disorder services. Work is in progress on that.
We are continuing the investment in mental health services through the NHS long-term plan, as I think most people know. The £2.3 billion is with NHS England, which has a long-term plan to deliver on mental health and is moving at incredible pace. Even today, although it is not relevant to the debate, it announced the opening of gambling clinics across the UK. Community services are being rolled out across the UK so that people in mental health crises do not end up in casualty. It is an incredibly impressive roll-out of mental health services across the UK, including for eating disorders.[Official Report, 5 March 2020, Vol. 673, c. 12MC.]
That long-term plan will give an additional 345,000 children access to mental health support; 380,000 adults access to psychological therapies; and 370,000 adults access to better support for severe mental illness by 2023-24. It commits to the delivery of eating disorder waiting time standards, which I have already spoken about, and I hope that we will reach those before the end of next year. The plan has also committed to the design and roll-out of a new integrated model of adult community mental health care.
To increase further the number of people seeking treatment for their eating disorder, the Government recognise that raising awareness and reducing stigma are incredibly important. Here I should come on to a few of the points made by the right hon. Member for Knowsley. I shall go through them backwards, because that will be more positive in terms of affirmative answers. He mentioned social media providers, their role in body image and the impact that they have on young women. My right hon. Friend the Secretary of State for Health and Social Care has already—this happened recently—held a roundtable with social media providers. It was an incredibly positive meeting, but that is something that needs to continue, because when it comes to social media interactors, providers and platforms need to be aware of the impact that their forums have on young women, so we are continuing that dialogue with them and, I hope, are continuing to push that point.
The right hon. Gentleman made a point about the entertainment industry and its relationship and responsibilities with regard to body image. I announced two weeks ago that I am holding a roundtable with the entertainment industry. That was as a result of the death of Caroline Flack, who took her own life. For me, that was a watershed moment. It is time for the entertainment industry to be aware that it does not have a duty of care only to the people who they take on a contract to work with them. This is not just about sudden fame and reputation loss. The industry has a wider responsibility in relation to images that it projects and how it projects them, because young women and, indeed, many people absolutely are influenced by what they see—their perceived role models—through the lens of television or the cinema. The entertainment industry definitely has a responsibility, so in response to the right hon. Gentleman’s question, I can say that I have already put that in train.
In relation to a review of the long-term effectiveness of CBT, I defer to the expertise and knowledge of our friend from the Scottish National party, the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), who made the point that short-term CBT may not be as effective, in terms of how it is delivered, for such long-term conditions. It may be part of the treatment, but as we know, when it comes to eating disorders, treatment is very prolonged in some cases. I am sure that CBT has a definite role, but it should not be seen in isolation. Management of eating disorders takes the input of physicians and psychologists—people who are expert in managing these conditions and working in this field. Therefore I would say yes, but not in isolation.
Dr Cameron
I thank the Minister for making that point. I think that there should very much be a formulation-driven treatment plan whereby all the issues that the person presents with are taken on board, and different aspects may require different parts of treatment. I do not think that often happens currently, particularly where people present to primary care services and perhaps do not get the specialist services that they need, but I hope the work that is being done will streamline that for the majority of people in the future.
Ms Dorries
I am sure that Claire Murdoch and Tim Kendall at NHS England are all over that and very aware of that. A streamlining approach to treatment is about getting people seen within the first week. If people are first seen within the first week when they present with their first crisis, that is the time when greater intervention can happen and when that treatment plan can be designed and put in place and there can be that entire care pathway through. I will not say that I think that that would shorten the illness, because I do not know. The hon. Lady probably knows more than I do, but I would think that an effective treatment plan with CBT and everything that is involved in that would provide a better outcome than piecemeal interventions along the way.
The right hon. Gentleman’s first point was careful consideration of Beat and so on. I am a huge admirer of Beat. It provides an incredible service. Its helpline deals with 30,000 people a year, I think, if I am not mistaken—it is a few weeks since I saw Beat. The support service that it provides, particularly to young women who are looking for someone to talk to and advice and help, is second to none. We are absolute supporters of Beat.
Let me just go on to the point made by my hon. Friend the Member for Broxbourne (Sir Charles Walker) about diabulimia. It is also of course the point that the right hon. Member for Knowsley raised repeatedly. We are absolutely committed to ensuring that people with diabulimia receive the treatment that they need. That is why NHS England announced in February 2019 the piloting of services. The services are being piloted on the south coast and in London, and NHS England will evaluate and monitor the pilots and take the learning from them. I will raise what the results show, if the results are through yet from the pilots, and what learning there has been and how it will apply across the UK.[Official Report, 19 March 2020, Vol. 673, c. 13MC.] I am sure that the officials will take a note, and when I have had that meeting, I will report back to the right hon. Gentleman and let him know exactly what the findings are and where we are going on that. The group that we are talking about is very small, but it is at the extreme end and requires very serious consideration.
I think that those are all the points that were raised and that I need to answer.
Barbara Keeley
Could I remind the Minister of another two? I think that a number of us raised the issue of training, and I asked whether she would be a champion of improving training.
Barbara Keeley
There is also the question about when waiting time targets will be introduced for adult eating disorder services.
Ms Dorries
Absolutely. On training for GPs, I take the hon. Lady’s point exactly. The NICE guidelines are incredibly clear, in terms of the Hope Virgo campaign and taking BMI, weight and other things into consideration. The NICE guidelines are clear, and it is up to the clinical commissioning groups to ensure that GPs and others do not take weight as a consideration. Tim Kendall is all over this and is working on it. We want GPs and others to abide by what are already very strict NICE guidelines. We have the guidelines; we just need the medical profession to implement them, but I had an idea when the hon. Lady asked her question. We are talking about training for GPs with the General Medical Council and we will continue to hold conversations about that, and I am sure that NHS England is doing exactly the same thing, but there are quicker ways to get information through to GPs.
When I was a nurse and I was training, it was the Nursing Times that informed us, on a weekly basis, of what was new in treatments and operative procedures. For GPs, it is Pulse and other magazines that they receive. I think that there might be a quicker way into GPs’ surgeries to alert them to the fact that the NICE guidelines are not being applied by GPs or by clinical commissioning groups. I think that there may be more inventive ways around that. Yes, training GPs absolutely is important; it is important to include this issue in the GP training programme, but in terms of getting a message through to GPs now, I think that we need to look at a more innovative way of doing that.
On money being diverted and ring-fenced, I think that the hon. Lady knows that the money from the £2.3 billion that goes to the CCGs is ring-fenced for mental health services only. They are not allowed to siphon it off and use it for anything else. We have our own queries as to whether some are doing that, and I know that NHS England, because I raised this with it the last time I met it, is doing an evaluation of clinical commissioning groups and having a look and checking that that money, which is ring-fenced, is spent only on—
Andrew Rosindell (in the Chair)
Order. Could I ask whether the Minister intends to give the proposer of the motion his usual two minutes to wind up the debate?
Ms Dorries
I think that the right hon. Gentleman, if he wants to talk to me at any time, knows that he can catch me anywhere. I will now give way to him.
Andrew Rosindell (in the Chair)
I thank the Minister and call Sir George Howarth.
Health Inequalities
Nadine Dorries Excerpts(4 years, 2 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)
I thank all Members who have taken the time to attend this debate and to speak about their experiences and their concerns.
As my right hon. Friend the Prime Minister said in January:
“Every single person deserves to lead a long and healthy life, no matter who they are, where they live or their social circumstances.”
As someone who spent the first 20 years of my life in a council house in the 10th most deprived area in the country, I know more than most how important that is, and no one can concur with his sentiments more than I.
Before Professor Marmot published his report, this Government had already made clear our bold commitment to level up left-behind areas. This Government have been clear that they will address the needs of the communities that are being left behind, where too many people lose their independence through ill-health and disability. Differences in health outcomes are not new. Health inequalities have existed under successive Governments. In fact, it is worth mentioning that Marmot’s report in 2010 was equally damning of the record of the previous Administration. The hon. Member for Leicester South (Jonathan Ashworth) is shaking his head, but I am afraid it was. These reports are important, inasmuch as they push and inform Government policy going forward.
It is also worth mentioning, to add balance to the debate, that the ONS has published new life expectancy data, and the good news is that the latest figures show a bump up, as noted by Professor Marmot yesterday. We must, of course, take care with such information—those are provisional quarterly statistics and are subject to change—but it is good news that life expectancy figures are going up.
Differences in health outcomes are not new. Our manifesto pledged to increase years lived in good health and tackle specific problems—for example, by eradicating rough sleeping by the end of this Parliament. Those commitments came on top of an unprecedented level of investment in our NHS, with an unprecedented £2.3 billion in my area of mental health. There has also been substantial funding for our hospitals, primary care and workforce. Reducing inequalities requires action in the NHS and across Government, and prevention is a priority for this Government to support long, independent lives lived in good health.
Due to the time constraints, I will move on to answer some of the points raised by Members in no fewer than 24 speeches. I would like to commend and congratulate the Members who made their maiden speeches today. They were accomplished and excellent. I am sure that they will be a huge addition to the House, particularly in the area of health.
I would like to address the points made by my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter). We will develop and publish a new UK-wide cross-Government addiction strategy, which I am sure will be good news to him. The strategy will set clear goals to reduce drug deaths and dependency on drugs and will include problem gambling for the first time.
My hon. Friends the Members for Mole Valley (Sir Paul Beresford) and for St Ives (Derek Thomas) and the hon. Member for Bradford South (Judith Cummins) raised dentistry as an example of inequality. We are committed to increasing access to NHS dentistry. Some 21.8 million adults were seen by dentists in the 24-month period ending on 31 December last year, and 7 million children were seen by dentists in the 12-month period ending in June of the same year. The issue of water fluoridation is mentioned frequently by dentists, and the Government will be looking into that.
My hon. Friend the Member for Ashfield (Lee Anderson) mentioned loneliness and the importance of socialisation and social prescribing, which can have a significant impact on physical and mental health. Our loneliness strategy acknowledges that tackling loneliness is a complex and long-term challenge, requiring action on many fronts.
My hon. Friend the Member for Newton Abbot (Anne Marie Morris) raised the issue of inequalities in rural villages and towns. She made her point clearly, and I am sure that it has been heard. My hon. Friend the Member for Guildford (Angela Richardson) spoke about prevention, and I thank her for her recognition of the Government’s investment in the NHS and our commitment to deliver on the long-term plan.
The hon. Member for Mitcham and Morden (Siobhain McDonagh) spoke about St Helier Hospital. I am not qualified to give her a response, but her points will have been noted, and I will ensure that they go back to the Department. We will get a response to her, and I thank her for her comments.
I can tell my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) that the NHS is setting up a national academy for social prescribing to champion social prescribing, which I am sure many Members will be pleased to know. Social prescribing can make a huge difference for people who are suffering from loneliness or other issues, so that they come together in the community.
I would like to conclude by thanking Members on both sides of the House. I would also like to thank Professor Sir Michael Marmot for his report on health inequalities. His dedicated work has shone a light on this important issue, not just now but back in 2010. This debate has demonstrated that this Government are facing up to the challenges and taking bold action to meet those challenges. We have invested over £16 million in public health over a five-year period, in addition to NHS spending on our world-leading NHS. We are making sure that—
Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)
claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
Question agreed to.
Question put accordingly (Standing Order No. 31(2)), That the original words stand part of the Question.
Innovation in the NHS
Nadine Dorries Excerpts(4 years, 2 months ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)
It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank my hon. Friend the Member for Bolton West (Chris Green) for bringing the issue to Westminster Hall. I have heard him speak on the matter several times. In fact, hon. Members in the main Chamber yesterday will have heard him make those points and others with the passion that he showed today. As well as passion, he has something that makes us nervous—absolute knowledge and understanding of the subject. That is welcome, and his depth of knowledge on tech and innovation in the NHS makes him a welcome addition to the House.
My hon. Friend mentioned the AI award that has just been announced, the adoption of new products, data and clinical trials. I will make a few points about each of those topics at the end of my speech. As he said, not just the Secretary of State for Health and Social Care, but everybody in the Department is passionate about high-tech innovation. Only yesterday, I heard about a new app called Skin Analytics. It has a phone attachment that takes an image of someone’s mole or skin that can be sent through and almost instantly diagnosed as to whether it is skin cancer and requires further treatment. The rate at which AI and technology are accelerating daily is phenomenal.
We can transform the health of millions of patients, improve health outcomes, reduce cost and reinforce the UK’s position as a global hub for life sciences and health tech within the Department, because we are so passionate about it. We can take advantage of those opportunities by seeing what can be achieved by using the technology that is becoming available daily. The UK has a world-leading single player health system, covering 65 million people and—I know that my hon. Friend knows this; I am almost embarrassed saying it—we are the biggest single buyer of medicines in the world. We have some of the world’s best clinical researchers leading universities, charities and life science companies. Indeed, 25 of the world’s 100 most used medicines were developed here, using a public and philanthropic research infrastructure that is, pound for pound, more effective than anywhere else in the world. We should be really proud of that, but we know we must go further.
The NHS long-term plan and the life sciences industrial strategy have set out an ambitious set of actions to create the most collaborative health innovation system in the world—one that gets the best new treatments and technologies from the bench to the bedside faster than ever before. It is beginning to make a difference, first through the Accelerated Access Collaborative, where leaders from across the NHS, patients, charities, industry and the Government are now coming together to tackle the major systemic barriers to the adoption and spread of innovation within the NHS. My hon. Friend is quite right to raise the fact that there have been barriers, but we are tackling the barriers now.
The AAC is supporting greater use of a range of proven innovations, which have the potential to benefit up to 500,000 patients and save the NHS up to £30 million; developing co-ordinated plans to ensure that the NHS is ready for transformative new technologies, such as the advanced therapy medicinal products—ATMPs—and the use of AI technologies in diagnostics and screening; and launching a new medtech funding mandate to drive the best value and most innovative medtech projects across the NHS. With long-term funding for the NHS in place, that collaboration is also now being backed by increased commercial flexibility—flexibility to ensure we can make the best new treatments and technologies available to patients, while ensuring long-term affordability for the NHS.
The impact has already been felt, with Europe’s first access deal for Kymriah and the breakthrough of the CAR-T—chimeric antigen receptor T-cell—therapy, just 10 days after the treatment’s European marketing authorisation, and a pioneering Government collaboration with pharmaceutical company Novartis for the drug Inclisiran to tackle heart disease, which could save up to 30,000 lives over the next decade.
The 15 regional academic health science networks continue to support the local adoption of cutting-edge technologies. More than 3,500 innovations from more than 2,500 companies have benefited from support from the AHSNs in recent years, ranging from new blood tests for pre-eclampsia, which can significantly reduce life-threatening complications in pregnancy, to devices that improve bowel cancer screening.
Finally, we are working to digitally transform the NHS to unlock the technologies for the future. The plans are already being delivered by NHSX. For example, we recently announced a £250 million artificial intelligence lab, which will build and rapidly test cutting-edge prototypes, but the real focus will be on finding and boosting existing technologies and ensuring they can be adopted across the NHS. Over the next three years, the lab will support the £140 million AI Award, led by the AAC, which will be designed to speed up the testing and adoption of the most promising new AI-enabled technologies. It will cover stages of the product cycle from proof of concept, to real-world testing, to initial adoption in the NHS.
By working together across the health system, Government and industry to deliver improvements, we can ensure NHS patients are some of the first in the world to benefit from the best new treatments and technologies. We will ensure that the UK continues to have world-leading life science hubs, where the best innovations get from bench to bedside faster than ever before.
My hon. Friend made a number of specific points. He mentioned AbbVie and its “Bridging the Gap” report. I thank AbbVie for its valuable contribution to the work in this area and I thank my hon. Friend for his support of its report. I know my officials and the Office for Life Sciences have been engaging with the report’s authors, as it has been developed, and they will be closely considering its recommendations. We have made a number of improvements to National Institute for Health and Care Excellence and Medicines and Healthcare Products Regulatory Agency processes since the data on which the report is based and published, including reforming the cancer drugs fund. I hope we are already beginning to see the benefits of those changes through quicker assessment rates.
I am going to speed up, so that I can get everything in. My hon. Friend mentioned the AI award. We believe the funding mandate and the AI award are a fantastic step forward in driving higher adoption of some of the most exciting new medtech in the NHS, but we know we may need to do more. We will learn from the first year of introduction, and we will continue to review how the schemes can be developed to support a wide range of projects in the future.
In terms of the adoption of new products, we recognise that in some cases new products will require a trust to adapt its care pathways or to train staff, and that is why we provided an additional £2 million a year to the AAC through our pathway transformation fund, to support adoption of the products it has selected for support.
I fully agree with my hon. Friend’s comments on the importance of the UK’s clinical trial system to patients and to our economy. The Government are committed to creating the best environment for clinical trials, both in achieving the ambitions set out in the life sciences industrial strategy and as we agree new future trade agreements. The system is coming together to deliver that. We have streamlined the Health Research Authority approval process to make clinical trial set-up faster. NHS England’s long-term plan sets out an ambition to see a million people registering to participate in health research by 2023-24 and to treble commercial research in the health system over the next 10 years.
The National Institute for Health Research clinical research network has also recently completed a competition to establish five purpose-designed centres, dedicated to last phase commercial research within the NHS’s capacity to deliver research. They will enable significant growth and provide more opportunities for patients to benefit from early access to innovation.
Finally, on making the best use of data for the NHS, which is of particular interest to me at the moment, with regard to the women’s agenda and using datasets within the NHS, we fully agree that the better use of NHS data promises significant benefit for patients, including better ways of predicting and diagnosing illnesses and the development of more effective treatments. We have set up NHSX to drive forward the digital transformation of the NHS and to ensure it can make better use of its data and new technologies. The Government have also invested £37.5 million in the digital innovation hubs programme, which will improve the access to and the quality of NHS data through seven health data research hubs, but it is absolutely essential that we build and maintain public trust in this area. That is why the Office for Life Sciences sponsored a robust piece of public engagement, led by Understanding Patient Data, on the commercial uses of healthcare data.
We are also developing a policy framework, which makes it clear that all commercial uses of healthcare data must have an explicit aim to improve the healthcare and welfare of patients in the UK and address the key concerns of the public, such as robust governance processes and transparency requirements.
I shall end where I began, which is to thank my hon. Friend for bringing his depth of knowledge and expertise in this subject to the debate. As I said, from the Secretary of State to the Ministers involved in the Department of Health and Social Care and officials working there, we all see innovation and technology as a way of improving access for patients, improving patient outcomes, reducing costs and enabling access to better and quicker treatments. Because of that, we are totally supportive of both the innovation and the high-tech agenda. It is debates such as this one, and the subject being raised regularly in the House in the way that my hon. Friend does, that keep pushing that agenda forward.
Question put and agreed to.
Health and Social Care
Nadine Dorries Excerpts(4 years, 2 months ago)
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Victoria Prentis
All too often when a baby dies, the shutters come down in a trust and we cannot get the answers that we need. Will the Minister—who is providing great leadership in this area—meet members of the all-party group on baby loss to discuss how best we can use MBRRACE-UK, HSIB and other investigators to get to the bottom of what happens? Will she also think about making maternal deaths a never event?
Ms Dorries
I fear that you will shout at me again, Mr Speaker, if I try to answer my hon. Friend’s question fully, because I agree with everything that she has said. Maternal deaths absolutely must become a never event, and we must focus on making pre-eclampsia and post-partum haemorrhage, which lead to such deaths, never events. I went to the first meeting of the APPG on baby loss and, as my hon. Friend knows, I am always happy to go and hear anything that anyone has to say about this issue that will help our work in trying to improve maternity standards.
[Official Report, 13 February 2020, Vol. 671, c. 988.]
Letter of correction from the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries):
An error has been identified in the response I gave to my hon. Friend the Member for Banbury (Victoria Prentis).
The correct response should have been:
Ms Dorries
I fear that you will shout at me again, Mr Speaker, if I try to answer my hon. Friend’s question fully, because I agree with everything that she has said. I will look into whether maternal deaths can become a never event, and, if possible, we must focus on making pre-eclampsia and post-partum haemorrhage, which lead to such deaths, never events. I went to the first meeting of the APPG on baby loss and, as my hon. Friend knows, I am always happy to go and hear anything that anyone has to say about this issue that will help our work in trying to improve maternity standards.