27 Nick Fletcher debates involving the Department of Health and Social Care

Building an NHS Fit for the Future

Nick Fletcher Excerpts
Monday 13th November 2023

(4 months, 2 weeks ago)

Commons Chamber
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Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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It is a great honour to speak today, and I congratulate my hon. Friend the Member for Uxbridge and South Ruislip (Steve Tuckwell) on his maiden speech.

Today we are looking at the role of our NHS, which we can all agree is one of the most important institutions of our great nation and, as such, one of the most well-funded, too. With an organisation as big as this, waste is always going to be discussed. Middle management and back-office staff are always targeted, poor private finance initiative contracts always raised. Then there are the millions spent on dilapidated hospitals, when really we should be replacing them—Doncaster Royal Infirmary is a glaring example—and cutting money spent on ideologies with their numerous flags and handsomely paid equality and diversity officers who earn far more than the nurses. We all must agree that, as much as there is waste within the system, we are also creating unnecessary costs outside the system. The NHS costs the taxpayer an enormous £168 billion each year. Record sums are spent year on year by this Conservative Government. But what can we, as individuals, do to help?

The difference between Conservative and Labour Members is that we on the Government Benches believe in personal responsibility. This can be seen in a whole manner of ways: eating and drinking sensibly; getting plenty of exercise; and stopping smoking. Then there are simple things that we could do, like keeping our GP appointments. Appallingly, each day, one in five appointments—20%—in one practice in my constituency is not kept by patients, taking away appointments that others could have, and with no consequences for those who miss them. We all know this and if we all took personal responsibility, we could save the NHS billions of pounds each year. I challenge the people across this country to take charge of their health and do their part in securing the future of our NHS.

Another area of our health that we need to look at collectively is mental health. There were people hoping that there would be something on mental health in the King’s Speech, but I think we can do much more ourselves, without relying on the Government. There appear to be many young people who are struggling with their mental health. Two questions arise: why, and what can we do? When I go into schools and meet young people, or receive letters from them, many seem so confused and afraid. We seem to be encouraging our children to be ashamed of this country’s past, and raising concerns and fear-mongering about its future and their futures too, when there is so much of which we should be proud. We seem to be encouraging them to look inwards to find an identity, when they already have a brilliant one. Relationships, sex and health education and literature in our schools deny the basic building blocks of life, such as that a man is a man and a woman is a woman. We teach them myths of 100 identities. We confuse their language with misuse of pronouns. We tell the boys that they are a problem to society and we compound that by telling girls that all boys are bad. We tell them that their future is doomed because of climate change. We encourage their parents to work from home, which, as we know, is increasing school absenteeism. Then we ask, “Why are so many young people struggling with mental health problems?”

There were many items in the King’s Speech that I believe are important to my constituents: the Victims and Prisoners Bill, leasehold reform, oil and gas licensing to keep our lights on, a Media Bill to regulate streaming services, the animal welfare Bill for the animal lovers and, for football fans, a regulator to ensure that they are consulted, among other items. Since in this debate we are speaking about the NHS, however, I encourage all of us to take personal responsibility for our own health and, much more than that to help the young people in our lives.

We must teach young people to be proud of the place where they live and the body they were born in. We need to be role models that they can aspire to, teaching them that looking outwards is so much better than looking inwards and for oneself, that being there for our fellows is better than narcissism. Getting off the computer and phone and being part of the community is the best thing we can do for our mental health. Then, just maybe, we can save the NHS some money, or at least save the resources for those who really need them.

I have two more points to make, one national and one local. The first is that we need a men’s health strategy. Some 13 men will have taken their lives today, 13 men will have died of prostate cancer and 88 men will have died of heart disease. It is a crying shame that we do not have a men’s health strategy. We have a women’s health strategy, and it is right that we have one, but we need one for men too. Locally, we have a phlebotomy clinic that is about to close. If ever there was a case of an integrated care board not listening to the people it is meant to be serving, it is this. We need to save that clinic. It takes the pressure off the GPs and it is a service that the people of Doncaster need.

There was much in this King’s Speech that we can look forward to over the next 12 months, to help this country to be great again. However, unless we all start taking personal responsibility, we will become a nanny state where the Opposition will be teaching us how to clean our teeth, which just proves that that is all they have to say.

Bladder and Bowel Continence Care

Nick Fletcher Excerpts
Thursday 29th June 2023

(9 months ago)

Westminster Hall
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Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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It is a pleasure to serve under your chairmanship, Sir Graham. I congratulate my hon. Friend the Member for South West Bedfordshire (Andrew Selous) on his moving opening speech. I also thank Prostate Cancer UK, PRS, the Men’s Health Forum and the Absorbent Hygiene Product Manufacturers Association for their campaigning work on this issue.

Since becoming a Member of this House in 2019, a key policy area that I have campaigned on is improving men’s health. The Boys Need Bins and Dispose with Dignity campaigns fall within that remit. They seek to break the taboo around this type of experience, which many men face but is never discussed.

There is no need for me to repeat the statistics that my hon. Friend set out, although they are important. However, the fact that we are having this debate at all shows that there is a need to discuss not only this issue but men’s health more broadly. In many ways, it shows that we are not taking men’s health seriously enough. It seems obvious to me that amending the Health and Safety Executive’s code of practice and guidance is necessary to ensure that men have access to the support they clearly want and need. It would be interesting to hear whether the Government support that in the name of equality, inclusion and dignity.

As I have stated many times in the House, and directly to Ministers, we need a men’s health strategy and a Minister directly accountable and responsible for delivery. Piecemeal initiatives and campaigns are welcome, but we would not have to do that work if we had an overarching strategy to look at all the health issues facing men and all the causes, and deliver all the solutions, just as the women’s health strategy does.

In addition to the statistics that underpin this debate, it is vital never to forget that one in five men do not live to 65, 33 men die every day of prostate cancer, and 13 men die every day by suicide. The psychological harm caused by this issue has a negative mental health impact on men. An overarching strategy would pull all that together. If we can have a women’s health strategy—which we need—why can we not have a men’s health strategy too? We could then deal with this issue under that umbrella. It could be the first win for the Government under a men’s health strategy.

It is important to deal with the common myth that men do not seek support for their health, and that they want to tough it out because they are men. Recent research from the Movember Foundation shows that men are more likely than women to make an appointment to see a health practitioner as soon as they think they have a physical health problem. Research from the Men and Boys Coalition shows that three in five men say they face barriers to seeing GPs.

The increasing problem with men’s health, which is in crisis, shows that the health sector is not male-friendly enough. Whether through the NHS, public health provision via councils or support through mental health services, supporting a men’s health strategy would start to change that, as would the initiative we are discussing today. People wrongly say, “Men do not speak up about their health,” when on issues like this they do and have. We must listen and act or men will think, “What’s the point?”

The Prostate Cancer UK campaign led by the actor Colin McFarlane shows that men are speaking up. There is even the annual March for Men happening next month—I encourage Members to sign up. We can no longer ignore these men, so we need the Government to change the code of practice and we need councils and health bodies to take a lead. I see that Winchester City Council is already doing so. We need to make it normal for bins to be provided—a new normal so that it is not seen as an issue or a pain, but just as the normal way of doing things. We need this normal and a new way of supporting men’s health.

I urge the Government to change the code of practice and—importantly—create a men’s health strategy and a Minister with accountability for this issue. We owe it to the men in our society and the women they share their lives with to deliver all this and more.

New Hospitals

Nick Fletcher Excerpts
Thursday 25th May 2023

(10 months, 1 week ago)

Commons Chamber
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Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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Thank you, Mr Deputy Speaker—he who is first will be last, and he who is last will one day be first.

I thank the Secretary of State for his statement, and I congratulate all Members who have been successful with their bids for new hospitals. Sadly, there is one name missing from the announcement: Doncaster. Although I understand that the RAAC hospital replacements are desperately needed, and I know that many of my constituents will benefit from the new A&E department in Bassetlaw, that does not remove the need for Doncaster to have a new hospital. There is a brownfield site right in the centre of Doncaster that is shovel-ready and ready to go, so will the Secretary of State—as well as maybe the Chancellor and the Secretary of State for Levelling Up—meet me to see what we can do to get Doncaster a new hospital? It would not just be a new hospital: it would revitalise the city of Doncaster, and we really need this.

Steve Barclay Portrait Steve Barclay
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My hon. Friend is right to champion the case of Doncaster. As he knows, while it is not in his constituency, the investment we are making in Bassetlaw is for patient care that, in a number of instances, will directly serve his constituents in Doncaster. That is why it is right that we look at capital investment on a system-wide basis, and I am very happy to have further discussions with him in conjunction with his local integrated care system as to that ICS’s future plans regarding its capital investment.

Food Labelling and Allergies

Nick Fletcher Excerpts
Monday 15th May 2023

(10 months, 2 weeks ago)

Westminster Hall
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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

Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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I beg to move,

That this House has considered e-petitions 585304 and 589716, relating to food labelling and support for people with allergies.

It is a pleasure to serve under your chairmanship, Sir Graham. I thank the petitioners for their campaign; I know that they are here today. Together, the petitions have received over 33,000 signatures. The first petition states:

“The Government should appoint an Allergy Tsar to act as a champion for people with allergies to ensure they receive appropriate support and joined up health care to prevent avoidable deaths”.

The second petition, on Owen’s law, asks for a change in the law around labelling in UK restaurants. It has three parts. First, it asks that restaurants

“put all information about allergens in their food on the face of the main menu so customers have full visibility on what they're ordering.”

Secondly, it requires servers to

“initiate a discussion with customers about allergies on all occasions”.

Finally, it states that there should be a register for all anaphylaxis deaths.

Those are the petitions, and I will discuss why the petitioners are asking for these measures. Sadly, they have suffered unbearable losses. Natasha Ednan-Laperouse died in 2016 after eating a baguette that did not have a complete list of ingredients. The baguette contained sesame seeds, to which Natasha was allergic. That caused her to suffer an allergic reaction, which resulted in her death. She was only 15—so young. Natasha’s parents Tanya and Nadim have already been successful in their campaign for Natasha’s law, which enforces a requirement for all pre-packed sandwiches to contain a list of ingredients and which became law in October 2021.

The second petition was started by Owen Carey’s sister Emma. Owen suffered from multiple allergies all his life and was used to ordering meals for his restricted diet. In April 2017, he ordered a chicken burger at a restaurant. He explained his allergies to the server; with no other information available, he was assured that he was safe. However, the chicken was marinated in buttermilk, to which Owen was very allergic. He knew instantly that something was wrong. He had a massive reaction and, after 45 minutes, collapsed and died. He died celebrating his 18th birthday—again, so young. They were both young people with their entire life ahead of them. We can all clearly see why Natasha and Owen’s families want to stop anyone else going through this.

I spoke to the families of Natasha and Owen so that they could explain to me in their own words exactly what they are trying to achieve. I am grateful to them for that. It appears that both petitions go hand in hand. The petitioners believe that if we had a tsar, they would have a champion who could work with families who have suffered bereavement and with charities that want to help, along with frontline staff, proprietors, supply chain businesses, the Food Standards Agency and all Government Departments that share an interest. It is a straightforward ask.

Margaret Ferrier Portrait Margaret Ferrier (Rutherglen and Hamilton West) (Ind)
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The FSA has highlighted the fact that while young people are more likely to experience a food allergy, they are less likely to tell a café or restaurant about it, especially if they have eaten there before. Does the hon. Member agree that we must empower young people to speak up about their allergies and make businesses aware of the importance of proactively asking customers about their potential allergies?

Nick Fletcher Portrait Nick Fletcher
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The hon. Member is exactly right. I was forwarded a list of many people who have fallen foul of that, and they always seem to be so young. I will definitely come on to what the hon. Member has mentioned.

The second petition seems relatively simple, too. How difficult can it be to put on a menu what allergens are in each piece of food? In fact there is already a law requiring that, but it falls short by requiring it “by any means”, which often means that allergen information is missed by those who need it most. The petitioners say that the law needs tightening up, but they are flexible in their ask: they say that allergens must be stated on the face of the menu, but that could be in paper format or electronic. For a server to make sure that a discussion is had seems another simple ask, and a list of the sad losses could be dealt with through the coroner’s office.

But as with many things in life, it is not quite as simple as all that. The industry is huge. Billions of pounds are spent each year on food from outlets of varying sizes. We have all been to a local caff or McDonald’s; some of us have been fortunate enough to go to some rather expensive restaurants in hotels with branches around the world. Then there are those in the middle, the squeezed small and medium-sized enterprises. Therein lies the problem: the variation among outlets and what and how they serve.

Fast food chains give a specification to their suppliers of the ingredients that their food is to contain, with no variations—that is what they ask for and that is what they get. But other outlets, big and small, often get swaps when they order their ingredients, pretty much like when we get an online supermarket delivery. A local caff may be able to cope with that, with a good proprietor keeping a check on what they are sent and very few menu changes throughout the year, if any. It may not be too much of a problem for them, but the large restaurants and some of the independents with fast-moving kitchens may struggle.

We have all seen a chef with 40 covers to do bellowing in someone’s ear, pots and pans everywhere, hot kitchens with hot atmospheres, young people trying to learn their trade, and impatient customers breathing down a server’s neck. These are high-pressure situations, often in open kitchens, and these people are all trying to make a living. Mistakes will happen.

Then there are menu changes. Many restaurants change their menu frequently to add to the customer experience. They have to offer a variety to keep it fresh, and hopefully in season too, but every change brings a problem—another allergy list and another place for an error to occur. It is not as easy as one first thought.

Margaret Ferrier Portrait Margaret Ferrier
- Hansard - - - Excerpts

Data from 2022 published by the FSA shows that when dealing with a risk of food allergies, smaller manufacturers will focus on the physical separation and secure storage of ingredients. In comparison, medium-sized manufacturers will take further steps such as cleaning between production runs and managing the packaging, labels and transport of products. Does the hon. Member agree that businesses of all sizes should have access to personalised guidance on how they can improve their allergy awareness in risk assessment?

Nick Fletcher Portrait Nick Fletcher
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I will be coming on to that point, but I believe that an allergy tsar, which the first petition asks for, will be able to bring those concerns together. That would help the industry immensely.

There are companies out there such as Control Catering that want to work with the Food Standards Agency and the industry to create a single source of truth. They want to work with manufacturers so that all data is seamlessly passed to the end user, the customer or diner. The petitioners believe that that is a sensible idea, as we have over 50,000 products across a huge supply chain going to many different outlets and 60 million-plus people across this land. The British Institute of Innkeeping and Hospitality Allergen Support UK feel it is sensible, too, but apparently the FSA is slow to respond when contacted about it. The industry believes that unless we have a joined-up approach, we could end up putting forward legislation that has the best intentions but turns out to be completely unworkable. I know that there is much more that the petitioners would have me say, but I must move on in the hope that other MPs will add their thoughts on the complexity of the issue.

The second part of Owen’s law would be for all servers to start a discussion with customers about allergies so that customers do not have to ask. My own experience is that that is happening anyway. However, I am fortunate enough to be able to answer no, so I am unsure how deep the conversation goes if the answer is yes. Stakeholders feel that training is required for all servers, but I understand that the industry suffers from a high turnover of staff, so that is not an easy task.

Ben Lake Portrait Ben Lake (Ceredigion) (PC)
- Hansard - - - Excerpts

I am grateful to the hon. Member for introducing this important debate. There is very often a high turnover of staff in the hospitality trade, but does he agree that technology such as electronic forms and QR codes might help? Even though staff members might work in a restaurant for only a couple of months at a time, such technology would enable them to quickly check when asked what ingredients are in the food they are serving.

Nick Fletcher Portrait Nick Fletcher
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The hon. Member is right. As we move forward in the digital age, we will be able to put options on menus that the server can discuss with the diners and things like that. Maybe the conversation should always be instigated, but if the answer is yes and the server is not adequately trained, they should be assisted by a person with higher authority or even the chef. Again, that may be difficult to implement, but a conversation must take place with an outcome that protects anyone who suffers with allergies.

Before I move on from this point, though, let me say that I believe that there is a responsibility on people who suffer with allergies to make that known. They must play their part. I know many are young, but I am a firm believer in personal responsibility and we must give the catering industry a chance. We must help it to help us if the system is not quite working as it should. All of us who are fortunate enough not to suffer should support those who do by being patient, by showing a caring attitude when ordering our food with guests and, if it is our child who suffers, maybe even by ordering what they order. That would help our children and the restaurateur, and it would show some skin in the game. If we want change, we should be prepared to bear a little cost ourselves and to make ourselves a little uncomfortable for the cause. The state cannot and should not be the answer to everything. We should all play our part.

Finally, Owen’s law asks that we maintain a list of all people who have died from anaphylactic shock. It would not necessarily be for the public domain or even name where the tragedy occurred, but it would be recorded to make the Government and all stakeholders aware of the size of the problem and to aid work on prevention as well as a cure. Professor Adam Fox believes that there should also be a list of near misses. Near misses are recorded in the construction industry; they should be recorded here, too. If we know the size of the problem, it may focus our attention on why there is a problem. Why are 40% of the population suffering with some kind of allergy? To me, that is the real question.

We can now see why the petitioners believe that the introduction of a tsar could help with the second petition’s aim of instigating Owen’s law. They believe that if we do nothing, we will see more tragedies, and if the industry simply states, “All our food may contain certain ingredients,” people with hypersensitivity will stay away. Some stakeholders believe that if we move too quickly with poor regulation, we will damage the industry and no doubt close businesses. So do we do nothing? Well, the petitioners and the industry at large agree that there should be a change, and appointing a tsar who could lead on solutions may just do that. It may help to bring forward legislation or ideas that will not only save lives, but save an industry that is battling on many fronts simply to stay afloat. I look forward to listening to what colleagues and the Minister have to say.

--- Later in debate ---
Nick Fletcher Portrait Nick Fletcher
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I hope the petitioners believe that they have heard a good debate today. We have heard an awful lot from people who understand this subject. They all want to help to bring everything together and ensure that the incidents and tragedies that have happened to the petitioners do not happen again. It seems to me that there is a lot of work going on, but in many cases it is siloed working, and a tsar would be able to bring it together. We could pick up the pace with that and prevent tragedies like those we have discussed from happening again.

One of the easiest things that restaurants could do would be to say that all their menus may contain something. Although that would cover them in some ways, it would take choice away for a lot of people. We need to get ahead of the issue. We need to look at it and see what we can do so that there is as much choice for everybody, and everybody can dine and eat safely. I believe that a tsar is probably the best way forward to start with. I appreciate the Minister acknowledging that there is an issue there; he has made copious amounts of notes to take away and work through with his Department.

I refer back to the part about personal responsibility. Obviously there is still work to be done, so to ensure that tragedies do not happen we must all work together to support and help individuals who we know suffer and ensure that those questions get asked if somebody forgets to say something. It is not something that should be ridiculed; it is massively important to people. We have a duty to look after everybody in society while we get food labelling to the place where it should be. May I finish by thanking the petitioners for all their work, hon. Members for contributing—I appreciate it, and I am sure it is appreciated by the petitioners—and the Minister for his comments?

Question put and agreed to.

Resolved,

That this House has considered e-petitions 585304 and 589716, relating to food labelling and support for people with allergies.

Reforms to NHS Dentistry

Nick Fletcher Excerpts
Thursday 27th April 2023

(11 months ago)

Commons Chamber
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Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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I will try to keep my contribution short, as many points have been covered already by hon. Members on both sides. The simple problem is that the dentists do not feel that they can function on their current contract, so asking them to do 110% of their contract when they do not want to do the initial 100% of their contract is not a way forward.

We need to look at the UDA contract to make it more financially viable, because at the moment dentists are taking on private work to subsidise their NHS work. The UDA contract is a problem across the board. If there were one or two dentists across doing it, we could say, “Well, maybe that’s their business plan.”, but it is not. It is happening across the board, and we need to look at the contract.

We also have a problem with dentists coming through. We need more dental places. As colleagues have mentioned, we ought, maybe, to look at a bursary for dentists who commit to stay in the NHS for at least five or 10 years, so that we have the dentists within the system to cope with the demand that is out there.

I am not 100% certain about taking dentists in from abroad. I always think when we pull the lever of immigration it goes against the grain of a Conservative Brexit MP such as myself, but there is also the fact that we are taking skilled people from other countries. If that is what we need to do to cover the backlog, then fair enough; I can understand a certain amount, but I always believe in training our own people and training them well, and I think that is what we should do.

Finally, I thank the dentists in my constituency. John Gatus is a fantastic chap and he has explained a lot about what we are dealing with now. I know the Minister is a good Minister. I know he has listened to everything that has been said in this debate and I know he wants to get this sorted out, but I ask him and everyone in this House to remember what it is like to have toothache.

We all need to remember that. Let us all cast our minds back to those 24 hours when we could get no sleep and we were in pain. It is dreadful, and an awful lot of my constituents are in that position now—or, what is worse, seeing their children go through it. We need to jump on this problem and we need to jump on it now. I am hopeful that the Minister will deal with this today.

None Portrait Several hon. Members rose—
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Performance-enhancing Drugs and Body Image

Nick Fletcher Excerpts
Tuesday 21st February 2023

(1 year, 1 month ago)

Westminster Hall
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Luke Evans Portrait Dr Evans
- Hansard - - - Excerpts

My hon. Friend makes an incredibly important point—these are dangerous prescription drugs, if they are not used properly. There is a plethora of side effects that are not talked about, from the short-term acute stuff that could mean someone has swelling of the brain or a clot, or is having a heart attack, or the long-term effects, such as depression, scarring acne or erectile dysfunction, which, particularly for young men, can have a huge psychological effect when they are trying to find partners. My hon. Friend is spot on. My heart goes out to Matt’s family; I am pleased there is a memorial for him.

Our role as responsible elected Members is to think about what we can do. The obvious area I get directed to is sport. It is actually quite hard to dope in sport, especially for an elite athlete. It does happen, but the culture is quite strong not to do so. Many athletes who want to be elite have come to me, as their GP, and have refused to take prescriptions because they are not sure whether it will be an exemption or clean, or whether it might get them in trouble with UK Anti-Doping.

Sport is an interesting area. I have met UN Anti-Doping a couple of times, and it is seeing people using these drugs to improve their image, but then finding out that they are quite good at sport and then getting into trouble with the authorities. The classic example is the young Welsh rugby player, who wants to look big on the streets when he is out and about, and wants to look good in Ibiza—and he finds out that having that size and strength is good on the rugby field. He starts playing semi-professionally and then gets picked up by UK Anti-Doping.

At the other end of the spectrum, we see cyclists, particularly affluent middle-aged men, who have the money and wherewithal to train, dedicate their time, buy the equipment they need, and start to see progression through the ranks of cycling. Then they meet the edge and ask, “What’s next? Let’s lose weight. Let’s have a fat burner. Let’s think about steroids or something else, like EPO.” That sees people caught out.

Those are the people going into elite or semi-elite athlete status; we have not even touched on society and the health aspects. We have heard a lot over the past 10 years about women’s health and body image, but less so about men’s. “Love Island” is back on TV at the moment, and we often hear a debate about how the females look: “Is there diversity? What about their shapes?” Very rarely do we hear that about the men. Nine out of 10 of them will have a six-pack, large shoulders and big biceps, and we seem to think that is okay.

Spencer Matthews from “Made in Chelsea” talked about the pressure and the need to use steroids he felt, because of his concern about what he looked like. We only have to look at what is currently in cinemas—the Marvel comic films—to see the aspiration set for young men.

Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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I congratulate my hon. Friend on securing this debate. Does he agree that boys and men are in a unique position in the 21st century? There are all kinds of pressures on boys and men that are often not seen, and which they often do not talk about. Does he agree that one way the Government could help is by putting in place a men’s health strategy? We could look at subjects such as this, and other issues that men are facing, as a whole to help men today.

NHS: Long-term Strategy

Nick Fletcher Excerpts
Wednesday 11th January 2023

(1 year, 2 months ago)

Commons Chamber
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Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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We have heard much negativity from the Opposition, which I need to address. First, I wish to thank all the nurses at Doncaster Royal Infirmary who did not go on strike. I hope the doctors will follow suit. Secondly, I wish to read out this redacted letter from one of my constituents:

“Dear Sir,

I recently had occasion to consult my doctor over an ongoing medical condition. The GP who examined me was courteous, clear and informative and referred me to Doncaster Royal Infirmary. I expected a long wait to be seen, but within a week I was asked to visit DRI. Again, expecting a long wait, I was surprised to be attended to by the consultant straight away. He was good humoured, explanatory and took the time to explain the condition. The following week, I received the results of the examination I had undergone.

At a time when the news is dominated by the failings of the NHS, I have to state that I found my treatment of the very best and my GP, the consultant and the staff at DRI deserve the greatest praise for their outstanding work.

I do hope that you will convey my appreciation to those concerned.”

I know that not everybody receives that kind of service, but let us give credit where credit is due. Perhaps the Minister will reward Doncaster staff by giving them a new hospital—I just thought I would get that in there.

We all know that many of the issues that we face are down to covid, but I am hopeful that, with the introduction of the integrated care boards, the additional staff and the additional funds to help with bed blocking, we can achieve the goals that our Prime Minister has stated and that soon all our constituents will receive the service that they deserve.

While I have the opportunity, I wish to take a few seconds to thank Anthony Fitzgerald and Richard Parker, who both work tirelessly in the health sector in Doncaster. Their work is unsurpassed by anybody else I know. I want to say one thing to the unions. We understand that this is a tough time, but these strikes will not help. The best thing that they can do is work with everybody—work with staff, work with MPs, and work with the NHS as an employer. Let us all come together and put the NHS where it needs to be and the country where it needs to be—the pride of Europe. Let us all get back to work and let us start doing that now.

Oral Answers to Questions

Nick Fletcher Excerpts
Tuesday 14th June 2022

(1 year, 9 months ago)

Commons Chamber
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Sajid Javid Portrait Sajid Javid
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I hold the covid virus responsible.

Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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I thank the Secretary of State for his recent visit to Doncaster Royal Infirmary. I apologise for the fact that the lights went out while he was there—it was not planned, but it did bolster my campaign for a new hospital. Will he meet me again during Men’s Health Week, to discuss a men’s health strategy, which many Members across the House believe would help an awful lot of men?

Sajid Javid Portrait Sajid Javid
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Yes, that is a very important issue and I will be happy to meet my hon. Friend.

Health and Care Bill

Nick Fletcher Excerpts
Diana Johnson Portrait Dame Diana Johnson
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I rise to speak to amendment (a) tabled by the Government in lieu of Baroness Sugg’s amendment—Lords amendment 92—which would continue the telemedicine service for early medical abortion that was introduced during the covid pandemic. First, I pay tribute to the noble Baroness Sugg for her persistence and her work in the other place.

This is about how we best provide essential healthcare to women, and remember that one in three women will have an abortion during their lifetime. It is about making access as straightforward and women-centred as possible. The Secretary of State recently made a pledge in his speech to the Royal College of Physicians when he talked about the need to

“empower patients and fulfil the promise of the technological leaps we’ve seen throughout the pandemic.”

Scrapping telemedicine abortion at this stage goes completely against what the Secretary of State was talking about. This is also about trusting women, as the Chair of the Women and Equalities Committee, the right hon. Member for Romsey and Southampton North (Caroline Nokes), has talked about and as my hon. Friend the Member for Birmingham, Yardley (Jess Phillips) has said today.

Such is the strength of the evidence that the Welsh Government recently announced that they will be making telemedicine for abortion permanently available. This sends a clear message that, while women in Wales can be trusted to use a healthcare service in a way that meets their needs, women in England cannot. Not only will there be unequal abortion access between the devolved nations, but this decision will lead to health inequalities within England for the most vulnerable and marginalised. I struggle to see how the decision to bring this service to an end after August is in line with the Government’s commitment to put women at the centre of their own healthcare, as detailed in the vision for the women’s health strategy.

Telemedicine has already enabled an estimated 150,000 women to access abortion care at home. Its removal means that every woman, regardless of her personal circumstances and health needs, will be forced to attend a clinic. Lords amendment 92 would ensure that women can continue to access a consultation with a clinician by telephone. To make it crystal clear to everybody, very importantly, face-to-face consultations will still be available. We have heard concerns about younger people, and face-to-face consultations will be available—

Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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Will the right hon. Lady give way?

Diana Johnson Portrait Dame Diana Johnson
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I am going to carry on because I know time is short.

Those consultations will be available if the clinician feels that that is appropriate or the woman wants to see somebody face to face. Let us all be clear: this is about choice. The continuation of telemedicine means that a woman would not have to travel long distances to attend a clinic if, for example, she lived in a remote area or had to make arrangements—

Nick Fletcher Portrait Nick Fletcher
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Will the right hon. Lady give way?

Diana Johnson Portrait Dame Diana Johnson
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I am talking about women’s experience, so I will continue, if the hon. Gentleman does not mind.

The woman may have to make arrangements if she has childcare or caring responsibilities, or she may have to take time off work. In the case of a coercive and controlling relationship, she would have to explain where she is going to a perpetrator, such as the Mumsnet user who said she had to visit a hospital to access abortion care and was “terrified” of her abusive ex-partner finding out where she was. She spoke of having to construct “various lies” about where she was that day and why she had to have someone look after her children.

I referred to NICE and the World Health Organisation in an intervention, but we should be aware that since telemedicine was introduced the risk of complications related to abortion has reduced, as women are able to access care much earlier in their pregnancy. I will rehearse the long list of supporters of the measure continuing: The Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of General Practitioners, the British Medical Association, the Royal Pharmaceutical Society, the Faculty of Sexual and Reproductive Health, the TUC, Women’s Aid, Rape Crisis, Karma Nirvana, the Terrence Higgins Trust, End Violence Against Women, Mumsnet, and many others. What I find most disappointing is that the Government are going against a wealth of robust and widely accepted peer-reviewed evidence from medical professionals and women’s charities, and appear to give greater weight to anecdote, erroneous opinion and misinformation focused on campaign groups with extreme views who bombarded a consultation. Sadly, that further emphasises that this is not an evidence-based policy decision.

Men’s Health Strategy

Nick Fletcher Excerpts
Tuesday 22nd March 2022

(2 years ago)

Westminster Hall
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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

Graham Stringer Portrait Graham Stringer (in the Chair)
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Nick Fletcher will move the motion and I will then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention in these 30-minute debates.

Nick Fletcher Portrait Nick Fletcher (Don Valley) (Con)
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I beg to move,

That this House has considered the potential merits of a men’s health strategy.

It is a pleasure, as ever, to serve under your chairmanship, Mr Stringer. Although this is only a 30-minute debate, I would still like to extend my thanks to the Backbench Business Committee for granting the time to discuss this extremely important issue. I am pleased that the Minister for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), will respond, given her very positive contribution to the Westminster Hall debate on prostate cancer earlier this month. I am confident that she will give a positive response today.

Over the past year, the all-party parliamentary group on issues affecting men and boys, which I chair, has continually heard from a range of national and international experts that there is a need for an improved focus on and a far more co-ordinated and strategic approach to men’s health in England. This approach has been adopted elsewhere, in countries, such as Australia and Ireland, which have their own men’s health strategies, as does the World Health Organisation in Europe. We all agreed that there are serious challenges in men’s health.

It is important to place on the official record that nearly one in five men do not live until they are 65, with an increasing gender age gap; that 13 men take their own lives every day; that men in some parts of Kensington and Chelsea live 27 years longer on average than those in some parts of the north; that one man dies of prostate cancer every 45 minutes; that nearly 6,000 men die an alcohol-related death every year; and that two thirds of men are overweight or obese.

The troubling matter for me is that the situation is not improving but seems to be getting worse. The time has come for the Government to take a fresh and strategic approach that is in keeping with their positive levelling-up agenda and their What Works approach to policy making. The Government approach to men’s health is based on individual conditions and is disease-based. However, as well as not having the impact that we would hope for, such an approach looks only at the outcomes of poor men’s health, not at the causes. To me, that is key.

We need to address and prevent the underlying causes and barriers that have a negative effect on men’s health, while also making the health system more responsive. For instance, if we continue to address suicide, alcoholism and obesity as separate issues, we will fail to see that they are often a result of similar circumstances. Why are men who live in economically disadvantaged areas dying from a whole range of illnesses far earlier than men who live in wealthy areas? There is no innate biological reason for that. We need to strategically join the dots on the causes, not place the outcomes in separate buckets labelled condition A, B or C, as is currently the case.

A men’s health strategy would ask more questions of the health sector. What of the gender age gap? It is a well-known fact that women live longer than men. Why is that? It was not always so. This is not something that we should just shrug our shoulders at and accept as normal. I want all men to have a long life and for those lives to be lived in a state of wellbeing. I am sure that nobody in the country would disagree with that ambition.

Another issue is that despite making up 75% of all suicides, men make up only 34% of those referred for specialist therapy. Why is that? Is it because they are not being referred or because suicidal men are not accessing the health system in the first place? It could be a combination of the two, of course, but why are men not getting the support they need, and what is being done to address that? We need to look at this at a systemic level. Of course, men need to adapt and help themselves, but the final responsibility has to be on society and the health system to change to help men.

During the APPG’s evidence sessions, the experts raised a number of points that struck home. When I visit my GP, which is thankfully rarely, I always notice how few other men of working age are there. We have to work out why and address that. Is it hard to get time off work? Are GP opening hours flexible enough? Do men fear that their bosses or workmates will raise questions about whether they are healthy and fit enough to do their job? Do they just get on with it? It could be all or none of those reasons.

Campaigns to encourage men to access the health system are necessary and welcome, but deeper issues need to be addressed. We also need to ensure that we do not look at men’s health from a negative perspective. Our approach should be based on the needs of men and boys, rather than on men and boys having to accept what they are given. That is the positive What Works approach taken by a number of men’s health strategies around the world. I hope that the Government can draw comfort from the fact that they do not need to start from scratch in devising a strategy, because strategic work is already being done in Ireland, Australia and elsewhere.

In addition, a host of leading men’s health experts and charities in the UK are ready and able and want to help the Government. The Government should look at the great work that is being done on men’s health in Leeds—everything good in life starts in Yorkshire. The Government could also harness the knowledge, expertise and help provided by a number of great, growing and pioneering organisations that support men’s health, including, to name a few, Andy’s Man Club, UK Men’s Sheds, Prostate Cancer UK, Lions Barber Collective, Men Walking and Talking, MANvFAT, Mates in Mind, Football Fans in Training, and Black Men’s Health UK.

In addition to their great work, all of those organisations know that men do talk and take action on their health when the right environment is created. Many of those initiatives also prove the importance of taking support to where men are, not to where it is thought that they should go—many experts have made that point. I am sure that those organisations are all on stand-by to help the Government, as are a number of health bodies, such as the Men’s Health Forum and the Patients Association, which support the proposal to create a strategy, with the former leading a national campaign.

Since becoming a Member of Parliament in 2019, I have been struck by how the Government are taking a fresh, constructive and positive look at all policy areas. Old ways of thinking are no longer taken as read. We can see that in the field of women’s health, where the Government are introducing a strategy for the first time, which I am sure all of us in the House support. To be clear, that is not a reason in itself for a men’s health strategy, but it does signal the need to have a consistent, cross-Government approach that takes into account specific, gender-based aspects affecting the health of women and men. Without a change in policy, it would be incumbent on the Government in the coming months to explain, with hard evidence, why and how their current approach is improving men’s health.

My concluding point is that a men’s health strategy would benefit not just men and boys but the women and girls with whom they share their lives and society. They all have fathers, uncles, brothers, cousins. This is a strategy for the nation as a whole. It would also be cost-effective, saving the health service millions of pounds in treating illnesses, and helping employers in reducing sickness levels. It is a win-win situation and would lead to a healthier, happier and more productive society for all. The Government have an ideal opportunity, with the coming White Paper on disparities, to start the ball rolling, and I am confident that they will take it. I look forward to hearing the Minister’s comments on this incredibly important issue.

Maria Caulfield Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
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It is a pleasure to serve under your chairmanship, Mr Stringer. I thank my hon. Friend the Member for Don Valley (Nick Fletcher) for securing this important debate, which provides us with an opportunity to discuss the health issues that affect men across the country. Although I am passionate about tackling the health inequalities that women face, there is no doubt that men also face specific issues.

I thank my hon. Friend for his work as chair of the APPG on issues affecting men and boys. It does a huge amount of work in this area and its report, “The Case for a Men’s Health Strategy”, is compelling reading. I thank him and all the members of the APPG for their work on that. He has discussed with the Secretary of State for Health and Social Care the potential merits of a men’s health strategy, and further meetings are planned as part of an ongoing discussion.

I do not want to generalise and put people in different categories, but there is a difference in the way in which women and men access the healthcare system. More than 100,000 women replied to our call for evidence. They told us that they often access healthcare but feel that they are not listened to and that it is a challenge to get the services they want. Men, on the other hand, often do not access healthcare services at all, and that is a significant barrier. They do not come forward for a variety of reasons, and my hon. Friend touched on some of them, including ease of access to services and sometimes the attitudes of employers or colleagues on seeking help. There are different barriers that certainly make a difference. It is true that the average male life expectancy in the United Kingdom is below that of women, although women spend a greater proportion of their lives in ill health and disability.

We also know that male and female life expectancy differs depending on where they live. We are absolutely passionate about ending that. It should not matter where someone lives or where they come from. Everyone should have the same health outcomes. A man in Blackpool can expect to live over 10 years less than a man in Westminster. We will publish our health disparities White Paper later this year to seek to address the gaps in life expectancy for men and women. I am particularly keen that the issues my hon. Friend has raised today are looked at as part of the health disparities White Paper, because he has provided some stark statistics that absolutely need to be tackled if we are to improve outcomes for men in particular.

The Department is already taking action to address conditions that affect men in particular, including suicide, heart disease and cancer, and other risk factors such as smoking. Although I do not want to generalise, we know that some men are less likely than women to seek help or to talk about suicidal feelings, and they can be reluctant to engage with health and other support services. Men are around three times more likely to die from suicide than women, and suicide prevention requires co-ordinated action and a national focus on men’s low uptake of services to help with suicide prevention more broadly.

Over the coming year we will review the suicide prevention strategy for England and focus on high-risk groups, including middle-aged men. I encourage the APPG to take part and scrutinise that to make sure that it addresses the very important issues that my hon. Friend has raised. We are making funding available. Almost £5.5 million is available this financial year through a suicide prevention grant to support the voluntary sector in particular.

I was interested to hear about the work in Yorkshire. My hon. Friend is right that part of the failure of NHS services to reach out to men is that we often expect men to come to those services. Organisations such as Men’s Sheds, where services can be brought to men, are often more effective, so I very much take his point and it is something that we need to look at.

Heart disease is one of the leading causes of death in men. The long-term plan is committed to several key ambitions to improve outcomes for individuals with cardiovascular disease, including enhanced diagnostic support in the community. I hope that our community diagnostic centres will bring healthcare into communities so that men are able to go for tests, screening and appointments slightly more easily than at present. Our ambition is to prevent 150,000 heart attacks, strokes and dementia by 2029, and we hope that our initiatives will improve outcomes for men.

Although smoking rates have fallen consistently across the population, the rates for men remain consistently higher than those for women. Men, however, generally report more success when they attempt to stop smoking, but it is still the case that smoking rates are higher for men than for women. We are undertaking an independent review of our tobacco control policies, led by Javed Khan. The review will make a set of policy recommendations that will give us the best chance to reduce smoking and achieve the Government’s smoke-free 2030 ambition. Again, I encourage the APPG to look at that work and to feed into it.

Finally, I will touch on cancer, because we know that lung cancer outcomes in particular are poorer for men than for women. We are trying to target our diagnostic services towards high-risk groups. One of our most successful areas has been our targeted lung health checks, which took place in 23 locations last year, with a further 20 being rolled out this year. We are using low-dose CT scans and are targeting, in particular, individuals who have smoked for a long time, those in high-risk groups and those in high-risk areas of the country. We are seeing remarkable success rates, with lung cancer being identified at stages 1 and 2 when it would otherwise have taken months for those individuals to show symptoms. Those checks will seek to improve the lung cancer outcomes for men.

Nick Fletcher Portrait Nick Fletcher
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I believe that a lot of smoking, obesity and alcohol problems stem from men being lonely. Many years ago, there was an advert that said that “You’re never alone” with a certain brand of cigarette I think that many men use those things as comforts and to pass the time. When men are feeling low, they might drink or go to the fridge. The men’s health strategy should look at that, and take an overarching view of all the issues, bringing them together. Clubs such as Andy’s Man Club are a fantastic place for men to talk and to feel valued and part of society, so that they do not feel lonely. When men do not feel lonely, perhaps they do not need to reach for those items that otherwise help them get through the day. I take on board what the Minister said about getting GP and health services to those clubs—that would be a fantastic thing to do. We should then automatically see a reduction in the issues that we are testing for now, such as cancer. However, I do also welcome the centres that the Minister has spoken about.

Maria Caulfield Portrait Maria Caulfield
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My hon. Friend is absolutely right. Although we are focusing on trying to diagnose lung and prostate cancer as early as possible, encouraging men to come forward and making them aware of the signs and symptoms, he is right that prevention—reducing smoking, alcohol and obesity—will help keep men healthier for longer. He is right that if men are lonely or do not feel like they have other avenues to meet people and get involved in society, they will reach out to smoking or drinking. Often, gambling is a way to meet people down the betting shop; a racecourse near me is very popular indeed. Men do have a different way of dealing with their emotional problems. They will not often talk about them, but meeting other people is a way of coping with some of the issues they face.

I have touched on several separate issues, which is exactly what my hon. Friend said we should not be doing. However, there is a golden thread running through all of them. The health inequalities for some groups of me, whether in life expectancy, life outcomes or accessing healthcare, are different from the issues and challenges that women face. We should not be dismissive of that, because those challenges are equally important.

I want to reassure my hon. Friend that the health issues facing men are being taken seriously. He has met the Secretary of State already and will be having further meetings. I think that today’s debate, in addition to our previous debate on prostate cancer, is the start of the conversation about how we improve outcomes for men. There are specific issues that they face, but there are also common threads that run through those issues. If we do not tackle those, we will not improve the overall health and life expectancy of men. I look forward to working with my hon. Friend further and to taking up some of the challenges that he has raised.

Question put and agreed to.