Contaminated Blood

Paul Monaghan Excerpts

Tuesday 12th April 2016 Commons Chamber

[Dr Paul Monaghan (Caithness, Sutherland and Easter Ross) (SNP)]

One of my first actions, following my election to this place, was to highlight the plight of those infected with contaminated blood in the 1970s and 1980s. I did this by writing to the Department of Health, following discussions with Julie, a constituent of mine. In July 2015, I also tabled early-day motion 334 to recognise

“the ongoing hardship and challenges faced by those infected with contaminated blood”

and to encourage

“the Prime Minister to implement promised arrangements to distribute an additional £25 million to those affected as soon as is practicable.”

Infected blood is one of the most terrible chapters in the history of the NHS. Many people have died or suffered long-term disability and hardship as a result of infection. Relatives have had to sacrifice careers to provide care and support, and in some cases partners and loved ones have become infected. Patients, families and carers have dealt with those difficulties with immense and enduring courage. My constituent Julie was born with a rare genetic condition known as Ehlers-Danlos syndrome, which requires treatment, including blood transfusions. She was infected with contaminated blood in 1974—42 years ago—while a young woman with her whole life ahead of her. Following a transfusion that September, she quickly developed symptoms of hepatitis and suffers today from a range of chronic and debilitating health conditions that have rendered her unable to remain upright for longer than 10 minutes at a time without becoming fatigued, owing to liver and lung damage arising directly from the transfusions.

Although now living in Scotland, Julie was infected in England. The liability for the current ex gratia schemes is based on where the individual was infected, rather than residency. This means that the English schemes and the consultation recently launched by the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), are responsible for supporting Julie and delivering the financial support she will require.

Julie is currently classed as Skipton stage 1 and has received an ex gratia payment of £20,000 but receives no annual award. Her medical condition means that she has great difficulty meeting the qualifying criteria for stage 2, which would increase her ex gratia payment and provide approximately £15,000 per annum in badly needed support. I have reviewed her correspondence with the Skipton Fund on the reassessment and have found it unhelpful, perhaps even deliberately obtuse.

[Brendan O’Hara (Argyll and Bute) (SNP)]

I thank my hon. Friend for giving me the opportunity to raise the case of my constituent Susan Webster who lost her partner, Charlie, almost five years ago, after he contracted hepatitis C as a result of contaminated blood, leaving her and their now 14-year-old daughter without any financial support. Since Charlie’s death, Susan and her daughter have received little or no Government help and have had to approach the Skipton Fund themselves. Today, they remain in a state of limbo while the Government dither over the future of the UK scheme. Does he agree that the Government, having dragged their heels for years, must now act to support the survivors of this scandal without any further delay?

[Dr Monaghan]

I absolutely agree with my hon. Friend. It is a tragic case that he outlines, and I will come to his specific point shortly.

On 21 January 2016, the Health Minister stated that the UK Government wanted to increase the amount of money on offer for victims of infected blood by £100 million, in addition to the £25 million announced in March 2015 by the Prime Minister. This takes the total to £225 million over the five years to 2020. As we know, there is a 12-week consultation on these proposals that closes this week, on 15 April. However, the proposed payment schemes have been heavily criticised by many of those affected for being outdated and confused in structure. That is my experience of them too. They also appear unfair.

The UK Government have estimated that the Department will spend a further £570 million over the projected lifetime of the reformed scheme, but analysis shows that the Department wants to cap annual payments for victims in England at £15,000 and that these will no longer be index linked and so will not increase with the cost of living. The UK Government also want to remove regular discretionary payments, including the winter fuel allowance and the £1,200 per child annual payment.

[Andrea Jenkyns (Morley and Outwood) (Con)]

On the point about the cost of living, I have several constituents in the same situation. One suggested that pension payments be increased to at least the level of the living wage. What does the hon. Gentleman think of that idea?

[Dr Monaghan]

I would absolutely support that suggestion. I would also note that many victims in England now face cuts of up to £7,000 a year, together with cumulative losses from the freezing of six annual payments to patients of £15,000 a year, time-limited support for partners and spouses after patients’ deaths, and the ending of help for the children and parents of those affected. Moreover, victims will no longer have access to grants for support with such things as mobility issues and modifications to property; nor will they have access to free expert advice.

The Haemophilia Society, which campaigns on behalf of victims of this scandal, has said that it has deep concerns about the proposals for England. It compared the proposals for England to those in Scotland, saying:

“These concerns are compounded by the fact that similar proposals in Scotland offer more generous payments to its affected community. There is a risk that, if both sets of proposals are accepted (as they currently stand), affected people in England will receive much lower incomes that those in Scotland.”

The Scottish Government have already provided £32 million over the last 10 years to the current UK-wide schemes, so they are already committed to support those infected in Scotland. Nevertheless, on 18 March this year, the Scottish Government announced a substantial package of increased financial support for those affected by infected NHS blood and blood products in Scotland, amounting to an additional £20 million over the next three years alone. The new Scottish scheme will see annual payments for those with HIV and advanced hep C nearly double from £15,000 to £27,000 a year, and those affected with both HIV and hep C will have their annual payments increase from £30,000 to £37,000.

[Sir Peter Bottomley (Worthing West) (Con)]

This is a pure inquiry. Would it have been open to the Scottish authorities to say that the increased levels of compensation would be available to all those affected within Scotland rather than on the basis of where people had acquired the infection?

[Dr Monaghan]

I do not think that would be possible because it would be an admission of liability, and these are ex gratia schemes with no liability in response to the payment.

In addition to the measures I have explained so far, a new support and assistance grant scheme will be established in Scotland to administer and provide more flexible grants to cover additional needs. Scottish Government funding for this scheme will increase from £300,000 to £1 million a year. In real terms, the new arrangements will mean additional financial support is available for all categories of infected people and their dependants in Scotland. In Scotland, we are clear that this is not the end of the process and that there will be ongoing work with patient groups on this matter.

In overwhelming contrast to the Scottish Government, the UK Government are proposing to cut funding for victims of this scandal, leaving vulnerable people thousands of pounds a year worse off. It is extremely disappointing that the UK Government do not think it important to support those who were infected in England, and it is clear that the proposed cuts demonstrate that the UK Government’s priorities lie with austerity, not with the victims of this terrible scandal. It is time for the UK Government to support those whose lives have been ruined by this unprecedented scandal. For people such as Julie, anything less literally heaps insult on injury.

Male Suicide and International Men’s Day

Paul Monaghan Excerpts

Thursday 19th November 2015 Westminster Hall

[Dr Paul Monaghan (Caithness, Sutherland and Easter Ross) (SNP)]

Thank you, Mr Rosindell, for the opportunity to consider the important issue of suicide, particularly male suicide. I represent the Scottish National party in this debate. I congratulate the hon. Member for Shipley (Philip Davies) on winning this debate, although I must admit that I found many of his remarks unrelated to its title.

I am certain that the lives of all of us here—men and women—will have been touched by a suicide in our family, circle of friends or wider social network; mine certainly has. The reasons why people are driven to take their lives are, of course, both complex and intensely personal. However, depression, alcohol and drug misuse, unemployment, family and relationship problems including divorce, social isolation, wealth inequality, social disadvantage and low self-esteem are identified as key triggers for male suicide. Sadly, those with severe mental illness remain at the highest risk of suicide, and, among them, those who refuse or are declined medical treatment are at a higher risk still and are particularly vulnerable.

In addition to health issues, social and economic factors influence people to take their life. I have alluded to wealth inequality; we know that men in mid-life from low-income backgrounds are consistently identified as the highest-risk group. In England, Northern Ireland and Scotland, the male suicide rate is approximately 3.5 times higher than the female rate; in Wales, it is approximately 4.5 times higher.

In September 2012, the UK Government published a report entitled “Suicide prevention strategy for England”, which identified the factors influencing increases in suicide rates in England. The report made it clear that periods of unemployment and severe economic problems adversely affect the mental health of the population and can be associated with higher rates of suicide. The report was followed up in 2014, when a study again found an association between those areas of England worst affected by unemployment and those with an increased prevalence of suicide. Between 2008 and 2010, there were approximately 800 more suicides among men, and 155 more among women, than might have been expected based on an analysis of historical trends.

Like me, my colleagues in the Scottish Government are deeply concerned about suicide rates, and they have put in place a suicide prevention strategy clearly setting out the actions they are taking further to reduce suicide in Scotland. The statistics on suicide in Scotland indicate a downward trend, even in male suicide rates, so the strategy is achieving outcomes that run counter to the general trend in the UK as a whole.

The Scottish Government strategy has five key themes: responding to people in distress; talking about suicide; improving NHS Scotland’s response to suicide; further developing the evidence base; and supporting a broad programme of change and improvement. In developing those themes, the Scottish Government have acknowledged that activities with a broader focus can effectively contribute to reducing overall suicide rates. That broader focus includes building personal resilience, and promoting mental and emotional wellbeing in schools and among the general population; working to reduce inequality, discrimination and stigma; promoting high-quality early years services; and working to eradicate poverty. All of that work is undertaken in the context of enhanced vigilance in respect of improving mental health, supporting people who experience mental illness and, of course, preventing suicide.

The Scottish Government’s original suicide prevention target was to reduce the suicide rate by 20% by 2013. Since 2002, when the target was originally set as part of the “Choose Life” strategy and action plan, we have seen an 18% reduction in the suicide rate. Between 2009 and 2012, Scotland saw the lowest number of suicides since the early 1990s. That reduction came at a time when many other jurisdictions were mapping increases.

Nevertheless, some trends are comparable with those in the UK as a whole. Taking probable suicide figures for 2011 and 2012 together, we find that almost three quarters of those who died in Scotland were male. That gender imbalance has been broadly consistent for much of the last 10 years. However, the major element in the 18% reduction in the suicide rate since 2000 has been the reduction in male suicides.

The Scottish Government’s suicide prevention strategy has now established a revised target, with the aim of reducing the suicide rate by a further 10% by 2020. That mirrors the global target established by the World Health Organisation. The strategy focuses on suicide prevention activities in communities and public services to enable people to live longer, healthier lives, which is one of the Scottish Government’s national outcomes. The strategy makes manifest the determined commitment of the Government of my country to continue the downward trend in the suicide rate, and to make progress towards meeting the WHO target.

International Men’s Day focuses on life issues, including the suicide rate, violence against men and boys, education and parenting. Those involved in International Men’s Day have stated:

“When 13 a men a day in the UK are dying from suicide, it is essential that everyone in positions of power, trust and influence does everything they can to help men talk about the issues that affect them.”

International Men’s Day supports the campaign for improved outcomes led by the Campaign Against Living Miserably, which also seeks to raise awareness of male suicide. CALM aims to encourage people to talk about male suicide in the hope that that will decrease the number of male deaths attributable to suicide across the UK. To the campaign’s great credit, its helpline receives more than 5,000 calls per month from individuals seeking advice and support. Some 80% of those calls are from men. The campaign has stated:

“It’s our belief that all of us at one time or another, regardless of gender, will hit a crisis and we could all do with specialist help when things go wrong.”

Those are wise words.

CALM has released a parliamentary briefing highlighting the adverse impact of the UK Government’s work capability assessments on suicide rates. It notes that each suicide costs an estimated £1.7 million, in addition, of course, to the much more obvious catastrophic emotional and social impact of a life being lost.

The Journal of Epidemiology and Community Health recently found that suicide was associated with the UK Government’s work capability assessment programme. The research found that for every additional 10,000 people subjected to work capability assessments, there was an association with an additional six suicides, 2,700 cases of reported mental health problems and an additional 7,020 prescriptions for antidepressants. That adds up to an additional 590 suicides, 279,000 cases of mental health problems and 725,000 additional prescriptions for antidepressants, based on current claim levels. Those figures are for England alone. The researchers noted:

“Our study provides evidence that the policy in England of reassessing the eligibility of benefit recipients using the WCA may have unintended…consequences for population mental health”.

Some 590 suicides at £1.7 million comes to more than £1 billion. We must, of course, add to that figure the cost of treating and supporting almost 300,000 people struggling with mental health problems, and of providing almost 750,000 prescriptions for antidepressants. Again, those figures are for England alone. Significant as the financial costs are, however, they fade into insignificance when compared with the human cost of lives lost, opportunities wasted and families destroyed by suicide.

It seems clear, therefore, that alongside health and economic and social status, UK Government policy directly contributes to the prevalence of suicide and imposes enormous financial pressures on public services already struggling to cope with significant budget cuts. Work capability assessments and the Work programme are having a significant negative effect on mental health. Reports repeatedly highlight the “heart-sink” felt when people receive a request from authorities to apply for jobs they are unlikely to win or hear anything back about. They also highlight the fact that the stressful targets enforced by jobcentres contribute to a lack of self-worth. Work capability assessments exacerbate feelings of failure and are increasingly cited as significant factors in individuals’ decisions to attempt suicide. When individuals are already vulnerable, likely to be suffering from low self-esteem, and experiencing chronic stress relating to the need to provide for their family, work capability assessments contribute nothing positive.

It is clear that more men than women take their life. Nevertheless, austerity and its mental health impacts are felt just as strongly by women and by those left behind in society. I suggest that the Minister take up the challenge of tackling the socioeconomic inequalities in society, and recognise that social exclusion is a significant risk indicator of suicide. I would like the UK Government to pay attention to the needs of boys, teenagers and young men to prevent vulnerability in later years. Perhaps more straightforwardly, I would like them to scrap the work capability assessment, which is proving far too costly, in terms of the human life and finance wasted.

Suicide must not be thought of as an issue that solely affects men, just because the number of deaths is higher among them. Any campaign targeting suicide must focus on the entire population.