Childhood Obesity and Diabetes

Pauline Latham Excerpts

Wednesday 24th April 2013 Westminster Hall

[Keith Vaz]

My hon. Friend is absolutely right. I hope that by securing the debate and by hearing the contributions of hon. Members, we can get a pathway to try and show that complacency will actually help people to get diabetes. That is why I hope that hon. Members will join me today in a war on sugar, a fight against fat, and a battle against the bulge.

We must address three key areas. The first is the role of Government in facing the obesity epidemic head on. That is closely linked to the second key area, which is the role of food and drink manufacturers. The responsibility deal was a flagship of the previous Secretary of State for Health, who is currently Leader of the House. It was launched in March 2011, but I am sorry to say, it appears to have failed. Voluntary agreements with industry have made little impact. The headline pledge to cut 5 billion calories a day is simply incalculable, arbitrary and misleading.

The Department of Health, in response to a parliamentary question of mine, said:

“It is not possible to measure the exact contribution of business’ actions to changes in consumers’ calorie consumption.”—[Official Report, 6 February 2013; Vol. 558, c. 339W.]

By February 2013, 122 companies had signed up to one or more of the responsibility deal’s six pledges, but it is what happens afterwards that really matters. Those pledges, sadly, in my view—I am ready to be convinced otherwise when the Minister replies—have, at best, paid lip service to the Government’s aim of getting the nation to eat more healthily, drink less, be more active, and have healthier working lifestyles.

[Pauline Latham (Mid Derbyshire) (Con)]

Does the right hon. Gentleman agree not only that parents have a huge responsibility to feed their children appropriately and ensure that they get adequate exercise, but that schools have a huge responsibility to give children nutritious, non-fattening and not sweet foods—healthy foods—and through sports, encourage them to take the exercise that will make them healthy and set in train for their whole lives the habits of exercising and eating healthily? It is not only about parents, because schools should help too, as well as the industry that he is talking about.

--- Later in debate ---

[Keith Vaz]

I thank my hon. Friend for her intervention. I did not know that that was the case, but if it is, it should be put right. All teaching establishments should be treated on the same basis and should all get the same message from Government.

Let us consider the issue of where schools are situated and the ability of fast-food chains to mushroom around schools. Many children purchase fast food on their way home from school. For many, fast food is readily available. For example, in my constituency, there are 61 fast-food outlets within a 1-mile radius of Rushey Mead primary school. Positive action has been taken by some local authorities. Waltham Forest council, for example, banned fast-food outlets near schools in 2008. However, more must be done to address the issue. Since 1 April 2013 and the creation of health and wellbeing boards, the onus has surely been on local councils to consider sensible planning restrictions to tackle childhood obesity.

Schools need to do more to educate pupils about the benefits of eating a healthy diet. I commend the excellent report by Ella’s Kitchen, “Averting A Recipe For Disaster”, which urges the Department for Education to address poor nutrition for children by making cooking in schools compulsory and by giving free breakfasts to every child. We currently have an epidemic of childhood obesity, which in 20 years’ time will turn into an epidemic of type 2 diabetes.

The incidence of diabetes is truly alarming. Sometimes we repeat these statistics so often that they lose their impact, but I have to repeat them again today. There are an estimated 3 million people in the UK with the condition, and a further 850,000 are thought to have the condition but are not aware of it. The complications from poorly managed and poorly treated diabetes are shocking. It is the leading cause of blindness, kidney failure and lower-limb amputations. Each week, there are 100 diabetes-related amputations; and each year, 24,000 people die earlier than expected due to complications from the condition. Not only are the health risks extreme, but the cost to the NHS is enormous. It is astonishing. The NHS spends roughly £9.8 billion a year and 10% of its budget treating the condition and its associated complications.

[Pauline Latham]

The right hon. Gentleman talks about amputations. My father had his leg amputated because of diabetic complications, but his problem was that he never stuck to his diet. People must be given more help to understand the complications that they can and probably will incur if they do not take the prognosis seriously and control their diet, because if they do not do so, they will have those long-term problems.

[Keith Vaz]

The hon. Lady is absolutely right. I do not want to steal lines from the Minister’s speech, but when she recently addressed a forum on diabetes, that was exactly what she said: diet is extremely important. We are all busy people and when we walk into the Tea Room for our cup of tea, we are faced with Club biscuits, Jaffa Cakes, Victoria sponges—plural—and all kinds of other things that entice us, so even if I go in saying that I must have a banana or an apple, I end up, as the hon. Member for Strangford has seen, picking up a Club biscuit. The hon. Member for Mid Derbyshire is absolutely right: diet is crucial. That is why I wish the newly appointed diabetes tsar, Dr Jonathan Valabhji, the best of luck in dealing with those figures.

How do we cope with this situation? There are practical steps that health care providers, local authorities and the general public can take, but the key is prevention. The new NHS health checks will offer those aged between 40 and 74 a check to assess their risk of heart disease, stroke, kidney disease and diabetes. If only I had had that check when I was 40, I would have discovered six years earlier that I had diabetes. However, new research revealed by the university of Leicester on Friday suggests that the checks could detect at least 158,000 new cases of diabetes or kidney disease, but they are not being taken up. I pay tribute to the work of Professor Kamlesh Khunti of Leicester university, who was behind the research that revealed the number of cases that could be discovered. The health check has enormous potential to find those in the early stages of diabetes or even with symptoms of pre-diabetes.

Oral Answers to Questions

Pauline Latham Excerpts

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

Of course, I understand the concerns of Cancer Research, and I know that the hon. Gentleman understands the personal tragedy that cancer can cause. The change in the clinical networks is happening because we want them to cover dementia, which we were talking about earlier, mental health services and maternity and paediatric services. It is right that they should do so, but I want to make absolutely sure that as we go through the restructuring the benefits of the cancer clinical networks remain as strong as ever.

[Pauline Latham (Mid Derbyshire) (Con)]

Will my right hon. Friend look at the east midlands cancer drugs fund? While I welcome the cancer drugs fund enormously, the east midlands will yet again underspend, leaving some of my constituents paying for their own treatment because they have been refused funding. Will my right hon. Friend please get his Department to investigate why?

[Mr Hunt]

My hon. Friend has mentioned the issue to me before, and I am happy to look into it in detail for her.

Oral Answers to Questions

Pauline Latham Excerpts

Tuesday 27th November 2012 Commons Chamber

[Dr Poulter]

We have had encouraging results from national pay negotiations at the recent NHS Staff Council, and unions are to consult their members on those results. There is general agreement that we need to maintain national pay frameworks, provided they are fit for purpose. I hope my hon. Friend will find that the south west pay consortium, which has been somewhat heavy-handed in the way that it has conducted its affairs, also sees the benefit of maintaining national pay frameworks. That is why we would like to see a quick resolution of the matter at a national level.

[Pauline Latham (Mid Derbyshire) (Con)]

6. What recent assessment he has made of the cancer drugs fund.

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

Since October 2010, more than 23,000 patients in England and more than 1,600 patients in NHS East Midlands have benefited from the additional £650 million funding for cancer drugs that this Government have committed to providing.

[Pauline Latham]

I thank my right hon. Friend for that answer, but I have previously raised in the House a constituency case where the NHS East Midlands cancer drugs fund would not pay for drugs that other CDFs would pay for, such as Avastin for second-line treatment of bowel cancer. Sadly, my constituent has since died because she could not get funding for the drugs she needed, having spent all her own money funding the treatment herself. Will my right hon. Friend meet me and my late constituent’s consultant, Dr Bessell, to discuss how we can end this postcode lottery?

[Mr Hunt]

Proud as we are of the cancer drugs fund, to hear such stories is extremely distressing, and our first thoughts are with the family of my hon. Friend’s constituent. We will of course look into the issue she raises, which is a cause of great concern. I know that the Under-Secretary of State for Health, my hon. Friend the Member for Broxtowe (Anna Soubry), is a neighbouring MP and would be happy to meet her to discuss the matter.

Children’s Cardiac Surgery (Glenfield)

Pauline Latham Excerpts

Monday 22nd October 2012 Westminster Hall

[David Tredinnick]

My hon. and learned Friend says I can make an exception for him, and I am delighted to do that.

The first point I want to make is that there is real concern that we are working on faulty statistics. The data used to make the decision were based on 2006-07. We need only consider the recent publication of the census in London to see the huge increase that there has been in population. There are shifting populations, and there is concern that the analysis is fundamentally flawed. It is not only my right hon. Friend the Secretary of State for Health who has had to consider flawed data recently. What about the west coast main line, whereby we found we were operating with completely inaccurate information? The right hon. Member for Newcastle upon Tyne East (Mr Brown) nods his head. This can happen in Departments, and we must take note of it.

My hon. and learned Friend the Member for Harborough and the hon. Member for Leicester South have addressed the issue of the ECMO link. To most reasonable people, it seems absurd that the two decisions will not be linked. I am sure that there are legal arguments, but somehow we must get a sensible decision so that both issues can be considered together.

The next point concerns the site of Glenfield. Glenfield is a hugely popular hospital not just with patients, but with surgeons. From, one might say, a feng shui point of view, it is on top of a hill outside the city, and it has a good, clean, clear energy. That is why everybody likes working there: it is nicer for everybody than the Birmingham site, as is proven, I would suggest, by a survey showing that only 2% of the staff in Glenfield want to move to Birmingham. It is not just BBC current affairs programmes that are jumpy about moving out of their current locations, as there is a real problem with the decision to move from Glenfield to Birmingham, as the hon. Member for Leicester South said. The body of knowledge built up over 20 years will dissipate, because many of the people who work at Glenfield simply will not move.

My next point involves the increased pressure on Birmingham, which has been referred to. Can Birmingham deal with it? Somewhere in the briefing papers is a point about Bristol. What happens if something goes wrong at Bristol and patients are moved around? My hon. and learned Friend the Member for Harborough made the point about the terrible tragedy in Wales, during which patients have been brought to Glenfield. Is it wise to concentrate all the resources in the midlands in one centre? I wonder whether it is.

[Pauline Latham (Mid Derbyshire) (Con)]

Birmingham is already having to send patients to Glenfield because it cannot cope with the numbers. Does my hon. Friend not agree that it seems silly to close such a popular centre? As he said, there will be a knock-on effect if other centres close, but patients are already being sent from Birmingham to Glenfield, and children are being sent to different hospitals because there is no room at Birmingham. It seems absolutely crazy that my constituents cannot continue to use the Glenfield hospital, where so much expertise has been created over a number of years.

[David Tredinnick]

I agree absolutely with my hon. Friend, who makes another valid point.

I will not detain the House for long, as other hon. Members want to speak, but I want to make two more points. I have had letters from all over my constituency from people who have benefited from Glenfield. Let us think for a moment. Who put the money into the unit in the first place? Was it all Government money? No, it was not. A lot of charities in Leicestershire have raised money to support the unit. What about their efforts? How will they feel, having struggled over the years to provide a superb local service? It will be a great injustice if that money is dissipated in a reorganisation.

I am delighted to see my hon. Friend the Minister in her place, and I congratulate my hon. and learned Friend the Member for Harborough and all the other Leicestershire Members, including my hon. Friend the Member for Loughborough (Nicky Morgan) and the hon. Member for Leicester West (Liz Kendall), across the Floor, who has worked on the issue. I say to my hon. Friend the Minister that this is a critical problem. Please help us.

health

Pauline Latham Excerpts

Tuesday 18th September 2012 Commons Chamber

[Pauline Latham (Mid Derbyshire) (Con)]

May I take this opportunity to welcome the new Health Minister, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), to his post and wish him every success in his new role?

I want to draw the attention of the House and, in particular, the Minister to two key issues in relation to type 1 diabetes. Some Members may be aware that I spoke on this issue last week in a Westminster Hall debate, but today I want specifically to urge the new health ministerial team to support the artificial pancreas project that is being funded by the charity JDRF. If the Department can find any funding to assist the research, that would be very welcome.

I wish to ask the Department of Health to end the postcode lottery that exists in the NHS on access to insulin pumps. At present, there are no answers on what causes or how to cure type 1 diabetes. The only way to find a cure for type 1 is through greater investment in medical research. If additional funding can be made available to cure, treat and prevent type 1 diabetes, it will result in long-term cost efficiencies for the NHS. It will also help the UK to retain its position as a world leader in this type of medical research.

Type 1 diabetes is a chronic, life-threatening condition that has a life-long impact on those diagnosed and their families. It strikes children and adults, staying with them for the rest of their lives. It is usually diagnosed in childhood between the ages of 10 and 14, but more and more children are being diagnosed much earlier, from 18 months onwards. It is an auto-immune condition; it causes the body’s own immune system to turn on itself and destroy the beta cells in the pancreas, leaving the body unable to produce the life-essential hormone, insulin. Insulin pumps cost between £1,000 and £3,000. There are additional costs for the consumable attachments, infusion sets, batteries and pump reservoirs, for which patients might have to pay themselves. The cost of those consumables could amount to between £1,000 and £2,000 per annum for each patient.

By contrast, the Scottish Government announced in February 2012 that all eligible under-18s with type 1 diabetes in Scotland will now have access to insulin pumps. They have also said that the Government are committing funding of at least £1 million to help NHS boards deliver pumps to under-18s who need them, as well as tripling the amount of pumps available to all people with the condition in Scotland. That has been followed by a further boost of £1.5 million this April in Scotland to provide more young people with insulin pumps.

Type 1 diabetes is a very different, distinct condition from type 2 diabetes, as it is not linked to lifestyle issues, such as diet and exercise. People with the condition rely on a programme of finger-prick blood sugar tests and insulin pump infusions or injections up to 10 times a day to stay alive. Although these prolong life, they are not the cure. A child diagnosed with type 1 diabetes when they are five faces 19,000 injections by the time they are 18. People with the condition are at risk of devastating complications, including blindness, heart disease, amputation, strokes and kidney failure, to name but a few.

Type 1 diabetes reduces life expectancy by about 20 years and there is a small but very real chance of sudden death. The short-term complications include debilitating hypoglycaemia, which, if left untreated, can lead to unconsciousness, coma and occasionally even death. Children never escape the responsibility of checking their blood sugar level and parents never have a day off from worrying about their children, even at night, as the blood sugar level has to be checked. Parents cannot relax because one of them must get up at night to check that their child is okay—or even still alive.

JDRF has told me that about 500 people in each constituency have type 1 diabetes. Therefore, more than 26,000 children in the UK have type 1 diabetes, which is as many as one in every 700. Some 98.6% of the children and young people who have diabetes will have type 1. The incidence of type 1 diabetes is increasing by about 5% year on year.

[Keith Vaz (Leicester East) (Lab)]

The hon. Lady is making an excellent and powerful speech. I declare my interest as a sufferer of type 2 diabetes. I wish to emphasise the importance of prevention work. She has talked about type 1, which is difficult to prevent; but in general, the more money that is spent on preventing diabetes, the less money that will need to be spent by the NHS in the future.

[Pauline Latham]

I thank the right hon. Gentleman for that intervention, because he is a big champion of tackling diabetes, particularly type 2, and he will speak up at every opportunity. Good care for not only the young with type 1, but for older people who can try to prevent themselves from getting type 2 diabetes will, of course, save the health service a huge amount of money.

As I mentioned, JDRF funds a large research programme to develop a closed-loop artificial pancreas, to help children with type 1 diabetes to live a life without the constant need for painful finger-prick tests and multiple insulin injections every day just to stay alive. It would give people with type 1 diabetes the freedom from those injections every day and has the potential to prevent some of the devastating complications that can arise from the condition. It would also give parents peace of mind that their children are much more likely to have stable blood sugar results, thus keeping them out of hospital.

The project involves two pieces of equipment that are already available to people with type 1 diabetes: a continuous glucose monitor that measures blood glucose levels regularly; and an insulin pump, such as the one I am holding, that painlessly administers insulin. The main task is to develop a computer that can talk to the two components and calculate exactly how the insulin pump should react and when to administer the insulin. That would close the loop to make the device a functioning artificial pancreas. This artificial pancreas is not yet commercially available, although the research team have already completed trials of the artificial pancreas in a hospital setting and are now beginning trials where children take the artificial pancreas home to see how well it works in a real-life situation.

Will the Minister please give an undertaking to monitor this research carefully and, if possible, lend his full support to this piece of groundbreaking research, which could improve the quality of life for so many young people in my constituency and many thousands across the country—it could do more than that; it could transform their quality of life.

The second issue that I would like to raise briefly this afternoon is the inequality that exists in our NHS in getting access to an insulin pump. The Minister may be aware that the Medical Technology Group recently carried out a freedom of information survey of every primary care trust in England, publishing its findings in “Pump Action—A Review of Insulin Pump Uptake and NICE Guidance in English Primary Care Trusts”. The report shows significant inequality in the provision of insulin pumps across England and a lack of adherence to National Institute for Health and Clinical Excellence guidance, with low insulin pump usage compared to the NICE benchmark. The average rate of insulin pump provision for people with type 1 diabetes is 3.9%, compared with the 12% benchmark recommended by NICE; it is nowhere near the 33% recommended for children younger than 12.

There is, without doubt, a postcode lottery on insulin pump access. The percentage of people with type 1 diabetes using an insulin pump falls as low as 0.25% in Medway and 0.3% in Croydon. In my county of Derbyshire, the rate is 4.4%, with 120 people using an insulin pump out of the 2,746 people with type 1 diabetes in the area—that is well below the NICE guidelines. May I request that the Minister take urgent action as soon as possible to address this issue? It simply is not fair that people can be denied treatment just because they live in the wrong part of the country.

Melanoma

Pauline Latham Excerpts

Wednesday 18th January 2012 Westminster Hall

[Pauline Latham (Mid Derbyshire) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hood, and I am grateful to Mr Speaker for selecting this important topic for debate. According to the British Journal of Cancer, the incidence of the most serious form of skin cancer, melanoma, is expected to rise by 52% in both men and women by 2030. One of the many tragic aspects of advanced melanoma is that, compared with other cancers, it disproportionally affects younger people. Indeed, more than a third of all cases of melanoma affect people who are under the age of 55. With such a high incidence, combined with the aggressive nature of melanoma, treatment options are very important.

I want to draw attention to the new and innovative drug, ipilimumab, also known under the trade name of Yervoy. Ipilimumab works in a new and unique way through a form of immunotherapy. It encourages the immune system to produce more cancer-killing cells. The drug is significant, and it has not been available to patients before.

In July last year, ipilimumab was launched in the UK with a licence approved by the European Medicines Agency. This is the first major advance for treatment of this cancer in 30 years. However, to the disappointment of patients and stakeholders, the National Institute for Health and Clinical Excellence announced on 14 October that it would not be recommending ipilimumab for the treatment of advanced melanoma on the NHS. I was profoundly disappointed to discover that the chief executive of NICE, Andrew Dillon, had deemed that this treatment was not

“a cost effective use of NHS resources.”

In response to that news, I held a stakeholder investigation in the Houses of Parliament and invited patients, carers, clinicians, charities—they included the patient support group, Factor 50, and the Karen Clifford Skin Cancer charity, also known as Skcin—and parliamentarians to come together and discuss their personal concerns about the negative preliminary guidance that was given by NICE.

[Rehman Chishti (Gillingham and Rainham) (Con)]

My hon. Friend mentioned that this disease affects younger people to a greater extent. One of my constituents, who is young and has young children, needs the drug Yervoy, which is expensive. Does she agree that we need to do everything that we can to ensure that those young children can see their mother for a longer period and that her last days are not lost days?

[Pauline Latham]

I completely agree with my hon. Friend, and I will come on to some cases in a moment. It is a very important point.

As well as coming together to share our concerns, the meeting was held to create a report that was submitted to NICE in response to the appraisal consultation document, in anticipation that it would be considered ahead of the NICE technology appraisal meeting, which took place on 16 November. We have had no response so far.

When holding the meeting on advanced melanoma, I was given the opportunity to hear first hand from melanoma patients, who are desperate to receive the drug. Melanoma often strikes at the younger end of the population. More than a third of all cases of melanoma occur in people below the age of 55, and it is the second most common form of cancer in the UK for those aged between 15 and 34. What those statistics on advanced melanoma in the younger population do not show is that many people in that age group will have children and so will face a very aggressive cancer, alongside the knowledge that they face leaving behind their children and family.

The patients whom I met at the meeting all echoed a simple and profound point: they are desperate to stay alive, so that they can be with their children, husbands, wives, partners and families. Given that treatment options for the disease have not advanced for three decades, how can it be fair not to release the drug for use by those patients who could have more time with their families? One young patient—a lady aged only 30—said at the meeting:

“I need to live. I have to live for my children. I just want a few more years so that my boys will remember me.”

Richard Clifford, the founder and trustee of the Karen Clifford Skin Cancer charity—Skcin—said at the meeting that

“median overall survival time after diagnosis is six to nine months. This is tragic because people have little time to prepare themselves and their loved ones for what is inevitably going to occur.”

I could not agree more with his sentiments. There is clearly an unmet need in the treatments available, and I believe that ipilimumab has a place in today’s treatment options, which are already scarce for cases of malignant melanoma. An experienced oncologist from Leeds who has used ipilimumab echoed that view at the meeting:

“It is the first drug that can help people live longer or make them more likely to be active for a meaningful period of time.”

I add a personal plea for help: my brother died from a malignant melanoma 11 years ago this month at the age of 54, one week after his birthday, leaving his wife and two teenage children. I know how debilitating this form of cancer is and how quickly it can spread. Apart from radical surgery, he had very few options in terms of the drugs on offer. As a result of Michael’s illness and death, I see my GP regularly, and I have had several pre-cancerous areas removed before they had the chance to progress to malignancy.

[Jeremy Lefroy (Stafford) (Con)]

I congratulate my hon. Friend on raising this important issue. As someone with very fair skin, I have had to have skin removed and examined, so I understand the potential consequences and the worry that people go through. Does she agree that we need more education about the consequences for fair-skinned people and, indeed, everyone of too much exposure to the sun and the overuse of sunbeds?

[Pauline Latham]

Yes, and I thank my hon. Friend for bringing that up. Sunbeds are still a problem, particularly among young women who think that having a tan makes them look healthier.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on bringing this matter before the House. Skin cancer is the deadliest cancer in Northern Ireland, and that is very worrying. The hon. Member for Stafford (Jeremy Lefroy) mentioned sunbeds. People under the age of 35 who use sunbeds increase their possibility of getting skin cancer. What does the hon. Lady think can be done? Does she think that councils need to do more? Councils have control of sunbeds, so perhaps they need to say, “No more.”

[Pauline Latham]

Yes, I would like that to happen. Looking tanned does not mean that someone is healthy. In fact, tanning increases the risk of malignant melanomas, which are rapid killers, and I would like councils to have the strength to say, “No.”

It may be expensive to prescribe the drug, but it is the first advance in treatment for a long time, and if used, may offer the opportunity of more trials to refine it, which could lead to its becoming even more effective. For young people with melanomas, it is a lifeline, even if they only survive for a relatively short time. Let us not forget the possibility that agencies, such as social services, and welfare benefits can cost the country huge sums if the remaining parent has to give up their career to look after a young family. Patients with this aggressive disease are expected to have a median overall survival time of six to nine months, but in trials, 46% of patients taking ipilimumab were still alive after a year, and in some cases, patients can live even longer.

At the stakeholder’s meeting on 8 November, we heard from a patient called Ian. He seemed well, spoke eloquently and raised many important points on access to treatment, which I urge hon. Members to read in the report that we submitted to NICE—I am happy to provide a copy. Sadly, before 21 December 2011, Ian became very unwell and was ultimately bedridden. The short time between Ian attending the meeting in November and his death a week ago demonstrates the aggressive nature of advanced melanomas.

Lack of access to the drug is still a major concern to all melanoma patients and, of course, to their families and friends. It is very distressing for them to know that there is a drug on the market that has been proven to prolong the lives of sufferers, if even for only a few months or years, yet they cannot access it through the normal channels. I acknowledge that ipilimumab is available in some parts of England through the cancer drugs fund, but it is not available in all areas, and the fund does not even exist in Wales—yet another example of inequality from the cancer drugs fund and another illustration of a postcode lottery.

[Chris Skidmore (Kingswood) (Con)]

On my hon. Friend’s point about a postcode lottery and regional variation, I think that she will be interested in figures that I recently obtained through a parliamentary question. They break down the number of registrations of newly diagnosed cases of melanoma—skin cancer—by local authority and region. I would happily give her a copy. In my region of Avon, Somerset and Wiltshire, there has been an explosion of newly diagnosed cases of skin cancer, from 254 in 1999 to 455 in 2008—an increase of 79%. The huge variation across the country shows that this is not just about the future, but that we have a problem now that we must urgently tackle.

[Pauline Latham]

Yes, I agree. I thank my hon. Friend for raising that point, because although we are talking about a big increase by 2030, he is right that melanomas are affecting more and more people, particularly the young, and they are usually a death sentence.

What will happen to those patients in areas covered by the cancer drugs fund who can access ipilimumab through the fund when funding ends in 2014? That further illustrates why it is imperative that NICE recommends ipilimumab, so that it is available across England and Wales to all patients who could benefit from it. The Minister knows that my concerns about access to treatments for other cancers—for example, Avastin as second-line treatment for bowel cancer via the cancer drugs fund—are well versed through parliamentary questions and speeches in the Chamber. I remain equally determined to ensure the availability to cancer patients of other life-prolonging drugs, such as ipilimumab.

Alongside Factor 50 and Skcin, I urge in the strongest possible terms that the Department of Health, the manufacturers and NICE work together, so that ipilimumab is available to appropriate patients across England and Wales. There are huge concerns that, without a positive decision on ipilimumab, patients will lose out on a lifeline to have those extra months or even years with their loved ones.

Oral Answers to Questions

Pauline Latham Excerpts

Tuesday 7th June 2011 Commons Chamber

[Mr Lansley]

I will, by all means, write again to the hon. Lady. The cost is not dramatic. Many organisations and people across the NHS have participated, giving freely of their time. Some 8,000 people have participated in the listening exercise events, of which there were more than 250. This has been immensely valuable; its value far exceeds any costs involved.

[Pauline Latham (Mid Derbyshire) (Con)]

A constituent of mine who suffers from bowel cancer has so far failed to be funded for Avastin on the NHS via the east midlands cancer drugs fund. She has already spent more than £40,000 of her own money. Her oncologist has written before on her behalf to appeal, but as not one of his appeals has been successful, for her or for any of his other patients, he is reluctant to write again to appeal for her, although she desperately needs this. What assurance can the Secretary of State give my constituent and her consultant?

[Mr Lansley]

My hon. Friend is assiduous in representing her constituent, and I will gladly discuss this matter further with her to see what the situation is. I should, however, emphasise that these are decisions being made in the use of the resources to deliver access to new cancer medicines for patients by clinical panels in each region—in each strategic health authority. To that extent, I am not seeking to substitute my judgment for that of the senior clinicians involved. None the less, if it would help my hon. Friend I will also arrange for the national clinical director for cancer services to have a discussion with her constituent’s consultant to examine this case.

HIV

Pauline Latham Excerpts

Wednesday 1st December 2010 Westminster Hall

[David Cairns]

I am grateful to my hon. Friend, who was a distinguished and long-serving Minister at DFID. In a sense, it is a false dichotomy to say that there is an AIDS epidemic in the UK and an AIDS epidemic in Africa and never the twain shall meet. One of the largest at-risk populations in the UK is the African community––people who come from Africa and are HIV positive, or those who contract the disease in the UK within the African community. I will speak about that in a moment.

My hon. Friend is correct to highlight the need to address the problem of the AIDS epidemic in Africa. Over the past few years, one of the most effective ways of doing that has been through the Global Fund to Fight AIDS, Tuberculosis and Malaria. The last Government had a good record in ensuring that the global fund was initiated, then adequately resourced. During the most recent meeting of the fund in October, high, medium and low targets were set for the level of replenishment. Unfortunately, the global community failed to hit the low target, let alone the medium or high targets.

I understand why the Government do not come forward and state the exact figures for the replenishment of the fund. Through DFID, they are conducting a multilateral aid review, and until they decide their priorities, they cannot say how much will be made available for the global fund. Until we can provide a figure, I encourage Ministers to let the world know, at least with rhetoric, that we remain committed to the global fund.

Much of the world looks to the UK for an international lead in tackling AIDS, and other countries will be looking to our figures for the replenishment of the global fund before making their commitments. The Government have an excellent opportunity to set a global lead. I was going to make those points about the international community at the end of my speech, but I have made them now.

Let me return to matters for which the Minister is responsible—she will be pleased to hear that—rather than the rest of the world. I will make three points about how we should respond to the ongoing HIV epidemic in the UK and our public policy; priorities. First, I will speak a little about prevention, secondly I will discuss testing and treatment; and thirdly, I will say something about care and support. Those three things do not exist in isolation; they are not, to use fabled management-speak, in “silos.” One point leads into another, but for the purposes of the debate I will say a little about each issue in turn.

The backdrop to this debate is not only the ongoing financial constraints under which all Governments around the world are operating, but the NHS reconstruction and reconfiguration that the Government have embarked on, as well as the messages contained in the public health White Paper, launched yesterday by the Secretary of State. Because the national health service is undergoing a process of change and transition, there is some uncertainty. Until we get answers to some of the questions that we raise, that uncertainty will continue.

As I pointed out in the main Chamber this afternoon, although the Minister’s responsibility on such matters is constrained to the NHS in England, the HIV virus does not respect geographical borders. It is incredibly important for the Government to work closely with the devolved Administrations in Edinburgh, Cardiff and Belfast to ensure a coherent, joined-up approach. That is the only way to tackle the virus in a way that will see a reduction in the number of people affected and reverse the rate of increase in new cases of the disease. Therefore, although I am addressing the NHS in England, the message must be heard by those who configure the NHS in the devolved Administrations. I was pleased to hear that the Secretary of State for Scotland will meet the Minister responsible for health in Scotland tomorrow, and will put that important issue on the agenda.

The first issue that I mentioned was prevention. In the early days of the epidemic, not much was known about the virus. There were no drugs and no effective treatment. Messaging was, by necessity, extensive and untargeted. Those of us old enough will remember the adverts with the collapsing tombstones and the gravelly voice telling us about the new virus—AIDS—and how dangerous it was. We remember the posters and the radio adverts, which were essentially blanket advertising for the whole UK. People debate the relative impact of those messages, but we remember that campaign many years after it happened, so it did have some impact.

The situation of those who have HIV in the UK today means that that type of mass media advertising is not perhaps the best way of getting a message to those most at risk. That point was made in the foreword to the “Halve It” document, by Lord Fowler, about which I will speak shortly. Lord Fowler was a distinguished former Secretary of State for Health and Social Security, and he is remembered very fondly by people who work on behalf of and alongside those with HIV and AIDS for the forward-looking approach that he took. As he acknowledges, such mass communication messages are no longer relevant, and the campaign must be more targeted.

Will the Minister tell us whether the Government’s strategies on sexual health and HIV propose to target messages on specific, at-risk communities, and particularly but not exclusively on younger gay men, for whom some of the safe sex messages may have been lost in time, and the African community? Those communities are not mutually exclusive, of course, but the messaging to each will have to be different. Particularly now that more heterosexual people are contracting the virus, many of whom are in the African community, there is a pressing need to develop messaging that speaks to that community and to its values and structures, whether through Church or faith networks or whatever, so that we can overcome some of the ignorance and stigma in the black African community in this country. I would be grateful for the Minister’s comments on what she proposes to do about that.

[Pauline Latham (Mid Derbyshire) (Con)]

rose—

[David Cairns]

I am happy to give way to a vice-chair of the all-party group on HIV and AIDS.

[Pauline Latham]

Does the hon. Gentleman accept that, in addition, white heterosexual people who perhaps have got divorced recently, after having had a monogamous relationship for many years, are now going out into the world of single dating and getting into a mess because they do not realise that HIV/AIDS is out there in the heterosexual community? Is that not an expanding area that we should also be targeting?

[David Cairns]

The hon. Lady is right. I was saying that the messaging should not go exclusively to gay men and to people in the African community. There must be a message for everyone, but the messaging needs to be differentiated. There will need to be different messages to different people, within relative constraints. I hope that the Minister will deal with her point.

There is concern. I am of the generation that came to maturity at the time when the AIDS epidemic—well, I might not have come to maturity yet; it is probably up for debate whether I have reached maturity.

--- Later in debate ---

[Pauline Latham (Mid Derbyshire) (Con)]

I am delighted to be speaking under your chairmanship, Mr Leigh, and I congratulate the hon. Member for Inverclyde (David Cairns) on obtaining this timely debate on world AIDS day. What is good about the debate is the unanimity between the parties. We often have heated debates, but we all appreciate the importance of today’s debate for people suffering from HIV/AIDS.

Now that the recent tough economic choices have been laid on the table, we are able to take an opportunity to review what is and is not working in the UK and try to make improvements. HIV/AIDS is a serious virus that poses a risk not only for those who are already suffering from it but also those around them. The ease of transmission of the disease means that, if we do not bring the number who have it back down from 83,000 or so, we run the possibility of letting the virus dictate our actions, instead of taking pre-emptive measures. Unfortunately, as a member of the Select Committee on International Development, I have seen at first hand that once the virus gets into sections of society where it becomes more prevalent, it can, left unchecked, destroy countless lives and families.

Britain is a world-leader in international development, and central in the international community’s voice and actions against HIV/AIDS worldwide. However, to be a credible voice and to make an inroad into the virus worldwide we need a credible tactic of beating the virus at home. Funding has been flatlining in recent years and we risk, if we are not careful, losing more than two decades of progress that has been made in fighting the epidemic.

The White Paper offers more flexibility to the health service, by offering GPs more control over the budgets that they inherit and how they spend the money allocated to them. Perhaps outlining the financial rewards of early screening will help to strengthen the argument. The Health Protection Agency recently estimated that the prevention of one new HIV infection saves the public purse between £280,000 and £360,000 in direct lifetime health care costs. That is a staggering amount per new diagnosed case. In 2008, had all of the UK’s 3,550 acquired infections been prevented it would have saved approximately £1.1 billion in direct health care costs.

Alternatively, we can look at the money that could be made, not saved, by early diagnosis. People living with HIV who have an early diagnosis can contribute wealth to the nation by staying in work for longer and therefore paying more in taxes; they are able to manage their health better, which results in their taking fewer days off sick. They can plan for their financial future so as not to require incapacity benefit in such large numbers, and by having quick access to antiretroviral drugs they can ensure that they do not require full-time carers, who are often family members, for so long. Their family can therefore go out and work and contribute to the national purse.

Of course, financial reward is not the only benefit of diagnosing HIV early. The significant social benefits to early diagnosis are equally if not more important. For instance, a 35-year-old male diagnosed early with HIV, and with quick access to antiretroviral therapy, would now be expected to live to 72—only a few years less than someone who would be deemed a perfectly healthy man.

Early diagnosis enables people who are HIV-positive to take positive steps in protecting others through safe sex. A recent study of newly diagnosed HIV-positive men who have sex with men reported that 76% had eliminated the risk of onward transmission three months after diagnosis. If the test comes back negative, of course, it allows the recipient a wake-up call and a chance to change their habits and think about the risks that they have been taking. In that way they are more than likely to help to prevent a future case of HIV in the UK.

Early diagnosis also allows the correct antiretroviral drugs to be prescribed. That in turn reduces the viral load and subsequently reduces the chances of transmitting HIV. By giving people the opportunity to take quick and effective measures against the virus we are putting them back in charge of their lives; they are not having their lives dictated by HIV. I should like the Minister to take note that women, and indeed men, who have been raped should automatically be monitored to ensure that if they suffer from HIV/AIDS it will be diagnosed extremely early; that is not something that they have chosen.

The truth of the matter is that the male gay community and the black African community are most susceptible to HIV infection owing to cultural sexual practice. There is a role for civil society in bringing UK levels of HIV down by bringing early diagnosis to those groups and deconstructing the stigma attached to screening for the virus. Everyone gets scared, intimidated and embarrassed from time to time and those natural feelings might be a barrier, preventing people in those at-risk communities from seeking early diagnosis.

Coming out of the financial turmoil of the past few years, it is important that we should take every opportunity that is given to us to make positive changes to the previous norm. We have the opportunity to put early screening at the heart of the public health White Paper and to create a social practice in which the stigma of screening is broken down through the participation of civil society. However, I believe that there is only one mention of HIV/AIDS in the White Paper. I simply ask that we do not let the opportunity slip away. Positive changes to the current HIV strategy can and should be made: most importantly, they need to be made.