Antimicrobial Resistance

Peter Dowd Excerpts

Wednesday 17th April 2024 Westminster Hall

[Peter Dowd (in the Chair)]

I call Will Quince to move the motion and then I will call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Will Quince (Colchester) (Con)]

I beg to move,

That this House has considered antimicrobial resistance.

It is a pleasure to serve under your chairmanship, Mr Dowd. Until November last year, I had the privilege of serving as Minister of State at the Department of Health and Social Care, alongside the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who I am pleased to see here in Westminster Hall today. If I may say so, Mr Dowd, it was a pleasure to work alongside her.

My hon. Friend will know that the DHSC is a Department where, despite one’s best efforts, one spends a considerable amount of time firefighting and dealing reactively with issues. During my time in the DHSC, many pressing issues concerned me, some of which remain today, but one in particular scared me.

If I told the House that there was an issue that was so serious that it is a top World Health Organisation global health threat, that it sits on the UK’s national risk register and that it costs the NHS around £180 million a year, would we be surprised if I also said that most people were not aware of it? What about if I said that globally there were 4.95 million deaths associated with this issue and that 1.27 million of those deaths were directly attributed to it? What if I said that one in five of all those deaths were of children under the age of five? Or how about if I said that deaths in the UK related to this issue are estimated to stand at 12,000 per year, which is the equivalent of deaths from breast cancer? What if I told the House that 10 million people—I repeat that figure; 10 million—are predicted to die globally each year by 2050 because of this issue if urgent measures are not taken?

This debate is about antimicrobial resistance, or AMR. If we walked out into Parliament Square now and asked 100 people at random what “AMR” is, I wonder how many of them would know. For the reasons that I have just set out, we should be aware of AMR and concerned about it. We should be pushing our Government, Governments globally and the World Health Organisation to do more to highlight this top global health threat and to take steps to address it.

AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become difficult or indeed impossible to treat, therefore increasing the risk of disease spread, severe illness, disability and—sadly—death. Although resistance is a natural phenomenon and not just a health issue, from a human healthcare perspective it is accelerated by inappropriate use of antimicrobial drugs, poor infection prevention and control practices, a lack of development of new antimicrobial drugs and insufficient global surveillance of infection rates.

As I have said, the World Health Organisation has declared AMR to be one of the top 10 global health threats, and it is also listed on the UK Government’s national risk register. In 2019, there were 4.95 million deaths associated with bacterial AMR across 204 countries, and 1.27 million of those were directly attributable, leading the WHO to declare it a top public health threat.

The OECD has found that one in five infections—I repeat: one in five infections—is now resistant to antibiotics, with the potential for that rate to double by 2035. In 2021, there were 53,985 serious antibiotic-resistant infections in England, which represented a rise of 2.2% from 2020. If left unchecked, resistance to third-line antimicrobials—the last-resort drugs for difficult-to-treat infections—could be 2.1 times higher by 2035. That means that health systems will be closer to running out of options to treat patients suffering from a range of illnesses such as pneumonia and bloodstream infections. Despite that—this is the really concerning part—no new class of antibiotics has been developed since the 1980s. Preserving and optimising our current antimicrobial arsenal is therefore not just urgent but paramount.

The consequences of AMR are huge. For urinary tract infections caused by E. coli, one in five cases exhibited reduced susceptibility to standard antibiotics. That is making it harder to effectively treat common infections. AMR also presents a threat to malaria control. Antimicrobial resistance is putting the gains of modern medicine at risk, because it makes surgical and medical procedures that are a normalised part of everyday life—such as caesarean sections, cancer chemotherapy and hip replacements—far more risky.

In addition to causing death and disability, AMR has significant economic costs. AMR creates the need for more expensive and intensive care, affects the productivity of patients or their caregivers through prolonged hospital stays and—I appreciate that this is a side issue—harms agricultural productivity. The World Bank estimates that AMR could result in $1 trillion of additional healthcare costs by 2050 and $1 trillion to $3.4 trillion of GDP losses per year by 2030.

Considering the huge risk that AMR poses to health security across the world, I do not believe that enough is being done globally to combat the current inevitability. Let me start by praising the UK Government for their action in this space, in particular the AMR five-year national action plan, or NAP, to contain and control AMR by 2040, which the NHS long-term plan details commitments to implement. I look forward to the update beyond 2024, which this period goes up to.

I could focus the rest of this speech on what more the UK could and arguably should be doing. We do need to see more on robust monitoring and surveillance. We need a significant public awareness campaign, greater investment in diagnostics, monitoring and screening—particularly in relation to rapid point-of-care testing—at local system level and, vitally, greater focus on infection prevention and management. However, I want to spend the rest of the time available to me focusing on international efforts and the role that the UK can play.

Oral Answers to Questions

Peter Dowd Excerpts

Thursday 25th January 2024 Commons Chamber

[Peter Dowd (Bootle) (Lab)]

T3. What assessment has the Minister made of the results of private sector trials in relation to the introduction of a four-day week? Will he meet me in due course to discuss the results of those trials?

[Kevin Hollinrake]

I thank the hon. Gentleman for that question. It is clearly up to businesses to decide if they want to trial a four-day week. We have made no assessment of any results. It is our belief that we should not run a Stalinist economy, where we tell private sector businesses how to operate their workforce and on what days of the week—he may differ on that particular perspective—but we have introduced important reforms that help businesses work more flexibly, including the flexible working changes that were introduced recently.

Menopause

Peter Dowd Excerpts

Thursday 26th October 2023 Commons Chamber

[Peter Dowd (Bootle) (Lab)]

I beg to move,

That this House has considered the matter of the menopause.

I thank the Backbench Business Committee for granting my hon. Friend the Member for Swansea East (Carolyn Harris) this important and timely debate in October, which is World Menopause Awareness Month. Regrettably, she is unable to attend or open the debate, so she has asked me, as a member and the treasurer of the all-party parliamentary group on menopause, to open the debate in her place. I am pleased and privileged to do so. I hope to do justice to her work, and that of the APPG and its supporters in this vital area affecting the lives of millions of women.

[Eddie Hughes (Walsall North) (Con)]

The hon. Gentleman says that this affects millions of women but, as the husband of a menopausal woman, I feel it is incredibly important that men, in their role as colleagues, friends or family members, have a deep understanding of the challenges of menopause, so that they can best support the women in their lives. Does he agree?

[Peter Dowd]

The hon. Member is absolutely spot on. That is why the APPG is working across so many areas to develop people’s understanding of menopause—not just women but, importantly, men as well.

The days of whispering the word “menopause” and keeping the changes in women’s bodies a secret and just getting on with it, so to speak, are thankfully beginning to be a thing of the past. The “Manifesto for Menopause” was launched last week at a celebratory breakfast in Parliament to mark World Menopause Day. Alongside the publication of the group’s “Manifesto for Menopause”, the reception featured new findings from a recent survey by Menopause Mandate of over 2,000 women. It found—it is important to get this into context—that 96% of menopausal women’s quality of life suffered as a result of their symptoms and almost 50% took over a year to realise that they might be peri or menopausal.

[Nick Smith (Blaenau Gwent) (Lab)]

My hon. Friend is making a great contribution. Women have told me that, when they experience symptoms such as itchy skin, aching bones, depression and anxiety, their GPs advise them on how to treat those symptoms, although the cause could be the menopause. Does he agree that extra training and support could help GPs to recognise menopause symptoms better, and could therefore help many women across the country?

[Peter Dowd]

That is a valid point and I shall be touching on it later.

According to the survey, only 12% of menopausal women were diagnosed by healthcare professionals, with a huge 60% discovering through their own research that they might be menopausal, and only 20% having had a positive GP experience. Among working women, 64% said that the menopause had a negative impact on them, but only 29% of their employers had a menopause policy.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for raising this issue. It is a massive issue for my constituents and the personal experience through my own wife is very clear. Given that 10% of women leave work during the menopause, saying that they feel and have felt unsupported and unable to continue—which really should not be the case—does he agree that there should be a greater obligation on businesses to help women?

[Peter Dowd]

That is another point that I will touch on later, but the hon. Gentleman is spot on.

Anyone who happened to be in Westminster Hall on Wednesday last week will be able to testify to the work that the APPG has done. More than 100 Members and others gathered for a photograph to mark and celebrate World Menopause Day. My hon. Friend the Member for Swansea East said she was not sure that visitors to Westminster Hall were ready to see so many women parliamentarians and others doing impromptu exercise squats. However, she also said that, if it was a good enough location for Henry VIII to play real tennis, it was certainly good enough for a group of menopausal women to highlight the benefits of exercise to their physical health and mental wellbeing.

The fact that those influential women, grassroots campaigners and clinical experts were brought together in Parliament showed the world that Westminster was listening; but listening alone is not enough while women continue to suffer. Listening will not help them get a diagnosis or access to treatment, or find the support they need. That requires action, and on World Menopause Day the APPG, which is chaired by my hon. Friend the Member for Swansea East, launched the menopause manifesto. Based on evidence that the group gathered by speaking to those affected by the menopause and experts in the field, the manifesto sets out seven recommendations, which we are urging all parties to adopt in their own manifestos ahead of the next general election.

I cannot stress enough how important it is to the 13 million women in the UK who are currently perimenopausal or menopausal, and to all around them who are indirectly affected—the hon. Member for Strangford (Jim Shannon) raised that point—to know that those in power will support them. The first recommendation in the manifesto is for health checks. Every time that is mentioned in conversation, people are genuinely surprised that it does not already happen. Many will remember receiving, on turning 40—along with the cards, gifts and the good wishes—an invitation to a 40+ NHS health check. Those “MOTs” monitor our weight and blood pressure, and are used to assess the risk of developing conditions such as diabetes, heart disease and strokes. What they do not include for women, at present, are any questions about, advice on or reference to the menopause, which is at best a surprise and at worst quite shocking.

There is strong evidence showing that many women are accessing primary care and being treated for individual symptoms because neither they nor their clinicians are recognising the root cause of those symptoms—a point raised earlier by my hon. Friend the Member for Blaenau Gwent (Nick Smith).

By raising awareness among medical professionals, who can, in turn, help to educate women at their 40-plus health checks, we can reduce the number of extra visits that women make to surgeries and prevent further misdiagnosis and inaccurate prescribing. We can also dramatically increase the number of women who get prompt and correct diagnoses and access to treatment pathways. We know that this would save the NHS money in the long run.

Many healthcare providers are now starting to include menopause in their standard packages, having identified the fact that patients are being sent for appointments in secondary care for an array of symptoms that have not been correctly diagnosed as menopause. By including menopause treatment as standard, they are reducing the cost to the NHS of these unnecessary appointments.

The second recommendation of the APPG’s manifesto is a national formulary for hormone replacement therapy. Although HRT is not the answer for all women, millions across the country rely on this treatment to manage their symptoms. We know that, in a 10-minute consultation, prescribers do not have the capacity to go searching for alternative treatments if a patient’s usual product is out of stock, and we have seen a supply shortage for many of these products. A national formulary would resolve this issue, as all eligible products would be easily accessible on surgery systems, thus eliminating the postcode lottery and regional variations that women are currently experiencing.

[Jim Shannon]

The hon. Gentleman is most gracious in giving way. He mentioned that there are sometimes disparities from, say, county to county. There are also regional disparities. I know he accepts that, and the Minister has taken note too. When it comes to providing better treatment, a recommendation has to be that every part of the United Kingdom—England, Scotland, Wales and Northern Ireland—should have an agreed strategy for helping women. Does he agree that there should be the same policy, the same strategy and the same response everywhere?

[Peter Dowd]

I agree with the hon. Gentleman. It is crucial that women are able to go to any surgery and, although there may be marginal differences in treatment or access to treatment, the substance is that they should ultimately get more or less the same access and the same treatment, depending on their needs.

The third recommendation also relates to prescribers. The manifesto calls for the inclusion of menopause as an indicator within the GP quality and outcomes framework. This change would help to balance the deficit in knowledge and understanding among GPs by incentivising improvement in diagnosis levels and treatment provision within primary care. If clinicians were better informed, they would be more confident in discussing menopause with patients at their health checks and in prescribing appropriate treatment, which would greatly benefit patients who visit their GP to seek support.

Moving away from healthcare, I am proud to say that, earlier this year, Labour committed to the fourth recommendation: mandating that all companies with more than 250 employees introduce menopause action plans to support those experiencing symptoms. That goes some way to addressing the points raised by hon. Members.

Alongside this, the APPG would like to see the provision of specific guidance for small and medium-sized enterprises and the introduction of tax incentives to encourage companies to integrate menopause in their occupational health plans. There are great examples of companies embracing the issue, and there are some excellent tools available to help, such as the British Standards Institute’s menstruation, menstrual health and menopause in the workplace standard. With research showing that one in 10 women are leaving the workforce and thousands more are reducing their hours or avoiding promotion, it is vital that more is done to address the impact of menopause on women’s economic participation.

The APPG is not asking for women to be given special treatment; we are asking merely for an understanding that working arrangements and environments may need to be flexible. This willingness to incorporate flexibility will benefit businesses, boost the economy and give women the confidence to progress in their career.

The manifesto’s fifth requirement is about the licensing of testosterone for women. It has always struck me as odd that when women reach menopausal age, which is different for everyone, they become deficient in three hormones—oestrogen, progesterone and testosterone—yet only the first two are available to women when they are prescribed hormone replacement therapy on the NHS. As my hon. Friend the Member for Swansea East has noted previously, if a woman wants the third hormone, they have to pay for a private prescription. The all-party group is calling for an evaluation of female-specific testosterone treatments, with a view to their being licensed by the Medicines and Healthcare products Regulatory Agency.

In the sixth recommendation, we are calling for better funding for research into the potential links between menopause and other health conditions, as well as the varying experiences of women from different backgrounds and ethnicities—that is very important. We know from the evidence that the APPG has received that those with conditions such as autism and attention deficit hyperactivity disorder can struggle more with their menopausal symptoms, and that those who have been treated for cancer often experience early menopause. So it is vital that much more is done to better understand the different journeys that women from different backgrounds are experiencing. In the past week, my hon. Friend told me said that she had been lucky enough to visit two universities, one in London and the other in her own home city of Swansea. Both are keen to do more to support their staff and to bridge the significant gaps in understanding around more complex menopause experiences.

[Jim Shannon]

I thank the hon. Gentleman very much for the scene he is setting. Small and micro-businesses are predominantly male-owned, so the issue for them is understanding how to put over the requests on behalf of ladies who are going through the menopause. Does he feel that the Government and the Minister should take that on board as well, to ensure that those businesses have the relevant information and guidance to do that within the small workforce that they look after?

[Peter Dowd]

The hon. Gentleman makes a good point and sets out an excellent idea. I am sure that the Minister, as part of the expansion or integration of the manifesto, can take it on board.

As I was saying, my hon. Friend was delighted that Swansea University announced last Friday that it would be introducing menopause into the curriculum for all of its medical students, as well as launching a menopause clinic for staff and students. I truly hope that it will be the first of many universities to do this. Future policy in this area, and an improved women’s health strategy, will be possible only if more funding is dedicated to this vital research.

The seventh and final part of the manifesto calls for a review of the demand for specialist menopause care. We need to look at existing provision, evaluate where increased secondary care is needed and assess other ways in which women could seek help. That might, for example, include access to specialist nurses in primary care and pharmacists, to ease the demand on GPs. That is another simple recommendation that would be easy to achieve, while having a significant impact on the care and support that women are able to access.

Nothing in the all-party group’s manifesto is difficult to achieve; no big contracts or big budgets are needed to make the changes that will significantly improve women’s experiences. The only thing that is needed is a commitment to prioritise this area of women’s health. We need a commitment to improve support, diagnosis and access to treatment for all those who need it. Who would not want that? I know that every Member of this House would want it. We need a commitment to show the 51% of the population who will directly experience menopause that they matter—that they really matter.

--- Later in debate ---

[Peter Dowd]

I thank all hon. Members who took part in the debate. I also thank my hon. Friend the Member for Swansea East, who regrettably cannot be here. I hope that I have been able to do justice to the points she raised with me.

I thank the hon. Member for Walsall North (Eddie Hughes) for relating his personal experiences and reinforcing the need to provide the support that women so rightly deserve. I also thank my hon. Friend the Member for Bradford South (Judith Cummins), who has done sterling work in relation to the Better Bones campaign and the inextricable links between osteoporosis and menopause.

My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) is, as ever, working in his constituency. He referred to his menopause workshop. I am really interested in the word bingo. I am intrigued about that and will speak to him about it in due course. The hon. Member for Bath (Wera Hobhouse) referred among other things to the review of the prescription regime, which is really needed. As ever, the interventions by the hon. Member for Strangford (Jim Shannon) were spot-on, clear and precise. I am pleased to have his party’s support on this matter. My hon. Friend the Member for Blaenau Gwent (Nick Smith), who intervened a couple of times—once on me—was focused on the key element of clinical awareness.

I thank the shadow Minister, my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare), for her response, particularly in relation to Labour’s workplace charter. I am pleased about the reaffirmation of that. I also thank the Minister for referring to the four-point plan for the workplace that is in progress, to the QOF review and to training in menopause.

We have covered a wide-ranging area. The seven recommendations or asks in the manifesto are out there for all to see. No doubt, we will return to this matter time and again. I hope that in the next 12 to 18 months we can make even more progress than we have in the past couple of years.

Question put and agreed to.

Resolved,

That this House has considered the matter of the menopause.

Petition

PANS and PANDAS

Peter Dowd Excerpts

Tuesday 12th September 2023 Westminster Hall

[Several hon. Members rose—]

[Peter Dowd (in the Chair)]

I was going to remind hon. Members to bob if they wanted to speak, but you have all bobbed, so thank you. I want to bring the Front Benchers in from 10.28 am.

Hormone Pregnancy Tests

Peter Dowd Excerpts

Thursday 7th September 2023 Commons Chamber

[Yasmin Qureshi]

I thank the right hon. Gentleman for his intervention. It is important to stress that it was the state, the NHS, involved in this.

In July 2015, I stood in this House and urged the Government to disclose all the evidence they had and to set up an independent inquiry. The then Minister, the hon. Member for Mid Norfolk (George Freeman), heard those concerns and agreed to an independent review, which would be led by an expert working group.

However, first, the expert working group was not independent. In fact, many of the experts were found to have conflicts of interest with the industry. Secondly, the review of the evidence conveniently ignored several important studies and then later said, “Oh, well, there was insufficient evidence.” Thirdly, the terms of reference of the review had said that it would try to find a possible link. Yet the reports’ conclusion said it was unable to find a “causal link”. How exactly does the Government intend to find a causal link, short of testing the drug on pregnant women?

[Peter Dowd (Bootle) (Lab)]

On that point about evidence, so many medical records were destroyed. How is it possible to have an absolute evidential base for the reports, when the evidence seems to have been destroyed?

[Yasmin Qureshi]

That is absolutely right; I thank my hon. Friend for that point.

I am pleased to see the right hon. Member for Maidenhead (Mrs May) in the Chamber. I know that, as Prime Minister at the time, she read this report. I note that in a recent Sky News interview she said

“I felt that it wasn’t the slam dunk answer that people said it was.”

I am truly grateful to her for commissioning Baroness Cumberlege to carry out a review that was both independent and credible.

Knowing what we now know, that the expert working group report was a whitewash, riddled with factual inaccuracies and conflicts of interest; knowing that studies from Oxford University have proven that the evidence in this report was deliberately manipulated to reach its conclusion; knowing that the Prime Minister of the day knew something was not right and then commissioned another review—how can it be right that any Government can continue to use this report to hide their sins?

Only a few weeks ago, lawyers used the report in court to defend their preposterous claims, and Ministers have used it as a basis to refuse and deny families redress. It is outrageous. I ask the Minister today: will she take a stand and do the right thing? Will she be courageous and read beyond the lines of the ministerial briefing she has been given? Only then will she agree with me that the expert working group report is not worth the paper it is written on.

The report stands in the way of justice for families affected by Primodos. I urge the Minister to work with us to set up an independent review of the scientific evidence, because I can assure her that only a truly independent review will find that there is an association between Primodos and malformation.

The scientific evidence is vast. Over several decades, numerous studies and animal experiments have found that the use of such tests can cause potential birth defects. In 2018, a team of academics at Oxford University conducted a systematic review of all previous human studies. They pooled together the data and found a “clear association” with several forms of malformation. At Aberdeen University, Professor Neil Vargesson has been working on this issue for years. He published research on zebrafish, which are genetically like humans, and found that the drug caused deformities in embryos. More recently, he has been working with human tissues and has again found the same association. There is another groundbreaking study take place in Sweden, which will be published soon. Again, that will continue to show how much evidence there is regarding this particular medication.

I have no doubt that later in the debate the Minister will stand at the Dispatch Box and tell the House that there is nothing she can do for the Primodos families because there is no proven association, because she has been convinced by the civil servants, the Medicines and Healthcare products Regulatory Agency and others. Would she like me to send her some of these studies—or perhaps I can hand them to her today? Is she willing to confront the truth, or is she going to be like her predecessors, burying her head in the sand? As long as she takes that position, she is standing in the way of truth and justice.

--- Later in debate ---

[Jeff Smith (Manchester, Withington) (Lab)]

It is a pleasure to follow my near constituency neighbour, the right hon. Member for Tatton (Esther McVey), and I join her and others in paying tribute to my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for her campaigns over the years, and of course to Marie Lyon for her many years of campaigning for justice for the families affected, including in my constituency.

When Baroness Cumberlege’s report “First Do No Harm” was published in 2020, it finally offered those families hope of justice. It was unequivocal in finding that those affected by Primodos had “suffered avoidable harm” and should be entitled to support and financial redress. That should have been a landmark moment. The then Health Secretary apologised, appearing to take responsibility and accept the report’s verdict, so it is really so disappointing that, as I stand here today, no Primodos-affected families have received any compensation payment to address what they have been through.

I want to emphasise the impact on individual lives by looking at two families in my constituency. Patricia McClellan had two children, giving birth to a daughter in 1969 and to her son, John, in 1971. She did not take any hormone pregnancy tests before giving birth to her daughter, who was born healthy, but she was prescribed Primodos when pregnant with John, who was born effectively missing an arm. When doctors came to assess him a couple of days after his birth, Patricia described being asked if she had taken any medication during her pregnancy, to which she replied that she had been given Primodos. She said:

“I will never forget the professor and the Doctors took themselves into my bathroom for a private conversation. I felt powerless as events happened around me.”

She had a succession of other disempowering, worrying and disappointing experiences with medical professionals while caring for John of the type that were highlighted in Baroness Cumberlege’s review.

She said:

“I have felt as though I have been kept in the dark for over 40 years. I just want answers and justice for my son and hopefully some closure to the trauma, guilt and stress that has affected almost my entire life.”

Sadly, Patricia died in 2019, never having received the closure and justice that she needed.

John has lived his whole life with the impact of his disability, and struggles with red tape and constantly having to go through the processes to get recognition of his disability from the Department for Work and Pensions. He and his daughter Leah, Patricia’s granddaughter, continue to fight for justice alongside other Primodos-affected families. Leah said to me:

“Being the daughter of a Primodos victim has also had its effects on me. I’ve lost trust in our health officials, I’ve witnessed the lies that have been told time and time again. Seeing my father deteriorate mentally and physically because of this is worrying for me.”

In Leah’s words, too many people affected by Primodos

“have sadly died since all this began. It truly feels like the Government is just waiting for them to pass on so this can be brushed under the carpet.”

[Peter Dowd]

The mother of one of my constituents was given Primodos in August 1972, two years after the standing joint committee for propriety in medicine said that it should have been withdrawn. Warnings were there for years. Why did that happen? Does my hon. Friend agree that my constituent, and his mother and father, who are up in the Gallery today, require justice to be done, and to be seen to be done by way of redress?

[Jeff Smith]

I could not agree more, and families across the country have been affected in such a way.

The Pierce family are another family in my constituency whose whole lives have been shaped by Primodos. Edward and Janet Pierce’s daughter, Louise, is now 54 years old. She was born with several different disabilities, which the families are convinced were caused by her mother having been prescribed Primodos. Louise has a severe mental disability, profound hearing loss, and difficulty walking. She has always required full-time care, which has been provided by her parents for most of her life. She lived at home with Edward and Janet until she was 50. Edward said:

“We didn’t realise the physical and mental effect this was having on our lives, it just creeps up on you.”

In 2018, Janet had a serious stress-related breakdown, leaving her with short-term memory loss and lack of awareness, and Edward now acts as her full-time carer. Louise went into full-time residential accommodation at the time of Janet’s illness. Edward said:

“I’m sure you can imagine the devastating effect this is still having on all our lives.”

It is so disappointing that the Government rejected the report’s recommendation for a new independent redress agency, and instead again highlighted the existing legal routes for redress. The Government apologised to people affected by the Primodos scandal, but are offering them no support. Those families lack the funding to be able properly to challenge the Government in court and get redress from existing legal routes, and they are being offered nothing else by the Government.

One of the specific recommendations in the Cumberlege review was the establishment of an ex gratia scheme for the victims of hormone pregnancy tests, and discretionary payments to provide redress for the stress, anxiety, psychological harm and toll of fighting for recognition experienced by those affected. That is what these families deserve.

Haven’t these families suffered enough? The mothers who were given Primodos are in their 70s and 80s now, and some have sadly died. Their children are mostly in their 50s. Time is running out to give them the redress they deserve. The Cumberlege report stated that

“while there is disagreement between experts about whether Primodos caused birth defects, the fact remains that thousands of women and unborn children were exposed to a risk that was acknowledged at the time.”

Primodos was deemed dangerous enough to pregnant women to be pulled off the shelves, and Baroness Cumberlege found that those families had suffered avoidable harm. In such circumstances, and having commissioned the report, surely it is the Government’s moral duty to implement that report’s recommendations in full or, failing that, to explain how those families will get the financial redress they deserve.

In July 2021, the then co-chairs of the all-party parliament group first do no harm responded to the Government’s response, welcoming their acceptance of four of the review’s nine recommendations, and a further one in principle. It also said:

“But we are deeply disappointed the Government has rejected calls for an independent redress agency or any redress for families whose lives have been devastated by medicines or medical devices. For those families justice has not been done today.”

One of those co-chairs, the right hon. Member for South West Surrey (Jeremy Hunt), is now Chancellor of the Exchequer. He has the purse strings and he could make those ex gratia payments happen.

We have heard today from the former Prime Minister, the right hon. Member for Maidenhead (Mrs May). She knows this issue so well and her remarks were powerful. I completely agree with the right hon. Member for Kingston and Surbiton (Ed Davey) that the drug companies must be held responsible. Ultimately, they should be the ones who pay, but in the meantime it is time for the Government to stop hiding and avoiding their responsibilities. It is time to act, and time to give these families the justice they deserve.

--- Later in debate ---

[Allan Dorans]

I thank the right hon. Member for his intervention; he is absolutely correct. The surviving victims are now mainly in their 40s and 50s. Many face a host of new medical problems and their bodies continue to suffer. Many have died prematurely.

[Peter Dowd]

The Public Authorities (Accountability) Bill—the Hillsborough law—would require public authorities to admit responsibility following adverse and mass casualty incidents. Some 97 people died as a result of Hillsborough, and a scandalous cover-up went on for decades. Would the hon. Gentleman agree with me, my constituents in the Gallery and other constituents in the Gallery, that it is time to end the cover-up and to establish how many people have died prematurely as a result of Primodos?

[Allan Dorans]

I would welcome that type of inquiry and the opportunity to view the outcome.

Despite serious concerns being expressed by the eminent paediatrician, Dr Isabel Gal, in 1967 indicating the possible dangers of Primodos, no official warnings were issued about these drugs until eight years later. There is strong and compelling evidence of systematic regulatory failures, demonstrating that the committees tasked with safeguarding the health of pregnant women failed in their duty of care.

When I was elected in 2019, I had never heard of the drug Primodos, and I suspect that is the case for many Members. I had heard of thalidomide, as it received far greater coverage in the media at the time. However, since then I have learned much about the horrors caused by Primodos—the devastating effect it had on unborn babies and on the babies born with horrendous birth defects, and the continuing, unimaginable tragic consequences for the mothers and families whose lives have been so cruelly affected by the drug. It is an absolute disgrace and shameful that those families have not only been utterly abandoned and ignored by the drugs companies responsible, but also by successive Governments, who actively put up barriers to avoid accepting the consequences of the manufacture, approval, prescribing and giving out of Primodos.

The drugs companies involved in the production of Primodos, the medical authorities at the time who failed to protect people and successive Governments are all liable for the suffering caused to the victims of Primodos. They are all culpable and guilty of negligence, for failing to put right this horrendous wrong put upon innocent people. It cannot be right that the fight for justice in these circumstances has been left in the hands of a few determined individuals battling against a huge global pharmaceutical conglomerate with millions of pounds of resources and our own Government.

I highlight the case of my constituent, Nan. I have her permission to share her experience and the effect that Primodos had on her and her daughter, Michelle. In January 1975, Nan was a recently married, healthy young woman. Feeling sick and suspecting she may be pregnant, she went to her GP for a pregnancy test, expecting—as was normal at that time—a urine test. Instead, her doctor gave her two Primodos tablets. By 1975, Primodos had already been banned for use as a pregnancy test for five years in Norway and Sweden. Nan put her utmost trust in the knowledge, experience and expertise of her GP. It was subsequently confirmed that she was about seven or eight weeks pregnant. She had a very uneventful pregnancy during which she neither smoked nor drank alcohol.

On 28 August 1975, Nan’s daughter, Michelle, was born. It was immediately discovered that Michelle was born with a hole in her diaphragm, which had allowed her bowel and spleen and part of her liver and kidney to be forced in to her chest cavity, crushing her lung. She was not expected to live, but through the exceptional skills of our national health service she survived and is now 48 years of age. Throughout her life, she has endured numerous operations and surgeries and long periods of hospitalisation. She has suffered severe health issues, including breathing difficulties, a weakened immune system, numerous bowel obstructions and inflammatory bowel infections, and she has been unable to conceive children. The horrendous effects of the debilitating physical, psychological and medical conditions and the extremely challenging health conditions suffered by Michelle and her parents for the past 48 years just cannot be adequately described by me with words.

When Michelle was born in 1975, Nan was unaware that the drug that she had been given to test for pregnancy had been associated with birth defects for the previous eight years. It was not until some two and a half years later that she read an article in the press that reported on a number of cases linking birth defects to Primodos, including internal organ damage similar to that suffered by Michelle. Since that time, Nan, along with many other women, has been fighting the injustice, where no one has ever been held responsible for the damage caused to so many lives through prescribing Primodos, which had been approved by the Government.

In February 2018, the then Prime Minister, the right hon. Member for Maidenhead (Mrs May), announced that Baroness Cumberlege would oversee an independent medicines and medical devices safety review. This review was, among other things, instructed to consider the consequences of Primodos. One of the conclusions in the report by Baroness Cumberlege is that Primodos should have been withdrawn from the market in 1967, after the first report by Dr Gal. However, the Government refused to accept responsibility for the effects of Primodos without a proven causal association, but admitted later, in a Sky TV interview, that there was a possible association. There was a moral duty for Government representatives on the Committee on Safety of Medicines to protect patients, but they failed in their duty of care by suppressing the evidence of harm caused by the drug. Even today, the Government continue to deny that they suppressed evidence, while supporting the flawed conclusions of the 2017 expert working group.

The damage to individuals, lives and families caused by Primodos, successive Governments’ lack of action and the failure to prevent, is immeasurable. This could be a far greater tragedy than thalidomide. Apart from frustration at the pharmaceutical companies and the glacial pace of Government in righting this tragic, historical wrong, the most chilling words we hear, increasingly regularly, are: “We have recently lost another of our Primodos family.” The tragedy is that we all know that those people died without receiving the justice they deserved. Even if compensation were paid, it would never fully compensate the families who were so tragically affected, or take away the immense guilt experienced by mothers who feel that they were in some way to blame for the defects that their children suffered.

It is well past the time for the current Government to put right this historical wrong, end the scandal and give some security to those who have suffered so much, thus allowing the mothers, fathers and the children who have survived some dignity and compensation for the tragedy that was caused through no fault of their own. The very least the Government can do is accept responsibility for the tragic circumstances, immediately issue a full apology to everyone affected by Primodos and compensate the victims. I and my party urge the Government to accept and commit to implementing the full recommendations of the Independent Medicines and Medical Devices Safety review and to set up a redress fund for families affected by Primodos.

Local Radio: BBC Proposals

Peter Dowd Excerpts

Thursday 22nd June 2023 Commons Chamber

[Peter Dowd (Bootle) (Lab)]

Under the banner of “digital first”, 39 local radio stations will have their content dramatically reduced, as we have all heard. Local radio will become regional and national, in many cases, after 2 pm. Now, I am not saying that we do not need digital—I have nothing against digitalisation—but it should not come at the cost of local radio. It is as simple as that.

Local radio has 5.7 million listeners every week, yet no meaningful consultation has taken place, so I have written to the director general, along with many Merseyside colleagues, to say that we are dismayed about the changes that will see weekend breakfast shows shared with Lancashire and Cumbria, which have very different audiences. The original plan also envisaged sharing with Radio Manchester, but it has been decided that Radio Manchester will be able to keep its breakfast show, despite it having fewer listeners than Radio Merseyside. Why? What is the rationale? I do not know, and I do not think they know.

At other times, broadcasting will be either regional or national. That will mean that a significant proportion of Cheshire will not be covered as appropriately and locally as it could be, which is a serious blow to our local democracy and will threaten listener numbers. Some specialist local radio shows, including a dedicated political programme on Friday afternoons, are being axed as well. Listeners are yet to be made aware of all the changes, which include the replacement of a popular local presenter who has excellent ratings by someone who is potentially less experienced.

We believe that local radio programmes provide a valuable service of information and companionship in communities, and that millions of people need to continue being served locally. Local radio is a lifeline for news and education, mitigating rural isolation—I know that—and supporting people’s mental health. It is a great incubator for new talent and one of the crown jewels of our public sector broadcaster. We have to protect it.

We are very concerned that those plans are being pursued without appropriate consultation. I have had a letter from the BBC since the announcement, but I did not receive one before—talk about putting the cart before the horse. We are asking the BBC to consider its approach and ensure that there is proper local consultation.

On a personal level, I was on BBC Radio Merseyside last Friday talking about an issue close to my heart: the air ambulance service, which helped my late daughter. We had a great 10-minute programme on what it means to our community, and we would not have had that were it not for local radio. I would not have had the chance, as a father, to make the case for it. That is what local radio does, so it has my full support. Those journalists do a fantastic job, and they need the support of every single one of us in this Chamber.

Heritage Sites: Sustainability

Peter Dowd Excerpts

Tuesday 20th June 2023 Westminster Hall

[Jamie Stone]

The hon. Gentleman makes his point eloquently. As he knows, my wife hails from the Province of Northern Ireland, and I know Greyabbey. He makes his point very well indeed.

Historic buildings are pieces of our history in the far north, and keeping them standing protects our heritage in the highlands, Scotland and the rest of the UK. In 2022, Historic Houses properties hosted over 26,000 events, such as festivals, theatrical performances and recitals. Listed buildings and their custodians make history, art and culture more accessible to people in communities right across the UK. It would be wrong to underestimate the value of listed buildings as sources of education as well as entertainment.

However, as I said at the outset, the climate emergency poses a challenge to the survival of estates and calls into question their long-term existence. Despite being sustainable partners who view decarbonisation as crucial to the preservation of heritage for future generations, custodians of listed buildings face practical barriers, which I am afraid to say include current planning permission and listed building consent, both of which inhibit the pursuit of net zero targets. For example, energy performance certificates use a metric of cost, as opposed to carbon. That often encourages the installation of new fossil-fuel boilers, rather than green alternatives such as solar panels, in listed buildings.

Furthermore, listed building consent adds delay, expertise and, indeed, hassle to the process of installing any energy-efficiency measures in listed buildings—even those with minimal impact on their historic fabric. I would suggest that the regulations are flawed and that they lead to the slow and difficult uptake of energy-efficiency measures. These houses were built to last, but the Government must allow them to adapt and change as necessary. Planning frameworks need to provide support for the implementation of sensitive energy-efficiency measures in a way that reflects the climate emergency.

Greater investment in renewable energy in off-grid rural communities is imperative, particularly in my constituency and other rural constituencies, because it would lower renewable fuel costs and increase self-sufficiency. That way, green energy projects in the heritage sector could be integrated into their surrounding communities. Reviewed planning frameworks must ensure that buildings are repaired and adapted in energy-efficient ways, not demolished. In short, heritage protections must be maintained and prioritised in future reviews of planning policies. We must put sustainability at the forefront of our thinking.

I am fully aware that housing is devolved to the Scottish Government, but perhaps—with the best will in the world—the two Governments could work together to ensure best practice. After all, having a chain of historic attractions all around the UK can only benefit the four nations of the United Kingdom. The United Kingdom has the oldest building stock in Europe. It would be shameful and reckless to let it succumb to insolvency when we have the tools to ensure its survival.

The point I want to make is simply this: the climate crisis is growing ever more urgent and we need to start taking tourism and heritage more seriously. We can do that by recognising this historic environment as part of the solution to achieving net zero. I suggest that tourism has for too long been treated as second rate—an afterthought to bigger, more important issues. We are talking about people’s livelihoods, the preservation of our national identity and, indeed, the very existence of our planet as somewhere we can live and work for many years to come—these are no small feats.

That is why I join the voices that have been calling on the Government to support heritage sites that are committed to net zero targets by publishing a review of the planning and regulatory reforms that face listed buildings. The survival of our country’s heritage requires a supportive regulatory framework, and we need it as soon as is humanly possible. I look forward to hearing the contributions of other Members present, and I thank them for attending the debate.

[Peter Dowd (in the Chair)]

I remind Members that they should bob if they wish to be called in the debate.

--- Later in debate ---

[Jonathan Gullis (Stoke-on-Trent North) (Con)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) on securing this important debate, because heritage sites and tourism mean so much to people in places like Stoke-on-Trent, Kidsgrove and Talke. I will start with a success story that shows what can be done to sustain important icons in our communities. The shadow Minister, the hon. Member for Manchester, Withington (Jeff Smith), visited Middleport pottery. I was delighted that he was able to see it; it is just a shame that he did not visit with a much sounder group of individuals like me, but I understand he was there in a party political capacity. Anyway, I am glad that he was able to see that fantastic work.

All thanks to His Majesty King Charles III: his charities came in and turned Middleport pottery around. It is a great icon of our history and heritage that was on the verge of crumbling and falling down. Today, it is a continuously working factory—the only factory in the world where pottery is still handmade and hand-printed. Every piece of Burleigh is unique to its owner.

Middleport pottery is opening up and giving tourists the opportunity to see a working factory in action, and to be involved in arts and crafts. It has developed the Harper Street project, which has an excellent veterans support network; it creates artwork for local veterans to sell. That gives them skills and ambition for the future, and helps them to tackle their physical and mental health ailments. There are fantastic organisations, such as Middleport Matters Community Trust, led by Vicki Gwynne, who does tremendous work. It ensures that young people and mothers get the support that they need all year round, through holiday activities and food programmes. It is linked to the Hubb Foundation, and gives important community support.

Channel 4 has used Middleport pottery for “The Great Pottery Throwdown”. Canal scenes in “Peaky Blinders” were filmed there. The site has been used diversely to bring in a sustainable income. The factory produces an awful lot of heat, so that is shared around the complex to drive down energy costs. Also, many volunteers kindly give up their time to support that success.

The greatest honour I have had as a Member of Parliament was seeing those at the heart of this Government—the Cabinet—have a regional away day in the Middleport pottery building. Hosting a Cabinet meeting, and knowing that those decision makers were in the community, was iconic for the people of Stoke-on-Trent. These local charities and organisations would maybe never otherwise be able to access Ministers at first hand; having them on their doorstep sent a real signal of intent and seriousness. I congratulate Boris Johnson, the former Member for Uxbridge and South Ruislip, on doing that. It was a big decision, and it meant a lot to the people of Stoke-on-Trent. I am delighted that Middleport pottery also recently received £249,962 from the National Lottery Heritage Fund.

Middleport pottery is a success story, but there are many challenges. Stoke-on-Trent is littered with beautiful buildings and historic heritage. The mother town of Burslem has many of those buildings. The Queen’s Theatre, the Victorian Burslem indoor market and the Wedgwood Institute are three iconic buildings. The city council recently found that it would cost between £30 million and £40 million to bring them back to life. Through feasibility studies, the council has been looking at what could be done with those spaces.

The indoor market—a fantastic building—had the Office for Place visit it; being the cheapest of the three, I think it is a real goer. It could be not only a great venue for meetings and conferences, but a performing arts space. Street food stalls could be set up there. An iconic building could be brought back into use. It was recently listed, which is important, because it gave us access to funds that were unavailable before. Stoke-on-Trent City Council took the risk of bringing the building back under the public purse. The council wants to see it future-proofed and used, so that Burslem can continue to thrive.

I welcome the Minister to come and see at first hand that iconic sight, and to stop off at the mighty Port Vale football club. There is another football team in the south of the city, but we do not need to worry about them quite as much. Port Vale are a great football team, and the Minister would be more than welcome there. Port Vale’s promotion from league 2 to league 1 has helped bring an awful lot of extra footfall into the mother town of Burslem. That supports pubs and independent restaurants, such as Agie and Katie, an award-winning west midlands food provider, as well as The Bull’s Head in Burslem, near the fantastic Titanic Brewery; it is a great epicentre.

There is one building that is iconic to the history of not just the city but the country: the Leopard pub. Sadly, arsonists attacked this important building and caused tremendous damage. It is where Josiah Wedgwood and James Brindley met to discuss and plan the Trent and Mersey canal, which fuelled so much of the industrial revolution across the city. Now, potentially just the frontage can be kept. The new owners are talking about turning the building into housing. I hope that can be done, but Government support is required to move those plans forward.

Price and Kensington teapot works is another important site. I am grateful to the Government for supporting my ten-minute rule Bill and including it in the Levelling-up and Regeneration Bill. It means that the current capped fine of £1,000 for someone found guilty under section 215 of the Town and Country Planning Act 1990 will be unlimited for the first offence, and will go up from £100 to £500 a day for a second offence. That will help us hold to account rogue and absent landlords, such as Charles Lewis and Co, which owns that great heritage site and was today fined up to £72,000 for its misuse. I hope that people such as Simon Davies of Kidsgrove, a local businessman, will come forward with plans to take over the site and deliver a new arts and cultural centre. It will be a corridor into Stoke-on-Trent north, off the A500. That would be really powerful, and would support the tourism industry. It would go into Middleport pottery, using the canal network.

Finally, there is a great sleeping giant that I have been proud to bang on about time and again: Chatterley Whitfield colliery, which is the largest complete deep coal mine site in Europe. It was the first colliery in the country to dig up 1 million tonnes of coal, and it did so not just once but twice. I congratulate Nigel Bowers, who in the recent honours list was recognised for his public service, and for standing up for such fantastic local charitable organisations. Stoke-on-Trent City Council, Historic England, the Chatterley Whitfield Friends and I have come up with a plan to make the colliery a really exciting centre for geothermal exploration; it can be used as a trial. The Coal Authority has revealed that there is pre-existing infrastructure that could help develop a mine energy project with a heat pump that can bring heat from the ground to the surface and power homes. The Coal Authority estimates that the site could generate about 1 MW of energy—enough to power 500 homes. I hope the Minister will take that back, feed it into Government and make the most of the opportunity to bring to that important site the investment that we need if we are to turn around that sleeping giant, which I want to see flourish.

[Peter Dowd (in the Chair)]

Just a bit of housekeeping: I expect to call the Opposition spokespeople at 5.16 pm, and I will give the mover of the motion a couple of minutes to wind up, so hon. Members have no more than five minutes each. Try to keep it under five minutes, please.