Midwives in the NHS

Peter Gibson Excerpts
Monday 17th January 2022

(2 years, 4 months ago)

Commons Chamber
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Siobhan Baillie Portrait Siobhan Baillie
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I could not agree more, and I thank my right hon. Friend for everything she has done for early years provision. When we think about the early years and the importance of giving children the best start in life, we remember that midwives have children in their hands at year zero; it could not be any earlier than that. I will give more details of the reality of the pandemic world and what midwives and NHS staff have faced, but the effect on the beginning of the relationships and the fear when you do not have your partner with you in the ward has been absolutely awful. I appeal to all Ministers to think extremely carefully about further covid restrictions, if they ever again become necessary.

We know that the staffing shortage does not affect only midwives and hospital staff, but it has a real impact on families trying to bring new life into the world. As the hon. Member for Strangford alluded to, 87% of RCM members say that they delay using the toilet due to lack of time, more than 75% skip meals, and over half say they feel dehydrated most or all of the time at work—no doubt telling women to hydrate while unable to do so themselves. These professionals have the lives of our most precious loved ones in their hands. I ask the House: are those really the conditions we want them to be experiencing?

I have had messages from midwives all over the country. Last year, I received a letter from a former midwife saying that she was

“extremely concerned about the deepening crisis within maternity care.”

She handed in her notice. That is a loss of more than 10 years’ experience in clinical midwifery—experience that we cannot magic up overnight to replace her. She felt that she could not always provide the good, kind midwifery care that she was trained to give. She cited increasing paperwork, long hours and the inability to work hours that fitted around her family as key concerns.  She had begun dreading each shift. Being required to work faster and do more than was humanly possible meant fearing making a mistake that could lead to a tragic outcome.

Another midwife wrote a blog entitled, “How do we keep going when there is nothing left to give?” in which she talks about midwifery being a celebration of new life and how midwives get to share the joy of families starting out, but also how they are struggling in a system that does not allow them to do what they dreamed of, trained for and worked so hard for. With no staff available or even in the pipeline, the midwife describes having to close facilities, reduce antenatal education, and minimise post-natal visits. Another midwife talks about trusts having to introduce incentive payments, selling back annual leave and employing agency staff, but even then staff are declining the extra work because they are so cream-crackered and feel constantly stressed that the money just does not get them over the line.

Maternity staff are all incredibly caring human beings and they want to do a good job. They tell me they can recover from the physical strain of their job each day, but the mental anguish is weighing heavier and heavier. That mental strain is very real, as problems and errors in maternity services can have devastating consequences.

Although outcomes for mothers and babies have improved in so many areas in the last 10 years, any loss is too great. Understandably, the families affected cannot rest until they have knowledge of what happened and believe that it will not happen again. My heart breaks for them and, if I am honest, I will struggle to tell their stories without crying.

Birthrights is a UK charity that provides advice and information on legal rights, and trains doctors and midwives. The Ockenden review, which looked at maternity services, took serious evidence following the devastating loss at the Shrewsbury and Telford Hospital, and I know that the Health and Social Care Committee has also investigated maternity. Approximately 59%—about £4.2 billion—of the value of new clinical negligence claims is attributable to poor maternity care. In 2021, maternal mortality rates were found to be more than four times higher for black women, two times higher for mixed-ethnicity women and almost twice as high for Asian women. There is clearly so much more that we need to learn and change.

I know that this is issue is close to the hearts of many across this House. Between them, the Prime Minister and the Leader of the House boast a lot of experience of births, and the Minister is an excellent person to be responding given her own professional experience. The Government have made two important commitments: the first is to train 3,650 student midwives over four years, starting in 2019-20, and the second is to employ an additional 1,200 midwives. Obviously, that is hugely welcome, but given the seriousness of the situation and the fact that midwives are taking to the streets, I ask the Minister to update us on any progress and explain the recent decline in the number of midwives.

Peter Gibson Portrait Peter Gibson (Darlington) (Con)
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I congratulate my hon. Friend not only on her pregnancy, but on securing the debate. As the son of a community midwife, I know how hard our midwives work. The issues that she is outlining are not just about recruitment, but about retention. Does she have any ideas on how we can tackle that retention issue, too?

Siobhan Baillie Portrait Siobhan Baillie
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It would be interesting to hear from the Minister on that. Midwives and some of the marchers have suggested talking about financial payments, but there also needs to be a culture shift. If we are asking midwives to do things that they desperately want to do, such as the continuity of care, but they do not have the staff teams to do them, they will feel as though they are failing. No money in the world will make that any better. Working together constantly and joined-up thinking are important to help that retention. I pay tribute to my hon. Friend’s mother.

I have some questions for the Minister. How many midwives are currently in training and recruitment? Why are babies not counted in the patient headcount to determine staff ratios? What measures, such as flexible working, are being considered to make the profession more attractive to those who have caring responsibilities or who are choosing a second career? Are we looking at salaries and financial support for students?

The issues that midwives face are incredibly complex, and as my hon. Friend the Member for Darlington (Peter Gibson) said, it is not just about staff. Midwives tell me that, without proper administrative support to reduce their huge non-clinical workload, they feel they are drowning in their jobs. The Association for Improvements in Maternity Services says that midwifery is a service that seems unable to support its own staff, including precious newly qualified members, with frequent reports of bullying. That is incredibly worrying. In England, that cultural problem was a key focus of the “Better Births” report in 2016, and it is an issue that the ongoing maternity transformation programme has been working to address.

The pandemic restrictions, which my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) mentioned, caused huge problems for mothers and partners. Mothers are now so scared that the restrictions will come back.

Eye Health and Macular Disease

Peter Gibson Excerpts
Tuesday 11th January 2022

(2 years, 4 months ago)

Westminster Hall
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Peter Gibson Portrait Peter Gibson (Darlington) (Con)
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It is a pleasure to serve under your chairmanship this morning, Ms Nokes. I pay tribute to the hon. Member for Strangford (Jim Shannon) for leading this morning’s vital debate on eye health and macular disease, which affects many millions up and down the country. Indeed, more than 2 million people in the UK suffer from partial or complete sight loss and the loss of vision is extremely detrimental to someone’s health and wellbeing. Things that many of us take for granted in our daily lives—driving, reading, recognising faces or experiencing colour—are taken away unfairly from those suffering from loss of vision. We know too that loss of vision can lead to further complications, greater care needs and loneliness.

I was pleased to receive reassurance from Ministers in response to my recent written questions that steps are being taken to address waiting lists, including prioritising urgent treatment for sight-threatening eye conditions such as age-related macular degeneration, which affects 23% of those with sight loss. I welcome the steps being taken to reduce the waiting times and backlogs in our health service, including £2 billion committed this financial year through the elective recovery fund to reduce waiting times. I am pleased to learn that the Government have also committed £8 billion between 2022 and 2025 to transform elective services and increase activity. That is joined by a further £5.9 billion in capital funding to support elective recovery, diagnostics and the vital technology that our health service needs to provide accurate diagnosis.

The NHS’s national eye care recovery transformation programme should ensure that existing money will go into improving effectively and efficiently the quality of the service and outcomes for patients. Through the Health and Social Care Bill, integrated care boards will improve patient access and empower primary care providers to tackle eye health and macular disease quicker and without putting further pressure on GPs and hospitals. The forthcoming appointment of a national clinical director for eye services in England, as outlined by the hon. Member for Strangford, is most welcome but long overdue. I know that that appointment will be welcomed by many with an interest in sight loss.

Tackling the issues of poor eye health goes further than just prevention. We must do more to help the sight loss community up and down the country. In my constituency, there are a number of projects and campaigns underway to improve the quality of life for those who are visually impaired. It is right at this point to pay tribute to Darlington’s phenomenal Darlington Action on Disability, led by chairman Gordon Pybus and chief executive Lauren Robinson. The association has been leading the way in campaigning to improve the life of members of Darlington’s visually impaired community. I am proud to support their current campaign to have tactile paving installed on the platforms of Darlington’s Bank Top station and I urge the Minister to lend her support to the push for Network Rail to install such paving when the station undergoes its £105 million refurbishment and expansion.

Yesterday, I spoke to Gordon, who highlighted to me the further problems facing people with sight loss in my town. They include vehicles parked on the pavement, which are both an obstruction and a hazard, with wing mirrors at head height, which cannot be located by someone using a cane or a guide dog. Other members of the community I serve have raised concerns with me about issues such as the rapid increase in the number of e-scooters on our streets, the poor placement of street furniture and other street clutter such as A-boards outside businesses, and the risk posed to those with sight loss from near-silent electric bikes and vehicles. Every Member of the House will have heard the same concerns in their own areas and I urge the Government to continue to listen to those most affected by poor eye health and macular disease to take steps to make our streets safer for them.

I am proud of the work being done by the Government on the matter, tackling waiting lists and investing in preventive measures. However, I urge the Minister to maintain and extend the level of support and investment over the coming years to ensure that we continue to support the visually impaired community in the UK.

Covid-19 Update

Peter Gibson Excerpts
Monday 13th December 2021

(2 years, 5 months ago)

Commons Chamber
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Sajid Javid Portrait Sajid Javid
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On the right hon. Gentleman’s question about the under-18s, the proof of vaccination for travel is available from today. The individual or the parent can go online and request it, and it comes in the form of a letter, which is perfectly acceptable to all the countries that we are aware of that require it. On his question on the current travel restrictions, he makes a very good point. Given that the omicron variant is fast becoming the dominant variant in our capital city and spreading rapidly throughout the country, the justification for having those rules is minimised. This is something that I have already raised with my colleagues in the Department for Transport, and I hope that we can act quickly.

Peter Gibson Portrait Peter Gibson (Darlington) (Con)
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I thank my right hon. Friend for the measures to enable travel for the 12 to 15 age group, which will be particularly welcomed by the Wray family in my constituency who are travelling tomorrow on what is possibly their last family holiday together. Will he clarify whether a person who is isolating today can switch to daily testing from tomorrow? Also, what plans does he have to extend the opening hours of the walk-in vaccination centres, such as the one at St Thomas’ Hospital just across the river, which will close at 8 pm tonight?

Sajid Javid Portrait Sajid Javid
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First, I hope that the Wray family will have many more holidays. No one wants this to be their last holiday as a family, but I am pleased that they can go ahead with their plans and that they will be able to access that proof for their children today. On the question of daily contact testing, I can confirm that people who are vaccinated—they have to be vaccinated—and isolating today will be able to move from isolation into daily contact testing from tomorrow, subject to the will of the House. On the opening hours, they will be increased, certainly for all the large vaccination centres. The minimum will be 12 hours, but many of them will be going way beyond that.

Health and Social Care

Peter Gibson Excerpts
Friday 3rd December 2021

(2 years, 5 months ago)

Commons Chamber
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Edward Argar Portrait Edward Argar
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I have not yet had the privilege of visiting the hon. Gentleman’s hospitals in this role; maybe at some point in the coming months, perhaps when they are not quite so busy, I will do so with him—if he will have me. We have committed to the investment, but it is important that that investment programme is run as a programme, with all the hospitals being looked at in terms of the phasing and profile of the investment to ensure it delivers the results we want. On that specific point, knowing the interest he has taken in it, I am happy to meet him to talk specifically about his local hospital project and the improvements to be made.

Peter Gibson Portrait Peter Gibson (Darlington) (Con)
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I welcome my hon. Friend’s statement, particularly the extra £112 million for north-east Yorkshire. Our NHS is a priority for everyone in this House and, indeed, a priority for every one of my Darlington constituents. Does he agree that putting our £33.9 billion cash boost on the statute book demonstrates this Government’s and our party’s unwavering commitment to the NHS?

Edward Argar Portrait Edward Argar
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I think it does exactly that, and demonstrates this party’s and this Government’s commitment to the NHS. What my hon. Friend has also demonstrated, as always, is his unwavering commitment to his constituents in Darlington and to championing their cause in this House.

Reducing Baby Loss

Peter Gibson Excerpts
Tuesday 20th July 2021

(2 years, 10 months ago)

Westminster Hall
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Peter Gibson Portrait Peter Gibson (Darlington) (Con) [V]
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It is a pleasure to serve under your chairmanship, Mr Gray. I pay tribute to my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) for securing the debate. Her personal story, which she bravely told today and in a previous and moving Westminster Hall debate, has shone a spotlight on the pain and anguish faced by parents who suffer the tragedy of baby loss.

Almost 60,000 babies were born prematurely in 2019, with one in five pregnancies ending in miscarriage during the same period. The effects of miscarriage, stillbirths and neonatal deaths are devastating for parents, with impacts that can and do last a lifetime. It is essential that the Government continue with their 2015 ambition to reduce the rate of stillbirths, neonatal deaths and maternal deaths in England by 50% by 2030. I welcome the provision in the NHS Long Term Plan to bring forward that ambition to 2025. To this end, the Government announced only this month, on 4 July, that they were making an additional £2.45 million available for NHS maternity staff in order to improve safety in care settings.

As the son of an NHS community midwife, I know the care, dedication and effort that our amazing midwives, such as the incredible team serving my community in Darlington, put into their vocation. They are on the frontline of safety, bringing new life into the world, and all too often they are at the side of parents who have suffered the worst loss imaginable. We must ensure that our midwives are provided with the skills to give the most appropriate care to parents at their time of bereavement.

In Darlington, I recently met Claudia and her husband, Andy, who have suffered two late-term losses—first, at 20 weeks of pregnancy and, more recently, at 18 weeks. Although Claudia was thankfully entitled to statutory sick leave to recover, Andy was not entitled to leave and had to negotiate with his employers to take time off. I am thankful to the two of them for meeting me to talk about their experience, the impact of those losses and the challenges they have faced. I am glad that they have continued to work with me to gather information and understand the patchwork of provision by UK companies whose employees suffer miscarriages. For the sake of Claudia and Andy, I am hopeful that the threshold for statutory bereavement leave will be revisited. The impact of a loss in the second trimester will almost always be just as painful, devastating and hard to overcome as a loss in the third trimester.

Another constituent, Angela, has shared her tragic story with me. Angela suffered two ectopic pregnancies and two miscarriages, and now feels that she will never experience one of the most natural things in the world: the honour of giving birth. Angela described to me that she feels crushed, and would like to see more support for people in her position than was available to her in the first years of the 2000s.

Improving maternity safety, delivering personalised care and improving training will all help to improve outcomes for future expectant parents across the UK. I sincerely hope that a future review of bereavement leave will be extended to those parents who suffer a miscarriage in the second trimester of pregnancy. I look forward to hearing from the Minister what more the Government are doing to achieve our national ambition to reduce baby loss.

I am thankful that the Government have taken and are taking firm action towards reaching the 2025 ambition that will reduce the number of future parents experiencing the pain that Angela, Claudia, Andy and my hon. Friend the Member for Truro and Falmouth have experienced.

Independent Medicines and Medical Devices Safety Review

Peter Gibson Excerpts
Thursday 8th July 2021

(2 years, 10 months ago)

Commons Chamber
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Peter Gibson Portrait Peter Gibson (Darlington) (Con) [V]
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Thank you, Madam Deputy Speaker; you will pleased to know that I will probably speak only for approximately three minutes, having got used to that time limit.

I am glad to have the opportunity to speak in today’s important debate, one year on from the publication of Baroness Cumberlege’s independent medicines and medical devices safety review. I thank Baroness Cumberlege and her team for their work, and of course the women who bravely shared their horrific experiences, which shone a light on the horrors of the mesh scandal. Without their bravery, the review would not have been possible.

It is vital that the Government continue to listen to the victims who were ignored for far too long. I was glad to hear reassurances from the Minister, following the publication of the report, that the Department is committed to doing so. I was proud to support the Medicines and Medical Devices Act 2021, part 1 of which established the role of an independent commissioner for patient safety and states:

“The Commissioner’s core duties are to…promote the safety of patients”.

If that prevents the repetition of any one of the mistakes from the past, it will have reduced pain and suffering for our constituents, and it will have done its job.

In my time as a high street solicitor, I acted on behalf of a number of clients who experienced horrific difficulties as a result of mesh implants, like those so clearly outlined by my right hon. Friend the Member for Elmet and Rothwell (Alec Shelbrooke). The trauma that mesh patients underwent was truly horrendous, and it is shameful that it took so long for action to be taken and for women’s voices to be heard.

I welcomed the announcement in February by NHS England and NHS Improvement’s women and children’s programme of care that it is commissioning specialist services for women with complications with mesh inserts. The regional centres will ensure that women receive specialist treatment to mitigate this awful suffering. I encourage County Durham and Darlington NHS Foundation Trust to ensure that its patients access the appropriate treatment applicable for the mesh implants they have and to get access to the justice they deserve.

Baroness Cumberlege’s review was a powerful reminder of the need to listen to patient voices in safety matters. I am glad that the Department of Health and Social Care has offered an unreserved apology for its mistakes in the past, and welcome the steps that it has taken so far to build on the report’s recommendations. I look forward to the Minister outlining any further response to Baroness Cumberlege’s report.

Eleanor Laing Portrait Madam Deputy Speaker (Dame Eleanor Laing)
- Hansard - - - Excerpts

I thank the hon. Gentleman most profusely for his brevity.

Covid-19: Contracts and Public Inquiry

Peter Gibson Excerpts
Wednesday 7th July 2021

(2 years, 10 months ago)

Commons Chamber
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Peter Gibson Portrait Peter Gibson (Darlington) (Con) [V]
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I am pleased to be called to speak in today’s debate about the steps that the Government have been taking in the last 16 months to procure lifesaving equipment and PPE for our incredible frontline staff across the country. This debate is nothing more than another attempt by the SNP to trot out its same old line seeking to smear the Government, pursue its separatist agenda and obscure attention from being focused on its own failures.

In Scotland, the SNP-led Government have been using the same procurement process for protective equipment but have failed to launch their own inquiry into the Scottish Government’s handling of the pandemic. Measures that this Government have taken have undoubtedly sped up Whitehall bureaucracy while operating without the need to break, suspend or change pre-existing legislation on contract awards and procurement.

It is testament to the speed at which the Government acted and delivered PPE that even while the virus was raging and there was a global PPE shortage, every single recommendation for the procurement of PPE went through an independent eight-stage process verified by independent civil servants. That approach has meant that the UK Government have been able to procure more than 22,000 extra ventilators, 11 billion items of personal protective equipment in England and 32 billion items for the whole of the Union, protecting those workers on the frontlines of both the NHS and social care. It is therefore no wonder that the approach taken to procurement by the UK Government has been used across the world. Japan, New Zealand and Finland have used similar approaches, while the devolved Administrations in Holyrood, Cardiff and Belfast use the same techniques and purposes

I welcome the fact that the Government have been open and transparent with their procurement process, with the independent National Audit Office acknowledging the Government’s exceptional work while ensuring that Ministers were not involved in procurement processes and had “properly declared their interests”. Meanwhile, the Scottish audit found that the SNP had failed to prepare for the pandemic and was paying tens of millions more than normal for its PPE supplies.

Today’s debate is nothing less than a poorly thought out move by the SNP to create more soundbites by failing to address its poor handling of the pandemic. Far from intending to help save lives and protect the most vulnerable, the SNP is seeking to distract attention from a disproportionate rise in cases and deaths in Scotland and its opposition to a Scottish inquiry into the handling of the pandemic.

This Conservative Government, thank goodness, are getting on with the fastest roll-out of the vaccine that has been seen across Europe while laying the groundwork for their own in-depth, independent inquiry in spring 2022, delivering for our whole United Kingdom.

A Plan for the NHS and Social Care

Peter Gibson Excerpts
Wednesday 19th May 2021

(2 years, 12 months ago)

Commons Chamber
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Peter Gibson Portrait Peter Gibson (Darlington) (Con) [V]
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It is a privilege to be called to speak in today’s debate and to support Her Majesty’s Gracious Address, which sets out a bold, ambitious plan to truly unite and level up every region of our United Kingdom more than a year after the 2019 general election, in which the Conservative party recorded its highest vote share and returned Members of Parliament for parts of the country that had either never elected a Conservative or had not done so for a generation.

The Gracious Address sets out how we will recover from the pandemic, supporting our economy and addressing the legacy of covid-19 by improving the health of the nation.

Just two weeks ago, the people of Hartlepool added another blue brick in our blue wall. Another great northern town with a proud history has seen the merit of electing a Conservative MP. That was undeniably a vote of confidence in this Prime Minister and his mission to bring about opportunity across our country and turbocharge our recovery from the effects of the pandemic.

In Darlington, a Conservative MP, a Conservative-led council and a Conservative Mayor—the re-elected Ben Houchen—are working together. It is that collective resolve that has seen a phenomenal level of investment in the short time since I was elected to this House. I can report that this Government’s investment is already seeing the unlocking of private sector investment in Darlington.

My right hon. Friend the Chancellor, in choosing Darlington for his northern Treasury, has unlocked a steady stream of other Cabinet Ministers heading north from King’s Cross, bringing more jobs to Darlington. Those include the Secretary of State for International Trade and, only yesterday, the announcement by my right hon. Friend the Secretary of State for Business, Energy and Industrial Strategy of 100 more jobs. We have seen £105 million invested in Darlington station, £23.3 million from the towns fund and, through the pandemic, millions of pounds to help our council respond and to support our businesses. I look forward to the future opportunities that the levelling-up fund will bring.

That investment is being matched by a firm commitment to continue to improve the health of the nation, investing in our NHS, delivering more nurses and bringing about comprehensive reforms for our social care sector. I welcome the Government’s commitment to introduce a health and care Bill that will deliver an integrated care system, ensure that NHS England remains accountable to taxpayers, tackle the growing problem of obesity and put the Healthcare Safety Investigation Branch on a statutory footing. The Government have committed to bringing forward proposals to reform adult social care, delivering an improved care system that provides the dignity and security that people deserve, as well as embarking on long overdue reform of the Mental Health Act 1983.

While the Opposition continue to focus on their internal strife, this Conservative Government continue to deliver on the people’s priorities. This Queen’s Speech delivers on those priorities, and I am pleased to support it.

UK Rare Diseases Framework

Peter Gibson Excerpts
Wednesday 24th March 2021

(3 years, 1 month ago)

Westminster Hall
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Peter Gibson Portrait Peter Gibson (Darlington) (Con) [V]
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It is a pleasure to serve under your chairmanship today, Mrs Miller. It was also a pleasure to listen to the hon. Member for Blaydon (Liz Twist), who opened this evening’s debate. She has been a tireless campaigner for those who suffer from phenylketonuria and I congratulate her on securing this important debate.

One in 10,000 babies across the United Kingdom is born with PKU. That rare inherited disease means that individuals cannot break down phenylalanine. If the condition is untreated, it can lead to damage of the brain and nervous system. Sadly, a number of my constituents suffer from the disorder, including, as I learned today, a three-month-old infant. I thank Samantha Parker, Kelly Thompson and Amy Duston, who suffer with PKU or have a child who does, for their engagement with me.

It was a bittersweet moment last month when NICE released its draft recommendation that, following discussion with the manufacturer of Kuvan, it could be used for children up to the age of 18. It was bittersweet because it means that as those children turn 18 they will face a cliff edge in their treatment. I fear that NICE has not fully considered the problem of an 18-year-old abruptly stopping treatment with Kuvan. The decision will lead to further difficulties down the line, and it does not address the treatment of adults with PKU.

I am hopeful on three counts for my constituents. I am optimistic that children will soon be able to access that life-changing drug, that NICE will reconsider the use of Kuvan for adults, and that as the exclusivity of Kuvan to BioMarin comes to an end it will become cheaper and more cost-effective as a treatment for all who suffer from PKU.

Covid-19: Government’s Publication of Contracts

Peter Gibson Excerpts
Tuesday 9th March 2021

(3 years, 2 months ago)

Commons Chamber
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.

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Edward Argar Portrait Edward Argar
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What this Government have done, and did in the context of the issues under discussion in this specific question, is recognise the huge need for PPE during the pandemic last year and take every step they could to meet that need. They secured a large number of contracts, which delivered 8.8 billion pieces of PPE to date. I think that is called delivering.

Peter Gibson Portrait Peter Gibson (Darlington) (Con) [V]
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More than 70% of PPE is now made in the UK, whereas it was less than 1% before the pandemic. When that is coupled with the expansion of more than 22,000 ventilators, we see that this Government have done an incredible job. Does my hon. Friend agree that the petty point-scoring of the Labour party is not what we need at this time of national emergency?

Edward Argar Portrait Edward Argar
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I am grateful to my hon. Friend. I have set out in my answers that what I think is most important for this country is that we work together— the public, private and voluntary sectors, and the Great British public—as we did, in this context. We have pulled together and done everything we can, including, as he alludes to, building that capacity for UK businesses to meet more of our need for PPE. That is a great success for those businesses and I pay tribute to them.