HPV Vaccination for Boys

Roger Gale Excerpts

Wednesday 2nd May 2018 Westminster Hall

[Sir Roger Gale (North Thanet) (Con)]

I beg to move,

That this House has considered the case for HPV vaccination for boys.

I am delighted to find you in the Chair, Sir Henry. Before I start the substance of my speech, I want to place on the record my appreciation for the help I have received from a number of people, most notably Professor Christopher Nutting, one of the country’s most eminent oncologists specialising in throat and thyroid cancers, and Peter Baker, the campaign director for HPV Action. I am grateful to them both for educating me. I am also indebted to Stephen Bergman and Jamie Rae, two sufferers from the condition we are going to discuss—I shall say more about them later. Finally, I place on record my appreciation of the work done by my hon. Friend the Member for Finchley and Golders Green (Mike Freer). The Minister will understand that he cannot be here this morning; he has Government duties and a vow of Trappist silence as a Government Whip.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

I have been there.

[Sir Roger Gale]

My hon. Friend the Minister indicates that he knows the problem only too well. My hon. Friend the Member for Finchley and Golders Green has done a significant amount of work in achieving the provision of human papillomavirus vaccine for gay men—a small but significant step in the direction in which I hope we may travel further this morning.

Until a relatively few weeks ago, I knew very little about this issue. I concede that entirely. Unlike one of my colleagues who was here in this Chamber yesterday morning while I was in the Chair listening to the debate, who had a relative who had died of bowel cancer, I have no personal experience. However, when I met Professor Nutting and Peter Baker, I was astonished at the speed with which they convinced me of the argument—and I am not a pushover when it comes to spending taxpayers’ money. I think it is a no-brainer, and I hope to persuade my hon. Friend the Minister, and others, on this cause.

The human papillomavirus causes, among other things, cervical cancer, throat cancer, anal and penile cancers, and cancer of the back of the tongue. The virus is carried by about 80% of the population, which means somebody in this room is a carrier; it is not uncommon. I would like everybody to take that on board. Go on the tube in the morning and there will be dozens of people carrying the virus—most of it dormant, and a lot of it non-malignant. It is contracted in sexually active youth and, for men, usually in their teens or 20s.

The point is that it is a slow-burn issue. Its effects are not experienced overnight. A condition contracted as a teenager or at university may not rear its head for 30 years. We are talking about men now in their 50s and 60s, who some of the eminent people sitting behind me in the Public Gallery are treating, waiting that length of time without realising that they have anything wrong with them at all, because there is no screening process for men, unlike the screening process for cervical cancer.

I spoke yesterday to two people, Jamie Rae and Stephen Bergman—both sufferers, and both in their mid-50s—who described their experiences to me. I will not go into too much of the gory detail. I heard again this morning of another experience: somebody’s colleague, himself an eminent surgeon, who had throat cancer and suffered many months out of work, which was a loss to the health service, damage to his family and, of course, the treatment. The treatment involves chemotherapy and radiotherapy; it may involve a tracheostomy; and it inevitably damages the saliva glands in the mouth, leaving the patient who survives with permanent dryness, considerable pain and ongoing discomfort. As I have indicated, there is also the social damage. Both Jamie Rae and Stephen Bergman described to me in graphic detail the processes they have been through and the discomfort—I use that word very modestly indeed—they have experienced. They described themselves as the lucky ones, because both those gentlemen have come through it relatively unharmed, but of course there are many others who do not.

The HPV vaccine has been available to adolescent girls since 2008. A pubescent girl of 12 or 13 is offered the opportunity to be vaccinated in school. The parents, quite properly, have a right to refuse that vaccine. Just in case anybody has any doubt, I am aware that there are a small number of cases where parents believe that things have gone wrong and that children have suffered as a result of the vaccination. That is medically unproven, but we have to recognise that the parents believe it. Parental choice is vital, and in the case of pubescent girls there is parental choice.

The process ties in directly with the Department of Health and Social Care’s cancer strategy, which of course is about prevention. The Department has done significant work on preventing or seeking to prevent other prominent cancers. Lung cancer is the obvious one, and the anti-smoking campaign is highly relevant in this context. Melanoma is another; something that people of a certain age, such as myself, probably did not bother with at all has suddenly become prominent as the realisation of the damage that the sun’s rays can do to the skin and the cancers that can arise from that has dawned on the population. Any responsible parent or grandparent now takes the trouble to ensure that their children have appropriate sunscreens at all times when enjoying the sun. HPV vaccine falls directly into that category. It is usable for prevention and, used properly, it works. That is proven. As I said, this has been available to adolescent girls since 2008.

We now come to the hard bit of the argument, because up until now I think everybody would probably agree that we are on a winner in using HPV vaccine, but of course there is the question of cost and efficacy. The argument has been deployed that herd immunity, to use the colloquial phrase, will mean it is not necessary to vaccinate boys, because if we eliminate the infection in girls, boys will not catch it from the girls. That is nice in theory, but wrong in practice.

I am told by those who know better than I do that the average young male has at least 10 sexual partners. The Minister might find that surprising; I did myself, but it is so. It depends whom we believe, but in the United Kingdom the vaccine has an uptake of between 70% and 83%, although in some parts of the country it is as low as 50%. A young man embarking on an exciting night out with his girlfriend therefore has a very high risk of contracting HPV from a girl who has not been vaccinated, and that is just in the UK. We overlay on that the foreign travel that many young people are now happily able to enjoy. Sometimes, with sun, sea and sand goes sex, and the risk of exposure to HPV in those circumstances can be even greater. Therefore, the idea that herd immunity will in time address the problem is fallacious, and this is where I have to accuse those who are responsible for taking the decisions—that is not the Minister—of short-termism.

I can see the attraction of the argument that extending vaccination would not be cost-effective and that herd immunity is coming downstream. Yes, the cases coming through now are historical, in the sense that the disease was contracted 20 or 30 years ago, so well before any immunisation. If we want to save money and damage health at the same time, that is quite a good way of going about it. I am seeking to persuade the Minister of the real value of having the courage—he is not lacking in courage—to take a long-term decision now.

The cost of immunising every adolescent boy within the relevant range in the UK is estimated to be, at the top end—this includes the purchase of the vaccine, which of course has to be negotiated by the health service, and its application—about £22 million a year. That is a lot of money, but in health service terms it is almost a bagatelle. Set against that, I am told by those with real experience, some of whom are sitting behind me in the Public Gallery, that there are about 2,000 patients a year—men in their 50s and 60s—who have developed throat, penile or anal cancers. The cost of treating those is about £21 million a year. Of course, that takes no account of the social costs and the other damage that can be done. In the case described to me this morning, of a surgeon who was taken out of play for a considerable time, the cost of treatment—of a replacement jaw, as well as the chemotherapy, radiotherapy, hospitalisation and everything else that goes with it—is looking like being somewhere between £50,000 and £100,000, and that is just one case.

[John Howell (Henley) (Con)]

My hon. Friend mentions the 2,000 people. Does he have an estimate of the total number of people who might be spared the effects of the virus if the actions that he proposes are taken?

[Sir Roger Gale]

I am afraid that I do not. The figure that I have is 2,000 people a year, so one has to assume that it is that—but it is growing.

The reason the condition is becoming more prominent, not less, is the change in sexual attitudes from the 1960s onwards, when practices that were previously unacceptable became acceptable. Oral sex, for example, became relatively commonplace. We can therefore expect, certainly within the next 10, 15 or 20 years, a significant rise in the number of cases. The discussion has to be about what happens after that and whether the herd immunity actually works. I am arguing that it will not, for the reasons I have given.

I have talked about the slow burn, the 20 or 30-year wait, and the costs to the health service, on which the view seems to be, “Okay, fine. Let’s kick that into the long grass. It’s not our problem.” There will be 15 Ministers between the present one, sadly, and the time when people are developing diseases. However, the condition of genital warts, which is also caused by HPV, takes only three, four or five years to incubate, and the cost of that annually is £50 million, so do the maths. The economics of this are unassailable, and on those grounds I defy anyone to challenge my argument. The argument comes down to herd immunity. Will vaccinating girls do the job or not? I have made it clear that I believe it will not, and I think that the time has come for the Department to take a further long, hard look at the issue.

Up to now, the Joint Committee on Vaccination and Immunisation has indubitably taken a short-term approach to this: “Does it work? Well, yes, the vaccine works. Is it worth it? Well, not if we are vaccinating girls. Let’s see what happens—kick it down the line and save £20 million a year today,” even if that means that in 10, 15 or 20 years’ time we will be spending not £20 million but £200 million a year, which will be in addition to all the social costs. I understand that the JCVI will meet in the first week of June. We were promised that a decision on extending vaccination would be taken in 2015. That was deferred until 2017 and has now been deferred without a date being set for the final result.

Before I conclude with a request to the Minister, I want to say this. Chris Curtis, chairman of The Swallows head and neck cancer charity, sent me a video this morning. It was compelling, because he has been a sufferer himself and he described his own circumstances. I want to say something to the JCVI, to each and every member of that august body, who are of course medically qualified in a way that I am not. What I want to say on behalf of all the people who have been treated and have approached me is what Chris Curtis said at the end of his video. Friends, when you are thinking of kicking this into the long grass because it is not going to affect many people for a very long time and we do not have to concern ourselves with tomorrow, remember what Chris Curtis said, very starkly: “Tomorrow comes very quickly.”

I will not ask the Minister to second-guess the JCVI—that would not be right. I do not believe that this is his decision to make, in the sense that I suspect he is little more medically qualified than I am. Neither of us has the expertise to make this judgment. Will he please convey that sense of urgency about tomorrow to the JCVI, with the firm and genuine request that he wants them to take a long-term view, and to make the decision on the balance of long-term cost, not savings tomorrow?

--- Later in debate ---

[Sir Roger Gale]

May I first thank you, Sir Henry, for presiding over this debate with lenience, and for allowing a frank discussion of what is clearly a sensitive subject? When we do not write speeches, as I do not, we fly by the seat of our pants and ad lib. Inevitably, we miss things. I am therefore particularly grateful to my hon. Friends the Members for Worthing West (Sir Peter Bottomley) and for Henley (John Howell), and to the hon. Members for West Dunbartonshire (Martin Docherty-Hughes) and for Washington and Sunderland West (Mrs Hodgson), who clearly has a tremendous grasp of the subject. Together colleagues have put flesh on the skeleton that I sought to create at the start of the debate. I am very thankful indeed for that.

I hugely appreciate the candour with which the Minister has spoken and the positive attitude he takes to this difficult issue. I also understand that from his point of view the timing is not easy, given the imminence of the JCVI discussions. I hope and believe that as a result of all the representations that have been made, not only in this debate but across the piece, the JCVI will now take what to some of us is the obvious decision and, for a relatively small amount of money, create a much better environment for both boys and girls in the future.

To conclude, the Minister said that he had two children. I have five grandchildren. We cannot wait. I quote again the remarks that were made earlier: “Tomorrow comes very quickly.”

Question put and agreed to.

Resolved,

That this House has considered the case for HPV vaccination for boys.

Bowel Cancer Screening

Roger Gale Excerpts

Tuesday 1st May 2018 Westminster Hall

[Sir Roger Gale (in the Chair)]

I apologise to Members for my late arrival; the previous debate finished early and I was under the impression that I was in the Chair only until 11 o’clock.

[Nick Thomas-Symonds (Torfaen) (Lab)]

I beg to move,

That this House has considered bowel cancer screening.

It is a great pleasure to serve with you in the Chair, Sir Roger, and I am glad that you have taken your seat.

Bowel cancer is the fourth most common cancer in the UK. Sadly, around 16,000 people die from the disease each year. It is estimated that between now and 2035, around 332,000 more lives could be taken by this awful condition. Nearly everyone will survive bowel cancer if it is detected at its earliest stage, but unfortunately only 15% of bowel cancer patients fall into that category.

--- Later in debate ---

[Nick Thomas-Symonds]

rose—

[Sir Roger Gale (in the Chair)]

Order. The situation we are in is entirely of my making, and for that I can only apologise. Given that there are so many Members present who might wish to intervene, I am prepared to stay in the Chair for six minutes of injury time to enable the hon. Gentleman to take interventions. I am sure that is illegal, but I am willing to do it, provided that the Minister and the hon. Gentleman, who are in charge of the debate, are prepared to accept that.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

indicated assent.

Oral Answers to Questions

Roger Gale Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Hunt]

The hon. Lady is absolutely right about how important is to increase the number of GPs. The most significant thing is what we announced this morning, which is five new medical colleges that are in parts of the country where it is particularly hard to recruit doctors. Our intention is that half the medical school graduates should be moving into general practice because it is so important.

[Sir Roger Gale (North Thanet) (Con)]

Thanet enjoys an ageing population and I am pleased to be a part of it. We will be delighted to know that one of the five new medical schools designated by the Secretary of State today is going to be based in east Kent: the bid from the University of Kent and Canterbury Christ Church University was successful. It will not have escaped my right hon. Friend’s notice that the Christ Church campus is in close proximity to an A&E hospital— the Queen Elizabeth The Queen Mother Hospital—and we hope very much to see all the benefits very soon. Thank you.

[Mr Speaker]

May I just say to the hon. Gentleman that if memory serves me correctly, he was born on 20 August 1943, and therefore, he is really not very old at all?

Organ Donation (Deemed Consent) Bill

Roger Gale Excerpts

2nd reading: House of Commons
Friday 23rd February 2018 Commons Chamber

[Mr Robinson]

Yes. I shall refer to some of the circumferential investment that will be necessary to ensure that our own system is successful. Of course we would be starting from a much higher level, because our infrastructure—the nursing provision that is so vital, the body of professional surgeons and the specialist units—is much greater than it was in Spain. However, we recognise the success of the Spanish system. At its heart is the ability to reach the families and talk to them. That should happen in any event, but we believe that when it happens against the backdrop of an opt-out system, it starts from a different position and is—we hope—likely to produce a more positive result.

[Sir Roger Gale (North Thanet) (Con)]

I think it fair to say that most, if not all, Members who are present today are here because we support the Bill and want to see it on the statute book. But—and it is a “but”—the hon. Gentleman said in his response to the point made by my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) that friends and family would be consulted. I think it important for the Bill to be very precise if the matter is not to be brought into dispute and if a wave of withdrawals is not to be generated, which is the last thing that we want. Will the hon. Gentleman ensure that that issue is very clearly addressed when the Bill goes into Committee, as we hope that it will?

[Mr Robinson]

I am grateful for the hon. Gentleman’s thoughtful and apposite intervention, and I can give him that assurance. Obviously, as the Bill’s promoter, I shall take a personal interest in ensuring that the right balance is struck. We should bear in mind that the balance will be struck in a context in which opting out is the law of the land, which I think changes the starting point of the discussions with families, but those discussions should nevertheless be handled with proper caution and respect in view of the moments of agony and the awful decision making with which families are faced.

Healthcare in Oxfordshire

Roger Gale Excerpts

Tuesday 17th October 2017 Westminster Hall

[Robert Courts]

I am grateful for that intervention, which is the mirror image of the point that I am making about Witney. The hon. Lady and I face exactly the same problem, but from other ends of the same road. We have the A40, the A34 and the roads inside and around Oxford. Whichever direction a patient is going in it is not a happy prospect for them, whether they originate in west Oxfordshire or in Oxford West and Abingdon.

Again, my point is that this has not been consulted on in any meaningful sense. It has been sprung upon the public when everybody understood, until now, that the future of the wider services would be considered in the round as part of phase 2 of the STP. Suddenly, these proposals were made public at the county council’s joint health overview and scrutiny committee meeting in September, only a matter of weeks ago.

The devil lies in the detail, as always. When we consider what we do not yet know, it becomes clear why it is so important to have a consultation. I would like to see, for example, a map showing where stroke patients come from—where the preponderance of those treated at Witney or Abingdon happen to be, so that we know where they can best be treated. That is not something the public have seen. We should know whether the Witney catchment area includes just the town, or whether it includes west Oxfordshire or Chipping Norton to the north of it. What will the interplay be between Witney hospital and the physiotherapy that is to be just down the road at Deer Park? What hours of care are being delivered now, and what is proposed for the future?

There may or may not be force to those points. We simply do not know. Once again, without a comparison of the status quo and the proposed changes, it is impossible to know whether what is being proposed is a downgrade to, and a reduction in, the services provided. That is the whole point of scrutiny. That is the whole point of consultation. That is not what we are seeing in Witney and west Oxfordshire at present. All this comes just a couple of months before the changes are due to come into effect, with no consultation in any meaningful sense, over a very compacted time period. It simply is not good enough for the people of Witney and west Oxfordshire.

The public can hardly be blamed if they wonder what the future of their hospital in Witney is, whether a ward is going to close or whether the hospital itself is in danger of closing—whether this is the beginning of a death by a thousand cuts, where Witney hospital becomes less and less viable as specialisms are removed from it. The ball is firmly in the CCG’s court. The public need to be reassured loudly and clearly by the CCG that no beds are closing. They need to be reassured that the loss of a specialism is not the beginning of a death by a thousand cuts, where the hospital is downgraded to the point at which it becomes unviable. They need to be reassured that a new specialism for the beds will be proposed, so that Witney hospital can look forward to a bright future in which it receives more services through phase 2, perhaps becoming a locality hub, building on the excellent, innovative emergency multidisciplinary unit that is already in place.

Of course, the CCG’s response will be that that work has not yet been done, but that just is not good enough. Why are we hearing the proposals now if some of the work that is still to be done lies a year in the future? At best, this is a situation that could result in exemplary healthcare services, structured to face the pressures on healthcare of a modern town, and the public are only seeing the negatives. At worst, something is being hidden. We need clarity. This is not about cuts or a lack of funding. This is about a failure to communicate with the public about what is happening to their treasured services. The future of Witney Community Hospital is paramount, and I look forward to the CCG making a statement that makes its bold and bright future clear very soon.

Hon. Members will be glad to know, I am sure, that I am coming to the end. I am very grateful to the Minister, to you, Sir Roger, and to all hon. Members for having listened to my rather wide-ranging speech. I have focused on Witney, with regard to Deer Park and the community hospitals, because those happened to be live issues recently, but the same issues apply to Chipping Norton hospital, which was a particularly live issue six months ago and I know will become an issue again in the future.

We have a CCG that does not seem to understand the duty—it is a duty—to involve the public in its decision making. That does not mean it necessarily has to bend to the will of what people say. It is entitled to come up with proposals itself, but it does have a duty to explain them and to explain why it feels that what it is proposing is in the interests of the people that it serves. It cannot just explain the decisions that it has already made, without explaining what is coming up on the horizon.

The fact that there have been three referrals by the HOSC to the Secretary of State in a year—over Deer Park, the temporary closure of maternity services at Horton and the permanent closure of full maternity and obstetric services at Horton—and multiple judicial reviews by the public, local councils and NHS groups, shows that there is a real danger, if it has not already happened, of a breakdown in relationships. That needs to be fixed, as the whole structure of decision making around healthcare in Oxfordshire is being called into question. I hope that this situation is unique to Oxfordshire and is not systemic across the whole country, but in any event, what has been happening over the last year is no way to construct the future of Oxfordshire’s healthcare.

I finish by saying that I and everybody here would like a constructive relationship with the CCG. That can be achieved, and it will be achieved when the CCG takes a look at the health services of Oxfordshire in the round; when it works in partnership with the county and district councils and the patient groups, which have so much to offer; and, above all, when the public and their representatives alike are properly consulted and not simply told of decisions. I know we can get to that stage and I very much look forward to doing so in the months ahead.

[Sir Roger Gale (in the Chair)]

Mr Howell has indicated to me very courteously that as one of Her Majesty’s trade ambassadors he has an unavoidable commitment. I know that the Opposition and Government Front Benchers will understand that he will therefore not be able to be present for their winding-up speeches, but he has undertaken to read them in Hansard.

Agenda for Change: NHS Pay Restraint

Roger Gale Excerpts

Monday 30th January 2017 Westminster Hall

[Dr Whitford]

rose—

[Sir Roger Gale (in the Chair)]

Order. You cannot take one intervention following another intervention. I call the Minister to speak.

[Mr Dunne]

I am very happy to give way to the hon. Lady.

Child Cancer

Roger Gale Excerpts

Monday 28th November 2016 Westminster Hall

[Sir Roger Gale (North Thanet) (Con)]

I had not intended to take part in this debate, but having heard what I have heard, I am moved to make a brief contribution. One of the most harrowing of the many harrowing things that a Member of Parliament has to deal with, particularly any MP who is a parent, is to be confronted by desperate parents with a desperately sick infant or young adult who are begging for help and are coming to their Member of Parliament as the last resort. In the course of a parliamentary career, I suspect that most colleagues will face that circumstance. If they have not already, they will in time.

Most of us will have been faced with the need or desire to fundraise to send that child to another country, often but not exclusively to the United States, for treatment that is not available here and that may or may not be efficacious. In my case, I experienced that at second hand rather than at first hand, unlike some colleagues present, but those of us who have experienced it know only too well that people will clutch at any straw. I would do the same, and I am sure you would too, Mr Davies. If the chance of success is 10%, they will take it, because 10% is better than 0%.

What grieves me is that so much effort goes into trying to react and therefore relatively little effort goes into trying to pre-empt. There are wonderful children’s hospices around the country, and I pay tribute to them. Demelza House in Kent is fantastic—there are many others—but the object of the exercise is to try to ensure that treatment is available so that children do not need to go into hospices at all.

One case that hit the headlines not so long ago was a child who was effectively abducted from hospital care and taken first to Spain and then elsewhere for treatment, because something was not available here and was available somewhere else. That straw was clutched at, and I would have done the same. Looking at what happens overseas and thinking of those hard cases, a couple of things come out from what has been said already today. Thankfully, the scale is relatively small. Equally thankfully, the scale of individual cancers is smaller still, but that in itself creates a problem. The point has been made that drug companies are reluctant to invest in the research and generation of drugs that might not be viable because there is no real market for them.

My hon. Friend the Minister has a background in science, and she will understand the possibilities that flow from co-operation probably better than anyone in the room. Having looked at the matter over a number of years and having seen the work that the Teenage Cancer Trust has done, it seems to me that we need to pull together all the expertise and concentrate on one or two centres of excellence, so that the scale and the ability for young medics to learn are viable. It is very difficult for someone to become expert in something if they do not have a patient to study. I urge the Minister to give an indication that the Government will make a Herculean effort, in a way that there has not been before, to pull together all the strands. We also need to maximise the possibilities of international co-operation, because work is being done in other countries.

[Mark Tami]

Sorry for talking about my experience again, but my son was very fortunate to find a donor. He had a stem cell transplant in the end. As a parent, that was great for us, but we were with other parents who were not so fortunate and who saw their children pass away because they could not find a donor. The awful thing is that there are people out there who would be a match, but they do not know it. I want to put on the record my support for Anthony Nolan and other charities that have saved so many lives. We really do need to do more. Stem cell transplants offer a great opportunity for not only treating cancer, but other things as well in the longer term. I simply want to put on the record how important it is that that very important work carries on and that we do not have the situation in which some are fortunate and some are not.

[Sir Roger Gale]

The hon. Gentleman is absolutely right. He was also right to pay tribute, as I and others should have done, to the Anthony Nolan trust.

I do not often argue for centralisation, but, in this case, given the scale and the limited resources that are available, it seems that a concentration of effort might deliver more results than a dissipation of that effort.

Finally, I want to endorse what the hon. Member for Alyn and Deeside (Mark Tami) said earlier. There is a crying need for support for families from day one from the moment the diagnosis is made and the family is informed. There is a huge need for support. Some are fortunate in having large and supportive families. Others much less fortunate face terrifying circumstances and isolation.

[Hannah Bardell (Livingston) (SNP)]

I pay tribute to the hon. Gentleman and others who have spoken so bravely. He is making a very moving speech. On support for families, I want to bring to the Chamber’s attention my constituent, Allison Barr, who lost her son Jak Trueman last year very tragically to cancer. She has worked to fulfil his dream of having a den for siblings, because the siblings of children who are lost are often forgotten. She has done a huge amount of work in the West Lothian community to bring Jak’s dream to fruition. We must remember that many different parties are involved when people lose a child to cancer.

[Sir Roger Gale]

That point is very well made indeed.

I conclude by saying that co-ordination and co-operation are necessary. International co-operation is necessary, and support for families is vital. In small rural communities and in close families, support may be built in, but in cities such as London, New York, Washington and Berlin, as in any big city in the world, there are lonely people facing difficult circumstances. I cannot think of any more difficult or more harrowing circumstance than the sudden knowledge that your child is faced with a life-threatening disease. I urge my hon. Friend the Minister to do everything she can to promote the co-operation necessary to solve these problems.

Accident and Emergency Services: Merseyside and Cheshire

Roger Gale Excerpts

Tuesday 22nd November 2016 Westminster Hall

[Rosie Cooper]

Does the hon. Gentleman agree that STPs are in danger of becoming a managerial exercise in contingency and risk planning, where the NHS speaks to itself? Several years ago, in the Health Committee, I put to Bruce Keogh the charge that where we were going, there would be 30-plus trauma centres in this country and every A&E would be downgraded. With STPs, the NHS is talking to itself, not the communities it serves, and it will come up with that very same plan. I can see that happening in front of me right now.

[Sir Roger Gale (in the Chair)]

Order. I have to make the point that these half-hour debates are specifically the property of the Member in charge. Mr Pugh is entitled to give way to whomever he chooses, but interventions should be interventions, not speeches, and every moment that is taken curtails the opportunity for the Minister to respond.

Psychosis: Early Intervention

Roger Gale Excerpts

Wednesday 7th September 2016 Westminster Hall

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this very important debate. The House appreciates his engagement with this issue, given all his wisdom and experience as a former Health Minister, and his continuing work since the 2014 paper “Achieving Better Access to Mental Health Services by 2020”.

Every Member of Parliament, on both sides of the House, will have had the experience in their own advice sessions of people coming to see them who either are experiencing mental health problems or are a family member trying to get help for a child or partner with mental health problems. I think that every Member of Parliament will also have somebody struggling with mental health issues within their own family or among their wider acquaintanceship, but it remains the case that the stigma around mental health issues means there is more concealment, more shame and more delay in reaching out to the NHS for the treatment and support that people need. We know that mental health issues are on the rise. We know that there is a relationship between recession, unemployment and mental health issues and we can see it in our communities across the country.

I have to declare an interest because my mother was a mental health nurse until she retired. She worked in a mental hospital called Storthes Hall in West Yorkshire, and like a lot of mental health facilities it was a former workhouse. Despite the dedication of the nurses and doctors who worked there, this former workhouse on the edge of the Yorkshire moors exemplified, in a very physical way, the Cinderella nature of mental health services.

All parties in this House are committed to parity of esteem between mental health and physical health, but this important debate tests that reality. As we heard earlier, mental health is not just an issue for the individuals concerned; it can have a very sad and serious effect on their families. My hon. Friend the Member for Bristol East (Kerry McCarthy) touched on the issue of black and minority ethnic men and psychosis. This subject is not often discussed in this House, so I will be forgiven for saying a little about it. It has been an issue for many decades that black and minority ethnic people are disproportionately represented in our mental health system at every level. If someone goes on to the wards of the Maudsley in south London or of mental health hospitals across London, they will see that a disproportionate number of the beds are filled by people of black and minority ethnic origin. In some cases, nearly all the beds are filled by people of black and minority ethnic origin.

This subject has been examined and studied since the book “Aliens and Alienists: Ethnic Minorities and Psychiatry”, which is by Dr Lipsedge, I think, and goes back to the ’80s. First, the issue is disproportionate representation, but then it is what sort of access to treatment people from black and minority ethnic backgrounds get. The first problem is their presenting late, and one of the reasons why black and minority ethnic people present late is that they are so frightened of the mental health system. I have dealt time after time with mothers who are struggling with sons with very serious psychosis whom they cannot manage and feel physically threatened by. When I say to them that they need to approach the national health service, they are often very resistant because they are so frightened. They believe that if they let their sons go into the mental health system, they will just be pumped full of—

[Sir Roger Gale (in the Chair)]

Order. I am sorry to interrupt the hon. Lady. I understand that she wishes to address the Member who moved the motion, but she is off-microphone and it is making it difficult for the Hansard reporter. That is why, traditionally, Members address the Chair.

[Ms Abbott]

It is true of many communities, and in particular the black and minority ethnic community, as the statistics prove, that they are reluctant to take family members into the national health system. When they finally have to engage with the national health service, their symptoms are much worse and it is far harder to get positive outcomes. I tell the Minister that it is really important to look at this issue of black and minority ethnic people and the mental health system, because it is causing real misery and problems within the community. We are less likely to be offered talking therapies and more likely to be offered electroconvulsive therapy. Again, mental health facilities within the prison service, such as Rampton, have disproportionate levels of black and minority ethnic persons inside those institutions.

Junior Doctors Contracts

Roger Gale Excerpts

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

I absolutely agree with that, but I gently say to the right hon. Gentleman that if that was the case, he has my mobile phone number and he could have contacted me, and he did not need The Sunday Times to be the first place I saw his proposal. If the people involved were genuinely serious about brokering a deal, that was not the way to go about it. We all have a duty to do everything we can to avert tomorrow’s strike, but his proposal to change the Government’s plans into pilots would mean, as he knows perfectly well, that seven-day care would get kicked into the long grass and would probably not happen. That would be wrong. As he well knows, we have a responsibility to patients to deliver our manifesto promises, and that is what we are going to do.

[Sir Roger Gale (North Thanet) (Con)]

I wonder whether my right hon. Friend can refresh my memory. Is it not the case that under the new contract those who are going to strike tomorrow—it is by no means all junior doctors—putting patients’ lives at risk, will be earning more, rather than less, and for fewer hours, rather than more? Would he also remind me of any other public sector employee who gets time and a half for working on a Saturday morning?

[Mr Hunt]

My hon. Friend makes an important point. The deal on the table is fair for junior doctors; there is higher premium pay for people who work regular Saturdays than there is for nurses, paramedics, healthcare assistants in their own operating theatres, fire officers, police officers and pretty much anyone else in the public or private sector. Under the new contract we are bringing down premium rates for Saturday pay, but we are making sure we compensate that with a 13.5% increase in the basic pay—to my knowledge, that is not being offered anywhere else in the public sector. That will mean take-home pay goes up for 75% of junior doctors. It is a very fair deal. It is designed to make sure that they are not out of pocket as we make changes that are safer for patients, which is why we should be talking about these changes and not having these strikes.