Austerity: Life Expectancy

Sharon Hodgson Excerpts

Wednesday 18th April 2018 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Paisley. I thank my hon. Friend the Member for Sheffield, Heeley (Louise Haigh) for securing this important debate and for her excellent and well-informed speech. It is of great interest—not only to me, but to the public, who I am sure will be listening closely to the Minister’s response today. I also want to thank the hon. Members for South West Bedfordshire (Andrew Selous) and for Witney (Robert Courts), my hon. Friend the Member for Vale of Clwyd (Chris Ruane) and the Scottish National party spokesperson, the hon. Member for Central Ayrshire (Dr Whitford), for their thoughtful and passionate speeches, even though I do not necessarily agree with all the things that were said.

As we heard, life expectancy has always gradually increased. Between 1920 and 2010, it increased from 55 to 78 years for men and from 59 to 82 years for women. However, the improvement began to stall in 2011 when the coalition Government came in. That cannot be just a coincidence. Since then, for the first time in over a century, the health of people in England and Wales has stopped improving, and has flat-lined ever since.

I must emphasise that researchers do not believe that we have reached peak life expectancy. The Nordic countries, Japan and Hong Kong all have life expectancies greater than ours and they continue to increase, so why is life expectancy flat-lining in the UK? Why is Britain being left behind and fast becoming the sick man of Europe? I know that the hon. Member for South West Bedfordshire said that that was not the case, but academic research by Danny Dorling, published in November 2017, which I have here, said:

“Life expectancy for women in the UK is now lower than in Austria, Belgium, Cyprus, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Liechtenstein, Luxembourg, Malta, the Netherlands, Norway, Portugal, Slovenia, Spain, Sweden, and Switzerland. Often it is much lower. Men…do little better.”

I think the hon. Gentleman needs to check his facts.

The life expectancy gap between the richest and poorest in this country is nothing less than shameful. According to the Institute of Health Equity, the longest life expectancy in the country is, not surprisingly, in the richest borough: Kensington and Chelsea. Men in Kensington and Chelsea can expect to live to 83 and women to 86. Unsurprisingly, you will find the lowest life expectancy in my part of it: the north and Scotland. In Glasgow, life expectancy for men is 73 and in West Dunbartonshire it is 79 for women—10 years of difference for men and seven years for women. The difference within the richest borough, Kensington and Chelsea, is even more stark. Despite living in the richest borough in the country, the most disadvantaged within it can expect to live 14 years less than their most advantaged counterparts. Does the Minister agree that this is completely unacceptable?

The north-south divide remains as relevant as ever when we look at healthy life expectancy—the years that people can expect to live a healthy life. In the south-east, the healthy life expectancy is 65.9 years for men and 66.6 years for women. However, people can expect a shorter healthy life expectancy in the north-east, where men have a healthy life expectancy of 59.7 years and women 59.8 years. That is significantly lower than the England average. Looking after those people during that unhealthy part of life means a huge cost to the NHS. It also means that the inequality gap in healthy life expectancy at birth between the south-east and the north-east is 6.2 years for men and 6.8 years for women.

What will the Minister do to address the life expectancy and healthy life expectancy gap between the rich and poor, and the north and south? It is simply unacceptable that the least advantaged in our society bear the brunt of this Government’s policies—wherever they live. Austerity is not a choice. It is a political ideology, which harms the poorest and the most vulnerable in our communities.

[James Cartlidge (South Suffolk) (Con)]

Rubbish!

[Mrs Hodgson]

It is not rubbish. Professor Sir Michael Marmot warned:

“If we don’t spend appropriately on social care, if we don’t spend appropriately on health care, the quality of life will get worse for older people and maybe the length of life, too”.

Sadly, we have seen this across the board. Despite the growing pressure on our health and social care service, the Government are responsible for spending cuts across our NHS, social care and public health services. While demand continues to increase, the Government have taken away vital funding, which could close the life expectancy gap.

Since local authorities became responsible for public health budgets in 2015, it is estimated by the King’s Fund that, on a like-for-like basis, public health spending will have fallen by 5.2%. That follows a £200 million in-year cut to public health spending in 2015-16. Further real-term cuts are to come, averaging between 3.9% each year between 2016-17 and 2020-21. On the ground, that means cuts to spending on tackling drug misuse among adults of more than £22 million compared with last year and smoking cessation services cut by almost £16 million. Spending to tackle obesity, which the hon. Member for South West Bedfordshire mentioned as a cause of shorter life expectancy, has also fallen by 18.5% between 2015-16 and 2016-17 and further cuts are in the pipeline. These are vital services for local communities and could benefit their health and lifestyle, but sadly they continue to be cut due to lack of funding.

How does the Minister expect to close the life expectancy gap without investing properly in vital public health services? An ounce of prevention is better than a pound of cure. The Government must invest in public health and prevention services, as that could play a significant role in closing the life expectancy gap that we are discussing.

When the Prime Minister made her first speech on the steps of Downing Street—the Minister is nodding, because she knows the quote—she said:

“if you are born poor, you will die on average nine years earlier than others.”

We were all pleased that the Prime Minister highlighted that issue, but I have been left disappointed with her Government’s lack of response to tackle it. We on this side of the House are committed to ensuring that our health and care system is properly funded, so that all children are given the best possible start in life and older people are treated with the respect and dignity that they deserve. I hope that the Minister will clearly outline what the Government will do to close the life expectancy gap.

[Ian Paisley (in the Chair)]

Before I call the Minister, I thank all hon. Members for complying so obediently with the timing that I requested.

 Orkambi and Cystic Fibrosis

Sharon Hodgson Excerpts

Monday 19th March 2018 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. I thank the hon. Member for Sutton and Cheam (Paul Scully) for his excellent opening speech, and I thank the 114,000 people who signed the online petition to enable us to debate it. As we have heard, the petition received more than 107,000 signatures in just 11 days—probably a record for such a petition—which shows how important Orkambi is to people with cystic fibrosis and their families.

I also thank my hon. Friend the Member for Dudley North (Ian Austin) for his sterling campaigning on this issue over a number of years, for his passionate speech and for organising the excellent roundtable in Parliament. I was unable to attend the roundtable, but a member of my staff took extensive notes and briefed me fully. I also thank all hon. Members who spoke in the debate. I was going to list them all, but so far there have been 23, and with me and the Minister that will make 25, so I will save everyone from the roll-call. Indeed, at the start of the debate it was standing room only, which shows the strength of feeling on this issue across the House. We have heard very moving accounts about family members and constituents, and that alone should be more than enough to make the case for Orkambi to be made available on the NHS as soon as possible. Finally, I thank the Cystic Fibrosis Trust for its continued “Stopping the Clock” campaign and for all the work that it does to support people with cystic fibrosis.

As we have heard, cystic fibrosis affects about 10,400 children and adults in the UK today. It affects one in 2,500 people, and one in 25 of us carries the gene that causes it. It is a life-shortening genetic condition, with the median survival for an individual with cystic fibrosis currently at just 47 years. Patients with cystic fibrosis therefore have to spend three to five hours every day on aggressive and indiscrete physiotherapy, and need nebulised treatments and strong antibiotics just to keep well. The medicines tackle the symptoms of cystic fibrosis rather than the root cause. That is why new precision medicines such as Orkambi will change cystic fibrosis care for the better.

Kalydeco is the first precision medicine used in this country for people with cystic fibrosis. It has transformed the lives of those receiving it. Patients report no longer needing a tank of oxygen to support their breathing, and greater health stability, so that they can plan their lives more securely. Some are taken off the transplant waiting list, as their clinical status improves dramatically. However, it works for only one in 20 people with cystic fibrosis. In comparison, Orkambi works for eight in 20 people. About 50% of individuals with cystic fibrosis in the UK have the genetic mutation that Orkambi tackles, so the approval of Orkambi for use on the NHS could benefit about 5,200 people living with cystic fibrosis.

Orkambi has been shown to slow decline in lung function by 42% and cut the number of infections requiring hospitalisation by 61%. It gives patients not only more control over their lives but a greater quality of life. Orkambi is available for patients in nine other countries: Austria, Denmark, France, Germany, Luxembourg, the Netherlands, Italy, Greece and the United States. Yet here in the UK, NICE has deemed it to be cost-ineffective, and at least two and a half years after being approved for use it is still not available for cystic fibrosis patients on the NHS. I welcome reports that, after over a year of waiting, dialogue between the drug company Vertex, NHS England and NICE has reopened, and that last month Vertex announced it had proposed a new portfolio approach to the Government on the funding of Orkambi.

I would be grateful if the Minister would elaborate on that in his response and tell us whether the Government are considering the offer seriously. I understand that some hon. Members may have had an update email from Vertex this morning, although I did not; there may be news on that front. I would also appreciate it if the Minister would acknowledge that, given the example of Orkambi, more needs to be done to change how drugs for rare long-term conditions are assessed by NICE. The longer patients go without those precision drugs, the longer they go on suffering irreversible lung damage. That is why we need urgent change.

[Mr Sweeney]

Many hon. Members have referred to the Scottish Medicines Consortium. Of course, healthcare in Scotland is a devolved issue but the issues are the same: there is still a two-year wait to get the matter through. Does my hon. Friend agree that there is a need for a closer working relationship between NICE and the SMC? Perhaps sometimes, with collective bargaining, a deal on price could be reached sooner.

[Mrs Hodgson]

Absolutely, I agree. I do a lot of work, as the Minister does and has done in the past, on access to cancer drugs. The same can be said in that context—that it is a postcode lottery not just within nations but between the nations, and that it need not be. The issue could be explored further.

NICE considers all the different benefits that a treatment could give, including living longer, but also having a better quality of life. That is hard to establish for some rare long-term conditions such as cystic fibrosis, making it hard for drugs to meet NICE’S requirements. There is a need for high-quality data on treatments, so that an accurate quality-adjusted life year model can be created. However, that is very difficult to achieve in short trials, particularly for rare long-term diseases such as cystic fibrosis, where “powering” a trial with enough patients is very difficult. People with long-term conditions often score their quality of life more highly than people who have developed acute conditions after being well, often because of differences of perception. If, during trials, people score their quality of life as high prior to treatment, subsequent quality-adjusted life year gains are lower.

The cost of developing a treatment for a rare disease is also high. Understanding the condition, developing an effective treatment and running the required trials in a small population is expensive. Treatments often have no competitors, so there is dampening of market forces, with negative consequences for the consumer or payer. NICE found that Orkambi was important and effective, but that the cost was too high. Vertex must therefore work as a matter of urgency to bring down the cost of Orkambi, so that thousands of cystic fibrosis patients can benefit from the drug on the NHS. The Opposition are committed to ensuring that all NHS patients get fast access to the most effective new drugs and treatments.

In response to the online petition, the Government responded:

“We want patients to benefit from clinically and cost effective treatments.”

What steps are they taking to bring that about? NICE’S guidance on Orkambi is scheduled to be reviewed in July 2019. Will the Government work with Vertex, NICE and NHS England to ensure that the review is brought forward so that thousands of patients can benefit much sooner from the drug on the NHS? It is clear from today’s debate that we need more and better treatments for cystic fibrosis in the UK. Last year, half of all people who died with cystic fibrosis were under the age of 31. It is unacceptable that while pharmaceutical companies, NHS England and NICE barter, people’s lives are at stake. The Government must therefore take responsibility for negotiating an agreement as soon as possible. I hope that the Minister will take on what he has heard today. I hope he will acknowledge how important it is to find a solution that guarantees that the current situation affecting the pipeline of treatments for cystic fibrosis will never happen again, and that thousands of patients will get access to the most effective drugs and treatments as soon as possible.

Organ Donation (Deemed Consent) Bill

Sharon Hodgson Excerpts

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

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I thank my hon. Friend the Member for Coventry North West (Mr Robinson) for securing this very important debate, for introducing this very important Bill and for his powerful and moving opening speech. I would also like to thank the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan), the hon. Members for Mid Worcestershire (Nigel Huddleston), for North Devon (Peter Heaton-Jones), for Dudley South (Mike Wood), for Chippenham (Michelle Donelan) and for Hendon (Dr Offord), and my hon. Friends the Members for Ealing, Southall (Mr Sharma), for Barnsley Central (Dan Jarvis), for St Helens South and Whiston (Ms Rimmer) and for Lincoln (Karen Lee) for their excellent speeches.

In particular, I pay huge tribute to my constituency neighbour, my hon. Friend the Member for Sunderland Central (Julie Elliott). She spoke so bravely and movingly about her daughter Rebecca, who as we heard has been on dialysis for a year awaiting a kidney transplant. I hope from the bottom of my heart—I am sure we all do—that her wait is over very soon and she is successful in receiving that gift of life from a wonderful donor.

This has been an excellent debate and an example of this House at its best, as it often is on Fridays during debates on private Members’ Bills. I would like to thank hon. Members who have previously brought this issue to our attention over the past decade or so, including my hon. Friends the Members for Mitcham and Morden (Siobhain McDonagh), for Newport West (Paul Flynn) and for Barnsley Central.

I commend the Daily Mirror for its fantastic campaign to raise awareness of organ donation since the case of Max Johnson, who we have all heard so much about this morning. He was then a nine-year-old boy in need of a new heart. I understand he is now 10, which is fantastic. I want to thank the hon. Member for North Devon for telling us all about Keira Ball, Max’s donor, who I understand saved four lives. I thank her very, very brave family for taking that brave decision on that most awful of days. I also thank the more than 13,000 people who have now signed the Change.org petition.

I also commend the scriptwriters of “Coronation Street”—of which, it has to be said, I am a huge fan as a northerner—for covering this issue so well. I note that the character Carla Connor this week received a kidney from her half-brother and that all is going well. At their best, soaps can play a huge part in helping to inform the public on such issues. I hope the storyline will touch on the importance of being on the organ donation register. Finally, I pay tribute to the thousands of people who have already participated in the Government’s public consultation on organ donation. I encourage others to do so, if they have not done so already, to let their voices be heard.

The topic of organ donation is understandably an emotional one, but I am pleased that so many people are now engaging in this debate and that we have the opportunity to discuss it in the House today. This debate and the publicity around it may encourage families up and down the country to have that important discussion about organ donation before the inevitable happens. There is no doubt that these discussions need to be had and that we need more organ donors in England. Almost 25 million people are on the organ donation register, but according to the NHS blood and transplant service, 7,000 people are waiting on the list for new organs. For them, it really is a life or death situation, so it is important that as many people as possible sign up to the organ donation register.

Over the past five years, almost 5 million people have joined the register, and in 2016-17 we saw the highest ever deceased donor rates in England. More than 50,000 people are living with a functioning transplant—Max is one of them—thanks to organ donation and transplantation in the UK. These are welcome developments, but we still have a long way to go. We currently lag behind other western countries. Tragically, around 1,000 people die every year—that is three a day—while waiting for a transplant. To save those lives, we need more people on the organ donation register making those decisions with their family’s knowledge, so that when the time comes, more lives can be saved.

[Mr Sweeney]

My hon. Friend makes an excellent case by citing statistics in England, but this is a cross-border issue as well. A great strength of our national health service is that no matter what part of the UK someone comes from, they can benefit from an organ transplant. If someone in Dumfries needs a kidney donation and the donor is from Carlisle, there will be no barrier or border on the route to getting access to that transplant. That is why MPs from all parts of the UK should support organ donation changes in all parts of the UK. That includes the Scottish National party; it is just a shame that SNP Members are not here today. Does my hon. Friend agree?

[Mrs Hodgson]

Yes, and I had not noticed that nobody from the Scottish National party is here. I do not know what the situation is in Scotland, but we still want people there to be organ donors. I am sure that Rebecca, the daughter of my hon. Friend the Member for Sunderland Central, would not refuse a kidney, whether from Scotland, Wales, Northern Ireland or anywhere, so that is a very good point.

[Mr Sweeney]

Will my hon. Friend recognise the great strides that the Labour party in Scotland has made in trying to bring in legislation on opt-out organ donation there? It is unfortunate that the Scottish National party blocked the progress of a Bill from Anne McTaggart MSP in the last session of the Parliament, but there is still hope, because a private Member’s Bill is progressing through the Scottish Parliament. We hope to have Labour and cross-party support to see such legislation progress in Scotland, as well as in Wales and England.

[Mrs Hodgson]

Excellent. I am really grateful to my hon. Friend for updating us all on the situation in Scotland because, as I said, I was not aware of it. I commend that Bill and hope that our SNP friends up in Scotland will act on and progress it as soon as possible.

[Matt Rodda (Reading East) (Lab)]

I pay tribute to colleagues in Wales, my hon. Friend the Member for Coventry North West (Mr Robinson) and colleagues from across the country. We heard very moving stories from colleagues from North Devon and other parts. We as a House have demonstrated the ability to work together today, and that is so important. One of the great strengths of the debate has been the way that we have focused on families and listened to their stories. For me, that has been a deeply moving experience. I commend to colleagues the importance of continuing to listen to families as the campaign goes forward.

[Mrs Hodgson]

Families are at the heart of this, as my hon. Friend the Member for Coventry North West, who is promoting the Bill, made clear, and I am sure that the Minister will as well. It is important that families’ voices are taken into consideration when these discussions take place.

I know that I am not alone in this House in carrying a donor card and being on the register. Like many other organ donors, I signed myself up because of a direct family experience. My Aunty Ella, who is sadly no longer with us, was one of the first patients to receive a kidney transplant at the fantastic Freeman Hospital in Newcastle way back in 1967. It was pioneering surgery back then, and it is great to hear my fellow Sunderland MP, my hon. Friend the Member for Sunderland Central, also commending the work of the fantastic renal team at the Freeman Hospital who are currently treating and supporting her daughter Rebecca so well. My Aunty Ella lived a full life because of her transplant. In those days, it was perhaps not as long as she would have liked, but she was able to see her children Norman and Stephen —my cousins—grow up to get married. All she wanted to do was to see them grow up, but she lived on to see them give her grandchildren. That is what organ donation is all about: it gives people a future. Just one donor can save up to nine people—as we heard, Keira Ball saved four—and it can give those nine people a future with their loved ones, which is why it is so important.

Of course, there are some concerns among some religious communities. We heard about that earlier from the hon. Member for Hendon (Dr Offord), and I know that my hon. Friend the Member for Leicester South (Jonathan Ashworth), the shadow Secretary of State for Health, has met representatives of one particular Jewish community to discuss their concerns. There are also concerns among black and minority-ethnic communities, as we heard from my hon. Friend the Member for Ealing, Southall (Mr Sharma). Although they are more susceptible to illnesses such as diabetes, hypertension and even heart disease, only 35% of black and Asian people in the UK—where the population average is 63%—agreed to organ donation last year.

[Mark Tami]

The same applies to stem cell transplants, which I raised earlier. It simply is not acceptable that those who happen to be white probably have an 80% to 90% chance of finding a possible match, whereas for those who come from a certain ethnic background the figure could be as low as 30%. I do not think we would accept that in any other walk of life.

[Mrs Hodgson]

My hon. Friend has made exactly the right point. This does not apply only to, for instance, kidney and heart transplants; it applies to the whole donor register. The Government must listen to the concerns of black and Asian communities, not just during the consultation but beyond, so that we can develop a solution to this problem.

[Eleanor Smith]

I hope that the Bill succeeds and that there will be consultation with members of the BME community to ensure the successful delivery of a public education programme to increase awareness.

[Mrs Hodgson]

That is precisely the point. It is a question of education and public awareness as well as the acceptance of the sensitivities that exist among all people, not just members of particular religious or ethnic-minority communities.

[Mr Virendra Sharma]

I am sorry to interrupt my hon. Friend while she is making such a strong point. One of my constituents rang me after my speech to suggest first that Members of Parliament could run roadshows, along with members of their local voluntary sectors, to raise awareness and to encourage people to register as donors and secondly that we could encourage the local education system to enable schools and parents’ associations to run awareness sessions. Would that not be the best way of both raising awareness and engaging with communities?

[Mrs Hodgson]

Absolutely. I think that schools are an ideal forum for a number of public health awareness messages on a host of issues to be delivered to young people.

Perhaps the solution to all these concerns has been developed in the two countries where the opt-out system is working well, Wales and Spain. In Wales, the system came into force in 2015. The law sets out that those who live and die there will be deemed to have given consent for their organs to be used unless they have explicitly said otherwise. Before that change in the law came into effect, a public awareness campaign alone resulted in an increase in the number of organs transplanted from 120 to 160. That was not huge, but it was a definite start. NHS organ donation statistics show an 11.8% increase between 2014-15 and 2016-17 in the number of people in Wales opting to donate their organs. That was the highest increase among England, Wales and Scotland. Although there has not been a notable change since the law came into effect, it is worth remembering that—as we heard earlier—Spain took almost 10 years to increase organ donation rates significantly.

Spain has had a soft opt-out system for 39 years. It is considered to be the world leader in organ donation and currently has the highest organ donation rates in the world. In Spain, consent is presumed in the absence of any known objection by the deceased, but family consent is still sought, as it would be here, we hope. In the immediate aftermath of this change in law, there was only a small increase in the number of organ donations and transplants, but there was a dramatic increase after 1989, when the Spanish Government made a big push to reorganise organ donation, as a result of which there was a medically trained transplant co-ordinator in every hospital by 1999.

It is unlikely that we here in the UK will have an identical opt-out system to Spain’s, but these are just two examples showing how an opt-out system can work and improve the lives of thousands of people waiting for an organ transplant. This also gives us the opportunity to learn from past experiences, to ensure we get it right in this country, which I am sure we all seek to do. I know the Government will be working to ensure that that is what happens, and the Opposition are passionate about world-class health services, but, as the NHS Blood and Transplant service made clear, we

“will never have a world-class donation and transplantation service if more than 4 out of every 10 families say no to donation.”

Some 90% of people surveyed by the British Heart Foundation say they support organ donation, but just 33% of those surveyed are on the NHS organ donor register. It is clear from what we have heard today that more people need to be on the organ donor register, and these difficult conversations must be encouraged, so that more lives can be saved.

[Luke Pollard]

During this debate, I went on to my phone and signed up as a full organ donor. Previously, I was a bit squeamish about giving my eyes, but I have been convinced by the arguments. Signing up only took two minutes; it was simple to do, and every Member could be encouraging our constituents to do so, too, by just going on to their phone and registering now, so we can get more donors before this Bill becomes law.

[Mrs Hodgson]

That would be great. Even the most technophobe of us should be able to manage doing that if it takes only two minutes, and maybe there could be one of those clever apps to make it even easier for all the young people to do this.

[Stephen Pound (Ealing North) (Lab)]

I have no knowledge of apps, but I do have my donor card here, held proudly in my hand, which I got by telephoning. When I introduced my Bill on this subject many years ago, I was accused, as were the supporters—including Dr Evan Harris, who brought in the Bill with me—of being Aztecs. Does my hon. Friend agree that the tide is now flowing in our favour and this is a piece of legislation whose need has been proven, but whose time is now?

[Mrs Hodgson]

Yes, very good, and I must apologise for not commending my hon. Friend for his Bill when I listed the people who had done work on this over the years. That makes us realise how many people have been pushing for this, and if my hon. Friend the Member for Coventry North West is successful today, his great achievement will be following in many other Members’ footsteps.

Whether it is clever people with their apps or people carrying the old-fashioned donor card, we in the Opposition and nearly all of us, or perhaps all of us unanimously, across the House this morning are in favour of a change to the organ donation law, to ensure that everybody whose life could be saved by organ transplant can have the gift of life. I therefore urge the Minister today to take the necessary steps to increase the number of people on the organ donor register, and I am sure this Bill will be a great asset in helping her to achieve that goal.

Cancer Strategy

Sharon Hodgson Excerpts

Thursday 22nd February 2018 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for leading the debate and for her excellent speech, and I thank the hon. Member for Basildon and Billericay (Mr Baron) for securing the debate. He is not in the Chamber, but I also want to thank him for the excellent contribution that he has made to the work of the all-party parliamentary group on cancer for many years. His expertise and passion about this matter are what has made the APPG so successful.

I also thank the other Members who have made excellent speeches about this important issue. I thank the hon. Members for Bosworth (David Tredinnick), the hon. Member for North Warwickshire (Craig Tracey), with whom I co-chaired the all-party parliamentary group on breast cancer—he raised the important issue of breast density, which, as he said, is an issue on which we really do need to make progress—the hon. Members for Dumfries and Galloway (Mr Jack) for Chippenham (Michelle Donelan), for Strangford (Jim Shannon), and for Inverclyde (Ronnie Cowan), the Scottish National party spokesman. I thank my hon. Friends the Members for Coventry North East (Colleen Fletcher), for Scunthorpe (Nic Dakin), and for Bristol West (Thangam Debbonaire), and my hon. Friend the Member for Lincoln (Karen Lee). She is no longer in the Chamber, but she made a powerful and emotional speech about her daughter, who would be so proud of her bravery today—as, I am sure, her grandchildren will be. I hope that the whole family were watching the debate today. I also pay tribute to my hon. Friend the Member for Easington (Grahame Morris), who, I think, has fought cancer twice.

[Grahame Morris]

Three times.

[Mrs Hodgson]

It is an absolute pleasure to see my hon. Friend in his place. Long may he stay there.

Cancer is, understandably, a very emotional topic. One in two people in the UK will be affected by cancer in their lifetimes, and, as we have heard from almost everyone who has spoken today, we have all been affected in some way ourselves. When my children were very small, I lost my mother-in-law to breast cancer. That is one of the reasons why I joined the all-party parliamentary group on breast cancer, and I am vice-chair of the group to this day. It is this emotion that encourages us and gets us all to come together to tackle cancer.

Over the years, there has been a steady improvement in cancer survival rates in England. However, we still lag behind the improvements of our European counterparts, and the number of new cancer cases continues to rise year on year. If these trends continue, it is estimated that by 2020 some 2.4 million people in England will have had a cancer diagnosis at some point in their life. That is why the Government must take urgent steps so that cancer diagnosis care and outcomes in England can be improved.

The cancer strategy was a welcome step forward to achieving the best cancer care and outcomes in the world, and Labour is fully committed to delivering, and helping to deliver, that strategy in full. However, as has been mentioned, there are some concerns across the House about the progress of the strategy. I am pleased that some of the targets have already been met, but I am under no illusions—many are no closer to being reached than they were almost three years ago. Will the Minister today commit to publishing a detailed progress update on each of the 97 cancer strategy recommendations by the end of this financial year, so we are all able to celebrate success but also focus our attention on more pressing challenges where needed? There are many challenges that the Government must face before achieving world-class cancer outcomes, but I will touch on only a few today: early diagnosis; waiting times; the workforce; and prevention.

On early diagnosis, we know that if a cancer is diagnosed early, treatment is more likely to be successful, but for cancers such as ovarian cancer and lung cancer it is often too late. The National Cancer Registration and Analysis Service found that over a quarter of women with ovarian cancer are diagnosed through an emergency presentation. Of those women, just 45% survive a year or more, compared with over 80% of women diagnosed following a referral by their GP. I should state at this point that I am chair of the all-party group on ovarian cancer. Similarly, research by the British Lung Foundation found that more than a third of lung cancer cases in England are diagnosed after presenting as an emergency. As a result, the Roy Castle Lung Cancer Foundation found that, if caught early, a person has up to a 73% chance of surviving five years or more. However, the current five-year survival rate for lung cancer is just 10% and, sadly, one in 20 lung cancer sufferers was not diagnosed until they had died. Cancer survival rates have doubled over the last 40 years, but those are shocking statistics. I therefore ask the Minister what his Department will be doing to ensure that cancers are detected even earlier, so that patients are no longer pushed from pillar to post trying to find a diagnosis.

Unfortunately, we know that once a patient has been diagnosed, they then have an agonising wait for treatment. Even if it was a wait of just a week, it would be agonising, but the 62-day target between urgent GP referral and treatment has not been met now for two years, meaning that patients are having to wait much longer than they should for treatment. Since the target was first breached in January 2014, over 95,000 people have waited for more than two months for treatment to start. Cancer patients should not be expected to wait so long. I therefore ask the Minister what his Department is doing to address this issue.

It is no secret that the NHS and the NHS workforce are under extreme pressure due to underfunding and understaffing by this Government. I want to place on record the fact that Labour Members do not take the NHS workforce for granted. We are incredibly grateful to them for their hard work, support and kindness to patients and their families. They are doing an incredible job despite the circumstances we currently find ourselves in, and we should never stop thanking them for the work they do to diagnose, treat and care for patients. The cancer workforce really are the backbone of the cancer strategy.

The improvement of early diagnosis and waiting times relies on an efficient cancer workforce, so the Minister must make these concerns a top priority if the targets in the cancer strategy are to be fulfilled. A report by Macmillan Cancer Support found that more than half the GPs and nurses surveyed in the UK say that, given current pressures on the NHS workforce, they are not confident that the workforce are able to provide adequate care to cancer patients. That is deeply worrying. The NHS workforce should be suitably equipped to diagnose, support and care for cancer patients, during and beyond cancer.

Through my work with the all-party parliamentary group on breast cancer, I have heard—as I am sure the Minister did during his time as the group’s co-chair—of the overwhelming support that a cancer nurse specialist can bring to breast cancer patients and their families. As we have heard, however, patients with secondary breast cancer are unlikely to have access to a cancer nurse specialist. Research from Breast Cancer Care shows that 42% of hospital trusts and health boards in England, Scotland and Wales do not provide dedicated, specialist nursing care for people with secondary breast cancer, even though they often have complex emotional and supportive care needs. Patients with secondary breast cancer are subject to a postcode lottery when it comes to having a cancer nurse specialist. What steps is the Minister taking to ensure that every cancer patient has access to a clinical nurse specialist?

There is no doubt that, if the cancer workforce had the time, resources and support they so desperately need, the recommendations in the cancer strategy would be achieved. I know that that is something the cancer workforce plan, published in December last year, aimed to address. Will the Minister update the House on the progress of the plan and outline how much funding the Government will be granting to ensure that the proposals in the plan soon become a reality? The NHS cancer workforce care for and support their patients every day, and we really need the Government to support the workforce, too.

Finally, I move on to the first issue raised in the cancer strategy: prevention. The World Health Organisation estimates that a third of deaths due to a cancer are the result of the five leading behavioural and dietary risks: high body mass index; low fruit and vegetable intake; lack of physical activity; tobacco; and alcohol. The subject of alcohol was raised by my amazing hon. Friend the Member for Bristol West. Tobacco was identified as the most important risk factor, responsible for approximately 22% of cancer deaths. Taking all five risk factors into account, it is estimated that between 30% and 50% of cancers could be prevented.

The Government’s tobacco control plan—which the Minister thankfully pushed to be published in his first weeks in the job—and the childhood obesity plan are welcome steps towards reducing the high rate of preventable cancers, but they will not go far enough if the Government continue to slash public health budgets. Will the Minister therefore commit to strengthening public health budgets, so that fit and healthy lifestyles can be encouraged across all our communities and help to contribute to cancer prevention? I know that, like me, he is passionate about making sure that England is one of the world leaders when it comes to cancer outcomes, but we are currently lagging behind. However, with the right funding and support from the Government, the cancer strategy has the potential to achieve that. I hope that he will take on board all that we have heard today and go back to his Department with an action plan of how best to move forward, so that we can really achieve world-class cancer outcomes in 2020.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 6th February 2018 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

Following the question from my hon. Friend the Member for Blaenau Gwent (Nick Smith) and the Minister’s answer, may I revisit the issue of energy drinks? She might know that a 500 ml can of energy drink contains 12 teaspoons of sugar and the same amount of caffeine as a double espresso, yet energy drinks are being sold for as little as 25p to children as young as 10, and around one in three young people say they regularly consume them. Given the health risks associated with energy drinks, will she tell me more about what steps she and her Department are taking to reduce energy drink sales to and consumption by children?

[Jackie Doyle-Price]

The hon. Lady will know that action against sugar is very much part of the childhood obesity plan that the Under-Secretary of State for Health, my hon. Friend the Member for Winchester (Steve Brine), is taking forward, but there is a lot more we can do to address the concerns about caffeine, which I know is high on his “to do” list. We will no doubt have more exchanges on this subject in due course.

Draft Human Fertilisation and Embryology (Amendment) Regulations 2018 Draft Human Tissue (Quality and Safety for Human Application) (Amendment) Regulations 2018

Sharon Hodgson Excerpts

Wednesday 31st January 2018 General Committees

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Henry. I want to make it clear from the outset that the Opposition welcome the amendments to the regulations. As the trade in and use of human cells and tissues becomes more complex, it is important that any risks are premeditatedly addressed, and the regulations will help us take a step in the right direction towards achieving that aim.

However, it is important that we never miss an opportunity to press the Minister on points worthy of being raised. We agreed with the chief executive of the Human Tissue Authority, Allan Marriott-Smith, when he said:

“These objectives support our aim to make sure human tissue is stored and used safely, ethically, and with proper consent.”

He went on to say:

“We are committed to working with our stakeholders to ensure a smooth transition and proportionate approach to implementation.”

That is a crucial point that I am sure the Minister will keep a close eye on, as the regulations are implemented. She will be aware that I will also be keeping a close eye on them in my Front-Bench role. I am especially interested to know how she expects to mitigate the high cost of implementation of these changes, as was highlighted in the consultation that preceded the draft regulations.

With those brief remarks, I will conclude. I look forward to hearing the hon. Member for Central Ayrshire and to the Minister’s closing remarks.

NHS Blood Cancer Care

Sharon Hodgson Excerpts

Wednesday 17th January 2018 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a genuine pleasure to serve under your chairmanship, Mr Wilson, and I congratulate the hon. Member for Crawley (Henry Smith) on his good fortune in securing this debate just before the launch of the report by the all-party group on blood cancer, which will take place afterwards. That was very opportune and well done. He made an informative and heartfelt opening speech, and I am sure that he can secure no finer legacy in memory of his mother than what he is achieving in Parliament today. I am sure his whole family are proud of him.

As we have heard throughout this debate, blood cancer is the third biggest cancer killer in the UK, and the fifth most common cancer, with more than 230,000 people living with the disease. For those people and their families—some of whom are here today or watching the debate—action is needed to improve the treatment and support on offer. That includes some of my own constituents who contacted me prior to this debate, and it is for them that we are here today. There is much that we can do to improve treatment and support, as so eloquently put by the hon. Member for Crawley, and others who have spoken today, including my hon. Friend the Member for Coventry North East (Colleen Fletcher), and the hon. Members for Gordon (Colin Clark), for Strangford (Jim Shannon), and for Central Ayrshire (Dr Whitford), who all made excellent speeches.

Blood cancer patients need to see their GP many more times before being referred to hospital than those with other cancers. Indeed, 35% of blood cancer patients had to see their GP three or more times before being referred, compared with only 6% of those with breast cancer, and 23% of those with all other tumour types. Such figures must be the fire beneath that spurs us on to do more, otherwise we will be failing the 230,000 people who live with this disease. Today I want to pick up on three key issues: first, patient experiences, and specifically the “watch and wait” principles of treatment and support; secondly, the improvements needed in research and access to treatments; and finally I will discuss post-stem cell transplant care. 

Each year, 5,000 people with slow-growing blood cancers do not start treatment straight away, but instead are placed on a regime called watch and wait. That means that patients are monitored until they reach a point where treatment must start. It can take many years for that to happen, which can add much pressure to a patient’s life, including the psychological struggles that they might face. That is understandable: it must be excruciatingly difficult for someone to live with a cancer, including a blood-borne one, yet not receive any treatment, even though they know they have the disease. 

To help fully understand this struggle, I want to read from a case study that was sent to me by Bloodwise, and written by the blogger who writes the “Diary of a ‘Fake’ Cancer Patient”. It states:

“About a month after diagnosis, I went to pieces and sat in front of my consultant panicking, crying and generally not coping.”

Reading the full case study is harrowing but heart-warming at the same time. That may sound peculiar, but it shows the scale of the struggle that blood cancer patients face under “watch and wait”, and also that when support is offered they can lead as normal a life as possible, and have the support to cope with the disease and the situation in which they find themselves. That is why Labour supports calls for tailored psychological support for patients who are on watch and wait, and it would be welcome if the Minister addressed that point when he replies to the debate.

It would be of great interest to hear from the Minister whether the Government plan to look at the perceived pitfall in the cancer strategy regarding the recovery package, and the failures to take into consideration the unique characteristics of blood cancer, as well as the use of terms such as “beyond cancer” and “post-treatment”, which can be alienating to blood cancer patients. As we know, blood cancers are very different to solid tumour cancers, and that determines the kind of treatment on offer to patients. For blood cancer patients, treatment is not about surgery or radiotherapy; it is about drugs to help to fight their cancer, and importantly, about access to said drugs. It is therefore crucial that innovation and the development of new drugs is encouraged to help improve patient outcomes. The Government must continue to commit to ongoing research to help save lives, and capitalise on our world-leading position as blood cancer research pioneers.

Lots of this work already happens, including charitable investment and collaboration between public bodies. One such example is IMPACT—a £4 million clinical trials programme that is jointly funded by Anthony Nolan, Leuka, and NHS Blood and Transplant services. By 2020, this exciting and much welcomed project will have established 12 clinical trials involving approximately 1,500 patients. It will play an invaluable role in achieving the vision set out in the Government’s life sciences industrial strategy and—most importantly—it will help to save lives. It is of utmost importance that the Government continue their commitment to this work.

We must also consider how the cancer drugs fund works, and how the temporary collection of data to make appraisal decisions can, for some rare blood cancers, lead to insufficiency in collecting robust data, and therefore to negative appraisals for drugs. I have raised concerns in the past about the way we appraise drugs—indeed, I worked with the hon. Member for Central Ayrshire when we were both co-chairs of the all-party group on breast cancer, and we carried out work on some breast cancer drugs, including Kadcyla. It is therefore disappointing, yet not surprising, that we find similar situations when it comes to blood cancer drugs with, for example, the drug ibrutinib being given to patients with mantle cell lymphoma. That drug received a negative appraisal, and later a positive one. That causes unnecessary distress and anxiety for patients, and it is important that such problems are addressed. I hope that the Minister will give us some steer on when the Government plan to rectify these matters.

Finally, I will touch briefly on the need for support for those living post transplant, and the care that should be on offer to them. It is estimated that by 2020 more than 16,000 people will be living post transplant, and they will therefore be more exposed to physical and psychological effects, such as graft versus host disease, depression and prolonged duress stress disorder. Although stem cell transplants can save a person’s life—that is fantastic—it is important that when someone’s life is saved, they can live it to its fullest. Sadly, only 54% of those who need psychological support actually receive it. That is down to the commissioning of post-transplant services not working for all patients, especially at the 100-day cut-off after a transplant, when responsibility for services moves from NHS England to CCGs, and therefore leads to gaps in the care and support provided. Is the Minister aware of that, and will he commit to looking at how that gap can be filled so that patients receive the best post-transplant support possible?

This debate has been incredibly important, and I am sure it has given the Minister a lot to think about. I hope that when he gets back to his office, he will look at this issue in depth and read the APPG’s report following its launch today—I am looking forward to that—so that all the 230,000 people living with blood cancer can be confident that the Government are doing their utmost to give them the best chance of living.

Junk Food Advertising and Childhood Obesity

Sharon Hodgson Excerpts

Tuesday 16th January 2018 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Dorries. I thank the hon. Member for Erewash (Maggie Throup) for securing this important debate, and for sharing her knowledge in her passionate speech. I also thank the other hon. Members who have spoken this morning for their eloquent speeches: my hon. Friend the Member for Reading East (Matt Rodda), the hon. Members for South West Bedfordshire (Andrew Selous), for Strangford (Jim Shannon) and for Angus (Kirstene Hair), my hon. Friend the Member for Bristol East (Kerry McCarthy) and the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald), who spoke for the Scottish National party.

The UK has one of the worst obesity rates in Europe, with almost two in every three people either overweight or obese. I am, as hon. Members can see, one of those two. I am back on a strict diet post-new year, with no sugar or alcohol for the foreseeable future—if any hon. Members see me with either or both in my hand, please take them off me—and I hope that by August there will be a lot less of me.

I commend the honesty of the hon. Member for Strangford. I have been on a similar journey to him healthwise, and I hope to share his success weightwise. It is hard though—if it were easy, nobody would be overweight. We have not all got metabolisms as good as a horse, as the hon. Member for South West Bedfordshire attests to. However, I started life as a skinny kid and was a slim teenager. I am proud to say that I was a size 10 when I got married, but I still ended up overweight as time went by. Therefore, I worry greatly when I see the stats, as I know we all do, for this country’s children.

As we have heard this morning, a pattern now emerges at a very early age. In 2016-17, almost a quarter of reception children aged between three and four were overweight or obese. In the same year, for pupils in year 6, it was more than a third. An obese child is five times more likely to grow up into an obese adult. I did not start as an obese child, and hon. Members can see where I got to, so it is important that the Government do all they can to ensure that child obesity rates are reduced as a matter of urgency.

As we know, obesity is linked with several health issues: lung and liver disease, heart attacks, strokes, seven or more types of cancer, and type 2 diabetes, all of which could be prevented with healthy eating and a healthy lifestyle. According to Cancer Research UK, continued eating and drinking patterns—alcohol is also a major factor in cancer—could lead to being overweight and obese and could cause an additional 670,000 cases of cancer in the UK over the next 20 years. Diabetes UK also warns that there are now 12.3 million people at an increased risk of developing type 2 diabetes. If overweight and obesity levels were to be reduced, three in five cases of type 2 diabetes could be prevented or delayed.

Obesity comes at a high financial cost too. Obesity and its related health problems cost the NHS in England an estimated £5.1 billion a year, projected to reach £9.7 billion by 2050, if the Government and the people themselves fail to take any action—as we have heard in the debate, people need to take action for themselves. That is why this debate is so important. If we do not do anything about obesity today, the children of tomorrow are the ones who will suffer.

There are many ways to address obesity. No one intervention is a silver bullet, but it is the Opposition’s belief that action on advertising and marketing can make serious inroads.

Ten years ago, Ofcom’s restrictions on junk food advertising came into effect, but over that decade, our viewing habits have changed, as we have discussed. At that time, the Ofcom report said:

“Advertisements of high fat, salt and sugar products should not be shown in or around programmes specifically made for children...For the avoidance of doubt this measure will remove all HFSS advertising from dedicated children's channels”.

Ten years on, as we all know, that is incredibly outdated and out of touch with the way children watch TV. Children are likely to watch TV with their family or watch programmes that are not on specific children’s channels, such as “The X Factor”, “Britain’s Got Talent”, “Hollyoaks” and other programmes.

A report by the University of Liverpool found that 59% of food and drink adverts shown during family viewing time were for high fat, salt and sugar products and would have been banned from children’s TV. The same report also found that, in the worst case, children were bombarded with nine junk food adverts in just a 30-minute period and that adverts for fruit and vegetables made up only 1% of food and drink adverts shown during that family viewing time. Ofcom’s restrictions on junk food advertising are therefore totally obsolete and in need of a serious update to protect children from the bombardment of junk food advertising from multinational companies.

Many of the charities and organisations that provided me with briefings for this debate called for junk food advertising to be restricted until the 9 pm watershed on all channels, which was something I was pleased to commit to in the 2017 Labour party manifesto and am proud to remain committed to. I hope that the Minister will hear the calls today from hon. Members across the House and will see why an update of the restrictions is necessary.

Children must of course also be protected from other forms of advertising, such as billboard and bus shelter adverts, as well as subtle advertising in films and in made-for-purpose games, which are so prevalent there is a name for them—advergames. “Newsnight” last night noted that there are major concerns with the regulations around confectionary firms and their marketing to children. There seems to be a loophole in the law with regard to advergames, which needs to be closed.

There are also genuine games that are very popular with children although they are not aimed at them, such as Candy Crush—I have to admit to having tried that one myself—which embed advertising in the game and have been shown to drive children's food choices. Sponsorship has also been shown to have a huge impact on brand awareness and purchasing decisions among children. Products high in fat, salt and sugar are often found to sponsor sporting events or teams of which children are a key part of the audience. For example, Cadbury is the official snack partner of the premier league.

The current restrictions do not encapsulate those areas, and in our digital world it is important that our restrictions advance to protect children. Will the Minister commit to holding a cross-Departmental meeting with colleagues in the Department for Digital, Culture, Media and Sport to discuss the urgency of addressing junk food marketing to children across those forums?

Not only do we watch TV and use the internet differently, but we also shop differently. Our sedentary lifestyles mean that we now rush into supermarkets trying to buy the quickest or cheapest products. As soon as we walk through the door, we are tempted with promotions, such as buy one get one free or three-for-two offers. Such discounts make up for more than half of all food sold in the UK, a higher proportion than in any other country in western Europe. We all love a bargain, but research has shown that 76% of purchases were unplanned and decided on in store, which shows the power of such promotions.

That trend is increasingly prevalent among families from poorer backgrounds who are not able to afford more expensive, nutritious and healthier food, or lack the skill to cook it. It is therefore no wonder that children aged five from poorer backgrounds are twice as likely to be obese, and that those aged 11 are three times as likely to be obese. Following what the hon. Member for South West Bedfordshire said, we also need affordable, healthy and nutritious products available on promotion to change habits.

I am sure the Minister will uphold the Government’s pledge to tackle childhood obesity, but their efforts are dwarfed by multinational corporations’ spending on junk food advertising. In 2016, the 18 highest-spending crisps, confectionary and sugary drinks brands together spent more than £143 million advertising their products. I recently met an advertising executive who has turned gamekeeper since having a damascene conversion—he now campaigns against added sugar and obesity. He told me how much effort multinational corps put into marketing specifically to children. It is not accidental, but a deliberate, well-thought-through and lucrative strategy.

Eighteen months ago, the Government launched their much-depleted childhood obesity plan, which left much to be desired. Will the Minister update us on the current situation of the childhood obesity plan? Will he commit to looking beyond it and going further by introducing the initiatives that have been suggested today, such as a 9 pm watershed on junk food marketing, which were sadly dropped from the original plan?

All of the arguments we have heard this morning point to the fact that essential Government action is needed to ensure that our children grow up in a healthy environment so they can be fighting fit for the future. I hope the Minister will take these suggestions back to his Department and think about how they can be implemented into a serious drive to reduce childhood obesity over the next 10 years. Childhood obesity must be addressed. We cannot have a soft-touch approach. We must do this for future generations of children, and make a promise to them that they can be some of the healthiest children in the world.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 19th December 2017 Commons Chamber

[Steve Brine]

Happy Christmas to St Helens as well. I agree that we need to work together. The Healthy Start programme, for which I am responsible, provides a nutritional safety net to hundreds of thousands of pregnant women and families with children under four. There is a slight increase in cases being reported in recent years. In part, that is due to much better diagnosis and detection. Some 1.1 million children get free school meals in England, and the Government are investing £26 million in breakfast clubs. Only last week, Kellogg’s was here with its breakfast club awards—an excellent innovation.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

That being said, it is disgraceful that under this Government’s watch we have seen a 54% increase in children admitted to hospital with malnutrition. Instead of seeing malnutrition rising, we really should be eradicating it. As the festive period is upon us and it is the season for good will and giving, will the Minister give this House an assurance that he will seriously address this matter to ensure that no child in this country ever experiences malnutrition?

[Steve Brine]

Of course we want no child in our country to experience malnutrition. I mentioned the Healthy Start scheme and the breakfast clubs. Healthy Start is an excellent programme run by Public Health England that encourages a healthy diet among hundreds of thousands of families with children under four. It is exactly that which is helping us to tackle this issue.

Hormone Pregnancy Tests

Sharon Hodgson Excerpts

Thursday 14th December 2017 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning), who opened the debate so powerfully, and my hon. Friend the Member for Bolton South East (Yasmin Qureshi), who has been a strident campaigner on this issue for more than six years and knew all about it before it had even reached my consciousness. She gave an excellent, if rather too short, speech. I thank all other Members for their passionate and thoughtful contributions; because of the time constraints, I hope they will please forgive me for not naming them all. Ultimately, thanks must go, as others have said, to Marie Lyon, the chair of the Association for Children Damaged by Hormone Pregnancy Tests. I am sure that I speak for all of us in the House today when I say that she has the utmost respect and admiration of Members from across the House.

I want to touch on not only the science that was used to come to the conclusions in the review, but what is missing and what should have been considered before any conclusions were drawn. I will then highlight why this is a matter of injustice and why it is important that answers are found, so that we can finally conclude this sad chapter.

The main sticking point of the review’s conclusions is that the expert working group found that the science did not support a causal association between HPTs during pregnancy and adverse outcomes. My focus will be on the science used and the historical documentation that we are aware of, but which seems not to have been considered—we heard about some of it in the excellent speech by the right hon. Member for Kingston and Surbiton (Sir Edward Davey). I will not deviate into the important argument about “possible” and “causal”, as that was covered comprehensively by other Members, including the right hon. Member for Hemel Hempstead.

I must make it clear from the outset that I am no scientist—I am sure that Members are aware of that—and my speech is not a critique of the integrity and expertise of the specialists involved. However, the conclusions arrived at in the report and the conversations I have had with many of those who have been involved in the campaign show a need for us to be critical of what was concluded by the expert working group. That is our duty as Members of Parliament, especially when it comes to what is such an important matter for so many women and their families, and also because a great deal of public funds were invested in the review over the past few years.

In the report’s consideration of the scientific detail regarding HPTs, it is argued that there are inconsistencies in the conclusions drawn from the evidence used. Take, for example, the fact that of the 15 studies that looked at heart defects, 11 favoured a link, and of five studies into limb reduction, all found a link, yet those studies were deemed to show “insufficient evidence” of the drug’s harm. Even information I requested recently and got just this week from the Medicines and Healthcare Products Regulatory Agency in the lead up to this debate is at odds with the conclusions of the review, including graphs that plot birth defects against the availability of HPTs. Even to my untrained eye, they show a possible link. In one graph on all malformations, it is clear that birth defects increased during the period in which HPTs were on the market, and shortly afterwards. They began to decrease soon after HPTs were taken off the market.

Further, in the briefing I received, the MHRA said that for every 100 babies born in the general population, around two to four are expected to have a birth defect, which means that 14,000 babies a year would be expected to be born with a birth defect. That is just generally. Using those figures, the MHRA concluded that for the more than 1 million women who took HPTs, as many as 19,000 babies would be born with a birth defect, irrespective of any additional risk from HPTs. Yet let us compare Primodos to thalidomide, for instance. More than 30 million thalidomide prescriptions saw 600 children affected in the UK, which is a rate—I have had help with these numbers —of 0.002%. Some 1.2 million Primodos prescriptions were sold and 800 children were affected, which is a rate of 0.06%. That shows a much higher prevalence caused by Primodos compared with thalidomide. It also shows how little meaning a comparison of HPT adverse reactions has against today’s prevalence of birth defects in the general population, and it is hardly a defence of disproving a link.

As I have said, I am no scientific professional, but I believe that the red flags that arise when reading what the evidence says and what conclusions were drawn from it are not ones that only an expert in this field would see. This reflects the arguments that were raised last week by Dr Neil Vargesson—that the report does not provide definitive evidence that the drug was safe. As others have said, the only conclusion that can be drawn is that a link cannot be ruled out.

That leads me on to my next point, which is to touch briefly on the historical perspective and cover-up of the evidence. We have got to use that word—it is the only word we can use—as this is something that should have been considered by the expert working group.

One such example was in 1975, when the UK regulator knew of a potential five-to-one risk that the drug could cause deformities, but that evidence was apparently later destroyed. This is a running theme—I do not have time to go into it all—through the chronology of this scandal. We see multiple examples of suppressed information regarding the adverse effects and delayed notification of those effects to medical professionals who administered the drugs.

It is also deeply concerning that this drug came into the market in 1958, with no studies on its effects at all until 1963. Five years passed before it even underwent teratogenic testing. It was still officially in circulation until 1975, but we are aware of cases of its use up until 1978. All the evidence uncovered should have been considered as part of the review. The question is: why was it not?

With any scandal such as this, it is important that those affected have the trust and confidence of any review or inquiry undertaken. In this instance, that has not been the case. The victims feel that the review has muddied the waters even more and that their views have been ignored. I have been told many harrowing stories, many of which we have heard today, and how, time and again, they have been ignored. These women did not ask to be given HPTs. Nor were they ever made aware of the effects that they could have on them or their unborn baby. They were just given them—sometimes out of a supply in a drawer on the doctor’s desk. There were no warnings, no explanations, no discussions.

A great injustice has been inflicted on these women. It is up to this House to put pressure on the Government of the day, here and now, in a fully cross-party, non-partisan way, to make things right. It is paramount that a judge-led public inquiry be conducted—one that is independent and can fully examine all the materials and documentation available and insist that all information be made public, including that which has been withheld so far. I hope that this debate helps us to take that one step further to achieving that.

In closing, may I quote the hon. Member for Mid Norfolk (George Freeman), the then Minister for Life Sciences? In October 2014, when he instigated this review, he said that the review would

“shed light on the issue and bring the all-important closure in an era of transparency”.—[Official Report, 23 October 2014; Vol. 586, c. 1143.]

Let this debate and the following actions by the Minister ensure that what was promised in 2014 is actually achieved.