Pancreatic Cancer

Stuart Andrew Excerpts

Wednesday 23rd May 2012 Westminster Hall

[Eric Ollerenshaw]

The hon. Gentleman can obviously read minds, because that point about research is in my next paragraph. His other suggestion about a UK-wide strategy is a really interesting and positive one, because pancreatic cancer obviously does not respect any boundaries, or any devolved Government or national Government. So he makes an interesting point, which the all-party group can perhaps consider.

Effective cures for pancreatic cancer remain stubbornly elusive, but we need to try to find ways to prolong patients’ lives and to ease their pain and suffering, while always remembering that, with cancer, it is not only the patient who is affected but the people around them, including their family. Cancer affects not just one person; its effect spreads to other people. I had not entered the cancer world before my own personal experience—I call it a separate world, because it is like entering a separate universe that has never been experienced before. Patients’ loved ones also experience suffering.

[Stuart Andrew (Pudsey) (Con)]

First, I congratulate my hon. Friend on securing this very important debate. I know how personal this issue is to him. Linked in with the point that he has just made, does he agree that this issue shows why it is so important that we have a strong hospice movement in our country? That is because hospices have the expertise and are able to treat conditions such as pancreatic cancer with a holistic approach, so that it is not only the patient but the extended family and loved ones who receive support—support that they need, too.

[Eric Ollerenshaw]

My hon. Friend represents Pudsey, a Yorkshire constituency, so he says it like it is. I will go on to say something about hospices; what he said about them is true. In a sense, for a lot of families cancer is almost like the end. With pancreatic cancer, proper treatment is vital and nobody should underestimate the work of the hospice movement. As I say, I will go on to say a couple of things about hospices.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 27th March 2012 Commons Chamber

[Mr Lansley]

I will, of course, ask Janet if she will meet the hon. Lady and her colleagues, but I think the hon. Lady might have noted that the NHS is performing magnificently. The quarter document published just this morning gives details of 14 performance measures across the NHS, in five of which performance has been maintained and in nine of which there has been improvement, so there has been no deterioration in performance. When the hon. Lady gets to her feet she should say to the NHS, “Well done for improving performance.”

[Stuart Andrew (Pudsey) (Con)]

Currently, there is a review into paediatric cardiac services going on. I recognise that that is independent of Government, but we now have the independent analysis of patient flows, which says exactly what we have been saying—that patients in south and west Yorkshire will not go to Newcastle. Does my right hon. Friend agree that this is an important development and that the options should reflect that because this is a serious problem for heart services in the north of England?

[Mr Simon Burns]

I congratulate my hon. Friend on his persistent championing of his constituents, but sadly I cannot be drawn into a discussion about evidence, facts and figures that might come up around this issue, because as he will appreciate it is an independent review which is divorced from Ministers.

Care of the Dying

Stuart Andrew Excerpts

Tuesday 17th January 2012 Westminster Hall

[Stuart Andrew (Pudsey) (Con)]

There is a famous saying that only two things in life are certain: death and taxes. In the short time I have been in this place, it seems we have talked a lot about taxes, but very little about dying. I worked in the hospice movement for more than 12 years, and the hospices have a wonderful saying that they cannot add days to people’s lives, but they can add life to people’s days. That is the fundamental point to make.

I want to talk about children’s hospices. I spent most of my time working for Martin House, which is a children’s hospice in Yorkshire. Children’s hospices are very different from adult hospices. Having also worked in an adult hospice, I have been able to see the differences between the two. Caring for a child with a life-limiting and terminal illness is incredibly difficult. The whole family need support, not just the patient. One father I spoke to said that, if he got up eight times in the night to go to his child, he considered he had had a good night’s sleep.

Many people are frightened of using a hospice, because the view is that that is where we go to die. In my experience, however, things really are much better than that, because hospices are about living and making the best of difficult lives. I want to give two examples, although I will try to be as brief as possible. Two parents came to see me after their six-week-old baby suddenly died. They had spent five weeks in hospital unable to touch the baby, but when they went to Martin House, they were allowed to hold the child. As they put it, they were allowed to be parents, rather than carers. That really shows the wonderful work that the hospice did.

Another thing also made me realise that, for many people suffering from terminal illnesses, the important thing is life and the issues surrounding it. I and other staff from the hospice were interviewing a young man who used it as part of a promotional video, for want of a better term, to help raise funds. The head of care asked him what the most difficult thing was about having a life-limiting illness. In my naivety, I thought he would say it was the fear of dying and the fact that his life would be short, but he said it was falling in love. I could not quite understand that at first, but he said, “Who is going to love me if I have a muscle-wasting disease?” I suddenly realised that the hospice movement was about helping young people who face not only a difficult disease, but the emotional difficulty of not being able to live their life in the way we do. Hospices do so much work to make the very best of difficult lives. The holistic approach they offer—the respite care, the emergency care, the terminal support and the bereavement support we have heard about—is vital to the families that need them.

While I was working at the hospice, it needed to raise £4 million a year. We got only 6% of that from the PCTs, which, frankly, is not good enough. We really should spend a lot more on providing excellent care to ensure that those who are coming to the end of their lives have the very best death possible. When the Minister looks at providing money for hospices, I urge her to recognise that children’s hospices provide very different care from adult hospices.

Life Sciences

Stuart Andrew Excerpts

Monday 5th December 2011 Commons Chamber

[Mr Lansley]

My hon. Friend makes a very good point, and far be it from me to comment further. He explained very well the benefits associated with investment and developments in Edinburgh and how the universities, the pharmaceutical industry and the NHS are working together there. That is also happening in locations in England, and across the United Kingdom we are providing real opportunities for international investment in biosciences.

[Stuart Andrew (Pudsey) (Con)]

During my time working within the hospice movement, it was my privilege to meet many patients and families. They naturally wanted everything at their disposal that would extend patients’ lives or at the very least make them more comfortable. At times, they would feel frustrated that patients in other countries benefited from drugs before they could, even though they were invented here. What is the Secretary of State doing to try to rectify that problem?

[Mr Lansley]

My hon. Friend makes a very good point from his personal experience. It is precisely because we recognised that patients in Britain were not getting access to the latest cancer medicines as quickly as patients in other countries that we were clear at the election that we would introduce a cancer drugs fund. Since the introduction of the fund in October 2010, more than 7,500 patients have accessed new cancer medicines through it. The early access scheme that I have described will go even a step further in anticipating the successful, efficacious introduction of new medicines in a way that allows patients and clinicians sometimes to access medicines even before the point at which they are licensed.

HIV

Stuart Andrew Excerpts

Tuesday 29th November 2011 Westminster Hall

[Pamela Nash]

We can certainly campaign on the matter. I will be happy to discuss that with the hon. Gentleman outside the Chamber. He makes a very important point: this issue is not just about the NHS and the Health and Social Care Bill in England, but about achieving agreements with the other Assemblies and Parliaments in the United Kingdom to ensure nationwide consistency in the treatment and support for people living with HIV.

I shall now discuss public awareness in the UK. Twenty-five years ago, Lord Fowler led huge public health campaigns about the virus. Leaflets were sent to every household in the country and there were very visible television campaigns. However, public awareness of HIV has undoubtedly fallen during the past 10 years. For my generation, it is just not a priority any more. Despite the very high increase in the number of young women contracting HIV, when I speak to my friends about this issue I find they rarely regard themselves as at risk.

Unbelievably, earlier this year, an Ipsos MORI poll found that one in five people do not realise that HIV is transmitted through sex without a condom between a man and a woman, and the same proportion do not know that HIV is passed on through sex without a condom between two men.

[Stuart Andrew (Pudsey) (Con)]

I congratulate the hon. Lady on securing the debate. It is a shame that it is only a half-hour debate, because the last time that we debated the issue, we had an hour and a half, I think, and even that was too brief. The figures that she is giving now are shocking, certainly for my generation, who are getting older now. I remember the HIV debate and campaign that she refers to and how phenomenally successful it was and how aware we all were of the dangers. Something needs to be done so that the younger generation realise the very severe dangers of having sex without protection.

[Pamela Nash]

The all-party group has consistently campaigned for the Government to put more funding into another national 1980s-style campaign. I hope that today’s debate and the events taking place throughout the week will get the message across to the Government that it is necessary to have that style of campaign again.

An increasing proportion of adults—about 10% at the moment—incorrectly believe that HIV can be transmitted through impossible routes, such as kissing and spitting. That is not helped by scaremongering media reporting. There was recently a report in Edinburgh about a couple who, when being arrested by the police, had bitten a police officer. Both members of the couple were HIV-positive, and that was the primary headline in the Scottish media, much to my disappointment. Misinformation fuels stigma and discrimination, which are still a daily reality for many people living with HIV.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 22nd November 2011 Commons Chamber

[Anne Milton]

I assure the hon. Gentleman that we do recognise the value of nursery milk. The only shocking thing is that the previous Government presided over a scheme whereby nursery milk is now costing double the retail price, and we urgently need to look at that. We are committed to continuing the scheme, but shocked at what has gone on before.

[Stuart Andrew (Pudsey) (Con)]

T8. An independent study of the patient assumptions of the Safe and Sustainable review has confirmed what many of us already knew: that, contrary to the review’s claims, most families in Yorkshire and the Humber will travel not to Newcastle but to Leicester or Liverpool. Will my right hon. Friend seek confirmation from the Safe and Sustainable review body that it will revise its options in the light of that new evidence?

[The Minister of State, Department of Health (Mr Simon Burns)]

I am grateful to my hon. Friend and I have heard the important point that he has made. No doubt the Joint Committee of Primary Care Trusts will also hear the point that he has made to me. I am sure that he understands that it would be totally inappropriate for me to give any view that might compromise the independence of Ministers on this independent review.

Ovarian Cancer

Stuart Andrew Excerpts

Wednesday 12th October 2011 Westminster Hall

[Stuart Andrew (Pudsey) (Con)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. It has been a good many years since I last did so, when I was chairman of the Welsh Young Conservatives and you were chairman of the national Young Conservatives. I am grateful for the opportunity to raise this important subject. I am conscious that many hon. Members wish to contribute, many of whom have personal and constituency experience of the disease. It is important to hear from as many of them as possible, so I shall make my opening comments as brief as I can.

My personal experience of the effects of ovarian cancer occurred some 40 years ago, and it meant that I never knew my grandmother. In her 50s, she suffered from the disease, which sadly took her life in my first year of life. She was buried on my first birthday. Clearly, at that age I was too young to know, but she was, by all accounts, a truly wonderful lady and, due to the cruel nature of the disease, her death was a loss that impacted on my family for many years.

Some 40 years on, I was elected a Member of Parliament in 2010, and like all new MPs, I am sure, I felt somewhat overwhelmed when I came to this place. What staggered me more than anything was the volume of invitations that I received from many different charities. One stood out—that from Target Ovarian Cancer. It stood out because it informed me that a constituent would be attending a reception, and because of the impact that the disease had had on my family.

I worked in the charity sector for 16 years and, as I was involved in politics, I thought I knew how to get to Members of Parliament, but I realised how wrong I was when I saw the volume of correspondence that I received. I thought it clever of Target Ovarian Cancer to make its invitation personal by bringing a constituent down here. In June, I attended that reception and had the opportunity to meet my constituent, Chris Shagouri. She is one of those people with whom one instantly clicks; she is inspirational. I listened to her speak about how late diagnosis of the cancer had impacted on her, her husband and her family. She talked about her ongoing battle to keep the disease at bay, and it is clear that she has great determination, but it was easy to wonder how much easier it might have been had the diagnosis been made earlier.

As the reception continued, I heard, time and again, moving stories from other women about their experiences. That and Chris’s persuasive manner convinced me to support the all-party group on ovarian cancer, which was being set up.

Sadly, diary clashes have restricted the number of meetings that I have been able to attend, but it is impressive that they are regularly attended by women who reinforce over and again the message that early diagnosis is necessary. At the most recent meeting, we heard again from women from throughout the UK about their experiences. At the most recent reception, four women gave personal accounts of their problems, which motivated me to bid for this debate. I am grateful to have been given that opportunity.

Ovarian cancer is not rare. It is the fourth most common cause of cancer death in women after breast, lung and bowel cancers. Every year, some 6,500 women are diagnosed and, staggeringly, 4,400 die every year. Just 36% of women who are diagnosed survive for a further five years. Those figures are staggering, compared with more than 80% for those who suffer breast cancer. It is also staggering that in three quarters of women who are diagnosed, the cancer has already started to spread. Those figures are scary.

The holding of this debate prompted someone to contact me this week. They wrote:

“My mother died aged 67 in 2009 with Ovarian Cancer. By the time she was diagnosed, the cancer wasn’t in the early stages and she was given only a 2% chance of living for 5 years. She fought all the way with various treatments and lived for 7 years after diagnosis.”

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on raising the issue. As he rightly said, every one of us can relate to a constituent or family member with the disease, and most people are aware that the cancer is hereditary or genetic. Does he believe that whenever someone is diagnosed with ovarian cancer there should be immediate checks on other family members—sisters, nieces, and daughters—to ensure that the hereditary effect is not passed on? Does he believe that that should be done quickly after diagnosis?

[Stuart Andrew]

I am grateful for that intervention. I agree absolutely that anything we can do to ensure early diagnosis of conditions can only help. In the long term, it is better for the individual concerned, and certainly better for the rest of the family, who go through equal concern.

[David Simpson (Upper Bann) (DUP)]

I congratulate the hon. Gentleman on securing the debate. Not long ago in my constituency, we ran an event to raise money for ovarian cancer treatment. An astounding finding was the number of young women aged 18 to 25 who are affected. I was astonished, because my impression had been that the disease affected older women, but it seems to be on the rise among younger women and is known as the silent killer. Does the hon. Gentleman agree that early intervention is vital? That could be done with blood tests, which some GPs have called for, and perhaps in schools, to identify this tragic killer of women.

[Stuart Andrew]

The hon. Gentleman makes an important point. I will talk about early diagnosis, which is crucial, as is awareness—making people aware of the symptoms. That is crucial in the campaign to fight this terrible disease.

I return to the letter that I was quoting from, which is relevant to the point that the hon. Gentleman made:

“I really hope the message regarding this disease can increase, as I wouldn’t want anyone else to suffer as my mother did. If she had gone to her GP straight away when she presented with symptoms and the GP acted straight away, then she may still be with her family, who miss her so much.”

That is a powerful testament to the problem that the disease causes.

According to figures from the National Cancer Intelligence Network, only pancreatic cancer involves a higher proportion of people diagnosed with the late stage of the disease. but with ovarian cancer, unlike pancreatic cancer, we know what the symptoms are. That was not always the case. The hon. Gentleman referred to it as the silent killer, which is often how it is referred to, but in most cases the symptoms go unrecognised for some time by the women or their GPs. It is alarming that Target Ovarian Cancer has found that one third of women waited six months or more after visiting their GP for a correct diagnosis. That is staggering.

The National Institute for Health and Clinical Excellence has published guidance on the recognition and initial management of ovarian cancer, and listed symptoms such as persistent bloating or increased abdominal size, abdominal or pelvic pain, difficulty eating and feeling full quickly, and the need to urinate more frequently. If women experience such symptoms frequently, particularly more than 12 times a month, they should undergo tests.

[Ian Paisley (North Antrim) (DUP)]

Under NICE guidelines, the first thing that should be done is a CA 125 test. Is the hon. Gentleman concerned that there are apparently restrictions on a GP’s ability to obtain that test for their patients, and importantly that there have been attempts block those tests from being carried through to pathology laboratories? The CA 125 test is the one thing that can spot the disease and increase the possibility of early diagnosis and greater chances of success.

[Stuart Andrew]

I am grateful for that intervention, which proves the need for the debate. I hope that we can take forward many of the issues raised today to try to tackle the disease. The hon. Gentleman’s point is incredibly valid and important.

NICE’s information is a step forward because it offers women, and importantly GPs, the chance to distinguish between ovarian cancer and more common but less serious conditions such as irritable bowel syndrome, which is the most common misdiagnosis. The ovarian cancer awareness measure, which is an accredited tool used by Target Ovarian Cancer in its pathfinder study, showed that only 4% of women felt confident of spotting the symptoms of the disease, and just 9% were aware that persistent bloating is the most common symptom of ovarian cancer. Compare that with 76% of women who recognise that a lump is the most common symptom of breast cancer.

[Kevin Brennan (Cardiff West) (Lab)]

Does the hon. Gentleman agree that because of the specificity of the symptoms of ovarian cancer, there is a case for a specific campaign to raise awareness of the disease, rather than relying on a generic campaign, which is the approach that the Government have tended to favour so far?

[Stuart Andrew]

The hon. Gentleman is in danger of stealing my thunder, but I am glad that he has emphasised my point before I have made it.

[Iain Stewart (Milton Keynes South) (Con)]

I congratulate my hon. Friend on bringing this important matter before the House. He is right to highlight awareness, but there is also the need for better information for women and their families following diagnosis. A close relative of mine was diagnosed with the condition, but there was a lack of knowledge of where to find more information about it. That led me and others to look online at a condition that was similar, but had a very different five-year survival rate. That caused a lot of unnecessary anguish to close family members.

[Stuart Andrew]

My hon. Friend raises a valid point. I worked in the hospice movement for about 15 years, and time and again we heard from parents of children at the hospice or patients in the adult hospice that when they were told of their disease, they almost went blank; they heard not the rest of the information, but just the dreaded diagnosis. It is crucial that people are given as much information as possible to take away and digest later.

As I said, 76% of women recognise the most common symptom of breast cancer, but there is clearly a lack of understanding about the significance of symptoms that they may experience due to ovarian cancer. Furthermore, GPs are not picking up the disease quickly enough. Just 22% of women are urgently referred to the two-week cancer referral route, and the rest are either sent away, or treated or referred inappropriately. Late diagnosis has been identified by the cancer benchmarking study, funded by the Department of Health, as a key driver for the poor ovarian cancer survival rates. That study seeks to understand the differing survival rates between countries for breast, lung, bowel and ovarian cancer. For some reason, despite the findings, ovarian cancer was the only cancer in the study not to be included in subsequent awareness campaigns. A large majority of women who are diagnosed in the later stages of the disease will experience recurrences, and many will develop resistance to chemotherapy.

My constituent, Chris Shagouri, is undergoing treatment yet again to try to slow the progress of the disease. Her strength and commitment to help to improve the lives of women who are diagnosed with ovarian cancer is amazing, especially when she could be forgiven for wanting to concentrate her efforts on herself and her close family. Chris Shagouri is representative of the many women who have attended meetings of the all-party group on ovarian cancer, and who share a determination to change the status quo. They often say that if just one woman gets a quicker diagnosis it will have been worth it, because for that woman this really is a matter of life and death. I hope that we can reach a better total than just one woman.

Treatments for ovarian cancer are highly intensive and invasive. An American study showed that, compared with women who have breast cancer, those with ovarian cancer spend nearly 10 times as long being treated in hospital in the first year after diagnosis and the last year of life. There have been no new life extending treatments for women with ovarian cancer during the past 20 years.

Why do members of the all-party group on ovarian cancer want to have this debate? Because we feel that, right now, an important opportunity to make much needed progress is being overlooked. I welcome the Government’s work, and commend them for it, with the cancer drug fund and the palliative care strategy —it was long overdue. In January, the Government published their new cancer strategy, which contained a strong commitment to improving early diagnosis and a multimillion pound investment in cancer awareness campaigns—fantastic stuff. It initially included regional breast, lung and bowel cancer campaigns, and recently we have heard that a national bowel cancer awareness programme will be rolled out next year, following the success of the pilots. New campaigns on oesophogastric cancers, and kidney or bladder cancer, will be run at a local level. The all-party group remains frustrated that ovarian cancer is not included in that admirable work.

The Government are committed to saving more than 5,000 lives a year from cancer by 2014-15, and women with ovarian cancer could represent 10% of that figure. Each year, up to 500 women lose their lives unnecessarily to ovarian cancer because we do not do as well as other European countries. The Government’s study showed that late diagnosis is a key driver of deaths from ovarian cancer in the UK, and it is curious that the condition was not included in the awareness campaigns in this country.

Why can an awareness campaign on ovarian cancer not be started now, even in pilot form? We applaud the Minister for the commitment to improve people’s chances of surviving cancer, but urge him to include ovarian cancer in the awareness work that is being done. Every day we wait, another one or two women, like my grandmother or such as Chris Shagouri, and many others who have been campaigning will lose their lives unnecessarily. As a matter of urgency, I ask the Minister whether he will consider an awareness campaign and whether he will meet with representatives from the all-party group on ovarian cancer to discuss how we can take such a campaign forward and stop other women suffering in future.

Congenital Cardiac Services for Children

Stuart Andrew Excerpts

Thursday 23rd June 2011 Commons Chamber

[Stuart Andrew (Pudsey) (Con)]

I beg to move,

That this House notes the review led by the Joint Committee of Primary Care Trusts into the reconfiguration of children’s heart surgery; welcomes its aim of establishing a more sustainable provision of congenital cardiac services in England which has strong support from professional associations and patient groups; notes that concerns have been expressed during consultation on the proposals; calls on the review to take full account of accurate assessed travel and population projections, the views of ethnic minority communities affected, evidence supporting the co-location of children’s services, and the need for patients and their families to access convenient services; and therefore calls on the Joint Committee not to restrict itself to the four options outlined in the review but instead to consider further options in making its final recommendations.

I thank the Backbench Business Committee for allowing us the opportunity to hold this valuable debate. I apologise to the Committee and the Clerks for taking so long to table the motion, but I feel passionate that it is right to get a motion that has the effect that we want. I have probably learned more this week than in the past year, and if I have not got it right, I am sorry. I also thank the hon. Member for Scunthorpe (Nic Dakin) and my hon. Friends the Members for Oxford West and Abingdon (Nicola Blackwood), for Leeds North West (Greg Mulholland) and for Winchester (Mr Brine), who have helped me through the past week.

This debate is timely, as the consultation by the review of children’s heart surgery around the country will come to an end soon. I completely agree with and support the professionals and patients who say that the review of congenital cardiac services is needed. Of course, we all want what is best for our children, and we want the best centres in the world. It is absolutely right and necessary that we learn from past mistakes in other units, but serious concerns about the process have been raised with me by clinicians and parents. I believe that it is my duty and that of others to scrutinise the review if we feel that there are problems.

There have been accusations that this has been turned into a political campaign. I stress that I have been keen not to make this a political campaign, and I have been incredibly impressed by the cross-party support of the Members from across the country who have been helping us. We will hear from other Members from all over the country—the debate is not just about the unit in Leeds—but I want to highlight the fact that my concerns relate to the review and not just to one centre. Although I will naturally refer to Leeds to highlight examples, I am sure that other Members will highlight similar problems with the review and relate them to their units. I am keen that the campaign does not set one centre against another, but that they are all considered equally.

I want first to deal with what I perceive as the flaws in the review. That is my main concern. From speaking to patients and families, I know that that has made them lose confidence in the review. We would all agree that public confidence in the review is important. The review has stated that the objective is to have centres that perform 400 procedures a year. The first version of the pre-consultation business case showed that patients from Doncaster and Sheffield would travel to Birmingham. That is absolutely right and in line with advice from the Yorkshire and Humber specialised commissioners, but in version 2 and the consultation options, the flow had changed to Newcastle. I understand that that helps the Newcastle figures, but I and anyone else who knows the area would surely question the likelihood of that happening. Far more plausible is that people would go to Birmingham or Leicester. What happens to Newcastle then? In addition, one of the options—the 400 minimum procedures—is not even met. The JCPCT explains that that is due to new patient flows.

At a number of centres, activity has increased in the past year. For example, Leeds is now doing 370 procedures a year, but in the pre-consultation assessment it was not afforded the same consideration as other centres that carry out similar numbers of procedures. Furthermore, the health impact assessment had not been completed before the final options were presented for consultation. The independent company undertaking that work said that this was not the usual approach taken in large reconfiguration proposals. That means that the public will have no access to the findings during the consultation period.

An issue that affects the black and minority ethnic community is that until 24 May the consultation questionnaire was available only in English and Welsh. As a Welsh speaker, I approve of having a Welsh version, but it was not until 12 weeks after the consultation began that the questionnaire became available in other languages, leaving just five weeks for the community to respond. In Leeds, more than 20% of the patients come from the BME community, so this is an important issue that needs to be addressed.

Finally, on the flaws, yesterday when the Safe and Sustainable team were here, we heard them say that co-location of services, in their view, meant anything up to 10 minutes away, yet the British Congenital Cardiac Association issued a statement on 18 February 2011, two days after the release of the business case, to clarify its professional view of the importance of co-location. I believe this demonstrates the BCCA’s dissatisfaction with the review’s interpretation of co-location.

[Julian Smith (Skipton and Ripon) (Con)]

My hon. Friend refers to a meeting of the steering group with MPs yesterday. Does he agree that it was a slightly strange meeting and that there was a significant degree of defensiveness on the part of the steering group?

[Stuart Andrew]

That is a very good description of the meeting. I agree with my hon. Friend. If nothing else, it is good that this debate got the review board to come to Parliament and speak to MPs so that we could express our concerns.

On the case for Leeds specifically, as I said a moment ago, co-location of services is considered crucial by the BCCA. In Leeds we have one of the largest children’s hospitals in the country. A considerable amount of time has been spent bringing all the children’s services under one roof at Leeds General infirmary. The centre serves a population of 5.5 million. I cannot understand why the option has not been considered for Leeds when it has been considered for centres in Birmingham and Liverpool. Yorkshire has a growing population and a growing BME community. As I said, 20% of the patients come from that community. It is crucial that we take account of population numbers when considering the review.

How we care for all those families is also important. When I worked at Martin House children’s hospice, it was not just the care of the poorly child, but the care of the whole family, that was important. When people have a very poorly child, they want their family to be together. It has been said that parents will travel anywhere. Of course they will, but does that mean that we should make them travel when there could be alternatives?

The Yorkshire and Humber congenital cardiac network board has a well-established network model, is regarded as an exemplar in this country and is held in high regard across the region by both the professionals and the patients involved in the service. Although this was recognised by Sir Ian Kennedy’s expert panel and Leeds Teaching Hospital Trust was awarded the maximum score for networks in that assessment, the JCPCT, as part of the scoring of options for future configuration of centres, gave all potential networks the same score. It is unclear why a proven track record of delivering an exemplary network model was not considered an important factor in the ability to deliver this across a larger population and greater geographical spread in the future.

On the requirement for a minimum of 400 operations, Leeds delivered 316 cardiac operations in the 0 to 16-year-old group in 2009-10 and 372 in 2010-11. The process of recruiting a fourth surgeon is under way. By the time the review’s recommendations are implemented, Leeds Teaching Hospital Trust will deliver the minimum number of operations, which is 400, and it will have the minimum number of surgeons, which is four, that the standards require from within the current population base. Equally, Leeds Teaching Hospital Trust has provided detailed information to the Safe and Sustainable team for expansion of the current service, should it be required to deliver a change in capacity to support patients from a centre that does not get designation.

The review said yesterday that the debate is not about current services. It is about what will be provided in the future. The figures that I have cited show that Leeds’ case for being a centre caring for more than 400 patients is strong. Many patients and particularly clinicians have pointed out to me that it seems odd that we are having a review of children’s heart services without referring to adult services. Many of those patients will be the same: those children will grow up, and the doctors who perform the operations are often the same people caring for both groups, so why are we not looking at adult services now? It has been suggested that that review should come later, but if we have made decisions about children’s heart surgery, surely we have pre-empted what might happen in the future.

[Greg Mulholland (Leeds North West) (LD)]

I thank my hon. Friend and neighbour for giving way. Going slightly further on his last point, does he realise that if those surgeons are no longer there, they will not be able to perform operations on adults? Adult surgery would be very detrimentally affected.

[Stuart Andrew]

I could not agree more. My hon. Friend is right; if we have a review of children’s cardiac services, surely we must consider what will happen to adult services. We should be talking about that now.

I could go on much longer and talk about the cases of various parents whom I have met, but I know that other hon. Members will do that, probably far more eloquently than I could. I am keen that the motion is supported because I want it to send a clear message to the review team that we are asking it to consider all the points that will be made today and all the points that have been made by the campaigns across the country. It was a privilege to go to Downing street the other day with children, patients and clinicians from the Leeds centre to present a petition of more than 500,000 names. That is a significant petition by anybody’s standards and a credit to that campaign.

I am concerned that after consideration of the consultation responses, it will be difficult to respond to all the evidence by pigeon-holing them into the four options in the review. That is why our motion today urges the joint committee not to restrict itself to those four options and instead to think outside the box, as they say. Let us look at a different proposal that delivers the services and the quality that we want and also takes account of all the responses that we have received.

Finally, I want to pay a personal tribute to all the families and campaigners, especially in Yorkshire and the Humber. In all the campaigning that I have ever done, I have never seen such a well-organised and dedicated campaign. The subject is sometimes emotional, but the responses that have come from patients across Yorkshire shows that there can be an alternative that delivers the services that we want. I hope the House will support the motion.

[Several hon. Members]

rose—

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[Greg Mulholland]

It would be very worrying if the extraordinarily overwhelming views expressed by people were ignored, but of course the clinical view is vital, and, as I have said, many clinicians have a problem with the flaws—clinical flaws—in the review.

[Stuart Andrew]

My hon. Friend mentioned the co-location of services. As I said in my speech, Leeds has spent considerable time ensuring that all children’s services are under one roof. If we lost the heart unit there, might not other services be affected as well?

[Greg Mulholland]

I have not yet had a chance to congratulate my hon. Friend on the way in which he has co-ordinated our campaign. It has been a pleasure to work with him so closely, and I look forward to continuing to work with him and other colleagues. He is right: one of those serious flaws is the failure to consider the impact on adult heart services, which would be a huge problem.

There is real concern out there, as has been demonstrated not only by the petition in Yorkshire and petitions in other parts of the country, but by the views expressed by many respected practising and retired clinicians. The concern about the closures is understandable, but there is also concern about the review itself. There is concern about the process, about the conclusions reached so far, about the lack of consistency in the recommendations, about the lack of logic in relation to the premise of the review, and, I am sorry to say, about a lack of impartiality.

That is why it is right for the House to have an opportunity to express that concern on behalf of all the areas concerned, and why it is fitting that the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), is present. I thank the Minister for the way in which he has engaged with us, and I urge Members in all parts of the House to support the motion, so that we can address the concern that has been expressed outside and inside the House by considering the possibility of other configurations.

I wish to echo three points that have been made about the wonderful Leeds unit. The first is about the co-location of services. The unit is a case of true co-location, which is what the British Congenital Cardiac Association has called “gold standard” care. Leeds is currently one of only two hospitals shown in the review to have such a type and level of service. Mr Joe Mellor, a consultant anaesthetist at Leeds, says:

“What is particularly upsetting about the proposals is that our patients from Yorkshire would leave the Leeds unit and have to travel to Newcastle or Leicester. Leeds has centralised all its children’s services onto one site. Neither Newcastle nor Leicester have come close to achieving this. Congenital cardiac surgery is a very complicated form of medical treatment. If in Leeds we encounter a problem where the child needs the help of an intestinal surgeon, or a neurosurgeon, or need renal therapy, or a host of other possible therapy, then we get it immediately in our own children’s hospital.”

Jonathan Darling, a consultant paediatrician at the Leeds General infirmary, states:

“To lose heart surgery from the Leeds Children’s hospital would be a huge blow, especially when we have just centralised services precisely to realise the benefits of having all paediatric services co-located on one site. The Review process does not seem to give sufficient weighting to this true co-location.”

I am afraid that it simply has not done so, which is worrying and quite extraordinary.

The second point that I wish to make is on the issue of population, which colleagues from the region have already raised. It simply makes no sense to close a wonderful unit that is already performing almost the number of operations that it must, when there are so many people in the area and the population is growing. I echo the comments of the hon. Member for Leeds East (Mr Mudie) when I say that of course we do not want to see the Newcastle unit close. We do not want to see any unit close, because this is about getting things right. However, I say to him and others that it would be absolutely perverse to close Leeds simply to enable Newcastle to perform a sufficient number of operations. If we stick to the number in the review, Newcastle can only perform that number of operations if Leeds closes. That is absurd.

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[Pat Glass (North West Durham) (Lab)]

I do not have a children’s heart unit in my constituency. I do not even have one close by. There are parents in my constituency who are 50 miles from the nearest unit, but they tell me that they do not care about that. They would travel to the ends of the earth to get access to the best provision. That is what matters to them, not having somewhere on their doorstep.

[Stuart Andrew]

I have to take issue with that. The parents I have spoken to are very concerned that they might have to travel. Of course they will travel as far as they have to, but if we can provide a service closer to their homes, should we not strive for that?

[Pat Glass]

They are saying that because they have a unit on their doorstep now. We do not all live in big cities, and some people have to travel a long way. Parents tell me that what they want is the best services, and even if they have to travel to get them, that is what comes first. Travel and access are issues to consider, but every parent who has contacted me has confirmed that the most important thing for them is that their child gets access to the best provision available, and to surgeons who carry out these complex operations a couple of times a week, not a couple of times a year. They tell me that they will go anywhere to ensure that their child gets the best chance of surviving and that their condition improves.

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[Catherine McKinnell]

The hon. Gentleman has put his thoughts and concerns issue on the record.

I mentioned the intentions of the Safe and Sustainable review, which was instigated by national parent groups, NHS clinicians and their professional associations. Those intentions must be the primary drivers in deciding the final outcome of the review.

I am equally concerned at suggestions that the decision and outcome of the review should be stalled, or that the remit should be altered. I am not alone in expressing such concerns. The Children’s Heart Foundation argues that that would leave

“the door wide open for another Bristol Baby tragedy”.

Meanwhile, the charity Little Hearts Matter believes that the Safe and Sustainable service reconfiguration offers—

[Stuart Andrew]

Will the hon. Lady give way?

[Catherine McKinnell]

No, I will not.

Little Hearts Matter says:

“The Safe and Sustainable Service reconfiguration offers a monumental opportunity to ensure that every child with a heart problem has access to the best heart surgery service that this country can offer—a gold standard service.”

I urge anyone in a position of influence, including hon. Members, to support that step forward, and not to halt the process because of personal bias.

A number of hon. Members are concerned about the co-location of children’s services. However, it is important to note that during the development of the £100 million new Great North Children’s hospital at the Freeman’s sister hospital, the Royal Victoria infirmary, a deliberate decision was made to retain children’s heart services at the Freeman, aligned with the world-renowned adult heart services there.

Services that simply did not exist 20 years ago have created a new generation of adults needing care, and the service at the Freeman allows for a seamless transition into adulthood. Of course, services at the Great North Children’s hospital are available to the Freeman in a matter of minutes—throughout the review process, they have been recognised as though they are on the same site.

In conclusion, I am not asking those who will make the final decision to give special treatment to the children’s heart unit at the Freeman, or indeed to the people of Newcastle and the north-east. I am all too aware how difficult this process has been for all children’s heart units under consideration. Each is valued and each has a great story to tell. However, I am asking that the decision is made on the grounds of clinical excellence and the quality of services that are currently provided, and on those grounds alone. I urge that a decision on the future of children’s congenital cardiac services is not put off or prolonged, because the safety of babies and children in need of heart surgery should be paramount in this debate.

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[Stuart Andrew]

I thank everyone who has taken part in this debate, which I think all will agree has been very good and knowledgeable. Members have spoken passionately in favour of their units. The right hon. Member for Newcastle upon Tyne East (Mr Brown) and the hon. Members for North Durham (Mr Jones) and for North West Durham (Pat Glass) spoke passionately in favour of the Freeman hospital. The right hon. Member for Oxford East (Mr Smith), the hon. Member for Southampton, Test (Dr Whitehead) and my hon. Friends the Members for Isle of Wight (Mr Turner), for Poole (Mr Syms), for Meon Valley (George Hollingbery), for Winchester (Mr Brine), for Oxford West and Abingdon (Nicola Blackwood), for Salisbury (John Glen), for Romsey and Southampton North (Caroline Nokes) and for East Hampshire (Damian Hinds) spoke in favour of Southampton. My hon. Friend the Member for Chelsea and Fulham (Greg Hands) spoke for the Royal Brompton—I do not think I am going to get through all these.

The fact is that this debate has got to the heart of the matter. We have discussed the issues that parents and patients have been talking about, but also the concerns that clinicians have been talking about. It is important that we hear those. We heard concerns that if this review does not happen, there could be another Bristol baby tragedy. However, it was reassuring to hear that the units we have are safe. We just need to make them sustainable.

In conclusion, this has been a most excellent debate. I am sure that the Safe and Sustainable team have been listening to Members on both sides of the House. Above all, what has been brilliant about the debate has been the reassurance from the Minister that the Safe and Sustainable review is now flexible over the options and should be flexible over the number of units. That will mean a lot to the people who have been campaigning so hard on this issue, and it shows that a Backbench Business debate can work and make a real difference.

Resolved,

That this House notes the review led by the Joint Committee of Primary Care Trusts into the reconfiguration of children’s heart surgery; welcomes its aim of establishing a more sustainable provision of congenital cardiac services in England which has strong support from professional associations and patient groups; notes that concerns have been expressed during consultation on the proposals; calls on the review to take full account of accurate assessed travel and population projections, the views of ethnic minority communities affected, evidence supporting the co-location of children’s services, and the need for patients and their families to access convenient services; and therefore calls on the Joint Committee not to restrict itself to the four options outlined in the review but instead to consider further options in making its final recommendations.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 26th April 2011 Commons Chamber

[Mr Burns]

I am afraid that I do not accept the premise of the question. May I tell the hon. Gentleman that this Government are not seeking and will not ever seek to privatise either the whole of the NHS or an individual trust? St Helens and Knowsley Teaching Hospitals NHS Trust is, like all other health trusts, currently agreeing plans to achieve foundation trust status by April 2014. That involves ongoing discussions with the North West strategic health authority and the Department of Health to determine the issues the trust faces and the actions needed to address them.

[Stuart Andrew (Pudsey) (Con)]

May I join my hon. Friends the Members for Leeds North West (Greg Mulholland) and for Shipley (Philip Davies) in supporting the children’s heart unit in Leeds? If the review fails to take full account of, and reflect on, the issues raised, what steps will the Secretary of State take to ensure that that is done so that we can fully understand the problems that would face families in Yorkshire?

[Mr Lansley]

I understand my hon. Friend’s concern and that of colleagues in other locations across the country. If—I repeat the “if”—the consultation were not to arrive at what he or others in any specific location regarded as justified conclusions, it would be open to them, as this is a service reconfiguration of the NHS, to seek a referral of the proposal to me as Secretary of State.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 8th March 2011 Commons Chamber

[Mr Lansley]

I would be grateful if the hon. Lady conveyed my very best wishes to the women of Darlington on international women’s day and said to them that I know from my visits to the north-east that a general practice-led commissioning pathfinder consortium has come together in their area. It is with that consortium and their local authority that they should look at which services they think should be provided in their area, and they will have the power to make that happen.

[Stuart Andrew (Pudsey) (Con)]

What plans does my right hon. Friend have to increase the number of single rooms in the NHS? Increasing their number will help to tackle mixed-sex accommodation, and increase privacy and dignity in end-of-life care.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

I thank my hon. Friend for that question. As was said earlier, privacy and dignity are central to all the care that we provide in the health service. Mixed-sex accommodation was not tackled by the previous Government; we are determined to tackle it now, and providing single rooms is part of that. Privacy and dignity must be maintained at all times.