Jimmy Savile (NHS Investigations)

Tessa Munt Excerpts

Thursday 26th February 2015 Commons Chamber

[Mr Hunt]

I do believe that that is the case. I want to put it on record that Buckinghamshire Healthcare NHS Trust, which includes Stoke Mandeville, has made huge progress in turning round and improving its culture. It came out of special measures last year and the staff and management are to be congratulated. His constituents can be confident that, although things are not perfect, huge progress has been made to improve standards.

[Tessa Munt (Wells) (LD)]

I welcome the report. I support mandatory reporting and I look forward to seeing some serious progress in this respect. Staff and volunteers in all sorts of settings need the ability to report outside their organisation. Where the state is a corporate parent or a carer, or a provider of an extended home setting, it is important that young and vulnerable people can find some way of reporting outside. Is the Secretary of State willing to strengthen the role, in conjunction with other Secretaries of State, of the local authority designated officer? Already we know that people in schools and colleges can go to the LADO, but surely that is also appropriate for health and care settings, homes, prisons, the armed forces and anywhere else where there are young and vulnerable people. The benefit is that the LADO is perceived as independent and is someone outside the employer’s strict reporting guidelines. It would give a better chance for victims to be heard, action to be taken and lessons to be learned.

[Mr Hunt]

I am happy to look into that, but hospitals have a responsibility to go to the LADO if there is an incident affecting one of their volunteers or staff. The report makes it clear that they should exercise that responsibility with great diligence, but I am happy to look into the idea that patients should have that access as well.

Head and Neck Cancer

Tessa Munt Excerpts

Tuesday 1st July 2014 Commons Chamber

[Jane Ellison]

All dentists are trained as undergraduates to look for such signs during routine check-ups and to pay close attention to patients’ self-reported history of smoking and drinking—both key risk factors. A new patient pathway, currently being piloted in 94 practices, includes an oral health assessment, which requires dentists to examine the soft tissue of the mouth; assess a patient’s risk in relation to oral cancer; and offer advice on lifestyle changes.

I am also pleased to say that the General Dental Council has confirmed that improving early detection of oral cancer is to be included as a recommended topic in its continuing professional development scheme.

The hon. Gentleman will also be aware that the Department has run a series of “Be Clear on Cancer” campaigns, and we keep all forms of cancer under review to see whether they might be considered within that campaign. As he made the case that oral cancers and head and neck cancer are becoming more common, they too will be kept under review.

As I have mentioned in previous debates, the NICE improving outcomes guidance in head and neck cancer, which was published in 2004, provides advice on the organisation of health care for adults with those cancers. Head and neck cancer has also been referred to NICE as a topic for quality standard development.

The NICE guidance has informed the development of NHS England's service specification for head and neck cancer, which was published last summer. This clearly sets out what NHS England expects to be in place for providers to offer evidence-based, safe and effective services.

Of particular relevance to patients with oral cancer is the £23 million radiotherapy innovation fund, which supports the radiotherapy centres across England to deliver increased levels of intensity-modulated radiotherapy. That is a more precise form of radiotherapy, which reduces the risk of patients with oral cancers suffering from a permanent dryness of the mouth as a result of treatment.

[Tessa Munt (Wells) (LD)]

The hon. Lady refers to innovative radiotherapy and I wonder whether she is aware of how much work is being done on the indications suggested by my hon. Friend the Member for Mole Valley (Sir Paul Beresford)—I congratulate him on this debate. I also wonder whether NHS England does not recognise that this type of radiotherapy can be used for anything except lung cancer.

[Jane Ellison]

I know that my hon. Friend has ongoing concerns in some of these areas and I will certainly draw her comments to the attention of NHS England and respond to her after the debate, if that is acceptable.

Since October 2010, the cancer drugs fund has helped more than 50,000 cancer patients in England and cetuximab is available through the fund for the first-line treatment of advanced head and neck cancer when certain clinical criteria are met.

I would like to reassure my hon. Friend the Member for Mole Valley that the National Institute for Health Research clinical research network is recruiting patients to 34 studies of head and neck cancer, of which three are focused on HPV-associated cancer. The NIHR also funds 14 experimental cancer medicine centres across England with joint funding from Cancer Research UK. Two of those centres have a disease focus on oral cancer.

I should make it clear, as I like to in every debate that we have on any health condition, that the NIHR welcomes funding applications for research into any aspect of human health, including head and neck cancer. I would certainly encourage my hon. Friend to encourage those that he knows in research circles to come forward with projects for which they might like to seek funding.

I thank my hon. Friend once again for securing today’s debate. I hope that the discussion, although it has covered some familiar ground for him, has been helpful in providing reassurance of our commitment to reduce the incidence of head and neck cancer and to improve the outcomes for those diagnosed with the disease. In particular, I thank him for championing the cause as these cancers are less well-known and for that reason they particularly benefit from parliamentary attention of this sort. I will undertake to keep him fully informed, as I hope that I have to date, as the matter and the JCVI’s considerations progress. I will also undertake to draw the attention of the JCVI to the debate and to my hon. Friend’s speech in particular.

Question put and agreed to.

NHS Investigations (Jimmy Savile)

Tessa Munt Excerpts

Thursday 26th June 2014 Commons Chamber

[Mr Hunt]

I do not rule that out at all. If someone has behaved in a way that is in breach of either the law or the regulations that were in place at the hospital in which they worked, and there is a way to have legal redress such that things like pensions can be docked, I think that they should face the full consequences of that.

[Tessa Munt (Wells) (LD)]

Child sexual abuse is always abhorrent. The victims are always innocent and nobody should be above the law. At the beginning of this month, six Members and I wrote to the Home Secretary—now we are supported by a further 104 MPs—requesting an investigation by an independent panel into at least eight cases of child sexual abuse going back over 30 years, where the evidence has been lost or destroyed by the police, by Her Majesty’s Customs and Excise and by other agencies, and where the cases have therefore been stalled or abandoned altogether. To date, we have had no reply, so can I ask the Secretary of State to encourage the Home Secretary and the Education Secretary, and anyone who else who might be moved to take the matter on, to do so, and accept that such an independent investigation is essential to search out the truth and to make sure that action is taken after that?

[Mr Hunt]

I would like to reassure the hon. Lady that we have a Home Office committee, chaired by the Home Office Minister from her own party—the Minister for Crime Prevention, the hon. Member for Lewes (Norman Baker)—that is drawing together all the lessons from Savile across all Departments. It is then going to take that view as to what needs to happen next to prevent child sexual abuse, and I would like to reassure her that the Home Office and the Government as a whole have no higher priority than that.

Severe Eating Disorders (North-East England)

Tessa Munt Excerpts

Monday 23rd June 2014 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I congratulate the hon. Member for Newcastle upon Tyne Central (Chi Onwurah) on securing the debate and not only raising important issues about the provision of services for people with eating disorders in her constituency, but doing so in the context of an important national debate, because many of us are aware that there has not always been a genuine parity of esteem between mental and physical health. If we are to have a holistic health service that focuses on better supporting people in their own communities, mental health will play an important part. In the north-east and elsewhere, it is vital that we try, in the first instance, to prevent people who have anorexia or other eating disorders from becoming so unwell that they need to be admitted as in-patients. That clear priority is not mutually exclusive to this debate, because it is clearly what good medicine and health care—whether for physical or mental health—is all about.

Eating disorders mainly affect young people, and I shall say a little about that as I address the specific concerns in the north-east that the hon. Lady outlined. Anorexia particularly affects women under the age of 25, from the early teens onwards. Research tells us that there might be more than 1 million people in the UK who are directly affected by an eating disorder.

Worse still, as the hon. Lady highlighted, anorexia kills more people than any other mental health condition, and the longer a patient is unwell with anorexia, the more likely the condition is to be fatal. Even before people begin to lose weight, they are failing to put on the bone mass that will sustain them as adults, and the disease is linked to osteoporosis and other conditions in later life associated with bone fracture. As the disease progresses, it becomes life threatening, particularly due to the muscle wasting that occurs to the internal organs, especially the heart. There can come a point, sometimes quite quickly, when as muscle mass deteriorates, it is lost preferentially from the heart. That increases the risk of heart attacks, which can often, tragically, be the cause of death in such cases.

We are also aware that eating disorders afflict young women at perhaps the most formative period of their lives. The peak age of onset of anorexia is 15. For bulimia it is two or three years later. On average, people with anorexia will recover, if they recover at all, after about six years of care. That highlights the importance of good out-patient services in delivering better care. If we can stop people getting to the stage where they become so unwell with anorexia, with better support through talking therapies and other interventions as part of good community-based care, that is a clear priority for mental health services and one that commissioners are taking very seriously in the hon. Lady’s part of the country, as she outlined.

Eating disorders span the transition between child and adolescent and adult services. This has sometimes led to unacceptable variations in care and fragmented services, as we heard. So how do we deal with this? Early diagnosis is key. We have to make sure that treatment is available to minimise the effect of these distressing conditions. But alongside this, and perhaps before this, we need to attack the causes as well. Eating disorders are often blamed on the social pressure to be thin, as young people in particular feel they should look a certain way. In reality, the causes are much more complex than that.

There are several risk factors—having a family history of eating disorders; depression or substance misuse; being criticised for eating habits, body shape or weight; being overly concerned with being slim, particularly if combined with pressure to be slim from society or for a job; and having an obsessive personality or an anxiety disorder. Other key causes of eating disorders are sexual or emotional abuse, the death of people who are close and other stressful situations. There are also issues specific to particular eating disorders, which I will not go into today. There are clear differences between anorexia, bulimia and binge eating disorder. Binge eating disorder has the added complication of the binge eating cycle, leading to increased blood sugar and potential links to diabetes.

It is important that such disorders are not looked at in the context of the mental health service in isolation. When we know that the cause of death may often be due to cardiac arrest in the case of anorexia, and when we know that there may be links between binge eating disorder and diabetes, it is important that an holistic approach is taken to the care of people who become very unwell. There is a link between the physical and the mental health services that are available to patients, and I know from conversations that local commissioners are looking at that in the way they deliver care.

Last year, the Home Office launched a report of its body image campaign, which highlighted the need to ensure that young people have healthier and happier futures where a wider spectrum of healthy male and female body shapes is represented. I am sure we would all support that.

I assure the hon. Lady that children and young people’s mental health, particularly in the north-east, is a priority for the Government. That is why we have invested £54 million in the four-year period from 2011 to 2015 in the children and young people’s improving access to psychological therapies programme, or children and young people’s IAPT services. This provides training in a number of evidence-based psychological therapies, not just the more common cognitive behavioural therapy or CBT, but systemic family therapy and interpersonal psychotherapy.

Given the complexity of the causes of eating disorders, that more holistic basis to the way that children and young people’s IAPT services work to get early intervention in place, and the £54 million supporting that deployment in the north-east and elsewhere, will, we hope, make a difference in the years ahead. We must recognise that we are coming from a baseline where there was no parity of esteem in terms of how the NHS prioritised eating disorders or how the NHS commissioned services for eating disorders. This investment in that early intervention will bring real improvements to the quality of care of people with eating disorders in the north-east and elsewhere. We know that early intervention is key. It is also important that we get a firmer understanding of the scientific basis and the research that underpins good treatment. The South London and Maudsley NHS Foundation Trust has conducted a £2 million programme of research specifically on the treatment of anorexia, which will improve treatment and care throughout the country.

In the north-east, child and adolescent mental health services have been transformed by the introduction of the children and young people’s IAPT services, which I outlined earlier, in the areas covered by three CCGs, namely Teesside, Newcastle, Hartlepool, Middlesbrough and Easington. Between them, they commission CAMH services for 61% of young people in the region already under other CCGs, and the other CCGs have agreed to follow them. Steps are being made in early intervention, in providing better support for people with eating disorders in the north-east.

[Tessa Munt (Wells) (LD)]

I recognise the similarities between what is happening in the north-east and in the south-west. We have young people being discharged from services when they reach the 18-week threshold or because they have reached a body mass index of 18, yet the Minister has accepted that this is a complex condition which sometimes takes five or six years to recover from.

[Dr Poulter]

That is absolutely right, and it is important that there is a strong link between what happens in the community and what happens at the specialist centre. We know that there are advantages to commissioning specialist beds for eating disorders. We know that there is good evidence supporting the fact that that delivers better care for patients. But it is important that there is a strong link between that and what happens to the patient and the young person when they are discharged from that care, and that there is proper support in the community for those people afterwards. That is what will be supplied in this context by the newly commissioned services at Benfield House, which specifically focuses on providing high-quality day services and real support for young people and their families.

Pancreatic Cancer

Tessa Munt Excerpts

Tuesday 4th March 2014 Commons Chamber

[Tessa Munt (Wells) (LD)]

I congratulate the hon. Gentleman on securing this debate. I should like to pick up on what he said about NanoKnife—there is also CyberKnife and Gamma Knife. Those are all modern, stereotactic treatments for cancer. I hope that he agrees that we need to concentrate not just on the drugs but on those particular types of radiosurgery, which can make sure that people live longer if they are given the trials that they need.

[Eric Ollerenshaw]

The hon. Lady makes an important point. Our point is that because of the poor pancreatic cancer survival rates and its late diagnosis, which is the key, it always seems that the pancreatic cancer patient is last in the queue. The quality of life assessments do not look long enough to justify a new drug or new radiotherapy, as has been pointed out.

Again, I pay tribute to Pancreatic Cancer Action, which got a great deal of press from an advert, not used at the time, saying, “I wish I had breast cancer”. That was effective in raising publicity about the impact of pancreatic cancer.

I am trying to put whatever pressure the Chamber is capable of exerting on the cancer drugs fund when it makes its decision on Thursday and on NICE for what it does to follow. Providing Abraxane and an extra two months could help ease this year’s 8,500 tragedies and start the process of making up for 40 years of lost hope.

--- Later in debate ---

[Jane Ellison]

The hon. Gentleman has made that point in other contexts before, and it is a perfectly good one. Of course, health is a devolved matter, but as regards research and what we know about drugs, there are lots of aspects on which England has taken a lead and on which the devolved Administrations co-operate. I regularly have exchanges of letters with my opposite numbers. When there are important lessons to be learned on behalf of all our constituents, we would naturally share that information and expect it to be looked at in all parts of our United Kingdom.

Our priority is to make sure that we get the best possible results for all NHS patients with the resources we have. That is why we have asked NICE to look at how drugs are assessed to ensure that patients can get the treatments they need at the best value for the NHS, and that the price the NHS pays is more closely linked to the value a medicine brings. These can sometimes sound like quite cold decisions, but they are designed to help us to have a sense of objectivity in what are always very difficult decision-making processes. I assure my hon. Friend that NICE will carry out a full public consultation before implementing any changes in the way that it makes these assessments.

My hon. Friend referred to NanoKnife, which was also mentioned in an intervention. I am advised, I am afraid, that NICE has published guidance on that procedure which states that current evidence on the safety and efficacy of irreversible electroporation for treating pancreatic cancer is inadequate in quantity and quality, and it recommends that the procedure should currently be used only in the context of research.

My hon. Friend mentioned research funding. We are often asked about the amount of funding put into one area or another and I always like to make the point that, rather than specifying subject areas, the National Institute for Health Research welcomes funding applications for research into any aspect of human health. These applications are subject to peer review and are judged in open competition, with awards made on the basis of the importance of the topic to patients and the NHS, value for money and scientific quality.

I have no idea whether parliamentary interest is part of that mix, but I cannot believe that it hurts at all. Such issues come up regularly, and whenever I meet people from different health institutions and the NHS I always make a point about the things in which Parliament has shown a particularly keen interest to debate and progress.

[Tessa Munt]

Will the Minister give way?

[Jane Ellison]

I do not think I have time, sadly, but I would be happy to speak to my hon. Friend after the debate.

I hope it will be of interest that the Government are investing a record £800 million over five years in a series of biomedical research centres and units, including £6.5 million of funding for the Liverpool biomedical research unit in gastrointestinal disease, which has a major focus on pancreatic cancer. Some really interesting things are coming out of the opportunities for biomedical centres.

Recruitment to studies associated with pancreatic cancer by the NIHR clinical research network has also increased more than fivefold, from 447 in 2008-09 to 2,744 in 2012-13, which is another measure of the increased emphasis and interest.

I again pay tribute to my hon. Friend the Member for Lancaster and Fleetwood for his campaigning on this issue and the work he has done to raise its profile in Parliament, and to all hon. Members for the interest they have shown. As I have said, it is great to see such good attendance at this debate. That is on the record and it is of great interest.

[Tessa Munt]

Do NICE and similar organisations accept reviews and evidence from other countries, be they in Europe or America, when they deliberate and make considerations, or is it only home-grown evidence that counts? Is there an acceptance of the views of clinicians from other parts of the world?

[Jane Ellison]

I will, if I may, take my hon. Friend’s question away and respond to it formally. Obviously, it is a matter for NICE and I will make sure that I get an answer for her. My understanding, however, is that an awful lot of peer-reviewed research from all around the world is looked at and that it is the quality of that research that is taken into account. I will respond formally to my hon. Friend and make sure that I have that absolutely right.

In conclusion, I thank those who have participated in this important debate and those who have stayed to show their support for it, which is valuable. This disease remains very difficult to treat, but the Government will continue to work with patients and charities—which have done so much good work—and with researchers, the pharmaceutical industry and, of course, the NHS to improve results for people with pancreatic cancer and to see whether we can make more rapid progress than we have made in the past four decades.

Question put and agreed to.

Oral Answers to Questions

Tessa Munt Excerpts

Tuesday 14th January 2014 Commons Chamber

[Mr Speaker]

Last but not least and I hope with exemplary brevity, I call Tessa Munt.

[Tessa Munt (Wells) (LD)]

What steps is the Secretary of State taking to ensure that the number of cancer indications treated in this financial year by stereotactic ablative radiotherapy does not fall below the number of treatments delivered in the 2012-13 financial year?

[Jane Ellison]

That is an area that the hon. Lady and I have discussed at some length. I know that she feels strongly about it. We have meetings coming up to discuss it and I think that it would be easier to deal with her detailed points in those meetings.

Oral Answers to Questions

Tessa Munt Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Jane Ellison]

We have spoken to NHS England, which has advised me that it is not aware of any reason to think that the March 2014 will not be met. As my hon. Friend knows, however, the day-to-day management of CCGs is a matter for NHS England, and I am sure he would not approve of Ministers trying to micro-manage CCGs from Whitehall. His strength of feeling is clear, and I am happy to have an ongoing dialogue with him and the all-party group on this matter.

[Tessa Munt (Wells) (LD)]

Having heard the Minister’s answer on survival rates and the importance of early diagnosis, may I ask her whether cancer patients in need of life-saving treatment recommended by their clinicians who have waited for more than two weeks because of the commissioners’ delay in agreeing funding have the legal right to insist on being treated once they have gone past the two-week deadline? If so, how would they do that?

Oral Answers to Questions

Tessa Munt Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

There are problems, particularly in large cities and at weekends. In fact, in the case of the reorganisation of services at Trafford general hospital, one of the things that we can invest in as a result is mental health facilities in neighbouring A and Es so that people have better access to the services they need.

[Tessa Munt (Wells) (LD)]

The Secretary of State will be aware of the case of Nadejah, the face of the Teenage Cancer Trust, who at the age of 23 has been refused the CyberKnife cancer treatment that could save her life. Her mother Michelle is here today. Will he intervene so that this young woman gets the treatment that her consultant, Professor Hochhauser, recommends, and will he meet Nadejah’s mother and me so that we can work together to unblock the funding so that she can get the treatment she so desperately needs?

[Anna Soubry]

I am more than happy to meet the hon. Lady and the family but, as she knows, this is a treatment that we have talked about endlessly, and we have had many meetings, which I am more than happy to continue to have with her.

Oral Answers to Questions

Tessa Munt Excerpts

Tuesday 16th April 2013 Commons Chamber

[Anna Soubry]

We are building two new machines specifically to deliver that treatment. I accept that these things often take a long time, but those machines are planned. In the meantime, NHS England has made it clear that people who need this specific type of treatment can receive it overseas and it will be funded accordingly.

[Tessa Munt (Wells) (LD)]

Two years ago, the Prime Minister accepted the installation of CyberKnife as the latest in cancer radiosurgery equipment at the world-leading Royal Marsden hospital cancer centre. At the last Health questions, I asked the Secretary of State whether he would accept one of the countless invitations to visit the Royal Marsden. The consultant clinical oncologist has issued and reissued that invitation, but has had no response from the Department. Will the Secretary of State now please visit CyberKnife at the Royal Marsden?

[Anna Soubry]

I have to tell the hon. Lady that, as she knows, there is some controversy over this treatment, which is backed by a very large and powerful American company. The Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), has visited, and I know that the Secretary of State has an extremely busy and full diary. It is not as simple as a visit; it is all about whether there is any clinical value.

Oral Answers to Questions

Tessa Munt Excerpts

Tuesday 26th February 2013 Commons Chamber

[Mr Jeremy Hunt]

If the hon. Gentleman had listened to my previous answer, he would have heard that the regulations are consistent with the procurement guidelines that his own Government sent out to PCTs. It is not our job to be a champion for the private sector or the NHS sector; we want to be there to do the best job for patients. That is the purpose of the regulations.

[Tessa Munt (Wells) (LD)]

T4. Two years ago, the Prime Minister welcomed the installation of CyberKnife, the latest in cancer radio surgery equipment at the world-leading Royal Marsden cancer centre, as an example of how the NHS has progressed. Since then, the Royal Marsden has invited successive Health Ministers to visit the cancer centre but no one has accepted the invitation, and I am aware that Ministers have been to see other cancer treatment systems. Will the Secretary of State follow the Prime Minister’s lead and visit the Royal Marsden to see for himself the great progress that has been made there?

[Anna Soubry]

I understand that the Secretary of State has been to the Royal Marsden, but I am more than happy to accept the invitation and look forward to going along and seeing it for myself.