Regulation and Inspection of Funeral Services
Tessa Munt Excerpts(1 day, 20 hours ago)
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Simon Hoare
I want to draw my remarks to a close, but not before I have given way to the hon. Gentleman.
Simon Hoare
I agree fundamentally; it would be “the rising tide that floats all ships” argument. I will give way briefly to the hon. Member for Wells and Mendip Hills (Tessa Munt), and then I have a couple of suggestions for the Minister.
Tessa Munt
My constituents would be really shocked to discover the lack of clarity in this matter. Does the hon. Gentleman agree that, as part of the licensing regime, anyone undertaking a funeral service in the community should be clear about where bodies are kept and the various arrangements that are in play? I have heard some fairly dreadful things about arrangements for those who have passed away.
Simon Hoare
I agree. In so many choices that we make, the consumer now rightly demands the highest of standards. People want to ensure that the departure of their loved one from the world is as dignified, graceful, calm and respectful as it possibly can be.
Simon Hoare
The hon. Lady is scowling at me in such a friendly way that of course I will give way.
Tessa Munt
Funeral directors deal with people at the most vulnerable time in their lives. It is not the time when somebody asks, “What is happening? Where is my loved one’s body? What are you going to do next?” All of that detail is assumed. When people are so vulnerable, they are highly unlikely to ask the questions that they really should ask, and that they would certainly ask if they were buying any other product or service.
Simon Hoare
The hon. Lady has hit upon the key word—assumed. Why would people think to think anything else? Funeral directors have chosen their profession—it is not like there is a conscript army of funeral directors, press-ganged into dealing with the deceased—so people presume and assume that the highest standards and quality will be deployed.
The hon. Lady is right that most of our constituents would be shocked that it is only section 25 of the Burial Act 1857 that makes it an offence to remove buried remains without a licence from the Secretary of State or, in relation to consecrated ground, without the permission of the Church of England, according to the rites of the Church. There is, however, a common-law offence of preventing a lawful and decent burial, where a person conceals the death of another person. That is not the same as not giving somebody a dignified burial. The death has not been concealed, because it has been registered—they have a death certificate—but it is what is done to the deceased thereafter that is important.
Let me make some points to the Minister—he may well need to respond in writing, rather than give a detailed answer from the Dispatch Box. He will have heard from Members from across the House, and he will know from conversations that he may have had with trade bodies and others, that there is a strong and growing appetite for licensing and inspection. The default position, as I understand it, is with the Human Tissue Authority, and some changes to its terms of reference would be required, which might be a good place to start.
There was a mixed reaction from across the local government family, but I still think that our local councils know the granularity of their jurisdictions. They will often be running the crematoria and the graveyards, and they will have official relationships with the funeral directors. They also have a long track record of inspection of premises. I am certain that when local government was given the duty to inspect licensed premises and facilities serving food, they said, “We have no experience in this”, but they very quickly picked it up.
I know that the trade bodies stand ready to work alongside and with local authorities, as they were going to do before the general election, to say, “This is what best practice looks like. Come and see our leading members and get a feel for this. We will then accompany you on inspection so that you get a feel about what to look for, the right questions to ask, and so on.” It was going to be an evolution in partnership between the quality operators and the Government. I think any and all of us would support anything—there is certainly a clear role for the Human Tissue Authority, but I urge the Minister not to rule out at this stage active and engaged involvement from the local government sector.
There is also a beefed-up supervisory role for the Financial Conduct Authority. We are all familiar with the TV advertising and other advertising, which I referenced, that says, “Pay a couple of quid a month and build up your funeral kitty. Your loved ones don’t have to worry about it.” I am aware of a few cases whereby people have gone in on a weekly or monthly basis with cash, paid it in good faith and been given a piece of paper. They have been given no receipt, the funeral director has not been registered, and the scheme has not been registered with the Financial Conduct Authority—the hon. Member for Kingston upon Hull West and Haltemprice (Emma Hardy) will remember that she had that with a number of her constituents.
Let me share with the House that such people are not the wealthy or affluent, who can say, “I can afford to write off the £2,500 or £3,000 I have put in.” These are people on limited, low incomes and limited means who are trying to defray the costs for their family by doing the right thing. We then find that all they have is a piece of paper in their own bank book or ledger, in which they might write things saying, “This is what I have paid in. Go and talk to Mr Whoever—they are my funeral director of choice.” Guess what? That person has done a moonlight flit; they have disappeared, and there is no record. We have never heard of them. They say, “Oh no, your mother only paid in £4.20, then she did not make any payments.” Nobody stands as the guarantor of last resort. That money is just lost and written off.
If only frightfully well-to-do people were affected, we would be sympathetic with them, but I suggest that the people affected are being proactively preyed on in areas of the country where there is not a vast amount of cash to go around. People are trying to do their best to ensure that their funeral is as cost-effective and problem-free as possible for their surviving relatives, and that it gives them dignity in their choice of being cremated or interred.
The Treasury needs to step up to this issue as well. We know that the Financial Services and Markets Act 2000 was amended by order in 2021, but it does not quite seem to be doing the trick. There is a problem when any issue requires interdepartmental solutions. We have the Treasury and financial regulation on one side, and there is the potential for Ministry of Housing, Communities and Local Government involvement on the other. There is also the Ministry of Justice as the sponsoring Department for death—not necessarily the best thing to put on a ministerial strapline, but the Minister is the Minister for death, as far as the MOJ is concerned. Who takes the lead? Who pushes it forward? Who convenes? Who gets it right?
This issue cannot be ignored. I say with the greatest respect to the hon. Member for Scunthorpe (Sir Nicholas Dakin), who I am privileged enough to count as a friend, that this is a complex and sensitive issue, and we are going to need to take our time. The canon of evidence on the need for progress is very clear and compelling. I suggest that the time for consultation and consideration has passed. The time is now for joined-up Government, energetic thinking and speedy delivery, which will give comfort and confidence to each and every constituent.
Apart from taxes, we know that there is only one other certain thing in this life: we have a span on this Earth, and it is not an infinite resource. We are all going to have to use one of these services at some point, so it is in the interests of the whole country to get this right. The Minister is jolly lucky, because the trade bodies and others are willing him on. They want to see this happen and are ready to act in quick lockstep in order to deliver it.
As the House has reflected in this evening’s debate, and as I hope the Minister will have picked up on, doing nothing and hoping for the best—hoping that somehow or another, by a process of osmosis, the bad actors disappear and the good actors rise to the fore and are the sole operators within this sphere—is, I am afraid, for the birds. I urge any right hon. or hon. Member to talk to any of their constituents, at a surgery or an event, and ask, “The funeral sector is regulated, isn’t it?” They will answer, “Of course it is.” “It’s licensed, isn’t it?” “Yes, of course it is.” When you tell them it is not, there is a look of total and utter astonishment. That situation cannot continue.
I suggest that the Minister could bring forward whatever legislation he needs, and it would probably pass this House in a couple of weeks. As the Minister has heard from across the House, this is now an urgent and pressing issue. I look forward to his reply, but more importantly, I look forward to seeing any legislation that he brings forward in order to enact a remedy that is long overdue.
Postural Tachycardia Syndrome
Tessa Munt Excerpts(2 weeks ago)
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Tessa Munt (Wells and Mendip Hills) (LD)
I thank the hon. Member for allowing me to intervene. My constituent Julie told me about her adult daughter, who has myalgic encephalomyelitis, or ME, and believes she also has PoTS. After struggling to find a specialist, Julie’s daughter finally got a GP referral to a consultant in Bristol, who said that PoTS was “a TikTok fashion” and refused her any testing. She had spent ages travelling and had a long wait, it was quite an effort to get around the building, and she was bed-bound for weeks as a result of the experience. That terribly dismissive approach left her unable to believe that she could try to get any other help, and I understand that that is not uncommon. What steps might be taken to ensure that people with complex, debilitating conditions can access informed and supportive specialist assessments?
Cat Smith
I thank the hon. Lady for that intervention; I will address those points in my speech if there are no further interventions. One of the most difficult things for someone with PoTS is to have to sit and stand up repeatedly, so hopefully I will get to the end of my speech.
Colleagues have been really helpful in highlighting that the average time taken for diagnosis is seven years. Indeed, the fight for a diagnosis is one of the first and the longest fights that a sufferer of PoTS will have to go through in order to begin to consider accessing services, although that is a different matter altogether.
During that devastating period, where sufferers have huge uncertainty about whether or not everything is all in their head or they really are fainting and feeling dizzy, they struggle to access any support and are often disbelieved. That leads to many sufferers of PoTS having to drop out of education, losing employment and withdrawing from social settings, which also has an impact on mental health, as hon. Friends have mentioned.
I do not believe that that is because doctors do not care; I think it is because awareness of PoTS remains astonishingly low within the medical profession. Most GPs will never have encountered the term in their training, and even among cardiologists and neurologists expertise in autonomic disorders is scarce. As a result, patients often find themselves being referred to different specialists, bouncing from cardiology through neurology to endocrinology and psychiatry, without there being any one clinician to join up the dots and provide the diagnosis.
The crisis in accessing specialist services has been brutally highlighted this week: we have learned that in London a major teaching hospital clinic has closed its doors to new PoTS patients and a second has reduced its capacity, so that it will see only local patients. All the rejected referrals are now being forwarded to a third London clinic, which is already totally overwhelmed and has a two-year waiting list. Those referrals will put extra pressure on that clinic and leave patients in the south-east without any access whatsoever to healthcare pathways.
This is blatantly a postcode lottery, whereby someone’s access to diagnosis and care depends entirely on where they live. This situation is summed up in an email that I received from a woman last week:
“I would like to note that I got involved with this as I am still unable to get a formal diagnosis of PoTS while suffering the symptoms, as the only specialist we had in Plymouth retired and my GP said they were currently unaware of where to send me for help. Please. I am begging. Please help.”
That is the desperation that many people experience: they can recognise their symptoms, they can use the internet and are quite confident that their symptoms match those of PoTS, but they have no way to get a diagnosis and then to access support.
The crisis has been made even more urgent by a recent surge in PoTS cases associated with long covid. Clinics that were already stretched thin are now being overwhelmed by more referrals, which is adding further pressure to a system that was already struggling to cope pre-covid.
Ultimately, these challenges point to a systemic gap, which is a lack of clinical understanding of the autonomic system. That system sits awkwardly between medical disciplines and is often overlooked in medical education. Until that changes, thousands of people with PoTS will continue to fall through the cracks—dismissed, misdiagnosed and left without the support they need to live well with a complex and chronic condition. The challenges I have described are not simply matters of medical complexity; they are also matters of policy and system design. People with PoTS are not falling through the cracks by accident. They are falling through because the system was never built to recognise or support them.
PoTS predominantly affects women, which contributes significantly to the fact that it takes seven years to be diagnosed. The delay in diagnosis of PoTS is a stark example of a concerning gender health gap in the UK, where many women receive poorer healthcare than men. I welcome the Government’s 10-year plan, but have serious questions for the Minister about its ability to help the PoTS community. It focuses heavily on prevention rather than diagnosis, yet that is not a coherent strategy for chronic multi-system conditions, such as PoTS, which often have genetic or variable causes. The NHS cannot focus just on prevention; there also needs to be adequate access to diagnosis and ongoing aftercare for chronically ill patients, such as those with PoTS, when there is currently no cure. We need an explicit commitment on the Government’s plan to overhaul education and training curricula to create 1,000 new speciality training posts. Although those changes are welcome, will they include dedicated education and training on PoTS for frontline clinicians, and will the new posts include specialists in autonomic disorders?
Finally, with the plan’s commitment to health data research service investment and making wearables standard in chronic care, I ask the Minister whether that investment will include dedicated research into PoTS. Will PoTS patients be explicitly included in the initiative to provide wearables, which are vital for monitoring a heart-rate driven condition? It is clear we need change and a clear co-ordinated strategy that brings together awareness, research, clinical care and social care.
My ask of the Government is clear, but it is fivefold. First, we need national guidelines, ideally from the National Institute for Health and Care Excellence, to provide the evidence-based framework that clinicians, including our overstretched GPs, need to diagnose and treat the condition. Secondly, the Government must require and ensure that commissioning bodies and integrated care boards execute their statutory duties to understand the prevalence of PoTS in their communities and provide for the needs of those patients. Thirdly, we need to ensure that every ICB has a clinical pathway and that all patients requiring secondary care have access to a high-quality service regionally and not just in central London—ultimately, the postcode lottery must end.
Fourthly, we must fully support existing specialist services, which are currently overwhelmed and under threat from closure by hospital management. That includes immediately intervening in the London crisis and protecting every single specialist across the country. Health is devolved in some countries of the United Kingdom, so that is more challenging, but this is a UK-wide issue—although I recognise that the Minister is responsible only for England. Finally, I ask the Government to make PoTS and related disorders a health and social care priority to ensure that affected people have equitable access to the NHS healthcare and social support that they deserve.
We have an opportunity to fix a long-standing wrong. We must not allow the thousands suffering with PoTS to remain invisible any longer. I thank hon. Members for coming out in numbers that I did not expect to support this 30-minute Westminster Hall debate; I hope that demonstrates to the Minister the strength of feeling across the country. All our constituencies have many people suffering from PoTS who are struggling to get diagnoses or to access services, and ICBs are letting down people with PoTS right across these islands. I urge the Minister to use this opportunity to take decisive action and set out how the Government are going to take people with PoTS seriously and ensure that they are no longer invisible.
Baby Loss
Tessa Munt Excerpts(2 weeks, 1 day ago)
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Tessa Munt (Wells and Mendip Hills) (LD)
This Baby Loss Awareness Week, we honour those children who are loved and missed, and we recognise the parents, siblings, families and friends who carry their memories every day. Today, I want to emphasise just how vital it is that we see the quality of bereavement care standardised, and that this standard is mandated for every NHS trust and health board.
My constituents John and Holly Osman live in Wells with their two lively children, six-year-old twins named Alex and Amelia. It may surprise some of my constituents that I speak about John, as we do not share a political perspective. However, we share a life experience with each other, many of my constituents and, I understand, one in every two people in this country: the terrible loss of a pregnancy or the death of a baby. That experience transcends all political differences.
Some eight years ago, John and Holly lost their much loved twins, Logan and Lottie, five months into their pregnancy. Logan and Lottie’s lives were short. Logan was with them for 15 minutes and Lottie for 57 minutes. Holly, who is in the Gallery this evening, tells me that registering their births and deaths will remain one of the hardest things they have ever had to do.
John and Holly were lucky to receive excellent bereavement care from the team at the Royal United hospital at Bath, which in 2017 and 2018 was piloting the national bereavement care pathway. Being able to deliver in the forget me not suite, where they receive care from trained bereavement midwives and spent two days with their babies making memories, is something they say they probably did not realise how much they needed then, but that they cherish deeply now.
As Holly highlights, the power of compassionate, skilled bereavement care cannot be overstated. It helps parents begin to process trauma, to create memories and to honour a life, however short. That care does not erase loss, but it brings dignity, acknowledgement and a foundation for healing. The care that parents receive in those heartbreaking moments stays with them forever. No one can turn back the clock, but we can make a difference through having compassion, understanding and better care.
It shocked me that 50% of bereaved parents reported that they were able to access the support they needed, but only 17% were able to do so through the NHS. I pay tribute to the NHS clinicians, midwives and support staff who deliver that care with tenderness and professionalism. Good care helps parents and families begin to navigate the painful journey of bereavement. Whether those NHS staff who engage with the bereaved family during this journey have received specialist bereavement training depends on where that care is being provided.
Poor care can deepen trauma. We know that bereavement leaves parents vulnerable to increased risk of developing mental health conditions. That is why it is essential that every bereaved parent in the UK has access to standardised high-quality bereavement support, including clear signposting, timely referrals and specialist mental health care when it is needed most.
Excellent bereavement care should not be a matter of luck or postcode. The national bereavement care pathway has finally been adopted voluntarily by every hospital offering maternity care in England, with the last trust having adopted it last year. However, in Scotland, the pathway has been mandated by Government. The difficulty with voluntary adoption is exactly that: it is voluntary, which means that the nine standards of care that comprise the bereavement care pathway are not national standards in England until they are mandated by the Department of Health and Social Care. I ask the Secretary of State to consider mandating the bereavement care pathway with immediate effect, so that families and friends can be reassured that care in the most difficult of circumstances will be exemplary.
To Lottie and Logan’s family and to the many others who have written to me, thank you for your courage in sharing the most personal of stories. Your love for your children and your determination to help other families is a gift to us all. We cannot take away the pain of loss, but we can ensure that no parent walks through it alone.
Oral Answers to Questions
Tessa Munt Excerpts(3 months ago)
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Wes Streeting
Thanks to the decision that the Chancellor has taken, spending power in social care is rising—not just through Department funding but in the spending power of local authorities. My hon. Friend is absolutely right: we have to get the right care in the right place at the right time. That often means better care for patients and better value for taxpayers.
Tessa Munt (Wells and Mendip Hills) (LD)
At midnight, The Times published an article on the ME final delivery plan, carrying quotes from three ME campaign groups. The charity Action for ME published a five-page briefing at the same time, and “BBC Breakfast” also featured the plan, so they had all read the plan. I checked with the relevant officers and went to the House of Commons Library about half an hour ago, and no plan has been published. More than 12 hours after the Department’s press release, no MP can access the plan. Is this how it should be?
Ashley Dalton
I thank the hon. Member for raising this issue. That is not what I was expecting. A written ministerial statement has been tabled, and I will speak to officials and make sure that that plan is available as it should be.
Covid: Fifth Anniversary
Tessa Munt Excerpts(4 months, 2 weeks ago)
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Tessa Munt (Wells and Mendip Hills) (LD)
Today, we mark five years since the start of the covid-19 pandemic. Just under 227,000 people in the UK died with covid-19 listed as a cause on their death certificate. Every one of those statistics is a mother, a father, a brother, a sister, a child, a neighbour or a friend. Thousands were separated from their loved ones, and that loss and grief may never fully heal.
Yet in the darkest of times, the British people shone with immense compassion and courage, and a sense of community spirit. Doctors, nurses and carers worked punishing hours, often risking their own lives; teachers, council workers and others worked in the toughest of conditions; and volunteers came forward in droves to collect and deliver prescriptions, shop for the frail and elderly, staff temporary centres to administer vaccines, and check in on neighbours. That resilience and solidarity showed the very best of who we are.
Sadly, that same spirit of public service was not reflected in the highest offices of Government. The findings of the first covid inquiry, led by Baroness Hallett, laid bare the truth that the UK was ill-prepared for dealing with a catastrophic emergency, let alone the coronavirus pandemic. We had planned for the wrong pandemic, one based on flu; we ignored the risks associated with other potential pathogens; we ignored warnings; and then we failed to act on lessons from past civil emergency exercises and outbreaks of disease. These were systemic and political failings that worsened people’s suffering. Let us be frank: the most vulnerable paid the highest price. There was cruelty in the rigidity of restrictions, with families kept apart even in their loved ones’ final moments. All of this was made more painful by the bitter hypocrisy of partygate, a betrayal of trust that mocked the sacrifices of millions.
The Lib Dems called for an inquiry in 2020, and we continue to demand answers. The full facts must be known about every aspect of the Government’s poor response. This is not born out of a desire for vengeance; the British people deserve to know the truth, and they deserve far better in future. We now have a moral responsibility to act, and this Government must commit to implementing the inquiry’s recommendations in full and without delay. Patients and care home residents must have a legal right to maintain contact with their loved ones; a comprehensive civil emergency strategy is essential; and the new UK Resilience Academy must train 4,000 people in resilience and emergency roles, as promised. Can the Minister give us confidence that this will be delivered?
The voices of frail and older people must be heard at the heart of Government planning. We call for a commissioner for ageing and older people, to ensure that their needs are never neglected again. Public officials must be held to a duty of candour—the Government’s promise of a Hillsborough law remains unfulfilled. Can the Minister say when survivors and families will see the legislation for which they have waited so long?
We must also confront a hard truth: our nation was less resilient because health inequality has left our population quite simply less healthy. Years of cuts to public health services under the Conservatives left us more vulnerable. The Lib Dems are calling for urgent action to increase the public health grant and allow communities to co-produce plans; establish a health creation unit to lead cross-Government efforts to improve health and wellbeing and tackle inequality; improve access to blood pressure checks in community spaces and expand social prescribing; introduce a new kitemark for health apps and digital health tools, ensuring that they are clinically sound; create a new levy on tobacco company profits to fund healthcare and smoking cessation services; and pass a clean air Act to tackle pollution and improve air quality.
Lastly, we must not forget those living with the consequences of the virus, as Members have mentioned. We call for a long covid register. As we remember those whom we lost, we owe it to them and to future generations to ensure that these lessons are not buried in reports and left on shelves, but lead to real changes that make improvements in our constituents’ lives. The British people were courageous, generous and selfless; they deserve a Government who act to match that spirit.
Madam Deputy Speaker
I call the shadow Secretary of State for Health and Social Care.
Breast Cancer Screening: Bassetlaw
Tessa Munt Excerpts(4 months, 2 weeks ago)
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Jo White
I thank the hon. Gentleman for his contribution and agree that it is worrying that only half of the trusts in England are meeting the national target of 70% of eligible women going for their screening, but next year we hit a milestone in that it is estimated that almost 1 million women will be invited for screening. I welcome the fact that NHS England is actively encouraging more women to book and attend their screening. Will the Minister provide more detail on that?
To be honest, in Bassetlaw I cannot wait for a national operation to kick in. Last month I launched the “Bassetlaw love your boobs, get them checked” campaign, supporting local women and encouraging women to go for their breast screening. I pay tribute to the wonderful Bassetlaw women who have been active in the campaign—women such as Liz Rew and Maria Charlesworth, who found lumps in their breasts and went for their screening. Barbara Baldwin and Claire Previn joined my campaign as they have had friends taken too soon by breast cancer; I do not want anyone else to have to go through that. Lynn Dixon from Bassetlaw had breast cancer in her family and was first diagnosed at the age of 36 after finding a lump, and she has just recently found another lump and was screened. This week she is facing further treatment for breast cancer. My thoughts and love are with Lynn right now. [Hon. Members: “Hear, hear.”] Jenny Bailey is a former NHS nurse and midwife in Bassetlaw who had her breast cancer identified following routine screening. The women from Bassetlaw are amazing, using their life experiences to join the fighting spirit, encouraging their friends, family and neighbours to get screened.
Tessa Munt (Wells and Mendip Hills) (LD)
I thank the hon. Lady very much for introducing this debate, because it is so important. I could not agree more that screening is incredibly important, but we also need to make sure that modern radiotherapy treatment is available for those whose breast cancer has been detected. NHS England has degraded the availability of radiotherapy treatment in many regions over the last 10 years. I understand that breast cancer patients from Bassetlaw have to travel over an hour, as they do in my area, to receive the radiotherapy that they need. What might the hon. Lady say about the Government’s new cancer plan? I hope it goes a long way to resolving the problem of getting access to radiotherapy, which is so effective.
Jo White
I welcome the hon. Member’s contribution. Women in Bassetlaw have to travel all the way to Sheffield once they have been diagnosed to have treatment and radiotherapy. That is a long journey and it would be better if the cancer could be treated in Bassetlaw. I wait to hear how that can be achieved in future years, because it is so important for people to be treated close to home.
Oral Answers to Questions
Tessa Munt Excerpts(5 months, 3 weeks ago)
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Wes Streeting
I am extremely sorry to hear about that particular case. It is really important that we support and facilitate better discharge, which is why we are reforming the better care fund and looking to better integrate health and social care services through our 10-year plan. I would be delighted to hear further from my hon. Friend about what we can do to improve in his area.
Tessa Munt (Wells and Mendip Hills) (LD)
Stephen Kinnock
As the hon. Lady knows, we now have a commitment to providing 700,000 more urgent dental appointments. Those who do not have an NHS dentist can call 111 and will be prioritised. We are very clear that every integrated care board has a target within those 700,000 appointments, and if they are not hitting that target, we will want to know why.
NHS England Update
Tessa Munt Excerpts(7 months, 2 weeks ago)
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Wes Streeting
We have to deliver improved services for patients in every part of the country. Her constituency and mine, which is on the London-Essex border, will have different needs, contexts and set-ups, and services may need to be shaped differently in order to meet those needs, but the standards should be consistent, the quality should be good and the safety should be guaranteed at all times. That is a far cry from where we are, and I genuinely think that decisions about services for her constituents will be far better taken much closer to her constituents and her community than here in Whitehall. That is why, as we are delivering month by month and year by year improvements in services for patients in every part of the country, we will also deliver the biggest devolution of power in the history of the national health service.
Tessa Munt (Wells and Mendip Hills) (LD)
I really welcome the Secretary of State’s statement, and I am particularly keen that he looks at the multiple layers of sign-off and the bureaucracy that sometimes forgets patients are at the other end of it. Hospitals in England have had to rely on charitable fundraising to buy some of the most cutting-edge radiotherapy machines because of NHS England’s policies and bureaucracy. This year, highly advanced machines such as the CyberKnife, which have treated thousands of NHS cancer patients over the past 10 years, will need upgrading, but NHS England is refusing to include them in this year’s funding because they were all bought by charities. The Secretary of State talked about giving people the tools to do the job. Could he change that policy, so that our hospitals do not have to continue relying on charities for the latest technology?
Oral Answers to Questions
Tessa Munt Excerpts(11 months, 1 week ago)
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Wes Streeting
I was terribly impolite; I should have welcomed the shadow Minister to his place in response to his first question.
Conservative Members seem to welcome the £26 billion investment and are happy to tell us how it should be spent, but they oppose the means of raising it. They cannot do all those things. They need to be honest with the country: either they support the investment in the NHS or they say they would cut it. Which is it?
Tessa Munt (Wells and Mendip Hills) (LD)
The Minister for Secondary Care (Karin Smyth)
The Darzi review made it absolutely clear that the NHS has been starved of capital. It is 15 years behind the private sector in its use of technology and we have fewer scanners per person than in comparable countries. That is why at the Budget the Chancellor announced an investment of £1.5 billion for capital funding, which will include investment for new artificial intelligence-enabled scanners, which will help tackle that backlog.
Tessa Munt
Residents in Somerset, and in North Somerset, my part of the world, recognise the £70 million that has been granted for new radiotherapy machines, as announced in the Budget, which will fund up to 30 machines. However, 70 machines will pass their sell-by date—their 10-year recommended life—by the end of this year. Will the Secretary of State and the Minister agree to meet Radiotherapy UK, which wants to highlight the huge cost benefits of having a more consistent, rolling programme of machine maintenance and replacement in the NHS 10-year plan?
Cancer Strategy for England
Tessa Munt Excerpts(11 months, 4 weeks ago)
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Tessa Munt (Wells and Mendip Hills) (LD)
I thank my colleague, my hon. Friend the Member for Wokingham (Clive Jones), for calling this timely and critical debate. It is good to see the Minister for Care in his place. I would like to mark the passing of many friends and some of my family who have lost their lives in a battle with cancer—a dreadful disease.
When I arrived here in 2010, my team and I started a five-year project tracking the use of radiotherapy in England, using freedom of information requests every six months to gather data on the availability and frequency of the use of stereotactic ablative radiotherapy in England’s then 51 cancer centres. It was not a pretty picture.
It is a pleasure to return to the subject of radiotherapy, about which many of my constituents in Wells and Mendip Hills care deeply, as do I. I recall that the hon. Member for Easington (Grahame Morris) and I had common cause. He represented a constituency in the north-east and I one in the south-west of England, the two areas with the greatest incidence of cancer per head of population. I hope and trust that every one of us is persuaded that when confronted with a serious problem or challenge, the odds of successfully tackling it are immeasurably improved if one has a plan. Without a plan, there is a serious risk of misguided or confused action. Benjamin Franklin, one of America’s founding fathers, reportedly said, “If you fail to plan, you plan to fail.” That phrase is as relevant now as when he said it nearly 300 years ago.
In England we are in a battle royale against this deadly disease of cancer, which will directly affect one in two of us and indirectly affect almost every one of us through our connections to friends or family. The evidence is absolutely clear: countries with a dedicated cancer control plan show a better overall five-year cancer survival rate. That is not anecdotal; it is the clear result of an international cancer benchmarking partnership study published in The Lancet Oncology.
A report in The Lancet Oncology by 12 leading cancer experts published a blueprint for a national cancer plan. Those experts were from Imperial College London, #CatchUpWithCancer and Radiotherapy UK, the Faculty of Public Health and Policy at the London School of Hygiene and Tropical Medicine, and the Institute of Cancer Policy at King’s College London. Their blueprint consolidates four reports published separately in The Lancet Oncology over two years, clearly outlining the necessary steps—a plan—to improve cancer outcomes.
The need for a plan is urgent. We had a 10-year one, which ran out in 2022. The then Health Secretary promised a new one. There was a five-month consultation, and then the next Secretary of State binned the whole idea. We are in a dire situation on the cancer front. Cancer mortality in this country is among the highest in the OECD. The key 62-day target to start treatment has not been met in England since 2015. When we consider that international research shows that a four-week delay in cancer treatment can increase the risk of death by 10%, this failure to meet that 62-day target has potentially fatal consequences.
If the Government are in any doubt about the consensus across the cancer care community on the need to get back to having a dedicated cancer plan, they need make only a cursory scan of all the charities and other stakeholders. Almost without exception, every organisation of any standing is in favour of getting a cancer plan and getting it fast. As is widely known, there are several main cancer cure pathways: surgery, chemotherapy and radiotherapy. Any cancer plan would obviously need to include all these pathways, but I would like to say a few words about radiotherapy in the context of any such cancer plan.
For clarity, I am talking about radiotherapy, not radiography. Radiography is vital. It is the use of techniques to scan an image to detect potential issues such as cancer. Radiotherapy is the use of high-energy radiation to kill cancer cells. If anyone is perplexed by my need to clarify that, they may understand when I say that some former Secretaries of State for Health and Social Care have been heard to confuse the two. I am confident that this Minister and the current Secretary of State will not suffer a similar confusion.
Radiotherapy offers technologically-advanced, cost-effective, personalised and precise solutions to treat more patients more quickly, more accurately and better. We have about 270 radiotherapy machines in England. Of those, 70 will pass their 10-year recommended life this year, and replacing them would cost £150 million. The Minister will know that this will be money well spent, as it takes people off the waiting lists and straight into treatment and gives them a life chance that is longer, and many will return to work, just like my hon. Friend the Member for Wokingham.
Until recently, radiotherapy has been overlooked in both priority and investment, so I would like to pay testament to the impressive work of Professor Pat Price of Radiotherapy UK, the charity she founded and still leads. I also thank the Secretary of State for Health and Social Care for agreeing to meet Professor Price, representatives of Radiotherapy UK and me, so that we can all do what we can to help. I am sure that the Minister for Care will also be involved in that conversation. Professor Price’s relentless campaigning is putting radio- therapy back at the heart of the political debate. This was reflected in the recent Budget announcement of £70 million for new radiotherapy machines. That money is not enough, but it is a really positive start.
The recent Radiotherapy UK productivity report shows that smart investment in the sector could create 87,000 new cancer appointments, and the need for a new national cancer plan including measures to boost radiotherapy is clear. Only 27% of cancer patients in the UK can access the radiotherapy that they need, compared with the international recommendation of 52% to 53%. In total, 7.4 million people in the UK live in radiotherapy cancer treatment deserts. Lord Darzi’s independent review of the NHS revealed that more than 30% of patients are waiting too long for their radio- therapy cancer treatment.
Radiotherapy cannot be used on all cancers, but where it is appropriate a typical radiotherapy cancer cure can cost as little as £3,000 to £5,000, which is dramatically less than chemotherapy. The case for a national cancer plan is well made. I urge the Minister to bring the experts in and to produce such a plan.
Mr Clive Betts (in the Chair)
I thank all hon. Members for adhering to the time guidance; that is really helpful. We now move on to the Front-Bench speakers, who will have 10 minutes each—