Coronavirus Update

Tulip Siddiq Excerpts

Tuesday 14th July 2020 Commons Chamber

[Matt Hancock]

The vaccine programme is getting all the possible support we can give it, including attention right across the top of Government. It is being led by Kate Bingham, who is doing the job brilliantly as chair of the vaccines taskforce. The best answer I can give is: no news is good news. We are trying to prove a negative: that, if someone has the vaccine, they do not get the virus. So the longer we go on without hearing there is a problem, the better. We are working to a reasonable best-case scenario of getting the vaccine in at some point this year, but I stress that that is the best-case scenario. The central scenario is somewhat later, and there is a chance that no vaccine will ever work. We need to work for the best and give our vaccine programmes the best possible support, but we should also be cautious about whether one will ever come off.

[Tulip Siddiq (Hampstead and Kilburn) (Lab) [V]]

A former director of public health who lives in my constituency has been in touch to express serious concerns about the real possibility of a second wave of coronavirus and his fear that lessons have not been learnt from the Government’s response to the pandemic. What plan does the Secretary of State have to get an independent body to conduct an accelerated review of the Government’s response to covid-19 so far, so that we do not make the same mistakes again?

[Matt Hancock]

We are looking at all the evidence and take very seriously all the academic, professional and medical studies into the pandemic and the response to it, both here and around the world.

Covid-19 Response

Tulip Siddiq Excerpts

Tuesday 2nd June 2020 Commons Chamber

[Matt Hancock]

My hon. Friend is right to raise that issue. All I can say is that we give all the support that we possibly can to the Scottish Government to help them to get their testing numbers up.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

In the London Borough of Brent, which covers part of my constituency, two thirds of communities are from a BAME background, so it comes as no surprise that some areas in Brent have the third highest rate of covid-related deaths in the whole of London. The Secretary of State has said that he recognises the disproportionate impact that covid-19 has on BAME communities, and he has said that black lives matter, but BAME communities are not interested in slogans or empty rhetoric from us politicians; BAME communities want to know what concrete and practical steps the Secretary of State is taking right now to ensure that BAME communities are protected when the lockdown is eased, so that the lives of no more people from my communities are lost.

[Matt Hancock]

The hon. Lady is quite right to raise this issue and to discuss it in the way she does. Working with the council in Brent, where this disease had one of the highest impacts at the start, we have managed to bring the incidence of disease right down. For instance, ensuring the protection of those living in care homes in Brent has led to the outbreak there coming right under control. Brent is a very good example of where, when we saw a focused outbreak at the start, we put extra resources in; we have put support into Brent Council, and together we have managed to get this disease under control.

Oral Answers to Questions

Tulip Siddiq Excerpts

Tuesday 5th May 2020 Commons Chamber

[Mr Speaker]

I welcome Tulip Siddiq to the Front Bench. I call the shadow Minister.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

Thank you, Mr Speaker. Last week, the Children’s Commissioner for England, Anne Longfield, said that the Government’s latest reduction in legal protections for children in care without proper scrutiny or an opportunity to scrutinise was not justified, given that the staffing in social care is “holding up”. The Labour party agrees with the Children’s Commissioner for England. Does the Secretary of State also agree with the Children’s Commissioner for England?

[Gavin Williamson]

On the regulations we have laid, we worked very closely with the ADCS—the Association of Directors of Children’s Services—on how we make sure we do everything we can to maintain the very best support for all children when they are in care. It and the sector have specifically asked us to make sure that some flexibilities are made available to them. This is a temporary measure that we have taken in response to concerns that people have raised about making sure they are able to provide the best care for the most vulnerable children. It is certainly not something that is going to be continued once we are through this crisis.

Autism and Learning Disability Training: Healthcare Professionals

Tulip Siddiq Excerpts

Monday 22nd October 2018 Westminster Hall

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

It is a pleasure to serve under your chairmanship, Dame Cheryl. I pay tribute to my hon. Friend the Member for Cambridge (Daniel Zeichner) for a moving and harrowing account of what happened to Oliver, and to the hon. Member for Kingswood (Chris Skidmore), the local MP, who has campaigned tirelessly on this issue.

I also pay tribute to Paula McGowan, who has shown such bravery in campaigning for her son. She and her family have felt such suffering following the death of Oliver nearly two years ago—I cannot imagine the pain of losing a child. I speak for all Members when I say that our thoughts are with her and her family.

The cross-party support for the petition shows the strength of feeling of all Members of this House, who want those with learning difficulties and disabilities to receive the best possible treatment. We all want to see NHS staff equipped to make the adjustments that so often prove the difference between life and death. I am sure the Minister agrees.

It is welcome that the Government are acting broadly in line with the recommendations of the learning disabilities mortality review. However, I felt their response fell short in one particular area. Page 19 refers to the introduction of an oversight group that allows for the input of self-advocates. That is positive, and I welcome that, but the response does not spell out how success will be measured, how targets will be checked, who will decide on service changes, nor how the implementation of changes will be assessed. More effective training programmes, such as those demanded by this e-petition, are developed and led by those with learning disabilities. The Government could have been more explicit in acknowledging that.

I want to speak about Treat Me Right: an inspirational autism and learning disability awareness training programme operating across north-west London and in my constituency. For Members and those in the audience who have not heard of it, Treat Me Right has been running for 25 years. It is delivered by Certitude, a not-for-profit social care provider. The programme was commissioned by the north-west London collaboration of clinical commissioning groups last year, following a grant from Health Education England.

Although reducing the number of avoidable deaths will require a broader strategy, Treat Me Right’s impact is beyond doubt. Having been co-founded by those with learning disabilities, it is now led by people with learning disabilities. It provides essential support for A&E staff, mental health teams and the London ambulance service.

Between June 2017 and March 2018, Treat Me Right trained 942 healthcare practitioners across north-west London in learning disability and autism awareness, and it will train an additional 800 NHS autism champions by the end of this year. The statistics do not tell the full story of the programme’s success, but they do go some way to explain why I and other MPs nominated it for the care and compassion award at this year’s NHS 70 awards.

There are two clear components in the petition’s demands for NHS staff to receive mandatory training: first, the need to pinpoint critical reasonable adjustments for patients with learning disabilities; and secondly, the need to alter a damaging culture that fails people with autism or learning disabilities, preventing them from receiving the treatment they need. On that, Mencap’s statistics are striking: just under two thirds of healthcare professionals—64%—said that a lack of practical resources for them and their colleagues contributes to the problem of avoidable deaths. That is shocking. Just over a quarter say that negative attitudes towards those with autism might also be a contributing factor.

Programmes such as Treat Me Right are proving to be an effective remedy. Trainers explain clearly how autism or their own learning disability feels for them, so NHS staff can learn about uniquely challenging situations that may arise during the course of their work. In addition to training, the programme offers two tailored health toolkits for people with autism—health action plans and health passports—which are essential for signposting the critical adjustments necessary on their arrival at A&E and other departments.

The Government’s response to the review talks of ensuring

“vigilant and proactive support for people with a learning disability.”

How better to achieve that than through mandatory training, and who better to lead that training than those who know the specifics of living with autism or a learning disability?

I welcomed John, a co-founder of Treat Me Right, to Parliament earlier in the year. He felt strongly that the training programme allowed him to share his experience of living with Down’s syndrome with NHS professionals, to tangible effect. His experience is reflected in the comments of healthcare professionals across Hampstead and Kilburn who have benefited from training by Treat Me Right. The team at Brent psychological services said that the training, especially on autism spectrum disorders, was like

“receiving a pair of glasses after not knowing you needed them”.

Such testimonies, and the fact that approximately 3,300 adults are registered with Brent CCG as having been diagnosed with a learning disability, mean that the work of Treat Me Right could eventually offer vital healthcare support to thousands of my constituents who have been suffering for years.

[Kerry McCarthy]

It sounds like a fantastic organisation. I wonder whether those lessons could also be rolled out to other public services. I have been talking to Avon and Somerset police, where there have been issues about tasering people who clearly should have been treated differently. Does my hon. Friend agree, particularly as the criminal justice system and the police often come into contact with people with autism and do not know how to treat them?

[Tulip Siddiq]

I absolutely agree with my hon. Friend that the issue is not confined to the healthcare services. It crosses borders, and she made an effective point about the police and others dealing with the challenges of autism that arise in everyday life.

[Hannah Bardell]

On a similar point, does the hon. Lady agree that staff in the Department for Work and Pensions should also be trained? Some of my constituents have not have positive experiences of the welfare system. I know that the staff have a difficult job, but often people are marginalised because of a lack of understanding.

[Tulip Siddiq]

Similar things come up in my surgeries. People come in and complain bitterly about the way they have been treated, simply because they have not been understood by service providers, whether at the Department for Work and Pensions when they needed social security, or elsewhere.

I would like the Minister to address how she will ensure that those with learning disabilities and their families will be treated as equal partners in setting targets for success and in deciding whether change is happening in the right way. How does she anticipate that all healthcare professionals, and not just a few, will get good quality learning disability training, and how will the challenge of resourcing that be met? We have heard Mencap’s estimate that 1,200 people with learning disabilities die every year because of an avoidable lack of access to good healthcare: it was pointed out earlier in the debate that it seems more deaths are of young people, which is shocking. I hope that the Minister will address that situation, which is simply horrifying. I hope that, in addition to answering my specific questions, she will explain how her Department is accelerating its efforts to reduce that figure dramatically in the coming months and years.

I pay tribute once again to Paula McGowan and those seated in the Public Gallery today, because I know it has been a difficult campaign so far.

Universal Health Coverage

Tulip Siddiq Excerpts

Thursday 5th July 2018 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the role of universal health coverage in tackling preventable and treatable diseases.

I would first like to thank the Backbench Business Committee for granting this debate. I have been lobbied fairly heavily on the subject and a number of organisations asked me to approach the Committee and request a debate. I am pleased to see the Minister in his place. He and I have discussed the matter before. It is probably one of those issues that involves not only the Department of Health but perhaps the Department for International Development. He once told me that he took part in a debate that covered five different Departments—I suppose he is a man of many talents—so he will be able to answer wisely for the Departments covered in this debate. I thank hon. Members for coming along to Westminster Hall on such a warm day, and given the almost end-of-season approach we seem to have to matters now.

I wish to begin, as we approach the 70th anniversary of our NHS, by thanking all those who have made that institution all that it is. I have said that in other places, but I wanted to say it publicly now in Westminster Hall. Many political parties have had the opportunity to be part of the creation of our great NHS, and many of us have had the opportunity to be cared for by it, both surgically—in operations—and through the care that nurses provide in hospitals, which I personally have had on three occasions over the past year. I am thankful to every person involved in the NHS, from the porter to the paediatric consultant, from the occupational therapist to the oncologist, from the scrub nurse to the surgeon, from the auxiliary nurse to the audiology clinician, and all people in between. I thank them all very much for all that they do for us as patients, but also for us as a nation. I want to put that on the record.

I thank NHS staff for making the NHS work in situations that often seem unworkable, due to stress and pressure. As the Democratic Unionist party’s spokesperson on health, I am frequently contacted by those who need more than the service has to offer. A great many times we focus on the problems of the NHS and where we are—that is the way life is—but we also need to reflect on how good it is and how much we owe it.

People often come to us with their problems; they do not necessarily come to us to tell us how good a job we are doing. Perhaps half a dozen people will call in a week to say what a good a job we are doing, but hundreds of others will come to us with their complaints. That is the nature of the job. It is not about complaining; it is part of the job. I believe that I must highlight where we are going wrong, or perhaps where we can do things better. We must see if we can do things along those lines.

Today it is my desire to thank all those who work in the NHS so tirelessly, who do not always get the recognition they deserve. The NHS is our nation’s greatest asset. A Member said in the main Chamber today during business questions that the NHS was probably our nation’s greatest accomplishment. I tend to agree, as I am sure would many others. The NHS embodies our British values of compassion and fairness. It represents our nation’s strong sense of justice and the desire to help those in need. With its quality of care and pioneering scientific research, it is a world-leading institution.

Across the whole of the United Kingdom of Great Britain and Northern Ireland, the NHS works in partnership with many universities and private companies on research and development for drugs that can help save lives. Queen’s University Belfast is one of those universities, and I know that because it is one of the institutions that I would call in on. Indeed, just three months ago I visited its cancer research team to see the scientific work they are doing. They were over here this week, along with staff from breast cancer charities, in the Attlee suite in Portcullis House, and we had a chance to catch up. What they are doing to try to find cures for cancer at all levels is incredible. There is also the complexity of breast cancer treatment to consider, because many people have different variations, so the drugs they take must be just as varied.

The NHS is the type of British export that can help underpin the UK’s global Britain vision, which I believe we lead the world on and which we can be the forerunners for. Health for all, which is the bedrock of this most beloved institution, is a principle that the UK originated in 1948, when it first embarked on the altruistic duty of creating a national health system to provide care to everyone, everywhere, without their having to experience financial hardship.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

I agree with everything the hon. Gentleman has said so far about the NHS. I saw its merits at first hand when I had a baby two years ago. However, I wish to make a point about the current shortage in the NHS of the BCG vaccine, which is used to treat tuberculosis. My constituent, Hussein, is 11 months old. He was born in Lebanon but is a British citizen. His parents have told me that their GP said that Hussein cannot have the BCG vaccine on the NHS because he was born outside the UK. Does the hon. Gentleman agree that although our NHS has a fantastic track record in tackling diseases and providing care, in order for it to have a successful future every British citizen must be entitled to the preventive medicines on offer?

[Jim Shannon]

I thank the hon. Lady for that intervention. I know that the Minister, like me, listened carefully to what she said. If there is clearly the anomaly that she outlines, the NHS should reply and make the vaccine available. I am quite incredulous that someone who is a citizen of the United Kingdom of Great Britain and Northern Ireland cannot have it. That is almost impossible to understand. I am sure that the hon. Lady will receive a response from the Minister in whatever time is left at the end of the debate.

The NHS is the purest and simplest definition of universal health coverage, and it is the world’s oldest and most successful model. The World Health Organisation estimates that half the world’s population lack access to essential healthcare services and that 100 million people are pushed into extreme poverty by healthcare expenses. We have problems as well. I get frustrated sometimes when constituents come to me. I am referring to Northern Ireland, where health is a devolved matter and therefore not the Minister’s responsibility, but I believe that these cases illustrate some of the issues. A constituent told me this week that a consultant had said to them, “Well, you’re going to have to wait maybe 53 weeks for an operation.” If people want to have an operation through private healthcare, however, they are told that it could maybe be done before the end of the month. As always, if someone can pay for something, they can have it done. We have these problems within the NHS in Northern Ireland and, I suspect, across the rest of the United Kingdom.

As I said, the World Health Organisation estimates that half the world’s population lack access to essential healthcare services and that some 100 million people are pushed into extreme poverty by healthcare expenses. Behind these horrifying statistics are tragic human stories of unnecessary loss and suffering. My parliamentary aide, who does a lot of speech writing and research for me, has travelled to Africa to work every summer, usually in Swaziland but also in Zimbabwe over the past couple of years. That is through Elim Missions, which is a church group in my constituency. She used to visit Africa every summer, during the recess, but she now has two young girls and has not been for a few years. When she came home each year, the tales she would tell about the hospitals she visited would break your heart.

Let me tie together these two stories: first, our NHS; and secondly—perhaps this is for DFID—the responsibility that I believe we have to reach out and help other countries. I referred to that in my earlier discussion with the Minister. My aide’s stories would really have broken your heart. The children’s ward was full of the cast-offs from hospitals in the UK. I do not mean that disrespectfully, because we do that in Northern Ireland—Elim Missions and many other groups do it. We fill containers with second-hand hospital apparatus that might need repairs and we send it out to Zimbabwe, Swaziland and other countries around the world. The equipment can still be used, but sometimes it is worse for wear. We would not put our children anywhere near some of those conditions, but the staff we met made use of all that apparatus and all those materials.

Children in orphanages went without basic medical care until nurses from the UK gave up years of their lives to provide medical training to local communities, for example on the importance of sterilisation. Sometimes the issues can be small, but necessary, such as the simple effect of drops. The hon. Member for Stafford (Jeremy Lefroy) and I were talking this morning about some other things. He said that when he was in Africa his son was taken very ill with pneumonia at eight months old. They did not have the small antibiotic drops that were needed, but once his son got them he became much better and got over the illness. That shows how small things can make a difference and how important it is that we do them.

The Luke Commission is a charity that has been operating since 2005. It takes free healthcare and hope to the most isolated populations in Swaziland. Mobile hospital outreach sites are set up in the remotest parts of that small country. The population is scattered and dispersed. Patients are tested, counselled and linked to treatment for HIV/AIDS. Swaziland has some of the highest levels of HIV in the whole world, and the whole of Africa in particular. Those suspected of having TB are X-rayed and started on medication. Voluntary male circumcisions are performed in an on-site 11-bed operating room, as studies have shown that the rate of HIV transmission is cut by 60% in circumcised males. Those are practical actions that can be taken to change things. More and more evidence indicates that lack of male circumcision is one of the primary reasons why the HIV prevalence rate is so high. These actions can reduce that. Nurses travel back to rural communities to check on newly circumcised men to ensure that they are healing, to answer questions and to provide HIV prevention education.

At the mobile hospital sites, schoolchildren are treated for skin and intestinal problems. Young people are fitted with new shoes. Those are practical, small things that can make a difference. I put on record my thanks to the Elim church charity and to the many other charities and churches across my constituency that gather products, whether clothes, shoes, medication or hospital apparatus—whatever it may be—to help fit out some of these places in Swaziland, Zimbabwe and further afield.

Handicapped people are analysed by Luke Commission medical personnel and given bush wheelchairs—they need a wheelchair that is practical. Follow-up treatment for patients with HIV, chronic disease, complex medical disease and various cancers is offered. Those with poor eyesight receive vision services and glasses, if needed. There is an ophthalmic surgical programme primarily focused on the removal of cataracts, which are a serious issue in parts of Africa. Those practical changes can be made easily. They do not need a lot of money or investment, but they can change lives. Can you imagine, Mr McCabe, not having your eyesight? Of all the things in the world that you would never want to lose, it would be your eyesight. I say that as someone who has worn glasses since I was eight. I understand the importance.

Packets of medication are distributed by the thousands every day, each prescribed by a doctor with instructions on usage in the mother tongue so that they are understood. Psychosocial and grief counselling is available, too. The pain and the tears they have are no less than the pain and tears we have. Some of the things that happen to them happen because they do not have medical treatment available. The Luke Commission team of nearly 100 people treated more than 61,000 patients in 2015. We can do a lot more with small things, but how many more could we affect?

Most recently, a young lady from my constituency gave up her time during her summer to help the Luke Commission. So many others from the UK give up their time to make a difference. Would the Minister be so kind as to outline the initiatives that are in place? I understand his remit may not stretch to that, but it would be helpful if he could give us some idea. What initiatives are in place to encourage our knowledge and skills to be shared worldwide, like the schemes of Doctors Without Borders and the Luke Commission? How are the Government sharing and disseminating the expertise and learning generated from the NHS with Health Minsters in developing countries?

We have great partnerships and the wonderful NHS. We are celebrating the NHS’s 70 years of tremendous work, but we should be trying to show other countries what we can do. Will the Minister give us some idea of how we can help developing countries? I believe that is our duty, and I would like to better understand how we can fulfil it. We need to take up the mantle and do more in our constituencies. We are doing practical, physical and financial things through churches and other charities that directly help in Africa and other countries across the world.

Countries in the developing world are already showcasing their ingenuity and political will in delivering universal healthcare. For example, Bangladesh has achieved wonders in national health in the last 25 years. More than 95% of Bangladeshi children are now fully immunised—that is tremendous. There have been other massive improvements: breastfeeding is near universal, and the level of stunting in children under five declined from 51% in 2004 to 36% in 2014—a significant decrease, showing what we can do if we influence and help both physically and practically. Community outreach by a skilled cadre of female community workers was instrumental in achieving almost universal immunisation coverage, the world’s highest coverage of oral rehydration solution, greater uptake of family planning, and innovative solutions for community-based management of sick newborn babies and severe and acute malnutrition.

Bangladesh is a world leader in reducing child mortality, but pneumonia remains a major challenge for policy makers. Sadly, childhood pneumonia is prevalent across many countries. The stats are alarming: every minute of every day, including today, two young lives are lost to pneumonia; in 2016, it claimed nearly a million children under the age of five in developing countries—more than HIV, TB and malaria combined. If we had the antibiotics available, we could tackle a lot of those problems. Pneumonia is a killer that leaves children gasping for breath and fighting for their lives, but it is also a disease that we have the power to prevent, diagnose and treat. We can do that, so how can we do it better to save those million children’s lives?

We know that an accessible and free health system is the most effective way of treating pneumonia. A fully integrated universal healthcare model can care for a child from the moment they are born until they reach adulthood. That will prevent deaths from pneumonia, which is the biggest killer. We are here today to find out what more can be done to provide UHC in countries around the world, including those in Africa and the middle east, India, Pakistan, Bangladesh and other countries where these problems occur. Millions of people around the world are denied their most basic rights of access to healthcare. We have UHC in this country, and I would like to think that one day we will be able to make it available across the world. As beneficiaries of the NHS, everyone in this room must believe we want everyone to have what we have: a system that is fair and free. We must therefore take steps to change things.

Pneumonia is a prevalent issue within the Commonwealth, too. Save the Children has calculated that children under the age of five living in Commonwealth countries are two and a half times more likely to die from pneumonia than children living in non-Commonwealth countries. When we hear those stats, we realise how big the difference is that we have to try to reduce. Will the UK Government raise the subject at the next Commonwealth Health Ministers meeting? If the Minister is in a position to use that power, I ask him to do so. He should certainly contact the relevant Department to ensure that it happens. What leadership role can the UK Government play, given that the UK is the chair of the Commonwealth for the next two years? I would like to think we can use that influential role. I know we will, but perhaps we should be reminded that we have that opportunity. We should try hard to make things happen.

I am incredibly pleased to have one of the world’s foremost research and medical centres in the wonderful Queen’s University. The steps taken in improving healthcare worldwide have been tremendous, including the most recent breakthrough regarding the targeting of antibiotics for pneumonia using groundbreaking cancer treatment technology. I mentioned Queen’s at the beginning of my speech, but I mention it again, because it is at the coalface of breakthrough technology. I asked Queen’s for a little more in-depth information regarding the breakthrough. That information is certainly something to be proud of. The Queen’s research team indicated that our struggle against infectious diseases is far from over, but they, with other universities, research and development bodies and private companies, are doing their best to make things happen. Globalisation has increased the risk of pandemics, which we get regularly, reminding us that whenever we accomplish something, another disease and pandemic comes along, and sometimes existing drugs are useless.

Unsurprisingly, antimicrobial resistance—AMR—is included in the recently released UK Government national risk register of civil emergencies that may directly affect the UK over the next five years. Our Government have been instrumental in assisting and responding, and it is always good that they do that. More than 80,000 deaths in the UK are estimated if there is a widespread outbreak of a resistant microbe. Far from being an apocalyptic fantasy, a post-antibiotic era in which common infections and minor injuries can kill is a very real possibility for the 21st century. We can never rest on our laurels with what we have done. We need to step forward and be more aware of what we need to do in the time ahead. New diseases are always developing, and there is always a need to match them. We should pay respect and give credit to organisations that do that well.

The O’Neill review on AMR sets out the global threat by highlighting that drug-resistant infections already kill hundreds of thousands of people a year globally. By 2050, it could be as many as 10 million—one person every three seconds. If we needed a reminder of the importance of the issue, that would be the figure. I am not sure if anybody in the Chamber will be around in 2050—I certainly will not be—but those who are could well face one of the debilitating diseases that we need to research now.

Of particular concern is the mounting prevalence of infections caused by multi-drug-resistant gram-negative bacteria, in particular Klebsiella pneumoniae. That pathogen has been singled out as an urgent threat to human health by the UK Government, the US Centres for Disease Control and Prevention, and the World Health Organisation due to extremely drug-resistant strains. Notably, Klebsiella infections have increased by 12% in the UK alone over the last five years. That tells us how things are developing, and that we need to be prepared.

Professor Chris Scott, the interim director of the Centre for Cancer Research and Cell Biology, is an expert in nanotechnology. In June, he teamed up with Professor Jose Bengoechea, director of the Wellcome-Wolfson Institute for Experimental Medicine, who is a world expert on infections by multi-drug-resistant pathogens, chiefly Klebsiella pneumoniae. Professor Bengoechea’s team discovered that it is possible to use the nanotechnology approaches that Professor Scott is developing for cancer to try to treat the bacteria that reside inside human cells and combat that pathogen. We have to listen to the experts and ask them to take things forward in the right way.

Although there is clearly a need for new antibiotic drugs, which must be the Government’s main focus in tackling the potential tsunami of antimicrobial resistance that we face, Queen’s research shows that with effective delivery of antibiotics we will gain a better therapeutic effect against a main protagonist of pneumonia. The complex scientific work that Queen’s is doing should make a difference. Patients may need to take an inhaler of particles containing antibiotics, as opposed to a simple tablet, in the specific case of pneumonia. It is possible that an advanced formulation of drugs could slow resistance developing in some instances and generate better outcomes for patients. It may also mean that we could extend the useful lifespan of some of our current antibiotics. To take that to patients, we need to prepare clinical grade material, but advanced formulations such as nanomedicine are difficult to manufacture. Life is never straightforward, but when we are given a challenge we have to take it on.

Investment is needed in the UK to provide facilities that can advance these excellent therapeutic strategies before they can be tested on humans. We have a process to go through and we must walk along those lines. When we come to the end of the road, we want to ensure that the medication is appropriate and safe. Additional funding needs to be allocated to new approaches to treat infections. Again, the Minister may wish to tell us how the Government are working through the Department of Health and Social Care with universities, companies and research and development on how that process can work, and perhaps how it can work better.

By thinking outside the box, as exemplified by the Queen’s University Belfast research, we will find much-needed new therapeutics. Several projects at Queen’s University Belfast are reaching the pre-clinical stage and are being stalled by the lack of investment, since pharma are still not interested in supporting this essential work. There are ways of going forward, but we need a wee bit of security as well. The lady from Queen’s University who was here this week talking about breast cancer research was funded through one of the Government Departments in Northern Ireland. Queen’s University also gave her a position, which brought her a bit of income. That meant that she could do her research here in the UK, and we in the UK can get the advantage and try to advance that as well. Other UK Government schemes, such as those supported by Innovate UK, also fall short in supporting pre-clinical work because there is still no commitment from pharma. I ask the Minister to consider standing in the breach, if that is possible, and supplying the necessary support and funding for Queen’s and other research centres to help us to do better.

It is expected that by 2035 more than 500,000 people in the UK will be diagnosed with cancer each year. To ensure that our health service can meet future demand, action to prevent cancer and other diseases must be at the forefront of any approach. We have heard today some of the figures, certainly on the mainland in relation to cancer and some of the delays. There are many problems in the NHS, but we are here to help the Minister and to encourage him and the Department of Health to move forward.

The Government must train and employ more staff to diagnose and treat cancers earlier. We can be proud of what the UK Government—our Government—do on healthcare, but we strive to do more, and the Minister strives to do more. The Department of Health is already looking across the world to see how it can share expertise. The Department for International Development is helping countries to strengthen their healthcare systems. What else could we achieve if we joined up the dots and worked together more on implementing universal healthcare?

We should encourage countries to raise their own domestic resources for healthcare, which could have a transformative impact. DFID has been fantastic at supporting the health system to strengthen, but that is not always free, which leaves behind the poorest and most marginalised. I referred earlier to those who are unable to get their operation through the NHS, but are offered the opportunity to pay for it. I am very unhappy with that system; it suits some people, but not everyone. We have to be ever mindful that some of the poorest and most marginalised people in countries across the world are at the bottom rung of the healthcare ladder. We should share our expertise on domestic funding for the NHS with Governments around the world, encouraging Governments to spend more on healthcare.

From 2011 to 2015 there was a cross-Government strategy on global healthcare. An update strategy could include recommendations on domestic resource mobilisation. I understand that the Department of Health has a global health team. It would be helpful to know the remit of that team and how they co-ordinate with DFID on global health issues. What is the connection? Do they have any input to the policy, strategy and the way forward? Do they have regular meetings?

In February 2014, the world watched in horror as Ebola swept across many parts of Africa. We in this country did our bit immediately to respond. We sent our service personnel, our experts and our medication. We were not found wanting, and we never will be. The horror turned to pride as we saw that role that UK aid and our healthcare professionals played in stopping Ebola and saving lives. We should be immensely proud of what our people did, and what our Government did and continue to do. That was the UK Government at their best. They co-ordinated the response to a major global health crisis and supported a country’s health system. How well that was done! We owe thanks to those personnel and to our Government for leading the way. We would never wish for Ebola or something similar to return. What can be done to implement that sort of cross-Government approach to supporting health systems?

I thank hon. Members for coming along to support me, and the Minister for coming along to respond. I thank hon. Members for their time. How does the Minister believe we can excel, improve and achieve an even higher level of global care?

BAME Blood, Stem Cell and Organ Donation

Tulip Siddiq Excerpts

Wednesday 27th June 2018 Westminster Hall

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Henry. I thank my hon. Friend the Member for Bedford (Mohammad Yasin) for securing this debate on an issue that is so important to my constituents in Hampstead and Kilburn. I will speak briefly.

More than 2,000 incredible people from Hampstead and Kilburn are on the Anthony Nolan stem cell register, a large proportion of whom are from BAME backgrounds. I mention that fact because, as Members from across the House have said, only 20% of patients from BAME backgrounds will get a perfect match, compared with 69% of people from white northern European backgrounds.

[Colleen Fletcher (Coventry North East) (Lab)]

I declare an interest: my husband had a stem cell transplant three years ago. His donor came from this country. Does my hon. Friend agree that, if we are to meet the needs of BAME patients who require a stem cell transplant, we must work with international registers? Increasing BAME donation in the UK alone is not enough. Some 60% of UK patients already receive stem cell transplants from international donors. That is made possible by Anthony Nolan’s incredible volunteer couriers, who collect donated stem cells around the world and transport them to patients. I hope the Minister will explain what steps the Government will take to support international registers.

[Tulip Siddiq]

My hon. Friend has stolen one of the questions I was going to ask the Minister, but I will forgive her.

In 2016, a young woman in my constituency called Lara, who was 27 years old and from a BAME background, needed a stem cell donor. The constituency snapped into action and organised the Match4Lara campaign. Elana Wall and Jacob Haddad, the volunteer co-ordinators for Anthony Nolan, co-ordinated 40 volunteers who spent their evenings packing spit kits and organising spit drives and spit drive socials. I went to a spit drive in the O2 Centre on Finchley Road, and I was impressed by the enthusiasm of the youngsters—especially those from a BAME background—who realised that if they took the spit test on the spot, there was a chance they could save a life. My younger sister, Azmina, participated and said that she found the science very accessible. She understood that she needed to raise awareness of the issue among young people. She has recently had a call to say that she could be a potential match for a patient.

Will the Minister address the request to integrate awareness-raising into the school curriculum? Will she talk about how the Department of Health and Social Care can work with international donor banks? That issue has been raised a few times already. How does she intend to spread the word about stem cell donation among young people, especially those from BAME backgrounds?

Cancer Treatment

Tulip Siddiq Excerpts

Thursday 19th April 2018 Commons Chamber

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

Seb Coe described her as “Mary Poppins in stilettos”. The Guardian called her “the ultimate loyalist” and many times rehashed the image of tiny Tessa Jowell throwing herself dramatically under a bus—presumably a London bus. Alan Johnson said she had

“all the warmth in the world but a core of absolute steel”.

The Evening Standard said:

“If you cut her veins, you would probably find the River Thames running through them.”

Google Maps decided to get involved and made her a London landmark, placing her between Big Ben and Westminster Hall—most apt, I think.

For me, Tessa Jowell, whom I worked for once, will always epitomise the best of my city, London. She has long been a professional and personal hero of mine. At one point, we were both Camden councillors, although she has achieved a lot more in her life than I ever will. As all Members have already mentioned in this powerful debate, it was Tessa who was fundamental to bringing the Olympics to London; it was Tessa who constantly talked about how we had to go all out to win and about how big prizes were never won by playing it safe; it was Tessa who said the Olympics would teach us Londoners to be resilient and to celebrate our diversity; and it was Tessa who told us the Olympics would show us the extent of our ambition. How right she was.

In the same spirit that Tessa has talked about her medical condition—the cancer that resulted in her having two seizures in a cab, about which she has spoken so powerfully—and with the same resilience, she has said she will use her experience to make life better for others and improve and lengthen the life of cancer victims. She has shown the same ambition in talking about using innovative cancer treatments that do not currently exist in the UK.

Tessa has inspired me to suggest that we in the House work together to launch an initiative similar to Dementia Friends. For those who do not know, Dementia Friends is an Alzheimer’s Society initiative that offers extensive information sessions so that people can learn about dementia and what they can do to help. The sessions play a crucial role beyond recognising just the signs of dementia, not least because the way dementia affects people varies hugely. I know we already have brilliant organisations such Cancer Research UK and care organisations such as Macmillan, but the role of a cancer friends initiative would be different. It would be more about understanding the medical condition, building resilience through networks and creating cancer friendly communities. Formalising such a body could support many thousands.

Having worked with Tessa, I know she has a strong support network, like no one else, of friends and family, but not everyone has that, as she will be aware from our conversations about loneliness—an important subject put on the map by my late friend, Jo Cox. Tessa would be the first to agree that because not everyone has these networks at their fingertips, it is necessary to consider launching a cancer friends initiative. Such an initiative could also bring profound benefits for those searching for stem cell donors.

I want to mention a constituent of mine, Lara, who has been very brave in the face of adversity. She had a similar condition, but was unable to find a stem cell donor because of her black, Asian and minority ethnic background. If people look into the figures, they will realise that only 60% of patients receive the best match, but if they are from a BAME background, that drops to 20%.

I raised the case of my amazing constituent Lara at Prime Minister’s questions, and I talked about the spit drive we had at the O2 Centre in my constituency. Lara actually managed to find a match and is undergoing treatment because of the network that came around her and the community in my constituency that helped her. A cancer friends initiative could certainly help to spread the word.

I want to talk about Hampstead and Kilburn—I think Tessa would approve of me bringing in my constituency, because she happened to mention her constituency every five minutes when we worked together. My constituency is blessed with some of the finest oncologists in the world. The Royal Free Hospital, which everyone will know about, is a European centre of excellence and is celebrating the 20th anniversary of its neuroendocrine tumour unit. It has grown from having 30 patients to having more than 1,800, and it will soon be joined by the Pears Institute, which will be one of the five leading centres of its kind across the globe, bringing clinicians together to research revolutionary new cancer treatments. Hospitals such as the Royal Free have benefited enormously from Tessa’s work in Camden, where she started out, but, as we know, her work has touched the whole country.

In 2015, Tessa gave a memorial lecture to mark 10 years since the 7/7 attacks. She said:

“This city, this country, this people are a model of resilience… Resilience is rooted in optimism. Behind the strength to stand firm lies the feeling that tomorrow will be better than today… Resilience relies on a commitment to our way of life but also the feeling that life can improve. Progress is not an illusion even in the darkest of hours.”

Tessa was talking about British people, but her words are a perfect testament to the character she has shown in fighting, even after she left these green Benches and was elevated to the red Benches. A model of resilience, a model of optimism, a model of a politician—our Tessa Jowell.

 Orkambi and Cystic Fibrosis

Tulip Siddiq Excerpts

Monday 19th March 2018 Westminster Hall

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. I pay tribute to the hon. Member for Sutton and Cheam (Paul Scully). I usually apply to speak in Westminster Hall rather than in the main Chamber because the waiting time tends to be shorter, but I have had to wait today because of the huge turnout, which is testament to his tenacity in securing this important debate. Many constituents have emailed us about how their condition has affected their lives. I will cut straight to the chase and say that all the people who emailed me were unanimous in their desire to see Orkambi made available on the NHS.

In all the representations I have received, whether from families who have been affected by the disease or from world class medical professionals in Hampstead and Kilburn, there is one clear message: cystic fibrosis patients do not have time to waste. I put this bluntly not because I want to state the obvious about a life-limiting condition, which has been made clear by all the contributors so far, nor to suggest that Ministers object to introducing the precision medicines that could extend life chances. I say it because it is the key message that must weigh upon all our contributions today.

I presume that most Members have received a briefing from the Cystic Fibrosis Trust, which does exceptional work in advocating for those suffering from the condition. I am proud to say that I have a constituent, Ffyona Dawber, who is a trustee and is passionate about this debate and patient education more broadly. Ffyona and her colleagues at the trust have told me over and over again about the possible benefits of Orkambi. They say that medicines such as Orkambi have been proven to add years to a patient’s life. They point to the fact that Orkambi has been shown to slow decline in lung function by 42% and to cut the number of infections requiring hospitalisation by 61%. As has been quoted many times, they point to the NICE appraisal of 2016 that said that Orkambi is both “important and effective”. Given that the possible benefits of Orkambi seem to be settled, it is necessary to spell out why the Government should act now and agree a sustainable solution over the cost.

It is also important to highlight the voices of those whose futures depend on the introduction of that important drug. My hon. Friend the Member for Erith and Thamesmead (Teresa Pearce), who is sitting next to me, talked about how we have to speak up for residents and constituents who cannot come here and speak for themselves. Many who have the condition cannot travel to Parliament to witness the debate.

I echo the words of a resident of mine, Caroline Brown, who wrote to me about her treatment for cystic fibrosis. She told my office that she felt “well supported” by the NHS. She paid specific tribute to the doctors and nurses at the Royal Brompton Hospital on the Fulham Road, saying that

“they are utterly amazing. I have had the best care there and I cannot fault them.”

Her tribute to the staff at the Royal Brompton reflects those paid by other local residents, especially those whose children rely on the specialist cystic fibrosis centre at Great Ormond Street. For patients such as Caroline, my constituent, the debate over Orkambi is about enabling our world-leading medical community to focus their efforts more sharply on those with advanced symptoms, and for pharmaceutical companies to get on with investing in research for aspects of the condition where the breakthrough represented by Orkambi still evades us.

It will come as no surprise to anyone to learn how Caroline felt about the situation surrounding Orkambi. As expected, she was clear in her support for its immediate roll-out. She said:

“When I look to the future it would be very comforting to know that, if I was to need it, there would be medication there that would help me. I can’t bear the thought of knowing that there is something out there that could potentially save my life, and that I am not able to take that as I couldn’t afford it. Being symptom free for someone with Cystic Fibrosis would be life changing.”

She went on to underline the consensus that exists among cystic fibrosis sufferers. A lot of them cannot meet and be in the same room for the reasons outlined by other Members, but there is one benefit of social media—I stress one benefit—which is that it has enabled a network of people with cystic fibrosis to discuss and reflect upon the key debates in the community and to share the experience of their treatments. She knows that fellow patients are unanimous:

“They all agree it should 100% be made available on the NHS. It should be available to everyone that needs it...it is sad that money is getting in the way of people's health improving.”

[Stella Creasy (Walthamstow) (Lab/Co-op)]

My hon. Friend is making an incredibly powerful speech. May I add the voice of my six-year-old constituent? She would not benefit from Orkambi, but we must recognise that, if we do not get this right, the other treatments that might help her will be subject to similar delays. She is only six years old, but she does not need any delay. Does my hon. Friend agree that this matter is not only about Orkambi, but about how we deal with life-changing drugs and whether we understand the power of them to make such a difference?

[Tulip Siddiq]

I absolutely agree with my hon. Friend. There are lots of heart-breaking stories from people who are six and even younger who share the frustrations of the people I am speaking for today.

Caroline, my constituent, was adamant that Orkambi is just one frustration that those with cystic fibrosis have over how the current range of treatments are made available. What aggravates my constituent is the fact that cystic fibrosis is the only incurable life-threatening disease where people have to pay for their prescriptions. I greatly sympathise with her view that charging patients for medication, in light of the fact that they often undertake between three to five hours of treatment a day, does not seem to square up to the rhetoric of Ministers who pledge their support for the cystic fibrosis community. As my constituent concludes, some people have to take thousands of pills over their lifetime, so paying for them makes life very difficult. Why should cystic fibrosis be an exception when people with other diseases do not have to pay?

I will close with three questions that I want the Minister to answer. Do the Government accept responsibility for the pace at which negotiations are being conducted, and will they apologise for the anxieties that patients are experiencing as a result? Secondly, what steps are Ministers taking to ensure that pharmaceutical companies will ensure that fair and responsible pricing for a deal can always be agreed when treatments are required on the NHS? Finally, will the Minister acknowledge the importance of finding a solution that guarantees we are never put in this position again for the future pipeline of treatments for cystic fibrosis and many other life-threatening conditions?

NHS Wholly Owned Subsidiary Companies

Tulip Siddiq Excerpts

Tuesday 6th March 2018 Westminster Hall

[Liz Twist]

I most certainly do agree. I think this is the start of a very worrying process, not just for facilities management stuff but potentially for other staff.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

My hon. Friend is being very generous in taking interventions. Unite points out that over the past five years, more for-profit companies have won contracts to run NHS services, with the total value of contracts awarded in 2016-17 standing at a staggering £3.1 billion. Does my hon. Friend agree that the Government must compel Her Majesty’s Revenue and Customs to close this tax loophole, so that NHS trusts are not forced to consider outsourcing NHS services?

[Liz Twist]

I most certainly agree that the issue is a dangerous one that needs to be looked at, and it is a very worrying one because, whatever happens, the staff who have transferred are in a very difficult position.

In the longer term, the establishment of the wholly owned subsidiaries leaves services open to privatisation in the future, continuing the fragmentation of our NHS, which is not in the long-term interests of all who use the NHS. There is no evidence that the plans will improve efficiency or productivity in the NHS. They exploit a tax loophole and seek to exploit the future workforce.

North Middlesex University Hospital NHS Trust

Tulip Siddiq Excerpts

Tuesday 12th July 2016 Westminster Hall

[Joan Ryan]

That was exactly the case and I am very concerned. It is not an exaggeration to say we were kept in the dark. All of us across Enfield and Haringey have, over the past year, raised the issue of North Mid in the Chamber at a local level and with Ministers at various times. We received no information until a recent meeting with the Minister, who, I am pleased to say, is here today. Prior to that, there was almost no answer to the points that we raised, other than to brush them aside with answers such as how much better the NHS is doing now than ever before. The phrase “kept in the dark” absolutely covers the situation, with those in the know including the likes of NHS Improvement, NHS England, the General Medical Council, Health Education England and, no doubt, the Department of Health. However, but for the actions of the General Medical Council and Health Education England, the situation for patient safety could be even worse.

I have had a number of meetings with the senior leadership teams at North Mid and at the Enfield clinical commissioning group, and many of the problems I will discuss today were not thought noteworthy enough to bring to my attention. If they were brought to my attention, the exposure of those problems was minimal, such that they did not raise the alarm bells that they should have.

In May, the severity of the situation at the hospital was discussed at a high-risk summit, involving several north London hospital trusts, clinicians and other stakeholders. MPs were not even informed that the summit was happening, never mind informed of the outcomes. I would be interested to know whether the Minister thinks that that state of affairs is acceptable given that our constituents have to suffer the consequences of the failures at the hospital. Even as of today, despite numerous requests, we have received no minutes of the high-risk summit and no account of what was discussed in any detail whatever.

Would the Government be willing to bring in early warning measures to ensure that MPs and constituents are kept properly informed about impending healthcare crises in their communities, rather than being notified after the crisis has hit? To do our job on behalf of our constituents—to safeguard their safety and interests in the use of and access to one of the most important public services any of us can imagine—we need some kind of early warning system. It is clear that very many people knew about the situation, but nobody who is accountable to the public at a local level was properly informed. I look forward to the Minister’s response to that point.

I am pleased to see my hon. Friend the Member for Edmonton (Kate Osamor) in her place, as the hospital is just inside her constituency, although it serves a large number of my constituents and constituents from Hornsey and Wood Green. I think it also serves practically the whole of Tottenham—my right hon. Friend the Member for Tottenham (Mr Lammy) is in his place, as is the hon. Member for Enfield, Southgate (Mr Burrowes). I am pleased to say that we have been working cross-party on the issue. Frankly, I will work with anyone—other hon. Members involved would do the same—who is willing to put the hospital first.

The CQC’s damning report into North Mid was published on Wednesday 6 July, and its inspection of the emergency department and two medical wards at the hospital was in response to a

“number of serious incidents…which had raised concerns about the standards of care”.

Between March 2015 and March 2016, there were 22 cases at North Mid’s A&E department where patients experienced serious or permanent harm or alleged abuse, or where a service provision was threatened. The CQC found that people were waiting far too long to be assessed on first arriving at the hospital, to see a doctor and to be moved to specialist wards in the hospital. The main experience of anybody turning up at the hospital’s emergency department was to wait, wait and then wait again.

The report tells of a lack of respect and dignity in how patients were treated, including a time when there was only

“one commode available in the whole of the ED”—

emergency department—

“to serve over 100 patients.”

Most people reading this will find that shocking.

Resources had been so stretched that, by the time the CQC issued its warning notice to the hospital in June, only seven of 15 emergency department consultants were in post, and seven of 13 middle-grade emergency doctors. As a consequence, junior doctors and medical trainees have been left unsupported by senior staff in A&E at night, including in emergency paediatric care. Junior doctors have been asked to perform tasks for which they are not yet qualified, and there have even been reports of receptionists with no medical training being used to triage patients, at least to the extent of deciding whether they should go to urgent care or the emergency department.

In February, A&E staff were so overwhelmed that patients, many of whom had already been waiting for hours, were told that they should go home unless they thought their illness was life-threatening. How can anyone be expected to know how ill they are without seeing a doctor? We have self-service checkouts in our supermarkets, but self-service A&E? I think not.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

I thank my right hon. Friend for securing the debate. Even though the hospital is not in my constituency, much of what she describes happens in hospitals in my constituency and just outside it. At Central Middlesex hospital, which is just outside my constituency but serves many of my constituents, healthcare provision has also been affected by cuts. A recent inspection by the CQC similar to the one that she is describing highlighted a lack of experienced medics for seriously ill patients. Does she agree that such staff shortages threaten patient safety?

[Joan Ryan]

I do indeed, and I am grateful to my hon. Friend for that intervention. One point that I argue most strongly is that, although the MPs concerned are banding together to defend our hospital and fight for adequate and safe service, it is obvious that this is not just about North Mid—North Mid is just the first point where the crisis has hit. This is an issue around outer London, across London and probably nationally, particularly for district general hospitals.