Tuberculosis

Virendra Sharma Excerpts

Wednesday 27th November 2013 Westminster Hall

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dobbin; I thank you for giving me the time to speak in the debate. I congratulate my hon. Friend the Member for Scunthorpe (Nic Dakin) on securing the debate, which is close to my heart, as I am the co-chair of the all-party group on global tuberculosis. I also congratulate and thank the many agencies and non-governmental organisations that work in this field, which have helped to raise the issue and bring it to the top of the world agenda.

There is an urgent need to address TB worldwide, but we must not forget that it is still a big concern in the UK, where the rate of TB cases is the highest in western Europe, with 9,000 cases last year alone. My constituency has the second highest rate in the country—156.8 cases per 100,000 people, roughly six times higher than the UK average and equivalent to the rate in Tanzania. It is important to remember that TB is very much a public health threat in parts of the UK, and that it affects people’s health every day, often with long-lasting consequences.

One of the key barriers to treating and eliminating TB in this country is stigma. TB is an airborne, infectious disease, which is deemed incurable and is associated with poverty. Many people are reluctant to tell their families, partners and community when they have the disease, which means they are much less likely to be treated. In the UK, stigma is a barrier that prevents people from seeking treatment when they start to feel ill. It also makes it difficult for health workers to identify other people who might have been exposed, because patients are often reluctant to admit to the possibility of their having infected others.

We cannot afford to ignore TB. It needs to be prioritised and talked about so that people do not feel marginalised and ashamed. We need to ensure that they are aware that TB can be treated and that they seek treatment when they fall ill.

We have a great health centre in Southall that offers TB screening, diagnosis and treatment. However, a third of patients in the area had a delay of more than three months between symptom onset and diagnosis. Although the proportion of people completing treatment was similar to the London average, slightly more were lost to follow-up.

We need to support social outreach projects in high-risk areas as a means of engaging directly with the community, rather than wait for people to come to the health services. That will help to raise awareness and stymie stigmatising, and will enable us to diagnose and treat TB earlier in at-risk communities. Case finding needs to be an active process to ensure that cases of TB do not fall between the cracks and remain untreated.

On a local and community level, outreach projects are crucial, but it is essential that we also have a national strategy on TB. The all-party group on global tuberculosis led the way in calling for a national strategy on TB. It is encouraging that Public Health England is currently developing such a strategy, which will be published in 2014. The national strategy will drive best practice throughout the UK’s clinical and social care for TB, but we must ensure that it is closely integrated with other Government policies on TB, including those of the UK Border Agency and the Department for International Development.

An interdepartmental ministerial group on TB performed that task at the turn of the century, but unfortunately it produced only one report before folding. That group should be revived. TB affects a wide range of Departments, and efforts must be made to enhance co-operation and co-ordination across their policies and interventions to provide the most effective response to TB in this country. A formalised, recognised structure with appropriate support is the best way to make that happen.

TB has been neglected for too long. It is a disease that people do not talk about and have forgotten, which increases stigma and reduces the likelihood that those in need will receive treatment and care. The UK does not need to commit finances to make a difference to how the disease is perceived, but it does need to show leadership and commitment domestically and abroad. It can do that by reaffirming that TB is a serious threat and a priority, and by committing to a local community strategy accompanied by a national, co-ordinated interdepartmental approach.

[Jim Dobbin (in the Chair)]

I have enjoyed the debate very much. In a former life, I worked in an infectious diseases hospital, specialising in TB.