Jim Shannon MP: speeches

Speeches

• 20 Nov 2024 · Blind and Partially Sighted People: Employment Support · Hansard source

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  The hon. Gentleman is absolutely right. I know that the Minister is an assiduous Minister who is here to help, and that the staff and civil servants behind him are taking notes on all these matters, so hopefully when he winds up the debate he will satisfy our requests. I also welcome the shadow Minister, the hon. Member for East Wiltshire (Danny Kruger), to his place; I wish him well in the role and look forward to his contribution. The Access to Work scheme has no minimum number of hours for eligibility for support, although people are generally expected to reach the lower earnings limit. Access to Work aims to help if someone needs support or adaptations beyond the reasonable adjustments; it helps pay towards them. What we have in place is excellent, but as the hon. Member for Glenrothes and Mid Fife (Richard Baker) says, people need to know what is available. The scheme is a great one, but the onus is firmly on the employers’ shoulders. That is where we are we are failing. There needs to be a pathway for our young people throughout schooling and into employment. We need to tell people who have not worked before, “It is not impossible. It can be done. It is within your reach to use your talents, intelligence and abilities and work as your peers do.” Debates like this one raise awareness, which is wonderful, but we need to ensure that any person who has a diagnosis of sight loss understands that they are not alone or expected to sit at home. They are part of this community, and there is a space for them and a role for them to play. The charities seek to hammer home that message and they do absolutely marvellous work, but we all need to do more. My hope is that this new Government will achieve that. I have known the Minister for years and he has always shown sympathy and compassion, so I know that he will be able to respond in a positive fashion and help people to do better. We have that opportunity, and the Government have that opportunity. Let’s do it.

• 20 Nov 2024 · Blind and Partially Sighted People: Employment Support · Hansard source

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  It is a pleasure to serve under your chairship, Dr Huq; I always look forward to it. I commend the hon. Member for Battersea (Marsha De Cordova) for setting the scene so very well on a subject that is of great interest to all hon. Members present and to me personally. It is only fair to put on the record my thanks for her leadership of the APPG on eye health and visual impairment. In the time we have known each other, I have always supported her in these debates; she used to be on the Opposition side of the Chamber, but has now been elevated. We look forward to working strongly alongside her and others in the years ahead, if God spares us. There are currently 57,500 people across Northern Ireland with sight loss, and the figure is expected to rise by over 25% by 2032. Today’s debate sets out the problem, but it also gives us an opportunity to think about what we can do to reduce that figure. Some 50% of sight loss is preventable, and it is that preventable 50% that I want to talk about. The message must be clear that eye tests are as necessary as any other health check. I work very closely alongside the opticians in Newtownards in my constituency: they come to me regularly with their ideas, and I always convey those ideas to the Health Minister in Northern Ireland and to the Secretary of State or Minister at Westminster. I cannot remember the technical term for it, but the opticians in Newtownards have the most up-to-date machinery for checking people’s eyes—it is phenomenal. My question to the Minister, if he does not mind my asking it at the very beginning, is what has been done to ensure more opticians’ tests, even for people who may think that they do not need one. I do not want to make them mandatory, because that would be wrong, but they should be made more accessible and available. I will give two examples of the importance of opticians’ tests. A gentleman I know quite well once came to see me. I said that he did not look very well—he was very pale—and he said, “Jim, I have an absolutely splitting headache.” I said, “Have you been to the doctor?” He said, “I have, and the doctor gave me some headache tablets.” I said, “Where are you going now?” He said, “I’m going to the opticians.” I said, “You go to the optician and tell him about your headache.” The optician took that man’s details and sent him directly from Newtownards up to Ulster hospital in Dundonald. He had a tumour the size of an apple in his head. Immediate surgery saved that man’s life. Another person I know quite well had been having headaches and blurred vision for some time. She would come to see me about benefits, and I would say, “Look, I think you should go and see your optician.” She did, and fortunately she had a tumour removed. It saved her sight and saved her life. What more can we do? We—when I say “we”, I mean the Government—can prevent eye loss. If the Government can get people to make appointments early, I believe we can see great things happening for the 50% of sight loss that is preventable. Back in June, the Department of Health in Northern Ireland launched two new guides to support adults with sensory disabilities in Northern Ireland. As always, I will give some examples that I hope are helpful for the Minister to take on board. The new resources, known as care pathways, map out the care and treatment that users can expect from professionals and support organisations to help them to manage their conditions. I welcome the excellent initiative to make a pathway to care and a future free from red tape and obstructions. My goodness! I know that there is red tape to get through—we understand that—but sometimes it becomes so burdensome that people just turn off. The guides were released in tandem with the Royal National Institute of Blind People and other charitable groups. The support provided for blind and partially sighted people by those in the charitable sector is phenomenal. They should be thanked for stepping up and filling the breach, as they so often do. I read recently on the RNIB’s website that it has a scheme called “SkillSET RNIB (2023)”, a Northern Ireland-based pre-employment initiative that offers opportunities for people who are seeking to gain employment for the first time or who are unable to continue in their current job because of sight loss. The hon. Member for Battersea has described the problems she experiences in coming to work and how technology lets her down; schemes such as these, in tandem with the Government Department back home and with the RNIB, can come up with ideas to address those issues directly and helpfully. They can enable people to find work and can encourage them in everyday life. I am also aware that the Department for Work and Pensions has the Access to Work scheme, which is operated through the Department for Communities in Northern Ireland. Access to Work can contribute towards any supplementary employment costs that result from a disability. Sometimes we come and present cases, but there are things that Governments do, both back home at the Northern Ireland Assembly and here. I believe that the DWP’s Access to Work scheme is available for any paid job, part-time or full-time, permanent or temporary.

• 20 Nov 2024 · Blind and Partially Sighted People: Employment Support · Hansard source

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  In my contribution, I outlined some of the things that we are doing in Northern Ireland. Obviously, that was to help the Minister with ideas that could be used here on the mainland. The Minister has outlined a number of things that are happening here. Does he intend to contact the relevant body in the Northern Ireland Assembly to ensure that we can work better together, share ideas, do things better and make life better for the people we are here for?

• 20 Nov 2024 · Blind and Partially Sighted People: Employment Support · Hansard source

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  As always, my hon. Friend adds important evidence that takes the debate forward, and I thank him for it. Hopefully the Minister is listening as well.

• 19 Nov 2024 · Windsor Framework · Hansard source

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  I commend the hon. and learned Member for securing the debate. He is right to mention farming. Does he agree that our farmers, who have been decimated by the inheritance tax proposals, will not be able to access state aid, while farmers on the mainland can apply for and get that aid? The Government must do the right thing: remove the protocol and return Northern Ireland to the UK in every way.

• 19 Nov 2024 · Food Banks · Hansard source

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  I commend the hon. Member for Aberdeenshire North and Moray East (Seamus Logan) for leading today’s debate and giving us all an opportunity discuss this issue. Christmas is the time of year when we think of those who are struggling and need support. I do not hesitate to say that, year after year, our food banks are pillars for such people in the local community, so it is really good to be here to discuss them. I cannot continue without putting on the record my sincere thanks to the volunteers who go above and beyond to support people who are struggling across the United Kingdom. I have a fantastic relationship with the local food banks in my constituency of Strangford. The first Trussell Trust food bank in Northern Ireland was in Newtownards in my constituency—my hon. Friend the Member for East Londonderry (Mr Campbell) referred to it—and it has built up a marvellous relationship with the local churches. It brought all the churches together in the best ecumenical way. It fed into that process, and its volunteers have helped so many people. If Members are free tomorrow between 9.30 am and 12 noon, Trussell Trust members will be in Parliament Square. There is another thing happening today that would have clashed with that event, so it will be put on tomorrow. In my constituency of Strangford, 3,064 emergency food parcels were provided between April 2023 and March 2024—a 57% increase. That included 1,284 for children—a 52% increase. Some 79% of the UK public agree that poverty in this country is a massive problem and that it is the Government’s responsibility to change that. We look to the Minister and the Government to bring about those changes. Whether we are in government or not, it is important that we do that. Food banks bring out the best in people. I see that in the people working in food banks who participate, contribute and help along the way. By April 2023, food inflation had risen by 19%, and it remained above 10% for much of the year. More than 200,000 people face hunger and hardship in Northern Ireland, including 130,000 working-age adults, 12,000 pensioners and 62,000 children. That gives an idea of what food banks do and how they reach out. In Northern Ireland, 25% of families in part-time work face hunger and hardship, as do 39% of people and families across the UK on universal credit. I imagine that the figure of 12,000 pensioners facing hunger and hardship will only increase this year. There are pensioners out there who depend on the winter fuel payment to keep them warm through the winter. All we can do is hope that they do not face the decision whether to heat their homes or put food on the table. Lastly, social security changes can bring help at the bedrock level by supporting those in most need, including by supporting those on the breadline with essentials. I hope that our Government and our Minister will do what they can to ensure that families do not struggle. I ask the Minister to consider meeting representatives from Northern Ireland to understand the full scale of the issue and see what more we can do to support those on the brink of poverty. If she is free tomorrow, I will see her at half 9 in the square.

• 19 Nov 2024 · Jailing of Hong Kong Pro-democracy Activists · Hansard source

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  I am sure that the right hon. Lady will gather the frustration that we all have, on both sides of the House, about what is going on; she probably shares it. What steps can she take with the Chinese Government to address what can only be seen as political lawfare, given that our Prime Minister seems to have some access to the Chinese President? Does the Minister agree that we cannot sit back while 47 people are found guilty of nothing more than proposing candidates for a democratic election, and that we are watching the death of any pretence of democracy in Hong Kong?

• 19 Nov 2024 · Ryan Cornelius: Detention in UAE · Hansard source

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  First, I commend the hon. Gentleman on securing this debate. I spoke to him before it. I have always been a speaker for human rights, as he and the House know. Whenever I hear stories like the one he has outlined so well, it tells me that there is injustice. The friendship between the UK and UAE does not matter; this is about justice and doing right when somebody is discriminated against. Does he not agree that the inaction of the Foreign, Commonwealth and Development Office—I say that respectfully—in respect of one of our citizens is incredibly concerning? The fact that Mr Cornelius has served his sentence, only to have the goalposts moved, does not speak of international justice, but injustice. I believe that our Foreign Office has an absolute duty to advocate for this British citizen.

• 19 Nov 2024 · Occupied Palestinian Territories: Humanitarian Situation · Hansard source

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  Members might be aware that I am a friend of Israel and I have visited Israel in a delegation to see at first hand the devastation that people are living through there this year. However, being a friend of Israel does not make me an enemy of the people of Gaza and I wish to make that very clear from the outset. This is an issue that stirs deep emotions and concerns, and I commend my colleagues for their dedication to discussing these critical matters, especially as we consider the recent and devastating events of 7 October. The attack on Israel by Hamas, a recognised terrorist organisation, was a tragedy of immense proportions. Over 1,200 lives were taken, and acts of violence committed so horrific that they have left an indelible scar. We witnessed the murder of innocent civilians, the targeting of women and children, acts of brutality that defy comprehension. The trauma of that day will remain with us, and more importantly with the victims’ families, forever. It is right that we call out those atrocities for what they are—acts of terror designed to destroy the very fabric of peace. Yet as we rightly condemn Hamas, we must also turn our attention to the humanitarian crisis unfolding in Gaza and the west bank. The Palestinian people, who have long endured hardship, find themselves caught in the crossfire of this conflict. They suffer from a lack of access to basic necessities, such as food, clean water and medical care. The destruction of infrastructure and the blockade have exacerbated that plight. Let me be clear that recognising the humanitarian needs of the Palestinian people does not and should not conflict with our unwavering support for Israel’s right to defend itself. The humanitarian situation in the occupied Palestinian territories, especially in Gaza, has reached a critical level. Attacks have disproportionately affected vulnerable groups such as women, children and the elderly. The healthcare system has collapsed and humanitarian access remains severely restricted, with only a fraction of aid trucks permitted to enter Gaza daily. The road to peace is complex, and part of that journey must include a mutual recognition of rights. Palestine must acknowledge Israel’s right to exist in every sense of the word—politically, socially, territorially—and with that recognition must come a clear and unequivocal renunciation of violence. Terrorist attacks launched from Palestine territories must cease, not only because they undermine peace but because they perpetuate a cycle of suffering for both Israelis and for Palestinians. I am particularly pleased to see the Minister in her place. She knows that I am fond of her because she answers questions and has compassion and understanding. The justice that she promotes is well known and so I very much look forward to hearing how the Government plan to address this pressing issue with urgency and clarity. Let us not forget that the humanitarian crisis in the occupied territories is a symptom of a deeper conflict. It is a conflict rooted in historical grievances, territorial disputes and mutual mistrust. Addressing humanitarian needs is essential but it must be accompanied by a robust effort to tackle those underlying issues. We must use all of our influence to encourage a return to meaningful negotiations between Israeli and Palestinian leaders. The ultimate goal must be a two-state solution in which both peoples can live side by side in peace and security.

• 19 Nov 2024 · Topical Questions · Hansard source

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  Can the Secretary of State confirm what assessment has been made of the number of women waiting for endometriosis surgery across the United Kingdom? What has been done to reduce waiting lists?

• 19 Nov 2024 · Infected Blood Inquiry · Hansard source

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  My constituent has mentioned an outstanding issue that must be addressed. Current proposals only include siblings who were under the age 18 and lived in the same household as an infected person for at least two years after the onset of the infection. The requirement for siblings to have lived in the same house should be removed. Does the hon. Gentleman agree that the loss and suffering of a sibling who did not live in the same household for two years is no less than that of a sibling who did?

• 19 Nov 2024 · Infected Blood Inquiry · Hansard source

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  Will the hon. Gentleman give way?

• 19 Nov 2024 · Infected Blood Inquiry · Hansard source

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  In my intervention on the hon. Member for Perth and Kinross-shire (Pete Wishart), I asked about the siblings who qualify. One sibling seems to be worth more than another sibling, and that seems absolutely wrong. I understand that there has been no reply to that in the Minister’s summing up. Maybe he is coming on to it—if he is, I apologise—but I would love to have a response, because my constituents have asked me to ask that question and ensure that we have a response.

• 18 Nov 2024 · Bus Funding · Hansard source

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  I welcome today’s statement. Will the Secretary of State commit to ensuring that funding will go to UK-based bus manufacturers, such as Wrightbus in Northern Ireland, which are reliable and efficient, and whose clean-energy buses meet the needs of customers as well as our environmental obligations? How will she ensure that we support the best of British?

• 18 Nov 2024 · Armed Forces Commissioner Bill · Hansard source

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  It is a pleasure to follow the hon. Member for Scarborough and Whitby (Alison Hume). With name like Hume, I presume that she must have some Northern Irish ancestry. I congratulate her on a superb maiden speech. Her constituents will be extremely proud of her contribution. We look forward to hearing a whole lot more from her in the future. I have a special interest in Whitby and Scarborough, simply because it is “Heartbeat” territory. I am from the generation that can remember all the songs from the 1960s, which is probably why I started to watch that programme. It is a pleasure to hear from the hon. Lady. I knew the right honourable Gentleman who represented the constituency before her, and I know that he will be just as pleased as the rest of us that she is here. It is a pleasure to participate in the debate. I declare an interest as I served in the Ulster Defence Regiment for three years, and in the Royal Artillery and Territorial Army for 11 and a half years. I am invested, as are all Members who have served in the armed forces, as well as those who have not, in the legislation before us. I am minded of the tens of thousands—probably hundreds of thousands—of people who have served in the armed forces in Northern Ireland. I am pleased to see the Minister for the Armed Forces in his place. I do not want to give him a big head, but whenever the Minister brings something to the Chamber, he always asks for our opinions and contributions, which means a lot to MPs. It is the honest way of doing things, and I thank him for that. Earlier on, the Secretary of State rightly said that this is “landmark legislation”. I think every hon. Member will greatly welcome it. I welcome the fact that the legislation will apply to Northern Ireland, something that we in Northern Ireland do not take for granted when it comes to the armed forces and what appears to be an appeasement of those who hate those armed forces in Northern Ireland. For the record, I commend Councillor Trevor Cummings, the veterans champion for Ards and North Down borough council, in my constituency of Strangford, on his great work and his interest in Army and police issues. He will welcome this legislation, just as I welcome it. We look forward to it being implemented in Northern Ireland to the same extent that it is implemented in England. I am pleased that respect and access to armed forces personnel support will be available, unlike access to the military covenant, which my party had to fight to see implemented in any form for our veterans. For too long, veterans in Northern Ireland have been treated as second class citizens, shamed for simply doing their duty. I hope this legislation signals a new approach to veterans in Northern Ireland. I asked the Minister a question in Defence questions earlier, and he came back with a very positive answer. I hope he will be able to repeat his answer, so that it is recorded in Hansard and will provide reassurance to people back home. I would like clarity about how the commissioner will ensure that those serving in all parts of the United Kingdom are treated equitably in the exercise of the new commissioner’s functions. I received a positive answer from the Minister when I asked that question earlier. Given Northern Ireland’s disproportionate contribution to reserve forces, we have a particular interest in ensuring that the commissioner provides an effective outlet for members of our armed forces and their families—it is important that we have that. How will the commissioner’s remit interact with the armed forces covenant, which was there before? There was some difficulty with that covenant, but I am encouraged by this legislation and I hope we will welcome the Bill’s Third Reading before too long. I was pleased that in the King’s Speech, there was recognition of the gratitude owed to those who have made sacrifices for our freedom and liberty. Today, we are here to scrutinise the outworking of that gratitude. In my opinion, that is not extravagant or groundbreaking, and a proper service should always have been delivered to those whose quality of life has been impacted by their service. In common with many other hon. Members, I know too many veterans whose internal scars from service have precluded them from keeping relationships with their family, keeping steady jobs or building friendships with people who simply cannot understand what they have been through. Many of those proud men and women would never apply for help, or complain about the lack of support that they have received. I welcome the fact that family members can now advocate to the Armed Forces Commissioner for services for a veteran; that is a massive step forward for veterans and their entire family unit. It is good news. Where we have seen difficulties before, we can see positives, going forward, which is good. I hope that part of the role of the Armed Forces Commissioner will be to ensure that veterans have an accessible route to support that will skip the red tape and arrive at a sensible approach. It is important that if a service member retires or leaves service while the commissioner is still processing a complaint, it is effectively transferred to the Northern Ireland Veterans Commissioner. Will the Minister tell us where that will fit into the process? A joined-up approach is important, so I seek assurance that that will happen. The Minister for Veterans and People is not in his place, but I know that he will be back shortly. I have invited him to visit the Beyond the Battlefield veterans centre in Portavogie in my constituency. Both the Minister for the Armed Forces and the Veterans Minister know it well, and I hope that the Veterans Minister will visit in the near future. The centre was designed and built with short-term respite for veterans in mind. It is a place for veterans and their families to come to for a break, with counselling services available, and for a change, to enjoy the peaceful and restful environment of the incomparable Ards peninsula, where I happen to live. The centre is excellent and is up and running. Harbour House provides shelter to ex-service personnel who are homeless or suffering from post-traumatic stress disorder. The centre does an excellent job, for which we are very grateful. Beyond the Battlefield, a charity that helps serving and retired members of the service community, transformed a once derelict building into a dedicated veterans centre. The charity provides practical help and advice on issues such as PTSD, war pensions, benefits, housing, medals and funerals. I have been pleased, privileged and honoured to work alongside the charity’s staff to help veterans move forward and make their life better. Entering Harbour House, veterans come into a welcoming reception area with tea and coffee making facilities, and there are 10 bedroom suites. The charity does a phenomenal job. There are plans to extend the facility, and I am sure that the Veterans Minister will be asked about that when he visits. The previous Government had hoped to provide some funding. I do not want the charity to have to come to the Government cap in hand, but it wants to do what it does better, and to add to what it has in place. Those 10 bedroom suites are full all the time, but the building could be extended to increase its capacity—and it would still be full. In Northern Ireland, we have a commitment to service. We never needed conscription in Northern Ireland because we were always able to get volunteers. When the Veterans Minister comes, we will show him the phenomenal job that Beyond the Battlefield is doing. It has a coffee shop that is open to the public, which helps to meet people’s needs and is well supported, but central funding is severely lacking. It is the only veterans respite centre in Northern Ireland. Its importance cannot be sufficiently underlined. It serves and looks after veterans from the six counties, and probably further afield. Beyond the Battlefield cannot secure funding, and relies on charitable fundraising. If someone wants a cup of coffee or a meal, Harbour House has been commended for its food. There is scope for more rooms to be created, and more good work to be done. The installation of the armed forces commissioner has been endorsed and supported by everybody, because it is the right thing to do, and will be best for everyone across this great United Kingdom of Great Britain and Northern Ireland. It will provide greater focus on the needs of our armed forces and veterans, and I believe that support for projects such as Beyond the Battlefield will naturally flow from it. I again thank the hon. Member for Scarborough and Whitby for setting the scene for this young man to make his contribution. She is the star; I am just a follower. Most of us in this House attended remembrance services last week. We are all aware of the debt that we owe to not simply those who gave their life in the world wars, but all those who have served—in guerrilla warfare from Afghanistan to Armagh, and from Erbil to Enniskillen. The debt is not paid in one day, with the recitation of a poem—I do not mean that disrespectfully—but through living and breathing. I hope that the creation of this post will breathe fresh air into the obligation that we have to those who offer us their all; I am convinced that it will.

• 18 Nov 2024 · Armed Forces Commissioner Bill · Hansard source

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  Many soldiers and other service personnel suffer from post-traumatic stress disorder and may be reluctant to come forward and seek help, but the people who know them best are their families, who can do so on their behalf. That is the great thing about the Bill: it provides that opportunity.

• 18 Nov 2024 · Financial Services: Mansion House Speech · Hansard source

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  I thank the Minister for her statement. We must welcome the news that London edges closer to New York as a financial hub. However, the Minister is aware that growth happens only if we attract investment. I believe that the decision to pool pension funds into larger investment vehicles is a bold one, yet the Chancellor must ensure that guarantees are in place, so that the mega-pool of pensions does not go down the drain, and that guardrails are in place to safeguard the nation’s pension pots.

• 18 Nov 2024 · Children’s Social Care · Hansard source

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  I welcome the Secretary of State’s statement. This is incredibly good news so I thank her very much—I think we all welcome it across this great United Kingdom of Great Britian and Northern Ireland. The Barnardo’s charity in Northern Ireland has indicated for a long time that it has been concerned about this issue, so it too welcomes the statement today. We in Northern Ireland have the highest rate of kinship care, along with Scotland, but a streamlined process with a decent level of funding would enable greater buy-in from those who have lots of love but not enough money. Any increase would also need additional funding for the devolved regions. Is the Secretary of State able to confirm that?

• 18 Nov 2024 · Primary School Breakfast Clubs · Hansard source

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  I commend the hon. Gentleman for securing this debate. There is such a crowd in the Chamber because we all agree with him. Northern Ireland launched the extended schools programme in May 2006. Since then, some £167 million has been given to the most disadvantaged areas to offer a wide range of services, including free breakfast clubs, and it has been successful. Does the hon. Gentleman agree that the Government and Parliament must provide greater central funding to ensure that all UK schools can offer free breakfast clubs to give children a good breakfast to boost their energy levels for the day? Quite simply, hungry children do not learn.

• 18 Nov 2024 · Independent Armed Forces Commissioner · Hansard source

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  I thank the Minister for his response to the questions. In Northern Ireland recruitment is at record levels—there has never needed to be conscription because there were always volunteers. Ever mindful of that, and of the need to ensure that the independent Armed Forces Commissioner has the same responsibility and power in every place in Northern Ireland, will the Minister please indicate strongly, if he can, that every council will be involved, and every person who needs help in Northern Ireland will get it?

• 14 Nov 2024 · Serious Fraud Office · Hansard source

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  Not so long ago a TV programme—I think it was “Panorama”—showed that dirty money and bribery was moving from Latvia to Germany and Northern Ireland, and it clearly showed that international criminal gangs and paramilitary groups are working together. Has the Solicitor General had an opportunity to discuss how better to tackle those gangs, for instance by working better regionally, or by working together with the Republic of Ireland to ensure that we combat those groups?

• 14 Nov 2024 · Fly-tipping · Hansard source

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  It is nice to see the hon. Lady back in the House and elevated to a Government position—well done. The Northern Ireland Environment Agency has revealed that it has cleaned up some 306 illegal waste sites in the last two years, with taxpayers footing the bill of half a million pounds—equivalent to 15 nurses’ wages. What discussions has the Minister had with the Minister in the Department of Agriculture, Environment and Rural Affairs back home in Northern Ireland about the cost associated with fly-tipping?

• 14 Nov 2024 · Council Tax · Hansard source

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  As the Minister will know, although we do not have council tax per se in Northern Ireland, the pressures on our family finances are on a par with those on the UK mainland. The Government need to be clear about just how much further the finances of average families will be stretched, because this is a very worrying trend. What extra help can families, especially disabled families, expect to receive this year?

• 14 Nov 2024 · Respiratory Health · Hansard source

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  I will never get it wrong again. I thank the hon. Member for Newcastle-under-Lyme (Adam Jogee) for his contribution. Air quality has been a massive issue for him since he came to this House; he has reiterated that over and over again. I am hopeful that he will have the success for which he hopes. He referred to deprivation and low incomes as factors. Priority for respiratory health is needed, as the Minister confirmed. The hon. Member for Redditch (Chris Bloore) rightly referred to the need for regular asthma check-ups. It is always a pleasure to work alongside the hon. Member for Blaydon and Consett (Liz Twist). She and I have talked about this issue over the past five or six years. It was a pleasure to hear her contribution, which included first-hand evidence from her surgery. I agree that we need improved access to diagnostics and medical help. I thank the hon. Member for Sherwood Forest (Michelle Welsh) for her personal contribution; nothing tells a story better than a personal contribution. As the Minister says, we hope that her family members are able to deal with their issues in a positive fashion, and hopefully the medical care will be there as well. The hon. Lady referred to how the disease drastically changes lives, with some people being unable to walk. She also focused on charity work, which is really important. The hon. Member for Winchester (Dr Chambers) referred to air pollution, as his party has done for many years. He underlined the problems and the impact on children, and he referred to our old housing stock. These are critical issues. We sometimes forget about farmer’s lung, but those who live in the countryside do not, because it is a big issue. He also referred to RSV, the impact on pregnant women and the importance of vaccination. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), reminded us that his first job related to this issue. That has allowed him to make an incredible input into the debate: we thank him for everything that he has put forward. It is fair to say that the last Government had a plan, but a more holistic approach is needed. I thank him for his role on the APPG. Prevention is absolutely the way to go, and data is important. He also mentioned spirometry. The Minister responded in excellent fashion. I wrote down all the things she said. I thank her for committing to a meeting. I am sure that her colleague the hon. Member for Gorton and Denton (Andrew Gwynne) will be watching the debate and will respond. She referred to her former job and vocation, in which she had dealings with COPD directly. I am also grateful for the roundtable commitment. The Government have committed to a smoke-free society, on which a Bill is pending: that will be important in preventing lung cancer, especially for children. She also referred to damp in homes, an incredibly important issue that comes up all the time in the main Chamber. The Minister responded very positively, if I may say so, to all the issues on which we required answers, including vaccinations, energy efficiency and fuel poverty. The respiratory network across the nation deals with COPD and major contributors to respiratory health issues, and the Government are committed to it. Respiratory health and biologics are priorities for the Government. It is not often that we have a debate with so much input from everyone, and yet we have a Minister who answers all the questions. Question put and agreed to. Resolved, That this House has considered respiratory health.

• 14 Nov 2024 · Respiratory Health · Hansard source

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  The hon. Member is absolutely right. If there are deaths of people with asthma that are attributable to not getting regular examinations or appointments with doctors or consultants, that is an issue that must be addressed. I am quite sure that the Minister is taking notes and that her civil servants and her Parliamentary Private Secretary will ensure that information is contributed to the debate. NHS waiting lists for respiratory care have risen by 263% over the past decade. Poorly controlled respiratory disease results in hospital admissions doubling during the winter period. COPD exacerbations are the second most common cause of emergency hospital admissions. These are worrying figures—as worrying as the issue to which the hon. Member for Redditch (Chris Bloore) refers. New research presented at the European Respiratory Society has shown that the biologics uptake for severe asthma is disastrously poor: the national median for patients in England with severe asthma between 2016 and 2023 is 16%. The uptake varied widely among integrated care boards: it was between 2% and 29% against a target of 50% to 60%. These are worrying figures that indicate an unfortunate trend that should concern us all. The burden of respiratory disease falls disproportionately on the most deprived. Adults in the poorest 10% of the country are more than two and a half times more likely to have COPD than the most affluent. The 10% most deprived children are four times more likely to require emergency admission to hospital due to asthma than the least deprived. Those figures show a fall-down and a need to focus on those areas. Lung conditions, especially asthma and COPD, cost the NHS £9.6 billion in direct costs this year and every year. That represents 3.4% of total NHS expenditure. Those conditions result in 12.7 million work days being lost every year. The stats indicate a massive problem that needs to be addressed. The illness and premature death associated with them causes reductions in productivity totalling some £4.2 billion a year, and the conditions have an overall impact of £13.8 billion on the English economy. All these stats tell us that we have a major problem. I ask the Minister that the NHS prioritise the issue. I understand that it was prioritised by the previous Government, but that that was not acted on because of the election, so I ask respectfully that it be prioritised in our strategy for the time ahead. Improving respiratory outcomes will help to achieve the Government’s ambitions to improve the nation’s health, to halve the disparities in health outcomes, to eliminate waiting lists, to break the winter crisis cycle and to enable everyone to live well for longer. I have a number of questions for the Minister; I think my staff have sent her a draft of my speech and the questions I will ask. Will she confirm that respiratory health will be a priority for the Government? That is my first big ask. The APPG strongly supports the Secretary of State’s three shifts, which were announced following the Darzi report. I very much welcome that report, and the Secretary of State has done extremely well: it was a difficult portfolio to take on, but he has shown that he has the ideas to take it forward strategically. I hope the Minister can provide an idea of how that will happen for those with respiratory health issues. The Darzi report proposes a shift from analogue to digital. We certainly have to improve the system that is used for our data and for healthcare more broadly, as the Secretary of State has said in the Chamber; I was very encouraged when I heard him talking about that shift. The other two shifts proposed are from hospital to community and from treatment to prevention. Those three should be front and centre, and they all have an important part to play in improving outcomes. The Government are right to highlight the impact of inequalities and deprivation on health. We strongly support their plans to achieve that through the three shifts, with which they have set a strategic course. The statistics are clear: we have to improve outcomes for the most vulnerable in society. Our No. 1 duty as elected representatives is to look out for our constituents, particularly those who are vulnerable—that is why we are elected representatives. Our duty is to look after those who are less well-off, those who are physically vulnerable, those who are disabled and those who have other issues in their life. Mortality rates from respiratory disease are higher among disadvantaged groups and areas of social deprivation, higher exposure to air pollution, higher smoking rates, poor housing conditions and exposure to occupational hazards. That has to be a major focus for us all. The trial of neighbourhood health centres could offer a significant shift from hospital to the community; the Government are considering that, and it is a good step in the right direction. We hope that we will enable a better focus for diagnosis and treatment of respiratory health, which could help to reduce inequalities. As the burden of respiratory disease disproportionately affects the most deprived parts of this great country, winter pressures are higher in those areas, so the centres need to be able to match the local challenges. Will the Minister indicate how that will happen? Part of the challenge relates to the provision of spirometry testing, which is an essential diagnostic tool for asthma and for COPD. Community diagnostic centres currently offer very few spirometry tests; some offer none at all. I ask the Minister to confirm that spirometry will be widely rolled out, especially in deprived areas where we need its use to be widespread in primary care. It would be extremely helpful if spirometry could receive sustainable funding to be equitably delivered. I welcome the Minister’s thoughts. As the Minister will be aware, the national screening committee has recommended introducing a targeted lung cancer screening programme across the UK. However, the screening programme only explores the possibility of lung cancer; unfortunately, it does not focus on addressing incidental findings of undiagnosed COPD identified during the screening. Including those findings would enable neighbourhood centres to help deliver better care for COPD. We are aware of some work being undertaken in Hull to roll incidental findings into potential COPD diagnoses. I ask the Minister and NHS England to look closely at the outcomes of that study, which I believe will give some direction on what needs to be done in the United Kingdom. We are deeply grateful to those in Hull who are working on COPD diagnosis. The national screening committee’s guidance on COPD has not been reviewed since 2019. I ask the Minister whether there are any plans to revisit that and to bring it up to date. It is five years since it was done, and the figures indicate a worrying trend of more disease. We need to have that in place. Overprescribing of SABA inhalers—short-acting beta agonists—remains a big problem. Guidelines would be of enormous help. I ask the Minister to ensure full support for the NHS to implement new guidelines. The APPG has been looking at the impact of inequality for some time. We highlighted that at our COPD event in the House at the end of last year. It was a well-attended event with constructive comments. As we always do in the APPG, off the back of that, we are looking forward more strategically, with a number of asks. We intend to hold regional events to enable local clinicians to inform us what more needs to be done. There is nothing better than asking clinicians the best way forward. They know. They deal with patients daily, and we deal regularly with constituents, and that helps us to focus attention, specifically on prevention. The number of asthma deaths is far too high. They are worryingly high, as the hon. Member for Redditch mentioned. It has to be a priority for us all to reduce deaths as quickly as possible and for that to be an integral marker in the 10-year plan. The Secretary of State is giving us a 10-year plan. Perhaps the Minister can tell us today where the asthma and respiratory health focus is in that 10-year plan. It needs to have that focus, and I hope we get that response from the Minister today. We are 10 years on from the national review of asthma deaths report and very little has changed in terms of asthma outcomes. A recent study showed that people on lower incomes reported greater use of oral corticosteroids than people on higher incomes. These findings highlight that there may be an increase in OCS prescriptions for people with asthma and COPD in more deprived areas. The study results are similar to those reported in the 2019 survey by Asthma and Lung UK. I again urge the Minister to keep an eye on that study, to see what lessons we can learn. I know the Minister is committed to making things better and we support her in her quest to do so, but I believe there are many who have helpful contributions on how that can be done. The APPG also welcomes improvements in inhaler technology, specifically the move to combination inhalers, which will ultimately eliminate the use of twin inhalers. That should benefit both asthma and COPD patients and will contribute to the NHS’s net zero targets. There are lots of things that have to be done. We all subscribe to the net zero targets—they need to be addressed—and this is a way of achieving two goals in one. We welcome the Government’s commitment to increasing the NHS workforce. That is very good news as well. We will see how that looks in the workforce plan next year. I ask the Minister to ensure that with a significant increase in staffing levels in primary care, we will see an end to untrained staff undertaking annual asthma reviews. I do not want to be too critical—that is not in my nature —but when there is an anomaly we have to address, it has to be said. The APPG warmly welcomes the promise of the outcomes of the 10-year plan, and we will submit our response to the consultation. To have any real impact on respiratory health, though, we believe the plan has to be disease specific and contain suitable outcome measures for respiratory health. Will the Minister confirm whether the plan will include disease-specific measures for respiratory health? Again, I ask the Minister to benchmark metrics at the start of the plan and to factor in regular outcome updates at three, seven and 10 years. If we do that at those points, we can chart the progress, or perhaps the lack of progress, and make improvements. The metrics could include fewer asthma deaths; reduced hospital admissions for asthma and COPD, especially winter admissions; prescription data; and reduced incidence of asthma and COPD in the most deprived areas. Interim data outcomes will enable us to determine whether the plan is on track to deliver the outcomes we all want to see. The use of biologics is of particular concern to the APPG and features regularly in our meetings. I am sorry to say that figures on the use of biologics in England are simply dreadful. The national median by patients with severe asthma in England between 2016 and 2023 sat at 16%, and the uptake varied widely among ICBs at between 2% and 29% against an uptake expectation within the clinical community of 50% to 60%. It just does not seem to be working. Biologics treatment has been described by our clinical advisers as life-saving for severe asthma patients. There is both wide regional variation in access, and unacceptable delays to the start of treatment. Many patients who need urgent treatment have to wait years to get access to the services that will prescribe biologics to them. That is an inefficient use of NHS resource and means that the health of patients is deteriorating while they wait for the right treatment. I do not want to see that, hon. Members do not want to see that, and I know the Minister does not want to see that either. We need more easily accessible severe asthma services. Again, I would be much obliged if the Minister could meet us to look at how we can provide better asthma care for those with the highest burden of disease. I hope that the NHS innovation and adoption strategy will put forward solutions to tackle low and variable uptake and the access to innovative treatments, such as severe asthma biologics. The APPG would like to see a funded transformation with the health innovation networks and clinical leadership on the implementation of NICE guidance on respiratory health at neighbourhood level and on the delivery of biologics. We are being constructive—the Minister knows that I will always be constructive because I believe we need to move forward together and ask the questions. I note the Secretary of State’s recent remarks on data sharing and the call by Asthma and Lung UK for greater data sharing in its report, which urges the Government to “Improve data collection and analysis across the care pathway to bring together primary and secondary data, and make high quality, publicly available data which will help ICSs target care where it is needed and ensure accountability”. We fully support that, and I do not think there is anybody in this room who would not support that, because it is absolutely the way forward. We are also looking closely at the recent increase in silicosis cases around the country, especially in relation to engineered stone. It is something that maybe not everybody is aware of, although I suspect those in this room are. There is a real threat that the rise in what are entirely preventable cases may add considerably to local health pressures. The Secretary of State has been clear that we need to address the waiting lists and take more action to prevent cases, and that is something I have suggested needs to be done as well. There are a number of recommendations in our silicosis report, and a key recommendation concerns wider data sharing between primary and secondary care. The APPG will hold a roundtable in the new year to ensure a timely discussion to inform the 10-year plan. I ask the Minister if she would be most kind and put it in her diary and come along. We are not here to give the Minister a hard time, but to take her contribution and help us to move forward together. The Parliamentary Private Secretary, the hon. Member for Aylesbury (Laura Kyrke-Smith), is not nodding because she cannot do that for the Minister, but she is indicating—I will send over the date, if that is okay. Since 2015, 250 to 300 patients have been diagnosed with CF each year. Despite medical advances in recent years, in 2022 the median age of death for those with CF was just 33. Wow—think about that. The Cystic Fibrosis Trust has called for greater financial support for people with cystic fibrosis for a number of years. In 2023, a University of Bristol study reported that a typical family with cystic fibrosis loses £6,800 a year due to the extra costs of living with that condition. The CF Trust has multiple requests, including for the Government to explore additional innovative market-incentive options to encourage the industry and others to fund research and trials for new antibiotics because of current antibiotic resistance. I believe we have seen a good and positive contribution to research and development, but we are probably at a cusp where a bit more investment and help would get us over the line. We need to prioritise diagnostics for antimicrobial-resistant infections to prevent further lung damage. The Trust’s final request is to implement an early warning alert system on pollution for people with respiratory conditions. I am looking forward to hearing what others have to say. The fact of the matter is that we have an opportunity this time because we have a Government who are spending £22 billion on the NHS. That is a massive amount of money. Every person in this great United Kingdom recognises what that means. It is the time to get it right. The Secretary of State has indicated that he is of that mind, and I know the Minister is also of that mind, so we have an opportunity to make effective change to the lives of people throughout this great United Kingdom of Great Britain and Northern Ireland. Some of the £22 billion will come to us in Northern Ireland through the Barnett consequentials, which is good news as well. It means that everybody gains across this great nation. I believe now is the time to act. We in the APPG want to do all in our power to inform, support and guide the Minister and her Department in effecting change and improving quality of life for those with respiratory health issues.