1.47 pm

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

I did not plan to speak in this debate. I planned to come along and show my support for the Bill by sitting on the Front Bench, but the powerful debate has compelled me to add my voice and to pay tribute to everyone who has worked so hard to get the Bill to this stage. I will not detain the House too long other than to pay tribute to the hon. Member for Thirsk and Malton (Kevin Hollinrake) for choosing this subject for his private Member’s Bill.

I have had a couple of opportunities to introduce a private Member’s Bill. One I was successful in enacting, and the other was sadly talked out by the hon. Member for Shipley (Philip Davies), who thankfully is not here today. That is probably why we are having so much consensus and success today.

It is great that the hon. Member for Thirsk and Malton chose this subject. There are always thousands of possible choices, but there could have been no better one. I offer him huge congratulations and thanks from all of us who have campaigned on this issue, not least the hon. Member for Colchester (Will Quince), who I am sure is off doing something important—he is probably doing some media. He should rightly get the plaudits for first introducing this subject in a ten-minute rule Bill.

The hon. Member for Eddisbury (Antoinette Sandbach) raised the issues of bereavement and baby loss in an Adjournment debate, and when she approached Members on both sides of the House, including the hon. Members for Banbury (Victoria Prentis), for Colchester, for North Ayrshire and Arran (Patricia Gibson) and me, about ​setting up an all-party parliamentary group, I did not hesitate. Indeed, I had some guilt because I had been here for 10 years and had felt the importance of all these issues but had never felt brave enough to do what she and other colleagues, who were brand new to the House, were able to do with such vigour and immediacy. So, I continually take my hat off to her and those other Members for everything they have done to show leadership on this and take it forward. The great success in the short two years that that all-party group has been going is astonishing, with the bereavement care pathways, the bereavement suites and now this Bill on bereavement leave and pay. I am so thrilled and proud to be a small part of that group and to support it as much as I can.

I just want to give a small example from my journey when this happened to me, as sitting here has brought it all back and brought tears to my eyes. It was a very different time then, 19 years ago, and I was working part-time. I was not on a zero-hours contract, but I did not get pay for being off sick. My employer was good and gave me time off, but it was without pay. Of course I got time off for the funeral, but without pay. I was off for about two weeks but it was never paid. I did not have to take holiday to grieve and have the funeral, but, equally, I was not paid. My husband had a good employer and could have taken time off with pay but, like the hon. Member for Beckenham (Bob Stewart) was saying about people dealing with grief in different ways, he could not wait to get back to work. That caused problems and I still have not quite forgiven him for that, because I really needed him then. However, he chose to go back to work, needing to do so as his way of coping. So it is right that this is not forced upon people, but he would have chosen to have taken that time later if the option had been available.

I want to end my comments by commending the Bill to the House. I hope it has a swift passage through; it would be amazing if we could get it on the statute book by Easter—that would be fantastic. Again, I thank all the hon. Members who have brought it this far, especially the hon. Members for Colchester and for Thirsk and Malton.

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

It really is an honour to be responding for the second time in this Chamber today on behalf of the Opposition.

First, I thank the right hon. Member for North Norfolk (Norman Lamb) for securing this very important debate. It really was much needed so that we could finally discuss in detail, and in the main Chamber, the issues around valproate and what the Government must do to address this injustice. He spoke with passion and obvious outrage on behalf of the thousands of women and children affected by this disgraceful scandal.

I, too, want to thank other hon. Members who have taken part in this debate, including the hon. Members for Congleton (Fiona Bruce) and for Eastleigh (Mims Davies), and my hon. Friends the Members for Newport West (Paul Flynn) and for Heywood and Middleton (Liz McInnes). My hon. Friend the Member for Bury North (James Frith) gave an extremely moving account of how the drug helped him as a young boy, making the point that, when used correctly, it can be a very good drug. We also heard contributions from the hon. Member for Strangford (Jim Shannon), my hon. Friend the Member for Lancaster and Fleetwood (Cat Smith) and the hon. Member for Central Ayrshire (Dr Whitford) who speaks for the Scottish National party. It has been a very good debate.

As we have heard, the issues of valproate and its effects on foetuses are not new. In fact, they span a significant number of years, going as far back as the 1970s and 1980s when the first cases of the effects of valproate were documented. Even recent scientific research has shown that valproate can have an impact on a child’s life, including a study finding that 10% of children exposed to valproate will be born with a major congenital malformation, with 29% requiring additional educational support and 6% being diagnosed with significant social communication difficulties, such as autism.

Although there has been some movement on making women aware of the risks of valproate during pregnancy through the valproate toolkit, there is still far more that should and must be done to support these women and their children who have been so seriously affected by this injustice. The scope of this issue is serious. Data from 2010 show that more than 21,500 women were prescribed valproate. Although not all those women will have become pregnant, or planned to become pregnant, it is worrying that, following the toolkit’s publication, there is still not enough awareness of the risks, with 85% of patients not receiving the booklet and 90% not receiving the pharmacist’s card. It is important that the Minister looks into this matter urgently and ensures that awareness is increased to help to address the lack of knowledge. That could save so many innocent lives from being irreparably damaged.

As part of that, will the Minister be minded to agree that the NHS should make it mandatory for every clinician prescribing sodium valproate to a woman or girl of childbearing age to have a conversation with her about risks during pregnancy, upon first prescribing the drug and at least yearly, before her prescription is renewed?​

Over the decades there have been countless opportunities for this drug to be investigated, especially when evidence from the 1980s grew. Yet the various regulatory bodies for medicines have failed to keep their eyes on it as an issue worthy of investigation, with only fleeting references in position papers and reports, and nothing substantial. This is why it is welcome that the European Medicines Agency, in one of its first public inquiries, on 26 September 2017 called together patients, carers, doctors, pharmacists and academics to look into the matter further. It will be interesting to see the outcomes of its investigation when it concludes.

We have a duty to set the mistakes or oversights of previous Governments right, which is why we are here today—to seek justice for the victims of sodium valproate in pregnancy and their families. The Opposition welcome calls for the Government to look into how they can compensate the families who have been so significantly affected.

It must be noted that, as others have said, the drug is an effective treatment. For many it may be the only drug that works for them. Nevertheless, there is a systematic failure to inform women of the dangers of taking valproate. If expectant mothers had had the risks laid out clearly for them, many children would not have been harmed, and I hazard a guess that we would not be debating this issue today.

For those reasons Labour promised, in our election manifesto earlier this year, that we would look into this further by holding a public inquiry if we won the general election. We now make a plea to the Government. The evidence collected by In-FACT shows that despite the Government, pharmaceutical companies and regulatory bodies knowing about the risks for 40 years, that knowledge was withheld from women, which meant they were unable to make informed decisions about their drug treatment during pregnancy. I must ask the Minister: why have we not got to the bottom of this injustice, and is it not about time that we did?

A lot of the issues that we must understand and investigate are historic, yet for some they are still very prominent in their present. Many families are living with the repercussions of not being given the relevant information.

Hon. Members may have watched “Victoria Derbyshire” in recent months, on which valproate has been discussed, including last month when Deborah Mann, who took valproate during her pregnancy, discussed how the drug had affected her daughter, Branwen. Deborah had been given a dose of valproate of 5,000 mg, five times higher than the recommended daily dose of 1,000 mg. Any dose above 1,000 mg is considered to have the largest level of risk. Branwen has had to wear splints every day since she was a little girl. She is in chronic pain every day. She has migraines and problems with her brain and eyes. At just 22, Branwen has been told that she could go blind, have a stroke or even die at any moment.

I recently met the inspirational Janet Williams and Emma Murphy, who a number of hon. Members on both sides of the House have paid tribute to. I now realise that they are in the Public Gallery. They set up In-FACT in November 2012 after two of Janet’s children and five of Emma’s children were diagnosed with foetal anticonvulsant syndrome. We heard in detail from the hon. Member for Congleton the extent of the appalling damage to Emma and Janet’s precious children, and all ​of it was preventable. Both Janet and Emma campaign tirelessly after being told—in the case of Emma, time after time after time—that these drugs were safe to take in pregnancy. These women did ask the obvious questions when the truth was already well known, and they were still told that these drugs were safe to take while they were pregnant. Can hon. Members imagine how that feels? As a mum, I would be absolutely furious—we all would. I would want answers. I would want justice, and so do Janet and Emma.

It is approximated that, since 1973, 7,000 children have been harmed by exposure to valproate. No doubt there will be many other families who have failed to conceive or who have had stillbirths or miscarriages—all because of this drug. That is why we must get answers, but it is also why we must look at what compensation we can give these families because of the failure of the NHS to protect and support them. The idea of compensation has been established by our neighbours across the channel, where the French Parliament has recognised the true scale of this injustice and established a fund worth €10 million to support the victims of valproate and their families.

Opposition Members believe that mistakes should be recognised, addressed and accordingly compensated for. We also believe that burying our heads in the sand and ignoring the demands of the victims goes against the nature of justice and righting the many wrongs of the past. These families must be supported and allowed to have a full investigation into the failures and damage they have had inflicted on them.

The Minister cannot ignore the scale of this tragedy and the numbers of people who have had their lives so adversely affected not through any fault of their own, but due to medication they were prescribed by the NHS. We are here today to ensure that the Government wake up to the enormity of this scandal and take immediate action.

More must be done to make women aware of the risks of taking valproate during pregnancy, and to ensure that the injustice that has gone on for far too long is righted, with answers found and support provided to these families, who have seen their lives turned upside down because of what can only be described as a cover-up. The Minister should and must listen to what has been said today. I hope he will assure the House that he has constructively listened and that he will start the process of righting this pernicious wrong by holding a full public inquiry and properly supporting these families. They need, want and deserve justice. They should, at long last, receive nothing less.

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

I thank my right hon. Friend the Member for Rother Valley (Sir Kevin Barron) for securing the debate. He is a long-standing campaigner on the issue of tobacco and its effects on society, and it is good to see that he is continuing his campaign. He made an insightful and thought-provoking contribution.

I also thank other Members who have made excellent speeches on this important issue, including the hon. Member for Chippenham (Michelle Donelan), my hon. Friend the Member for Ipswich (Sandy Martin), the hon. Member for Harrow East (Bob Blackman), my hon. Friend the Member for Stockton South (Dr Williams), the hon. Member for Colchester (Will Quince), my hon. Friend the Member for North Tyneside (Mary Glindon), and the hon. Members for Witney (Robert Courts), for Eastleigh (Mims Davies) and for Stirling (Stephen Kerr).

I welcome the fact that the debate is taking place during Stoptober. It is nearly a year since our last debate on the tobacco control plan, which—this may interest some Members—marked my first outing as shadow Minister for public health. While the Minister I shadow has now changed—it is now the hon. Member for Winchester (Steve Brine)—the most significant change since our last debate is that, thanks to him, we finally have a new, updated tobacco control plan, which we were all very pleased to see. It is welcome that, after a long-drawn-out 18-month delay, we now have a plan that will take us a step further towards creating a smoke-free society.

Labour Members have welcomed the plan and its ambitious and noble goals, but we remain concerned about how it will be effectively implemented and achieved, especially given the short-sighted cuts in public health budgets, which my hon. Friend the Member for Stockton South highlighted knowledgeably in his excellent speech. As we know, the previous plan was extremely successful and reduced smoking rates from 20.2% to 15.5% but, as we have heard from every speaker today, it remains the case that smoking is still a serious issue in our society in terms of both its financial and human cost. Smoking and its related health problems cost our already financially strapped NHS more than £2.5 billion each year. If we were to seriously address smoking in society, we could ​reduce that financial cost and direct the money towards improving our NHS and ensuring that we have a healthy society.

It is estimated that 200 people a day die from smoking-related illnesses. In 2015, 79,100 people aged just 35 or over died because of smoking. It is not just adults who are affected, but babies and children. In 2010, as a result of pregnant women smoking, 19,000 babies were born with a low birth weight and an increased chance of taking up smoking later in their lives. As we heard in the excellent speech made by the hon. Member for Colchester, last week was Baby Loss Awareness Week. The hon. Gentleman is co-chair of the all-party parliamentary group on baby loss, of which I am proud to be an officer. It is estimated that up to 5,000 miscarriages, 300 perinatal deaths and around 2,200 premature births each year are attributed to smoking during pregnancy. Those saddening and distressing figures show exactly why we are here today to debate this issue and to ensure that the tobacco control plan is as effective as possible so that we can achieve a smoke-free society, and, in particular, support women during pregnancy.

We also know that smoking rates remain persistently high, especially among people with mental health issues, as my right hon. Friend the Member for Rother Valley mentioned. The plan sets out various recommendations relating to mental health, including improving support for smokers with mental health conditions and training for mental health staff to help to reduce smoking among that group, but I should like to hear from the Minister exactly what measures have been taken on the basis of those recommendations.

It is equally worrying that, as a number of Members have pointed out, the level of smoking remains high among those who are unemployed or members of lower socioeconomic groups, especially given the estimate that tobacco was 27% less affordable in 2016 than it was in 2006. There are a host of reasons for that, including the tax on tobacco products. I agree with the hon. Member for Chippenham that we should never seek to reduce that tax, for all the reasons that she gave, but it is deeply worrying that those groups, for whom poverty is rife, are not being sufficiently helped to quit smoking. During last year’s debate, I quoted figures that showed that if smoking were reduced among those living in poverty and the costs of smoking to them were reinvested, we could make serious progress towards the eradication of poverty. Will the Minister give us an idea of what consideration he has given to the idea that reducing smoking could be a vehicle for ending poverty in society?

There is a clear drive in the plan for action on smoking cessation to be taken at a more local level. We do not disagree with that; in fact, we welcome it. We all agree that a “one size fits all” approach does not work, because of the geographical variations when it comes to smoking in our society. In my own region of the north-east of England, smoking rates are 25% higher than those in the south-west, and it is therefore unsurprising that the prevalence of lung cancer in the north-east is close to double that in the south-west. This is why it is important for us to do more at a local level to reduce smoking. However, I must urge the Minister—I know that he takes these matters very seriously—to bear in mind that “localising” action does not mean abdicating responsibility at a national level.​

The Prime Minister’s driving mission on the steps of Downing Street in the summer of 2016 was to call out the burning injustices of inequality in our society, but we have yet to see that come to fruition—as we know, the Prime Minister has been a bit busy with Brexit. I know that the Minister is also passionate about the burning injustice of health inequality, because we have worked together on many health issues over the years. I know that he understands the importance of improving public health as a mechanism of prevention, and reducing the burden on our NHS by addressing the issues at source. However, the Department in which he is now a Minister has overseen some of the deepest cuts in public health services in recent years. I am sure the Minister knows the figures for these significant cuts, but for the benefit of the House, I will quote statistics used by the Royal Society for Public Health, meaning that I know they are accurate. It says that the total cuts mean that there will be £800 million less in public health budgets between now and 2020-21, which must have a significant impact on smoking cessation rates.

A study conducted by Action on Smoking and Health and funded by Cancer Research UK found serious budget cuts to smoking cessation services, with a growing number of authorities admitting they no longer have a specialist stop smoking service that is accessible to all smokers. This must be paired with the damaging analysis of Department for Communities and Local Government figures on local government spending by the King’s Fund, which found that wider tobacco control faced cuts of more than 30%. If the tobacco control plan is to be truly successful, as I know the Minister wishes, it cannot be pushed for in isolation from the cuts to public health budgets. The two are inextricably linked and cannot be dealt with in silos.

The Minister must go away and look into this matter and the effect it will have on the outcome set out in the TCP. Now that we have a blueprint in front of us, which we are all grateful for, it is time to ensure it is achieved completely—not partially and not just in bits, but completely.

The Minister has been given much to think about during this excellent debate, and I hope that, in his relatively new role, he will be the champion needed to improve smoking cessation and reduce the prevalence of smoking in our society. Now is the time not for simple, warm words, but rather for concrete, defining action that drives forward this agenda.

There are many actions to take, but I know the Minister has a true passion for health improvement and prevention. He cannot allow the power he now has at his fingertips to be squandered when it comes to implementing this plan. I say again that the plan, as good as it is, cannot be seen in isolation from other Government actions and policies. Ensuring that the right funding is in place to fulfil the plan’s vision and ending the disastrous cuts to public health budgets is the only way we can truly see the plan’s vision realised.

10.40 am

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

It is a pleasure to serve under your chairmanship, Mr Owen. I thank my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) for securing this very important debate and for her excellent contribution. The Opposition fully support her four asks of the Government.

I commend all other speakers for their thoughtful and passionate contributions, and I thank their constituents who allowed their experiences to be shared with us. I especially want to thank Kath Sansom, who leads the Sling the Mesh campaign, for all her hard work in uniting the women affected by vaginal mesh implants and for raising awareness of the tragic impact that mesh implants have had on so many lives. I also thank other hon. Members who have spoken out about this issue for such a long time—in particular, my hon. Friend the Member for Pontypridd (Owen Smith), who spoke with such knowledge and passion. It was vital that he took part in this debate, and I thank him for everything he has done on the issue.

The experiences we have heard about today are incredibly distressing. I have the utmost sympathy for those suffering because of mesh implants. We are here to stand up for those women, and we seek answers and Government action on their behalf.

Let us start at the beginning, when women are told that the best course of action is to have a mesh implant. They are told that the procedure is quick and cheap, but, as we have heard, the low financial cost of the implants is far outweighed by the huge human cost to those women for the rest of their lives.

The NHS and the MHRA say that the risk of complications is low, at 1% to 3%, but a report by nine leading medics put the risk much higher, at 15%. If leading bodies and medical professionals cannot agree, how can patients be expected to make informed decisions? Health professionals are supposed to outline clearly and explicitly the risks of any operation that a patient is asked to undergo to ensure they can weigh up the risks and benefits for themselves.

As we have heard, the mesh implants are made of the same material as some drinks bottles. They can shrink, twist and curl at the edges. The material can degrade, cut through internal tissues, poke through the vaginal wall and stick to organs, causing pain, incontinence, urinary infections and a loss of sex life. Marriages have been destroyed and people have been left unable to walk, work or even to pick up their young children. Knowing those risks, how many in this Chamber would consent to a mesh implant? It is time to take women’s health and wellbeing seriously. They need to be listened to. Their voices need to be heard and their concerns believed so we can put right this injustice and prevent it from going on any longer.

Since this debate was announced, I have been inundated with emails and tweets telling harrowing stories of how women have been affected by vaginal mesh implants. I am sure everyone in the Chamber has received the same ​sort of emails. Just last night—very late in the day—I received an email from Sling the Mesh with an attachment containing 210 emails out of the 400 it received following the Minister’s answer to my question during Health questions last week, when she said there is not enough evidence to ban the mesh. Those emails are packed with evidence, and I am very happy to pass them on to the Minister. They all detail how the implants have been life-changing, but unfortunately not for the better.

Julie has had to give up her job as a paramedic, and is now trapped in a world of pain and medication. Kath has lost her passion for mountain biking because it is now impossible to get on the bike. Suzi says that her pain consumes her every day.

Another woman, Tina, also shared her experiences. For four years, she went to her GP and accident and emergency several times with excruciating pain, and was sent from pillar to post. She was told that the pain was due to irritable bowel syndrome, painful bladder syndrome and a slipped disc, and that the mesh implant was absolutely not the problem. After four years of searching for answers, she went private and spoke to a surgeon who finally believed her pleas about her pain and partially removed the mesh. She says that her recovery has been successful and she is no longer in pain, which is excellent, but four years is such a long time to lose. We know that many, many women are unable to go private to end their trauma, but they should not have to do so.

After this debate, there is a lobby of mesh-injured women, which I encourage the Minister to attend. We will be joined by Dr Robert Bendavid, who has flown in overnight from Canada. That shows that this really is a worldwide scandal. Many countries, including our own, are just waking up to the horrors of vaginal mesh. In Australia the Senate is holding an inquiry, and in the US vaginal mesh has been considered a high-risk device for nearly a decade. As we heard, vaginal mesh has been suspended in Scotland since 2014, yet across the border the Government have rejected a ban in England and have failed to empathise with the approximately 8,000 women who have been admitted to hospital with a mesh complication. That is not surprising, considering that just 1,000 mesh admissions have been reported to the MHRA as a mesh-related issue. Surgeons are clearly reluctant to report that mesh is the issue, which lets their patients down and distresses them further.

Our next concern is what the Government are going to do to support women who have had to leave because of the effect of vaginal mesh. Most GPs do not attribute the pain to the mesh, so it is very difficult for those women to claim personal independence payments, disability living allowance or any other benefits. They have to rely on their families’ finances, which is incredibly frustrating and distressing to the victims, especially those whose families are unable to support them. We must also consider the women who are suffering in silence and have not come forward yet because of the intimate nature of the issue. After hearing of the experiences of others, some women may be embarrassed or just too scared to come forward for fear of being dismissed as a hysterical woman.

At Health questions last week, the Minister said that a NICE update on vaginal mesh implants is expected at the beginning of next year—my hon. Friend the Member ​for Pontypridd also mentioned that—but that is too little, too late for the approximately 200 women who will get a vaginal mesh implant on the NHS between now and then and the thousands of women who have already been affected. One of my constituents reached out to me to say that she is worried because she is due to have that surgery soon, and she asked for my advice. Obviously, we cannot give medical advice, so I told her to watch this debate and speak to a surgeon. If there is a chance that a car or an aircraft could cause harm, it would be immediately recalled while the problem was investigated. Why does the precautionary principle not also apply when the health and wellbeing of thousands of women is in jeopardy?

Last week, the Minister said there was not enough evidence to warrant asking the MHRA to reclassify these procedures, but there was so little evidence to justify beginning them in the first place. What exactly is she waiting for? Given what we have heard today, I hope she will recognise the urgent need for action on this issue and justice for those women. I hope she will take these calls back to the Department of Health and ensure that no more women are subject to the risks of vaginal mesh implants. That is why the Opposition are calling for an urgent public inquiry into the number of women adversely affected by vaginal mesh implants and into why the safety of so many women was disregarded. We urge NHS England and NICE to act immediately to update the guidance and suspend the use of vaginal mesh today. It is our duty to ensure that the failings are understood and corrected so that they never happen again. That should be a matter of urgency for the Minister and the Government, and I trust she will respond positively to these calls.