Sharon Hodgson MP's report - Mar-Apr 2017 number 94
Click on picture above to read Sharon Hodgson MP's report - News from Westminster - Mar-Apr 2017 number 94
Sharon Hodgson MP's report - Feb-Mar 2017 number 93
Read Sharon Hodgson MP's report - News from Westminster - Feb-Mar 2017 number 93
In her capacity as Shadow Minister for Public Health, Sharon was invited to speak to a group of Socialist Health Association members in the North East about public health and prevention. In her speech, Sharon raised concerns over the progress of the Five Year Forward View's promise of a "radical upgrade in prevention and public health" and how the crisis and mismanagement the NHS is facing is currently not allowing this promise to be fulfilled.
You can read Sharon's speech below:
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Thank you for inviting me to speak to you this morning.
The Socialist Health Association is an organisation of academic specialists, medical practitioners and those with health interests within the organisation, and I know that myself and the rest of the Shadow Health team greatly appreciate the work you do to support Labour’s approach to all matters related to health policy.
Health inequality is an issue which we continually need to work on to get right, especially here in the North, where it is well documented that our region and other northern regions have persistently poorer health than the rest of the country. This gap has widened over the last four decades.
Figures show this to be the case, with latest public health outcomes data showing that the North-East and the North-West have the lowest life expectancy compared to London and the South-East, which have the highest.
It was highlighted in the Due North report that since 1965, there have been 1.5 million excess premature deaths in the North due to the disparity in health outcomes.
This is something that cannot be ignored.
This shows what we all know to be true: people in the more deprived areas of the country do not live as long as those in more affluent areas.
This is exacerbated by the fact that those short lives can also be unhealthy lives. Long-term health conditions, cancer prevalence, and addictions are all far more common in more deprived areas of the country.
It is not only the health of people which is affected by health inequalities, but also there is an economic argument to be made too. In England, as a whole, the cost to the NHS of treating illnesses and diseases arising from health inequalities is estimated at £5.5 billion a year, and ill-health means a loss to industry of £31 to £33 billion each year in productivity.
If we are to improve health outcomes and reduce health inequalities in our region, and indeed across the country where there are pockets of persistent inequality, then it is important that we look at how our health and social services are working now and how we need to ensure services are working towards improving the health of our nation, especially through prevention.
The NHS, Social Care and Public Health Funding
It goes without saying that this winter saw our NHS face unprecedented challenges which has pushed it virtually to the brink.
In the week of 9th January to 15th January, we saw 69 trusts out of 152 reporting serious operational pressures at some point during that given week – with the average deemed to be 50 Trusts a day reporting operational pressures.
There are countless stories in the media about the pressures the NHS is facing, and sadly, the Government have buried their heads in the sand and acted as if the issue isn’t as bad as it is in reality.
Whilst we are seeing the NHS facing a crisis, we are also seeing yet another reorganisation of services at a local level through Sustainability and Transformation Plans (STPs).
Whilst in principle, the idea of improving integrated services through STPs is a welcome idea, there are real and perceived concerns on the ground – not just here in the North, but across the country – that the efficiency savings are all about cuts, rather than improving clinical services for patients.
Pair all of this with the pressures in adult social care services, which saw a cut in funding of £4.6 billion in the last Parliament and experts warning there is an expected £1.9 billion funding gap in social care this year alone, then there is no wonder why there is no ability to seriously address health outcomes and inequalities.
Even in my own area of policy – public health - we are beginning to see what could be a crisis.
Whilst the total spend on public health is just over 4% of GDP, the then Chancellor in 2015, announced a £200 million in-year cut to the pot of money, and then in the Autumn Statement announced an average, real-terms cut of 3.9% until 2020.
It is estimated that that by 2020-21, public health funding will fall to just over £3billion, compared to the £3.47billion in 2015-16.
Even though the Government has ring-fenced this money when it reaches local authorities, there is no guarantee it will continue in the next spending round in 2018.
It is hypothetical what will happen, but when local authorities are strapped for cash already, if the ring fence is removed, there is a real concern that those councils with difficult decisions to make may take from this budget to plug other areas.
This can in some way be backed by current figures on the cuts we are seeing to public health services, as reported in the Health Select Committee’s report: Public Health, post-2013, where they cited figures by the Association of Directors of Public Health.
These figures showed the stark impact of the cuts we are already seeing. Take for example, health checks in 2015-16 which saw a cut of 27% and soared to 59% in 2017-17 with a 1% decommissioning.
Or weight management support which saw a 32% reduction and 9% decommissioning in 15-16, which then rises to 52% reduction and 12% decommissioning in 2015-16.
What we are seeing in the NHS, social care and public health is a complete mismanagement and lack of commitment to fund these important services properly.
This is something I have raised with Health Ministers across the House of Commons: if you cut from one area in the health and social care service, you will see a knock on affect in others.
This has unsurprisingly been met with disregard from ministers who fail to recognise the impact their mismanagement is having on these vital services and the health of the country.
It must be remembered, that for a region – such as our own – where ill-health and health inequalities are clearly apparent that this approach to our health services will have a serious impact on regions which are already at the lower end of the spectrum of dealing with health problems.
Yet, also this approach, especially to public health, goes completely against NHS England’s Five Year Forward View, which promised: “a radical upgrade in prevention and public health” and the Prime Minister’s own commitment to reduce health inequalities when she took office.
It is clear that the radical upgrade and desire to address these issues are not being met. In fact, it could be described as going backwards, or at best, staying still. Neither option is a welcome one.
However, if we remember the state of the NHS currently, which is fighting crisis after crisis every day, then it is not surprising that this worthy commitment to prevention and reducing health inequalities is not being worked towards.
How do we address this?
What we need to see is this radical upgrade made a central theme to any approach to improve services and not see them cut to the bone.
For me, improving the health of our nation is not just a health priority but a social justice one as well.
Because of persistent ill-health and poor health outcomes, people here in the North are not being allowed to reach their fullest potential and instead held back by inaction to improve their health, both through interventions but also providing them with the tools to improve their health themselves.
To do this, the NHS needs to bring forward a new funding settlement for the NHS and social care in the upcoming Budget, which will not only give the NHS the vital funding it needs to deal with increasing pressures, but also in order that it can begin to achieve its vision of radically upgrading prevention and public health as called for in the Five Year Forward View.
This should also include a rethink on the current approach to public health – the false economy of reducing funding when pressures remain the same, or increased, shows a complete lack of joined up thinking by the Government. And this is something I will push them to rethink at every available opportunity that I have as Labour’s Shadow Minister for Public Health.
It seems illogical to me that you cut prevention budgets, which will just present problems further down river in the NHS which as we know is already facing difficulties when coping with the demands it has now.
However, it cannot all be about funding. Labour’s approach at the last General Election was two-fold: one, ensuring interventions happen when necessary, especially at younger ages to correct bad habits which could lead to ill-health in adulthood, and second, ensuring that adults have the tools in their arsenal to make healthy lifestyle choices to live fulfilling lives.
This is something that I hope to continue to build upon in my time as Labour’s spokesperson on public health and ensure that any policies we propose will help seriously shift us away from the current situation where persistent health inequalities remain the norm.
To end, health inequalities are a serious issue that cannot be ignored. Reports after reports have shown that we have not made many serious inroads into health inequalities, and that is why it calls for a radical approach which doesn’t weaken the already fragile state of affairs we are seeing.
With innovation and political will, we can ensure the gap in health inequalities shrinks and health outcomes improve. To do this, we need that step change in ethos called for in the Five Year Forward View towards prevention but an NHS which itself is healthy enough to seriously begin to work towards this vision – if that does not happen, then it will never be achieved.
I hope in the discussions that we can start the process of doing just that, and I hope that you will all feed your thoughts and ideas into the Health and Social Care Commission.
In her capacity as Shadow Minister for Public Health, Sharon responded to a Backbench Business Debate on Breast Cancer Drugs, specifically the drug, Kadcyla and other drugs used for treatment of breast cancer.
Image copyright BBC Parliament 2017
You can read Sharon's speech here: Breast Cancer Drugs Backbench Business Debate 26.01.17
Speech pasted below:
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
I thank my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) for securing this debate, following the very sad news that her friend Samantha Heath, who had been receiving this life-extending treatment, had heard from NICE that it was being taken away from her. I am pleased that she was able to secure this important debate through the Backbench Business Committee.
I also thank all colleagues who have attended the debate and made excellent speeches, sharing with us their experiences and thoughts, including the hon. Members for Milton Keynes South (Iain Stewart), for Portsmouth South (Mrs Drummond), for Louth and Horncastle (Victoria Atkins) and for Wycombe (Mr Baker), my hon. Friends the Members for Torfaen (Nick Thomas-Symonds) and for Wythenshawe and Sale East (Mike Kane) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who spoke for the SNP. I am sure that the Minister has been given lots to think about, and I look forward to her response shortly. I also thank Breast Cancer Now for its work campaigning on this matter, along with Breast Cancer Care for its continued dedication and its support and advocacy for individuals with secondary breast cancer.
In my contribution, I will first briefly establish the documented and perceived benefits of Kadcyla, and then, building on that, discuss the broader issues around the provision of off-patent drugs, before moving on to present the problems with determining the funding of a drug based principally on its cost-effectiveness as judged by NICE.
Kadcyla’s continued funding through the cancer drugs fund in 2015 was a great success for patients and patient advocates. At the time, the value of the drug was recognised and the concession was made that, despite its high cost, its positive impact was worth the funding it needed. Yet just over a year later, the alterations to the cancer drugs fund have prevented the future funding of this drug, along with, potentially, that of a number of other secondary breast cancer drugs such as palbociclib and Perjeta—I hope that I pronounced those correctly—as it moves towards becoming a funding mechanism for under-researched but innovative drugs with cost and value as a principal driver, and away from its original principle, which was to finance drugs that were too expensive to be recommended by NICE but proved effective in treating cancer patients.
We can all agree that patients have benefited significantly since the introduction of the cancer drugs fund, but the progress that has been made in recent years in improving access to cancer drugs is now at risk. That is unsurprising, given the cash-strapped state of the national health service—we have discussed that in the House recently in the past few weeks—which faces pressures to provide these costly drugs that are developed by large pharmaceutical companies, and is forced to consider costs rather than clinical need. I hope that the Minister will tell us whether those concerns have been assessed, and how she plans to address them. We have heard a number of good suggestions today about how funding may be redirected.
Mary Glindon (North Tyneside) (Lab)
Is not the situation made all the more poignant by the fact that since 2001, the incidence of breast cancer has been rising by 9% every year?
That is a very good point. It may be that more and more people are coming forward and being diagnosed, but, as my hon. Friend says, this will clearly become more of an issue, not less of an issue, in the years to come.
As we have heard today, it is estimated that Kadcyla benefits 1,200 women every year in England alone, and that on average it can increase the length of a woman’s life by six months, although reports suggest that in the case of some women that can stretch into years. Even if it is measured in months, however, the extra time is surely priceless to the women and families involved. I speak from personal experience, as I lost my mother-in-law to secondary breast cancer 20 years ago this year, when my children were very small. I know that she fought for every extra week and day in the end, and that she would have given anything for an extra six months to spend with her grandchildren. We all wanted that little bit longer for her. For all those 1,200 women, that extra time is time with their families. It means seeing their children reach perhaps one more milestone, starting school or university, getting married, or even giving them a grandchild. What is the cost of such moments, such memories, which are so precious and which help families so much with what, ultimately and inevitably, will follow?
The hon. Lady has made a powerful point. In the case of the most aggressive cancers, the period between diagnosis and death can be very short. As the hon. Lady says, any extension of life enabling women to celebrate family events, or anything else, is incredibly important, and we should not lose sight of that.
I agree. What price can be put on those precious months?
Thangam Debbonaire (Bristol West) (Lab)
I have some investment in this. My own experience of breast cancer treatment over the last two years has left me passionate about the issue of prevention and early diagnosis. Will my hon. Friend join me in not just thanking the breast cancer charities—as she has already done—but calling on all Members to spread the word among all the women they know that they must learn how to examine their breasts? I learnt how to do it from a comic sketch in a television programme: that is how I diagnosed my lump. I want everyone to learn how to do it, and also to learn what they can do to help prevent breast cancer, because, although there is no magic prevention method, there are ways of reducing the risk.
Although we have not so far touched on prevention or early diagnosis, they are vital issues. We have discussed them in the House on many occasions, but they can never be discussed too often, and I am grateful to my hon. Friend for raising them. Let me add that I am happy every day to see her back in this place, and doing so well.
What also stands out with Kadcyla is the reduced side effects, as we have heard, as opposed to alternative breast cancer treatments, the side effects of which can include the inducement of osteoporosis and an increased risk of blood clots. As some colleagues will, sadly, know first-hand or through experiences of family and friends or constituents, the side effects of some cancer treatments can be truly awful, and in some cases are daunting enough to prevent the acceptance of further treatment entirely. It is a common perception that women make the decision to end their treatment much earlier than planned, despite it prolonging their life sometimes. That is because they feel the suffering they are enduring as a result of the treatment is not worth the additional life it is providing to them, because it is all about the quality of that life.
Research conducted by Genentech in the United States on the side effects of Kadcyla found that less than 5% of women taking the treatment suffered any hair loss. Through my work as co-chair of the all-party group on breast cancer, I know that hair loss can be a highly traumatic experience for women undergoing cancer treatment and is one of the most discussed side effects of cancer treatment in general. Given that in this debate we are discussing the treatment of secondary breast cancer, which is ultimately a terminal disease, the best outcome we can offer through treatment is both the extension of life and the preservation of the quality of life enjoyed pre-diagnosis. Therefore, because Kadcyla causes fewer side effects, it represents a treatment that can effectively achieve not only an extension of life, but the preservation of some of that quality of life enjoyed by these women pre-diagnosis. So I look forward to hearing from the Minister about what she is doing to ensure women will benefit from this vital treatment in the future.
I will now move on to how we can better support off-patent drugs, especially for breast cancer. Drug patents typically last for 20 years—although sometimes only 10 years—and at the end of that patent there is very little incentive for the drugs to be licensed for use in another indication. These drugs are still clinically effective in many cases and can be a low-cost effective treatment, but currently the NHS has no method for making them routinely available.
Bisphosphonates are one such example of an off-patent drug that is not being made universally available to patients, despite evidence showing its effectiveness. It is estimated that, if given to the entire eligible population, this drug could prevent one in 10 breast cancer deaths. It is therefore concerning that research conducted by the UK Breast Cancer Group found that only 24% of breast cancer clinicians were offering bisphosphonates to patients. Solving this issue therefore provides an opportunity to improve breast cancer survival rates, and it is something that I hope the Minister will consider carefully.
I want to finish by discussing the cost-effectiveness of drugs. Currently NICE measures cost-effectiveness using quality-adjusted life years—QALY—and one QALY is equal to one year of life in perfect health. As I am sure colleagues will agree, it is almost impossible to objectively measure someone’s quality of life, and there are questions surrounding the morality of attempting to do so, as raised in NICE’s “Social value judgements” paper on the moral evaluation of drugs.
As is so often the case in these debates, a clear cause of the problem lies with how NICE approves drugs. At the last general election, Labour proposed a top-to-bottom reform of NICE, ensuring that drug acceptance and funding is determined solely by clinical need, not with cost or value considerations. This debate shows there is clearly a need to re-address these issues.
As I have already mentioned, Kadcyla patients tend to experience considerably fewer side effects, and this can potentially have a positive impact on their ability to enjoy a higher quality of life post-diagnosis. Because of practicality and cost implications, it is almost impossible for NICE to comprehensively and effectively measure this exact quality of life. However, what we can say, without a doubt, is that these individuals would suffer a lower quality of life without Kadcyla, and this, I believe, deserves more attention and value in the process of drug approval and funding.
The current funding of drugs is becoming based on the cost-effectiveness of a drug, rather than the clinical need, yet, as this debate has shown, it should not be the final deciding factor as it disregards very personal reasons for many people who rely upon drug treatments. Kadcyla has benefited many women during their time living with a terminal disease, and has now been pulled, devastatingly, out of their reach.
It is the Minister who has the levers of power to address the problems in the system which is letting these women down. Members from across this Chamber have eloquently made their case to the Minister. I hope she has listened—I am sure she has—and will give these women and their families some reassurances today.
Sharon Hodgson MP's report - Oct-Nov 2016 number 89
Read Sharon Hodgson MP's report - News from Westminster - Oct-Nov 2016 number 89
Sharon Hodgson MP's report - May-Jun 2016 - number 86
Read Sharon Hodgson MP's report - News from Westminster - May-Jun 2016 - number 86
Sharon speaking in the 3rd Day of Queen's Speech Debates on Defending Public Services
Image copyright Parliamentary Recording unit 2016
During the third allotted day for MPs to debate the legislative programme set out in the Queen's Speech, Sharon spoke about defending two of our country's most important public services: the NHS and the BBC.
You can read Sharon's speech in Hansard here: Sharon Hodgson MP Third Day of Queen's Speech Debates on Defending Public Services 23.05.16
Text of speech pasted below:
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
I was hoping for a lot more from this Queen’s Speech. I hoped that there would be something to address the ever-growing housing crisis in this country. I also hoped that there would be something on the environment or on the long-awaited and much-promised Bill on wild animals in circuses. But mainly, I hoped that there would be some hope for my region and my constituency. Yet again, however, we heard only scant warm words with the brief mention of the northern powerhouse—the Chancellor’s pet project—which does not even seem to reach the north-east.
I do not think the Chancellor heeded my words on the lack of measures for the north-east in his ultra-shambolic Budget back in April, when I warned him that, despite his ambition to be king of the north, he needed to recognise that there was a lot more of the north beyond Manchester before he got to the wall. Mercifully, his time as Chancellor is almost up. Who knows where he will be when winter comes, post-referendum: in No. 10 or in the wilderness on the Back Benches? His legacy for the north-east is, sadly, only more pain and hurt.
Today’s debate is all about our public services, and I want to highlight the damage that is being inflicted on them by this Conservative Government, who are continuing to starve them of proper investment while forcing through damaging and unnecessary legislation. The Tories are now trying to dismantle and ruin two of our country’s greatest and most precious institutions: the NHS and the BBC. These are two public services that we probably all use almost every day and both are central to our national way of life. This Government are hellbent on completely changing the culture and ethos of the two institutions. They have already started the process, but we must not let them complete it.
Since the Conservatives came into office in 2010, the NHS has faced crisis after crisis, all of which could have been avoided if it had been given proper investment and support. Instead, we saw an unnecessary top-down reorganisation of the NHS that disjointed funding streams and placed unnecessary burdens on services through cuts that have been detrimental to our constituents’ experiences of using the NHS. This abysmal mismanagement of the NHS by the Health Secretary and his equally appalling predecessor is compounded by the fact that 3.7 million people are currently on waiting lists, by the understaffing of our hospitals and by patients’ struggles to see their GP. The mismanagement has been acutely felt in the north-east, with the prime example being the underperformance of the North East Ambulance Service NHS Trust. That was the subject of a Westminster Hall debate about two weeks ago in which I and a dozen other north-east colleagues raised our numerous concerns. I hope that the Government have listened to those concerns and will act as soon as possible.
Instead of addressing the issues that the NHS is facing on a day-to-day basis, the Health Secretary took it upon himself to enter into a protracted fight with our junior doctors. They do an amazing job of treating patients in difficult circumstances, yet he has battled with them remorselessly over their pay and conditions. It is welcome that a deal has now been struck between the Department of Health and the junior doctors after everyone was at last brought back around the negotiating table. However, this all could have been avoided, including the recent strike action, if only the Health Secretary had meaningfully listened to the junior doctors’ concerns about the impact the proposed changes to their contracts would have on the NHS.
The Health Secretary must rethink his entire strategy for the national health service and ensure that it does what it was created to do. I want to quote from the leaflet that every home received when the NHS was launched in 1948:
“It will provide you with all medical, dental and nursing care. Everyone—rich or poor, man, woman or child—can use it or any part of it.”
It was Nye Bevan who said:
“Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community”.
We should have seen something like that in this Queen’s Speech. But wait—no, that only happens in a Labour Queen’s Speech. That is how we got our NHS in the first place.
The BBC is another of our treasured public services that the Government are trying to undermine. The Culture Secretary is using tactics that can only be described as bullying and intimidation to make the BBC accept a new charter—which is in no one’s interests other than those of commercial media moguls—and he has shown his true colours by going on record as saying that the disappearance of the BBC is a “tempting prospect”. Those are the words of the man who is supposed to be in charge of nurturing and championing British culture and talent.
The Government’s proposals aim to hobble the BBC, and they will put its position as an independent public broadcaster in jeopardy by introducing Government appointees to oversee the organisation. That is a clear attack on the BBC’s independence and its ability to hold the Government to account. Putting Government-approved people on the board would threaten the very existence of the BBC as we know it. Peter Kosminsky, the director of “Wolf Hall” and winner of the BAFTA Best Drama award, has said that
“the BBC’s main job is to speak truth to power—to report to the British public without fear or favour, no matter how unpalatable that might be to those in government.”
Those words remind us exactly why the Government must maintain the integrity that the BBC has come to be respected for, not just in the UK but right across the world.
The BBC is not only one of our main sources of news and information; it also acts as a beacon for British culture and talent and is a true cornerstone of UK plc. From giving that much-needed break to up-and-coming artists on BBC radio stations to the many TV programmes that showcase the greatest aspects of British life—commercially successful shows such as “Strictly Come Dancing” and “The Great British Bake-Off”, informative and incredible documentaries such as “South Pacific”, “Frozen Planet” and the many other David Attenborough documentaries that have taken us into some of the most remote and exotic places in the world—the BBC is the very best of British in everything it does, and we get to enjoy all that for the remarkably good-value price of just 40p a day while sitting in the comfort of our own home. However, the Culture Secretary has persistently put the future of commercial BBC programming in jeopardy by saying that the BBC should focus on broadcasting for the public good. He clearly forgets that all shows broadcast by the BBC, whether commercial or informative, are for the public good. The two cannot be separated because commercially successful programmes help to fund world-class documentaries that are viewed across the globe. My Opposition colleagues and I will do everything in our power to ensure that one of our most treasured institutions is protected, continues to drive creativity in the 21st century, and is accessible to all.
Going back to Peter Kosminsky, he also said in his acceptance speech at the BAFTAs:
“It’s not their BBC, it’s your BBC.”
Never have truer words been said about our BBC. We need to defend it at all costs from the damage that this Government wish to inflict upon it. Our NHS and BBC make us proud to be British. When it comes to damaging those two precious public services, the Government will not get an easy ride either from Opposition Members or from the wider public watching today.
Jake Berry (Rossendale and Darwin) (Con)
Does the hon. Lady agree that the BBC is uniquely able to tackle difficult issues such as controlling abuse? She may have been following the recent story in “The Archers” relating to Helen Titchener, which showcases the BBC at its best. If the hon. Lady goes on to the “Free Helen Titchener” JustGiving page, she will see that the BBC has been involved in helping to raise £130,000 to support women’s refuges across the country.
I am so pleased that I allowed that intervention, because it was excellent. I thank the hon. Gentleman for that, and I do agree with him.
The NHS and the BBC are cherished institutions, providing an essential public good. They are the very best of British. The proposals are a damning indictment of this Government’s attitude towards our country and those two great institutions, of which I believe the whole country is immensely proud. That is why we cannot allow them to be dismantled or diminished in stature or performance. On the day that the NHS was founded, Nye Bevan said:
“The NHS will last as long as there are folk left with the faith to fight for it.”
His words apply equally to the BBC in this context, as much as he intended them for the NHS. We need to have faith now, and we need to fight for both of them before it is too late. Otherwise, the NHS and the BBC, which our grandparents’ generation so proudly created, will no longer be there for our grandchildren, who will never forgive us.
Sharon speaking in the Performance of North East Ambulance Service (NEAS) Westminster Hall Debate 04.05.16
Image Copyright Parliamentary Recording Unit 2016
As Chair of the Northern Group of Labour MPs, Sharon secured a debate for North East MPs, who after dealing with many constituent cases and reading even more reports in local press over the last few years, were able to raise their concerns directly with the Government about the Performance of the North East Ambulance Service.
Read Sharon's speech in Hansard here: Sharon Hodgson MP Performance of North East Ambulance Service Westminster Hall Debate
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
I beg to move,
That this House has considered the performance of the North East Ambulance Service.
We as a country pride ourselves on our world-class NHS services, which are the envy of the world. It is therefore always important that we highlight failures and shortcomings to ensure that our services do not fail our constituents when they need them most.
Strains on services are part and parcel of life in the NHS, but in recent years the pressures have been exacerbated by the Government’s policies. Ever since the Conservatives were elected to office in 2010, the NHS has struggled due to their mismanagement. In particular, the Health and Social Care Act 2012 implemented a costly, top-down reorganisation, which was neither needed nor wanted. It led to a disjointed funding model and resulted in my local ambulance trust, the North East Ambulance Service, running an expected budget deficit of £3.5 million for 2015-16. It comes as no surprise that I have received a growing number of complaints and concerns about the NHS in recent years, which is why this northern group of MPs decided that we had to call for the debate.
All the services that the NHS provides are important, but when someone suddenly falls ill in an emergency such as a stroke or a heart attack, or has a fall or an accident, it is understandable that they have high expectations of our ambulance service. The important work that paramedics do in our region day in, day out is undeniable, but, as the cases that my constituents have brought to my attention and those that have been reported in the press show, patient safety is in jeopardy. That is mainly due to waiting times, which, as the cases I will outline illustrate, have increased and are causing distress to many of my constituents.
For red 1 and red 2 cases—potentially life-threatening incidents—the trust remains below the national standard. Although that is reflected across the country—only two ambulance trusts in England met red 1 standards—it is concerning that, in our region, that failure has continued for the past three years, despite the fact that our response time of eight minutes is higher than the national average. That is exacerbated by the fact that red demand calls have increased by 21.3% in the past 12 months. The performance targets for the fourth quarter of 2015-16 were breached, leading to the trust’s third consecutive quarter breach.
I called this debate to give myself and my fellow north-eastern colleagues the opportunity to raise cases and concerns directly with the Government to ensure that our constituents receive the very best standard of service, which they rightly expect. It is right that we raise concerns with the Government, who are ultimately responsible for the service and can ensure that something is done about the problems we raise. I will touch on some of the many cases ranging from 2012 to 2016 that my constituents have brought to my attention, and I know that other Members will do the same.
Helen Goodman (Bishop Auckland) (Lab)
I am most grateful to my hon. Friend for securing this extremely important debate. I am very concerned about the management. That was highlighted to me when I wrote a letter to the North East Ambulance Service about ambulance services in Teesdale. I got a letter back headed, “Ambulance services in Weardale”. The worst thing that happened was to Violet Alliston, whose partner rang three times in an hour. No ambulance came, and she died. That is obviously totally unacceptable.
I thank my hon. Friend for that very sad example, which I fear and predict will be one of many—perhaps not all with such a tragic ending—that we will hear this afternoon.
The correspondence I have received about ambulance waiting times in my constituency makes it clear this has been a persistent problem since 2012. I was first told about the problem with waiting times by the league chairman of the Wearside football league after he raised concerns with the North East Ambulance Service directly about numerous incidents. In his correspondence, he said that waiting times for football players who had broken their leg had continually gone over 70 minutes. In one case, after a player broke their leg, the league chairman called 999 at 11.40 am, but he was called back and informed that no ambulance was available and that he should take the player by car. He rang 999 back and complained that that went against what trained first aiders were told about not moving people with broken bones. An ambulance then arrived at 1 pm—80 minutes after the initial call—and the young man was taken to hospital.
Ever since that case, I have received a range of correspondence from other constituents highlighting failures and shortcomings in ambulances going out to emergencies. An issue particular to my local area—I do not think it is replicated in other parts of the region, although we may hear differently when other colleagues speak—is that ambulances struggle to get to certain parts of my constituency due to confusion in finding the address. That has been repeatedly brought to my attention by my constituent, Mr Walker, who for the past two years has highlighted the difficulty that ambulance crews have getting to the Usworth Hall estate in Washington. When a shocking murder took place in the area in 2014, the ambulance did not arrive for more than an hour and the man died.
An example of that failure happened when a woman was in labour and her sister-in-law had to deliver the baby because the ambulance went to the wrong street. The children of the woman in labour had to search the streets for the ambulance. When they found it, they guided it by foot, as they were not allowed on board, for more than a mile to where it should have been.
I could give many other examples. It has been a persistent issue for the residents of Usworth Hall, who, through Mr Walker, have highlighted their concerns and their exasperation at those problems. On each occasion, I forwarded their concerns to the North East Ambulance Service, which looked into each issue. To its credit, it has tried to address them. That was highlighted in a letter to me in July 2014, in which it explained that it had set up an electronic flag system for all residents in Usworth Hall and had a duty manager from its control room go out and survey the area for problems. However, Mr Walker contacted me again at the beginning of April and informed me that an ambulance was parked outside his house one evening. When he went out to speak to the staff, he found that they were lost and supposed to be in another street.
Paramedics understandably do not have the local knowledge that residents have, but sat-nav equipment is provided to help ambulances get to the right destination at the right time.
Mary Glendon (North Tyneside) (Lab)
Does my hon. Friend think that those delays could be because of the shortage of paramedics and the fact that, as the service has admitted, it uses volunteers and private contractors to provide ambulances? That exacerbates the problem of people not knowing how to get to where they need to be.
My hon. Friend makes a very good point. I will come on to the shortage, which is running at about 15%, and the stress on paramedics, to which she alluded.
If the sat-nav equipment continues to fail, and if my interventions on behalf of my constituents and the ambulance trust’s action do not rectify the situation, there needs to be a serious investigation into what is going wrong. We cannot have our ambulances driving round lost on estates looking for the right street.
My most recent piece of casework is from February and is deeply concerning. It concerns my constituent, Mrs Ellen Sherriff. I feel that using the words emailed to me by my constituent’s husband, Mr David Sherriff, can help to highlight the situation and the distress that can come from having to wait hours and hours for an ambulance to arrive. I hope that you will allow me a moment to read out Mr Sherriff’s words, Mr Bailey. He said:
“Ellen became unwell at 10.35am yesterday morning with severe head pain on the right-hand side. She felt like she was going to pass out. I checked her blood pressure which was very high, so phoned 111 at 11am and spoke to a call handler who told me he was sending an emergency ambulance and not to be worried if it arrived with blue lights.
Two and a half hours later no one had come. Ellen remained unwell and could not stand any light.
I phoned 999 and was told the ambulance that was coming had been diverted to Cramlington but that we would be next unless a more urgent call came in.
At 2.40pm, a patient transportation ambulance arrived with two ambulance men. I asked why it had taken so long. They said given the circumstances Ellen should have been seen earlier. They had no equipment, not even a blood pressure machine. They said they couldn’t risk moving Ellen in case they caused the bleed in her brain to become life threatening and they would send for a paramedic. They would also remain here till he arrived. They also complained to the control room regarding the wait.
They sat outside until 5.30pm, 6 and a half hours after I first phoned. When the paramedic first arrived he examined Ellen and said she should have been in hospital 5 hours earlier.”
It was not until 6 pm, more than eight hours after the initial phone call, that my constituent, Mrs Sherriff, was admitted to hospital, where it was discovered that she did indeed have a bleed in the brain and that she should have been there much sooner.
Until Friday, Mr Sherriff was still awaiting a response to his complaint, which was sent in February. Perhaps the prospect of this debate ensured that he eventually got it. The trust has admitted errors in the handling and categorising of Mrs Sherriff’s condition, meaning that it was continually not treated with the urgency required. The trust has apologised and said that a “reflection and learning session” has been given to the original call handler, but this case could easily have had a tragic ending.
Pat Glass (North West Durham) (Lab)
I thank my hon. Friend for securing the debate, which is important to all of us. Does she agree that the issue is not only with the ambulance service? Last summer, in the middle of the night, I took a relative to the university hospital in Durham. In the morning, when I came outside, I counted 12 ambulances stood outside the hospital and unable to discharge their passengers and get patients admitted. The whole system in the north-east is now simply not working.
My hon. Friend makes a valid point—we often hear about the queues of ambulances at accident and emergency. Patients have waited hours and hours for the ambulance to come, but when they get to the hospital, they sit in a queue outside. I have raised that with my local hospital. There is a huge breakdown in the system. Something is going seriously wrong, and it is completely unacceptable. Mrs Sherriff, a patient who had a suspected bleed in the brain, had to wait for more than eight hours before getting to A&E. That is truly shocking, and all those cases mentioned highlight concerns that the Government and the North East Ambulance Service must address.
I have one more issue to discuss before concluding, and that is to do with the numbers of qualified paramedics, which my hon. Friend the Member for North Tyneside (Mary Glindon) mentioned in her intervention. When waiting times are going up and demand is rising, we clearly need to look at workforce retention and recruitment. Our paramedics do an amazing job, but they cannot be in two places at the same time.
At this point, I want to place clearly on the record that I am not apportioning any blame or criticism at all to any paramedic or ambulance crew. They do an amazing job, under very difficult and trying circumstances, day in, day out, and they should not be placed in situations whereby, once allocated, they race through traffic to a call, within the appropriate time allowed, only to be faced with stressed and sometimes angry people, who say, “Where’ve you been? I’ve been waiting four, five, six or seven hours.”
Alex Cunningham (Stockton North) (Lab)
I congratulate my hon. Friend on securing this debate. I have an example from my constituency. A young lad, a teenager, had a road traffic accident, getting a compound fracture of the leg, but it took three hours for an ambulance to get to him.
When I met the ambulance chief executive, she told me that the problem is that the organisations that do employment and support allowance assessments are poaching qualified paramedics from the ambulance service, creating a great hole. There is a role there for Government, perhaps, to talk to the whole organisation, to see what can be done to put a stop to that.
My hon. Friend makes a valid point, which I will touch on, although he made the case well. We have to look at the slippage, to where in the rest of the health service the paramedics are haemorrhaging, and why. I will say more about that in a moment.
Paramedics are there to treat people and give them emergency—perhaps life-saving—healthcare, but before they can even start to treat them, they might first have to calm the patient and relatives down, because of something that was completely out of their hands. It is therefore no surprise that, nationally, there is a shortage of qualified paramedics, and all trusts are struggling to fill vacancies so that they can operate at full capacity. The North East Ambulance Service has a 15% shortage, and is plugging the gap with private and voluntary organisations, as my hon. Friend the Member for North Tyneside mentioned. The service has said, however, that it will be up to full establishment in a year, but how many more people will wait for hours and hours before we get to that stage?
Something therefore needs to be done about the recruitment and retention of paramedics, especially since evidence has shown that more staff are leaving the profession than ever. Also, mental health charity Mind reported that 62% of blue-light emergency service workers have experienced a mental health problem and, worryingly, one in four has considered ending their own life. It is shocking to think about the stress that those people are working under.
It is no surprise that research conducted jointly by Unite, Unison and the GMB revealed at the end of last year that more than 1,500 paramedics had left the service in 2014-15, compared with 845 in 2010-11—still a high number, but a little more than half the later figure. Of paramedics surveyed as part of other research by the three unions, 75% had considered leaving the profession due to stress and pay.
Action therefore needs to be taken on recruitment, which is why I welcome the work of my local university, the University of Sunderland, which in partnership with the North East Ambulance Service has launched a diploma programme in paramedic practice. It will pair theoretical study with practical training over two years, and it will help to address the shortages faced by not only our regional trust, but other trusts around the country. That innovative work by my local university, alongside that of the outstanding paramedic practice degree at Teesside University, which is seen as a beacon of best practice in our region, if not the country, is important and will help.
It is, however, unsustainable not to address strategically the staffing shortages and the increasing demoralisation of a workforce who are haemorrhaging away, because that is clearly having an impact on waiting and call-out times for emergencies. That is why I hope that the Minister will address those concerns, and outline what the Government are doing to deal with recruitment and retention. How will she work with my local ambulance service trust to ensure that it reaches the target of being fully operational by this time next year? How will the ambulance trust ensure that those who are recruited into the field are retained and do not slip off to work for other parts of the health service, so that we do not see further shortages down the line?
It is important that our emergency ambulance services are up to the standard that we all expect. That means working collaboratively among ourselves, as the local Members of Parliament who represent our constituents and their concerns, and with the Department of Health, NHS England and the North East Ambulance Service Trust. Our constituents deserve the best standards in our NHS, and it is up to the Government seriously to address pressures on our NHS services, especially the case of the workforce in the ambulance service.
I hope that the Minister has listened carefully to my concerns, and will listen to those that my colleagues from the north-east who have attended the debate today express. I look forward to hearing what she has to say at the end of the debate.