Sir Mark Tami
MP for Alyn and Deeside · Labour · United Kingdom
“On the point made by the hon. Member for Harrow East (Bob Blackman), Bellway is certainly a company that has done this. Indeed, many people did not even realise that they had a leasehold house and only found out quite a while afterwards when all the costs started to come down the road.”
“The thing that really surprised me was that Wembley is not just your average stadium; it is a purpose-built stadium that we would expect to have the best security, yet that number of people were able to get through. As my hon. Friend said, that could potentially have caused the loss of life.”
“The hon. Gentleman mentioned the work of Harefield Hospital. My son has been at Harefield for four months after having a heart transplant just before Christmas; it has been a very traumatic time. I would like to place on record the incredible support and care the hospital provides.”
“I promise the hon. Member that I will not. As someone who is very pro-nuclear, I believe that one big issue is that we have loads of reviews, and identify all the problems and what we will do, and then never actually do it. If we do get around to building a station, we build one—not a number of them; just one.”
“I have been to Finland and seen its waste repository. It is not rocket science—it is not that difficult. We have put this off for years and years. The argument always used against the industry is, “There is no answer to the waste.” Well, there is an answer, and it is straight- forward. We just need to make that decision.”
“The right hon. Lady is making an important point. This should not be a bolt-on. It should be part and parcel of the treatment. We tend to address the physical side of the illness, open the door and away we go, and we do not ask people about some of the issues that they are struggling to cope with.”
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“Even if someone is doing physically well, that sense of dread never goes away for them or their family members. Because of patients’ varied needs, psychological support can take many forms. Clinical psychologists and others working in improving access to psychological therapies services are able to help those with the most complex needs. Clinical nurse specialists, who we know are hugely valued by patients, can enhance overall wellbeing by providing general emotional support based on skilled communication and effective provision of information. The third sector, meanwhile, provides a wide range of services, including helplines, online forums and peer support. There is no silver bullet, however, and many different actors have a role to play.”
“First, psychological support is for everyone, not just those with diagnosed mental health conditions. Secondly, the families of patients should also be offered psychological support, and thirdly, it seems that patients and their families are not getting the psychological support they need. Let me address those points in turn. First, psychological support is for everyone, not just those with diagnosed mental health conditions such as depression or post-traumatic stress disorder. That includes patients who are feeling anxious, worried or frightened, and those who are having trouble adjusting to their “new normal”. The fear of cancer returning can be particularly difficult to manage. For example, some blood cancers relapse, which can be a common occurrence.”
“She says: “Emotionally, in the first year after treatment I think I was shell-shocked because you’re trying to catch up with everything that has happened to your body. You feel like you’re a failure and you’ve failed to bounce back in the way you think you should have done.” Ciara, who finished treatment in 2016, says: “The fear of cancer never leaves you but I’m trying now to think, if it comes back, it comes back. I can’t live under that shadow. But it is so difficult to mentally recover.” Finally, Chris, who finished his treatment for head and neck cancer in 2016 stated: “People say to me, ‘I bet you wake up every morning feeling glad to be alive.’ You know, it can’t be further from the truth.” The stories from Joanna, Ruth, Frances, Ciara and Chris affect all cancer patients—they cover everybody. So what do we need to do?”
“For her, this means her eyes are constantly dry, she cannot perform fine motor skills too well and her feet are in constant pain because of nerve damage. Ruth says: “The biggest downside of my whole transplant experience has been the complete lack of support since leaving hospital. It felt like I was on my own—my GP has offered me nothing. I’m on the waiting list for a counsellor, but it’s very long… I’m surprised you’re not referred to a counsellor as soon as you’re diagnosed.” As well as those patients who have received transplant, the charity Macmillan has provided me with some other brief personal stories. Let us take Frances, who finished treatment for Hodgkin’s lymphoma five years ago.”
“It was the worst she had felt since the actual diagnosis. Her daughter was only a teenager at the time, and the caring role of mother to child had to be reversed. In Joanna’s own words: “I think my lowest emotional time was after transplant. I questioned why I’d gone through this experience and just couldn’t see an end in those first three to four months… I wish there had been more psychological support for me and my family—even though staff tried their best, when I really needed help, it just wasn’t there.” Joanna’s story is not unique. Ruth, a teacher from Yorkshire, also received a stem cell transplant in 2016. In the two years since, she has experienced many ups and downs, and she is still dealing with chronic graft versus host disease.”
“All of this can have an impact on patients’ ability to study and work, and with that can come financial issues and even a loss of their identity. It can be completely and utterly overwhelming. With all this in mind, it is perhaps not surprising that in response to a survey of more than 300 stem cell transplant patients conducted by Anthony Nolan, the UK’s stem cell transplant charity, nearly half—47%—said that they needed emotional and psychological support, such as counselling or group therapy. It is surprising and even shocking that only half—54%—actually received it. Let us take some individual cases. Joanna received a stem cell transplant in 2016 to treat acute myeloid leukaemia. It saved her life, but when she got home to her family, she could not get off the sofa or out of bed.”
“Members some idea of what it can be like for those living with the long-term effects, approximately half will suffer from graft versus host disease, which is when their new immune system attacks their own body. I can certainly say that this is not a particularly pleasant experience, and in the worst cases it can actually kill the patient as well. Patients can also experience infertility, premature menopause, sexual dysfunction, fatigue and problems with their eyes, bones, teeth, joints and muscles, and they are at higher risk of infections and secondary cancers. In addition, it is not unusual for patients to be left with a range of psychological effects, including depression and post-traumatic stress disorder.”
“First, the patient must spend a number of weeks in hospital isolation to protect them from infection. This alone can be a very difficult experience, with patients often feeling very cut off from the outside world. Things such as patchy wi-fi, poor facilities and rooms without windows do not exactly help with this experience. Hopefully, the patient then begins their recovery, which brings with it entirely new physical, emotional and practical challenges. In fact, of all cancer treatments, stem cell transplant patients experience some of the most severe long-term effects, and it is for that reason that they are often described as patients for life. To give hon.”
“Despite the fact that there are more than 1.4 million incredible individuals on the UK stem cell donor register, there are still patients who miss out on the life-saving transplant they need because either no donor is available or a donor cannot be found early enough. My experience with my son was that we were very fortunate to find a donor. That donor then failed his medical, which was a traumatic experience for the family. Not only were we concerned about what the problem was for the donor, but we did not know whether the donor would return to fulfil that pledge. We will be eternally grateful that he did. Even when a patient does find a match, this is not the end of their journey. Tellingly, the day of the stem cell transplant is commonly referred to as day zero.”
“It goes without saying that cancer can take a huge emotional toll on patients and those close to them, right from the moment of diagnosis. Less well understood are the consequences of cancer treatment, which can affect patients’ lives on a daily basis and leave them needing support for many years afterwards. No group illustrates that better than stem cell transplant patients. Every year in the UK, around 2,000 blood cancer patients need a stem cell transplant from a donor to save their life. It is usually their last hope. One third of patients will be lucky to find a matching donor in their families, but the remaining two thirds of patients will require an unrelated donor. The search for a donor can be extremely stressful.”
“I am grateful to be granted this debate on psychological support after cancer treatment. I recognise that there will probably be fewer Members here than there have been in the last few hours, but I thank anyone who stays to hear what I have to say. When we talk about cancer, the conversation often starts with survival. Overall, survival has doubled in the last 40 years in the UK, but we lag behind the best in Europe, and survival rates for certain cancers—such as lung, brain and pancreatic cancer—continue to be extremely low. That means there is, rightly, a drive towards earlier diagnosis and access to new and innovative treatments. However, for most patients, just living is not enough. They want to live well, and that is why we must do more to ensure that patients receive the best possible psychological support after cancer treatment.”
“For parents, the figures are similar: more than half of parents—63%—said that they experienced depression, more than one third experienced panic attacks, and 84% experienced loneliness. It goes without saying that surviving cancer is brilliant news. However, I urge the Minister and everyone here today to remember that although survival rates are improving, people are living with the effects, including the long-term effects, that cancer has dealt them. We must do more to ensure that patients such as Joanna, Ruth, Frances, Ciara and Chris not only live, but live well. That means taking action to improve the provision of gold-standard psychological support. Finally, I thank Anthony Nolan, CLIC Sargent, Macmillan and the Teenage Cancer Trust for their help.”
“Member for Winchester (Steve Brine) gave evidence to the all-party group, he said: “For the 80% of children who survive, they’ve got it all ahead of them, so we have to make sure that we tool them up to live their lives.” Can the Minster tell us what she and the Department are doing to give children, teenagers and young adults the tools they need to deal with the psychological consequences of their treatment? CLIC Sargent’s 2017 report, “Hidden Costs”, found that 79% of young people felt that cancer had a serious impact on their emotional wellbeing, 70% experienced depression, 83% experienced loneliness, 90% experienced anxiety and 42% experienced panic attacks during their treatment.”
“Furthermore, NHS England should engage with children and young people with cancer to ensure that the recovery package meets that specific need. The all-party group also recommended that the Department of Health and Social Care and the Department for Education should re-examine their proposals in the mental health Green Paper and take account of the impact of a long-term physical condition on young people’s mental health. When the Under-Secretary of State for Health and Social Care, the hon.”
“As Kate Collins, chief executive of Teenage Cancer Trust, summarised: “Young people have told us that actually the experience of being spat out at the end of treatment can be as traumatic as diagnosis, because all of a sudden you’ve been radically changed, you’ve been through this remarkable transformation experience in lots of ways, you’ve faced problems that lots of adults have not had to face…you may be clear of cancer but often young people are living with long-term effects, be they psychological or physical.” The all-party group therefore recommended that the Department of Health and Social Care makes mental health support for children, young people and parents a key part of diagnosis, treatment, follow-up and recovery.”
“Friend the Member for Bristol West (Thangam Debbonaire), who set up the group and chairs it. She is doing sterling work and I thank her for that. When parents and young people were surveyed, 73% felt that not enough was being done to ensure access to post-treatment support. Some 26% of parents and young people identified mental and emotional help as the biggest improvement needed.”
“That is very important. What we tend to do throughout the whole process is address the disease itself and its physical aspects, but we do not address the psychological damage and problems that can occur. My hon. Friend is absolutely right that we need to do that. Before I close, I would just like to take a moment to talk about the specific needs of children, teenagers and young adults who have had cancer. They experience many of the same physical and psychological problems as adults, but they also face some unique challenges, such as the impact on their growth and development, education and future prospects. Earlier this year I was very pleased to be part of the inquiry into patient experience by the all-party parliamentary group on children, teenagers and young adults with cancer. I would like to put on record my thanks to my hon.”
“Does the Minister agree that we use the word “cured” far too often, as though there were a cut-off point when people are cured and therefore exactly the same as everyone else, and exactly the same as they were before? The problem with that is that it is not true: it does not take full account of the reality.”
“My hon. Friend will be aware of CLIC Sargent’s campaign. In an event today, the charity highlighted the cost of travel for families with children who are in treatment. The average is about £200 per month. We need to do a lot more to support families and to cover some of those costs.”
“We must not forgot mental health either. It is very important that we provide support and counselling afterwards. After what these young people have gone through, it is important they receive mental health support.”
“I understand what the hon. Gentleman says, but does he not accept that there are cases in which people do not have any intention of selling the property? It might be on the market at inflated price, but if not, when someone tries to buy it, every obstacle is put in their way to stop the purchase.”
“The fact that the risk of people with learning disabilities dying before the age of 50 is 58 times higher than the rest of the population is scandalous in itself.”
“Does the hon. Gentleman agree that we have to address the demand particularly in countries that on the surface adhere to the rules but allow trading below that to carry on and in some cases encourage it?”
“I am very pleased that my hon. Friend has secured this important debate. I should declare that I am chair of the all-party parliamentary group on stem cell transplantation. My hon. Friend makes a point that is particularly relevant for the BAME community—often the donor will come from outside the UK. There have been a number of cases where there have been difficulties with visas. Time is vital in this area and we need a fast-track process to make sure that those people can get here as quickly as possible.”
“My hon. Friend is making a powerful case, but as someone who has recently renewed their shotgun licence, I should say that that is a very thorough process. I would not want the wrong impression to be given of people who shoot for sport—I shoot only clays; I do not shoot animals—because it is a very responsible sport.”
“(Urgent Question) : To ask the Secretary of State for Business, Energy and Industrial Strategy to make a statement following the publication on Friday of the Airbus Brexit risk assessment report and its implications for future investment and job security in the UK.”
“Is it not the case that, without clarity on Brexit, investment could be placed outside the UK—either in the EU itself or in low-cost producer countries such as China where the company has a plant? Airbus’s concerns are real and shared by many other manufacturers such as BMW and Siemens. The Government need to wake up and listen rather than just address Tory infighting.”
“Are not those comments indicative of the chaos in Government over Brexit and of the Government’s approach to anyone who dares to raise genuine concerns? Airbus has been raising those concerns privately for 12 months and getting absolutely nowhere. Can the Secretary of State explain why it is now, when it has done it publicly, that it is shouted down by Cabinet Ministers? Will he meet me and representatives from Airbus to address the serious concerns raised in the report? Does he accept that the lead-in times for investment in aerospace are long and that the sums of money are huge? For Airbus, it is all about securing the next generation of wing work, and these decisions are being taken now.”
“I thank you, Mr Speaker, for granting this important urgent question and I thank the Secretary of State for his response. Does the Secretary of State agree that the continued operation of Airbus in the UK is vital to the UK economy and that we need to take seriously its worries and concerns? Alternatively, does he support the comments of the International Trade Secretary, who said that we should ignore the views of business? Or does he agree with the views of the Health Secretary, who said that it was inappropriate of Airbus to raise concerns? Finally, does he support the more direct approach of the Foreign Secretary, who said, “F*** business”? I know that the Foreign Secretary has to be elsewhere today; I believe that he has gone as far as Afghanistan to avoid the Heathrow vote.”
“It is particularly difficult for those who attend benefits assessments on a day when the symptoms are not as bad, because there is no acceptance that the illness can be very bad on some days, but not quite as bad on other days. Does the hon. Lady agree the benefits system must look at the longer term picture, rather than the short term?”
“9. What recent discussions he has had with the Secretary of State for Business, Energy and Industrial Strategy on the steel industry in Wales.”
“US steel tariffs represent a major threat to the Welsh steel industry, so what are the Government doing not only to get the US to see sense, but to limit the threat of displaced steel being dumped in the UK and further undermining our steel industry?”
“Does the right hon. Gentleman agree that the problem with the blockade is that those very workers were probably the first to suffer from it?”
“My constituent is currently working on a five-year project in France, and his Bulgarian wife is staying with him. What is her status, post Brexit, to return to stay in the UK with her husband and their two children?”
“My hon. Friend is making a very powerful case. Does he agree that these sorts of cases affect not only the individual involved, but the whole family, particularly the children?”
“The hon. Gentleman talks about recorded cases, but does he accept that in their normal line of duty, there is an acceptance that police officers are roughed up and pushed around? Much of that is not even taken into account.”
“The hon. Gentleman keeps saying that this is about releasing equity. What people are actually doing is borrowing against the perceived wealth of the property.”
“On the British Steel pension scheme, does the hon. Gentleman agree that the FCA has been very slow to react, when it was clear in certain locations that there were many problems with the way some people were advising people to get out of the scheme?”
“Is my hon. Friend as alarmed as I am—she clearly is—that today and tomorrow women will be having operations that might well cause them complications in the future? Does she agree that these operations should be stopped until we find out the truth?”
“My hon. Friend mentioned women feeling that they were alone, which is one of the main problems. I have spoken to a lot of people who were told that there was not a problem and that they were perhaps the only ones experiencing a problem. People were on a host of painkillers and were not told that others had experienced the same and that it was a much wider problem.”
“Does the hon. Lady agree that many women were told that this was like a miracle cure—a very quick fix—and were not given all the facts about it?”
“My hon. Friend mentioned removal of mesh. Does he agree that there should have been a lot more research about how easy it is to remove, because it is actually very difficult and only a few surgeons will undertake that work?”
“The Secretary of State is talking about the long term, which is very important. For a company such as Airbus, the relationship with its suppliers, which is not a short-term relationship but a long-term one, is also very important. It is because such a relationship is so important that there are fears about how long Melrose will actually invest in GKN and keep hold of that company.”
“Does the right hon. Lady agree that the situation is also very frustrating for those who fail to get a diagnosis of autism, particularly when their local authority is not able to provide one, or says that it does not have the resources to do so? Even if a person pays privately for one, the local authority will not accept that as a diagnosis.”
“Does my hon. Friend agree that another crucial time is when someone moves from children’s services to adult services? That can be a very traumatic period if it is not handled properly.”
“My hon. Friend mentioned right to buy. Some of the right-to-buy houses that were originally bought by their renters have now been sold on, often to landlords. Some of those properties are not in the best condition and on many estates they are the ones that really stick out, often because rogue landlords are not looking after them.”
“Clearly the Toyota announcement was extremely good news, but it was planned over a number of years. Does the Secretary of State agree that the company, along with others such as Airbus, has major concerns about the post-Brexit situation, particularly if we have tariffs?”
“Further to that point, the Countess of Chester hospital was built to serve Chester and Deeside, yet I cannot have any view about it, despite the fact that a large number of people from Wales will attend that hospital.”
“Does the hon. Gentleman agree that unfortunately, in perhaps only a small number of companies, one trialist is replaced by another and then another, and so on? Those companies use trial shifts as a way of getting free work.”
“Many supply companies are worried that if there is a high uptake, which I think we would all support, the infrastructure will not be there to support it. It is just not true that electric vehicles do not use a great deal of power, so there are concerns about strain on the system as a whole.”