Sir Edward Leigh
MP for Gainsborough · Conservative · United Kingdom
“Those of us who love the Jewish people and faith know that the reason why they have overcome all the empires that have tried to destroy them is that they are primarily people of the book and not the sword, but what is happening in the west bank is violent and egregious.”
“I am grateful to the Secretary of State for looking again at Lincolnshire. I made the point to her predecessor that the proposal for a Greater Lincolnshire authority was, in the eyes of many people, just a gerrymander. Will she look again at it and stop dividing West Lindsey and North Kesteven in half?”
“If the centre does not take action, nasty extremes will take over. The fact is that we are in acute danger. These people can now launch from anywhere on the north French coast and are escorted to our shores. Frankly, we are being invaded, and the public are completely fed up.”
“May I congratulate the Prime Minister on what he said about Ukraine and on how he conducted himself there? Our enemies should know that this House is completely and utterly united in standing behind the Ukrainian people.”
“What concerns me is the jobs of my constituents who work at Scunthorpe. That is all I am worried about; I have no ideological objection. If it is what is needed now, fair enough. As long as the blast furnaces are totally uneconomic because of high energy costs, however, it can only be a sticking plaster.”
“One of the poorest wards in the entire country is Gainsborough south-west ward. Why is the Secretary of State splitting West Lindsey in half? Why is he taking Scampton away from Gainsborough? It makes no sense. Why is he cutting away the nuclear fusion site from Lincoln?”
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“My hon. Friend the Member for Aldershot (Sir Gerald Howarth) has done the House a great service in ensuring that we have this debate. It is such an important debate that it is a matter of regret that we are having it in Back-Bench time in Westminster Hall. The effects of marital breakdown on society are enormous. It is a modern plague and it is causing not just expense but misery. We have to speak up about it all the time, because there is almost a conspiracy of silence about such issues.”
“We are told, “Britain has changed. You have to accept it,” but do we not have a right to speak up for what is right?”
“Indeed. One in eight divorced or separated fathers do not see their children at all. The Daily Telegraph story continues: “Almost a million men in the UK are estimated to have dependent children with whom they do not live. Almost 130,000 of them have no contact at all with their children.” A story in The Daily Telegraph on the British social attitudes survey said: “The belief that couples should ideally get married before starting a family has effectively collapsed within a generation, the British Social Attitudes survey, the longest running and most authoritative barometer of public opinion in the UK, shows. Only a minority of people now view marriage as the starting point for bringing up children, with support for that view almost halving in less than 25 years.” Do we not have a responsibility for the change in social attitudes?”
“Why are not the Churches, schools and Government crying that out from the roof tops?”
“Absolutely right; but it is the people at the bottom of the heap who suffer the most. We are not talking about society divorces in the 1950s. We are talking about hundreds of thousands of people living, effectively, a tragic life. The Marriage Foundation has interesting statistics, including: “45 per cent of young teenagers (aged 13-15 years old) are not living with both parents…Half of all family breakdown takes place during the first two years”; but—and this is the important point: “Amongst parents who remain intact, 93 per cent are married…In sharp contrast, of the 47 per cent of children born to unmarried parents today, the report predicts that just 11 per cent will reach the age of 16 with unmarried parents still together.” Marriage works. It is best for children. Every statistic proves it.”
“That is not just because the current situation is a modern plague that costs us £46 billion a year—it is not just about the cost. The point is the human misery that comes in its wake. That is why the debate is so important.”
“The fourth argument is that a transferable allowance would help to make work more rewarding for many of the poorest in society. The fifth is that transferable allowances should be introduced as soon as possible to compensate for the attack on one-earner families resulting from the introduction of a higher-income child benefit charge. The sixth and final argument is the stay-at-home spouse argument; most one-earner families do not have the option of becoming two-earner couple families. The Government are at least doing one small thing. It will not, on its own, persuade anyone to get married or stay married; but at last we have a statement. That is what we want today from the Minister—and from the Prime Minister and all Ministers. We want them to have the courage to stand up for traditional marriage.”
“First, the UK is out of line with international convention in not recognising marriage in its tax system. We are virtually alone of all big countries. One-earner married couples—those who would benefit from a transferable allowance—are thereby at a serious disadvantage relative to comparable families. The second is the distributional argument: introducing a transferable allowance for married couples will disproportionately benefit those in the lower half of the income distribution. In that way, it is quite unlike the coalition policy of increasing the personal income tax threshold to £10,000. The third argument is about the married couples allowance, which was dismissed by some as something of an anomaly, but which played a key role in sustaining one-earner families.”
“The Government are making one effort. They have said that they will bring in a transferable allowance for married couples. It is a matter of regret and has already been noted that the Labour party spokesman is here alone. Fair enough—he will speak in a moment; but it is a matter of regret that the Labour party has continually laughed at the proposal from the Chancellor of the Exchequer. The Labour viewpoint is “This is rubbish and will not make any difference.” The fact is that if one member—usually the mother—of a married couple who are doing their best to bring up children decides to stay at home, they are uniquely disadvantaged by the tax and benefits system. There are six key arguments that drive a coach and horses through the arguments against the transferable allowance.”
“Does the Minister recall the very worrying Keogh report, published last year, which showed that Lincoln hospital in particular had a higher than average mortality rate? Some of us felt that if we had a stroke or a heart attack, it would be a lot safer for us to be taken to the nearest big city, such as Leicester or Nottingham. Will the Minister join me in welcoming the fact that Lincoln hospital has made progress since then, and is now expected to have a below-average mortality rate?”
“We Conservatives would be foolish to concede the forum of debate on economic justice to Opposition Members. Conservatism has never existed, and should never exist, in some hyper-capitalist vacuum. Of course, we know the value of economic freedom and the marketplace, because we can see the unimaginable leaps in prosperity and the reduction of poverty that have taken place under free market economies over the past 200 years.”
“The idea of minimum income standards is, in some ways, tied to that of the living wage. There has been a lot of debate about the living wage, but mainly focusing on areas such as London and the other big cities. I believe that the concept applies even more powerfully to the countryside. The social teaching of the Churches, which is a rich vein of thought and very much to be recommended as a read, puts strong emphasis on justice in the relationship between employers and their employees. For an employer to deprive a worker of his justly earned wage is traditionally described as “a sin crying out to heaven for vengeance”. It is that important. Provided that an individual is working full time, it is basic justice that he or she be paid enough to support himself or herself and their family.”
“I turn briefly to support for farming. I welcome my right hon. Friend the Secretary of State’s announcement that the Government will reduce the planned common agricultural policy modulation rate from 15% to 12%, which shows that the Government are listening. Like many rural Members of Parliament, I have been approached on the matter by farmers, and the National Farmers Union has rightly been concerned about it. I know it is a matter for Europe rather than for us, but my personal view is that we should still try to transfer more agricultural subsidies from larger farms and estates and towards working farmers, many of whom are struggling. We need to help them more. It is obvious that we have a problem of poverty in rural areas, and that there is not sufficient political weight to address it.”
“I am a bit technophobic, I admit, but when I am sitting in my cottage trying to use my local wi-fi and get on to broadband to do my parliamentary business, it is ridiculously slow. It is absurd—if I were trying to run a business, I would be out of business by now. I simply could not work in my own rural area. I have to do all my work from a computer in London. The internet simply does not work fast enough in rural areas. In 2010—again, this is fact, not rhetoric—only 5% of urban areas had broadband speeds lower than 2 megabits a second, whereas the figure was 23% of rural areas. Surely that must be a priority for the Government. We are going to encourage people to avoid heavy transport costs and so on by working at home, are we not? How can we charge the rural economy if we have such slow broadband speeds?”
“There was a local couple from north Lincolnshire on television who could not even afford to go on holiday in England, because they could not afford the petrol to get where they wanted to go on the coast. People are having real difficulty in affording petrol, and some people in rural areas do not have a car and so have virtually no transport. I do not want to say a great deal about access to broadband internet, because my hon. Friend the Member for Thirsk and Malton dealt with the matter so skilfully. However, we all know that average broadband speeds are much slower in rural areas than in cities, and that a higher proportion of rural households have slow or no broadband.”
“Some 96% of urban households have a regular bus service, and the 72 Members of Parliament who represent constituencies in Greater London have fantastic tube and bus services. Only 42% of households in rural areas have a regular bus service. Famously, in my constituency in north Lincolnshire, we have the train service between Gainsborough, which I represent, and Cleethorpes, which runs once a week. Imagine a train that runs once a week—it is truly bizarre. We cannot assume that everybody in a rural area, in the type of village in which I live, has access to a car, although there have been tremendously impressive efforts such as dial-a-bus services. Even if they do have access to a car, the cost that I have mentioned—£90 a week—may be truly prohibitive.”
“The average for England is £58. In rural areas, the highest proportion of income that is spent on an individual commodity or service goes on transport. We should consider the sort of wages that people in rural areas earn. There are a lot of retired people on relatively modest pensions. They have to spend an average of no less than £90 a week on transport if they live in hamlets or isolated dwellings, which is an enormous burden. It is obvious that most people who live in rural areas travel further than other people—45% further per year than the English average and 53% further than those who live in urban areas. Plainly, the very DNA of rural existence requires travel over longer distances. We in Lincolnshire know all about long distances.”
“The Government’s statistical digest of rural England for 2013 notes that, proportionally, more households in rural areas are in fuel poverty than the national average. That is obvious—it is a clear fact. Fuel poverty is even greater in sparse villages and hamlets than it is in rural towns. Some 36% of rural households are off the gas grid, as the hon. Gentleman said, as opposed to only 8% in urban areas. As we all know to our personal cost, those households are reliant on much more expensive domestic fuels than others. I do not pretend that I know the answer to that problem, but I know that the Minister will address it when he sums up. Average weekly household expenditure on transport in urban areas is £55. In rural towns and their fringes it is £62, in villages it is £78, and in hamlets and isolated dwellings it is £90.”
“To reach a minimum living standard on 2010 levels, the research indicates that single working adults need to earn at least £15,600 a year in rural towns, £17,900 in villages and £18,000 in hamlets or remote countryside. Those in urban areas need earn only £14,400. For couples with two children, the annual earnings requirement is much higher at about £33,000 to £42,000, depending on the circumstances. I assure the House that many people who live in rural areas do not earn anything like £42,000 a year. The Minister, who is an excellent Member of Parliament, knows the scale of the problem in Cornwall. Rural poverty is a real problem. The hon. Member for Ynys Môn mentioned fuel poverty.”
“We do not have a sufficient number of Members of Parliament or, dare I say it, Members in marginal seats, but we have a right to speak out because there is a clear injustice in the national funding formulas against rural people, who are often living in poverty. That is not just rhetoric; it is fact. There have been a number of academic studies on the minimum income standard. That concept was invented by researchers and is carefully worked out. It is based on what members of the public think people need in order to have the minimum acceptable standard of living. There is no doubt that people in rural areas tend to have to spend 10% to 20% more on everyday requirements than those in urban areas, even though they often have lower wages or salaries.”
“The cost of living in rural areas is often not recognised. One can get bogged down in statistics and details, but it is important that we, as Members of Parliament who represent rural areas, put on the record the sheer cost of living in rural Britain, compared with living in urban Britain. People who live in entirely rural seats a long way from the capital are very under-represented in this city. Often, our voice does not get through. That affects all essential public services. In policing, despite high rural crime—I am a victim of rural crime myself—Lincolnshire is bottom of the heap for funding per head. It affects transport and hospital services. Again and again, despite the fact that incomes are lower in rural areas, the funding that we receive from central Government is inadequate. Our political voice is not powerful enough.”
“Friend the Member for Thirsk and Malton, because there is no bedroom tax—it really is a spare room subsidy. In rural areas, we have to try to find a way—she was feeling her way towards this point—to distribute low-cost housing and to move people on from housing that is under-occupied so that younger families can get into it. As she said, this is a complex issue because there is not enough low-cost, single-bedroom social housing in rural areas. Local councils such as East Lindsey and West Lindsey district councils in my area are working on the problem and the local housing associations are very aware of it. I agree with her to the extent that localism comes into this. In this complicated area, central Government must work with local councils to ensure a good supply of low-cost housing.”
“They recognise the need for new housing and for new affordable housing in particular. Surely we believe in localism. I thought that localism was a primary undertaking of the coalition Government. It does not behove central Government to impose their views about the nature of house building on rural councils. I am all in favour of encouragement and of a broad framework. However, if people of worth and ability are to be encouraged to serve on councils in Lincolnshire and other rural areas, they must believe that they will have some influence and power, and that knowing their local areas gives them some right, in broad terms, to determine how much new housing should be built. To turn to a vexed issue, I want to disagree with one of the points made by my hon.”
“I believe that the planning process should respect the views of local people, particularly given that there are good planning reasons relating to local archaeology and the proximity to RAF Scampton, as well as the famous view that I have mentioned. Localism affects other parts of the planning process. If Members read the front page of The Daily Telegraph today, they will see a banner headline that contains remarks made by my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), who sits in the No. 10 policy unit and is therefore a man of some influence. He talks about the national planning policy framework and makes the point that the views of local people about new housing must not be overridden by central Government. Local councils are not naturally nimbyist. The people who sit on them are democratically elected.”
“Member for Scunthorpe (Nic Dakin) knows that view very well. It is a fantastic view. Perhaps it is not as good as the view that you have, Mr Deputy Speaker, in the forest of Bowland, but we do almost as well in Lincolnshire as you do in Lancashire. We are very proud of that. It is likely, however, that local people will soon be ignored by the planning authorities and that vast wind farms, higher than Lincoln cathedral, will be built along the Lincoln edge. This is not a debate about wind farms, but it is a debate about rural areas and surely it is a debate about the right of local people to have a say. The planning committee of West Lindsey district council has opposed unanimously the application for those vast wind farms.”
“However, the reality of life in remote rural areas that are, dare I say it, less fashionable than the Cotswolds or Buckinghamshire, such as the part of north Lincolnshire that I represent, which is three and a half hours from London whatever form of transport one takes, is often very tough indeed. That is why this debate is important. My hon. Friend the Member for Thirsk and Malton and the hon. Member for Ynys Môn (Albert Owen) outlined in a very measured way some of the extra costs of living in rural Britain. I will deal with those costs in a few moments, but first I will talk about planning and localism. If I walk out of my cottage on the edge of the Lincolnshire wolds, which is an area of outstanding natural beauty, I can walk up the hill and have an uninterrupted view over the vale of Lincoln to the Lincoln edge. The hon.”
“My hon. Friend the Member for Thirsk and Malton (Miss McIntosh) has done the House a great service in ensuring that we have a debate on rural affairs—a subject we do not talk about enough. There is an altogether too rosy picture of rural life, particularly in metropolitan circles. Some of the people who write our national newspapers seem to think that we all live in lovely stone houses in Cotswold villages inhabited by media moguls and retired admirals having country lunches. That is not to say that retired admirals can afford to live in the Cotswolds any more—it is probably only retired hedge fund managers who can.”
“I hope and trust that the Minister will give us good news in those regards when he responds.”
“The freedom of the marketplace must be protected within an orderly context, with the best being conserved and the important and vital things that might otherwise be destroyed by the cold calculations of mere profit being preserved. In rural areas such as mine in Lincolnshire, that means businesses, farmers, employers and local and central Government coming together to co-operate for the common good, whether on agricultural subsidies, flood defences, the price of petrol or many other matters. I am sure the Government are trying to listen to country people, but it is important that we speak out and put pressure on the Government. We need action on fuel poverty, the cost of living and disparities between rural and urban areas, particularly with regard to Government funding, which is in the Government’s control.”
“I am thinking more of the problems that are loaded on to the great majority of people in the countryside, who are not farmers and do not work for farmers but who are living in fuel poverty, are retired or find difficulty with their transport costs. Their children have difficulty in getting housing, and they perhaps work in low-paid jobs in the catering industry in local towns. That is more typically the structure of the current rural economy than the historic structure of large numbers of people working in agriculture. I was talking about economic freedom and the value of the marketplace, but also about the common good, and I want to finish on that point.”
“That is an interesting point, but we cannot go back in time to a structure created under the Attlee Government whereby agricultural wages boards determined what wages were paid in the agriculture sector. Let us look at the farming economy in Lincolnshire. I live on an estate of 5,000 acres—I do not own it, I hasten to say. When the boards were created, there would probably have been 40 or 50 agricultural labourers working the estate. Now, there are only one or two. Although the hon. Lady’s point is fair, I do not believe that agricultural labourers’ wages are quite the problem in current rural Britain that they were in the immediate post-war period.”
“So, a Labour Government are going to transfer resources and funding from marginal seats in the great cities to Conservative seats in rural areas, are they?”
“T6. Further to the Secretary of State’s earlier reply, will he confirm that this country is a proud signatory of the original European convention on human rights and a founder member of the Council of Europe? Indeed, for its first five decades, the convention was hardly a controversial issue. The problem is that the Human Rights Act 1998 has been used by the European Court of Human Rights in a proactive way to deal not with gross abuses of human rights like those that we saw in fascist Europe, but with the decisions of a democratically elected Parliament. Why do we not simply remain a member of the Council of Europe, keep the convention, repeal the 1998 Act and create our own Bill of Rights?”
“I am sorry to say this to the Minister, but he has not replied to the point made by my hon. Friend the Member for Beverley and Holderness (Mr Stuart). Of course, the Government can do what they like—they can set a cap—but the Minister must respond to the point that the Government cannot legislate against sin. The fact is that people are desperately hard up. If we legislate or put a cap on one thing, the evil moves to another, almost worse practice. The Minister must make some effort, in the real world, to answer my hon. Friend’s point.”
“In warmly congratulating the Chancellor on putting hard-working families and enterprise growth at the centre of the statement, may I draw his attention to those people in hard-working families who occupy key managerial positions and who typically earn just over £40,000 a year? More and more of those families are being dragged into paying higher rate income tax—perhaps as many as 2 million by the end of this Parliament. I ask him to bear those people in mind because they are the key to our recovery.”
“There is a view that dermatology does not matter and that it does not kill. This is both complacent and wrong. Many skin diseases have horrendous effects, even when they are not fatal. Skin cancer is a major killer, and there would be benefits from renewed focus on this disease, both to help people avoid it in the first place and to identify and treat it quickly where it occurs. The statistics on the burden of skin disease are eye-popping. Some 54% of the United Kingdom population experience a skin condition in any 12-month period. Of those, 14% seek medical advice, usually from a doctor or nurse in the community. Some skin conditions will be trivial, but many are not. Skin conditions are the most frequent reason for people to consult their GP with a new problem. Some 24% of the population visit their GP with a skin problem each year.”
“In preparing for this debate, I consulted widely among the different interests in skin disease, and I am grateful for the insights that I was given. It is noteworthy that the same themes emerged from all quarters. Skin disease is extensive and has a great impact. It results in profound psychological consequences for many, especially for those with severe variants of conditions. It is under-treated in the NHS, and there are commissioning issues that relate partly to dermatology’s continuing to be something of a Cinderella disease. Talking to people, I heard the expression “Cinderella disease” time and again. Most crucially, there is wholly inadequate training, notably among general practitioners, to enable doctors to handle the dermatology cases that will come their way in day-to-day practice. Why is this?”
“It is a pleasure to serve under your chairmanship, Mr Turner. I am grateful for this opportunity to debate issues relating to the provision of dermatology in the NHS. This area has received little parliamentary attention over the years, given the considerable morbidity and mortality for which skin disease is responsible. Indeed, I think I am right in saying that this is the first debate in the House of Commons in several years on dermatology and how it is treated in the NHS. I should declare an interest, because we are always supposed to. I have a skin condition called rosacea. It is not that serious; I take antibiotics every day and it is controllable, but it has, of course, led me to take an interest in this subject.”
“This is often combined with another so-called minor field of medicine. I am told that many miss this teaching altogether, not regarding it as important, and joke about taking a “dermaholiday”. That is like the NHS employing an army of plumbers who are highly knowledgeable about boilers and blocked drains but who do not know how to trace a leak or mend a pipe. By failing to provide adequate education in dermatology, which is an important field of medicine, we are badly failing to meet the needs of patients.”
“Friend the Member for Mole Valley (Sir Paul Beresford) who chairs that group and does it well. Despite the fact that skin disorders are both serious and the most likely reason for someone to go to their GP, training and knowledge of dermatology among primary care health professionals is generally very limited. Perhaps “very” is wrong, but it is certainly limited. Astonishingly, there is no compulsory requirement for dermatology training in undergraduate or postgraduate medical programmes of study. Dermatology is still not included in all undergraduate medical school curriculums; it is optional in some, and untested in others. In five to six years of medical training to become a doctor, the average medical school offers—I found this incredible— less than a fortnight of teaching in dermatology.”
“Skin conditions are sometimes very visible, and some people are highly prejudiced against those who have them, and make little attempt to hide that. That can lead to stress, depression, anxiety, and other related problems. There is a beautiful picture in the Louvre of a child reaching out to an old man, probably their grandfather. The child is beautiful and the old man, who obviously suffers from rosacea, is deformed and hideous. The point of the painting is that beauty lies inside, not on the skin, but that is not often the view of modern society, so skin conditions lead to psychological stress. Many of these facts—I could go on, but I will not—are set out in detail in the recent report on the psychological effects of skin disease published by the all-party group on skin. I pay tribute to my hon.”
“Other common conditions seen by specialists include vitiligo, urticaria, rosacea, herpes simplex, shingles, vascular lesions, benign skin tumours, benign moles, solar keratosis, viral warts, non-malignant skin cancers—I know all about that, too—and malignant melanomas. The list is almost endless, running as it does to a couple of thousand different conditions, each of which can have profound effects on the lives of those who have them. People who suffer from these diseases often do not want to speak about them. I am attempting, in this small debate, to give these people a voice. It is worth saying that serious psychological effects are sparked by skin disease. We live in a society where we are subjected daily to images of perfection, selling everything from make-up, fashion and holidays to ice-cream.”
“Then there is acne—I know all about that, too—a condition most commonly associated with adolescent teenagers. Although the condition is thought to be linked with hormonal changes during puberty, some 80% of young people above the age of 11 will have a degree of it at some point. It can affect people well into their adult lives, and it can be severe. Acne scarring is permanent. About 5% of women and 1% of men have acne over the age of 25. In a not inconsiderable number of cases, acne is widespread and ever-present, producing feelings of shame, despair and even, I am sorry to say, suicide in some cases. Acne is particularly tricky, psychologically, because it is often at its worst when the young emerging adult is feeling at their most self-conscious.”
“For those who have it or those, such as parents, who have to care for a child with it, eczema can be highly debilitating. Sleep deprivation is common in children with eczema and, therefore, of course, in their parents. It causes major disruption to family life, not least because of the application of endless amounts of ointment. I know all about that. Psoriasis, from which my brother and my mother suffered, has serious effects. It affects only 2% to 3% of the population, but often has devastating consequences for those who have it. Its onset is typically at 15 to 24 years, which is such a crucial stage in a person’s development. It is an immune condition that triggers excess replacement skin cells, which can lead to raised plaques on the skin that can be flaky, sore and itchy. It is a serious problem.”
“I am not surprised. I found similar figures in Lincolnshire. I should think that the same sort of problem will be found anywhere in the England. The most common reasons for people visiting their GP are skin infections and eczema. Nearly a fifth of all GP consultations relate to a skin disease. Atopic eczema is the most common form of eczema. All my children have had it, and one of my boys suffered badly. Some children suffer grievously from it. It can affect people of all ages, but is primarily seen in children and affects up to 20% of children by the age of seven. Most people grow out of it, but a number of adults continue to show symptoms at a later age, some having the condition for life. Eczema is typically characterised by red, sore and itchy patches of skin.”
“I urge all interested parties—Health Education England, the royal colleges, the General Medical Council and the ultimate employer, NHS England—to use half or all of that extra time on a proper dermatology rotation, which would ensure that the GPs of the future are properly equipped to address their future work load. If that is to happen, funding must be made available to ensure that there is adequate consultant time to train budding GPs and to pay their salary while they undergo the hospital training.”
“For undergraduates, the British Association of Dermatologists recommends a two-week full-time attachment to a dermatology unit, with a realistic assessment at the end of the course. The association thinks that dermatology should also be taught when undergraduates work with general practitioners in the community. When trainee GPs are undertaking their two-year hospital placement, a six-month post in dermatology alone, in a combined post such as dermatology and general medicine, or in a combined minor specialty rotation would go a long way towards helping trainee GPs to take a special interest in dermatology, which is what we need. The GP training period is likely to be lengthened by 12 months.”
“Work this year suggests that the number may be nearer to 700,000; that is what dermatologists tell me, because they are dealing with such a volume of cases, day by day. Studies show that the skill of GPs in diagnosing skin lesions needs improvement, and other studies raise concerns about the standard of skin surgery offered in primary care. In 2012, the Royal College of General Practitioners updated its curriculum statement on the care of people with skin problems. The statement goes a long way towards recognising dermatology as a key component of a GP’s training. The statement sets out a number of expected key competences within the field, but crucially, dermatology remains an optional component.”
“As awareness of litigation increases in the NHS, GPs are, unsurprisingly, less and less willing to take risks, so they refer more and more patients to secondary care. I understand that the general hospital in Lincolnshire—this echoes the point raised by my right hon. Friend the Member for Chesham and Amersham (Mrs Gillan)—has seen a 26% rise in dermatology referrals for secondary care in the past year, and it is not alone. The exploding incidence of skin cancer, an ageing population and side effects from new potent drugs are all driving referral rates. It has been guesstimated that there are 100,000 cases of skin cancer a year in the UK, but the number is not known for sure because the NHS does not collect figures for cancers that are not melanomas.”
“In a moment, I will address the fact that skin diseases can have fatal consequences. As GPs often do not have adequate training, they are not able to spot conditions that can be very dangerous. Training is important. In a 2008 survey of final-year medical students, only 52% of 449 respondents said that they felt they had the necessary skills to manage skin conditions. A lack of education and training may lead to fatal errors, and I stress that point because skin disease is not only about psychological damage. Skin lesions mistakenly taken to be benign can lead to cancer. Conversely, inappropriate referrals to secondary care can be costly and are blocking up big parts of secondary care.”