Endometriosis and Polycystic Ovary Syndrome (PCOS)
These are common long-term conditions that can have a significant impact on a woman’s life. I believe it is important to raise awareness of the impact on women worldwide.
To provide support, all obstetricians and gynaecologists have been trained in the diagnosis and treatment of these conditions; it is a core part of their training. The NHS has published clinical guidelines on the management of endometriosis, and PCOS, to assist doctors.
Through its mandate to NHS England, the Government has set out ambitions to improve the care and support of people with long-term conditions in order to help them to live healthily and independently, with much better control over the care they receive.
I agree that swift diagnosis helps to ensure women are able to access the treatment and support that they need as quickly as possible. However, I understand that there are currently no plans to reduce the diagnosis time for endometriosis. Given the highly invasive nature of the diagnostic procedure and the varying degree to which women experience symptoms, it can be more appropriate to treat mild symptoms on clinical grounds and reserve a laparoscopy with its inherent risks for women with more significant symptoms. However, NHS England has developed a service specification for severe endometriosis under the specialised commissioning area of complex gynaecology, ensuring that specialist training is available to support diagnosis. While I know that this will not be what you were hoping for, I would certainly be happy to work to raise awareness of the condition and its symptoms to ensure women are empowered to seek help when they experience endometriosis.
I welcome the work of Endometriosis UK and Verity, the UK PCOS Charity, to raise awareness of these conditions, as well as providing sufferers with further information and access to clinical trials and the latest research. In addition, I know that the Government already provides £1 billion funding each year to the National Institute for Health Research, an organisation which invites scientific researchers to apply for funding support, across all fields, including for conditions like endometriosis and PCOS.
Alongside this, I support the Government’s commitment to increase NHS spending by £33.9 billion by 2024/25. This will enable the NHS to fund its own plan for the future, the NHS Long Term Plan. In addition, I know that the APPG on Endometriosis has recently published a report following an inquiry into the impact of the condition, which my colleagues in the Department of Health and Social Care will carefully consider as part of their ongoing work to support women's health.
I completely understand what an incredibly emotive issue this is, and I appreciate the strength of feelings around this matter. It is for this reason that, as with other matters of conscience, the Government adopts a neutral stance on abortion, allowing Conservative MPs to vote freely according to their moral, ethical, or religious beliefs. This is a convention which I support wholeheartedly.
Abortion care is an essential part of care for women, and safeguarding measures are still in place as part of care during the pandemic. The Royal College of Obstetricians and Gynaecologists has offered guidance on this issue which can be found here:
Guidelines have been issued which enable women to take both Mifepristone and Misoprostol at home for the duration of the outbreak, so that they do not have to visit a medical practice and risk exposure to the virus, and to enable doctors to prescribe medicines from home via telephone or video consultations without consulting a second practitioner, so that abortion care can be provided even in the case of staff shortages. I have been assured this alteration will last only as long as the temporary provisions enacted by the Coronavirus Act 2020 to protect women seeking care endure. The medicines must still be instigated prior to nine weeks and six days into the pregnancy. I am aware of data that indicates an increase in the number of abortions carried out in April 2020 by comparison with April 2019; I am also aware that the same dataset shows lower abortion rates during May and June 2020 compared with the same months in 2019. The pandemic has had an impact on many aspects of daily life, the full picture of which may not be clear for some time to come. I will, of course, continue to monitor this sensitive issue.
I understand that a consultation has been announced to explore whether these temporary changes should be enacted long term. You can find more information on that here:
I have been distressed to read news reports of cases where abortions had been sought and enacted after the ten week legal limit for taking the medicines at home, and have caused further illness and even death. I understand that these instances are being investigated to ensure that women are accessing safe care, and that clinicians are properly supported through the consultation process. While it would be inappropriate for me to pre-empt the outcome of these investigations, I will continue to support all efforts to ensure safety is a paramount consideration for any amendments to regulations, however temporary. I will continue to monitor this issue closely.
I know that making a decision regarding abortion care can be an extremely difficult time, and I believe that we must do all we can to support women to make an informed decision, taking into consideration all their options, with medical professionals offering impartial advice. I will continue to do all I can to ensure plenty of information is available to women making enquiries relating to abortion care including all options available to them.
COVID-19: Access to Public Toilets
I know many people in the constituency with certain medical conditions greatly value being able to use public toilets. As we live with this virus, I understand some people would like to avail of these facilities to wash their hands.
During this difficult time, I welcome that billions have been made available to local authorities to address pressures they are facing in response to the Covid-19 pandemic, including improving the provision of public lavatories.
Guidance on ways that public spaces such as lavatories can be opened has been provided to local authorities. It is up to your local council to provide this service where possible and in accordance with the latest scientific advice, and I will continue to liaise with them on this issue.
You may also be interested to know that the Non-Domestic Rating (Public Lavatories) Bill is making its way through Parliament. This will legislate to provide 100 per cent business rates relief for public lavatories, alongside over £6 million in compensation for lost income to local councils in England and Wales.
COVID-19: Vaccine Prioritisation - Teachers and School Staff
I am delighted that three vaccines - Pfizer/BioNTech, Oxford/ AstraZeneca and Moderna - have been approved for use in the UK. We have been making great progress with our vaccination programme, giving us all clear hope that the end of the pandemic is in sight.
The Joint Committee on Vaccination and Immunisation (JCVI) has set out guidance on priority groups for Covid-19 vaccination. The Committee has considered evidence on the risk of exposure and mortality by occupation, and decided that everyone aged over 50, including teachers, are eligible for vaccination within the first phase of the programme. In addition, anyone who is under 50, but has an underlying health condition which puts them at higher risk of serious disease and mortality, including teachers, will be eligible for vaccination within group six of the first phase. I welcome that the Prime Minister has set a new target for all adults to have been offered a first vaccine dose by the end of July.
The JCVI has recommended that the vaccine programme proceed into phase two on the basis of age groups, with those aged 40 - 49 invited first once the initial priority phase has been completed. I understand your concerns about the vaccination of teachers, but rapid vaccine deployment is the most important way of increasing public health benefits against severe outcomes from Covid-19. As such, a strategy centred specifically on occupational groups would be more complex to deliver and may require new vaccine deployment structures which would slow down vaccine delivery. Various studies have also shown that teachers are at no higher risk from Coronovirus than the general population, and so prioritising them over groups at greater medical risk would cost lives. I therefore support the committee's recommendation to proceed with the vaccine programme based on age groups. I also would not support the Government over-riding the JCVI’s medically-based decisions on the roll-out.
COVID-19: Vaccination Passports
I am incredibly proud of the progress that the UK is making in vaccinating the population, with one in three adults receiving their first dose, and I am delighted that the Government reached the goal of offering a vaccine to priority groups 1-4, over 15 million people, by 15 February.
While I understand that a range of options are being considered to encourage people to receive the vaccine, the Government does not plan to make the COVID-19 vaccination mandatory.
As set out in the Government’s Roadmap towards easing restrictions, four programmes of work have been established to consider different aspects of how the UK should handle COVID-19 from summer onwards. One of these is a review into whether COVID-status certification could play a role in reopening our economy, reducing restrictions on social contact and improving safety.
Of course, COVID-status certificates raise complex ethical and discriminatory issues that would need to be worked through. This is something I know the Government and the Prime Minister are conscious of and I welcome the fact that the Government is considering these issues fully as part of the review.
The Government does not intend to introduce a vaccine passport for its own use, but many other countries are considering only admitting people who have been vaccinated, and it would be unfair not to provide British holidaymakers with proof of vaccine so they could travel. There are many private venues (such as care homes) that have similar plans, which I understand are legal if proportionate to the risk. For all their faults, I think the development of vaccine passports of some form is inevitable internationally. It is not new – I myself have a yellow fever vaccination passport which must be shown travelling to certain countries.
COVID-19: FFP3 Masks for NHS Staff
I would like to reassure you that continuing to ensure our frontline staff are properly protected is of paramount importance to me, and to my colleagues on all sides of Parliament.
I am encouraged that over 3 billion items of PPE have been delivered since the start of the outbreak to 58,000 health and care settings. Almost 28 billion items of PPE have been ordered overall from United Kingdom-based manufacturers and international partners to provide a continuous supply in the coming months and the Government is confident in the stocks and sources of supply of PPE to meet the needs of health and social care over the coming months.
FFP3 face masks are designed for use when carrying out potentially infectious aerosol generating procedures. Risk assessments in the workplace establish when different PPE is appropriate: FFP2 respirators may be more appropriate and deliver the required level of safety for the care a member of staff is delivering, FFP3 masks are not always necessary. I know that the Government has worked with the NHS and with a range of suppliers to ensure that health and care facilities have plenty of PPE of the correct standard.
Support for those with Motor Neurone Disease (MND)
I know that MND can have a devastating impact on a person’s quality of everyday life and be a real struggle for patients and their loved ones. Please allow me to assure you that ensuring early diagnosis and support for those living with MND remains a key priority of the NHS.
With early diagnosis key to treating the symptoms of MND, I am glad that the National Institute for Health and Care Excellence (NICE) has published new guidelines for clinicians on the assessment and management of MND. These set out the signs and symptoms of the disease and recommend that patients suspected of having MND should be referred without delay. The Royal College of GPs and the MND Association have also worked together to produce a ‘Red Flag Tool’ which sets out key signs of MND to help GPs to identify suspected cases and ensure prompt referral.
I also recognise the valuable contribution made by carers of people with MND, many of whom spend a significant proportion of their life providing support to family members, friends and neighbours. I agree that carers must receive the right support to help them carry out their caring roles and a new cross-Government National Carers Strategy is being introduced to look at what more can be done to support existing and future carers.
I was extremely interested to read about the research undertaken by the University of Edinburgh which identified an issue with MND patients' nerve cells, suggesting that this damage could be repaired by improving the energy levels in mitochondria. While I understand that this research is still in early stages, it is a most welcome step forward, and I will certainly follow this closely.
I am aware of the February 2020 Meeting of the APPG for MND, while I am unfortunately unable to attend due to a prior longstanding commitment, I will continue to follow this issue closely.
COVID-19: Support for Alzheimer's Patients
I imagine how challenging it must be for families caring for loved ones with Alzheimer’s during this difficult time, particularly those who have needed to take on extra responsibilities. I know that the Government is working closely with system partners, stakeholders, local authorities and the care sector to monitor the impact of COVID-19 on people with dementia and to identify what additional actions may be required to ensure safety, and access to the right support and care.
In addition, research through the National Institute for Health Research was commissioned on how to manage or mitigate the impact of COVID-19 on people with dementia and their carers living in the community. The research has considered the best ways to support people to stay well during the outbreak, including help to manage the psychological and social impacts of social distancing, self-isolation, and lockdown. You can find more information, including summary leaflets, here: http://www.idealproject.org.uk/covid/
I agree that we should do everything we can to offer support to people with long term health conditions, as well as those who support them, throughout this difficult time, and I will certainly continue to monitor this issue closely.
COVID-19: Self-Isolation Payments
The introduction of the £500 Test and Trace Support Payment is for people on low incomes who are unable to work from home while self-isolating.
I believe it is right that we both encourage compliance with the duty to self-isolate and support those who have lost vital earnings opportunities from having to self-isolate. It is important that any potentially fraudulent payments or payments made in error are investigated and that when administering the scheme, local authorities work to ensure that misappropriated funds are clawed back.
The introduction of a legal duty to self-isolate from 28th September 2020, a system of fines for those in breach of this duty and the Test and Trace Support Payment will help ensure that self-isolation is properly adhered to and we are better placed to protect communities from Covid-19.
I welcome the additional £20 million which the Government is making available to local authorities to support the operation of the system of Test and Trace Support Payments in addition to a further £10 million for discretionary payments to those who could face hardship as a result of self-isolation.
COVID-19 Vaccine: Gaps Between Dosage
Moving to a 12-week gap between vaccinations is a public health approach centred on doing as much good for as many people in the shortest possible timeframe. The short term efficacy for the Pfizer vaccine is around 90 per cent, and around 70 per cent for the Oxford vaccine.
I am aware the British Medical Association has released a statement questioning the decision to delay the second dose, however they are not supported by the Joint Committee on Vaccination and Immunology, the British Society on Immunology or the Medicines and Health Products and Regulatory Authority in this. Those three bodies are in agreement with the Government’s decision and dispute the scientific claims being made by the BMA about the reduced efficacy of the second dose due to the delay.
Exploratory analysis has shown that a longer dose interval may actually increase immunity from the Oxford vaccine, and while Pfizer has not evaluated an alternative dosing schedule, the Moderna vaccine, which uses the same mRNA technology, has data to support high efficacy up to 108 days after the first dose. This has since been highlighted by both the Chief Medical Officers and by the Chief Executive of AstraZeneca himself, who has emphasised that the prioritisation of the first dose is ‘absolutely the right approach’.
Due to this, many other countries are carefully monitoring the progress of the UK’s vaccination operation and considering adopting the delayed second dose themselves.
COVID-19 Vaccine: Ensuring accessibility for the blind, deaf & disabled
I can assure you that I take the issue of vaccine take-up incredibly seriously and I welcome the Government's commitment to move the UK's vaccine programme forward with pace. I am sure you will agree that when offered a vaccine everyone should take this up and get vaccinated.
I also firmly believe that accessibility is a key priority, and so I welcome that the Department of Health and Social Care has been working to ensure information is provided about the vaccine in audio, Braille, large print, easy read and British Sign Language.
The framework for rolling out the vaccine outlines that providers are responsible for ensuring that their vaccination centres are accessible to all members of their community and take steps to improve access and reduce potential inequalities for people eligible to receive vaccinations. Patients booking vaccination appointments can choose a site that meets their accessibility needs and transport requirements and will be informed of the distance of the site from the postcode they have entered.
I will be happy to work with vaccination hubs in and around South Cambridgeshire to ensure that everybody can access this vaccine as soon as they are invited to do so.
COVID-19 Vaccine: Prioritising those with ADHD & Autism
I know this has been an incredibly difficult and worrying time for people with learning disabilities and autism. As your MP, I am absolutely committed to supporting people with learning disabilities and autism through every stage of the pandemic, as I know my ministerial colleagues in Government are.
I understand that the Joint Committee on Vaccination and Immunisation (JCVI) has carefully considered the prioritisation of those with learning disabilities and autism. Current evidence strongly indicates however that the single greatest risk of mortality from COVID-19 is increasing age and that the risk increases exponentially with age. When compared to persons without underlying health conditions, the absolute increased risk in those with underlying health conditions is considered generally to be lower than the increased risk in persons over the age of 65. The exception to this is the clinically extremely vulnerable. JCVI's advice is therefore to offer vaccination to those aged 65 years and over followed by those in clinical risk groups aged 16 years and over. This includes those with severe and profound learning disabilities.
It is important to note also that while the JCVI has given its recommendations on the first phase of prioritisation (groups 1-9), JCVI is still due to come forward with further recommendations of further prioritisation. I will make representations to ministers to seek assurance that people with learning disabilities are carefully considered again by JCVI.
I know that the JCVI is in the process of considering the next phase of the vaccination programme and they have said that the points raised with them regarding the wider numbers of persons with mild and moderate learning disabilities and autism will be taken into account in the relevant discussions and considerations ahead. I will be following developments closely.
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