argyrotsipi/train-dataset huggingface dataset:
Mental Capacity (Amendment) Bill [Lords] — House of Commons, 2019-02-12
Topic: Health
Christopher John Bryant (Labour, Centre-left): Yes. People will also attribute bad intention to the person when what is happening is that the short-term memory is simply not functioning properly. For instance, someone with very little short-term memory may find it difficult to turn up on time, as I mentioned earlier. That may be not because they are being lazy, truculent or difficult but simply because their brain does not work in that way. It may mean that their capacity is so diminished that, according to the Bill, they cannot make decisions. Alternatively, it might just be one of the elements that needs to be dealt with—they need to find tricks to circumvent the problem, and medical and clinical professionals can help This is why I tabled my amendments. Neurorehabilitation, when done well and on a sustained basis, can take an individual from being low functioning and high dependency, perhaps needing three or four people just to be able to wash themselves, clothe themselves and provide for themselves physically, to a much higher level of personal functionality and much greater independence. I have made that argument from a different place, in the sense that taking someone from needing four people to look after them to just one person coming in once a day for an hour or so could be an enormous financial saving to the taxpayer. That is why neurorehabilitation and the work that has been done in many cases can be so important Neurorehabilitation is really important in relation to the Bill. We might be able to take somebody from a place where they are not truly able to make a decision about what treatment they should be undergoing and, according the Bill, deprive them of their liberty, to a place where that would no longer be appropriate. My anxiety is that if there is no incentive in the system to ensure that neurorehabilitation is provided to people, there is a danger that we just discard them and leave them by the side, particularly as we are now talking about a three-year term rather than a one-year term. I think the clauses at the end of the Bill militate in favour of renewal, rather than providing a clear option not to renew at that point I have an anxiety that perhaps in some care homes and other places there just might be an incentive to think, "Well, this person isn’t going to get better so we’re not going to do anything to try to help them to get better." I do not want to give up on so many people. Thanks to what the Government have done with the major trauma centres, we now save about 800 or 1,000 more lives every year following road traffic accidents and the like, but we need to give people quality of life. We do not have enough people working in this field. We need to recruit many more people. If 20 people were inspired by what we are talking about today to go and work in that field—there are so many high rewards for people working to take people from high dependency to low dependency—that would be a success in itself.
Mental Capacity (Amendment) Bill [Lords] — House of Commons, 2019-02-12
Topic: Health
Mary Elizabeth Twist (Labour, Centre-left): Does my hon. Friend agree that the all-party group inquiry heard some remarkable examples of people who have gone through the pathway with neurorehabilitation prescriptions and are increasingly able, with great work and support on everyone’s part, to carry out many functions?
Mental Capacity (Amendment) Bill [Lords] — House of Commons, 2019-02-12
Topic: Health
Christopher John Bryant (Labour, Centre-left): Absolutely. One key thing that we saw repeatedly—this is an issue for the Bill, I think—was the fluctuating nature of some brain injuries. For instance, fatigue is a very common feature of many brain injuries. I do not mean just feeling tired because you are sitting at the back of a debate in the House of Commons and somebody is wittering on for far too long and you fall asleep, but real, genuine fatigue. I mean the kind of lassitude that leaves you unable to move from one side of the bed to the other. It is often misunderstood, because it might look like laziness to somebody with a judgmental eye. That lassitude can pass or go through phases and can sometimes be a bit difficult to explain or predict. I am therefore really keen that we ensure, in all the processes in the Bill, that anyone with an acquired brain injury is regularly and repeatedly reassessed so that they have an opportunity to escape. That is important.
Mental Capacity (Amendment) Bill [Lords] — House of Commons, 2019-02-12
Topic: Health
Christopher John Bryant (Labour, Centre-left): Yes. The Government have effectively already said that, but to be really nasty, we should have had the code before today, in all honesty, even if it was only in draft form, so that we would be able to see what we are really talking about, and I would then not have been talking about these amendments I want to bring my remarks to a close as soon as I can. We need to build in an incentive to make sure that there is proper neurorehabilitation provision for people with acquired brain injuries. All too often, patients and carers in this field feel as though they are being processed. That is not because health clinicians are nastily minded, but because people sometimes end up having to deal with so many different departments that they feel as though they are being pushed from pillar to post. That is why it is really important that the Government strike the right note when it comes to the next stage of introducing the code Amendment 1 simply says that "the Secretary of State must lay before Parliament a report on" the "likely effects" of the Bill on ABI before it comes into effect. Amendment 2 requires the "relevant person", who could be somebody managing a care home, to consider "the effects of any treatment undergone by the cared-for person, including prescription brain injury rehabilitation therapy" in addition to the length of time since the assessment was originally made. Amendment 3 would mean that an authorisation that was not renewed would lapse after 12 months, after a time specified in the original authorisation, or, as I would like it to be, "at the end of a period of prescription brain injury rehabilitation therapy" I think that is key to making sure that there is an incentive to ensure that therapy is provided. Amendment 4 refers to the renewal of an authorisation and requires the responsible body to take into account "any treatment to be undergone by the cared-for person, including prescription brain injury rehabilitation therapy" I do not think that any of those amendments would do the Bill any harm—no harm at all—and I am feeling a bit more grumpy with the Minister than I was yesterday when I met her, so who knows? We might end up voting on them.
Mental Capacity (Amendment) Bill [Lords] — House of Commons, 2019-02-12
Topic: Health
Madeleine Moon (Labour, Centre-left): Does the Minister agree that one of the most essential things everyone should do while they are well is make sure they take out an enduring power of attorney that names the person they want to oversee their health and wellbeing should they be in a situation such as this? Also, many families are intimidated into making bad decisions out of fear that the care home might say, "If you don’t do as we say, or if you complain, move your parent." Giving power into the hands of care home managers is a very dangerous situation.
Mental Capacity (Amendment) Bill [Lords] — House of Commons, 2019-02-12
Topic: Health
Paula Michelle Sherriff (Labour, Centre-left): What assurances can the Minister give that the regulations will be genuinely co-created with practitioners and cared-for people? If they are not, how can we be sure that the amendments are not a way of clandestinely watering down the protections of the Bill?
Mental Capacity (Amendment) Bill [Lords] — House of Commons, 2019-02-12
Topic: Health
Barbara Mary Keeley (Labour, Centre-left): We should not be in this position of having less than two hours on Report. This Bill has been rushed. We were in the same position on Second Reading, and it is absolutely unacceptable for such an important Bill to be rushed through as it has been today. I spoke to the Minister about this yesterday. She could have chosen to bring the Bill back on a different day, and I am sorry that she has not I am every bit as concerned about this Bill as I was on Second Reading. It remains deeply flawed. It weakens the current safeguards for people who lack capacity, and we have not even had a clear answer to the question that the hon. Member for Totnes (Dr Wollaston) just asked about the current backlog of DoLS applications. It is not clear how that will be cleared The Minister said at the start of Committee that she would work constructively with other parties on this Bill, but that has not been reflected in our experience. She has dismissed many of the serious concerns raised both by Opposition Members and by the many charities and representative groups outside the House with an interest in the Bill I said in Committee that our amendments were the bare minimum required to ensure that the Bill is fit for purpose. The Government rejected all our amendments in Committee, and, despite some movement on one or two issues since, the Bill retains the majority of the significant flaws it contained on Second Reading. It is sad that, having been through all the stages, this is where we are We have tabled further amendments to address some of the glaring holes that remain in the Bill, and I thank all the stakeholders who have helped us, including the Alzheimer’s Society, VoiceAbility, Mencap and Lucy Series. Without these amendments, we simply do not believe that the Bill is fit for purpose, and we oppose it progressing further.
Mental Capacity (Amendment) Bill [Lords] — House of Commons, 2019-02-12
Topic: Health
Christopher John Bryant (Labour, Centre-left): I was expecting my hon. Friend the Member for Stockton North (Alex Cunningham) to go on a bit longer, but now that I have the Floor, let me say this There is quite a bit of consensus, certainly among Labour Members, that there are elements of the Bill with which we are not happy, and I am sure that we will vote on those in a few moments. What the Minister said earlier makes me hopeful that she will do her level best to ensure that the way in which the needs of people with acquired brain injuries can be met will be clearly laid out in the code of conduct. As my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) said, some of the issues are very specific to them; they are different from those affecting other people in the same category The deprivation of liberty is one of the most important issues that Parliament ever has to consider. We all accept that, and it was referred to by both the Minister and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley). I hope that we manage to get the code of conduct right, at the right time, and that the process we use ensures that as many as possible of the users, patients, carers and organisations that are involved in this matter on a daily basis have a real opportunity to feel that they can own that code. I think that that is the point at which the Minister might manage to assuage some of our concerns, although some Labour concerns are extremely strong As I told the Minister yesterday, I do not intend to press my amendment to a vote. She is smiling now. I therefore beg to ask leave to withdraw the amendment Question put and agreed to. Amendment, by leave, withdrawn.
Licensing of Medical Devices — House of Commons, 2019-02-12
Topic: Health
Owen Smith (Labour, Centre-left): I rise to talk this evening about medical devices and the way in which they are licensed and regulated. They are a very important and growing part of medicine, and they can save and transform lives—indeed they have done for millions of patients over many generations. However, when faulty or poorly designed or poorly looked into and proven, they have also damaged, and indeed ended, the lives of many thousands of patients around the world. My principal point is that the regulatory system for medical devices in our country, and across Europe and arguably the wider world, is simply not fit for purpose and must be properly reformed The term "medical devices" is rather vague. It refers to everything from bandages to syringes through to heart pacemakers and artificial joints, and I want to be clear that what I am talking about is the more complex end of the spectrum: the more high-risk, class III as they are called, implantable devices.
Licensing of Medical Devices — House of Commons, 2019-02-12
Topic: Health
Mark Richard Tami (Labour, Centre-left): I want to put on record my thanks for all the work my hon. Friend has done on mesh. Does he agree that we must be careful that what might appear to be a relatively cheap quick fix can turn out to be a massive problem for a lot of patients?
Licensing of Medical Devices — House of Commons, 2019-02-12
Topic: Health
Owen Smith (Labour, Centre-left): I thank my hon. Friend for his thanks, and I will talk about mesh shortly as it is illustrative of the wider problem The problem is best summed up not in my words but those of the Royal College of Surgeons, which said at the tail end of last year, in response to a big journalistic investigation, that we need to see in our country urgent and drastic regulatory reform and in particular that we need to start with the creation of a compulsory register for all new devices and implants that go into patients in the UK. Will the Minister commit to that Let me give a couple of examples of what I am talking about. Last year alone in the UK surgeons operated on patients for 80,000 knee joints, 60,000 hip replacements, 50,000 pacemakers and 7,000 usages of surgical vaginal mesh, down from its height in 2008 when there were 14,000 instances of surgical vaginal mesh inserted into women. Let me pause for a moment to talk about that example of vaginal mesh and why its use has declined so precipitously. The answer lies in what I am talking about—in the development and marketing, and the fact that, as with so many of these devices, their true safety and efficacy is only revealed in the real world once they have been implanted into patients, and sometimes after many years. Many of the variants of vaginal mesh, like most of the other devices now on the market, are developed without any real clinical trials, and certainly without the randomised controlled clinical trials we are familiar with in respect of medicines; that is an extraordinary fact. We understand why that is the case, but there are other ways in which the device manufacturers could ensure their devices were safer and definitely not going to harm patients.
Licensing of Medical Devices — House of Commons, 2019-02-12
Topic: Health
Owen Smith (Labour, Centre-left): The hon. Gentleman, who has also done excellent work on mesh as co-chair of the group, is completely right Our regulatory system for these devices, including mesh, is more akin to the system that applies to toasters or plugs, and the way in which they get kitemarks, than to the way in which medicines are approved. It is so problematic that, last year, the journalist I was talking about applied to get a kitemark—known as a CE mark—for surgical mesh. However, the item in question was a bag that had previously been used to keep oranges in, but they still succeeded in getting a CE mark for it. It obviously was not put into a woman, but real mesh has been and is being put into thousands of women all over the world, including those suffering from organ prolapse and stress urinary incontinence. The real impact of the mesh has been revealed in the chronic pain, disability and even death suffered by many women as a result of the mesh warping, breaking, morphing, changing its constitution and cutting into organs inside the body. This was revealed only after years of sales.
Licensing of Medical Devices — House of Commons, 2019-02-12
Topic: Health
Paul John Sweeney (Labour, Centre-left): My hon. Friend is making a powerful speech about the devastating impact that mesh has had on women. I discovered the real impact of it when a constituent came to visit me on Friday. Wendy talked about the impact that it had had on her life. She said that she had been concerned about the mesh and had discussed it with her surgeon, who had insisted that it was not mesh but tape. She was therefore misled by a medical professional. Does my hon. Friend agree that that is another worrying aspect of how these medical devices are being marketed and communicated to patients?
Licensing of Medical Devices — House of Commons, 2019-02-12
Topic: Health
Owen Smith (Labour, Centre-left): Yes, I absolutely agree. There are many instances of similar mis-selling of these products to women. We need to examine the relationship between the doctors who are selling or marketing these products to their patients and the companies that develop them. Some have an interest in those companies, and others are getting a money benefit through doing this in the private sector. All these things desperately need to be looked at The terrible truth is that the surgical mesh scandal that is unfolding is just one of the scandals relating to medical devices. We had the metal-on-metal hip joint scandal, with metallosis poisoning people’s bodies. We had the scandal of textured PIP breast implants poisoning women’s bodies. Those implants are now connected with increased incidences of cancer. We had spine-straightening devices for children that were only ever tested on corpses. We had pacemakers such as the Nanostim, which was designed to sit inside the heart and work for up to 19 years. It has now been removed from the market because the batteries started to break down and cease to work and, worse, it was giving people electric shocks. The devices are now being cut out of people. Between 2015 and 2018, UK regulators alone received reports of 64,000 adverse events involving medical devices. A third of those incidents resulted in serious medical repercussions for patients, and 1,004 resulted in death.
Licensing of Medical Devices — House of Commons, 2019-02-12
Topic: Health
Ann Clwyd (Labour, Centre-left): I would like to pay tribute to the tremendous work that my hon. Friend has done on mesh. Quite a number of people in my constituency have suffered as a result of the use of mesh, and they are extremely grateful for the work that he has been doing. About 20 years ago, we had the scandal of silicone implants, and someone in my constituency had a double mastectomy because the silicone had leaked inside her body. These problems are still happening. We set up a register, but suddenly the register disappeared. I am glad that my hon. Friend has made a point about the register and asked for the Minister’s commitment on this.
Licensing of Medical Devices — House of Commons, 2019-02-12
Topic: Health
Owen Smith (Labour, Centre-left): I am grateful to my right hon. Friend for her kind words. She is completely right to say that there are devices on the market here and across the world that are still causing grave medical problems for patients. The question we have to ask is: how did these things get on to the market in the first place? How have we got so many of these devices that are causing such significant problems? The common problem that unites mesh with all the other device scandals in our country and across the globe is the weakness of the regulatory system in the UK, in the EU and, to a lesser extent, in America, where the pathway for testing approval, marketing and surveillance of such devices just is not good enough How does the system work? It will shock people to hear that we do not have a central body that is responsible for checking out, authorising and licensing devices in the same way as for medicines. If a company in the UK wants to create a new prosthetic hip joint, it does so and then it shops around among a group of what are called notified bodies. These are effectively commercial organisations that are in turn licensed by the MHRA to be a body that checks safety and efficacy through the clinical data provided by the companies and then gives them their conformité Européenne—their EU kitemark. Once a company has received that mark, the device can be sold all across the EU Companies do not need clinical trial data in order to substantiate their claims that devices are efficacious and safe. Quite often—this is true of a remarkable proportion of the devices on the market—they do not even have to undertake first-hand clinical evaluations themselves and can rely on being follow-on products that go through a regulatory pathway that is termed as being "substantially equivalent" to the products that have gone before. For instance, there are examples of mesh on the market now that are the 61st iteration of an original licensed mesh that is no longer on the market because it was proven to be dangerous. There is no real mandatory post-marketing surveillance of these devices. Given that the difficulty of randomised control trials versus placebo for a device—someone cannot put a wooden heart into one patient and a pacemaker into another in order to see which one works—means that there will be a degree of risk in testing such things in the real world, one would think that we would have a system that would test how devices are doing in the real world and get companies or the Government to monitor them, but we do not, which is in stark contrast to the regime for medicines. Changes are coming into effect, however. A new medical devices regulation was launched across the EU in 2017 and will come into effect in May 2020. It was introduced with the acknowledgement of many of the problems that I have highlighted.
Tourism — House of Commons, 2019-01-31
Topic: Culture
Lilian Rachel Greenwood (Labour, Centre-left): One of the things that drives tourism is the arts, including theatre. Will the Minister join me in congratulating Nottingham Playhouse and its new artistic director, Adam Penford, on winning regional theatre of the year in The Stage awards? Does he agree that the theatre not only demonstrates outstanding creativity, but engages with and serves our communities, works hard to make the arts accessible to everyone, and provides yet another good reason to visit Nottingham?
State Pension Age: Women — House of Commons, 2019-01-31
Topic: Health
Karen Elizabeth Lee (Labour, Centre-left): As my hon. Friend knows, I was a nurse, and I am of the WASPI age too. A lot of the people I worked with had worked long and hard all their lives, as care assistants and housekeepers as well as nurses. They did not earn enough money to save anything. Now the goalposts have moved and they cannot retire, but they are too old to do that really hard, physical work. It is terrible—shameful. Yet we hear a lot of warm words about looking after our NHS staff.