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Resolved,
That this House takes pride in London's heritage and status as a leading global capital city; notes that its outstanding success over many centuries has depended upon its rich mix of people, innovation and energy; further notes that it is an international leader in financial services, the arts, media, higher education, medicine and scientific research and tourism; welcomes the Government's commitment to London's continuing economic, social and cultural success, and to enhancing its status as a world class city; applauds London's high levels of productivity and success in attracting inward investment that benefits the whole of the UK; recognises that this success is backed by record levels of funding from this Government for education, health, the arts, culture, creative industries, crime prevention, transport and other key public services that have resulted in substantially higher employment, substantially lower unemployment, record police numbers including more community support officers and police on the beat, massive increases in bus services and people using them, with an extra 100 million bus trips and an extra 180 million Tube journeys taken a year; applauds the leadership of the Mayor of London, working in partnership with the Government in the key areas of transport, planning, economic developmnent and policing; praises the work of the police and security services in remaining vigilant to keep the capital safe; and condemns outright Opposition attempts to talk down and undermine the continued success of our great capital city.
DEFERRED DIVISIONS
Motion made and Question put forthwith, pursuant to Orders [28 June 2001 and 6 November 2003],
That at this day's sitting, the Orders of the House of 28th June 2001 and 6th November 2003 relating to deferred Divisions shall not apply to the Motion in the name of Mr Ben Bradshaw relating to Protection of Animals during Transport.—[Mr. Jim Murphy.]
Question agreed to.
PROTECTION OF ANIMALS DURING TRANSPORT
Motion made and Question put forthwith. pursuant to Standing Order No. 119 (European Standing Committees),
That this House takes note of European Documents No. 7969/01 and ADD1, Report from the Commission and draft Regulation on the ventilation in road vehicles, carrying livestock on long journeys and No. 11794/03, Commission Communications and
- draft Regulation on the protection of animals during transport and related operations and amending Directives 64/432/EEC and 93/119/EEC; and supports the Government's objectives of seeking a significant improvement in animal welfare during transport and better enforcement of those rules throughout the European Union.—[Mr. Jim Murphy.]
Question agreed to.
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Laryngectomy
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Jim Murphy.]
7.27 pm
Mr. Tom Clarke (Coatbridge and Chryston): The catalyst for this debate can be traced back to a letter that I received from the Lanarkshire Speakeasy group. Contained in the letter was a poignant plea for support for people who had developed cancer of the larynx and ultimately had to have a laryngectomy. The letter was signed by Ann Muir, of whom I will say more later.
My principal aim tonight is to highlight the plight of laryngectomees, and in particular how they are treated in relation to applying for disability living allowance. There is a genuine belief in the group that they are not being treated fairly. I look forward to the response of my hon. Friend the Minister, and I welcome her presence.
In terms of local government boundaries, the group encompasses North and South Lanarkshire councils, which have a population of 628,000 people. It is a voluntary group whose purpose is to offer hope and encouragement to laryngectomees—people who have had their voice box removed due to cancer of the larynx—and to families and carers. Its prime objective is to ensure that all members, of whom there are approximately 100, are included in all aspects of community and social activities. One of its most significant achievements is to encourage people back into society after radical surgery, as laryngectomees often withdraw from contact outside their own family circles. The secretary of the group, Ann Muir, is an outstanding person, possessed of an amazing fighting spirit. I believe that there is no praise too high for this remarkable woman.
Let me explain to the House what laryngectomy is all about. Ann Muir has told me of her own experience. Often people are unaware that they may have a problem until certain symptoms become evident. They include hoarseness or change in the normal voice lasting for more than three weeks, breathlessness or difficulty in breathing, difficulty in swallowing, a cough or chest infection and a swelling in the neck. After a family doctor has been consulted, a series of tests will be carried out to check a patient's general health and confirm or rule out a cancer diagnosis.
The lowest point for any patient is the simple shock of being told "You have cancer." It is at that point that every cancer patient knows what may be facing him or her. Ann underwent radium treatment for six weeks on 33 separate occasions in order to avoid a laryngectomy. A special mask was made for her, and she was bolted on to a table for treatment. Despite Ann's bravery, she admitted that that was a most frightening experience. The larynx, or voice box, has three main functions: to allow the air that we breathe to reach our lungs, to protect the lungs by closing when we swallow food or drink, and to project our voices when the vocal cords vibrate.
As the radiation treatment was insufficient, Ann was told that she must have a laryngectomy. Cancer of the larynx is quite rare, affecting fewer than 3,000 people each year in the United Kingdom. More men than women develop it, usually after the age of 50—although
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only the other day I was talking to a woman whose partner, aged just 43, has just had a laryngectomy.
A total laryngectomy is an operation to remove the larynx completely. Just think what that must be like. Following the operation, breathing and communicating will be done very differently. Patients are so medicated for the first four to five days that they are completely confused. Ann said that at that stage she saw herself in a mirror. Visitors would say that she was looking well; Ann's response was that if she was looking well, heaven knows what she would look like when she was ill.
One week after the operation, a patient's face and neck are massively swollen. There are holes in the neck and tubes coming out everywhere, with pain control the only salvation. Ann's granddaughter visited her and said "Gran, I don't like those. They look like teeth in your neck." The youngster was not to know that the metal stitches and the clamps were to hold Ann's head together.
For surgical voice restoration, a catheter was inserted through a small hole in the back of Ann's trachea. The catheter keeps the hole open so that the voice valve can be put in place later. Once all that has been overcome, the next phase—that of learning to talk—begins. Removal of the larynx means that talking can no longer happen naturally, and the way in which a person breathes has been altered permanently. When that process is complete, the real task of rebuilding the person's life truly begins.
Mr. Huw Edwards (Monmouth) (Lab): I am sure that my right hon. Friend will want to join me in paying tribute to those medical specialists who perform this procedure, including those at the Singleton hospital in Swansea who treated my father four years ago, when he was 83. He is alive and well, and speaking well, following that operation.
Mr. Clarke: I am extremely grateful to my hon. Friend for that timely intervention. His high regard for the medical profession is widely shared by those with experience of this condition.
The pain, suffering and inconvenience of all that I have just described inevitably lead to a permanent life change. Families have to make adjustments to help a person cope. There is the psychological impact of coming through such a traumatic experience, all the time thinking that one could have died.
In my discussions with Ann, I also met another laryngectomee, Bill Wright, who is the chair of the Lanarkshire Speakeasy group. What struck me was the love and devotion of his wife Ellen, who explained that since his laryngectomy she has never had a proper night's sleep. Without complaint, she constantly lies awake listening to her husband breathing, with great difficulty, during the small hours of the morning.
In preparation for this debate, I consulted various bodies, not least the Department for Work and Pensions office in my constituency. I had a meeting with Mr. David Collie, who is my main point of contact on all DWP matters. Two other representatives from the disability benefit centre were at the meeting. The purpose of the consultation was to establish what the DWP provides in terms of service to constituents. At the conclusion of my speech, I will return to the pre-eminent
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role that the DWP should perform on this issue. For now, I record my thanks for the Department's co-operation both nationally and locally so far.
Assessing a disability living allowance form in the first place is not as easy as one might think. For example, my local DWP office does not have a DLA application form available. Filling in such a form or forms would be an ordeal for most people, never mind a person who has just undergone major surgery. Someone said to me, "You would need to be a Philadelphia lawyer to cope."
The fact is that there are two sets of explanatory notes accompanying two forms. DLA 1A section 1 has 68 questions, with 141 options. DLA 1A section 2 has 159 questions, with 188 options. Is all this really necessary? When DLA was first introduced, a DLA form was available in the Benefits Agency offices. A member of staff used to spend an hour or longer helping people to fill in the form. That staffing resource is simply not available in today's restructured offices. Before somebody points out that all a person needs to do is telephone for assistance, I remind the House that we are talking about laryngectomees—people who do not find it easy to talk, and certainly not for as long as it would take to complete the DLA forms.
Why does it have to be a paper application? Are there no alternatives that take into consideration the person's needs and disabilities? Moreover, when one finally gets round to completing the forms, we are entitled to ask how they are dealt with. In the office that processes the applications, there are trained decision makers, with supervisors to keep them right and even doctors available if they need to consult on any medical matters. The Department of Work and Pensions has all the resources to hand, and all its needs are covered in full. But what about the client? Inevitably, tonight I want to focus precisely on those clients.
Is it any wonder that when Ann Muir was starting up her voluntary group and visited every person in Lanarkshire who had experienced a laryngectomy, she was appalled at the standard of neglect that she discovered? I have no wish to exaggerate the position; there was not neglect in every home. However, there was sufficient evidence of such neglect in more instances than I believe should have been the case. It cannot be right that when a person has suffered all that is involved, they then arrive at such an unacceptable stage.
A new study on the problems faced by people affected by cancer when assessing benefits in Northern Ireland has revealed that many lose out on the financial support to which they are entitled. The report "Benefits Access for People Affected by Cancer in Northern Ireland" is the result of a project undertaken jointly by Macmillan Cancer Relief and the Northern Ireland Social Security Agency. Interviews with patients, carers, health and social care professionals, agency staff and other advice centre workers helped to identify the main barriers that people affected by cancer face when attempting to access benefits.
Heather Monteverde of Macmillan said that the outcome of the report confirmed what Macmillan had been hearing from patients for years. She said:
"Our experience has told us that financial concerns are second only to physical pain as a cause of stress for people with cancer and their carers. We're delighted that the Social Security Agency has worked with us on this project to get a clear picture of the problem. We now look forward to the implementation of the recommendations."
"By working together, we can ensure that people affected by cancer get the benefits advice and support they so clearly need."
In my view, Heather is absolutely right.
What do I want to see on the ground for people who have had a laryngectomy and others with cancer? I want to see the DWP take a leading role in bringing together health, local government and other agencies to analyse the scale of the problem. I want to see joined-up government in action for the people who need it. I want cancer patients to be made aware of what benefits they are entitled to claim. I want experts such as welfare rights officers to help to complete those labyrinthine application forms.
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