Contribution
It is a pleasure to serve under your chairship, Dr Huq. I welcome the Minister and the shadow Minister, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst), to their places. Most of all, I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate. He outlined the issues comprehensively in his opening speech, as we would expect.
According to the Circulation Foundation, vascular disease is as common as cancer and heart disease, accounting for 40% of deaths in the UK. That represents a huge disease burden on individuals and the NHS, yet we rarely discuss it in Parliament. It is a leading cause of preventable disability, with associated complications being worsened by the fragmented care available to patients.
Living with vascular disease means living with chronic pain, reduced mobility and often an isolating loss of independence. Many patients are left with a sense of powerlessness, which has a huge impact on their mental health and wellbeing. Sadly, we are all too familiar with the issues in the vascular sector: inconsistent standards and access to care; the dreaded postcode lottery in services; pathways and referral routes that disproportionately impact deprived communities; and under-investment in prevention. It seems to be yet another area of the NHS where, as we have been arguing this week on the Health Bill, too much time and money is spent responding to failure rather than improving the quality of services for patients and preventing and delaying deterioration in the first place. We must do better for people with vascular disease and for their families.
Having dealt with the harrowing case of a constituent, I know that a lack of care and the medical risks and implications of vascular disease can spiral out of control, leading, in the worst cases, to the premature death of a family member. It is incredibly upsetting when that happens. I cannot begin to imagine how devastating that experience must be.
A report from the all-party parliamentary group on vascular and venous disease highlighted the avoidable harm that gaps in vascular care can cause to patients. It confirmed that gaps in vascular care are resulting in avoidable harm, highlighting:
“Delayed diagnosis, inconsistent referral pathways and variable access to specialist care”
for people with peripheral artery disease, venous disease and diabetes-related foot complications. It said that those problems are resulting in
“thousands of avoidable lower-limb amputations each year.”
Discussions with the primary care network in my North Shropshire constituency have revealed that our county has one of the highest rates of lower-limb amputations because of these gaps in care. I cannot imagine the trauma caused to those who have lost a limb, knowing that it might have been avoided. It is time we aspired to ensuring a consistent level of care across the country.
I have been contacted by companies in the pharmaceutical sector that have highlighted the disconnect between acknowledgment and action. PAD is named as a “neglected” CVD risk factor, but it lacks the priority status, funding mechanisms and performance standards given to other conditions. They have also highlighted that the need for new surgical and interventional techniques is acknowledged but not operationalised with delivery timelines or resource allocation, and that there are no metrics for PAD. The absence of PAD standards or metrics in the main performance monitoring tables means that progress cannot be tracked and local ICBs cannot be held to account if they are falling behind.
The modern service framework is obviously a welcome step forward, but the Government should also take a look at the all-party parliamentary group’s calls for a national foot attack pathway, a community foot protection service, national maximum waiting times for patients, the reform of commissioning to reward outcomes and the acceleration of proven innovation, which must be rolled out more widely.
Beyond that, the care that the NHS provides at its front door must be strengthened so that symptoms are caught and treated early. The APPG’s report highlights how prevention-led, community-first care is needed to transform the vascular sector, diagnose conditions earlier and relieve pressure on acute services. Liberal Democrats want everyone with vascular disease to have a named GP to ensure continuity of care, which has been shown to improve outcomes and quality of life for those with long-term conditions.
Fixing the back door of the NHS is just as crucial for us. We have long been pressing for better social care, including free personal care and more support for family carers. Obviously, we welcome the steps that the Prime Minister took over the summer recess to ensure movement on the social care issue.
Our proposed package would make it easier for people with long-term conditions and disabilities to access flexible working. It would support those suffering from vascular disease to access the world of work wherever possible, and hopefully transform their mental health and independence, too.
Given the prevalence and severity of these conditions, I urge the Government to develop a strategy to transform the vascular sector to give patients the timely support and treatment they need. I look forward to hearing what steps the Minister will be taking to address this issue.