Dialysis Care Outcomes — [Sir George Howarth in the Chair]

Part of the debate – in Westminster Hall at 3:00 pm on 19th May 2022.

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Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 3:00 pm, 19th May 2022

I thank the hon. Lady for those wise words, and I absolutely agree with her. She is right. We should never be guided entirely by finance, but we cannot ignore the financial implications. If we—by which I mean the NHS—could better use the moneys for early intervention, early diagnosis and early medical action, and reduce the cost, that would be beneficial to the NHS.

The clinical and cost benefits of home dialysis are well established, but despite 17 years having passed since the National Institute for Health and Care Excellence first highlighted its ambition for just 15% of patients to take advantage of home haemodialysis, as many as eight out of 10 dialysis patients are still treated in centre. That is a big challenge, but it is something I believe in, and I am confident that the Minister can embrace that challenge and give us some idea of how we can move forward in a positive fashion to deliver even better.

Some of those people will have successful transplants, although a transplant is only a form of treatment, not a cure. I have a particular interest in this matter because I have a nephew called Peter Shannon, born with a kidney the size of a peanut, or the wee nail on my finger. I remember when my boys were running about—obviously, young boys or young girls are always full of life, but he never had the energy. He was always a terrible colour—yellow, the colour of a bowl of custard—and he never really moved forward physically until he had a transplant at the age of 16. When he had that transport, his life transformed; if only that were possible for everybody, but it is not. I have been a great supporter of organ transplants all my life, and I am very pleased that the Government accepted the legislative change to make everybody a donor unless they opt out. I was always in favour of that legislation. In Northern Ireland, my party —the Democratic Unionist party—had perhaps not truly embraced it in the past, but it has now. I cannot say I am a pioneer in the party, but I am pleased that that legislation has also been endorsed by the Northern Ireland Assembly.

Many other dialysis patients will have no choice but to dialyse to replace their kidney function and to stay alive. The majority will do so three times a week at a hospital or clinic, every week for the rest of their lives, because once a patient starts dialysis, they are on it forever unless they receive a transplant. Across this United Kingdom there are nearly 30,000 people, from young to old, on dialysis. They come from all walks of life and are united by a remarkable strength and resilience to continue with this long-term, gruelling, life-saving medical treatment.

When dialysis is needed, in an ideal world the patient and their care team will consider and decide together whether to dialyse at home or in-centre. There are two forms of home dialysis therapy, with haemodialysis being the most common. Tubes are attached to needles in the arm or via a line to the neck, with blood passing through an external machine that filters the toxins and water from the blood before returning it to the body—it is almost like a cleansing process, but medically. Suitable patients can safely undertake that procedure themselves at home, carrying out sessions that meet their clinical needs to a routine that fits their lifestyle, including overnight while they sleep. In peritoneal dialysis, which is the other form of therapy, a catheter is placed into part of the abdomen via a surgical procedure.

Since its introduction in the 1960s, most dialysis care is delivered in-centre, with patients required to travel to a hospital three times a week for four hours of treatment. Many patients who dialyse in-centre benefit from the care of the UK’s excellent nephrologists, nurses and support staff, and from a sense of community with others receiving dialysis. However, that treatment is more intense over a shorter period of time, which might not suit everybody. It can be extremely draining, and it often leaves patients feeling physically exhausted as the body is pushed so hard during those treatments, and their toxin and fluid levels build up again immediately while they face a long wait until their next dialysis session. As a result, those patients must adhere to strict fluid and diet restrictions, and they must also travel to and from their dialysis centre, which is a time-consuming and often exhausting experience.

I visited the dialysis renal unit at Ulster Hospital in Dundonald some time ago. It is a new centre, and I met many of the people there. I knew two of those people personally. One was Billy McIlroy, who passed a few years ago. He went there for his dialysis treatment three days a week, which I know kept him alive. Another guy called David Johnson also attended that dialysis unit. He got a kidney transplant eventually, so his life changed greatly. I had already been given the details of what happens in dialysis, but actually seeing it showed the reality—it gave a physical understanding—of what those people were going through three times a week. For them, travelling from home and going home again was six hours of their day.