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

Part of the debate – in Westminster Hall at 3:36 pm on 19th May 2022.

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Photo of Feryal Clark Feryal Clark Shadow Minister (Health and Social Care) 3:36 pm, 19th May 2022

It is a pleasure to serve under your chairmanship, Sir George. I congratulate Jim Shannon on securing this important debate and on his continued advocacy on the issue. He is a voice for issues that often do not get enough time in this place.

I thank the hon. Gentleman for sharing the experience of his nephew, Peter, because experiences help to paint a picture of how these conditions impact on real people’s lives. Yesterday, I was delighted to meet two kidney patients, Dale and Tejal, through Kidney Research UK, who told me about their experience of suffering with kidney disease and of dialysis, and about the impact that is having on their life.

I praise the important contributions made by the hon. Members for Rutherglen and Hamilton West (Margaret Ferrier) and for East Lothian (Kenny MacAskill). It is a pleasure to have the Minister in her place. It is the first time we have had an exchange in a debate in Westminster Hall, so I welcome her today.

I pay a huge tribute to the fantastic advocacy undertaken by charities such as Kidney Care UK and Kidney Research UK. They are great champions for patients and will no doubt have been a support to colleagues in their preparation for the debate.

As we have heard, today’s debate is particularly timely, given that tomorrow marks the second anniversary of the law that changed organ donation to an opt-out system. That change has made, and will continue to make, a massive difference for patients with kidney disease and other conditions, and it is right that we recognise that.

In the UK, some 3.5 million people, and rising, are living with kidney disease, so we cannot afford to ignore the issue. We know the debilitating effect that living with kidney disease and undergoing dialysis can have on patients. As the hon. Member for Rutherglen and Hamilton West said, it is not just the disruption that it causes to their everyday lives that we must consider, but the physical and mental consequences of living with a long-term condition.

Unlike treatments for conditions such as cancer and heart disease, treatments for kidney disease, such as dialysis, have barely changed in the last few decades. For patients living day in, day out with the effects of dialysis, that lack of progress is simply not good enough. Research led by Kidney Research UK has shown that new developments in treatment, such as high doses of intravenous iron, can make a real difference to patients.

Sadly, such new developments are not being delivered uniformly across the UK, leading to the kind of postcode lottery that affects so many long-term conditions. It is no surprise that those who are already the most vulnerable are the worst-off when it comes to being able to access treatment at home. The hon. Member for Strangford highlighted that point, and we place further emphasis on it because of the stark health injustice facing people in this country. The rate of patients receiving at-home treatment was almost 23% in the most affluent areas of England, compared with 15% in the most deprived areas.

We know that people from lower socioeconomic groups are more likely to develop and die earlier from chronic kidney disease. We also know that when people from those groups experience kidney failure, they have poorer survival rates on dialysis and fewer are treated with peritoneal dialysis. That inequality extends to lower rates of kidney transplants and increased rates of transplants being affected by episodes of rejection.

Those inequalities are stark and cannot and should not be tolerated. We can and must do more to ensure that everyone, regardless of their background, can access the treatment that works best for them, including being able to dialyse at home. For too many people, at-home dialysis is just not an option.

People with chronic kidney disease, for which there is no cure, already experience financial difficulties because of barriers to employment and additional costs of disability. With utility bills soaring, people have to shut off their heating or skip meals just to be able to afford to continue their vital treatment, as colleagues have mentioned. Figures from Kidney Care UK show us that the additional cost for a dialysis patient doing five overnight sessions a week is £1,454. That was before the energy price cap increased in April. As hon. Members have already set out, that is a stark increase in bills. Energy prices are already soaring and are set to rise even further when the cap rises again in October. What assurances can the Minister give to dialysis patients who face those added pressures that they will be protected from the cost of living crisis, here and now? Some 30,000 people in the UK rely on dialysis to stay alive. They cannot afford to wait.

Just yesterday at Prime Minister’s questions, we heard the Prime Minister reassure patients that the NHS is responsible for covering the costs for at-home dialysis patients. Sadly, that simply does not chime with the experiences of dialysis patients up and down the country. Although the NHS service specification advises that NHS trusts reimburse the additional costs of home dialysis, reimbursement is inconsistent across the country. Many patients receive no or very little financial support to pay for the additional costs of carrying out treatment at home. Some do not even have the luxury of having the option of a reimbursement scheme discussed with them; they are simply left to fend for themselves.

There are some wonderful charities supporting patients living with kidney disease and on dialysis. The work they do to support patients is incredible and invaluable. Kidney Care UK handed out more than half a million pounds-worth of grants to patients and their families in 2021. In that time, they saw a rise in demand of 47% for their immediate hardship grants of £300. Patients are having to rely on charities to be able to fund their bills to pay for treatment, because the Government are not implementing their own policy properly. This is simply not acceptable and it must be changed.

Millions of our disabled, elderly and vulnerable neighbours are at the sharp end of this crisis. They simply cannot afford to live with dignity. Many are living through this nightmare, feeling like they have been totally abandoned by the Government. Labour’s plan for a windfall tax on oil and gas companies would take up to £600 off household energy bills and put it back in people’s pockets. I am sure the Minister will have heard yesterday, and many times before, that that will make a real difference to people on dialysis. It will make a difference now.

Many Ministers have been asked this, but I am asking the Minister today: will she back Labour’s plan for a windfall tax? Patients on dialysis deserve better security and the respect of the support they are entitled to. It is time for the Government to deliver. I look forward to hearing the Minister’s response.