1. What plans his Department has to update legislation on the taxi and private hire vehicle industries.
12. What assessment he has made of the effectiveness of legislation on the taxi and private hire vehicle industries.
Another opportunity to inform, another chance to perform—what is better than that, Mr Speaker? As my hon. Friend the Member for Hornchurch and Upminster (Julia Lopez) may know, the Law Commission provided a report on reforming taxi and private hire vehicle legislation, since which the sector has undergone profound and rapid change. With characteristic assiduity and determination, I will lead the response to such change, so protecting passenger wellbeing.
What discussions has the Minister had with the Mayor of London to find a workable way forward on taxi legislation in the capital that balances healthy competition with the properly enforced regulations that safeguard passengers and keep our city moving?
As I glanced at the Order Paper, as you must also have done, Mr Speaker, I noticed my hon. Friend’s change of name due to the happy event of her marriage, on which the whole House will want to congratulate her. [Hon. Members: “Hear, hear.”] She has become our own J.Lo My discussions with the Mayor are regular. The Government are determined to find a way forward on taxi regulation. This is not just about the capital; we need to consider the whole issue of taxi licensing. As I have said, our absolute determination is for public safety and wellbeing, but we have to balance that with consumer choice.
Sex offenders and others banned from driving taxis by local authorities are providing the same service simply by applying for a licence to drive a minibus. Will the Minister continue the work done by me and his predecessor on closing that loophole?
I met Leeds City Council just yesterday to discuss such issues. Licensing poses real challenges, which is why I set up a working party to consider the whole matter following a Westminster Hall debate on this subject. That working party will consider the very issues that the hon. Gentleman and many others have raised and then report back to me, and it would be reasonable for us to publish its findings early in the new year.
I declare an interest as a member of Kettering Borough Council. The taxi drivers and private hire drivers of Kettering do a fantastic job ferrying local people around, but all these things need regulation and the council does its best. Which council does the Minister think is the best at regulating the taxi trade in small towns? How might that best practice be rolled out across the country?
I would not want to pick from among all my favourite towns. However, there are concerns about the inconsistent application of regulation and guidance, which is one of the things that the working party is considering. The key thing is that there has been a lot of change, partly as a result of modern communications and how people access information and book taxis and private hire vehicles. As Disraeli said: “Change is inevitable. Change is constant.” But a benevolent and diligent Government must constrain change while maintaining choice.
When the Communities and Local Government Committee considered child sexual exploitation in Rotherham, one issue was the involvement of some taxi drivers. The Government’s commissioners brought in higher standards, including the provision of CCTV cameras in all taxis. However, those rules can be undermined by taxis coming in from places outside Rotherham where the same standards do not apply. Indeed, taxis that fail the test in Rotherham can go elsewhere, get a licence and drive back into Rotherham. That is the real problem. The problem is national, but does the Minister recognise that it is particularly acute in Rotherham? When will he act?
As I said, this is not just about London; it is about places across the country. There is a case for new statutory guidance, and while I do not want to second guess the working party and its recommendations, I think we will issue some new statutory guidance early next year.
Following the high-profile cases of child sexual abuse in Rotherham and Oxford, taxi licensing was strengthened in those council areas. However, despite repeated calls for legislation reform, including from the Law Commission, the Government have refused to close the loopholes that allowed drivers to be licensed elsewhere and effectively game the system. Will the Minister commit to introducing national standards to ensure safety across the industry?
I welcome the hon. Lady’s question. She is right that the system is being gamed. Where a local authority tightens the system—Leeds City Council described this to me yesterday—neighbouring authorities sometimes adopt a more permissive regime. That cannot be right, which is why I want to introduce new guidance and greater consistency in how licences are issued. At the end of the day, this has to be about public safety, security and wellbeing. The whole House would want that, and we really do have to take action.
2. What steps his Department is taking to prepare the civil aviation sector for the UK leaving the EU.
5. What assessment he has made of the potential effect on the aviation sector of the UK leaving the EU.
We want our future relationship with the European Union to be mutually beneficial. It is in the interests of both sides to maintain closely integrated aviation markets. However, it is the Government’s responsibility to prepare for all potential outcomes. The Government continue to work closely with the aviation sector to ensure the industry continues to be a major success story for the British economy.
What European destination would want to turn away planeloads of spending British tourists?
My right hon. Friend makes a good point. Those with any concerns about 2019 just have to answer the question: how many hotels in Spain would be empty if the Spanish Government choose not to continue our aviation arrangements? That is why we will continue to make good progress towards satisfactory arrangements for the future.
In light of that answer, can the Secretary of State give an assurance that the Government will pursue an unchanged operating environment for the aviation sector in the Brexit negotiations with the EU?
I can give the hon. Lady that assurance. We believe it would benefit all the nations of Europe to continue the freedom of the aviation sector that we have seen over the past decade and more. That freedom particularly benefits regional economies and regional airports across the European Union, in this country and elsewhere. It would be foolish for anyone to try to stop that freedom.
The nine freedoms of the air guaranteed under the European common aviation area have enabled the growth of low-cost air travel, with average leisure fares to Europe falling by a third since 1993. We have already seen easyJet hedge against a no-deal scenario, but what assessment has the Secretary of State made of the implications of the UK falling back on the Chicago convention? What would that mean for the future of UK airlines, UK airports and affordable flights for UK consumers?
The hon. Lady needs to remember that aviation regulation operates at a global level, at a pan-European level—in which there is an “open skies” agreement—and at a national bilateral level. I have worked carefully with the airlines and all those involved, and I am certain that not only will aviation continue post-2019 but that everyone wants aviation to continue post-2019. The individual case of easyJet relates to the question of cabotage within the European Union, which is clearly a matter for debate. It will be a negotiation for the whole sector because, although we have successful airlines such as easyJet operating flights within the rest of the European Union, we also have a large number of continental hauliers doing business within the United Kingdom. It is to everyone’s benefit that such liberalisation continues.
European competition law will no longer apply after Brexit, so how does the Secretary of State propose to allocate airport slots? By auction, or in some other way?
Of course, the big question is about the expansion of slots at Heathrow airport in particular, which will be a matter for the Government both to negotiate and agree. Right at the top of our priority list in allocating slots—and we have committed to this in what we have said about the proposed expansion of Heathrow airport—is that we reserve slots for regional connectivity. One of the key benefits of Heathrow airport expansion is the global connections it will provide to cities across the whole United Kingdom. Whatever approach we take, we need protection for those regional links.
The Secretary of State may be in denial, but the Chancellor has finally fessed up to the fact that, if there is no Brexit deal, it is conceivable that flights between the UK and the EU might be grounded. Is it not time for the Government to get their finger out and give the reassurances that the aviation sector so badly needs?
I am surprised that the hon. Gentleman, an experienced lawyer, did not read everything the Chancellor said. The Chancellor said that that was not going to happen and that, therefore, he will not spend a lot of money preparing for it. The actual reality is that we are doing a lot of preparatory work for all eventualities but, of course, the reason the Chancellor said what he said is that, as he says, that is not going to happen.
3. What discussions he has had with the Mayor of London on upgrading the London Underground.
As I said a few moments ago, Ministers and officials from my Department regularly meet the Mayor and his representatives to discuss transport in London. These meetings cover a wide range of issues, including upgrades to the London underground.
The London underground upgrade was stalled for years under Labour but has made big progress under the Conservatives. So does the Minister share my regret that under the new Labour Mayor at city hall we are seeing vital upgrades shelved indefinitely?
My right hon. Friend is right to be disappointed; the Mayor has decided to pause the purchase of new trains for these lines, as she describes. As she knows, transport in London is a matter for the Mayor and it is for him to agree the investment programme for transport, but it is a disappointment and he must do much better.
Whether we are talking about the 1974 Piccadilly line trains, which are almost as old as me, or the even less reliable 1992 Central line ones, autumnal leaf fall at the moment is causing havoc for the above-ground sections of the tube in suburban locations. Does the Minister know when these old workhorses that are now past their sell-by date are going to be sent to the knacker’s yard?
I can sense, as you probably can, Mr Speaker, a clamour coming from across the House. The rallying cry I have issued is that the Mayor must do more and better, and it seems that the hon. Lady joins my calls.
4. If he will provide funding for a Shipley eastern bypass.
As my hon. Friend will be aware, the Government have allocated significant resources to West Yorkshire for local transport schemes through the local growth fund, including £781 million over 30 years from local growth funding and “gain share”. In addition, I am pleased to be able to inform him this morning that £2.3 million is being allocated to Bradford Council for improved traffic management systems as part of the £244 million NPIF—national productivity investment fund—funding being announced today. Later this year, we will start consultation on the major route network, which may provide the routes to securing the Shipley eastern bypass that he is concerned about.
I am very grateful to the Secretary of State for that answer and I very much welcome the new bypass fund that he is setting up, appreciating the difficulties that many motorists have in getting around. Does the new fund mean the long wait that local businesses, local residents and I have suffered waiting for a Shipley bypass may soon be at an end?
As I indicated, it is very much my hope that a number of schemes around the country will start to be brought forward for development under this fund. I would be rather surprised if the Shipley eastern bypass is not one of those brought forward as a proposal to the Government early on. As he knows, I will be joining him to see the issues around the Shipley eastern bypass and to see the possible routes shortly, and I have no doubt that he and his colleagues in his constituency will be making strong representations when I visit.
No one begrudges the money for a Shipley bypass—certainly no one in Huddersfield does. What we are angry about in Yorkshire is the fact that this Minister has taken away the money and the promise for a trans-Pennine railway electrification. That is what we will not forgive him for. He must get his act together and invest in the north.
The hon. Gentleman has gone way off the road, he really has.
I did mention Shipley.
He mentioned Shipley but it is not sufficient simply to animadvert on Shipley. The question ought to relate to the matter.[Interruption.] Which is a bypass, as somebody has observed, very originally and wittily from a sedentary position.
It is worth putting on the record that I have not announced any changes to that programme. There is money for the trans-Pennine modernisation. I am expecting the detailed proposals from Network Rail later this year. However, it is worth saying that we are spending more money on more projects across the north of England than any Government have for decades and decades, including during the 13 years when Labour was in government. It is also worth saying that we have electrified four times as many miles of railway in the north of England alone than Labour did in 13 years in government. So I am not going to take any lessons from Labour Members about commitments to the modernisation of the transport system—in the north or elsewhere.
rose—
Ah, another pertinent inquiry on the Shipley eastern bypass I feel sure.
Many of my constituents would like to visit Shipley on many occasions, but in order to do so that they would have to travel along concrete sections of the A180, which causes great disturbance to residents in Stallingborough and other villages in my constituency. Will the Secretary of State urge Highways England to look favourably on funding improvements to that section of the A180?
I know that Highways England listens carefully to the comments made at Transport questions. My hon. Friend highlights something that is an issue in his area and throughout the country. I am clear that we need to do everything we can to ensure that the technology for future road surfaces delivers both durability and quietness.
rose—
Ah, yes! I chaired the South Lakes Pupil Parliament in the hon. Gentleman’s constituency on Friday. The children there spoke of him with great warmth and affection.
That is very kind of you, Mr Speaker; I hope you will indulge me. Just like Shipley, Kendal is a beautiful northern town with severe congestion problems. It is beautiful and thriving despite the fact that it has a prehistoric road network. Is the Secretary of State aware that there is a long-stalled plan for a northern access route that would solve congestion in the town and open up the industrial estates to the north-east of the town? Will he meet me and business leaders to see whether we can move things forward and make that plan happen?
I am always happy to meet the hon. Gentleman. I am not aware of the specific scheme he asked about, but it is precisely for the reasons he outlined that I have set aside money to create the bypass fund for the years ahead. I recognise that in a number of important regional towns too many areas are congested as a result of through traffic. That is particularly true in the Lake district and the major route through Kendal to get to places such as Windermere. I will happily talk to the hon. Gentleman about that.
Wellingborough is very similar to Shipley—one might even argue that the two MPs are rather alike in their views—but one problem that my constituents find in getting to Shipley is that they cannot get through Isham because a bypass has not been built. Is the Secretary of State able to offer some encouragement about the Isham bypass, which would enable my constituents to get to Shipley more easily?
May I first wish my hon. Friend a happy birthday? I am slightly surprised to see him wearing a more muted tie today. Although I cannot give assurances on every individual scheme, it is very much my intention that the bypass fund is there to fill in holes in what was once the strategic network. The network was de-trucked many years ago, leaving congestion problems in many regional towns and on many important regional routes, without an obvious and clear route to secure funding to ease that congestion. In the coming months I will consult colleagues from across the House as to how best we manage the process of getting that fund and those projects going.
As a Yorkshire MP, it is always good to see promises of investment in places such as Shipley. Nevertheless, this summer the Secretary of State said to The Yorkshire Post: “The success of Northern transport depends on the North” Will he explain how, with London getting 10 times as much money for transport investment as Yorkshire and the Humber gets, that is going to happen?
I am afraid some of the figures bandied around by think-tanks in the north are simply inaccurate. We are putting more investment into transport in the north of England than there has been for decades and decades—into the road system and the rail system. We are replacing every single train in the north with either a brand new train or one that has been refurbished as new. It is a long-overdue programme. It did not happen in 13 years under a Labour Government, when there was money aplenty. Even in tighter financial times, we see it as a priority to develop transport in the north, and that is what we are doing.
6. What recent discussions he has had with the Secretary of State for International Trade and the Secretary of State for Exiting the European Union on the timetable for introducing new aviation agreements after the UK leaves the EU.
I meet my right hon. Friends the Secretaries of State for Exiting the European Union and for International Trade regularly—indeed, I did so yesterday—to discuss the UK’s exit from the EU. Seeking new aviation arrangements—both with the EU and with those states where we currently rely on EU-negotiated arrangements for market access—is a high priority for my Department. We aim to have the new arrangements in place well before the day of exit.
The Secretary of State obviously agrees with the absolute need for aviation agreements, through either bilateral means or an EU-wide arrangement. Will he tell us how many DFT staff have expertise in negotiating aviation deals and how many are working on deals as we speak?
I have a big team that is experienced in dealing with such things, because, across the world, we have bilateral arrangements with countries in all continents. I have experienced teams that are working on that right now. We are pursuing the necessary successor arrangements that we will need for flights to countries around the world, and there is nothing but good will and constructive discussion between us and those countries in ensuring that there is no interruption in flying.
Not only is the aviation timetable agreement important, but so is the securing of routes. Will the Minister tell us what has been done to secure routes for Belfast City and Belfast International airports to make sure that Dublin does not receive, to our detriment, the routes that we should be getting instead?
Of course, the choice of routes is ultimately down to the airlines themselves, but the hon. Gentleman will know that we provide significant support for important links from Northern Ireland, and we will continue to do so. The biggest difference for Northern Ireland will come with the expansion of Heathrow airport towards which we are working at the moment, and a guarantee of slots to provide excellent connectivity for Northern Ireland, Scotland, England and Wales into countries around the world.
The Scottish Government have not been able to cut air passenger duty because the UK Government have not properly implemented an exemption for Inverness airport. Given the importance of low-cost carriers to Scotland’s regional airports, it is important that the Scottish Government are also involved in any discussions. However, to allow sufficient time for EU ratification, the aviation agreements need to be concluded by October 2018. How many staff does the Secretary of State have working on these matters, and what guarantees can he provide that travel will continue uninterrupted?
The hon. Gentleman makes his comment about air passenger duty in Scotland, but we did what the Scottish Government asked: we devolved air passenger duty and they have not cut it. I am afraid that they are discovering the realities of government. It is all very well making demands from the Opposition Benches, but when they actually have to take tough decisions, they discover that it is not all that easy. We are seeing that they are failing to deliver for the people of Scotland. When it comes to planning for aviation after Brexit, things are different, because we are planning for that and we will deliver. We will see, post 2019, that aviation continues to be the success story that it is today.
7. What steps he is taking to reduce harmful emissions from road transport.
15. What steps he is taking to reduce harmful emissions from road transport.
The Government’s plan for tackling nitrogen dioxide concentrations, which was published in July, sets out a number of steps backed with £3 billion of investment in air quality and cleaner transport. These include the tough new real-world emissions tests for new models of diesel and petrol cars.
What progress is being made on setting up low-emission zones in various parts of the country? How are the Government ensuring that there is a workable national framework for those zones?
As the hon. Gentleman knows, we have published the clean air plan and we are working very closely with local authorities regarding clean air zones. There is also a wider duty on local authorities that are not specifically part of the zones themselves to bear air quality in mind, and we also support them through the Department.
Encouraging the use of public transport is key to tackling air pollution. Does the Minister accept that the increase in rail fares at twice the rate of wages since 2010, and the decreased use of buses while the Conservatives have been in office, have made air quality worse?
The hon. Gentleman is correct about the importance of buses. Only yesterday, I met the chief executive of Go-Ahead buses, which is very active around the country, and we specifically discussed that matter. I have held such discussions with other operators and will continue to do so in the coming months. We also considered retrofitting and improving passenger numbers.
Does the Minister agree that one of the ways to reduce emissions is to encourage rail travel, but that one of the barriers to that is poor service. Travellers from West Yorkshire using Virgin are experiencing increasingly poor service due to staff shortages, and there is a suspicion that Virgin is cutting back so that it can increase profits. What are the Government doing to hold train operating companies to account?
I can only admire the hon. Lady’s ingenuity in crowbarring a point about Virgin rail into a question about road transport emissions. Obviously the rail Minister, my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard), is better placed to answer that, but let me draw her attention to the work that we are doing through the cycling and walking investment strategy on improving the links between rail and cycling.9
E10 fuel can reduce emissions from road transport. Can the Minister confirm the Government’s commitment to introducing E10 in the UK in 2018?
As the hon. Gentleman knows, we have been looking closely at this issue and will make an announcement in due course.
8. What steps his Department is taking to accelerate the availability of smart ticketing on the rail network.
We are investing some £80 million through our smart ticketing on national rail programme, so that all passengers have a paperless option for their journey by the end of 2018. We are also working to facilitate a rail industry pilot of smartcards on mobile phones, as well as rolling out pay-as-you-go ticketing across the hon. Gentleman’s franchise.
I welcome Southern railway’s plans to introduce smart ticketing across its network. I have also put in a request for the Oyster system to extend south of Gatwick airport to Three Bridges and Crawley stations. However, will my hon. Friend please speak urgently with GTR, the parent company of Southern, as their new ticket machines at many stations, including Three Bridges, have been malfunctioning, causing passengers significant disruption and queues? That situation needs to be resolved.
I am grateful for that comment. Ticket vending machines, which are meant to be among the most straightforward of equipment on our railways, seem to cause more problems than any other type of equipment. I understand that Govia Thameslink Railway is due to visit every ticket machine over the coming fortnight to make sure that the software is updated and that the machine functions properly, although I share my hon. Friend’s concern and will be meeting the supply chain in due course to emphasise the importance of getting this right.
I welcome progress on smart ticketing, and also plans for new ticket machines on the station platforms in my constituency, but the Northern Rail service through my constituency has been absolutely abysmal in recent weeks. May I echo the question that my hon. Friend the Member for Dewsbury (Paula Sherriff) asked? What is being done to hold train operating companies to account when trains are overcrowded and short of carriages, and when there are cancellations and delays and people cannot even get to work on time?
I share the concern. We have continuous contact with the train operating companies at an official and a ministerial level—I frequently meet them. Where there are sustained examples of poor performance, they are escalated to what is called the national taskforce, where the train operating company must present to the wider industry what measures it is taking to reverse poor performance, and I will then meet that train operating company. I recognise the concerns around Northern. My primary concern at this stage is to ensure that new infrastructure is opened around the Greater Manchester area so that Northern can operate new rolling stock to replace the appalling Pacers, and introduce the new services that the Ordsall Chord, in particular, will enable.
Can the Minister require train operators to allow passengers who start their journey at a station that has no ticket facilities to use a print-at-home ticket, so that passengers at Langley Mill station in my constituency can actually use the cheaper advance tickets that they currently cannot?
I think that is a perfectly fair observation. We are seeking to ensure that when technology enables new forms of ticketing to be introduced, we move on that as far as possible. That includes paperless ticketing. It also includes work on barcode ticketing, which can be displayed on mobile phones. We have to do much better at ensuring that people may choose the ticket mode that works best for them.
I welcome what the Minister says about smart ticketing, but in advance of that, might he have a word with the rail authorities about how many tickets they send out? When someone pre-books, they get between eight and 10 tickets. Surely it is not beyond the wit and wisdom of the rail companies to put that information on one ticket. I hate to think how many forests we cut down for one rail journey.
I think that the rail authorities have already heard what the hon. Gentleman has said. I have noticed that I now get my seat reservation and my ticket on the same piece of paper, instead of on five. As we move towards more forms of paperless ticketing, we should have no pieces of paper at all unless we want them.
We were told £45 million, but the cost was £96 million. We were told 11 train operators co-ordinated, but it was just five working separately. We were told all passengers, but it was just season ticket holders, and full season ticket holders at that. Only 8% of those now eligible are using the system, with its scope cut, and it being overspent and massively overtime—and then the Government handed the problem back to the train operators. From this example in the south-east, can we really have confidence that the Government can deliver smart ticketing?
There is quite a straightforward reason why we can have confidence about the future, and it is largely because the south-east flexible ticketing programme did not just deliver smart ticketing across the south-east, which many passengers are now using, but put in place the architecture and computer systems that will enable smart ticketing on national rail to be a success.
Well, it was a pretty damning report from the National Audit Office. Yet again we have a Government unable to deliver on the railways and on something as simple as smart ticketing. Labour will be at the cutting edge of rail tech, while this Government still expect people to book separate tickets from separate operators—one national chaos under the Tories, one national public service with Labour. How much longer will the Government champion fragmented ticketing on a fragmented railway?
I always get rather frustrated when people have had an answer but paid no attention to what I said—but there we go. The report from the National Audit Office was important. It contained a number of lessons, which we took on board when setting out the national smart ticketing programme. Technology is changing rapidly. We have to make sure that the schemes we put in place now meet what technology can do in a year’s time, or two or three years’ time. We will be moving fast with tickets, and tickets will be unbelievably advanced by the time the Labour party ever gets back into power.
9. What steps his Department is taking to reduce congestion on the strategic road network.
Tackling congestion, as you will know, Mr Speaker, is at the forefront of the Government’s plans to provide a modern strategic road network that supports our growing economy. The Government are investing in the largest programme of improvements on our national roads that we have seen for many decades, as the Secretary of State said—£15 billion between 2015 and 2021 alone. In addition to providing extra capacity on the busiest motorways by making them smart motorways, the Government will improve specific parts of the network where investment can tackle congestion, improve journeys and support economic growth.
I thank the Minister for that answer, and I welcome the Government’s investment in a feasibility study into finally building junction 18A on the M4. However, one of the options under consideration is to build that new junction at Pucklechurch, which would devastate the local green belt and divide two extremely historic communities. With the decision expected early next year, residents are being left under a cloud of uncertainty, so will the Minister speak to Highways England to ensure that this undeliverable and unsupportable proposal is ruled out as early as possible?
I thank my hon. Friend for highlighting Highways England’s work to develop proposals that would improve access to the M4. The scheme will be vital to unlocking the potential for housing developments in that area. As he will know, the Secretary of State has seen the site for himself, and he and I are taking the issue very seriously. I will be discussing it, among other things, with Highways England when I see its chief executive next week.
Is not the real answer to cutting road congestion, and for that matter roadside emissions, to invest in expanding rail freight capacity? For example, Peel at the port of Liverpool is investing £750 million, including in rail freight. Why are the Government not stepping up and playing their part?
I thoroughly dispute the idea that the Government are not playing their part, not least because we are heavily investing in HS2, which will run very close to that port and support it.
Is my hon. Friend aware that many Harlow motorists face significant problems from ever-increasing congestion and the ever-increasing number of terrible accidents on the M11? Will he investigate that to see what can be done?
We are absolutely aware of these issues and officials focus on them, as they do on issues on other strategic parts of the road network, but I would be delighted to meet my right hon. Friend to look at the issue further.
As has been said, reducing congestion on our roads requires serious investment in our rail infrastructure, so when will the Government give the north our fair share of rail investment and, in particular, agree to a Crossrail of the north that is fully integrated with HS2 at Piccadilly station?
As the hon. Lady will know, the Secretary of State made clear—[Interruption]—and reminds the House again that the north is seeing the biggest single investment in rail for many decades.
10. What plans he has to issue safeguarding directions for the unsafeguarded sections of the Crossrail 2 route.
A thorough analysis of the Crossrail 2 business case is being carried out by the Department to ensure it is a robust scheme, as is undertaken for all transport scheme proposals. Once this analysis has been completed, the Secretary of State will be in a position to outline the next steps on Crossrail 2, which will include any discussions and decisions on future plans for updating the current safeguarding directions.
I listened carefully to the Minister’s answer. However, the delay to Crossrail 2 is causing real anxiety to constituents in Wimbledon and across south London and causing investment decisions to be delayed. Will he urge the Mayor to get on with the funding proposals so that the Department can make a decision one way or the other?
As Members have heard this morning, we have regular meetings with the Mayor. I assure my hon. Friend that one of the most common topics for discussion is how to ensure that Crossrail 2 is both affordable and fair to the taxpayer. It is really important that we do not unduly raise public expectations or, indeed, provoke undue concerns in relation to Crossrail 2 ahead of developing a fair, sustainable and deliverable funding plan.
11. When his Department plans to make a decision on the mechanism for the Tyne and Wear metro to receive funding to replace and renew its rolling stock.
The Department accepts the need to replace the Nexus fleet and is actively discussing the most appropriate method of funding this vital work with Nexus and the Treasury.
The metro system’s rail stock is more than 40 years old, and I am afraid to say that it is failing on a daily basis, causing delays for its 40 million users each year. On 17 July, nine of my right hon. and hon. Friends representing the Tyne and Wear area and I wrote to the Secretary of State about this issue. We again wrote to him on 12 September asking for at least an acknowledgement of our concerns. It may surprise you, Mr Speaker, to hear that we have not yet had an acknowledgment, never mind a reply. My patience is wearing a little thin on this. The people of Tyne and Wear deserve much better from this Government, even though they have no MPs in the area.
I am always disappointed when I hear that we do not achieve what we should in our correspondence. I am sorry that the hon. Gentleman has not had an acknowledgement; we will draft one immediately today. I assure him that I personally understand the importance of the metro system to the people of the north-east. We understand the need to replace these ageing carriages, and we are keen to ensure that we make a decision as soon as possible.
Transport spend in the north-east is only £220 per head, compared with £2,000 per head in London, and the effect of that can be felt every single day on the Tyne and Wear metro. Will the Minister commit that the investment will be publicly funded, not coming from some financially engineered private finance initiative scheme, so that the public benefits of a decent transport system can be publicly controlled?
We continue to work closely with the Treasury to make sure that we get the right funding package to deliver these carriages, which I know the network needs. In response to the hon. Lady’s concern about levels of investment in her region, I point out that we are finally completing the motorway to the north-east that Labour never built in 13 years.
13. What assessment he has made of the potential merits of removing tolls on bridges.
It is Government policy that those who benefit from the significant improvements that estuarial crossings bring should help to pay for them. Successive Governments have taken the view that tolls are justified when private finance enables key road infrastructure such as significant river crossings to proceed and to be maintained.
I am sure that the Minister will be aware that residents in my constituency are paying in excess of £1,000 a year in toll charges for the new Mersey Gateway bridge, although the previous Runcorn bridge was toll-free and tolls are being scrapped across the whole United Kingdom. Will he honour the commitment made in 2015 by the former Chancellor, George Osborne, that Warrington residents would be exempt from these tolls? Although the Minister has previously rejected this offer, will he now agree to meet me and my constituents?
I am not aware of having rejected any previous invitation. I would be delighted to meet the hon. Gentleman and his constituents. The Government’s position is very clear. We intend that the tolls will go when the bridge has been paid for. Unfortunately, when crossings are being tolled, there has to be equality, because otherwise the untolled bridge ends up being loaded up to the point where the original purpose is defeated. The good news is that this is a major piece of new infrastructure, and that is all to the good.
14. What steps he is taking to promote cycling.
The Government want to make cycling and walking the natural choices for short journeys and parts of longer journeys. In April this year, as the hon. Gentleman knows, we published the first ever statutory cycling and walking investment strategy for England. The strategy sets out our plans for increasing cycling and walking, and it identifies £1.2 billion of funding for the period up to 2021.
I am due to go for a bike ride with the Greater Manchester cycling commissioner, Chris Boardman, in a few weeks’ time. As he is a former Olympic champion and maillot jaune holder, I am not looking forward to it and I am spending a lot of time in the gym. Chris is about to publish his strategy for Greater Manchester. What resources will the Minister put at Chris’s disposal, so that he can implement it?
I wish the hon. Gentleman very good luck in his ride with Chris Boardman, and I hope that Chris knows what he is letting himself in for. I have met both the Mayor of Manchester and Chris directly to discuss this strategy, and Chris has been kind enough to share it with me and my officials. Of course, from a central Government standpoint, we will do what we can to support it.
16. What recent assessment he has made of the equity of the distribution of regional transport infrastructure investment.
The most recently published statistics on the distribution of regional transport infrastructure investment appear in Her Majesty’s Treasury’s “Country and Regional Analysis November 2016”.
In response to a question from my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), the Secretary of State seemed to cast doubt on the existence of inequalities in regional infrastructure spend. He should know that Yorkshire and the Humber has the lowest per capita regional infrastructure investment in the country at just £190 per head, compared with £1,900 per head in London. What are the Government going to do to address that basic unfairness?
I always try to be helpful in the Chamber, and I know that the hon. Gentleman is doing his best, but a lot of what has been published about this is, quite frankly, just wrong. He may be drawing on the Institute for Public Policy Research North figures, which do not take account of the whole picture. They consider only 40% of the national infrastructure pipeline, exclude schemes that cross regions and ignore the majority of smaller transport schemes. He is a diligent constituency MP, so he will know that they do not include—perhaps he has not factored this in either—the work that is being done on local roads at junction 36 of the M62. I hope that when he stands up to speak again in this Chamber, he will welcome the Government’s commitment to his area of the north of England.
I am sure that the right hon. Gentleman is closely familiar with junction 36, about which, I dare say, we shall hear more in due course.
May I urge my right hon. Friend to be very granular when making such sub-regional assessments, to ensure within a regional context that rural areas, not just urban areas, secure the funding that they need?
As my hon. Friend, who is such a great champion of his constituents, knows, I am a representative of Lincolnshire, so I could hardly fail to have rural interests deep in my heart.
This week, the OECD argued that addressing the regional productivity divide between high-productivity areas, such as London, and lower productivity regions can be a key channel for fostering long-term growth and sharing prosperity. Does the Minister not accept that the Government’s cuts to rail upgrades will entrench regional transport inequalities and damage business by embedding the regional productivity divide?
Let us try to find common cause, shall we? It is absolutely right that we look at regional investment inequalities, and it is absolutely right, too, that we do not regard all investment in the south of England as good, while ignoring the rest. The Government are not doing that; that is the point. The Government are rebalancing investment across the whole kingdom, for we recognise that. I could be tiresome—[Interruption.] I know that that is hard to believe, but I could be, if I were to list the series of investments we are making in rail and road across the north. Rather than tiring you, Mr Speaker, or the House, we will set them out in a note, which we will distribute afterwards. Perhaps, then, the hon. Gentleman will also try to find common cause. To start with, he might want to look at the transport investment strategy that we have published, which is a starting point for learners in this field.
The Secretary of State has claimed that cancelling upgrades means affected areas will be spared disruption and that electrification is no longer necessary because the same benefits will be achieved with bi-mode trains reliant on diesel. Is his policy to provide regions across our country with second-rate railways, and is not the reality that his claims about the wonders of polluting diesel are, like digging for victory, a load of tripe?
Again, I simply say, let us look at the facts. We are investing in rail in the north. After all, this Government are investing in Transport for the North to do exactly what he describes. It is true that we need to look at a range of technologies to achieve what we want, but the answer to the hon. Gentleman’s question is: new trains, faster routes, more rail, more road investment—what is there not to like about that?
17. What plans he has to develop transport infrastructure in Scotland.
I am up again—and up for it, by the way As my hon. Friend knows, transport powers are devolved in Scotland. Nevertheless, investments are being made by the UK Government in rail and road on both sides of the border help to bind our kingdom together—united forever.
I thank my right hon. Friend, but what specific plans does he have to improve north-south rail connections other than High Speed 2, including the east coast main line, to ensure we truly are a connected kingdom?
For such a specific question, a specific answer is required. Investments in the east coast and west coast franchises will bring great benefits to the people of Scotland. An additional £2.7 billion has been given to the intercity express programme, providing 500 new carriages, increasing the number of seats by 20% and reducing journey times between many of the great cities of our united kingdom.
The port of Grangemouth in my constituency handles 80% of Scotland’s container traffic. Will the Minister advise us what discussions he has had with his Scottish counterpart regarding any post-Brexit delays at borders and traffic chaos or road jams in the Grangemouth area?
I was in discussion with my Scottish counterpart just this week—not on that subject, but we do communicate regularly. The next time I have the opportunity to speak to that gentleman, I will certainly raise the matter that the hon. Gentleman has raised in the Chamber today.
18. What steps he is taking to improve the condition of local roads.
All the Christmases are coming together, Mr Speaker My hon. Friend will be pleased that we announced in July that we were awarding Cornwall County Council £5 million in addition to its normal funding towards a project that will target carriageway treatments to improve the quality and longevity of 53 sites on Cornwall’s rural roads. All works will be completed by April 2018.
I thank the Minister for that answer, but in rural areas such as Cornwall it is important to maintain not just the condition of the road surface but the verges and overhanging trees in particular. I recently visited a local bus company, Roselyn Coaches, which is spending many thousands of pounds a year repairing its buses because of damage caused by overhanging trees. Does the Minister agree that local authorities such as Cornwall County Council must use their powers to cut back trees and keep our buses running?
As I said in my first answer, we are doing our bit. My hon. Friend is assiduous in keeping Cornwall County Council on its toes. It is its responsibility to ensure that carriageways are properly cared for in the way he described, and it is not easy to keep such a flat-footed Lib Dem council on its toes.
The right hon. Gentleman’s performances in the Chamber are always a source of great excitement—especially for the right hon. Gentleman.
T1. If he will make a statement on his departmental responsibilities.
Before I respond to any topical questions, may I take this opportunity to express my thanks, and I hope those of the whole House, to all those involved in the repatriation of passengers affected by the collapse of Monarch Airlines? It was a huge effort across government, but particularly by the Civil Aviation Authority, and we all have good reason to be thankful to the team involved.
Boston is a growing port and a growing town. New housing developments have preserved a route for a Boston distributor road, with which I know my right hon. Friend is familiar, but what will he do to help us to deliver the expensive but vital bridge in the middle of the distributor road, which we cannot of course ask housing developers to fund entirely?
Indeed, as my hon. Friend knows from my past visits to Boston, I am well aware of the importance of the Boston bypass project. The town is situated on an A road with a congestion problem and is one of those for which I would expect to see proposals come forward for the bypass fund. We will look very carefully at the bridge issue, and I am very happy to talk to him about that.
You may not be aware of this, Mr Speaker, but just last week there was another great train robbery: £600 million was removed from Scotland’s rail budget because the Tories ripped up a long-standing funding formula. For the sake of Scottish rail users, will the Secretary of State get together with the Treasury and give Scotland the correct funding?
This is an historic moment: the Scottish National party is opposing a funding allocation that uses the Barnett formula. I was under the impression that it regarded the Barnett formula as sacrosanct. However, when the UK Government use the Barnett formula, it complains. The SNP cannot have its cake and eat it.
T2. The excellent Rail Minister is drawing up a new franchise for east midlands railways, which will improve the service. Will he be able to publish an indicative timetable, so that my constituents can see how their rail service will improve?
I was more than happy to meet a cross-party delegation of Northamptonshire and Bedfordshire MPs this week to discuss this very issue. We have located the information that my hon. Friend desires, and I will place it in the Library and write to him.
T8. If High Speed 3 connected Leeds and Manchester via the Calder Valley line, that would be an absolute game changer for my part of the world. Given that the Secretary of State was keen to spend time in my constituency during the general election campaign talking about how important rail was to the area, will he update the House on whether and when that connection could become a reality?
There is a two-stage programme of modernisation for rail in the north, despite the nonsense that the shadow Secretary of State was talking earlier. Initially, we are replacing every single train in the north. We have modernised the Calder Valley line and are about to launch the modernisation of the main trans-Pennine route between Leeds and Manchester Of course we have done other things, such as electrifying the railway line from Liverpool to Manchester and creating the first ever link between Manchester Victoria and Manchester Piccadilly. A whole range of things is happening. What we said at our conference and will be confirmed at the Budget is that we will set aside funding to create the links between HS2 and Northern Powerhouse Rail. I am now waiting for the detailed Transport for the North proposals for Northern Powerhouse Rail. In the short term, we modernise the trans-Pennine route, and in due course we will build Northern Powerhouse Rail to ensure that we have those better links for the future.
T3. To make much-needed housing developments acceptable, it is essential to provide the right infrastructure—road structure, in particular—to cope with traffic increases. Often, only a small section of road is required: the small spine road through the proposed Staplegrove development in Taunton, for example. Although an application has been made to the housing infra- structure fund, will the Minister advise on what other pots of money might be available to make this housing acceptable?
I am grateful to my hon. Friend for the question. As she says, the Government made available £2.3 billion precisely for such schemes, as part of the national infrastructure fund. I would be delighted to have a good look at the scheme with officials and ministerial colleagues at the Department for Communities and Local Government. I direct her attention to the £12 billion that has been committed over the period 2015 to 2021 through the local growth fund, through local enterprise partnerships, to support local strategic projects.
How is the Secretary of State holding Volkswagen to account for its emissions scandal?
To answer on my right hon. Friend’s behalf, I should say that the answer is in so far as the situation allows us to. As the hon. Gentleman will know, we have not ruled out legal action of our own. We are waiting for the German legal authorities—under European law, given the origin of these technologies—to make their decisions. Once they have done that, we will take a final view. But we have been extremely clear about our view in general about how the company has behaved.
T4. Community transport plays a vital role in connecting communities in rural areas in west Oxfordshire and throughout the country. Such groups are worried about the impact of the issue and use of section 19 and 22 permits. Will the Minister confirm that if local community groups are registered as not-for-profit organisations, they will not be treated as commercial providers even if they pay a driver and take a fare?
I have two things to say. First, we very strongly support community transport operators in general. Secondly, we have been under some pressure to clarify the rules regarding local transport operators who are tacitly operating commercially. I am sure that that is not the case in Oxfordshire, but it is in other parts of the country. If my hon. Friend’s transport authority has a difficulty, he is welcome to get it to talk to my officials and/or the Community Transport Association.
The Shipping Minister will be aware of huge concerns regarding a time lag of almost an hour on a number of occasions between distress at sea and the tasking and launching of an RNLI boat. What can the Minister do to ensure shorter response times in that golden hour, particularly at Maritime and Coastguard Agency level? After all, RNLI men I know have told me that they would prefer 10 false alarms than to be late at the scene of a real distress call.
This a very serious matter, and the hon. Gentleman and I have met to discuss these issues. I take a very clear view that we must be rigorous in the way that we deal with them. There have been disasters, such as the Louisa disaster in his constituency. The first thing to do is to offer commiserations to all those involved. As he knows, I have spoken to the chief inspector of the marine accident investigation branch. I have asked for his view, as quickly as possible, on the very issues the hon. Gentleman raises. I will keep in close touch with him and other Members when I hear that view.
T5. There was widespread excitement last December when the Secretary of State announced a plan to publish a rail strategy document. Will he say what progress he has made and whether he will publish the report that his Department has commissioned on the future of rail franchising?
I expect to set out our further plans on the rail industry very shortly.
Further to the question from my hon. Friend the Member for Warrington South (Faisal Rashid), who was right to point out the impact of the new charges on the Mersey Gateway will have on his constituents, as well as the charges that are being introduced on the existing Silver Jubilee bridge, will the Minister tell us how many existing crossings, which were previously free, have had charges introduced on them in the past 10 years?
I would be happy to write to the hon. Gentleman with that information, but one concern is what the cost to local authorities would be. When we ran the numbers, as part of the wider decision, it became clear that the five local authorities involved would have to pay an extra £350 million to £400 million. That is an important further consideration.
T6. The Minister will be aware that, on the east coast main line, the rail franchisee competes with open-access trains. As a result, it has the highest customer satisfaction rating in the country. Can we not extend that practice throughout the country, so that everybody can enjoy the full benefits of rail privatisation?
We welcome open-access applications. They have made a real difference to many towns and cities around the country. It is clear that open access should happen where there is capacity for it to take place, so that it fills in gaps and puts in competition. The Office of Rail and Road is very careful in judging when it can permit open access and when it cannot. It looks very carefully at every proposal, and we welcome them.
Further to the question from the hon. Member for Na h-Eileanan an Iar (Angus Brendan MacNeil) about the potential late tasking of lifeboats, will the Minister meet me, parliamentary colleagues and the coastguard to ensure that the launch protocols the coastguard uses are not adding undue delay in the tasking of lifeboats in emergencies?
I am very conscious of the sinking of the Solstice off the hon. Gentleman’s constituency. I have met him, too, and I know how much he cares about this issue. I care about it, too, so yes of course I will do that. Furthermore, let me be absolutely clear to him, the hon. Member for Na h-Eileanan an Iar and the whole House. In respect of looking at these matters with assiduity, we will leave no stone unturned. If there can be improvements, there will be improvements.
T7. Can the Minister provide an update on the progress of the mid-Cheshire rail line?
I certainly can. I was pleased to meet both my right hon. Friend and the mid-Cheshire rail line promotion group in her constituency back in August. Since then, we have been liaising with Transport for the North. She will be aware that one of its key strategic corridors is the Wales and the west stretch in the north-west. It is looking at how the mid-Cheshire rail line scheme fits into its strategic proposals, and I hope to hear more in due course.
To return to community transport operators, many are concerned, including North Norfolk community transport, that the new ruling will push it under, with the loss of absolutely vital rural community transport links. What is the Minister doing to ensure that that does not happen? What is the timescale for the consultation? When will it actually come in, because the uncertainty is very dangerous?
I fully recognise the concern. As the right hon. Gentleman will know, the Department is being very careful. There will be no rapid over-enforcement. We will give people as much chance as possible to show that their activities are not commercial in the required sense. We will launch the consultation later this autumn and then take it from there.
In the same vein, I recently met Basildon community transport, which expressed grave concerns and is already pointing at a neighbouring community transport operator closing because of the uncertainty. Will my hon. Friend agree to meet me, Basildon community transport and the Community Transport Association to clarify the situation?
Yes, of course. I have met the Community Transport Association to discuss this at length, as my officials have been doing for some time, and other community transport entities. I would be delighted to meet my hon. Friend and his constituents.
Domestic air travel is surely an integral part of the UK’s transport infrastructure. In their planning for Heathrow expansion, how much have the Government budgeted to increase the number of domestic routes to London from Scotland, Northern Ireland, the north and the south-west?
I hope that this is not a question of our budgeting, because I hope that the links will provide strong commercial opportunities. Governments seldom fund airline routes except in specific cases, such as our recent decisions over the air link from Northern Ireland to Stansted. I hope, however, that the opportunities created by the expansion of Heathrow airport for the regions around the country will mean a thriving trade and attract airlines to take those slots.
I know that the Rail Minister will share my excitement at the prospect of the first new station in the bay since world war two at Edginswell. Will he agree to meet me and the local council to see how we can take this forward and what the prospects might be for new stations funding?
I am aware that it was one of the unsuccessful bidders in the most recent round of the new stations fund. We make a point of giving positive feedback whenever we can to help make sure that future bids have the maximum chance of success, so I am more than happy to meet my hon. Friend and his council to discuss how we can maximise the opportunities.
The service on the Treherbert line is shockingly bad. Trains are regularly cancelled. When there should be four carriages, there are often two. Obviously, there is to be a new franchise, let by the Welsh Government, but we need more investment in the rail network, and that is down to the Westminster Government. We have 6% of the railways in this country in Wales. Why do we only get 1% of the investment?
In Wales right now, we have the biggest electrification programme in the country coming soon; we have new trains coming to Cardiff, Swansea and Pembroke Dock; we have a big investment programme funded by central Government in the valley lines; and I am now looking at what changes we can make to the north Wales line, where there is a real need for improvement.
(Urgent Question): To ask the Secretary of State if he will update the House on Government action following the Grenfell Tower fire.
It is now just over four months since the tragedy of Grenfell Tower. Since then, the Government, the local council and the wider public sector have been working hard to ensure that everyone affected by the fire gets the support they need and that all tall residential buildings across the country are safe Since I last updated the House on 5 September, the number of households seeking rehousing has risen to 202. As before, this increase has been caused by members of larger households choosing to be rehoused separately. The local council has now secured more than 200 suitable local permanent properties. Negotiations are under way on others, and by Christmas it expects to have more than 300 available. As of this week, 112 households have accepted an offer of either temporary or permanent accommodation. Of these, 58 have moved in, 44 into temporary accommodation and 14 into permanent accommodation The Government are determined that everyone who needs support gets it regardless of their immigration status. We have previously established a process to grant foreign nationals who were resident in Grenfell Tower or Grenfell Walk 12 months’ leave to remain in the country with full access to the relevant support and assistance. Last week, the Immigration Minister announced a dedicated route to permanent residency for the survivors. This policy will allow them to apply for free for two further periods of two years’ limited leave. After this time, they will be able to apply for permanent residence Meanwhile, our work to ensure the safety of other tall buildings continues. A total of 169 high-rise social housing buildings in England feature some of the aluminium composite material cladding, and our programme of testing has identified 161 that are unlikely to meet current fire safety standards. The particular focus of current efforts is now on supporting remedial work on those 161 buildings. We are also improving our understanding of the situation for the privately owned high-rise residential buildings with ACM cladding, so that all such buildings can be as safe as possible We have made clear to councils and housing associations that we expect them to fund measures that they consider essential to making buildings safe. However, if councils have concerns, they should get in touch with us. We will consider the removal of financial restrictions if they stand in the way of essential work. To date, 32 local councils have expressed concern to us in principle. We have liaised more closely with seven of those, and one of them has now submitted supporting evidence for consideration by my Department.
The terrible tragedy of Grenfell Tower was a national disaster. At such times, people look to the Government to lead and to act. The survivors, and the relatives of at least 80 people who lost their lives, deserve no less. I do not doubt the Secretary of State’s good intentions, and I pay tribute to the work of the frontline staff, volunteers and local groups who helped immediately after the fire and are still helping to support the survivors; but, more than four months after the fire, the facts are these Only 14 of more than 200 Grenfell families have new homes. Fewer than one in 10 of the country’s 4,000 other high-rise tower blocks has been tested by the Government. The Secretary of State has refused any Government funds for essential fire safety work on other high-rise blocks. Can he confirm that 152 Grenfell households are still in hotels, although the Prime Minister said on 17 July: “I have fixed a deadline of three weeks for everybody affected to be found a home” The Prime Minister told the House on 22 June: “We can test more than 100 buildings a day”.—[Official Report, 22 June 2017; Vol. 626, c. 169.] Can the Secretary of State confirm that, in fact, the Government have tested the cladding on fewer than 300 high-rise blocks? On 20 July, he told the House that the Government would “make sure that they have the support that they need.”—[Official Report, 20 July 2017; Vol. 627, c. 1025.] Can he confirm that he told the Communities and Local Government Committee last week that there would be no Government funding for councils or housing associations for essential retrofit fire safety work Grenfell survivors have a deep mistrust of those in power who failed to respect social housing residents for so long. When Ministers make pledges but fail to act, or fail to ensure that others act, that fuels a wider lack of trust and confidence. The buck stops at the top. Will the Secretary of State now, four months on, secure the extra homes that are needed for all the Grenfell families, provide the Government funds that are needed for urgent remedial work and to retrofit sprinklers, and set a date to come to the House to tell us that every other tower block in the country is safe—not “as safe as possible”, as the Secretary of State said earlier—for the people who live in it Many of the Government’s decisions, reviews and inquiries are good, but they will not be good enough until the Government get a grip, and get these fundamental problems sorted out.
I know that the right hon. Gentleman cares as deeply about helping the survivors of this terrible tragedy as I do, and as the entire Government do, and it is a real shame that he should try to treat it as some kind of political points-scoring opportunity. He knows exactly what the situation is, not least because I updated the Select Committee—whose members included his colleagues—just last week. The Committee had an opportunity to go into many of the issues in detail, as a Select Committee should, and I am sure that the right hon. Gentleman followed all that. This is not what the victims of the tragedy want to see, and it not what the country wants to see. They want to see all of us working together to do whatever we can The right hon. Gentleman asked me about housing. I have talked about that before, but I am happy to say again that the victims of what was easily one of the most terrible tragedies ever to have taken place in our country are people, not statistics. We must work with them and listen to what their needs are. For example, there were 151 households at the start, with Grenfell Tower and Grenfell Walk—the two buildings—taken together, but we are now working with 202 households. That has happened because some of the survivors have asked to split where there are larger families or for other reasons, and we have listened to that. We have listened to every single case, and not one request has been turned down. That, of course, means we have to find even more permanent and temporary accommodation, but that is not our consideration; our consideration is the needs of the victims themselves It is right that every family should be properly assessed for their housing need, and should be listened to. Every single family has been offered an assessment by professional housing officers. Some of them have met a number of times, because if they change their mind we need to listen to them. Literally only a handful have not yet had that meeting, but that is at their request, because they are not ready; they will typically be a bereaved family who are not ready to engage. They would rather not go through that process now, and we have listened to them, too After the assessments, we have tried to determine—obviously the council was leading the work—whether the survivors wanted to be back in an apartment block again, or if they want a house, and whether there are any other needs. Some families say they do not want to live in the borough, but would prefer to move closer to family elsewhere. All of that is being listened to; we are trying to action all of that and listen to it There can be a time lag when families have identified a property—as I have said, 112 families have accepted offers of temporary or permanent accommodation. That lag occurs between acceptances and moving in, because every family has been offered a moving-in package so they can choose the décor, the furniture and any other things that will make their life comfortable. That has been listened to, and of course that will take time That is how we are treating these people: as real people and survivors, not as statistics. I know the right hon. Gentleman is not saying that they are statistics, but sometimes it does come across like that. I urge him to work with us, and to listen to what work is actually going on The right hon. Gentleman also asked me about the building test. I have given the House an update on the numbers, and a fuller update was given last week at the Select Committee. He asked particularly about the speed of the tests. The Prime Minister rightly said previously that the testing facilities can test up to 100 samples a day. They were specifically testing the samples of ACM—aluminium composite material—cladding that were sent in, and they were done at the speed that they were sent in; the testing facilities can only operate at the speed at which the samples are sent in Those tests have subsequently been superseded by the more comprehensive systems tests, which test the whole ACM cladding system. As the right hon. Gentleman knows, that was tested during the summer and it gave a fuller result. I have just shared the numbers of social buildings and private buildings tested so far, and following on from those results, both the interim and remedial action plans that have been put in place. Finally, the right hon. Gentleman asked about council funding. He rightly said that I have stated before that I will make sure that all councils have the support they need. That is exactly what I and this Government are doing. Councils are rightly expected to carry out all essential works, and they will determine, as the legal owners of the properties, what is genuinely essential work; and if they cannot afford it, that should not be a reason not to do the work. Whether they are interim measures or the final remedial measures, the work must happen, and if the councils need support through financial flexibilities, we will provide that. Again, I gave a fuller account to the Select Committee, so perhaps the right hon. Gentleman will take another look at that.
I commend my right hon. Friend on keeping the House updated and the comprehensive nature of the updates he has given to the Communities and Local Government Committee Given the terrible traumatic circumstances that the victims of Grenfell Tower have been through, is it not much more important that they have a home they can call their own, and that we take the time to achieve that, than that we rush to push people into homes they do not want?
I thank my hon. Friend for his comments. He is right: we must take the time that survivors ask of us. We cannot rush any survivor into making a decision with which they may eventually be uncomfortable. Even in circumstances, which have arisen, whereby survivors have accepted a property offer, moved in and then changed their minds and said, “Actually this is not what I wanted”, we should listen to them. We should work at their pace—that is the right thing to do.
Reacting to incidents such as Grenfell is always challenging. After the Prime Minister’s comments yesterday, there are more questions about the Government’s handling of the fire and its aftermath. In Scotland, a working group is reviewing evidence on fire suppression measures, including sprinklers to ensure the safety of residents in high-rise buildings. Sprinklers are only one of a range of risk-reduction measures, but we are reviewing them. The Government dismiss them, telling one council: “The fire safety measures you outline are additional rather than essential.” Why do the Government seem to deem any risk-reduction measure as additional, not essential Ninety-two households have yet to be found new homes, despite rehousing being a priority. After four months, hundreds of people are still living out of suitcases and hotels and it is simply not good enough. It is time to stop the words—people need action. Will the Secretary of State guarantee that permanent homes will be found for everyone before Christmas?
I remind the hon. Gentleman that a full, independent review of building regulations and fire safety rules and regulations has been set up. That is one way in which we can make changes and learn lessons from the terrible tragedy The hon. Gentleman talked about what is essential and non-essential for fire safety. As I said a moment ago, we expect councils and housing associations to take expert advice, certainly from their local fire and rescue service, but it is then for the council, not the Government, to determine what is essential.
What is the formal final total of fatalities? How many victims remain unidentified?
Obviously, the police conduct that work independently, but I can give my hon. Friend the latest number: 80 people are missing, presumed dead. That is the latest information that the police have, but they have committed to keeping people updated.
I, too, thank the Secretary of State for coming to the Select Committee meeting and answering questions so thoroughly last week. I want to return to the point about the essential fire safety work that other councils have got to do on their tower blocks. The Secretary of State has talked about extra flexibilities, probably extra borrowing, for those councils, but he has ruled out any money from the Government to help fund the work. Does he realise that many councils may have to defer or cancel other essential maintenance work on properties, putting the lives and health and safety of other residents at risk? Will he reconsider and recognise that this is a national problem, and that the Government should at least share responsibility with local councils to deal with it?
I thank the hon. Gentleman for his work through the Select Committee and the scrutiny that he and his colleagues provide. Last week was a welcome opportunity to meet the Committee and discuss this and other issues The hon. Gentleman asked specifically about funding and whether the funding requirement could delay other work. Given that each council’s situation is different, I cannot give a general answer for all councils. I said to the Select Committee, and it is worth repeating to the House, that I have set out a process for a full, top-to-bottom review of social housing, not just of the rights of tenants and how they are treated—the redress systems—but of our approach as a country to social housing, which has not been looked at for a generation. We will set out our thoughts in a Green Paper and discuss them with the Select Committee and any other colleagues who want to talk about them. That is an appropriate way in which to consider the wider issues, including renovation, around social housing.
I thank my right hon. Friend for coming to the House again today. He obviously recognises that the fire at Grenfell has implications for the wider area. What are the Government doing to listen to residents’ concerns and how are they addressing their needs?
I am pleased that my hon. Friend has raised that point. He will know that in London in the wake of the tragedy we have asked councils to check the quality of buildings, not just the fire safety, but other matters. For example, cracks so big that you could put your hand into them were discovered in the walls of the Ledbury estate tower blocks in Southwark. All those issues, including structural matters, need to be looked at. My hon. Friend the Minister for Housing and Planning has had a series of meetings and will travel across the country to meet and listen to social housing residents. There is also the Green Paper and the review that we are carrying out.
Following the fatal fires at Shirley Towers in Southampton and Lakanal House in Camberwell, coroners recommended retrofitting sprinklers in high-rise residential buildings to prevent deaths. Will the Secretary of State therefore explain why the Housing Minister recently wrote to Nottingham City Council to say that the sprinkler system that it requested was additional rather than essential? The Government should be doing everything in their power to prevent such tragedies, so should they not launch a separate formal review into the wider neglect of social housing? The failure to use the Grenfell inquiry to examine wider neglect is an act of neglect in itself.
The hon. Gentleman refers to the coroners’ reports following the two previous tragedies, and he is right that in both cases the coroner asked social housing providers to consider the provision of sprinklers. It was recommended that the then Secretary of State write to housing associations and councils to pass on that recommendation, which is exactly what the Secretary of State did at the time As for the wider funding issues, I have already answered that question.
The whole House will agree that it is important that those who have been directly affected by the fire have their voices heard, so will the Secretary of State update us on what meetings the Government have had with the victims?
My Department, which has been leading the Government effort, has been heavily involved right from day one of this tragedy, as have several councils—not just the Royal Borough of Kensington and Chelsea. London boroughs came together quickly under what is a called a gold command, and all councils have been involved in working with and listening to the victims. Over the summer, a majority of the victims came together to set up Grenfell United under their own initiative, and there have been regular meetings with the group’s committee. I met the group at a meeting to which every survivor was invited, and the victims Minister and the Prime Minister have also met the group.
I was troubled to hear the Secretary of State tell the Communities and Local Government Committee that councils would be expected to reprioritise in order to complete essential fire safety works post-Grenfell. Will he confirm whether it is my constituents living in temporary accommodation and desperately waiting for a new home or those waiting for much-needed major works who should be reprioritised? Can he not see that, unless the Government provide grant funding for essential fire safety works, the long-term impact of the tragedy across the country will be a deepening of the housing crisis? We owe it to the victims and survivors to do better than that.
As we discussed at the Select Committee, councils are expected to do whatever work is necessary to keep people safe, including interim measures and final remedial measures. They will get support from the Government in the form of flexibilities that will allow them to do that work. The hon. Lady referred to other work, and I believe that I have answered the question about how that should be considered in a fuller review, because that issue is bigger than the essential work. We need to look beyond the essential work to see what else needs to be done by the Government to improve social housing more generally. I am sure she would welcome the steps that the Government have taken towards that, such as the commitment to put an additional £2 billion into social housing that was announced just a couple of weeks ago.
I was pleased to hear the Secretary of State’s comments about social housing and to hear that, as recommended by Sir Martin Moore-Bick, the Government are looking more closely at social housing issues. Will the Secretary of State update us on the first steps that are being taken to put something in place?
My hon. Friend refers to the Green Paper on social housing that we are already working on. One of the key ways in which we will develop that paper is by listening to people who already live in social housing—not just those in one area. London is important, but we want to listen to people from across the country about the issues they face in terms of the quality and type of social housing. We want to hear about redress and how to ensure that we can have a better system, so that we can listen and take action when residents come up with issues.
Can the Secretary of State imagine a situation in which so many thousands of people were in potential danger that would not be treated as a national issue for the Government? We have a Secretary of State who is trying to wash his hands of responsibility. The commissioner of the London fire brigade says that retrofitting sprinklers in tower blocks “can’t be optional, it can’t be a nice-to-have” Does the Secretary of State agree with the commissioner, and will he work with local authorities to retrofit sprinklers in tower blocks?
With respect, I do not think the hon. Gentleman has been listening to my responses. As I have said, and I repeat it again for his benefit, it is for property owners—local councils and, in some cases, housing associations—to determine what is essential, after taking the advice of their local fire and rescue service, the local experts. Once they take that advice, we will listen to their determination.
I welcome the work my right hon. Friend has set out. He mentions the social housing review; should not that focus on our need for dramatically more social housing? Will he lobby the Treasury for tax incentives for housing associations, and will he liberalise planning rules so that we can build social housing for the 21st century?
I am pleased that my right hon. Friend raises that point. He highlights the importance of social housing, which is a significant part of the total housing delivery in this country. That is why we want to provide more support for housing associations and ambitious councils that want to build more homes—one reason we recently announced the additional £2 billion. We listened to the sector when it said it wanted more certainty on rents from 2020 onwards, and we have provided that.
The Secretary of State has talked about financial support through financial flexibilities, but I would be grateful if he specifically confirmed, or even agreed, that what he is referring to is a loan and that financial provision needs to increase because budgets have been cut Charities have raised more than £24 million for the survivors of this horrific tragedy. How do they access that money, and how much of it has already been accessed?
First, on flexibilities, in some cases it may well be a loan. If a council’s housing revenue account borrowing limit is increased, that will be an additional loan, but in some cases councils have approached us to ask for a one-off authority to make a transfer from their general fund reserve—in that case, it will not be a loan I am glad that the hon. Lady highlights the charities. Charities raised more than £20 million of funding immediately after the tragedy, and they continue to raise money. I commend their work, which will really help the victims of this tragedy. More than half the money has been distributed so far. Of course, distribution is not a Government job—it is up to the charities—but the Department for Digital, Culture, Media and Sport has tried to co-ordinate for the charities so that they can work together to ensure that they help victims in the best way.[Official Report, 1 November 2017, Vol. 630, c. 1MC-2MC.]
I commend my right hon. Friend and the Department for their granular approach to this tragedy—that seems the right approach. Finding the truth and identifying justice is crucial. Will he update the House on the progress on the inquiry?
My hon. Friend raises one of the most important issues following this tragedy: the need to seek the truth and justice for the survivors, their families and their friends. Of course, he will know that that work is rightly being led through an independent public inquiry—a judge-led inquiry—and that work has begun. It is not for me to comment on how it is progressing or on the final timing of it, but it is right that this has been set up. The judge will get the co-operation of everyone he needs it from, be it Government, my Department or others. The police work and the police inquiry are going on separately, and I expect the police to continue to give public updates on that.
An Erdington tower block tenant asked me, “Will the Government pay to keep us safe?” The west midlands fire service has advised £41 million of works, including the retrofitting of sprinklers, but the city is reeling from £700 million of cuts to its budget. Will the Government pay to keep the tenants of Birmingham safe?
First, if the city had managed its public finances better, it might be in a better position. But when it comes to essential work, of course there should be no shortcuts. Any support that it needs will be provided. I have talked about how that support can be provided and the type of works it needs to do. As I have said, and am happy to repeat, it is essential that the city take the advice of its local fire and rescue service, which it has done—that is important and it is good to see. We will look at that, but it is the legal owner of that building with a legal responsibility to keep it safe. Whatever it comes to us with and determines as essential, that is what we will listen to, and this is how we will work with it to help provide the flexibilities it needs.
Will my right hon. Friend please reassure me that the victims’ views will always be given paramountcy by the Government and that when making decisions about the recovery their views will be taken into account above all else?
I can absolutely assure my hon. Friend that victims’ views come first, second and third.
Does the Secretary of State not recognise that escaping from a 20-floor tower block is exactly the same in Birmingham, Manchester and London, so leaving this to local decisions is not good enough? Local authorities will face having to replace panels and trying to retrofit sprinklers in a short period. I do not see that that is manageable out of a normal essential works budget.
The hon. Lady raises an important point about how this is about not just the funding, which I have talked about at the Dispatch Box a number of times, but capacity—the capacity to commission the work, and to make sure the replacement cladding, the scaffolding and all the essential bits and pieces are available. That is why one of the first things we did, working with the Department for Business, Energy and Industrial Strategy, was to set up an industry response group, with representatives of industry across the UK, to make sure we are co-ordinating the availability of essential materials and capacity, including the specialist labour that will be necessary. As well as the funding, that is also a necessary part of this and we are very much involved in it.
I am chairman of the all-party group on local government, and along with other members of the group I have been following closely the responses of individual local authorities. I recognise that much hard work has been done to monitor the situation in social housing, but to reassure people up and down the country, will the Secretary of State confirm that his Department is monitoring the response of councils, particularly those facing financial problems and those perhaps with a lack of expertise within them?
Yes, I am happy to give my hon. Friend that reassurance. From day one, when we put the building safety programme in place, the number of people in my Department—the specialists—dealing with this has increased dramatically. One reason that has been necessary is that every building that has been identified—where, first, there had to be testing, and this was followed by the results of the testing, the interim measures and the remedial measures—has been allocated to an individual in my Department. So an individual has been following how the local authority, housing association or private sector operator has handled the testing and their response to the results of that testing. That has been necessary to make sure that all the necessary work takes place, and we will continue to do it for as long as is necessary.
I welcome the announcement of the social housing review, but will the Secretary of State please reconsider, as part of that review, my request of some weeks ago for an audit of all social housing? That would enable us to understand things such as the extent of concrete cancer and the percentage of homes with sprinklers, and therefore to best understand the scale of the problem and the investment that is needed, to which the hon. Member for Cleethorpes (Martin Vickers) perhaps alluded. That would be most welcome.
I will reconsider it.
We must never forget the incredible work of the firefighters on that day. The fire and rescue service faced 30% cuts up to 2015, and local government settlements suggest there will be cuts of a further 20% before 2020. Meanwhile, firefighter pay has been capped at 1%. Is the Secretary of State at least having conversations with the Chancellor about a moratorium on fire and rescue cuts and about increasing firefighters’ pay?
The House cannot commend enough the work done by the fire service—not just what it did in response to this terrible tragedy, but its work in general up and down the country. With respect to the response to the tragedy, there is no evidence that there was a resource issue; however, it is correct that the ongoing independent inquiries are the ones properly to assess that, not us in this House. I direct the hon. Gentleman to the work that is being done through the independent review of not only building regulations, but fire safety rules and regulations. It is just the kind of thing that the review can look at.
The Secretary of State has confirmed that it is for local authorities to seek expert advice in determining what work is essential to keep tower block residents safe. As my hon. Friend the Member for Eltham (Clive Efford) said, fire chiefs’ advice is unambiguous: the retrofitting of sprinklers cannot be optional or a “nice-to-have”; it is something that must happen. Why, then, did the Minister for Housing and Planning tell Nottingham City Council that sprinklers were “additional rather than essential”? Is he wrong?
We have asked Nottingham City Council for further information. What I have said generally for every council, whether it is Nottingham or others, is that it is for the council to determine what is genuinely essential, and that must be based on expert advice.
Lewisham Council has done all the safety checks and is doing all the remediation works to ensure that our blocks are safe, and it doing that at great cost. The Government said that such work would be fully funded, yet no funding is forthcoming. Are the Government trying to bankrupt councils?
Lewisham Council is one of the number of councils I mentioned earlier that have contacted us. We are in more detailed discussions with a few of them, and we have asked for further information and are looking at it.
What is the Secretary of State doing to build public confidence among the people of Barton Hill, Kingsdown, Redcliffe, Hotwells and elsewhere in my constituency in the content, scrutiny and enforcement of fire and building safety regulations?
The hon. Lady will know about the work that has been going on with respect to publicly owned buildings, which include those owned by housing associations as well as by local councils; I have set that out previously and done so again today in detail. Like all other Members, she will have in her constituency private sector buildings, including the tall buildings above 18 metres, some of which we have tested if samples have come forward to us On 5 September, based on the expert advice that we had received, I wrote to the chief executive officer of every council to ask them to put in place a procedure to work out what other private buildings they have that would meet the criteria, to make sure that they are tested and to confirm for themselves that they are safe. I also took the opportunity to remind local council leaders and chief executives of the powers they already have under the Housing Act 2004 to take enforcement action, if they need to, on building regulations, if the work was recently done, as well as the powers that the fire and rescue services have under the fire safety order.
I remind the Secretary of State that the withdrawal of billions of pounds of revenue support grant from local authorities has been a unilateral decision of his Government since 2010. Therefore, placing that responsibility on local authorities in that light is beyond contempt. The residents of my 24 tower blocks in Gateshead really do express their deep sympathy for the occupants of Grenfell Tower, the bereaved and the traumatised, but they are also looking for peace of mind. Their buildings are not clad in the same way as Grenfell Tower, but they do live in blocks that have no sprinkler systems, and many of them in blocks with single stairwells. They have to live there whether they are elderly, infirm, disabled or vulnerable. They are looking for peace of mind from this Government and from this Secretary of State, and I am looking for it now.
In that case, the hon. Gentleman should be reassured that his council, like others, has received expert advice and has been asked to work with us in checking all buildings locally, whether they are in the public or the private sector. Where it needs further support and advice from us, those are available. It has also been reminded of the extensive enforcement powers.
Will the Leader of the House give us the business for next week?
The business for next week is as follows: Monday 23 October—Second Reading of the Automated and Electric Vehicles Bill Tuesday 24 October—Second Reading of the Smart Meters Bill Wednesday 25 October—Opposition day (3rd allotted day). There will be a debate on social care followed by a debate on supported housing. Both debates will arise on a motion in the name of the official Opposition Thursday 26 October—General debate on the implementation of the Modern Slavery Act 2015 followed by general debate on global LGBT rights. The subjects for these debates were determined by the Backbench Business Committee Friday 27 October—The House will not be sitting I should also like to inform the House that the business in Westminster Hall for 23, 26 and 30 October will be: Monday 23 October—Debate on an e-petition relating to eligibility for mortgages Thursday 26 October—Debate on International Freedom of Religion or Belief Day Monday 30 October—Debate on an e-petition relating to proportional representation I am sure that the whole House will join me in marking national adoption week. The love and support offered by so many in this country to otherwise vulnerable children is to be celebrated Finally, the festival of lights, one of the happiest holidays, also begins today, signifying the victory of good over evil, knowledge over ignorance and light over darkness. May I take this opportunity to wish everyone a very happy Diwali?
I thank the Leader of the House for the forthcoming business—again, it is just for one week, not two—and also join her in wishing everybody peace and prosperity for Diwali. I also thank her for providing an advance copy, which I got via email on Tuesday, and the Vote Office in Portcullis House for having hard copies of it for Members on Monday This week, the sky darkened, a hurricane hit our islands, and the Government continued with their game playing both here and in Europe. I want to reiterate what you said after the motion yesterday, Mr Speaker, which was that “the Leader of the House has to be the House’s representative in the Government.”—[Official Report, 18 October 2017; Vol. 629, c. 956.] I am sure that the Deputy Leader of the House, who was in his place yesterday, will have informed the Leader of the House about the outcome. There were seven points of order following the debate. Member after Member—and you, Mr Speaker—wanted to know what the position is when the House votes 299-0. As the shadow Secretary of State for Work and Pensions said in her point of order, if the Government have retreated on certain aspects of a policy, the Minister should come to the House and explain This is where we make the law. The hon. Member for Gainsborough (Sir Edward Leigh) was right to say that this is not a school debating chamber. You made it very clear, Mr Speaker, that the Government should come to the House, because a motion was passed to pause the roll-out of universal credit. It took a week for them to end the charges on the helpline for universal credit. This is a disorganised Government who are disrespectful to the House. What do we say to the democracies around the world; to the UK Youth Parliament, who are coming here on 10 November; to young people as they learn about democracy; or to those who voted to get their sovereignty back? No wonder the EU negotiating team think the Government are amateurs. That is why they want to speak to the Opposition Could the Leader of the House please tell us how the Government will honour the result, as the Official Report put it: “Resolved, That this House calls on the Government to pause…Universal Credit”—[Official Report, 18 October 2017; Vol. 629, c. 955.] Is that really it for the business for next week: Monday, robot cars and Tuesday, smart meters? Are those the most pressing things for the House to debate? The shadow Secretary of State for Transport told me that the Government have accepted our amendments, so it is effectively our Bill The country is crying out for action—not calls for evidence—on housing, education, health, and the mounting debt caused by stagnant wages and increases in the cost of living, which we want to address in our Opposition days. But the Leader of the House must give the House a commitment today that non-urgent statements will not in future be used to disrupt Opposition days. I know the Government did not want to hear about people in rent arrears struggling to feed their families when they are in work, but that is the reality when Government policy is failing Mr Speaker, I want to draw your attention to another alarming situation. The Sanctions and Anti-Money Laundering Bill—a very serious Bill, to make provisions enabling sanctions to be imposed to comply with UN obligations “or other international obligations”: the EU cannot be mentioned at all on the face of the Bill—had its First Reading in the House of Lords yesterday, but the Bill will be printed today. That must be a first—where a Bill has passed its First Reading and no one has seen its contents until a day later. It should be one for the Foreign Secretary, but perhaps he cannot be trusted with the Bill. Worse still, the House of Commons cannot be trusted with the Bill. So will the Leader of the House please explain why that Bill started in the other place When will the European Union (Withdrawal) Bill come before the House for its Committee of the whole House stage? I read in an email yesterday that it will be after the November recess. Is that correct? Should we not be discussing it here? Will the Leader of the House please tell us what is happening May we have a statement on the growing scandal of the missing NHS files, as revealed in the Public Accounts Committee? There has been no response to the letter from my hon. Friend the Member for Stockton South (Dr Williams) on referrals for children with autism; 142 Members across the parties want to know why parents and children in a place like Stockton have waited nearly four years from the point of referral to specialist assessment. NICE guidelines say it takes three months. We are failing those children, some of whom are absolutely brilliant and see life in a different way from us Finally, it was great to attend the Women of the Year lunch last Monday with other hon. Members. The winners of the awards are truly deserving. The leadership award went to Dany Cotton, the first female commissioner of the London fire brigade, for her leadership in response to the Grenfell Tower fire. The international award went to the White Helmets, as a favoured charity of our dear colleague Jo Cox. It says: “To save one life is to save all humanity” The main award went to the women of the emergency and medical services following the Manchester bombing—doctors, nurses, paramedics, the deputy chief constable and community police officers. I know the whole House will join me in acknowledging the work that those women have done in difficult times, as we all work towards a more equal society.
May I start by absolutely sharing in the hon. Lady’s praise for all those amazing women who won awards in the Women of the Year award ceremony this week? Our thanks and gratitude go to all those who contributed in the response to the appalling Grenfell Tower tragedy and those who rushed out to help after the Manchester bombing. I completely share her awe at what they have achieved The hon. Lady raises a number of issues. I will try to address them all but if she will forgive me; she spoke very fast—[Interruption.] I will try to get to all of them. She raised first the issue of the number of points of order last night in response to the Opposition day debate. She is aware that, as you said, Mr Speaker, the resolution of the House was passed, and that the Government are indeed not bound by that resolution, as you pointed out yourself. However, I assure all Members on both sides of the House that the Government are listening and have been listening. As my right hon. Friend the Secretary of State for Work and Pensions said yesterday, and as was reiterated by the Prime Minister in Prime Minister’s questions, the DWP, as a result of issues raised in the House, has looked again at charges for those using the DWP helpline and has agreed that those charges should be stopped. That is direct action as a result of concerns raised across the House It is important—again, the Department for Work and Pensions has been listening carefully—that more is done to ensure that those claiming universal credit are aware that they can get up to 50% of the first month’s payments in the form of an emergency payment within seven days or even earlier. It is also important that many different efforts are being made by the DWP to work with landlords to ensure that those on universal credit do not get into difficult rent arrears. As colleagues will know, it is possible for rent to be paid directly to landlords, and that is now the case for many universal credit recipients. So I assure colleagues that the House is absolutely being listened to, and the concerns being raised are acted on. I can also assure colleagues that DWP Ministers will come back to the House, as they have several times, to update it on progress in addressing the concerns raised by Members across the House. [Hon. Members: “When?”] That will be as soon as there is more to tell the House about the achievements that have been put in place. It is very important that the Government show that we are listening and taking action. If hon. Members wished to be fair about it, they would accept that a great deal of progress has been made, and it is important that we continue with that The debate yesterday specifically called for a pause in the roll-out of universal credit. I can reassure hon. Members that the roll-out schedule already includes a number of pauses. There has recently been one; the next is scheduled for January. The roll-out of universal credit is being done over a lengthy period However, it is important that we go back to the origins of universal credit. Even the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) on the Opposition Front Bench agrees that universal credit is a good move for those trying to get back into work. It consolidates six benefits into one. It provides more support for those trying to get into work. Three separate studies show that universal credit recipients get into work faster than jobseeker’s allowance recipients. Because of the simple taper rate, there are no hours rules and cliff edges, as there are with tax credits. And, of course, universal credit covers up to 85% of childcare costs, versus 70% with tax credits. All of those things are really important to support recipients to get into work, which is good for them and good for their families The hon. Member for Walsall South also raises the question of when the European Union (Withdrawal) Bill will come to the House for its next stage, which will be Committee of the whole House. I want to reassure hon. Members that, as has been widely reported and as is well known, 300 amendments and 54 new clauses have been put forward. It should be reassuring to the House to know that the Government are looking carefully at those amendments and new clauses to ensure that, when the Bill does come back to this Chamber for a response and for the debate—we have eight days of debate, with eight protected hours on each day—the responses will be well thought through However, I would like to point out to Members on both sides of the House, who may not be aware of this, that there is nothing odd at all about a pause between Second Reading and Committee of the whole House. Specifically, with a constitutional measure such as the Fixed-term Parliaments Act 2011, there were six sitting weeks between Second Reading and Committee of the whole House. With the Human Rights Act 1998, there were 10 sitting weeks between Second Reading and Committee of the whole House. With the Scottish Parliament (Constituencies) Act 2004, there were eight sitting weeks between Second Reading and Committee of the whole House. I hope that that reassures hon. Members that there is nothing odd or anything to fear from this slight pause. It is our clear, stated intent to show respect to the House by coming back to it with clear, considered responses to all the proposals made by hon. Members on both sides. The hon. Lady asked why the Sanctions and Anti-Money Laundering Bill has started in the other place. She will be aware that through discussion among the parties it is important that we schedule legislation appropriately between starting in the Lords or in the Commons. There is nothing odd about a Bill starting in the other place. This Bill was considered suitable for their lordships to consider with the level of expertise that they have. She will be aware that this week we have had the Second Reading of a Brexit Bill on nuclear safeguards, and further Brexit Bills will be introduced in this House and in the other House, as is perfectly normal parliamentary procedure The hon. Lady raised the length of time that it has taken for referrals of children and young people with autism. I share her concern about that issue, and I am happy to raise it specifically with the Secretary of State for Health—I know that he is concerned about it himself. I urge Members to seek appropriate methods, either through Health questions or through a debate, to raise this very serious issue further.
May I put to my good friend the Leader of the House a Conservative long-term point of view about the events of last night? It may be that in future we have a minority Labour Government. They may produce a policy that we think is deeply contrary to our personal liberties. We may muster a majority in Parliament against it. What happens if that future Labour Government then say, “We’re sorry—you’ve set the precedent, this is only an expression of opinion, and we’re going to ignore Parliament”? Frankly, the road to tyranny is paved with Executives ignoring Parliament. I therefore urge my right hon. Friend to listen to Parliament. I believe that the Secretary of State should come and make a statement, and it should be a statement full of meat. Parliament does matter. If we, as Conservatives, live by the sword now, our Conservative values might die by the sword in future.
Can I assure my hon. Friend that there is no precedent being set here? The Government, like different parties and different Members, will look on a case-by-case basis at whether they will vote on specific motions or not. There is no precedent being set. I have just explained at some length that this Government are very clearly listening to Parliament and have very clearly taken action as a result of concerns raised in the House. I have also given an assurance that DWP Ministers will come back to this Chamber to update Members on progress with rolling out universal credit.
I thank the Leader of the House for announcing the business for next week Well, last night went well, didn’t it? What an anti-democratic shambles—an utter embarrassment for this House. Just when we thought this Government could not demonstrate more contempt for the democratic arrangements of the House, they have got into the lift and taken us down another couple of levels. I do not know what will be next. Maybe they will refuse to answer questions from the Dispatch Box. Maybe they will even try to abolish all these inconvenient voting Opposition parties. They might even do the country a favour and abolish themselves. The Leader of the House has to get a grip and the vacuous nonsense has to stop. She is the Leader of all of the House and she has to take that responsibility seriously. The first thing she needs to say is that she takes the view of the House seriously. We voted last night to pause the roll-out of universal credit, the Government have to accept it, and we have to hear that from a DWP Minister at the Dispatch Box What about the EU repeal Bill? The delay is not because of all the amendments the Leader of the House talks about—it is because the fractious Conservative party cannot agree a solid line on all this, and they are terrified of any possible defeat. That is why we are not seeing the repeal Bill. There is talk now that we might not even see it much before Christmas. We have to see it soon We are getting all this talk about a no-deal hard Brexit, and these guys are actually serious about putting forward this flavour of disaster. We need to have a debate to see how much it will cost. We know that Scotland and the north-east of England will be impacted the hardest by a no-deal hard Brexit, so can we have a debate on all this Lastly, can we have a statement on Catalonia, which is perhaps the biggest crisis we have seen in mainland Europe? There is talk today of suspending the national Parliament and of repression on the streets. When will we get a statement on that?
I am grateful to the hon. Gentleman for his contribution. I could repeat all the points I have already made: I absolutely take my responsibilities seriously; I am, absolutely, Parliament’s representative in Government as well as Government’s representative in Parliament; and I am listening very carefully. As I have assured hon. Members, the Department for Work and Pensions has taken action as a direct result of points raised in this House by Members from across parties, and it will come back to this House to provide further updates on progress made as a direct result of points raised in this House The hon. Gentleman talks again about the European Union (Withdrawal) Bill. I think I have made the point very clearly that out of respect for this House, the Government are doing justice to the very significant concerns that have been raised about procedures and policy in the EU (Withdrawal) Bill, and it will come back to the House just as soon as the Government are prepared to do justice to the new clauses and amendments that have been tabled by Members. In addition, it is absolutely normal practice in this House to have a pause between Second Reading and Committee of the whole House, particularly on large constitutional Bills, to make sure that we are able properly to consider all the points raised The hon. Gentleman also raises the significant and very concerning matter of the Catalonian situation. He is right to do so, and I say again that we have all been very concerned and dismayed to see the violence on the streets in Spain. However, Spain is a very key ally of the UK, and we do urge all parties to ensure that any actions taken are constitutional and legally justifiable.
On rare occasions, I have been in trouble with the Whips for not voting for Government policy. Yesterday would have been the first time that had I voted for Government policy, I would have been in trouble. We cannot ignore the will of the House. This is about not just Opposition days, but Back-Bench business days—and what if a motion put forward by the Government is lost, because the Government ignore it The fact is that we have to have a mechanism whereby the Government formally come back and explain what action they are going to take as a result of a vote in this House. May I suggest to the Leader of the House that she considers that proposal this week, and that she comes back next week and says that that is exactly what is going to happen? Will she tell us that within 12 weeks of a vote, a Minister—perhaps even the Leader of the House—will come back and explain what action has been taken? [Interruption.] I said within 12 weeks. [Interruption.] Oh, tsk—stop! That could perhaps be called the Leadsom convention.
My hon. Friend has raised that perfectly reasonable suggestion on a number of occasions. As I have made clear, it is the intention of DWP Ministers to come back to this place to update the House on progress frequently and, I am sure, certainly within the timeframe that he mentions. I think it is very important to be clear on this: this is not some new precedent. On the universal credit issue yesterday, the Secretary of State for Work and Pensions came to this House and responded very fully to points and concerns raised by this House. It is perfectly right that the House continues to raise issues and that Departments continue to respond to them.
I thank the Leader of the House for the business announcement for next week, and for confirming the two Back-Bench business debates on Thursday 26 October on the implementation of the Modern Slavery Act 2015 and on global LGBT rights. May I, however, entreat her once again to give us some notice of future Back-Bench time? We received eight applications from right hon. and hon. Members on Tuesday this week, but we were unable to confirm to them that we had any debating time in the Chamber to allocate to them. It may be difficult at the moment for the Government to know what they want to do in their own time, but surely they could let the Backbench Business Committee know in a timely way what time they intend to allocate to us I am very privileged to say that I was re-elected as chair of the all-party group on housing in the north last night, when we received representations from a number of chief executives of housing companies in the north of England. I am afraid to say that the message from them is that housing arrears are building in universal credit roll-out areas. In the discussion earlier, the Secretary of State for Communities and Local Government told us that local authorities have a responsibility to retrofit sprinklers and undertake safety work, but if they have major problems with their housing revenue accounts and are at the borrowing cap, it is very difficult for them to do so. Some reality needs to kick in here I have one last point. I do not know if it is just me, but my mobile phone does not seem to be working as well in this building as it has done in the past. I am wondering whether the scaffolding now cladding many parts of the building is acting as a Faraday cage for mobile phone signals. If that is the case, we need to do something about it so that Members can communicate with one another and with their constituents.
I am grateful to the hon. Gentleman for his points. On Back-Bench days, as I said last week, we will always seek to give him as much notice as we possibly can. He will appreciate that there is a lot of new legislation—we are still in the early days of this new parliamentary term—and we need to get started with a number of competing priorities. He will appreciate that we will give him as much notice as we possibly can, and I was delighted that we were able to protect time last week for some of his important debates. We will continue always to listen and to seek to address any specific concerns he has On social landlords, as I mentioned earlier, it is possible to have direct payments to landlords from universal credit recipients: 34% of social sector tenants on universal credit now have such an arrangement. I encourage the hon. Gentleman to make sure that landlords are aware of that facility. I know that Ministers have taken away that point from yesterday’s debate and will look at it carefully again On the hon. Gentleman’s third point, I had not previously heard about mobile phone problems. I am pleased to say that my mobile phone still seems to be working, but I certainly understand that there may be some problems relating to the scaffolding and I will look into the matter.
Will my right hon. Friend find time for a debate on encouraging people with learning difficulties to get involved with the performing arts? On Sunday, at the London Palladium, the Countess of Wessex, the chairman of the Royal Mencap Society, Mr Derek Lewis, and many parliamentarians witnessed an absolutely inspiring performance by the Music Man Project.
I regret, in that case, that I was not invited. The Government aim to ensure that Britain is one of the world’s most creative and exciting places to live. As part of this, we are absolutely committed to ensuring access and equality within the performing arts, and of course to making sure that creative professions are accessible to talented individuals irrespective of their background. I thoroughly welcome my hon. Friend’s question, and I will look to find time for such a debate.
Has the Leader of the House seen the very worrying series of openDemocracy reports this week on the role of dark money in the EU referendum, including revelations of illegal donations to the Democratic Unionist party and new questions today over the real wealth of Arron Banks, the main financial backer of Leave.EU? Given the widespread public concern about foreign, particularly Russian, interference in western democracies, will she assure the House that the Government and the Electoral Commission will examine these reports very carefully, and reassure our country that all the resources spent during the referendum were from permissible sources?
The right hon. Gentleman raises an incredibly important point. Of course, any specific information should always be raised with the Electoral Commission to ensure that any wrongdoing is caught. I absolutely share his concern that we need to make sure that all donations are indeed permissible and legal.
Last week, I was delighted to host an event in Parliament to highlight the issues of familial hypercholesterolemia, or FH—a genetic disorder. I also ran the marathon this year in support of Cardiac Risk in the Young, which promotes heart screening. Some 1,300 young people in Eastleigh have been screened in memory of Claire Reed. Ensuring that those young people with risks are screened saves countless lives. Will the Leader of the House find time for a debate in this Chamber on heart screenings?
First, I congratulate my hon. Friend on that marathon; I remember her absolute exhaustion the following day, and we were all in awe of her achievement. She raises an incredibly important point about how screening, particularly for heart issues, can save lives. I encourage her to seek an Adjournment debate on that very important matter.
I am enormously grateful to the Leader of the House for her personal support for my private Member’s Bill, which we will be debating tomorrow. I wonder whether she could do something else to help. As things stand, if Second Reading goes through tomorrow, as I hope it will—many Members had their photograph taken yesterday in support of the Bill—and even if we get it through Committee in a couple of weeks, it will not reach remaining stages until the end of April. That is a long time. If the Government wanted to—if it had a gap in the legislative programme, perhaps—it could decide to adopt the Bill and give it Government time on the Floor of the House before Christmas, so that we could get it on the statute book.
As the hon. Gentleman is being so charming and persuasive, I absolutely assure him that the Government are behind his Bill. It is entirely right that we should protect emergency workers from abuse and violence and completely wrong that they should be attacked by people whom they seek to help. I assure him that we will make our best efforts to bring forward his Bill as soon as we can.
On yesterday’s debate and debates more generally, my observation is that there is often very little time for Ministers to respond to the many points raised by Members. Many Members spoke yesterday, but the Minister had only 10 minutes to respond. Will the Leader of the House consider making more time available for Ministers to respond I wanted to ask the Leader of the House for a debate on strategies for increasing participation rates in sport. There was an announcement yesterday by the sport that started in my constituency about Project Rugby, an initiative encouraging the disabled and those from the BAME community to play rugby. I was interested in the remarks made by my hon. Friend the Member for Southend West (Sir David Amess) about those with learning disabilities taking part in theatre. They can also play rugby. Can we encourage such initiatives?
I share my hon. Friend’s love of rugby—both the sport and the town; I am thinking in particular of my own home team, Northampton Saints. He is right to highlight Project Rugby, an excellent initiative to try to get more people with disabilities, and BAME people, to participate in the sport. It is a fantastic game and I encourage all Members to promote it as far as they are able.
I gently say to the Leader of the House that if she is worried about the number of amendments to the European Union (Withdrawal) Bill, she might consider giving it more time when it finally turns up in this House to be debated I wanted to ask the Leader of the House a specific question, Mr Speaker; I know that you recognise the important work done by the Intelligence and Security Committee. Given the serious terrorist incidents that we have seen this year and the fact that the Committee, as I understand it, has not met since April, will the right hon. Lady explain when she expects it to be established and when it will start its important work?
The hon. Gentleman is right to raise the issue. The Committee will be established just as soon as it can be. It requires that names be put forward from both sides of the House, and there are particular screening procedures and so on. I assure the hon. Gentleman that it will be re-established as soon as possible.
Does my right hon. Friend agree that it is vital for Members to able to raise their concerns, both local and national, about the ongoing defence review? Will she agree to hold a debate on the issue, which could have huge implications for my constituency if the future of RM Condor and 45 Commando is not clarified?
My hon. Friend raises a very important point not just for her constituency, but the country. I can tell her that in July the Government initiated a national security capability review—the NSCR—which will ensure that the UK’s investment in national security capabilities is joined up, effective and efficient. It is being led by the National Security Adviser. The Ministry of Defence, the Home Office and our security services will make a full contribution to that review. She may like to know that there is a Westminster Hall debate this afternoon. She may wish to take part in it.
Will the Leader of the House go back to Department for Work and Pensions Ministers and tell them it is no good them coming to the House at some point in the future? They should be here on Monday and they should be saying to people what they are going to do about the will of Parliament, as expressed in yesterday’s vote. We already have universal credit in my constituency. The latest figures from Gedling Homes show that 92% of its tenants on universal credit are in arrears. That is not an accident, but a direct consequence of Government policy. It is a new Poor Law and we need to do something about it now.
As I have said to a number of hon. Members, the Department for Work and Pensions has heard the concerns of this House. The Minister has specifically said that he will look more closely at the issue of rent arrears. A number of those rent arrears are rolled over from the previous system, and are not as a direct result of universal credit. Let us be clear: universal credit is designed to help people to get back into work. It consolidates six complex benefits into one. It provides more support, more encouragement, more ability for people to increase their hours and not lose their benefits, and more support for childcare. It is designed to help people into work and it is succeeding.
I just received a letter this morning from the Under-Secretary of State for Transport, my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) stating that the A12 upgrade is to be delayed. This is an extremely significant piece of infrastructure in East Anglia. For my constituents, it is probably their most important road. I am obviously very concerned to hear this news, but I received the letter 17 minutes after Transport questions. Given that I did not have the chance to raise the issue then, will my right hon. Friend consider a debate on road infrastructure? I am sure that many other colleagues would like to consider the significance of such issues.
I am very sorry that my hon. Friend just missed Transport questions and I can quite understand his frustration. He will be aware that billions of pounds of new road programmes are being introduced, including £2.3 billion on a new housing infrastructure fund to ensure we can provide more roads that facilitate housing development. I would be very happy to take up his specific point with the Department for Transport. I am also sure that Transport Ministers will be keen to hear from him.
While I am sure the answer was given in good faith, the answer the Leader of the House gave to my right hon. Friend the Member for Exeter (Mr Bradshaw) is untrue. The Electoral Commission has confessed that it has no mechanisms to find out whether there has been interference by cyber-techniques from Russia, by botnets and by artificial intelligence. These methods of distorting and buying elections have come in since the rules for the Electoral Commission were laid down. We must look seriously at this issue. I recommend the Leader of the House reads the journalism of Carole Cadwalladr, who has named precisely the organisations that may well have rigged the result of the referendum, because we know it is in Russia’s interests to destabilise Europe.
Just to be very clear to the hon. Gentleman, I was not suggesting that the Electoral Commission should investigate; I was merely saying that information should be reported to the Electoral Commission, as indeed it has been in all areas of fraud, misuse of voting and so on. The Electoral Commission should then be in a position to bring in the legal and police services, should it decide there is a case to answer. It is very important that as much evidence as possible is brought forward and not just left as rumours and accusations. These things need to be investigated properly to make sure our electoral system remains as free and fair as we all hope it is today.
Does my right hon. Friend agree that although winter is coming, one freeze that millions of hard-working people want maintained is the fuel duty freeze? Is she aware of the campaign by FairFuelUK and many MPs not just to keep the freeze, but to stop taxes on diesel car owners? Will she make a statement on what the Government are doing to help hard-pressed motorists?
My hon. Friend has been a real champion for drivers and has been extremely successful in his bid, in that over seven long years this Government have rejected the fuel duty increases that the last Labour Government proposed should occur automatically each year. Car drivers are now significantly better off as a result of lower fuel taxes. I suggest, however, that he makes his submission to the Chancellor in time for the Budget.
As several Members have pointed out, there is rather a large gap in the Government’s legislative programme. I am sure that the Leader of the House would like to fill it, for instance with a debate on the £400 million needed for St Helier hospital or on the funding that Sutton’s schools lack. However, I would like to support the bid by the hon. Member for Perth and North Perthshire (Pete Wishart) for a debate on no deal and its impact. Such a debate would enable Brexit supporters on the Conservative Benches to talk in advance to the businesses that would be crippled by no deal, to the communities on the border in Northern Ireland that are worried about the security considerations, and to EU citizens in the UK and UK citizens in the EU for whom no deal would be a disaster. Who knows, perhaps some of those Brexit supporters might even change their minds by the end of the debate.
The right hon. Gentleman is well aware that the Government’s clear position is of seeking an all-encompassing agreement on free trade and other matters of co-operation with our EU friends and neighbours that will be to their benefit and certainly to the UK’s benefit. Unfortunately, his position is that we should seek to subvert the will of the people as expressed in last year’s referendum. As I understand it, the position of the official Opposition and the SNP is that we should accept whatever the EU offers, which clearly would not be to the advantage of the UK people. Britain’s interests are best served by sticking with the Government in their determination to seek a sound and comprehensive agreement with our EU friends and neighbours.
The Government have done much work on, and given great support to, our cities and city regions, but our provincial towns, and particularly coastal communities, do not get the benefit of a trickle down from the economies of a nearby city. Will the Government find time for a debate on the support that they can give to our provincial towns?
My hon. Friend is a great champion for his constituency. I have had the pleasure of visiting him there twice, including to open an offshore wind farm, which I know has brought growth to his area. He is absolutely right to raise the importance of focusing on specific issues facing coastal towns, and I am sure he will be keen to seek a Westminster Hall or Adjournment debate specifically to discuss the interests of his constituency.
May we have an urgent debate on the role of the voluntary sector? I received a report today of a lady in my constituency who has had to sell her child’s pushchair so that she can pay her electricity bill. Organisations such as the East Durham Trust in my constituency are a vital safety net for the most vulnerable, but they are running low on food bank donations. The trust is crowdfunding online through its website, www.eastdurhamtrust.org.uk, for a “people’s takeaway” so that children in my constituency do not go cold and hungry owing to the roll-out of universal credit. What will the Leader of the House do to support organisations such as the East Durham Trust that are struggling to meet the growing demand of services caused by the Government’s failures, such as the roll-out of universal credit?
The valuable work done by charities and the voluntary sector that the hon. Gentleman talks about is appreciated throughout the House—it is certainly appreciated by many of our constituents. He may well wish to seek an Adjournment debate. Let me point out, however, that under this Government the number of children living in workless families has dropped by almost 1 million households, which is absolutely vital. Progress is being made. Employment is the highest that it has ever been, and universal credit is designed to help people to get into work. It is incredibly important for us to continue to pursue policies that help people to enjoy the security of a pay packet that benefits them and their families.
Will the Prime Minister be making a statement to the House on Monday about this weekend’s EU summit, and what other Government statements will be made next week?
My hon. Friend will know that statements are announced on the day by the usual methods. It is a convention that the Prime Minister comes to the Chamber to make a statement on European Councils and I am sure that she plans to do so as normal.
I congratulate the Members who secured the Back-Bench debate on global LGBT rights that will take place next week. The Government have an appalling record on the detention and deportation of LGBT asylum seekers. Will the Leader of the House confirm that a Home Office Minister will respond to that debate?
I think that all Members recognise that the Government have done an enormous amount to promote LGBT rights, including by introducing same-sex marriage. The hon. and learned Lady may well wish to raise her specific point during Home Office questions, but I think we can all celebrate the huge achievements that have been made in this country in addressing discrimination against LGBT people, and doing as much as possible to ensure that they have equal access to every aspect of our daily life.
May I join my right hon. Friend in wishing Shubh Deepavali to Hindus, Sikhs, Jains and Buddhists not only in this country, but throughout the world? I apologise in advance to the hon. Member for Rhondda (Chris Bryant) as I will not be able to support his excellent Bill tomorrow. That is not because I do not agree with it—I do—but because I shall be visiting no fewer than nine temples in my constituency and others to celebrate the Hindu new year May I invite Members who were not able to attend the Diwali reception that we held on the Terrace yesterday to join us at our seminar on Monday night? It will provide an excellent opportunity for Members in all parts of the House to understand the true meaning of this great festival.
I join my hon. Friend in celebrating this wonderful festival. I agree that it is important for us all to understand its purpose and origin, and, again, I wish all Members a very happy Diwali.
Following this week’s announcement on sentencing for dangerous driving, will the Leader of the House consider providing time for a debate on enforcement? My constituency is experiencing serious problems with dangerous and erratic driving, and it is only a matter of time before that leads to serious injury or even death. The West Yorkshire police force has lost nearly 40% of its traffic officers in the last five years. What use are new laws if they cannot be enforced?
The hon. Lady raises an important issue that matters a great deal to Members on both sides of the House, which is why we have decided to address concerns about dangerous driving. Enforcement is, of course, absolutely key. I commend the amazing work of our police forces in enforcing all our laws, and this law will be no different in that respect.
Will the Leader of the House draw the attention of all relevant Ministers a very important ten-minute rule Bill that will be introduced on Wednesday week by my right hon. Friend the Member for Newbury (Richard Benyon)? It proposes the introduction of a statute of limitations to prevent the persecution, through legal process and the courts, of veterans for events that occurred in Northern Ireland up to 40 years ago.
My right hon. Friend is very consistent in supporting the protection of those who were involved in events that happened long ago and are still under investigation today. I absolutely assure him that the Government are unstinting in our admiration for the role our armed forces played in ensuring that Northern Ireland’s future would only ever be decided by democracy and consent.
This week I attended a Government roundtable on ending gang violence and exploitation. The necessity that Government Departments develop a joined-up approach and share data to tackle the root causes was absolutely evident, so may we have a debate in Government time on how Departments can work together to tackle this important issue?
The hon. Lady raises an important matter, and I encourage her to find a way to ensure that a debate on it is held in this place, perhaps through the Backbench Business Committee. The Government take this matter incredibly seriously, and she will be aware that the Home Office is taking steps both on prevention and education, as well as on stamping out this kind of violence.
May we have a statement from the Leader of the House on modern democracy? Our constituents send us here to represent them and to hold the Government to account by voting in this place. What message does it send to our constituents when the Government feel that they can ignore the will of this House?
I say again that the Government are by no means doing as the hon. Lady suggests. We are listening. I have been absolutely clear since coming into this role that the Government are determined to listen to views from right across the House. That is evidenced by the work of the Department for Work and Pensions and yesterday’s statement, and, following yesterday’s debate, by our doing more to help those applying for universal credit, which Members across the House agree is there to help and support people, and which is succeeding in getting more people into work.
The Government guarantee the mineworkers pension scheme, but 50% of the surplus goes back into Government pockets. They have had a £3 billion windfall. Mineworkers and their families want a better deal for their years of toil at the coalface. May we have a Treasury statement so that my uncle Desi, my uncle Jackie and their comrades get their fair share?
We all agree that the work done by coalminers over so many years to keep the lights on did a huge service to this country. The hon. Gentleman might well wish to raise this issue at Business, Energy and Industrial Strategy questions, or through an Adjournment debate.
Earlier this month I had the honour of accompanying my local police force on a Friday evening shift. I was appalled by the lack of respect for our officers, so I applaud, as I am sure the whole House does, the efforts of my hon. Friends the Members for Halifax (Holly Lynch) and for Rhondda (Chris Bryant) in this area, and support the Bill that we will consider tomorrow. However, important though that is—it is truly vital—I was horrified to learn that a third fewer warranted officers are now on shift on Friday nights than was the case 10 years ago, so they are completely overstretched. May we have a debate in Government time about the number of warranted officers serving in our forces? We have lost 501 in the past eight years.
I reiterate that I share the hon. Lady’s support for the private Member’s Bill of the hon. Member for Rhondda (Chris Bryant). I look forward to it receiving its Second Reading tomorrow I understand that the hon. Lady’s police force is achieving significant progress in the fight against crime. It is performing exceedingly well, for which I congratulate it. However, as she will no doubt be aware, the proportion of officers in frontline roles has increased to over 93% from an estimated 91% in 2010, and police budgets are being protected.
More than 900 of my constituents are being placed on universal credit from 1 November, so will the Leader of the House explain how I can reassure them, given that we have no date in the diary for the Department for Work and Pensions to come and talk to us, that they are not being used as guinea pigs?
I can absolutely give the hon. Lady an assurance. As I have said several times today, universal credit is designed to help those looking for work. According to three independent studies, it has resulted in many more people finding work than was the case under jobseeker’s allowance. It is improving opportunities to get jobs, it enables people to keep more of the benefit as they increase their hours, and it helps much more with childcare costs In accordance with the DWP’s statement to the House yesterday, the scheme is also being improved so that the costs of calls to the helpline will be waived, and more instruction will be given to jobcentre officials to ensure that people know that they can get up-front emergency payments. The Department has taken away a list to consider and Ministers have assured me that they will come back with further updates as soon as they have more to tell the House about progress on addressing those issues The House called for a pause and the Department has been clear that it has just had one to ensure that it can update and upgrade systems. It plans another in January. Members should therefore be reassured that the Government are listening carefully and acting on the points that Members raised.
I am gravely concerned about the chaos in Walton prison in my constituency. It had a snap inspection, and received one out of five, the worst possible score. The governor was removed last week and the NHS trust that provided healthcare at the site has today pulled out of its contract. The mayor of Liverpool and I have learned all that through the media, with no contact from Ministers or the Prison Service. I wrote to the Minister for Prisons and Probation on Monday and I am waiting for a reply. Will the Leader of the House advise me on the breakdown in communication between the Government, the Prison Service and local representatives? Can we at least have a debate or statement on health, safety and welfare across our prisons network? What more can I do to get answers about Walton prison?
That sounds like a very concerning issue and the hon. Gentleman is right to be worried about it. I understand that the Secretary of State for Justice will meet the chief inspector of prisons today to discuss the specific issue and I am certainly happy to raise the matter with the Secretary of State after business questions However, the hon. Gentleman will know that we are putting an extra £100 million a year into the frontline to recruit 2,500 more prison officers by the end of 2018 and investing £1.3 billion in a modern, fit-for-purpose prison estate, with up to 10,000 new modern prison places during this Parliament. The hon. Gentleman is right to raise the issue and I will happily take up the specifics with the Secretary of State.
It was not just Opposition Members voting against universal credit yesterday who defeated the Government, but the will of the people at the general election, which decreed that the Conservative party does not have an overall majority in the House. The Government have bunged some money to the Democratic Unionist party and they think that that gives them the right to behave as if they have an overall majority, but they do not. We need from the Leader of the House—our representative in the Cabinet—a statement about what she will do to ensure that the minority Government respect and act upon the House’s decisions.
The hon. Gentleman needs to ask himself why, if the Conservative party has no right to govern, we are sitting on this side of the House. The Conservatives won 56 seats more than the nearest party to us, and we are governing under well-established rules through a confidence and supply agreement The hon. Gentleman again raises the issue of money going to the Democratic Unionist party, but that is not the case. There is further investment for the restored Northern Ireland Executive, but to be clear, according to the latest figures, only £232 per person has been spent in recent years in Northern Ireland on transport, compared with £504 in Scotland. It is right to provide the money that goes to Northern Ireland for city deals and to promote health and infrastructure. The Government have provided many billions of pounds for city deals in other parts of the United Kingdom, so there is nothing strange about that As I have said time and again, the Government are determined to listen to colleagues from all parties. We continually revert to the fact that the Opposition are determined to talk about process rather than the serious policy challenges that face our country on which the Government are determined to make progress.
I thank you, Mr Speaker, for your wise words last night about the huge number of points of order that were made. Unfortunately they have fallen on deaf ears. The Government showed disrespect not only to Parliament but to my constituents, who continue to suffer day in, day out, under the ill-thought-out universal credit scheme. Instead of trying to answer the questions herself, will the Leader of the House get a Minister from the Department for Work and Pensions here on Monday so that the Department can be held accountable for its actions and show respect for Parliament’s vote yesterday?
I say again that the universal credit programme has received approval across the House because it is helping more people into work. It enables people to keep more of their benefits as they increase their hours and it helps with childcare costs. It is intended to help people. The Department has made it clear that it has listened to points from hon. Members of all parties about implementation, and it is taking action, such as getting rid of call charges to the universal credit helpline and ensuring that people know that they can get emergency payments up front. Evidence shows that the scheme helps people to get into work and gives them the security of a pay packet that benefits them and their families.
There is no pause in Scunthorpe, where universal credit is being rolled out this week. Local partners, whether Ongo, the social housing provider, private landlords or the citizens advice bureau are genuinely concerned that what my hon. Friend the Member for Gedling (Vernon Coaker) described—an increase in rent arrears and evictions—will happen locally. What would the Leader of the House say to my constituents, who hear that the House has said so clearly that there should be a pause, when nothing then happens?
I would say to the hon. Gentleman’s constituents that the Department for Work and Pensions has listened to the House and acted straight away. There has just been a pause, and that is why the Department could take action quickly to improve the roll-out of universal credit. A further pause is planned for January, and DWP Ministers will come back to the House to provide further updates in due course. The hon. Gentleman’s constituents should therefore be reassured that this benefit, which is designed to help them get back into work, will be improved as much as possible.
It is not just universal credit that causes people untold misery. I have a constituent, Mr McMaster, who, when he transferred to a personal independence payment from a lifetime’s enhanced disability living allowance award, was given only four points and lost his benefits. The stress that that caused meant that his marriage suffered, he tried to commit suicide and he nearly lost his house and car. Out of sheer desperation, he reapplied for PIP, using the same evidence that had been presented previously. Luckily, the right decision was made and he was given an enhanced award in both categories. Will the Leader of the House make a statement outlining what the Government will do to review that iniquitous system, and will she apologise to my constituent?
The hon. Gentleman is right to raise that case. As constituency MPs, we all have examples of where we are not happy with interpretation or with the assessment of individuals, and it is right to raise such cases. I am pleased to hear that his constituent has had a good result, and I commend him for taking up that case. However, it is important from a policy point of view that proper systems are in place to assess those who receive disability benefits, that that is fair and is seen to be fair and that there is an appropriate appeal process, in addition to support from MPs, when we feel that the outcome is in doubt.
The trade unions from BAE Systems at Brough are visiting Parliament this week to talk to MPs about potential job losses, and 140 MPs from both sides of the House have signed a letter asking the Government to think again about the out-of-service date of the Red Arrows Hawks, many of which were built in the 1970s. Is it therefore not time for a statement about securing those jobs and, more importantly, our sovereign capability?
I share the hon. Lady’s enthusiasm for the Red Arrows, which are beloved in this country and do a fantastic job. To be clear, there is no requirement to replace the Red Arrows Hawk T1. We have a large fleet of around 75 aircraft from which the Red Arrows display team can draw. There has been no reduction in Red Arrows flying hours, and it is incorrect to suggest, as some have, that numbers have been reduced at displays. The Government have helped to secure orders for Hawk aircraft from Qatar, securing production for next year, and we are pressing hard for further export deals. There is no need for an early replacement for the Red Arrows as a decision is not needed until at least the end of this Parliament.
May we have a statement detailing the Government’s expectations for lifeboat provision? There is considerable concern in Ceredigion that proposals under the recent coastal review of Cardigan bay would leave the entire Ceredigion coastline without sufficient all-weather lifeboat provision.
The hon. Gentleman makes an important point, and I encourage him to go direct to the Department for Transport. If it is aware of the situation, it will be equally concerned. If he would like to write to me, I am happy to raise the matter on his behalf.
Over the past three months, I have attended the opening of four pensioner lunch clubs. The common theme coming from the groups, which are mainly run by volunteers, is that pensioners are lonely and are struggling to feed and cook for themselves. The clubs are trying to help to build community cohesion. Will the Leader of the House find space in Government time for a debate on loneliness and its impact? It would allow colleagues on both sides of the House to highlight the excellent work of the commission on loneliness set up in the name of our former colleague Jo Cox.
I commend the Jo Cox Commission on Loneliness for its excellent work. I have taken part in some of its presentations in the Speaker’s apartments, and I congratulate you on raising awareness, Mr Speaker. I agree with the hon. Gentleman that loneliness among the elderly is a serious concern, and I have initiatives in my constituency to try to bring people together more frequently so that communities can work together to try to alleviate loneliness. I am happy to support any proposal that he wants to make to highlight that issue further. I would add, however, that I am proud of this Government’s efforts to ensure that pensioners are now much better off than they were when we came into government in 2010 and to protect pensions and the pensioners’ uplift, which has been incredibly important for those on low fixed incomes.
My constituent Mrs Withers has been caring for her diabetic grandson since 13 August. She has thus far received no financial support due to non-co-operation from the child’s mother, who has been given until November to respond to requests to transfer benefits to the grandmother. May we have a debate in Government time about the financial support available for those who take on emergency childcare arrangements and about ensuring that guidelines and payments are consistent throughout the country?
I am sorry to hear about what is obviously a difficult situation, which the hon. Gentleman is absolutely right to raise. I encourage him to speak directly to the Department for Work and Pensions, which I urge to take up this specific issue.
The Leader of the House says that the Government are listening, but the only thing they did yesterday was scrap helpline charges. It frankly beggars belief that it takes an Opposition day debate for the Government to decide that 55p a minute is too much to charge cash-strapped people to call the very Department that is making them cash-strapped. The Secretary of State for Work and Pensions kept recommending yesterday that claimants visit their local jobcentre, but at the same time the Department is shutting nearly 70 jobcentres across the country. Sheffield’s Eastern Avenue jobcentre is due to close on 17 November, but the Department is yet to publish a cost-benefit analysis for the decision despite claiming that it is based solely on the need to make savings. I am yet to be convinced that the Department has even conducted such an analysis, so can we have a debate in Government time on that decision before the jobcentre is closed, causing misery for claimants in the area?
I gently say to the hon. Lady that she cannot have it both ways. She cannot complain that the Government are not listening to the House and then say that it is not right that the Government should act on the views of this House, rather than independently. That seems a little back to front. On universal credit, the key point is that the Department for Work and Pensions is responding both to its own pauses and its experiences of the roll-out of universal credit to date and to the representations of Members from right across the House. The Government are determined to make universal credit a huge success and to deal with implementation issues as they arise. I assure Members that that is the case As for jobcentre closures specifically, the hon. Lady will be aware that we still have a significant fiscal challenge as a result of the state of the economy that we were left with in 2010. We continue to try to take steps to live within our means. I know that Opposition Members do not understand this, but the reality is that every day we continue to spend more than we receive in taxes means another day of debt for which our children and grandchildren will be forced to pay, so we need to live within our means. The reduction in jobcentres is actually being offset by an increase in the number of work coaches, who will provide more support to people who need it. We are merging a number of smaller offices into bigger sites, so that we can save the taxpayer money, but we are not changing the service we offer. Wherever possible, we are improving that service for those who are looking for work.
On Tuesday, Muhammad Safdar made several discriminatory comments in the National Assembly of Pakistan against the Ahmadiyya Muslim community of Pakistan. He accused the faith group of being untrustworthy and a threat to Pakistan, arguing that it should be banned from the armed forces. Coming from the son-in-law of a former Prime Minister, such comments are dangerous and will surely fuel prejudice towards the already persecuted Ahmadiyya Muslim community. Will the Leader of the House agree to a statement on that pressing issue?
The hon. Gentleman raises a significant issue. I absolutely encourage him to raise it directly with the Foreign Office, which will no doubt have further information to share with him on the steps that the UK Government can take.
Linked to universal credit is the whole question of funding, including for women’s shelters, for example, and nursery provision. Can we have statement on that?
The hon. Gentleman raises a separate issue about support for women who are suffering from domestic violence, and I assure him that—[Interruption.] Am I misunderstanding his question?
My point is that the two are linked, but if the Leader of the House wants to talk about it separately, the issue is about funding for women’s shelters, which has been badly cut.
Then I think I did understand the hon. Gentleman correctly. He raises an incredibly important point about protection for women who are experiencing domestic violence, and DWP Ministers took away some action points from yesterday’s debate to look more at ensuring that women who need protection from abusive partners are receiving it. More broadly, the hon. Gentleman should welcome, as we all do, the Government’s bringing forward of new measures to try to protect people from domestic violence and other domestic abuse, which is so appalling and unacceptable in this country.
Will the Leader of the House join me in celebrating the British citizen youth awards? The awards are being granted today to celebrate young people from across the country, including my constituent Grace Warnock Will the Leader of the House also provide a statement on how her discussions are going on topical questions on devolved matters?
I am delighted to congratulate Grace. The hon. Gentleman did not say what she is receiving her award for, but the House congratulates her The question about the time allotted for topical questions on devolved matters comes up from time to time, and we regularly review it. Obviously there is sometimes a challenge that questions on UK issues would be appropriate for other Departments, rather than just the territorial offices. There is always a balance to be struck in ensuring that questions go to the Departments that are best able to give the appropriate answer.
On Monday we had the incredibly disappointing news of 400 redundancies at Vauxhall, and I was grateful for the opportunity to raise it on the Floor of the House that day through an urgent question. I will return to the issue of the plant’s future in the coming weeks and months, but there was also other news on jobs that day in the form of a constituency-by-constituency report on the effects of automation. The report predicted that around 30% of jobs in my constituency will be lost to automation in the next 10 to 15 years, and the figure is higher in other constituencies. I just do not think the Government have a strategy or plan to deal with that impending challenge, so can we please have a debate?
The hon. Gentleman is right to raise the very concerning issue of job losses at Vauxhall, and he has done so again today. He will be aware that the Government are doing everything possible to ensure that those who lose their job are helped into work elsewhere. I am sure he would join all Members of the House in celebrating the fact that there are over 3 million more people in work than in 2010, that there are more than 3 million apprenticeships for young people and that there are almost 1 million fewer workless households with children than in 2010. Those are all things to celebrate and, as it kicks in, automation should enable us to transform jobs into the skilled jobs of the future, which is why I am delighted that the Automated and Electric Vehicles Bill has its Second Reading next week. The Bill will create more high-technology, skilled work in this country.
When I arrived in the House a few months ago I knew that democracy was not necessarily the most efficient process, but last night I realised just how dysfunctional it is at present. It was the fourth time that the Government have been defeated on a substantive issue. We are obviously spending a significant amount of valuable time on such issues, so we should be heard. We should have received a statement from the Government last night. Will the Leader of the House ensure that the Government hear our views?
I assure the hon. Gentleman that the House’s views are being heard by the Government. As I have said throughout today’s business questions, the Department for Work and Pensions has heard not just the issues raised in yesterday’s debate on universal credit but what Members on both sides of the House have said in recent weeks. The DWP has not just heard but has taken action. The business discussed in this House is always heard by the Government, who take careful action on it. I assure him that that will continue.
On a point of order, Mr Speaker. Yesterday, my hon. Friend the Member for Southend West (Sir David Amess) mentioned the sad passing away of Sir Teddy Taylor. I also bring to your attention the sad passing away over the summer of the former MP for Keighley, Mr Gary Waller. I mention it because he was president of the Harlow Conservative Association for a number of years, and he was also a councillor for Sheering, a village in my constituency. He was incredibly active.
I am grateful to the right hon. Gentleman for his point of order, which gives me an opportunity to respond sympathetically. Sir Teddy Taylor was very well known to me, and he offered me much encouragement in the early years when I was contemplating the possibility of a political career. I remember Sir Teddy coming to speak at Essex University in, if memory serves me correctly, January 1984. Although it was 33 years ago, I remember it as keenly as if it was yesterday. I have written to Sheila to offer my condolences. Much was said yesterday about Sir Teddy that was fully merited Gary Waller I also knew, although much less well. I heard about his passing over the summer, not least from his ex-wife. He was very well known, and he was a very cultured individual. I think it entirely fitting and characteristically gracious that the right hon. Member for Harlow (Robert Halfon) has recorded his respects in this way.
On a point of order, Mr Speaker. Have you had any notification from the Government on whether they intend to make a statement on the military campaign against Daesh in Iraq and Syria? I am sure you will be aware of the widespread and authoritative media reports showing that Raqqa has fallen and that Daesh has been evicted. Given that the Government asked for and got specific authorisation from this House to deploy UK armed forces in that theatre of war, I would expect them to come forward as soon as possible with an update on what is happening.
I am grateful to the hon. Gentleman for his point of order. I am aware and other colleagues will be conscious of his long-standing interest in these matters. That interest, incidentally, will be very widely shared by other colleagues. I have received no indication from any Minister of an intention to make a statement. Ministers and other occupants of the Treasury Bench will have heard, or will shortly hear of, his point of order. It is perfectly open to Ministers to volunteer to come to the House next week to make a statement Alternatively, and possibly as an attempted insurance policy, it is open to the hon. Gentleman to seek other means by which to secure the presence of a Minister. If I may very gently say so, Members undertaking such initiatives can benefit from the advice I am about to proffer, which is that such submissions should be detailed and comprehensive. When such written submissions are detailed and comprehensive in initiating, developing and concluding a compelling argument for the presence of a Minister, they have a greater prospect of success.
I beg to move, That this House has considered the Government’s publication of the new Tobacco control plan I begin by thanking the Backbench Business Committee for allocating time for this very important debate. I also welcome the Minister to his new post in the Department of Health, and I am sure he will hear much more about this issue in the months to come I have no financial interest, but I should mention that I am an honorary fellow of the Royal College of Physicians, as it is heavily involved in the debate on tobacco I have repeatedly called in this House for the publication of a comprehensive tobacco control plan to replace the Government’s previous plan, “Smoking Still Kills,” which expired in 2015. I welcome the Government’s publication of this new five-year strategy this summer, which seeks to achieve what they term a “smokefree generation” Despite a long-term reduction in smoking rates, tobacco use remains the leading cause of preventable premature deaths and ill health, accounting for about 100,000 deaths each year in the UK. In addition, 23% of all hospital admissions for respiratory problems in 2014-15 were directly attributable to smoking. I thoroughly welcome the falling adult smoking rates in England—down from 46% in 1974 to 15.5% in 2016—but I have to say to the Minister and to the House that we cannot take this work for granted. That is why we need the tough but achievable targets that the new current control plan contains Smoking and the harm it causes are not evenly distributed, as hon. Members will know. People in more deprived areas are more likely to smoke and less likely to quit. Smoking is increasingly concentrated in more disadvantaged groups and is the main contributor to health inequalities in England. Men and women from the most deprived groups have more than double the death rate from lung cancer of those from the least deprived areas of the UK. I am not saying there is exactly a north-south divide, but where money is divided in such a way that is likely to happen. Rates do vary between north and south on occasion, as we see if we examine smoking during pregnancy rates, which vary from 2% in the Central London clinical commissioning group area to 27% in the Blackpool CCG area.
Data produced by Public Health England show that in my local authority area 18.1% of women smoke at the time of delivery compared with the national average of 10.6%. The plan says that it will reduce the prevalence of smoking during pregnancy. Does my right hon. Friend agree that every CCG and local authority will have to have sufficient funds to carry this work forward?
Clearly that is the case. I agree with this publication and its intention, but there will be issues to address on different forms of funding. I will discuss that a little later in my speech. We can see from the two figures from central London and Blackpool that there is a challenge out there; this difference alone can have a dramatic impact on health inequalities, as maternal smoking causes up to 5,000 miscarriages, 300 perinatal deaths and 2,200 premature births in the UK each year In my area of Rotherham alone, the smoking rate among people in managerial and professional occupations is about 10.2%, but that leaps to 29.4% among those who have never worked or are long-term unemployed. Such facts clearly show that we are still struggling to get through to certain groups within society, and the Government must do more to identify ways of getting through to these difficult-to-reach groups.
The right hon. Gentleman is setting out the harm caused by tobacco. As a recent convert to the benefit of e-cigarettes in assisting people to stop smoking, I wonder whether he will be talking about the valuable role they play. Does he agree that it is a bit of a shame that the tobacco control plan does not go further in recognising the role that e-cigarettes can play?
I will comment on that, but I think the hon. Gentleman ought to be happy that this is the first time in any tobacco control plan that e-cigarettes have been mentioned and there is some intent to do things with them I welcome the acknowledgment of the seriousness of the issue for people with long-standing mental health problems, as the smoking rate is a staggering 40% among those with a serious mental illness. That is another area that needs to be targeted and worked on. The control plan rightly states that joined-up working and integrated commissioning between local government and the NHS are very important. This is not just the case in hospitals when people are admitted; we must focus on prevention and early diagnosis. For example, dentists are the only healthcare professionals who frequently see healthy patients and so are in an excellent position to identify possible oral health problems early on.
We welcome the tobacco plan and the reduction in the number of people who smoke from 20% to 16%, but there is one anomaly here, to which the right hon. Gentleman has referred. I refer to chewed tobacco, as it is not mentioned in this plan and there does not seem to be any plan to address this. Oral cancer is one of the major cancers across the UK, with some half a million people affected by it. Action on this was recommended 11 years ago. Does he feel, as many in this House feel, that chewed tobacco should be part of this tobacco plan and that there should be legislation to address this?
I am going to go on to discuss some of the issues relating to that situation. As I said, dentists are the only ones who normally see healthy people. I am aware that some GPs—we have one sat here in the Chamber—talk to healthy people even though these people do not think they are healthy at the time, but the situation is a little different for dentists. This early identification is crucial, as mouth cancer patients have a 90% chance of survival if the condition is detected early, but that plummets to just 50% if their diagnosis is delayed I say to the hon. Gentleman that I worked in an industry where people used to chew tobacco because we could not smoke at work. I tried it once at the age of about 16 and I am pleased to say that I never went near it again, although I used to smoke cigarettes when I came up from underground—that is a long, long time ago now. The general health implications of smoking are well known and documented, but mouth cancer often gets overlooked. This is the point: despite its killing more people in the UK than cervical and testicular cancers combined, there is still an alarming lack of public awareness towards oral cancer. There are thousands of chemicals contained in a single cigarette, and their point of entry is the mouth. Smoking helps to transform saliva into a deadly cocktail that damages cells in the mouth and can turn them cancerous Pharmacy teams also have an important role to play in promoting and encouraging attempts to stop smoking; as Members will know, in Healthy Living pharmacies and others, this is part of the job they do in advising people. These teams can be trained to be very effective in that. This often occurs in the community, but hospital and GP-based pharmacists are also well placed to offer this support. They are well placed to offer stop-smoking interventions with behavioural support and medication. In fact, the National Pharmacy Association is re-evaluating its position on e-cigarettes. As frontline healthcare professionals, pharmacists and dentists are exquisitely positioned to make a difference to health outcomes The Government must look to protect public health funding for stop-smoking services in particular if their aims are to be achieved. A growing number of local authorities have already stopped providing stop-smoking services for general smokers. The King’s Fund also highlighted that in 2017-18 local authority funding for tobacco control faces cuts of more than 30%. We have seen the transfer of commissioning responsibilities for public health services to local authorities, and subsequent cuts to the public health grant. A study by Cancer Research UK and ASH—Action on Smoking and Health, an organisation I have been involved in for more than two decades—found that 39% of local authorities reduced their smoking cessation budgets, despite the public health budget being ring-fenced by central Government. These are the issues that are happening down below, but we need to be aware of them All this has led to a reduction in mass media campaigns to motivate quitting, which are so vital to direct people towards the services that are on offer. Only this morning, I saw that the British Lung Foundation has published a report showing, yet again, that stop-smoking support is one of the most cost-effective treatments for people with COPD—chronic obstructive pulmonary disease Recently, in my role as vice-chair of the all-party group on smoking and health, I visited a smoking-cessation service—the one led by Louise Ross in Leicester. The team in Leicester have been trailblazers in the use of e-cigarettes for cessation purposes. They told me that Leicester’s stop-smoking service was the first in the country to go “e-cig-friendly” on No Smoking Day 2014. Since then, the team has built up a comprehensive bank of knowledge and insights, developed from many discussions with both vapers and smokers, that can be drawn on to help people get the best advice when they decide they have had enough of smoking. I had a discussion with a nurse who works in that service and who was using e-cigarettes in working with pregnant women to try to address our awful statistics on the effect of smoking in pregnancy. Most smoking-cessation services could do worse than talk to the people in Leicester about exactly what they are doing on that There has clearly been an increase in e-cigarette usage since the publication of the previous strategy in 2011: in 2012, there were some 700,000 e-cigarette users, and that had risen to 2.8 million by 2016. There is growing evidence to support the successful use of e-cigarettes as a smoking cessation aid. The Office for National Statistics found that in 2016, some 470,000 people were using e-cigarettes as an aid to stop smoking, while an estimated 2 million people had used the products and completely stopped smoking. I believe that e-cigarettes played a huge part in the beating of the target in the previous tobacco control plan. It is clear that e-cigarettes do not suit everyone, though, so there still needs to be a wide range of licensed stop-smoking medication to use alongside much-needed behavioural support.
Some 4,000 people in my Stockton North constituency use e-cigarettes and 14,000 people still smoke. Can my right hon. Friend envisage a day when e-cigarettes are available on prescription, like other products?
I actually had this conversation in Leicester, although I was not going to mention it in my speech. There is an issue—I think it was in a column in one of the national newspapers many months ago and I have tried to avoid it. If somebody avoids spending £20 or £25 a week on cigarettes, should they get free NHS prescriptions, if they are eligible, to help them to quit? There is a debate there, but I shall say no more than that at this stage I asked the team in Leicester what they thought about e-cigarettes on prescription for people who are eligible for free prescriptions, and they said that there might be a case for doing it for a month to break the person away from the cigarette-smoking habit and get them on to e-cigarettes. For the purposes of this debate, I shall leave that where it sits, but there might be a case for it. We clearly need more evidence on the use of e-cigarettes for smoking cessation so that we can make a better estimate.
I accept that the right hon. Gentleman wishes to park the issue of whether e-cigarettes should be available on prescription, but does he think that e-cigarette manufacturers should have a little more freedom—the tobacco products directive places restrictions on the advertising of e-cigarettes—to tell people about the nature of their products and how they can help people to switch from tobacco?
I shall address that briefly, because I know that other Members wish to get involved in the debate. The simple answer is that that is one of several issues that need to be addressed. The best thing smokers can do for their health is of course to quit smoking altogether, but it is clear that e-cigarettes are significantly less harmful to health than smoking tobacco. Public Health England found that e-cigarettes are around 95% less harmful than smoking cigarettes. My instinct is that the remaining 5% is down to the fact that they have not yet been tested for long enough for it to be said that there is little or no danger at all. There is no evidence that e-cigarettes act as a smoking gateway for children or non-smokers, but research is still needed on their long-term use, and it should be carried out. Quitting smoking is always best, but there is clearly a hard core of smokers who have so far struggled to quit; they must be the people we focus on. It is worrying that an ASH survey found over a three-year period that the number of people who thought that e-cigs were “as or more dangerous” than cigarettes rose from 7% to 26%. That is why we need Government-funded research. I find it incredible that statistic is moving in that direction, rather than the opposite, although I must say that the debate on e-cigarettes, both in the Chamber and elsewhere, has not always been particularly clear Other innovations are continuing the “nicotine revolution”. Manufacturers are developing additional smoke-free products to persuade heavy smokers who would not otherwise quit smoking to switch to smoke-free alternatives, among which are the heated-tobacco products that have come on to the scene in the past year or so. Referred to in the “novel tobacco products” category of the tobacco control plan, such products could be the next step to reaching those hard-core smokers who, although they did not get on with e-cigarettes, are looking for another way out of smoking. I was pleased to see in the plan that Public Health England will continue to lead the investigation into the use of novel products as stop-smoking tools, with the evidence updated annually, and that PHE acknowledges that novel products are currently the most popular aid to stopping smoking in England Many people are wary of so-called novel products and the fact that many are produced or funded by tobacco companies. We must recognise that tobacco companies have in the past been extremely dishonest about the harms of smoking and the products they have sold, so we urgently need more research on these devices, and I hope the Government’s annual review will help to provide more information. I have been anti-tobacco for more than two decades in this House, but we should not ignore the potential benefits for people who have not been able to stop with more traditional smoking-cessation products just because some of these products have tobacco connections. It is vital that we all focus our minds on the reality of getting people off this habit that is still killing people and shortening the lives of more than 100,000 of our fellow citizens every year Many of the products I am talking about are covered by the EU tobacco product directive, which has resulted in many good things, including the establishment of reporting and notification requirements for tobacco products. Nevertheless, stakeholders have raised issues with some of the other requirements, and we may be able to use Brexit as a chance to look at the directive. I understand that we have been thrown into the TPD at the last minute. We have had the debate and I do not want to bore anyone with it further. We need to move on, because that is what happens in politics sometimes. We need to talk about what should be happening now and in future for the sake of our fellow citizens. Brexit is coming, so we should not be tied into a timetable for any changes to the TPD—although I do not even know the potential timetable for any further debate on Brexit. Nevertheless, if there is any discussion about changes to the TPD, we need to ensure that all stakeholders are involved in working groups to design a directive that works for the good of the United Kingdom, taking into account the issues I have mentioned For all its positives, there is a glaring problem with the tobacco control plan, and we all know what it is: money. Although not short on lofty ambitions, local authorities face huge strain and will not be able to deliver the kind of joined-up smoking-cessation services that the tobacco control plan deserves. Luckily, there are people who can help. Tobacco companies have made a fortune selling cigarettes. We might well argue that they got us into the mess we are now in, so it is only right they get should us out of it. They have the resources and customer base to help smoking cessation tools to get straight to the people who need them most. If the industry is willing to commit to a future based on e-cigarettes and other reduced-harm products, we should take them up on the offer and allow the Government and local authorities to partner with them to ensure we have the financial and technical assistance needed to help smokers to quit. I would not have said that five years ago, but five years ago we did not have these products that can clearly help a lot of our fellow citizens to get off cigarettes.
It was remiss of me earlier not to pay tribute to my right hon. Friend for all his work on this issue in recent years. Will he talk a little about people with mental health conditions and the fact that the tobacco control plan emphasises the need for parity of esteem in their treatment, in a similar way as there should be parity of esteem between the treatment of mental health conditions and the treatment of the general population? For that parity of esteem, the professionals who work with people with mental health conditions would need the necessary expertise and education. Will my right hon. Friend join me in encouraging the Minister to step up education for mental health professionals so that they, too, can be part of the campaign to help people to quit smoking?
I will indeed. The use of e-cigarettes in mental health institutions or in prisons could go a long way towards alleviating some of the problems in such institutions. When I was Chair of the Health Committee, we looked into smoking in public places in 2005-06, and we saw tobacco in effect being used as a form of control in some institutions, and everyone knew the damage it was doing to the people in those institutions. A lot of institutions have moved on now, though. It is a matter for the Prisons Minister, not the Minister who is present, but we need to consider the availability of e-cigarettes in such institutions so that we can get people away from this life-threatening habit In conclusion, the tobacco control plan offers the groundwork for a comprehensive strategy that is much broader than just cessation and that must include measures that reduce uptake as well as those that increase quitting. They should include reducing the affordability of tobacco by increasing taxation, which has been happening in this country for many years now. I will certainly have a close eye on the Budget in a few weeks’ time, as we need a renewed commitment from the Government to the tobacco tax escalator. Any money that is raised should be ring-fenced for use in smoking cessation and mass media campaigns to motivate quitting and enforcement of age of sale, which is also an issue. When the mass media campaigns ended after the 2010 general election—people were no longer seeing them on television or in other parts of their life—the demand for smoking cessation services reduced We all want a smoke-free society as soon as possible. We on the Labour Benches, and even some tobacco companies, are now saying that as well, so the Government could not ask for a better opportunity to take this further, to do it more comprehensively and with more success. The challenge now is to make sure that reality lives up to these ambitions. The tobacco control plan needs to be properly implemented and built on if we are to achieve those goals.
Order. Before I call the next person to speak, may I say that we have plenty of time for this debate and I hope that we will manage without a formal time limit? I much prefer to rely on the reasonableness and honour of hon. Members to have regard for others as well as themselves. If every speaker takes approximately eight minutes or so, then everybody who has indicated their wish to speak will have an equal chance to do so. If that does not happen, I will impose a time limit.
I am delighted to have the opportunity to speak in today’s debate on the Government’s tobacco control plan, which was unveiled in July 2017 and is supported by the British Heart Foundation. It is a co-ordinated effort to bring together the NHS, the Department of Health and local government to tackle smoking Although smoking in the UK is declining, the problem should not be underestimated. There are still 7.3 million adult smokers in the UK, and more than 200 smoking-related deaths a day in England, which costs the NHS millions every year. I welcome the plan and the £16 billion that has been ring-fenced by the Government for local public health services until 2021 Those who use a local stop-smoking service are four times more likely to quit. The figures are astonishing. As the daughter of a smoker of more than 20 years, I have seen at first hand the journey that needs to be replicated to achieve the goal of a “smoke-free generation” The success of the 2011 to 2015 tobacco control plan reduced adult smoking rates from just over 20% to just over 15%. The aim now is to reduce rates to 12% and lower by 2022. That is not only right, but essential. We must work to save the 79,000 preventable deaths in England per year and the £11 billion that smoking is costing the economy Smoking is not a necessity. A cigarette is not a fashion accessory; it is the way towards lung and mouth cancer, strokes and heart disease and a host of other ailments and illnesses that kill. Let me be clear: I believe in choice and individual freedom, but I also believe that the Government have a role not only to guide, but to signpost and to promote the choices that will lead to healthier lifestyles. That is why I am so proud that the Government are prioritising the issue of smoking Some people have said to me: “Michelle if people want to smoke, let them.” I respond by saying that we must arm those people with all the information—the warnings and the facts. We must work together to deglamorise smoking. As has been pointed out, the smoking industry also has a responsibility to play its part. We must guide people and steer them to make informed choices. We must also discourage them, otherwise we will have to pay their NHS bills—money that could be spent in other sectors of the NHS. I often ask people, “If smoking were invented today and we knew all the risks and effects, would it be so freely available and popular?” Armed with the facts, we often make different choices in life My mother started smoking in an era when the health consequences were not known. I saw her struggle, desperately trying to give up. My Dad describes that time as a caricature, with my mother wearing anti-smoking patches and smoking cigarettes, while chewing anti-smoking gum and seeing a hypnotist, all at the same time. She simply tried everything. All the hypnotist did was to get her on to menthol cigarettes and give her a fear of hypnotists, so that did not go quite to plan. That taught me that, to break the cycle, it needs to be killed at the root, and people need to be prevented from smoking in the first place. I must add that my Mum has now not smoked a cigarette for seven years. [Hon. Members: “Hear, hear.”] Instead, she has e-cigarettes. Although that cannot be seen as the answer, it is very much part of the solution As part of the tobacco control plan, I want to touch on the support provided for pregnant workers, which aims significantly to reduce the likelihood of a person smoking while having a child. Currently, more than 10% of pregnant women smoke, and the plan is to get it down to 6%. Smoking during pregnancy increases the risk of stillbirth. Babies born to mothers who smoke are more likely to be born underdeveloped and in poor health. It is important that we give those mothers all the support and information available. For example, within the plan, NHS England will work to reduce smoking in pregnancy through carbon monoxide testing at antenatal care facilities and referrals to stop smoking services through the Saving Babies’ Lives care bundle Support, advice and information are crucial. We must make sure that all mothers are aware of the dangers of smoking. I urge us to be bold—bold with our information and bold with our warnings.
Information is key to this matter as well. ASH has told me that the Government no longer have the measure of the number of people with mental health conditions who smoke. Does the hon. Lady agree that the Government need to re-establish a national measure for smoking rates among people with mental health conditions, as that will aid planning and the provision of services?
Indeed, we have problems among many categories in the country. By 2018, the target is to ensure that all mental health facilities are smoke free. We need to identify why people with mental health problems are turning to smoking and then target those issues I urge us to be bold with our information and warnings. We should not be afraid to shock in our marketing material, because we in this House have a duty to those who have yet to have a voice and the ability to choose for themselves As I mentioned before, perhaps the section of the plan that will prove the most successful is the backing of evidence-based research into e-cigarettes. As the right hon. Member for Rother Valley (Sir Kevin Barron) said, it is the first plan to reference e-cigarettes. In 2016, it was estimated that 2 million people had used e-cigarettes and completely stopped smoking, while a further 470,000 were using them as an aid to quit There has been a great deal of discussion on e-cigarettes—the pros and the cons—so what is needed now is more evidence to support them and enable their use positively. They are not risk free and they are addictive—it would be wrong not to mention that—but I agree with Public Health England, which recommends that e-cigarettes are used in areas not covered by the smoke-free legislation and that organisations do not include them in their smoking policies. It is true that we do not know the full extent of the medical effects, but we do know that, for the majority of people, they are the only way to stop smoking and they are by far a better alternative In addition, statistics show that people rarely start on e-cigarettes. They use them as a way of breaking their cigarette addictions. It is important to remember that, to tackle smoking effectively, we need a prevention strategy as well as a strategy to help people quit smoking. Dr Andy McEwen, executive director of the National Centre for Smoking Cessation and Training, stated that switching from tobacco to e-cigarettes substantially reduces the major health risk. I urge the Minister to push the case for a review by the National Institute for Health and Care Excellence, which currently is at odds with Public Health England on this topic As I said, we have seen many worried headlines about e-cigarettes, particularly for young people. However, the latest and largest study, based on five separate surveys, gathered data from 2015 to 2017 and was from a collaboration including experts from Public Health England. It showed that a tenth to a fifth of 11 to 16-year-olds had tried an e-cigarette. However, only 3% or fewer used them regularly, and they were already smoking tobacco-based products. Among young people who have never smoked, the use of e-cigarettes was completely negligible, despite the media headlines. It is also important to remember that they are restricted in terms of the minimum age sale and the tight restriction on marketing. Let us be clear: the best thing that a smoker can do is to quit smoking. However, the evidence is increasingly clear that e-cigarettes are significantly less harmful to health than smoking tobacco Another area that I want to mention is inequality in smoking. By 2022, the Government expect to reduce the inequality gap in smoking prevalence between those in lower paid or manual occupations and those in higher paid or professional occupations. For example, the plan includes promoting links to “stop smoking” services across health and care systems in the UK. However, it is important that we look at the causes, not just the symptoms, when we examine why those in lower economic circumstances smoke more, and why they struggle more to quit. That is why support to councils is so vital, so that they can identify local trends and solutions. I would be interested to hear more about the Government’s plans to invest in research into the causes. We do need to pay more attention to the challenges that are faced by the disadvantaged and those from lower socio-economic groups As someone who believes in low tax in general, it would be remiss of me not to point out that on this subject I passionately argue that we should maintain a high duty rate for tobacco products. It is a disincentive for people to start smoking, especially the young, and I urge the Government to go further in the upcoming Budget. Of course, enforcement is nothing without encouragement to give up. So, to conclude, I echo the sentiments that tackling smoking requires a plan—a plan that seeks to prevent smoking, but also assists those who currently want to give up smoking. This plan does that. Treating smoking-related illnesses is estimated to cost the NHS £2.5 billion a year, while the wider cost to society is a staggering £12.7 billion. But the real cost is the human lives—those that are cut short, and the families that suffer: families in Wiltshire, in my constituency, and up and down the country. I am delighted that in Wiltshire there are now 25% fewer hospital deaths from smoking-related illnesses, but that is still too many, and that is why creating a smoke-free generation is essential.
I am concerned about the damage that smoking does to my constituents. Almost 15% of the population of Suffolk smoke. More than 7,500 admissions to Suffolk hospitals every year are attributable to smoking. Those who do not quit will have roughly a one in two chance of dying prematurely from smoking-related diseases The tobacco industry is deliberately producing products that it knows will kill its customers. While the market for cigarettes is mercifully in decline in the UK and other rich countries around the world, it is still growing in low-income countries, where the industry regularly uses tactics that would be illegal in this country, including the deliberate sale and marketing of cigarettes to young people and children. As a result, more than 7 million people die from the consequences of tobacco use each year. Almost four fifths of the world’s 1 billion smokers now live in low and middle-income countries. Money spent on tobacco is money not spent on other household needs. In Kenya and Bangladesh, tobacco cultivation has replaced food crops, leading to local food insecurity. In Malawi, at least 78,000 children are forced to work in tobacco fields, preventing most of them from attending school. Tobacco growing around the world is responsible for a loss of biodiversity, land pollution due to the use of pesticides, soil degradation, deforestation and water pollution. The result of all that deeply destructive and irresponsible activity is that the four major tobacco manufacturers are some of the most profitable businesses on earth. It is impossible to hold an ethical investment in a tobacco company. To invest in tobacco is to seek to make money from environmental destruction, social exploitation, disease and premature death. That is increasingly understood by investors, because last year AXA, one of the world’s largest insurers and a major part of the Ipswich economy, divested more than $2 billion of tobacco industry assets. I welcome its decision. Tobacco-free investment policies have also been announced by AP4, one of the most influential pension funds in Sweden; Medibank, the largest health insurer in Australia; Fonds de Réserve pour les Retraites, France’s public pension fund; the Irish sovereign investment fund; and CalPERS, the largest public pension fund in the USA. So far in 2017, tobacco-free investment decisions have been made by AMP Capital, Bank of New Zealand, SCOR, PME, ACTIAM and Aviva, the largest insurer in the UK. In addition, ABN AMRO, the global bank, will cease lending to tobacco manufacturers. Those very welcome individual decisions now constitute a clear trend In that context, it is increasingly absurd that large investments in tobacco are still held by local authority pension funds across the United Kingdom. There is a fundamental contradiction between the local authorities’ public health responsibilities and their investments in tobacco, which actively promote the biggest public health problem confronting this country I understand that pension fund trustees have a duty to run their funds to secure strong returns for beneficiaries. Local authority workers depend on sound investments for their pensions. Case law has now made it clear that local authority pension fund trustees may consider non-financial factors when setting investment strategies, provided that any restrictions they place on investment as a result of such consideration do not significantly affect financial returns. But how immoral does an investment have to be before the financial returns no longer trump the moral question?
The hon. Gentleman is making a powerful argument, but will he consider the fact that many tobacco manufacturers are actively investing in non-tobacco products, which may change their whole future investment strategy? In the light of that fact, should not investors—pension funds and so on—look at that long-term development of such businesses rather than their current position?
I thank the hon. Gentleman for his intervention, but I do not agree with him. If a company is producing something that is detrimental to the whole world, the best approach is to disinvest from it How bad does an investment have to be before its financial returns no longer trump the moral question? Are there no factors that could lead a pension fund to divest on moral grounds alone? Such factors could—and in my view should—include the UK’s treaty obligations. For example, article 5.3 of the framework convention on tobacco control, to which the UK is of course a party, states: “In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law.” Guidelines for the implementation of article 5.3 were agreed back in November 2008 at the third conference of the parties to the convention. Recommendation 4.7 states: “Government institutions and their bodies should not have any financial interest in the tobacco industry, unless they are responsible for managing a Party’s ownership interest in a State-owned tobacco industry.” I am delighted that the UK has no state-owned tobacco industry, but the level of public investment in private tobacco firms in this country flies in the face of the convention As leader of the opposition at Suffolk County Council—before I was elected to this august House—I brought forward a motion proposing that the county’s pension fund should disinvest from tobacco funds. The motion was passed unanimously. The pension fund committee then commissioned legal opinion on how to divest, but the opinion was that the committee could not legally do so Does the Minister believe that our local authorities should also invest in, say, pornography—a very profitable business I am led to believe? Profit should not be the only consideration for pension fund investment. We can and must do better, and responsible disinvestment by local authority and public sector pension funds is the right place to start. This is an issue on which the public health Minister could usefully engage, and I hope he will make a commitment to do so when he replies to the debate.
It is a pleasure to follow that contribution by the new hon. Member for Ipswich (Sandy Martin). I agreed with almost all of what he had to say—except perhaps about pension funds investing in pornography, which I think stretched the point. I also congratulate the right hon. Member for Rother Valley (Sir Kevin Barron), who I have known since I was elected as a great champion of anti-tobacco and anti-smoking measures I should declare an interest as the chairman of the all-party group on smoking and health. For me, this is a personal issue: both my parents died of cancer, directly as a result of smoking, and I do not want anyone to go through what my family had to go through My hon. Friend the new Minister for public health is the third Minister I have berated about getting the tobacco control plan published, and I congratulate him on the fact that it was duly published almost in his first few days in his role. I thank him for that, and I look forward to many such measures, which we will be calling for, being given equal standing and impetus We should, of course, review the outcome of the previous plan, which expired at the end of 2015. The three ambitions of the old plan, which included reducing smoking rates among adults and children, were more than achieved, and I congratulate Governments of both political persuasions on that. We just about made the target of reducing the level of smoking among pregnant women to below 11%, although that happened somewhat later than envisaged in the plan. We now have the lowest prevalence of smoking ever recorded among adults and children We are still in the position where 80,000 people a year die from preventable smoking-related diseases, and the single cause of that is tobacco. It is the only product available legally that, if people use it as the manufacturer intends, will kill them. My hon. Friend the Member for Chippenham (Michelle Donelan) made the point that were tobacco to be discovered now, there is no chance that it would ever get to the stage it has Tobacco kills half of lifetime smokers. On average, smokers lose 10 years of their life expectancy. For every death that is caused, about 20 smokers suffer from a smoking-related disease, so the problem is not only death but smoking-related diseases and the cost to the health service Every year in Harrow, my local borough, about 1,500 hospital admissions and 200 premature deaths are caused by smoking-related diseases. If we extend the picture across the country, we see that there is a huge problem Tobacco control policy should have as its objective the end of smoking, which I absolutely support. The Minister states in the plan that the aim is “to create a smokefree generation”, which is a wonderful idea, but if we go further into the plan, we see that the aim is to cut smoking rates to no more than 12% by 2022. That is too weak a target—we should be looking to go much lower than 12% by 2022 I particularly welcome the targets to cut the number of 15-year-olds who smoke regularly to lower than 3%, and to cut the number of pregnant women who smoke to less than 6%. Those key targets will have long-term effects. The reality is that most people who smoke—two thirds—acquire the habit before the age of 18, so one of the key issues is to prevent young people from starting to smoke. If we can achieve that, we can make sure that we cut off the supply of smokers. We know that once people are addicted, it is much harder for them to give up smoking Funding for tobacco control is essential. We need to be clear that the headline figure for public health spending has increased since 2013, rising 25% each year, but that does not take into account the extra responsibilities that local authorities have. Analysis by the King’s Fund has shown that once we take those responsibilities into account, local authority spending on public health has fallen in real terms since 2013-14 by 5%. At the same time, the population has grown by 3%, so the reality is that we are seeing a reduction in spending In Harrow, spending on tobacco control has fallen from £364,000 a year in 2013-14 to £9,000 in the current year—a decline of 98%. If we analyse Department for Communities and Local Government returns, we see that spending on tobacco control across the country has fallen by 33%. That cannot be acceptable It is clear that one of the issues we have to address is stop smoking services, which are key to helping people to get off smoking in the first place. They are highly cost-effective and they would make sure that we reduced the number of deaths. Every smoker who goes to a GP or any doctor should be relayed to a stop smoking service immediately to help them to give up smoking. Clearly, that will cost money, and I share the view of my hon. Friend the Member for Chippenham that the tobacco industry should pay for the damage it does to our national health service and our health. Imperial and Japan Tobacco International make joint profits of about £1 billion a year, and they should be charged for cleaning up the damage that these products cause on the basis that the polluter pays. In the United States, the tobacco industry is required to pay an annual user fee, which means that the Food and Drug Administration collects more than $2 billion a year The Government introduced the annual tax escalator of 2% above inflation, but that is due to end in 2020. We should increase it and make sure that the money raised is ring-fenced so that it can be used to implement smoking-cessation measures. That would not only encourage the tobacco industry to look at what it does to prevent people from smoking, but discourage it from manipulating prices to subsidise cheaper brands and encourage people on low incomes, or young people, to start smoking—we know that the industry does precisely that. As we move in that direction, we should see an increase in tobacco tax A licensing system for tobacco should be introduced to make sure that we have complete control, from manufacturer to retailer. That would ensure that we could have proper enforcement all the way through the process and take action against the illicit trade One issue that is very prevalent, but is not mentioned in the tobacco control plan, is oral cancers. The British Dental Association estimates that between 91% and 93% of oral cancers are preventable and that two thirds are caused directly by smoking or by chewing tobacco. Large numbers of people who originate from the Indian subcontinent—between 40% and 50%—chew tobacco that is unregulated. There are no warnings on any of this tobacco and nor is there any estimate of how much damage it is doing, but large numbers of people from the Indian subcontinent who chew tobacco routinely present with oral cancer as a result. We should make sure that there are health warnings on these products, and that people are warned about the consequences of taking them. Tobacco does not have to be included within these products, but frequently it is included. If tobacco is involved, clearly there should be warnings and proper regulation should be in place. My hon. Friend the Minister has suggested that there are no plans to do anything about this, but I urge him to review the situation very closely, examine the evidence, and then act in the same way that he has done on the tobacco control plan.
I am grateful to my right hon. Friend the Member for Rother Valley (Sir Kevin Barron) for securing this important debate There used to be a time when cigarettes were perceived as cool—but people were being conned. Powerful tobacco companies were placing their products in movies and using careful branding to make us think that cigarettes would make us more attractive, more athletic, or even smarter. What they forgot to tell us was they also leave people unable to breathe, cause heart attacks, and kill half of those who use them. Some 15% of adults in the UK still smoke. In some parts of my constituency, half of all people still smoke. Not surprisingly, these are also the areas where people die youngest. I predict that in 50 years’ time nobody will smoke. We will look back on the 20th and early 21st centuries and shake our heads and laugh at the idea that people were poisoned with tobacco and paid for the privilege Like many Members in the Chamber, I would like to see England smoke-free. That means no young people starting to smoke because they know that it will make their breath smell and their teeth bad, no pregnant women smoking because they know that each time they smoke a cigarette their baby is also smoking a cigarette, and no young parents smoking because they know that their kids will copy them as soon as they are old enough. It means people in their 40s and 50s quitting, because lungs decline rapidly if people continue smoking beyond this age, and in time they struggle to breathe. It is never too late to stop. It is best never to start, because stopping smoking is one of the hardest things that someone will ever do—but one of the most worthwhile. As many Members have mentioned, half of all cigarette smokers will die of smoking-related conditions. There is a powerful case for continuing to take stronger action towards a smoke-free society, and I welcome much of the tobacco control plan for England It is important to recognise success. Smoking rates in the north-east of England have fallen to just over 17%—down by almost a half since 2005, and the largest regional fall in smoking rates in the country. Having 200,000 fewer smokers in the region could mean 100,000 fewer premature deaths. This is, in part, due to the work of successive Governments who have pushed the issue up the agenda I welcome all the ambitious targets that the tobacco control plan for England sets for future reductions, but I particularly welcome the focus on stopping smoking in disadvantaged social groups. The decline in smoking in our society has not been uniform and, as in many areas of society, many people have been left behind. However, it is wrong to think that just providing services to people living in poverty will be enough. My experience of working in areas of socioeconomic deprivation in England has taught me that health behaviours do not occur in isolation. It is genuinely hard for someone to stop smoking if they are worried about how they are going to pay their next bills; they are threatened with losing their benefits, perhaps even having to wait six weeks for universal credit; they have insecure work; they live in a community threatened by crime and antisocial behaviour; and they are struggling to look after their family. Smoking is often a symptom of other problems. Reducing smoking requires poverty reduction and true engagement at a community level to make life better and easier for people living in areas of deprivation I would now like to focus on those with mental health conditions. As has been mentioned, the smoking rate among people with mental health conditions has remained stubbornly high. In Stockton South, the rate is about 40%, even though smoking rates have fallen among the rest of the population. It is one of the single largest factors in the lower than average life expectancy among people with a mental health condition. For someone who has a mental health problem, stopping smoking is good not just for their physical health but for their mental health too. There is evidence that if someone with depression stops smoking, it can have an effect on improving their mental wellbeing similar to taking antidepressants Closing the gap in smoking rates is not a straightforward task. It is a challenge that requires a collaborative approach, including not just the NHS but communities, mental health charities, anti-smoking organisations and, not least, smokers themselves. I welcome the plan’s commitment to work with the Mental Health and Smoking Partnership to identify how we reduce rates of smoking in this population. However, while the ambition of the plan is welcome, it is not clear how the Government intend to assess progress within the population of those with mental health problems. I would be grateful if the Minister could tell us what he intends to do to make sure that there are reliable, national ways of measuring smoking rates among the whole population of those with mental health conditions, not just those with severe mental health problems. Government should know how they will assess whether targets are being achieved Like other Members, I am concerned about cuts that local authorities are making to public health funding, their hands often tied by huge Government cuts. I am particularly concerned about cuts in smoking cessation services. The evidence is quite clear: well-run services that combine behavioural therapy and prescription of nicotine replacement products offer smokers who want to quit the best chance of success. Community-based interventions to tackle inequalities are stressed in the plan, but that will be empty rhetoric unless the funds to do this work follow. The five year forward view and the sustainability and transformation partnerships place a significant emphasis on prevention. The pressure on NHS services in future can be significantly eased if we ensure that we make the necessary investments in prevention now. Government must finance the public health provision necessary to put effective tobacco control policies into action and to enforce tobacco control legislation where it is being broken. That Government commitment is threatened by austerity, and by cuts in local government funding in particular It would be a welcome boost if the political consensus that exists in this House—it spreads across all parties— on the need for tobacco control were supported by a commitment to fund local authorities in England to deliver the radical steps that we now need to make the next push towards a smoke-free society.
I rise to speak primarily as the co-chair of the all-party parliamentary group on baby loss. I apologise to some extent if I appear a little like a broken record on this subject, but in many respects I do not apologise because we have so much work to do in this area. I want to focus, if I may, on smoking in pregnancy. My hon. Friend the Member for Chippenham (Michelle Donelan) has eloquently put some of these points already, but I want to go into somewhat more detail The Prime Minister spoke of the burning injustice that sees the poorest in this country die on average nine years earlier than the richest. It is essential for the tobacco control plan significantly to reduce the health inequality between richest and poorest in Britain. Those who earn £10,000 a year are twice as likely to smoke as those who earn £40,000. As the Minister knows, we have massive issues with regard to smoking in pregnancy and regional variation: 2% in Richmond, 2.2% in Wokingham, and 2.4 % in Hammersmith; yet 26.6% in Blackpool, 24.4% in South Tyneside, and 24.1% in north-east Lincolnshire. Women in routine and manual jobs are almost three times more likely to smoke during pregnancy than those in managerial and professional roles. Teenage mothers are six times more likely than those over 35 to smoke throughout their pregnancy I applaud the success of the 2011 to 2015 tobacco control plan. As my hon. Friend the Member for Harrow East (Bob Blackman) pointed out, we exceeded the ambitions in the plan and reduced the adult smoking rate from 20.1% to 15.5%. I also applaud the Minister’s ambition to reduce the rate of adult smoking from 15.5% to 12% or less by 2022, and I further welcome the ambition to reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less, notwithstanding my earlier point about regional variation To be clear, this is absolutely not about criticising or demonising women who smoke during pregnancy. Tobacco, as Members have already pointed out, is highly addictive and it can be incredibly difficult to stop smoking. In relation to stillbirth and neonatal death, the Government have set some really ambitious targets: to reduce the rate by 20% by 2020, and to cut it in half by 2030. In order to achieve that, we have to be clear about the fact that the biggest modifiable risk factor for those issues is smoking in pregnancy. I have raised these statistics in the House before, and I make no apology for reiterating them today. One in five stillbirths is associated with smoking, and women who smoke are 27% more likely to have a miscarriage. Their risk of having a stillbirth is a third higher than that of non-smokers. Mothers who smoke are more likely to have pre-term births and babies who are small for their gestational age Then we have second-hand smoke. Maternal exposure to second-hand smoke during pregnancy is an independent risk factor for premature birth and low birth weight, but only one in four men make any changes to their smoking habits when their partner is pregnant. The number of sudden infant deaths could be reduced by more than 30% if children were not exposed to second-hand smoke. The Royal College of Physicians has estimated that 20% of pregnant women are exposed to second-hand smoke throughout their pregnancy, increasing the risk of many poor birth outcomes. If every pregnancy were smoke-free tomorrow, there would be around 5,000 fewer miscarriages, 300 fewer perinatal deaths and 2,200 fewer premature births each year I want briefly to raise with Ministers the question of vaping and e-cigarettes. Although I appreciate, notwithstanding points already made by colleagues, that the jury is still out on these products to some extent, and although quitting outright is always the aim, these products must surely be better than smoking, especially for pregnant women. I encourage the Minister to work with the Treasury to investigate some kind of levy on the tobacco industry. Incidentally, the tobacco industry has huge investments in vaping and e-cigarettes; in fact, most of the biggest e-cigarette companies are owned by the major tobacco manufacturers.
Perhaps I should start by declaring an interest as an electronic cigarette smoker myself. I have seen at first hand the health benefits of moving from smoking to electronic cigarettes, including being able to run much further and feeling much healthier. A smoker who gives up for, say, six months will start to feel the same benefits. I encourage the hon. Gentleman to seek a lot more research in this area.
I thank my hon. Friend—I use that description intentionally—for that intervention, and I think she is absolutely right. Without wanting in any way to sound patronising, I applaud her for making the move from smoking cigarettes to using e-cigarettes. The evidence is out there to suggest that it is a great way to transition off smoking and off nicotine entirely. Far more research needs to be done in this area, and I hope that the Chancellor is looking at how we could, in the Budget, encourage tobacco manufacturers to provide these products for free to women who are struggling to give up smoking during pregnancy, in particular I would also like to touch on the important issue of carbon monoxide monitoring. Challenges remain for staff in implementing the NICE guidance, particularly in relation to carbon monoxide screening. NICE has recommended since 2010 that pregnant women be screened for exposure to carbon monoxide. The current tobacco control plan reiterates the importance of that and further commits to recording women’s carbon monoxide levels in the maternity services dataset. However, front-line staff do not universally have access to carbon monoxide monitors We know already that babies who are exposed to carbon monoxide are more likely to suffer birth defects, to be born prematurely and to have a low birth weight, so it is incredibly important that we look at this area. Carbon monoxide screening is one of the key elements in supporting women who smoke to access quit services. Properly embedded into services, screening can transform outcomes. The evidence from the north-east shows that following a comprehensive programme to train midwives, provide them with monitors and set up referral routes to local quit smoking services, smoking in pregnancy rates fell by nearly a third. We know that this absolutely works I stress to the Minister that carbon monoxide monitors are not an optional extra; they are an essential tool for midwives. We would never ask midwives to do their jobs without, for example, blood pressure monitors. In the same way, all midwives should have access to CO monitors. Part of the problem is that there is no consistent national approach to the provision of these vital pieces of equipment. Local decisions determine whether midwives and health visitors have access to them, so there is local variation I would also like to touch on training for health professionals. The smoking in pregnancy challenge group, a coalition of health and baby charities, produced a report in July examining the training needs of midwives and obstetricians in England. That report was launched at a joint event of the all-party group on baby loss and the all-party group on smoking and health. I co-chaired the event, and the Minister kindly attended and addressed the meeting. I do not need to remind the Minister of this, but the report found that although health professionals have generally received training about the harms of smoking in pregnancy, a majority have had no training in how to communicate those harms to women and support them effectively to access the treatment that is available. Health professionals say that, in the absence of training, they lack the confidence to engage in such conversations The report recommends that such training form a regular part of mandatory midwifery training and be embedded into obstetricians’ continuing professional development. Can the Minister outline the steps that are being taken to review and implement the findings of this report? Will consideration be given to extending the analysis undertaken by the smoking in pregnancy challenge group to look at training needs, involving key stakeholders such as other health professionals To conclude, I very much welcome the new tobacco control plan and the commitments that the Minister and the Government have made in this area. Is there more that we can do? Yes, of course, there is much more that we can do. I know that the Minister, the Secretary of State and the Minister of State, my hon. Friend the Member for Ludlow (Mr Dunne) are as passionate as I am about reducing our miscarriage, stillbirth and neonatal death rates I repeat, because it is really important, that this debate is not about demonising or criticising women who smoke during pregnancy. I fully appreciate how addictive smoking is; it is really hard to stop. Like my hon. Friends the Members for Chippenham and for Harrow East, I have seen my parents struggle. They have both been smoke-free for many years, and I am very proud of them, but it is incredibly difficult When it comes to pregnancy, we know that all parents want to give their baby the best possible start in life, so I thank the Minister for all the work that he and the Department have done so far. I ask him to keep a watchful eye on this issue and to be pragmatic in ensuring that the Government give anyone who is struggling to quit smoking the tools and the support that they need to help them to achieve that goal.
It is an honour to follow my friend the hon. Member for Colchester (Will Quince). He highlighted, importantly, the dangers of pregnant women smoking, and he was very supportive of women who find themselves smoking during pregnancy. I congratulate my right hon. Friend the Member for Rother Valley (Sir Kevin Barron) on securing this Back-Bench debate. The knowledge he brought to his opening speech set the tone for the debate I am pleased to take part in the debate because I am a member of the all-party group on e-cigarettes, and I believe that vaping is a safe and popular alternative to smoking. I have never smoked or vaped. I am the oldest of five siblings, and none of us has ever been a smoker. I put that down to the fact that both my parents smoked all their lives, and smoking never held any charm or attraction for me or my brothers and sisters when we were young people Because my parents, other relatives and friends smoked, and I am married to someone who started smoking at the age of nine, I think I understand why people smoke and the impact it can have on their lives. When my parents started to smoke in the 1940s, people were not fully aware of the dangers of smoking. Now, we all know that smoking can kill or cause serious lifelong illness. It makes me so sad to see so many young people starting to smoke The hon. Member for Harrow East (Bob Blackman) mentioned mouth cancer. That reminded me that I lost a colleague, who was in her early 60s, to mouth cancer, and only a year before she had seen her son, aged in his 40s, die of the same horrible disease, so I know how awful it can be Vaping is important as a safe alternative to smoking for people of all ages. I am pleased that for the first time the tobacco control plan focuses on vaping as a viable alternative to cigarettes. As my right hon. Friend the Member for Rother Valley has said, independent studies by Public Health England and the Royal College of Physicians have recognised that vaping is at least 95% less harmful than smoking, and research by the University of St Andrews has found that the cancer risk from vaping is only 1% of that of smoking. Many other valid statistics from various bodies now support vaping as a safe alternative for smokers, as has been highlighted in the debate I am pleased to say that many of my family and friends, including my husband, have all stopped smoking and now use vape products, and although many people so dear to me tried to give up smoking and always returned to tobacco, I am sure many others across the country are as happy as I am that relatives and friends have made this choice on vaping The commitment to support stop-smoking services is commendable, but in my experience—I undertook training to run smoking cessation sessions some years ago—it is very difficult for people diagnosed with diseases that might be smoke related to give up smoking. We all know that ill health can increase stress levels, so reliance on the habit at such a time can increase and it can be really tough to give up. Being able to switch to vaping for people in such situations is very welcome. I wish I had been able to recommend people, such as those who had had a heart attack, to switch to vaping when I was trying to help them to stop smoking, because those were difficult times for them I believe that the promotion of vaping and e-cigarettes is key to the Government achieving their vision of a smoke-free generation as part of the tobacco control plan. I support the view of the UK Vaping Industry Association that article 20 of the tobacco products directive, which conflates vaping products with tobacco products, should be reviewed, and that restrictions on advertising, packaging and product size should be lifted I do, however, have a warning for the Government. Much of the attraction of vaping is that, after the initial outlay for equipment, it proves a much cheaper way to enjoy the habit than smoking. I seek an assurance from the Government that they will ensure vaping always remains affordable, and that they will not be tempted to impose an excise tax that would force up prices and give smokers less reason to switch. Finally, I agree with colleagues that the Government must put their money where their mouth is if the tobacco control plan is to succeed.
May I say what a pleasure it is to follow the hon. Member for North Tyneside (Mary Glindon)? I am glad that vaping has been of assistance to her family, and that things are on the up from that point of view. May I also thank the right hon. Member for Rother Valley (Sir Kevin Barron) for securing the debate? We have had a really important debate this afternoon. He raised some critical points, and I thank him for doing so May I also take this opportunity—I have not yet had such a chance—to welcome the Minister to his place? I know he is absolutely passionate about healthcare, and that he will bring to his role all the dedication and enthusiasm of someone who is in the lucky position of having a job that is also his passion. It is good that he will be responding to the debate I gave a lot of thought to how I would approach the debate. For a Conservative who generally takes the approach of pursuing individual liberty, there is perhaps some tension in favouring a control mechanism that takes away people’s individual choice. Some excellent points have been made, and two speeches in particular really nailed it. The first was by my hon. Friend the Member for Chippenham (Michelle Donelan), who made the point that were tobacco discovered today, it is inconceivable that it would be freely available on the high street in the way that it is. It seems to me that that is an historical anomaly. The second was by my hon. Friend the Member for Harrow East (Bob Blackman), who spoke movingly about his parents’ deaths from cancer. I am very sorry to hear of that, but it really emphasises everything we are saying in the debate. Of course, we always have to balance the libertarian desire for freedom with the public health interest, and I hope that those two important points have really hit home with hon. Members I have spoken at length this week about healthcare in Oxfordshire, its future and my concerns about the way it has been managed. While we must always look at treatment—ensuring that we will one day find a cure for cancer, and in the meantime that we care for those who have cancer with every means at our disposal—we really must continue to fight. What I mean is that we must continue to decrease as much as possible the number of people who suffer cancer in the first place We are in the presence of some particularly cold and hard facts. The cost of having 7.3 million smokers is that smoking is the biggest killer. It is clearly identified and open to view as the biggest cause of cancer. It leads to more than 200 smoking-related deaths a day, or 16% of those who die. There are 79,000 deaths per annum —79,000 preventable deaths, 79,000 personal tragedies—to say nothing of the 20 times the number of people who, for every death, are suffering from preventable smoking-related conditions. It seems to me that there is an enormous emotional imperative: we must tackle smoking and the damage it causes If I have not persuaded hon. Members on an emotional level, let us just look at the hard economic facts. Smoking costs the economy £11 billion. There is a £2.5 billion cost to the NHS, with 474,000 hospital admissions. Let us just think what we could do for the NHS if we could divert that funding towards the care of conditions that are not avoidable or preventable. There is a £4.3 billion cost to employers, and a £4.1 billion cost to wider society, including the £760 million going to social care. Let us just think about how we could treat dementia or Alzheimer’s if we could divert the money from conditions that are preventable towards those that are not Moreover, not only is smoking a cost to the economy and a personal tragedy for those affected, but it is overwhelmingly targeted on the poorest. This health condition is actively feeding inequality. Children of smokers are two to three times more likely to be smokers themselves. The Prime Minister has spoken—very powerfully, in my view—of how the poorest are dying up to nine years earlier than the richest, and half those deaths are smoking related. This condition affects the poorest in society the most Surely the economic, moral and health arguments are overwhelming when it comes to the Government’s ambition of creating a smoke-free Britain. It is into that arena that the Government step with this plan The good news is, of course, that stopping smoking produces health benefits in months and it is easier, relatively speaking—I appreciate that it is not easy—to give up now than it ever has been. There is the technology. We have heard about the help given by vaping or e-cigarettes; last Stoptober, 53% of those who gave up did so with the assistance of e-cigarettes Happily, yes, the prevalence of smoking is declining more sharply than for many years, and this is where the tobacco control plan stands. The last one hugely exceeded expectations: the percentage of people smoking declined from more than 20% to 15%. I applaud the Government for taking forward bold, imaginative and forward-thinking measures as we tackle this public health crisis. The Government wish to reduce the inequality gap that I mentioned, get adult smoking rates down from 15.5% to about 12% and reduce the percentage of 15-year-olds who regularly smoke from 8% to 3%. That is so important, given that the early years govern people’s health choices for the rest of their lives My hon. Friend the Member for Colchester (Will Quince) and I spoke in the baby loss debate earlier this week; I mentioned that smoking was one cause of problems during pregnancy. I am glad that my hon. Friend brought that issue up again today. He is right to say that it is difficult to give up smoking. We are not being censorious in talking about pregnant women who smoke, but it would be much better for everybody if we reduced the proportion who do from 10% to 6% The Government are providing £16 billion for public health funding to local councils, which are best placed to marshal resources and help people in their areas. Perhaps most effective has been the mass media campaign. Many years ago now—it is a distant memory—the campaign against drink-driving started, and it has had an incredible effect in shaping public expectations. I am not suggesting that smoking is on the same level—there is a recklessness in drink-driving that is not so stark in smoking—but as my hon. Friend the Member for Chippenham said, the issue is education and making it clear that someone is much more likely to hurt themselves and others if they continue to smoke I will not speak for much longer, but I want to make one or two brief further points. The first is that the Government propose a joined-up approach between local authorities and NHS England, which I encourage as it produces results. I am also encouraged by the “smokefree NHS” section of the plan—the NHS leading by example. I have discussed the impact on employers; the NHS is a large employer, so it is important that it should lead the way Lastly, I want to comment briefly on mental health. The NHS is leading the way as far as those using, working in or visiting the NHS are concerned, and the practice of escorting people from mental health hospitals on and off premises is due to end now that the health problems have been identified. Let us be clear: although 40.5% of people with serious mental health difficulties do smoke, they want to stop smoking just as everybody else does. I hugely encourage that. This is an example of the Government’s taking an approach to mental health in the round. Yesterday, I asked the Prime Minister about help given to military personnel, but this is another example of how to ensure that the issue is not just addressed in only one silo of society Thank you for letting me speak for a little while, Madam Deputy Speaker. Like the British Heart Foundation and Action on Smoking and Health, I welcome the plan enormously. It builds on recent Government work on tackling smoking. The proposals are ambitious and bold, and I ask everyone to support the Government’s plan to create a smoke-free generation.
It is a pleasure to follow my hon. Friend the Member for Witney (Robert Courts). I also congratulate the right hon. Member for Rother Valley (Sir Kevin Barron) on bringing this debate to the main Chamber, on enabling an important conversation about the coming of smoke-free Britain, and on the long-term work he has done on this issue. I welcome my neighbour, the public health Minister, my hon. Friend the Member for Winchester (Steve Brine); I applaud his progress and focus on this issue and encourage him to be as ambitious as possible Many colleagues will be aware that I am passionate about trying to keep fit and healthy, although serving in the House precludes much of that, and about working to reduce heart conditions among people of all ages. It should come as no surprise that I very much welcome the Government’s new tobacco control plan. I chair the all-party parliamentary group on running—please join. I also actively support Cardiac Risk in the Young and belong to the all-party parliamentary group on arrhythmias. I could not be more passionate about these issues. Smoking claims more than 200 lives per day in England. Think of how many lives we are losing from preventable causes. We have also heard about the £11 billion cost to the economy Last November, I held the parliamentary reception for carers’ rights day and I shall do the same next week; the long-term impact of this issue really concerns me. Like many Members, I am not here to lecture; we are all sympathetic and we have been measured in our comments. I believe in choice, but more importantly in education and understanding the real impact on families and our NHS. We simply know that smoke-free is best I know first hand what the addiction can do to long-term health and quality of life. As we have heard today, we simply would not allow a smoking culture to start growing today so we cannot ignore the challenge it has left us. Smoking has blighted my life—sadly, it can blight relationships and families all too often. Like many, my mum became a smoker in the late ’50s to stay slim and attractive and avoid putting on weight. It was fashionable, and the reality of its impact on health was simply never understood. She could never, ever give up: it was the first, the last, the everything—an addiction and a habit. She always said, “I wouldn’t know what to do with my hands; I’ve tried knitting!” E-cigarettes did help, but we were unclear at the time whether they were better or worse. There was great help from GPs, including hypnosis, gum, tablets, lozenges, wands—you name it; it did not work. My dad smoked heavily throughout his life, although to be honest he enjoyed all the so-called good stuff as well. But it all resulted in my being a sandwich carer, with young children and older parents on whose health smoking had taken its toll. Both my parents died in their early 70s from smoking-related heart issues—both before my 40th birthday, and both before I came to this place. They did not have a chance to see their grandchildren grow up, as happens in many families as a result of smoking Alongside our transformative success on smoking in public places is further good news: back in October 2015, smoking in cars with children was banned and that was also transformative. But there is also bad news—how often do we see people in work vehicles flouting smoking rules? Air pollution is having a growing impact on our mindset. We need to make sure that people are doing what is safe at work. Earlier this week, I was at a British Lung Foundation event highlighting its Breathe Easy campaign, which I applaud The 2011 and 2015 tobacco control plans had those successes and should be applauded—adult smoking rates are down almost 5% over that period—but we must continue to be bold. I am so pleased about the Government’s new plan. As we heard from my hon. Friend the Member for Chippenham (Michelle Donelan), action is essential: just saying that we have made some progress is not good enough By 2022, the Government expect to reduce the smoking rate to 12% or less, reduce the prevalence of smoking in pregnancy by almost half, and permit innovative technologies. We all know about vape shops and the prevalence of vaping on our high streets. It cannot be ignored and we must research it. I do not want, 20 or 30 years down the road, to have on our hands the results of thinking it was the new messiah when it was not. However, it may be, so let us do the research As a strong supporter of and believer in the excellent work of the British Heart Foundation, including in my constituency, I thank it for all it does. Public Health England tells me that since 2014 there are still about 20,000 smokers in Eastleigh. I welcome the previous Chancellor’s announcement of £2 million for the British Heart Foundation for the replacement of local defibrillators. I would like the Government to help with work on an app, so we know where those defibrillators are. The former Chancellor made the announcement because his constituent, Fabrice Muamba, survived only because of a defibrillator. Let us legislate to have them on planes as well—they cost about £700. My constituents Graham and Anne Hunter have seen the benefits of defibrillators. After losing their daughter, Claire Reed, they would absolutely welcome both the app and the defibrillators. It was as a result of them talking to the Chancellor that the £2 million was provided I welcome the Government’s plans to seek to reduce smoking among those with mental health conditions. We know that the most deprived and challenged will always be the most dependent. Those in a lower paid job are, sadly, still more likely to smoke or, more importantly, to stay a smoker. I stress to the Minister the importance of tackling the health inequality of this particular group in driving the next phase forward I congratulate the Government on their bold vision for a smoke-free generation and I look forward to further progress. All the lives we can save, and all the resources we can save, are absolutely worth it.
With your kind permission, Madam Deputy Speaker, as a Scottish MP I hope to make a short contribution to the debate on a tobacco control plan for England. I shall make some reference to the situation in Scotland, to highlight the cost of smoking in human suffering and death, as well as the cost impact on public health budgets and the overall economy. I welcome the debate on this vitally important matter and congratulate the right hon. Member for Rother Valley (Sir Kevin Barron) on securing it. I also applaud the Backbench Business Committee for granting the time The tobacco control plan builds on the successes of the previous control plan, established by the coalition Government, and aims to herald a smoke-free generation—I say that while recognising that much yet needs to be done. I wholeheartedly support the principle of preventative spending on early intervention, which can prevent negative health outcomes later in life. I also welcome the investment in tackling ill health and recognise that it has the potential to save a significant amount of public spending in the long term and can help to reduce health inequalities. I do not underestimate the power of addiction. For that reason, I feel that where there is a will to stop smoking we should do everything possible to help people to help themselves I welcome recent falls in the number of adults who smoke in England and Scotland, and the number of children exposed to second-hand smoke. However, smoking rates in Scotland are still higher than in England, and we must be prepared to do much more to reduce this figure. Currently in Scotland, tobacco use is linked to 10,000 deaths a year On e-cigarettes, I am a firm supporter of having a robust regulatory framework, which ensures all devices are safe and acknowledges their potential use in smoking-cessation programmes. I welcome the fact that earlier this year the Scottish Parliament voted to ban the sale of e-cigarettes to under-18s and to limit advertising, moves I fully support because they will protect the health of our young people On the tobacco control plan for England, I acknowledge that the previous plan reduced adult smoking rates in England from 20.1% to 15.5%. That is indeed progress. I also applaud the ambition in the plan to reduce adult smoking rates from 15.5% to 12% or less by 2022. It is welcome that the plan is supported by the British Heart Foundation, which recognises it as an important tool in reducing the rate of strokes and heart disease. I compliment the Government on the fact that the World Health Organisation has designated England as one of the best places in the world to give up smoking. The strategy is based on a joined-up approach between the NHS, the Department of Health and local government. That can only be good, too I welcome the ambition of the plan to reduce the number of 15-year-olds who regularly smoke from 8% to 3% or less; reduce the smoking rates among adults in England to 12% or less; reduce the inequality gap in smoking prevalence between those in lower paid, routine and manual occupations, and those in higher paid professional and managerial occupations; and reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less. I also applaud making all mental health in-patient service sites smoke-free by 2018, as was mentioned by my hon. Friend the Member for Witney (Robert Courts). It has been a source of frustration for me for many years, as I am sure it has been for other Members, to visit hospitals for various reasons and find people congregated around the entrances, often having been escorted there by health workers who I am sure would prefer to be doing more productive things. I also welcome the ambition of permitting innovative technologies than minimise the risk of harm and maximise the availability of safer alternatives to smoking I hope we all support the idea of creating a smoke-free generation without any reservation. Effectively enforcing existing legislation on proxy purchasing and standardised packaging to reduce the uptake of smoking among young people is a very noble objective. Supporting pregnant smokers to quit, which will undoubtedly increase the life prospects of children yet unborn, and reviewing the sanctions for retailers who consistently break the law designated to protect young people from smoking, is welcome. As the right hon. Member for Rother Valley mentioned in his opening speech, in 2016 it was estimated that 2 million people had used e-cigarettes and had completely stopped smoking—that must be very good news—while at the time a further 470,000 were using them as an aid to quit In 2013, the Scottish Government introduced a five-year tobacco control strategy entitled “Creating a Tobacco-free Generation”. It set the target to reduce smoking prevalence in Scotland to 5% or less by 2034—again, a very ambitious and welcome target. The strategy set out a range of measures to support young people to choose not to smoke, to protect children and all people from second-hand smoke, and to continue to support those who do smoke to quit. Actions taken by the Scottish Parliament in recent years to control tobacco, and to limit and tackle the harm caused by tobacco, include legislation to prohibit smoking in public places, which came into effect in March 2006; raising the age of sale for tobacco from 16 to 18 in 2007; implementation of a tobacco retail register in 2011; a ban on self-service sales from vending machines in 2013; and the introduction of a tobacco display ban in shops from 2013 I turn now to the impact of smoking. According to Scottish Government statistics, tobacco use in Scotland is associated with more than 10,000 deaths and about 128,000 hospital admissions every year. According to the Office for National Statistics, smoking prevalence in Scotland among over-16s was 17.7% in 2016—an estimated 942,644 smokers—compared with the UK-wide smoking prevalence of 15.8%. Smoking prevalence in Scotland fell between 2003 and 2013 but has remained fairly static since. Some 35% of adults in the most-deprived quintile of the Scottish index of multiple deprivation smoke compared with 11% in the least-deprived quintile According to ASH Scotland, on average lifelong smokers die about 10 years sooner than non-smokers. The estimated cost to the NHS in Scotland alone is £323 million. According to the Scottish Public Health Observatory, for every 1 percentage point by which smoking prevalence is reduced, the NHS could save £13.4 million. One last set of numbers underlines the cost of smoking: ASH Scotland estimates that smoking costs Scotland around £1.1 billion annually, including £271 million in healthcare costs, £692 million in productivity losses due to active smoking, £60 million in productivity losses due to passive smoking, £34 million in clearing smoking-related litter and £12 million in fires caused by smoking in commercial properties.
As an ex-smoker who went cold turkey many years ago, I agree with most of what has been said. Like many others, however, I come from a family where parents and grandparents smoked. I welcome all measures to help people to stop smoking. Does the hon. Gentleman agree that we need more investment in prevention, not least through public health budgets, but that those are now in the hands of local authorities, the cuts to which have been abominable over the years? Does he agree that more money needs to be invested in public health?
I note in the plan the £16 billion commitment to funding public health programmes, in conjunction with local authorities in England, which is surely welcome news.
Just to reiterate, although it is local authorities that spend the money to help people give up smoking, which is warmly welcome, the savings go directly to the health service, and so the money is not recycled back to those helping people to stop smoking to meet the considerable expense incurred.
I thank my hon. Friend for his intervention and his moving and impactful contribution earlier Behind the numbers on lives and costs, there is above all else the human suffering and the suffering of the families who lose family members to this terrible disease. I welcome any and all efforts to help people across the UK stop smoking.
I am grateful to the right hon. Member for Rother Valley (Sir Kevin Barron) for securing this important debate on the tobacco control plan for England. I congratulate him on his work over the years and, as a testament to that, on the general consensus today Scotland has its own strong tobacco control strategy. The Scottish Government have implemented and overseen a number of progressive actions on smoking, and I am grateful to the hon. Member for Stirling (Stephen Kerr) for listing many of them, which shows the strength of the consensus in the Chamber to which I referred. Record investment in NHS Scotland on smoking cessation services has helped hundreds of thousands of people to quit smoking, and our aim is to create a tobacco-free generation by 2034. Last year, the Scottish Parliament celebrated the 10-year anniversary of the smoking ban and welcomed comments from the World Health Organisation praising our excellent example of global public health leadership Not everything that we want to achieve can be done in isolation, however. A good example of something that required UK-wide co-operation was the introduction of standardised packaging for tobacco products. However, I want to focus on another area that requires co-ordination across the jurisdictions of the UK, and indeed of Europe and the world: the illicit tobacco trade. I press the Minister to report on progress to secure a Europe-wide traceability system, which is still being discussed at the European Commission, and to confirm that the UK Government will rapidly ratify the illicit trade protocol, the first subsidiary treaty under the WHO framework convention on tobacco control Illicit tobacco undermines public health policy because it makes tobacco products available at a low price and often in branded packaging. It damages public revenue because it reduces the take from tobacco taxation. Figures from Her Majesty’s Revenue and Customs for 2015-16 estimated that the illicit market share in the UK for cigarettes was 13%, with the figure for hand-rolling tobacco 32%. The tobacco tax gap in that period was estimated at £2.4 billion, so clearly the illicit trade undermines our tobacco control strategy The involvement of the major tobacco manufacturers in the illicit trade is a major concern. Their involvement is evidenced by the fact that their genuine products—not counterfeit ones, or so-called cheap whites—form the largest share of the illicit market. The Scottish Government have committed to continue to support strong national and local alliances to tackle illicit tobacco. In 2009, the enhanced tobacco sales enforcement programme was introduced to enable the Scottish Government and trading standards officers throughout Scotland to work with Her Majesty’s Revenue and Customs to tackle the availability of illicit cigarettes and their sale to people under 18 As we all know, there is an open border between England and Scotland, and if the amount of illicit tobacco rises in England, it will affect Scotland, as well as Wales and Northern Ireland. Scotland needs a commitment from the UK Government that they will ensure that local authorities in England are adequately resourced to conduct the fight against the illicit trade. At present, that is absolutely not what we appear to have.
The hon. Gentleman makes a powerful point. Does he concede that the tobacco companies themselves deliberately overproduce products for certain countries, knowing that they will be brought into the UK by illicit means and sold as illicit products? The tobacco companies themselves have a key role in this.
The hon. Gentleman makes a good point. The tobacco companies are indeed the villains in this scenario For the last 20 years, the UK has had an effective and well-resourced anti-smuggling strategy, and HMRC’s tax gap estimates have fallen by about a half since the peak in 2000, but there is every reason to fear that that success is under serious threat and that the progressive reductions in the market share of illicit tobacco may soon go into reverse. That is already suggested by recent small upticks in HMRC’s figures There is a specific problem for local authorities. Figures from the Chartered Trading Standards Institute published at the end of last year showed that the total budget for trading standards across Great Britain had fallen from £213 million in 2009 to only £124 million in 2016, and that the number of trading standards staff had fallen by more than half. That means that the chance of catching someone selling illicit tobacco or supplying it to an unscrupulous retailer or local consumers is significantly reduced. Information from local enforcement action can be used to help to track the supply chain, and less information means less tracking and intelligence, which cannot be in the interests of either public health or the public finances I urge the UK Government to make rapid further progress at the European and international level. The EU’s revised tobacco products directive establishes a new traceability system for all tobacco packaging, and that requires a coding system that can be accessed by enforcement officers to give information about the movement of products through the supply chain from manufacturer to retailer—this addresses the point made by the hon. Member for Harrow East (Bob Blackman). The system also requires security features to prevent tampering and ensure that products are genuine The European Commission has been carrying out consultations and research on the system’s specifications. While I consider its current proposals to be largely constructive and sensible, there are tobacco industry systems that the manufacturers are desperate to see states adopt to implement the directive requirements. The coding system developed by the four major manufacturers is known as Codentify, although it has now been hived off to a nominally independent company. In my opinion, it does not fulfil the requirement for independence in the protocol to eliminate illicit trade in tobacco products. That protocol explicitly requires Governments to take responsibility for control measures, rather than relying on industry self-regulation, which has clearly failed to deliver in the past. I therefore ask the Minister to confirm that the UK Government intend to participate in the European traceability system, and also to state clearly that they will work to ensure that its specifications include robust requirements for independence from the tobacco industry. The industry must not control the traceability system, either directly or indirectly through proxies A global tracking and tracing system is offered by the World Health Organisation’s illicit trade protocol, which was rightly negotiated as the first subsidiary treaty under the framework convention on tobacco control. The EU system will have to be consistent with the protocol, but it is obvious that a working global system would be even more effective than one that is confined to the EU. The protocol also contains other important provisions on control of the tobacco supply chain, including the requirement for manufacturers to conduct due diligence with their customers and to keep proper records of their transactions The UK Government have stated that they will become a party to the protocol on numerous occasions, including in their new tobacco control plan, and I welcome those statements, but they are yet to do so. I ask the Minister to give a clear commitment that the UK Government will move rapidly to ratify the protocol. A date for ratification would be excellent. It certainly needs to happen before 10 July 2018, which is the deadline if the UK is to be able to participate in the first meeting of the parties in October 2018 in Geneva Like others who have spoken, I welcome the tobacco control plan for England. It is not perfect, but it does represent a real commitment to tackling the smoking epidemic. I trust that it will also strengthen continuing co-operation with the Scottish Government, as well as the Welsh and Northern Ireland Governments, in addressing this No. 1 public health priority. However, the approach still needs to be strengthened and supplemented, and action against illicit trade is at the top of my “to do” list I very much hope that the Minister will be able to make the commitments that I have called for today, along with other Members on both sides of the House, and I look forward to the arrival of the first truly smoke-free generation throughout the United Kingdom.
I thank my right hon. Friend the Member for Rother Valley (Sir Kevin Barron) for securing the debate. He is a long-standing campaigner on the issue of tobacco and its effects on society, and it is good to see that he is continuing his campaign. He made an insightful and thought-provoking contribution I also thank other Members who have made excellent speeches on this important issue, including the hon. Member for Chippenham (Michelle Donelan), my hon. Friend the Member for Ipswich (Sandy Martin), the hon. Member for Harrow East (Bob Blackman), my hon. Friend the Member for Stockton South (Dr Williams), the hon. Member for Colchester (Will Quince), my hon. Friend the Member for North Tyneside (Mary Glindon), and the hon. Members for Witney (Robert Courts), for Eastleigh (Mims Davies) and for Stirling (Stephen Kerr) I welcome the fact that the debate is taking place during Stoptober. It is nearly a year since our last debate on the tobacco control plan, which—this may interest some Members—marked my first outing as shadow Minister for public health. While the Minister I shadow has now changed—it is now the hon. Member for Winchester (Steve Brine)—the most significant change since our last debate is that, thanks to him, we finally have a new, updated tobacco control plan, which we were all very pleased to see. It is welcome that, after a long-drawn-out 18-month delay, we now have a plan that will take us a step further towards creating a smoke-free society Labour Members have welcomed the plan and its ambitious and noble goals, but we remain concerned about how it will be effectively implemented and achieved, especially given the short-sighted cuts in public health budgets, which my hon. Friend the Member for Stockton South highlighted knowledgeably in his excellent speech. As we know, the previous plan was extremely successful and reduced smoking rates from 20.2% to 15.5% but, as we have heard from every speaker today, it remains the case that smoking is still a serious issue in our society in terms of both its financial and human cost. Smoking and its related health problems cost our already financially strapped NHS more than £2.5 billion each year. If we were to seriously address smoking in society, we could reduce that financial cost and direct the money towards improving our NHS and ensuring that we have a healthy society It is estimated that 200 people a day die from smoking-related illnesses. In 2015, 79,100 people aged just 35 or over died because of smoking. It is not just adults who are affected, but babies and children. In 2010, as a result of pregnant women smoking, 19,000 babies were born with a low birth weight and an increased chance of taking up smoking later in their lives. As we heard in the excellent speech made by the hon. Member for Colchester, last week was Baby Loss Awareness Week. The hon. Gentleman is co-chair of the all-party parliamentary group on baby loss, of which I am proud to be an officer. It is estimated that up to 5,000 miscarriages, 300 perinatal deaths and around 2,200 premature births each year are attributed to smoking during pregnancy. Those saddening and distressing figures show exactly why we are here today to debate this issue and to ensure that the tobacco control plan is as effective as possible so that we can achieve a smoke-free society, and, in particular, support women during pregnancy We also know that smoking rates remain persistently high, especially among people with mental health issues, as my right hon. Friend the Member for Rother Valley mentioned. The plan sets out various recommendations relating to mental health, including improving support for smokers with mental health conditions and training for mental health staff to help to reduce smoking among that group, but I should like to hear from the Minister exactly what measures have been taken on the basis of those recommendations It is equally worrying that, as a number of Members have pointed out, the level of smoking remains high among those who are unemployed or members of lower socioeconomic groups, especially given the estimate that tobacco was 27% less affordable in 2016 than it was in 2006. There are a host of reasons for that, including the tax on tobacco products. I agree with the hon. Member for Chippenham that we should never seek to reduce that tax, for all the reasons that she gave, but it is deeply worrying that those groups, for whom poverty is rife, are not being sufficiently helped to quit smoking. During last year’s debate, I cited figures that showed that if smoking were reduced among those living in poverty and the costs of smoking to them were reinvested, we could make serious progress towards the eradication of poverty. Will the Minister give us an idea of what consideration he has given to the idea that reducing smoking could be a vehicle for ending poverty in society There is a clear drive in the plan for action on smoking cessation to be taken at a more local level. We do not disagree with that; in fact, we welcome it. We all agree that a “one size fits all” approach does not work, because of the geographical variations when it comes to smoking in our society. In my own region of the north-east of England, smoking rates are 25% higher than those in the south-west, and it is therefore unsurprising that the prevalence of lung cancer in the north-east is close to double that in the south-west. This is why it is important for us to do more at a local level to reduce smoking. However, I must urge the Minister—I know that he takes these matters very seriously—to bear in mind that “localising” action does not mean abdicating responsibility at a national level. The Prime Minister’s driving mission on the steps of Downing Street in the summer of 2016 was to call out the burning injustices of inequality in our society, but we have yet to see that come to fruition—as we know, the Prime Minister has been a bit busy with Brexit. I know that the Minister is also passionate about the burning injustice of health inequality, because we have worked together on many health issues over the years. I know that he understands the importance of improving public health as a mechanism of prevention, and reducing the burden on our NHS by addressing the issues at source. However, the Department in which he is now a Minister has overseen some of the deepest cuts in public health services in recent years. I am sure the Minister knows the figures for these significant cuts, but for the benefit of the House, I will quote statistics used by the Royal Society for Public Health, meaning that I know they are accurate. It says that the total cuts mean that there will be £800 million less in public health budgets between now and 2020-21, which must have a significant impact on smoking cessation rates A study conducted by Action on Smoking and Health and funded by Cancer Research UK found serious budget cuts to smoking cessation services, with a growing number of authorities admitting they no longer have a specialist stop smoking service that is accessible to all smokers. This must be paired with the damaging analysis of Department for Communities and Local Government figures on local government spending by the King’s Fund, which found that wider tobacco control faced cuts of more than 30%. If the tobacco control plan is to be truly successful, as I know the Minister wishes, it cannot be pushed for in isolation from the cuts to public health budgets. The two are inextricably linked and cannot be dealt with in silos The Minister must go away and look into this matter and the effect it will have on the outcome set out in the TCP. Now that we have a blueprint in front of us, which we are all grateful for, it is time to ensure it is achieved completely—not partially and not just in bits, but completely The Minister has been given much to think about during this excellent debate, and I hope that, in his relatively new role, he will be the champion needed to improve smoking cessation and reduce the prevalence of smoking in our society. Now is the time not for simple, warm words, but rather for concrete, defining action that drives forward this agenda There are many actions to take, but I know the Minister has a true passion for health improvement and prevention. He cannot allow the power he now has at his fingertips to be squandered when it comes to implementing this plan. I say again that the plan, as good as it is, cannot be seen in isolation from other Government actions and policies. Ensuring that the right funding is in place to fulfil the plan’s vision and ending the disastrous cuts to public health budgets is the only way we can truly see the plan’s vision realised.
I thank the hon. Member for Washington and Sunderland West (Mrs Hodgson), my ministerial shadow and my friend—she certainly is that. I congratulate the right hon. Member for Rother Valley (Sir Kevin Barron) on securing this important debate. The Backbench Business Committee was an excellent innovation that arrived in this House at the same time as me—there is no correlation between those two things, I should point out—and debates such as this would not necessarily have happened without it. So well done to the right hon. Gentleman, and to all the Members who have participated. As the shadow Minister said, it is Stoptober, which is an excellent time to have this debate, but of course our passion to cut back on smoking rates is not confined to October Let me say a bit about the tobacco control plan and try to respond, as far as I can, to the points raised in the debate. My ministerial brief covers a wide area: public health, primary care, and cancer. That might appear to be a disparate agenda, but there is a plan. For me, all of my responsibilities come back to prevention and in particular how we prevent some of the major diseases; cancer is, of course, still the biggest preventable killer in our country, and the link to smoking is obvious and has been given by many Members. To give some obvious examples, our work to tackle the harmful use of alcohol, our strategy to tackle obesity and specifically childhood obesity, and our tobacco control plan are all about doing more to prevent ill health in our country, and above all cancer The TCP is not an end in itself; it is part of a plan. The shadow Minister kindly said that publishing it was down to me. At our very first health orals, she asked when it would be published, and I gave the answer that it would be published by the summer recess. She then shouted out, “Which summer recess?”, but the plan had been started and I wanted to get it right and to get it out. It is amazing what announcing things at oral questions will do to our officials. Anyway, we got it out, and I am very pleased with it The last TCP ran from 2011 to 2015 and was considered highly successful; I am grateful to the many Members from all parties for saying that. All the ambitions we set out in that plan were exceeded. We introduced a significant amount of legislation over the course of the plan, as did the Labour Government before then. There was the ban itself, then the ban on smoking in cars containing children, and then, last year, the introduction of standardised packaging, which is a first for Europe. The UK remains a world leader in tobacco control, and Governments of both parties have a proven track record in reducing harm caused by tobacco. The country has made a significant reduction in the prevalence of smoking over the past 25 years, from 27% in 1993 to just over 15% today. That is some achievement.
At the moment we have symbols on every bottle of alcohol sold in the UK. I appreciate that this is under EU rules, so other Government Departments would need to look at this, but could we consider having “no smoking while pregnant” symbols on all smoking products, rather than just one in six, as is the case at present?
I will look at that point; as ever, my hon. Friend makes a pertinent point from the Back Benches—where I do not think he will be forever, I might add. [Interruption.] It is evidently not my decision I have given the relevant figures, and we are now considered by independent experts to have the best tobacco control measures in Europe. We published the new plan this year to build on that success, but there is no room for patting ourselves on the back in this game, and we still have a huge amount to do We still have 7.3 million smokers. That exerts a huge impact on our communities and our NHS. Tobacco use is the biggest contributor to cancer, accounting for more than one in four UK cancer deaths, and nearly a fifth of all cancer cases in this country. Research by the Independent Cancer Taskforce reported that up to two thirds of long-term smokers will die as a result of smoking if they do not quit. We have heard from a number of Members across the House about people whom they have loved and lost, and they are not statistics; they are people’s mothers and fathers, and sons and daughters, who have been lost to cancer. Cancer is not contracted through smoking alone, of course, although it accounts for a huge part of the cancer rate. We must remember that 200 people die every day due to smoking; I think every Member will join me in saying I want us to do better than that The plan sets our interim ambitions en route to that goal. Over the next five years we want to reduce the prevalence of adult smokers to 12%. In answer to my hon. Friend the Member for Harrow East (Bob Blackman), I would like to go lower than that, but that is the current figure in the plan. It is not necessarily an end-point, however, and it is not an end in itself. We should also remember the prevalence of 15-year-olds who regularly smoke. We want to get that down to 3%, and the prevalence of pregnant smokers—which so many Members have mentioned today—down to 6%. We want to reduce the burning injustice—a number of Members have used that term today— that sees some of the poorest in our society die on average nine years earlier than the richest, so we will focus, as the plan says, on people in routine and manual occupations We want to focus on other groups particularly affected by smoking, such as people with mental health conditions and those in prisons. The hon. Member for Stockton South (Dr Williams) rightly spoke about that being part of a wider poverty reduction programme. That has to be central to the plan, which is not just owned by the Department of Health and me. It is a cross-governmental plan and everything that we do should be part of that aim to reduce poverty. That is why the Prime Minister said what she did. I guess that the hon. Gentleman does not agree with everything she said, but surely he must agree with her words on the steps of Downing Street about poverty reduction.
The statistics in some of our cities are much higher than in others. In my city of Bradford, the Minister will know that the figure for smoking prevalence is about 22%. Public health is so important; does he recognise the importance of giving more resources to public health and councils, which have experienced significant cuts in recent years?
I simply say to the hon. Gentleman, who has not been present for the debate, that that point has been made. I also point out that we are giving £16 billion of ring-fenced public health spending to councils in England, which is significant. However, I shall come back to his point if he will bear with me To achieve the ambitions in the plan, we need to recognise that smoking is increasingly prevalent in particular groups in society and in particular areas. That is why we need to shift the emphasis from national to local action, and support smokers, particularly in disadvantaged groups, to quit. Now is not the time for more legislation—we have done that bit. I do not rule it out forever, but successive Governments have done that part. Now is the time to redouble our efforts to focus on our top priority groups such as pregnant women, young people and people with mental illnesses. We must focus on the people and areas with the greatest need Let me give an example. Yesterday, we published the two-years-on plan from the national cancer taskforce, which looks at the cancer strategy. It is full of good case studies. One that especially struck me was the Manchester lung cancer project, whereby we screen people arriving at supermarkets in certain parts of Manchester. That has led to improved cancer detection and outcomes for the local community that are quite staggering. Why do that in Manchester and not in Hampshire—in Winchester in my constituency? That is because there is a high prevalence of lung cancer driven by smoking in the Greater Manchester area. I visited Macmillan’s headquarters in London and sat and listened to some callers on their support line. I asked about regional disparities and they said that when they got calls from that part of England, they were about lung cancer, and that is no coincidence The example I gave is a policy response from the Greater Manchester authority, led by Andy Burnham, formerly of this parish, who has already put in place a plan that will mean 115,000 fewer smokers by 2021. I pay tribute to Andy, with whom I worked a lot in the House through my chairmanship of the all-party parliamentary group on breast cancer. I know that he has been greatly affected by that, and he is great partner for us on this matter. That is exactly the kind of thing we meant when we said in the tobacco control plan that we wanted local areas to develop their own local strategies There are many other good schemes locally—for example, the Fresh programme operates in a dozen local authorities in the north-east. I wonder whether the hon. Member for North Tyneside (Mary Glindon) is aware of it. She made an excellent personal speech, and I congratulate her on managing not to turn into a smoker, given the family background that she described. All the evidence suggests that children who grow up in families where the parents smoke go on to do so. The hon. Lady clearly knows something that we do not Leicester provides great examples of innovative stop smoking services, and the right hon. Member for Rother Valley mentioned Leicester and namechecked the council officer, who I suspect will keep that Hansard report. Well done to Leicester I recognise that hon. Members are concerned about local stop smoking services, but as I said in response to an intervention, we have a £16 billion ring-fenced public health budget. The Government believe that local authorities are best placed to make decisions on how the services should be prioritised to meet the needs of their populations. That is why I gave the example from Manchester. I am many things, but I am not best placed to decide what works in Leicester or Manchester; locally elected politicians are best placed The Government will continue to publish data that help local people hold those locally elected leaders to account. That is a crucial part of the plan. Public Health England, for which I am responsible, will continue to offer support to local authorities to help them develop their local approaches in the most cost-effective and evidence-based way. As Minister, I will continue to be a passionate advocate for evidence-based tobacco control plan policy making. It is an integral part of my mission to reduce the toll of preventable cancers I want to say something about the Government’s approach to e-cigarettes, which almost every Member who spoke mentioned. The new control plan commits to monitoring the safety, uptake, impact and effectiveness of e-cigarettes and so-called novel tobacco products. We must find a better term than that. The plan charges Public Health England with the responsibility of including messages about the relative safety of e-cigarettes in their quit smoking campaigns. I am pleased to say that that is already under way and that PHE’s current Stoptober campaign, for the first time, highlights e-cigarettes among the array of tools that smokers can use to improve their chances of quitting successfully As we like to say during Stoptober, there has never been a better time to quit. I will leave to my right hon. Friend the Chancellor the several Budget submissions around e-cigarettes. The suggestion of my hon. Friend the Member for Colchester (Will Quince) of providing free e-cigarettes to pregnant women who are smokers is certainly worthy of consideration. I noted that the hon. Member for North Tyneside is not necessarily a fan of changes to e-cigarette levies, so it is fair to say that we so not have unanimity across the House on that. PHE is already preparing its new year quitting campaign, which is rolled out in January each year, and it will reprise the hard-hitting messages that we have seen on our televisions. It is through consistent messaging that we can hope to reverse the harmful, mistaken and increasingly widespread belief that vaping is no safer than smoking. It clearly is The right hon. Member for Rother Valley made an excellent speech, touching on health inequalities and how smoking disproportionately hits the poorest in society. There is huge variation in the figures for pregnant women, with smoking rates of between 2.3% in London and—to correct the record—28.1% in Blackpool. He also made an excellent point about dentists and oral health. PHE-commissioned training will continue to ensure that local authorities have access to the training they need to provide effective help to quit and the information they need to work with patients. He chairs the all-party parliamentary group on pharmacy—I think we will be meeting soon—so he would say this, but he spoke about pharmacists and healthy living pharmacies, which have been particularly good. He referred to Government research, and PHE is committed to reviewing the evidence on e-cigarettes on an annual basis, and is working closely with Cancer Research UK and the UK Centre for Tobacco and Alcohol Studies to deliver a forum to ensure that we continue to have that strong evidence base I think I need to wind up by 3 o’clock, Madam Deputy Speaker. Is that right? [Interruption.] “Well by,” she says. Okay, let me conclude by thanking everyone who has spoken today. I particularly enjoyed the speech of my hon. Friend the Member for Chippenham (Michelle Donelan). It was hypnotic in many ways but very good, and I noted her Budget submission. As usual, I thank my hon. Friend the Member for Harrow, although I suspect that his berating me on this subject will not have started and ended today. The hon. Member for Ipswich (Sandy Martin) made a consistent point about local authority pension schemes, and it must be for local authorities to make such decisions and then answer to members of the scheme, their elected members and, of course, the residents who elect them and get to make such decisions every day In closing, I appreciate the many challenges and I appreciate the support that the House has given to tobacco control legislation over many years. It is now up to us to provide a national lead and to support our local authorities and ensure that they carry through what is in the plan. I thank my friend the right hon. Member for Rother Valley for introducing today’s debate and ensuring that tobacco control is no longer a partisan issue; this is now about the tobacco control plan.
I just have a few reflections. Several people mentioned my involvement in anti-tobacco measures in this Chamber over many years, but it was never just me. Whether sat on the Opposition or Government Benches, I had allies on the other side who forced different Governments to take different positions all the time. Listening to the debate, we have now reached a consensus. We started off by banning tobacco advertising and promotion, then smoking in public places, then point of sale advertising and now we have standardised packaging. It has been just wonderful to sit here and recognise the fact that we now know what is in our midst, shortening the lives of many tens of thousands of our fellow citizens, and we are now seriously doing something about it. I say to the Minister—if I was on the Government Benches, I would say the same—that I do not see any need for further legislation. We need to implement what we have already done on smoking cessation to help people break this habit. I am thankful for what was said about me, but it is was not just me; there have been teams of people at different times It has been really good today that we have recognised the new products on the market, such as e-cigarettes and other novel products—I think “novel” is a European term that has come in from the tobacco product directive. No matter who owns them and no matter who is promoting them, people now recognise that such products can potentially be very useful in getting citizens off this killer—tobacco shortens the life of 50% of those who use it. We need the research, and we need to be determined I enjoyed all the Front-Bench speeches, and I say to my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) that I loved the parliamentary Labour party brief I received last night—I cannot always say that when I talk about tobacco products or tobacco policy in this House. We now need to make sure that we improve things for our fellow citizens as soon as possible Question put and agreed to. Resolved, That this House has considered the Government's publication of the new Tobacco control plan.
I beg to move, That this House notes with concern that there has been a systematic failure to inform women of the dangers of taking the epilepsy drug sodium valproate during pregnancy, resulting in thousands of children being born with congenital malformations, disabilities and developmental disorders since the 1970s as a result of fetal exposure to the drug; welcomes the launch of the Valproate Toolkit by the Medicines and Healthcare Products Regulatory Agency in February 2016 to ensure that women are informed of the potential risks of the drug, but further notes with concern a recent survey which found that 68 per cent of women have still not received these safety warnings; calls on the Government to take immediate steps to ensure that the materials in the Valproate Toolkit are distributed to all prescribing clinicians, pharmacists, and women who are being prescribed the drug; calls on the Government to require all clinicians prescribing sodium valproate to women and girls of childbearing age to discuss annually with the patient, the risks during pregnancy before a prescription is renewed; and further calls on the Government to bring forward proposals for a care plan and financial assistance to the victims of sodium valproate in pregnancy and their families I congratulate you, Madam Deputy Speaker, on getting through this debate’s catchy title I start by thanking the Backbench Business Committee, on behalf of the all-party parliamentary group on valproate and other anti-epileptic drugs in pregnancy, for facilitating this debate. I also pay tribute to Janet Williams and Emma Murphy, who are present today. They have fought tirelessly on this cause over many years, and we owe them an enormous debt of gratitude It is fair to say that “scandal” is an overused word in political discourse, but it is appropriate in this case: a family who have suffered as a result of a mother taking valproate in pregnancy would regard it as an absolute scandal, and we need to treat it in that way. There are many similarities to the thalidomide scandal. A group of women, over many years, took a drug during pregnancy without knowing the risks, with awful consequences, and we owe them a duty—that is the important point.
I apologise to the right hon. Gentleman for not being able to stay for the whole debate I, too, pay tribute to Janet and Emma for the campaign they have run. This debate is a great tribute to their efforts. Does the right hon. Gentleman agree that the real scandal is that we have known about the problems with this drug since the 1960s, but, as he says, expectant women were not told? The Government and the pharmaceutical industry knew there were dangers.
I thank the hon. Lady for her intervention, and I completely agree with her. Interestingly, the original product licence in March 1974 stated this, way back then: “In women of child bearing age, it should only be used in severe cases or those resistant to other treatments.” They knew in the ’70s, yet the appalling scandal is that so many women since then have had their life turned completely upside down, with enormous consequences for their children, because they were not told.
My constituent Nicola took sodium valproate through her pregnancy, and her son has chronic fatigue. The impact on her family is immense and expensive. We have fought for, and managed to secure, medical support for her through hospitals in Manchester, but does my right hon. Friend agree that there needs to be a Government fund to ensure that victims have such support, rather than having to rely on their own means?
I completely agree. I will make the case a little later, but it seems unanswerable and the Government need to reflect on that What happened was worse than just the neglect of not telling women. The minutes from the 18 July 1973 meeting of the sub-committee on adverse reactions, a sub-committee of the Committee on Safety of Medicines, have been uncovered. That document reveals a real outrage, because it talks about keeping the information from women—deliberately withholding it “especially as it could give rise to fruitless anxiety.” It continued: “Nevertheless, they thought it would be best if prescribers were all made aware of the nature of the evidence and recommended that a statement similar to that proposed by ICI”— in respect of another product— “could be included in all relevant data sheets but not on package inserts so that there would be no danger of patients themselves seeing it.” That is extraordinary.
Would the right hon. Gentleman share my great disappointment if the original documents were to go missing from the archive while these debates and this campaign are ongoing?
I thank the hon. Gentleman for that intervention. Issues such as this are of enormous concern and this raises the question whether there needs to be some sort of inquiry or Hillsborough-style panel to look at exactly how it has happened. However, it is important that we focus on the top priority, which is ensuring that women get told, that this drug is not used inappropriately and that a compensation package of some sort is put in place.
Given what the right hon. Gentleman has said, is it not even more extraordinary that, even now, this information and these warnings are not getting through effectively to pregnant women and their families? My constituent David Tout’s son has been affected by this, as have 20,000 children across the country in every one of our constituencies. There is no sense of urgency from the MHRA—Medicines and Healthcare Products Regulatory Agency—or from the Government.
I thank the right hon. Gentleman for that, and he is right in what he says; I, too, feel that there is a sense of inertia. For goodness’ sake, for as long as women are not getting told about this, more such babies are being born. That is the awful horror of this.
Many of us in the House have been approached by constituents or groups about several of these drug scandals, which represent a paternalistic time, when the patient was not part of a team in an open discussion with the doctor. I am sure there are many of these, so should they be looked at together, as the principles of them all are the same?
That is a profound comment to make and it reflects a changing attitude and culture; it is thankfully now less paternalistic than it was. However, elements of it remain and we need to keep fighting against that. The hon. Lady makes a good point: this relates to other products, too.
rose—
I will take this intervention and then I ought to make progress.
Is the right hon. Gentleman aware of research done by the Independent Fetal Anti Convulsant Trust—In-FACT—which found that up to 400 babies affected by valproate have been born since the toolkit was launched in February 2016?
I thank the hon. Lady for the intervention. I am aware of that figure and again it is shocking. It makes the point that this is a continuing scandal, not something from the dim and distant past Since the 1970s, more information has emerged bit by bit. In 2000, the information given to patients was changed to refer to the warning, but it took until then for anything to emerge. In 2005, Sanofi made an addition to this, and an interesting question is whether it downplayed the risk. That is one point that raises the question whether some sort of panel investigation needs to take place. In 2005, Sanofi said on its warnings to patients: “Some babies born to mothers who took Epilim during pregnancy may develop less quickly than normal and may require additional educational support” That is putting it at its mildest, because the implications were far more serious. The question is, did it know then? These things need to be investigated further It is important to state what the risks are. Among the general population there is a 2% to 3% risk of foetal abnormality. If valproate is taken during pregnancy, that risk rises to 11%, and possible defects include spina bifida; malformations of the face, including cleft palate; malformations of the skull, limbs and organs, including the heart; and respiratory issues. It is incredibly important not to disregard the fact that when people take valproate during pregnancy there is also a 30% to 40% risk of developmental problems, including life-changing issues such as poor speech and language skills, delayed walking and talking, behavioural problems, interaction and communication issues, low intellectual abilities, memory problems, noise sensitivity, sensory issues, attention deficit hyperactivity disorder and autism spectrum disorders. The consequences are incalculable. It is estimated that 20,000 babies have been affected since the 1970s. It is also important to remember the profound impact on the mothers themselves, who too often have been treated as if they are to blame for the problems their children face and who then face years of guilt. That is a really shameful aspect of all this I have some case studies. Becky Parish, a mother from my own county, Norfolk, says: “Logan is 7 and was born with a 7 mm unilateral cleft lip and palate…which the geneticist confirmed was due to Fetal Valproate Syndrome…He also has grommets and struggled with glue ear and bronchitis as a baby” He has needed “constant speech therapy” and suffers ear infections. Becky describes how Logan “has all facial features of FVS” and is short in height and low in weight for his age. He has “severe aggressional and destructive behaviours, including violence against others and self-injurious behaviours” and so it goes on. This is really significant. There is sometimes a danger when we talk in general or abstract terms, but when we hear the stories of the affected families, we realise just how awful it is Becky says “social”—social services—“blamed me for it”. Her assertion is that in her case social services thought that the problems related to a detachment disorder, with the implication being that the mother was in some way to blame. She says: “Social blamed me for it and so did the school—and now I feel more guilt due to it being FVS. Because no matter how much someone says I didn’t know and it wasn’t my fault, the guilt never goes away. And sadly it never will.” That is really shocking Becky decided not to continue with valproate when she became pregnant with her youngest child, who is now five. She says that it was not a difficult decision, because in her view her child’s health was “far more important” than her own seizures, but that must have been a terribly difficult judgment for her to make. Nevertheless, she stopped straight away and was not put on any alternative treatment, despite conflicting messages from health professionals. Her specialist nurse told her that—wait for it—she was being selfish, and made her upset at her 12-week scan. However, her neurologist said that coming off the drug was the best thing she ever did. So she got two completely conflicting messages Carolyn Allen in Southampton talks about how her son requires support for a number of the effects of the condition, including deafness in his left ear, noise sensitivity, and speech and language delay. She says: “He has been referred to portage, speech therapy, occupational therapy, ophthalmic, hearing clinic, physiotherapy, community paediatricians and has already had one operation to release his tongue tie.” Just imagine the massive impact of this condition on that family Paula Hartshorn, a mother from Leeds, says: “The powers-that-be need to think about the devastating impact this has on families, and how these families have to just cope and instantly know how to deal with all these complex medical issue. We have been left to give up on our jobs, careers, social interactions, and everything that goes with a well-rounded life. There are no breaks for us.” The stories are heartbreaking Kazzy Southam from Blackpool tells a story of not finding out about the condition until her daughter was nearly 20. Her voyage of discovery began when she met Janet and Emma in 2014. This was after her daughter had been diagnosed with learning disabilities, dyspraxia, and social anxiety disorder. She had to fight to get a geneticist to investigate and give advice. Eventually, it was confirmed that her daughter had foetal valproate syndrome. It was a shocking fight for her to get justice, and she should not have had to go through that. She says: “To me, she is an angel and I wouldn’t change her for the world. She said to me not long ago: I wouldn’t want to be ‘normal’—I like my mad head. But it hurts me to say, she doesn’t and won’t know any different—all down to the pills I took for my seizures.” I ask Members to imagine living with that throughout their life. The Minister really needs to reflect on this. It seems to me that the Government have an obligation to do good by these people and not just to say that they must resort to the local authority or the clinical commissioning group for whatever might be available in their locality. There is a moral duty here and we must accept it just as we did with thalidomide I became aware of this scandal when I was a Minister and met the campaigners in September 2013. I was horrified by what I heard, having known nothing about the condition until then. I asked the Medicines and Healthcare Products Regulatory Agency, which attended the meeting, for an urgent review of what was being done to stop more and more mothers giving birth without knowing of the risks. In October that year, the MHRA asked the European Medicines Agency to undertake a full review. That review reached the conclusion—it was very little different from what the product licence said back in 1974—that the product should be used only if all other drugs are ineffective or are not tolerated. It also advocated a strengthened warning to ensure that all mothers were aware of the issue In January 2015, the MHRA issued new information with stronger warnings, education materials, patient information leaflets and so on. Eventually, in February 2016, the toolkit was issued: I have it here. It may not look like a toolkit, but it is. It is of value, because it gives information to clinicians and patients about the risks involved. Again, the scandal is that the information has not been communicated to very many of the affected women In September this year, a survey carried out by the UK’s three leading epilepsy charities—Epilepsy Society, Epilepsy Action and Young Epilepsy—found that the warnings were not getting through. Some 68% of women of childbearing age had not had any of the materials released as part of the valproate toolkit. That is not acceptable.
I thank the right hon. Gentleman for accepting a further intervention. He is making a very powerful case. The hon. Member for Central Ayrshire (Dr Whitford) mentioned the paternalistic approach that the medical profession has perhaps taken in the past. Is he as shocked as I was to learn that that paternalistic approach was still in evidence some two years ago when I met the pharmaceutical company Sanofi to discuss getting information out to mothers? The company told me that it would be inappropriate to make the information available, as it was unsupported by detailed advice from doctors. Of course it is important that women should be able to discuss the matter with their clinician, but they are able to understand and interpret intelligence, too.
I thank the hon. Lady for her intervention and pay tribute to her for her work on the all-party group for valproate and other anti-epileptic drugs in pregnancy, and for her campaigning. Yes, the response she got from Sanofi two years ago was unacceptable. It had the effect of hiding from women the full extent of the risk. Women should be presented with the evidence so that they can have a full discussion with the clinician about what steps to take. The September 2017 survey also found that 18% of women did not know of the harm—it was not that they had not received the toolkit, but that they still did not know. The system is failing those women.
I stand here as an advocate for my constituent, Ms Carol Short, who describes her son as a 26-year-old locked in a man’s body, but unable to do much more than a 10-year-old. Does the right hon. Gentleman agree that it is shocking, with the clinical commissioning groups and all the funding that comes from the public sector, that we still cannot get this message through? Might one solution be shorter length prescriptions, to increase the likelihood that women receive more regular advice?
That suggestion is worth exploring. There certainly should be regular reviews—discussions on the woman’s intentions about childbirth, and on the appropriateness of the treatment for that woman at that place and time I acknowledge an important danger. If all the focus is on the risk of valproate, there is a risk that women will simply give up and take no medication during pregnancy, and that there will be a rise in unexpected deaths through epilepsy. SUDEP Action raised that really important issue. Already, every year, 1,200 people die sudden unexpected deaths in epilepsy, and of that total SUDEP Action estimates that about 42% are avoidable. We definitely do not want any increase in that number. For me, that points to the need for all women—indeed, all people—with epilepsy to have access to specialist teams, wherever in the country they live. My worry is that access is haphazard and variable Last Friday I met a specialist team in Norwich. It is a very good team, and they explained to me how they have managed to reduce the use of valproate by women in the childbearing years to a very small number. They say it is only a very small subset, for whom there is no alternative. Thus they can focus all their attention on those women. They said that there is considerable variability around the country—that many women do not get access to a specialist team. I would like the Minister to commit to the publication by the Government of data for every CCG showing the level of prescribing of this medication, to enable us to pinpoint where over-prescribing is taking place The interesting and rather concerning point is, if those specialists that I spoke to are right that only a very small subset of women of childbearing age need to take valproate, why is it that still, of the 173,787 people with epilepsy taking valproate, 17,848 are women of childbearing age? That looks like substantial over-prescribing, which is completely contrary to the current guidance. If the guidance is clear that it should not be prescribed to women of childbearing age unless there is no alternative that is safe for the individual woman, why on earth are so many women still being prescribed this medication? It is a scandal, and the Government need to get to grips with it We need a holistic approach, so that women have access to specialist care and so that full consideration can be given to the right arrangements to ensure that no woman is on valproate who need not be during those years of childbearing age. Then we might start to see an end to this awful continuing scandal. Finally, I shall outline the steps that the Government and others should take. First, the toolkit must reach everyone. It must surely be mandatory, not voluntary. Given the clear evidence from the survey of the number of women who are not getting the message, we cannot rely on the current system to work, because it is not working. As the hon. Member for Lancaster and Fleetwood (Cat Smith) said, 400 affected babies have been born since it was introduced. That cannot continue; the warnings must be mandatory, along with raising awareness among GPs, pharmacists, specialists, midwives and health visitors Secondly, people should have an annual discussion with their GP or another health professional. The Epilepsy Society has argued that that should happen, and it is very much consistent with the valproate toolkit, which highlights the need for regular review. There should be face-to-face discussion with a health professional before the prescription is renewed Thirdly, all women should have access to specialist units, wherever they live. We must end this haphazard, variable position around the country, and we must address fully the concerns raised by SUDEP Action. Professor Ridsdale, a consultant who has specialised in this area of policy, says: “A useful outcome of this exercise would be that whoever prescribes Valproate agrees to identify and provide regular advice to women and girls at risk. Better still, that policy-makers and providers start exploring how ongoing structured self-management advice might be offered to everyone with epilepsy.” That is surely the ambition we should set Fourthly, we should publish the prescribing rates for valproate for every CCG. The Government say they have a commitment to openness, and this would be a good demonstration of it, because we would be able to identify where the real problems exist and where women are not getting access to good enough advice Fifthly, we should ensure that only those women who absolutely have to take valproate do so during their child-bearing years, in accordance with the advice, and that we end what appears to be the significant over-prescribing of this medication for such women Sixthly—this comes back to some of the interventions that have been made, including by my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron)—there must be a financial support package. In a way, that comes down to the Government’s duty to these people. This has gone on for many decades, so my point is not directed just at this Government, but they have the responsibility here and now to do right by these people. There is an overwhelming moral case for them to do that, and it is not good enough for Ministers to simply say that support is available locally through local authorities or CCGs. These families have suffered an injustice, and the Government have a moral obligation to address it. If it is right for thalidomide victims, it is right for those who have lost out severely as a result of valproate. In France, a €10 million initial fund has been established, and it could be increased. The Government need to take the same step in this country Seventhly, there must be a statement of regret or apology for the people who have been let down by the system so very badly. Finally, there is a case for an inquiry or a Hillsborough-style panel so that we can understand how on earth this outrageous scandal could ever have happened, how it has gone on for so many decades, letting down so many families, and what lessons can be learned to ensure that this never, ever happens again.
Order. If colleagues could stick to around nine minutes, we will be able to get everybody in.
I pay tribute to the right hon. Member for North Norfolk (Norman Lamb) for so eloquently articulating the concerns that many of us share about the taking of sodium valproate by expectant mothers I am speaking today because I believe there is a case for Ministers to answer on the grounds of compassion and justice as to how and why pregnant women were allowed to take sodium valproate for so many years without being better advised and informed, and without their unborn children being better protected from the risks. That is particularly the case since professionals became increasingly aware of those risks over the years—as early as 1973. As we have heard, the risks are huge. At the end of the day, the people who should have been able to weigh them up and choose whether to take valproate while pregnant were the mothers. I appreciate that in 1973 we were, as has been said by a practitioner in medicine, in a more paternalistic era, but that was not the case as the years went by, and certainly not in 2016, when the valproate toolkit—the patient guide that I have here in my hand—was published Mothers were not given the relevant information and, sadly, far too many still are not. It is absolutely critical that they are given it, because the toolkit is stark, stating: “If you take valproate when you are pregnant it can harm your unborn child…Taking valproate…can cause birth defects and problems with development and learning…In women who take valproate while pregnant, around 10 babies in every 100 will have a birth defect”, such as “spina bifida…facial and skull malformations…malformations of the limbs, heart, kidney” and other organs. It goes on to say that “about 30-40 children in every 100 may have developmental problems” such as “learning to walk and talk…lower intelligence…poor speech and language skills” and “memory problems.” It states that “it is…important that you…know about these risks” But for years women did not know about the risks when medical professionals did. They might not have known, and probably did not know, all those details. However, I have with me a copy of a letter from the Committee on Safety of Medicines—the precursor to the MHRA—from 1973. It refers to a number of studies and says: “it is now clear from other studies…that the use of anticonvulsants during pregnancy…is liable to produce other abnormalities as well as hare-lip and cleft palate. The risk appears to be low and not sufficient to justify stopping the use of anticonvulsants when they are necessary for the control of epilepsy.” There we have it—the Committee on Safety of Medicines was aware of this in 1973. The documentation relating to the licensing application in 1974, which the right hon. Gentleman mentioned, says that the product is licensed “for use in general, focal or other epilepsy. In women of child bearing age, it should only be used in severe cases or those resistant to other treatment” So we now know that the dangers were being raised as long ago as 1973 and 1974 In response to these concerns, the CSM instructed that an alert must “not go on the package inserts” so that patients would be protected from “fruitless anxiety”. Because patients did not see anything, they were denied the information and therefore the choice to abstain from this drug. Yet very much more anxiety was caused for many of them when the reality was that thousands of babies were born with life-changing disabilities and deformities that could have resulted from taking this drug during pregnancy.
Does the hon. Lady find it even more shocking that it was decided to keep this information from women in 1973-74, in the wake of the thalidomide scandal, when it should have been uppermost in people’s minds that pregnant women needed warning about the drugs they took? That should have made it more likely that women were informed about the risks.
The hon. Lady makes a very good point Further warnings were issued. In 2000, a patient information leaflet from the producer, Sanofi, said: “It is known that women who have epilepsy have a slightly higher risk of having a child with an abnormality than other women. Women who have to take Epilim in the first 3 months of pregnancy to control their epilepsy have about a 1-2% chance of having a baby with Spina Bifida.” In 2005, Sanofi added: “Some babies born to mothers who took Epilim during pregnancy may develop less quickly than normal and may require additional educational support” and that some “babies born to mothers who took Epilim…during pregnancy may develop less quickly than normal or have autistic disorders.” Warnings were emerging over the years, but nothing was done to ensure that patients were told. Why did patients have to wait almost 30 years to be warned of the risks Janet Williams and Emma Murphy, whom the right hon. Member for North Norfolk (Norman Lamb) mentioned and whom I have had the privilege of meeting, are tenacious and brave women who have campaigned for years and set up a support group for affected families. I pay tribute to them, and I want to tell the House a little bit about their family situations. Janet has two sons aged 26 and 28: Lee and Philip. Janet took Epilim, but nothing else, during both pregnancies. She told me: “I wasn’t offered anything else—and no one told me of the risks.” Lee, at 26, has curvature of the spine, Asperger’s, learning difficulties and memory problems, and he cannot hold down a job. Philip, at 28, has even more problems. He has problems with hearing, vision, speech, language and walking, as well as floppy joints. He is still fully dependent on Janet Emma had her children a generation later. She has five children, aged eight to 14: Chloe, Lauren, Luke, Erin and Kian. They have all been diagnosed with a number of symptoms. All have varied problems, including autism, incontinence, deafness, cerebral palsy and curvature of the spine, and all are slow to develop. Emma took the same dose of Epilim during each pregnancy. She told me that she questioned that, but was told that it was the best drug to control her seizures and that her baby would be fine. She took no other drugs during her pregnancies. No one warned her of the risks The tragedy is that those two women represent more than 1,000 others in their support group, the Fetal Anti Convulsant Syndrome Association. Together, they founded the Independent Fetal Anti Convulsant Trust, a registered charity, to campaign for better awareness of the risks of taking valproate, to prevent further such difficulties occurring, and to challenge the Government. There is, as I say, a case to answer, and I do not believe that we would be here today were it not for these two women.
Does the hon. Lady agree that women such as Janet and Emma are ideally placed to get compensation, should the Government agree to a system similar to the €10 million French compensation scheme for Depakine?
I certainly think that has to be looked at as part of the case that Ministers have to answer I would like to say much more but time prohibits me. We have heard some of the terrible statistics that have already been cited about the 20,000 children who could have been affected since the risks were first known about, the 400 children who are still born each year with symptoms, the 28,000 women of childbearing age—according to ONS figures—who are still being prescribed the drug, and the 68% of women in this situation who say that they are not properly informed of the risks What do I ask of Ministers? I ask the Minister to agree that significantly more needs to be done urgently to raise awareness of the risks of taking sodium valproate among pregnant women and those who could become pregnant. Does he agree that although Ministers might have come to know about the risks only relatively recently, the producer Senofi, the MHRA and its predecessor, the Committee on Safety of Medicines, knew about them and should have done more to address them? They should have published information and improved warnings years ago Does the Minister accept that the support needed by mothers such as Janet and Emma, who have to care for their children with foetal valproate syndrome, is major and may be lifelong, and that much more needs to be done to consider how that support can be improved and funded? Janet and Emma tell me that the current provision through local councils and health authorities is wholly insufficient and that care plans are needed for the many affected children Is there any reason why, as I said at the outset, Ministers cannot look at what we in this country can do to support these families now, without further delay, and certainly without awaiting the final decision of the European Commission regarding the link between sodium valproate and birth defects? After all, we are leaving the EU. Does the Minister now have full confidence in the MHRA’s ability to effectively inform and guide healthcare professionals on the use of the prescription of sodium valproate for epilepsy, and does he think the same can be said of the MHRA’s involvement over the years? Finally, will the Minister, at an early date, meet Janet Williams and Emma Murphy, as well as a group of Members who are concerned about this issue, to respond to their concerns and to my call that our Government at the very least have a case to answer?
It was heartbreaking and infuriating to read the news that 68% of the women who are taking valproate today were not aware of the risks. That is a failure for all of us. We debated this issue in March 2013, and we have put down early-day motions. There was a television programme, chaired by Huw Edwards, in which the victims took part. We thought we had cracked it: we thought we had advertised enough so that no one, after 2013, could be in the position of not realising the terrible risks caused by taking valproate in pregnancy I am not making any criticism of anyone, except the MHRA, and we must look at our relationship with the regulatory body. The former Minister, the right hon. Member for North Norfolk (Norman Lamb), did all he could. He has a great and honourable record as a compassionate campaigner on many issues. It is a shock to all of us in that we did not expect there to be compensation, but it should now be coming along. It is not compensation in any serious way, but it is some admission that a terrible mistake has been made—not by the mothers, but by the system It is helpful to look back at what happened with thalidomide, which I remember vividly. There were 2,000 cases of birth defects in the United Kingdom; there were 20 in the United States. Why? The reason is that we went on prescribing Destobel for a year after the birth defects were suspected, because the drug company was adamant about it. It had tested the drug on animals, including pregnant animals—pregnant rabbits, even—and only when it went back to do another test of a particular strain of the drug on pregnant rabbits were the birth defects reproduced. That shows the limits of animal testing. The real difference was that the regulatory body in the United States would not accept thalidomide in that form, and its use produced a very small number of cases: 20 compared with 2,000 We have had the effect of a drug called Vioxx for arthritis sufferers. According to the Food and Drug Administration in America, it caused 60,000 deaths; imagine it—60,000 deaths. How many bad reactions did the MHRA have in this country? About six. We would still be using it if the FDA had not discovered that death was one of the side effects of the drug, which was taken by millions GlaxoSmithKline in America has been fined—it is hard to believe—$3.5 billion. What was the fine for? It had suppressed the evidence of the trials it had carried out. It did not publish any of the negative results of the trials it carried out, and only the ones that were neutral or favourable. Drugs that were killing people were getting on to the market—this is a British company. What did the MHRA do in this country? Nothing! I wrote to them saying, “For goodness’ sake, you have to act against GlaxoSmithKline.” It is no coincidence that the person who chaired the regulatory body for more than a decade was a previous employee of that company. I am not saying that in this instance the body did absolutely nothing; it did produce the tools and provided advice, but that clearly did not work—how could it have done if 68% of the women still taking the drug did not know This issue applies to all Governments; it has been raised many times before. What we need is a regulatory body that is not paid for or controlled by the pharmaceutical industry but is independent and controlled nationally. Some years ago in Italy, the system changed. The pharmaceutical industry still pays for running the body, but for the past 20 years each Government have said that they would not have a fully independent body because they did not want to pay for it, although it was fine if the burden was taken by the pharmaceutical industry itself I do not want to say that we are all against the pharmaceutical industry, which has produced miraculous results this century. Valproate is a very good drug: everyone I have spoken to who has used it says that it is very effective and that it reduces seizures, epileptic fits and the incidence of bipolar disorders. We do not want to stop its use at all and we want to appreciate its quality, but after these four years, when the evidence from parents who have suffered has been there, clearly nothing has worked. We must look to reform our regulatory system, appreciating the value of the drug but at least setting up a fund that can express the sorrow of the country and the regret that we have not sorted this matter out or given warnings to future parents. We must make sure that the reforms suggested by the right hon. Member for North Norfolk proceed as a matter of great urgency.
Will the hon. Gentleman give way?
He has finished.
I thank the right hon. Member for North Norfolk (Norman Lamb) for securing this important debate and the Backbench Business Committee for allowing us time in the main Chamber to consider this issue. I also pay tribute to campaigners who have done so much to raise it As one who works closely with constituents so gravely affected by the use of Primodos as a pregnancy test, I recognise the huge importance of airing such concerns on behalf of our constituents as widely as possible so that all can hear. There is so much work to do on Primodos, and I hope to bring those concerns to the Prime Minister shortly. As the chair of the all-party parliamentary group on women in Parliament and a former member of the Women and Equalities Committee, I want to take the time today to note, along with colleagues, that many Backbench Business and Westminster Hall debates seem to focus on women’s health issues: Valproate, Primodos, vaginal mesh. It is great to see such an issue raised in the main Chamber.
I come back to the point I made earlier. We seem to see these themes. Rather than having multiple separate inquiries, should we consider issues such as Primodos and valproate together? Common learnings need to come out of them.
I absolutely agree. I hope to pull that issue together as I go on with my remarks. It is really important that we raise the case of sodium valproate, which, as we have heard, is still in use. All of these issues need to be looked at Common to this debate—and in all such cases, including Primodos—are the hidden, missing and lost documents, along with a delay in education and information. That was raised again today by the right hon. Member for North Norfolk. I pay tribute to Sky News for its exposés on valproate and Primodos, because this really matters to the families affected.
My hon. Friend raises a valid point about media coverage. I congratulate right hon. and hon. Members on raising the issue in the Chamber today, but I am concerned that it might make some women nervous about taking medication if they are pregnant, or are considering whether they would like to become pregnant and are on medication. Surely one of the messages we want to send out today is, “Please consult your doctor and do not respond to everything you read in the press if you are taking epilepsy medication.”
I thank my hon. Friend for her intervention. Many of us have constituents, friends or family who are affected by epilepsy, which, in itself, is very serious, or by bipolar disorder. Appropriate use remains very important. For the vast majority of patients, treatment can be effective and useful if it is done right—if managed, if educated and if understood. The argument, therefore, should not be about ceasing use, but about telling the truth and looking at appropriate use during pregnancy. Men use the drug too, so we need to take a balanced approach and reflect all situations.
The hon. Lady is making really good points. I totally agree with her that the drug is appropriate for most people. I just want the guidance to be followed. The guidance is clear that for women of childbearing age it should not be used unless there is no alternative. We just need to stick to that guidance and make sure it is implemented everywhere.
Absolutely. Speaking about this issue in this Chamber will empower our women constituents, before and during pregnancy, so they can be informed and make the right choices. That is the outcome we should all be hoping for Similar issues were raised yesterday during a debate in Westminster Hall on mesh implants. New mothers in particular had taken the advice they were given without hesitation. A woman’s first pregnancy can be an unsettling time with all the changes their body goes through. I would imagine that for people suffering from epilepsy or bipolar disorder that time is even more nerve wracking. It is absolutely right that we are measured when we talk about these issues It is important that our specialists ensure that women are given the correct and proper guidance. Patients need knowledge and they need it more than anyone. They live with the consequences if things go wrong and they will always look back on their decisions. If they have not been given the right information, how can they truly know they have made the right decision for themselves and their family? Siblings are often impacted as well The Government and MPs have a really important role to play in raising awareness of medical issues during pregnancy, including those concerning sodium valproate. I recognise the efforts that have been made, with labelling on packages. I am sure the Minister will agree, however, that more needs to be done. This drug, introduced in 1974, has been crucial, but support for families affected is also crucial. I welcome the fact that young people who have been affected are to be included in the new framework for health and social care for children and young people. It has been a real battle, but clinical commissioning groups and local authorities are getting to grips with it. It is really important that they receive support on a local level. I welcome the Minister’s forthcoming meeting with the all-party group, and I know that Ministers are taking this matter seriously, but I ask the Department for assurances on similar health issues affecting women, such as those relating to Primodos and mesh implants. We have moved to an incredible place on blood contamination—some of my constituents were affected by that—and constituents have written asking me to raise this issue too. We want more action, and there is a common denominator.
Two years ago, I asked the Minister to extend the Primodos inquiry to include valproate, but my request was declined because, I was told, the two issues were very different, yet they seem to be quite similar. Does the hon. Lady think that that was a missed opportunity?
As a woman in Parliament, I think that any opportunity not taken to raise women’s issues is a missed opportunity, and I know the Minister is listening intently The hon. Member for Newport West (Paul Flynn) raised a point about the seemingly cosy relationship the MHRA has with the drugs companies, when it suits it, and sometimes the laissez-faire attitude it adopts, when it suits it. It is incomprehensible that greater independence cannot be injected into this area. We need openness and reform. I would like the Minister to take a look at the position in France and consider setting aside some funding for compensation for medical accidents Few in the Chamber can imagine the hardship, guilt and heartbreak of the impact of taking a simple prescription drug during pregnancy and finding out later that it might have had an effect on one’s child. I am lucky to have two healthy beautiful daughters. We are all at the mercy of decisions we take during our pregnancy and the professional guidance we receive. We are fortunate to have the opportunity to raise awareness among people in this situation, but there are those not lucky enough to be sufficiently informed. This is an important debate, therefore, and I urge the Department to work with the MHRA to give patients full confidence in it on all pregnancy matters.
I am pleased that we are having this important debate, and I pay tribute to the right hon. Member for North Norfolk (Norman Lamb) for securing it and for setting out so clearly the issues involved. My career before I was elected was as an NHS clinical scientist. Working in a biochemistry laboratory, I was very familiar with sodium valproate as part of the battery of anticonvulsant drugs for which we regularly tested patients to help their clinicians better monitor their treatment and ensure that their dosage was at the optimum level. Until I met Emma Murphy, however, and became aware of her campaign, I was not aware of what appeared to be a systematic failure to inform women of the potentially damaging effects of taking valproate during pregnancy Only after watching a television programme about foetal anticonvulsant syndrome did Emma herself became aware that her own children’s health problems were probably attributable to the anti-epileptic drugs she had taken while pregnant, which had been prescribed to her from the age of 12. Like everyone in the House, I pay tribute to Emma Murphy and Janet Williams for their great campaigning work The damage to the developing foetus is thought to be caused in the first trimester of pregnancy when the anti-epileptic drug crosses the placenta into the foetus, and the effects depend upon the dosage and the drug. Sodium valproate, or Epilim, is indicated in 80% of cases of foetal anticonvulsant syndrome. Experts such as Dr Peter Turnpenny, clinical geneticist at the Royal Devon and Exeter Hospital, say that Epilim may affect about 560 babies every year. He adds: “About 10% of foetuses exposed to sodium valproate will have a major congenital malformation such as cleft palate. 12% are likely to be diagnosed with a neurodevelopmental disorder.” Reports linking valproate to birth defects started to appear, most notably, in 1981, with a paper by H. Nau entitled “Valproic Acid and its Metabolites”. In 1983, the British Medical Journal published an article in which the Royal Liverpool Hospital cited two cases suggesting a link between birth defects and valproate taken during pregnancy. The American Journal of Medical Genetics cited seven cases in 1984 of children born with malformations to mothers taking valproate, and the Journal of Paediatrics cited 26 cases in 1986. The list goes on. It would appear that the evidence was steadily building up with the publication of more and more cases linking valproate to birth defects. The Committee on Safety of Medicines and the Medicines and Healthcare Products Regulatory Agency noted those reports, and, I hope, monitored the use of valproate, particularly during pregnancy.
We have heard about various scandals. In the case of Vioxx, which was mentioned by the hon. Member for Newport West (Paul Flynn), trials did not show a problem but real-world use did. Does the hon. Lady think that we need some kind of reform of the reporting system? There is something that we call a yellow card, and patients can now fill it in themselves, but many of them do not realise that. I feel that there is not enough “flagging up” when patients suspect that they are suffering from side-effects.
The hon. Lady is absolutely right. She and I are well aware of the yellow card system, because we have both worked in the NHS, but how many people out there know that they can report side-effects of drugs, or even suspected side-effects? We really have a job to do in conveying that message to the general public, and we also need people to collate the information and act on it A definitive paper stating that there was a clear link between valproate taken during pregnancy and birth defects was published in 1995. It was entitled “Foetal Valproate Syndrome”, and was written by geneticists at St Mary’s Hospital, Manchester. It is clear that the evidence has been building up for a long time, so why does it appear that women were not warned about the potential dangers of taking the drug in pregnancy?
That 1995 report concluded that the “risk” of foetal valproate syndrome when babies were exposed to valproate was “significant”.
That was probably the first research paper to suggest that it was not just coincidence and that there was a causal relationship, which is why it is seen as definitive The pharmaceutical company Sanofi, which many Members have mentioned, has stated that it has kept in line with scientific knowledge when reporting side-effects in a foetus. However, from as early as 1983 the CSM and the MHRA reported the problems caused by taking sodium valproate in pregnancy, but did not insist that Sanofi issue warnings in the form of a patient information leaflet Even now, to this day, epilepsy charities report that women are not aware of the potential risks when taking the drug in pregnancy. A survey has shown—I know it has already been mentioned, but it does no harm to reinforce these findings—that 18% of women taking sodium valproate were not aware of the risks during pregnancy, and 28% said that they had not been informed of any risks. That is despite the production by the MHRA of a valproate toolkit designed to help healthcare professionals to talk to women with epilepsy about the risks of taking valproate during pregnancy.
The hon. Lady is making an incredibly valuable contribution to the debate. Does she agree that if it is clear during a period of time that the amount of a drug that is being prescribed is significantly more than the guidance suggests is appropriate, it is not acceptable for the drug company, the regulator and the Government simply to be passive and to allow that to continue? If we knew that this drug was being over-prescribed, which appears to be the case, why on earth was action not taken?
That is a very good point, and if we manage to establish an inquiry, it should look into the issue of over-prescribing I want to mention other agencies. The European Medicines Agency has also recommended a strengthening of measures to reduce the risk of harm to babies born to mothers taking valproate. Information from the House of Commons Library outlines a situation in France, which has already been referred to, with an estimate that between 425 and 450 children were affected by birth defects attributable to valproate from 2006 to 2014. The French Parliament this year voted to set aside €10 million for claims related to valproate. The Health Minister, Marisol Touraine, described this as a “starting point” and stated that compensation would ultimately be paid by those deemed responsible: “I regret that Sanofi didn’t seek an amicable settlement as a matter of principle. I hope Sanofi will change its position.” Sanofi had no comment to make on the Minister’s remark. A class action has also been brought by the French association for people affected by sodium valproate against Sanofi In the UK, in 2004 a class action was brought by a group of families under the Consumer Protection Act 1987, which was expected to go to trial in 2011, but the litigation was discontinued prior to this after the Legal Services Commission withdrew funding. It is disappointing that this Government have said that there are no current plans to introduce a compensation fund similar to that in France, and I urge them to reconsider I fully support the remedial steps outlined in the motion, including the call for an inquiry, and this Government must bring forward a care plan and financial assistance for the victims of this national scandal.
I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this important debate, which I hope will compel change. I also join colleagues in putting on record my thanks and admiration for the FACS Association founders, Emma Murphy and Janet Williams, who are here today. Emma and Janet are an inspirational pair who have turned their life-affecting experiences as victims of this syndrome, and their knowledge of victims of it, towards justice on the issue and the demand for better knowledge of the risks that sodium valproate poses to our unborn children I speak as someone who for 10 years or so took sodium valproate, not in utero, but in childhood. At seven years of age, I was rushed to hospital with meningitis. Within a few hours, I was fighting for my life and in a coma for two days before responding to a spinal tap. I was one of the fortunate ones and survived without any of the known side-effects such as deafness, blindness or amputation, which routinely follow for those suffering from meningitis. Instead, I was left with epilepsy for the six years that followed. During that time, I got pretty close to the NHS, its out-patients and out-patient wards, and its brilliant teams of nurses and doctors, who worked together to get me better. I was prescribed sodium valproate, and dutifully took Epilim for at least six years, so I stand here also to give voice to epilepsy sufferers in this country Let me give the House a sense of what it is like to endure a convulsion. There is a stillness at the control centre of the mind, but a violent movement of the body—an arm, the head or legs. You are aware of it but unable to prevent or stop it. I recall that it is possible to steer it, though I do not know how. I remember, as a young boy, enjoying, like most siblings, bunking down in a bedroom with a sibling and being able, on the rare occasions I had convulsions—only between 4 am and 6 am —to wake my sister, with whom I had enjoyed a sleepover in one of our bedrooms. She alerted my parents and I was observed until the convulsion stopped because there is nothing that can be done Epilim—sodium valproate’s commercial name—is widely thought to be the greatest contributing factor to curing me of epilepsy. But for a simple twist of fate, I might have consumed the drug at a different time. When Emma and Janet presented me with the National Archives papers of minutes from 1973 and 1974, when decisions were taken to withhold the knowledge of the risk to foetal development, I was stunned. There were notes in those minutes advising two consecutive, different Governments not to include any warning or information on the risk. It is all too familiar: another national cover-up and further scandal from those closed decades; the “we know what’s best for you” attitude taken by the few to the many, and often said by men to women; the long wait for social justice, and a burning injustice finally coming to light. There was conspiring against the women for whom the drug was prescribed I want to spread not fear, but knowledge of sodium valproate. I stand here as a record of its effectiveness, but I also stand up for the unborn children, the women and the expectant parents to whom the risks are not widely enough known. I welcome the news that warnings will feature on the outside of packaging and hope that our medical leaders and the Government will appreciate that issuing guidance is not the same as ensuring knowledge I support practical steps such as the distribution of the valproate toolkit to all clinicians, pharmacists and women for whom the drug is prescribed. The Government have a duty to respond with practical steps to address the problem. However, our fight is as much against the cover-up as it is for the clear picture we need to send to parents where mum is taking valproate Let this be another moment where we draw caution for all those in positions of power who are about to make decisions that keep people in the dark, or withhold information that is life-affecting, life-changing or poses risk to life. Life will catch up with you. The truth will out. An open and tolerant society has freedom and equality of access to information as a guiding principle to life in it On health, decisions should not be made for us, but taken with us: nothing about us without us; a democratic voice at the table; an informed patient choice, not deals in the dark. We have a democratic deficit in decision making on health matters and services. Sadly, on the evidence of last night, there is a democratic deficit on the part of the Government, too. They say they are a listening Government, but I think we have a Government who refuse to hear I urge the Government to listen, to make amends for this national scandal, to look at compensation, to address the lack of knowledge, to apologise to the women and to the children who are now men and women themselves, and to make clear our instruction that no content or information pertaining to health and medical prescriptions and the decisions for patients to make should ever be withheld again.
It is always a privilege to speak in these debates. I give special mention to the hon. Member for Bury North (James Frith), whose powerful and personal summary of his life has greatly added to the debate. Everyone who heard his contribution will appreciate it and thank him for it. The right hon. Member for North Norfolk (Norman Lamb) set the scene so capably, outlining the case for addressing valproate and foetal anticonvulsant syndrome. I pay tribute to him for the summary at the end of his speech, about which I will speak later, and his eight recommendations. If there are any recommendations to follow, those are they, as everyone in the House will agree. I thank all the other hon. and right hon. Members who have spoken, because their contributions were equally as important, and I also thank those who made interventions. The House shines better whenever we discuss issues on which we can have an input both personally and on behalf of our constituents, and this is one such issue There is no greater gift from God than a little baby. I have two wee granddaughters, and I adore them. We maybe do not spend as much time with them and our children as we should, but we try. They are both perfect in my opinion, even if they have some tantrums. As girls, perhaps they have different tantrums to boys—I only had boys, so I do not know. We live on coffee in my office—I suspect everyone else is the same—and I have watched my parliamentary aide as she refused her normal 10 cups of coffee and drank only caffeine-free beverages for nine months during her pregnancies. Indeed, her not drinking coffee was the first indication that she was expecting again. She had had two miscarriages but now had one baby and was expecting her second, so she was going to take every step that she could to ensure that the baby was perfect. She said that the reason for not drinking caffeine was that it can make the baby’s heart beat a little fast. Mothers everywhere will do almost anything to ensure that they protect that little life when they know of its existence. Unfortunately, as this debate has clearly shown, some mothers did not know what was happening, which is why I feel strongly that more research must be done for the mothers who have long-term health problems and do not know how the medication they need may affect their children. Every Member who has spoken has made that point I want to throw another point into the equation. People with ulcerative colitis, Crohn’s disease and other conditions who have infusions such as infliximab have to come off them if they want to get pregnant. Some people are made aware of such things, but does everyone know that? I suspect not, but they should. The hon. Member for Central Ayrshire (Dr Whitford) and others referred to the yellow card scheme, and people need to be made aware of when incidents happen. More needs to be done to ease families’ minds, and that is why I join with colleagues today to ask for more to be done not only in the case of this epilepsy medication, but with more long-term medications in general. We must look beyond this debate and encapsulate what other people are saying Sodium valproate is an anti-epileptic drug that is associated with greater risks in pregnancy than other AEDs. Other valproate medicines include valproic acid and valproate semisodium. The Medicines and Healthcare Products Regulatory Agency reports that, although the general risk of foetal abnormality is 2% to 3%, the risk for women taking sodium valproate is around 10%. Did those women know? This debate illustrates that they did not, but they should have known. We have to address the issue now The birth defects can include spina bifida and limb, facial and skull malformations. The use of sodium valproate in pregnancy can also affect a child’s development. Many Members, including the hon. Member for Bury North in his powerful speech, have told us exactly what valproate does. Children have delays in learning to walk and talk. The drug can lower intelligence, and affected children have poor speech and language skills compared with children of the same age. There have unfortunately been many scandals over the years, and my constituents made me aware of the thalidomide scandal, to which I can relate. The hon. Member for Eastleigh (Mims Davies), like me, spoke in yesterday’s Westminster Hall debate on mesh implants: I have been contacted by many affected women, and they did not know what the risks were, either. They have lived with the repercussions for years. One Member mentioned a lady who had to go in three times in six years to have operations before she was cured The same is true of Primodos. A Member who is not here told me about his involvement with that issue. There many such scandals and, as other Members have said, we need to bring them all together under one headline I am not a doctor, and I have no medical skills, but I can read about symptoms. I have no medical training, but it appears that the risks are significant enough that people should be fully informed of them before they are prescribed such medication. The massive risks in taking these drugs during pregnancy will then be embedded in their minds Many of us were supplied with the Epilepsy Action briefing. The statistics are hard to read, but they are very clear. I also thank the Library for the in-depth information it has provided so we can prepare for this debate. The surveys to which hon. Members have referred go back to 1995-96, when a possible problem was first mooted, but no action was taken. The Library briefing says: “This survey has been repeated in 2017, when it was found that 18% of women taking the epilepsy medicine sodium valproate didn’t know the risks this medicine can pose during pregnancy and 28% of women said that they had not been informed of the risks of this medicine in pregnancy.” How can it be that lessons have not been learned Dr Rhys Thomas, an honorary consultant in epilepsy at the Royal Victoria Infirmary, Newcastle, says: “This is a dramatic and important survey focusing on a crucial area for women with epilepsy. As a medical community, we clearly could be doing more, and should be doing more. Even if women are being told of the risks, this may be at the wrong time for them—or in the wrong way.” Sometimes the risks are not explained in a way that people understand, which is wrong. We need to have the conversation, and it has to be repeated. People need to be aware of the risks, and I am not sure that that has happened in the way it should The Medicines and Healthcare Products Regulatory Agency figures suggest that up to four in 10 babies are at risk of developing disorders if valproate medicine is taken during pregnancy—that is massive. How can it be ignored? Approximately one in 10 babies is at risk of physical birth defects. Babies affected by sodium valproate can have severe problems that require lifelong care and support. Are we looking at prevention? Are we looking to the future? Are we looking at what the long-term care will be? I suspect not It is estimated that 20,000 babies have been affected and 400 babies a year are born to women taking sodium valproate. Epilepsy Action, the Epilepsy Society and Young Epilepsy have surveyed more than 2,000 women with epilepsy, and they found that some women are still not aware of the risks of taking epilepsy medicine in pregnancy. More than a quarter, 28%, of women who have taken an epilepsy drug have not been given information. That would indicate to me that a knowledgeable medical professional should have taken the time to go through the risks of being pregnant with people on the drug. After someone has become pregnant, it may well be too late, so those discussions with the GP are very important. It is not a matter of someone simply stopping a drug when their pregnancy test is positive, as that is not the safe way to do things In conclusion, I urge that the eight points are followed, but that we should put in place the compensation fund that everyone in this House wants to see, because that will at least help the families affected to deal with the financial positions they are in.
I call Cat Smith. If she could finish at half past, I would be grateful. In addition, if the wind-ups could be about nine and a half minutes long, that would allow us to bring in Norman Lamb.
Thank you, Mr Deputy Speaker. It is a pleasure to be able to be squeezed into the end of this debate, and I shall be brief. For me, this debate started within days of being elected as an MP in 2015, when my constituent Janet Williams got in touch to ask whether she could meet me. When I was first elected, I imagined that I would meet most of my constituents back up in Lancashire, but Janet was keen to get a meeting in quickly and she chased me down to Westminster. I met her in Portcullis House, along with Emma Murphy. Both of them have been mentioned a lot in this debate, and I pay tribute to the work they do on this important issue When I met Janet, my jaw hit the floor, as I could not believe that in this day and age women were still being prescribed drugs that were harming their unborn babies and they were not being told about it. But it was not just that they were not being told about it; a cover-up was taking place. I find this to be a national scandal, and I do not use those words lightly. I have met Janet’s sons, Philip and Lee—they are both constituents—and for them this is a life sentence. Janet should not feel guilty for taking the drugs that her doctors told her to take during her pregnancies, but her sons will continue to need care throughout their lives; they are young men in their 20s and so that is a huge social care need This scandal started in the 1970s but, as I have said, it continues today, with women in this country still being prescribed this drug. It is a great drug—it is a very effective anti-epileptic-fit drug and it is good at treating bipolar conditions and migraines—but we need women to have knowledge about it. We need to share knowledge with women so that they can make decisions about their own bodies and own health in pregnancy. So I urge the Minister to respond to the call to publish prescribing data so that we know whether certain areas of the country are overprescribing this drug to women of childbearing age, as colleagues have mentioned. I also add my voice to the call for a public inquiry into this national scandal, and for an adequate compensation package for all those many people and their families who are affected by this national scandal.
I, too, pay tribute to the right hon. Member for North Norfolk (Norman Lamb) for securing this debate and trying to air this issue again. Epilepsy affects 1% of the population—600,000 people—and it is not a trivial condition. It is dangerous. As we have heard, 1,200 people a year die due to epilepsy, and we must not diminish that fact. At the lowest level, someone who has a fit after being well controlled suddenly cannot drive again, which can have quite a big impact, but at the other end of it there is death. We therefore must be careful not to send out a message that anti-epileptic drugs are bad, or even that Epilim is. It works really well, and it is one of the drugs that often can control the most dangerous seizure—the tonic-clonic or grand mal, as it used to be called—without the use of other drugs Almost all anti-epileptic drugs carry risk. Sodium valproate is the worst by far, but all the ones we have heard of in the past—phenytoin, phenobarbital, primidone and carbamazepine—carry some risk. We therefore have to recognise that it is not just as though the doctors prescribed the wrong drug. This condition is really hard to deal with, and we need people to have specialist input. We are really asking that from when girls reach puberty until they reach menopause or get into their 50s—when there is no risk of them having children—decisions are made with them by specialists As we have heard, there was obviously a recognition right back in the ’70s that sodium valproate could bring about congenital abnormalities, but what appears to have changed is the scale. If we look back, we see that people used to discuss a 2% risk of malformation and “some possibility” of developmental delay. We are now talking about 10% of children having a birth defect, which might be something like a minor cleft palate that can be dealt with, right through to spina bifida, meaning the child faces major physical disability. On a much worse scale, some 40%—almost half—of children face some form of developmental delay, which might mean an autistic spectrum disorder, learning difficulty or ADHD. That is a big change We heard earlier about the 1995 paper that started to bring these cases together. Before that, there were predominantly case reports—someone saying, “Oh, this is odd; I’ll write it up”—but we needed someone to bring things together. When we hear that 400 affected babies have been born in the year since the recent attempt to deal with this issue, we realise that had the yellow-card reporting system been working when we had perhaps 500, 600 or 700 cases a year, the situation would have been spotted much more quickly The system utterly failed to recognise a pattern and has to be reformed. If a woman gives birth to a child with a birth defect, or there is in the very early years recognition of some kind of major developmental delay, and she is on a drug, that should be reported, and I do not care what the drug is. Her GP may never have seen such a thing before and might not recognise that there could be an association, but someone sitting in the MHRA who is receiving 400 or 500 reports certainly ought to The obvious question is how to tackle this issue. The toolkit was put out in February 2016, because we have recently recognised the huge scale of the problem—the change is the recognition of the scale. It is therefore shocking and incredibly disappointing to hear that more than two thirds of women have not received any part of it. It is great that there is now some marking on packaging, but perhaps more of that needs to be combined, because we then do not have to depend on people remembering to hand something out or to pick something up. We would be empowering women to say, “Oh, what’s that? You’ve never talked to me about that,” and both sides would have the chance to have a discussion We have predominantly focused on the results of using sodium valproate during pregnancy but, as the hon. Member for—
Strangford.
Sorry. I am not doing very well today. Six hundred and fifty names is hard enough; adding another 650 constituencies just does my head in As the hon. Member for Strangford (Jim Shannon) mentioned, by the time a women is pregnant—crucially, by the time she knows she is pregnant—it is too late, because these abnormalities happen in the first trimester: those first two months when the brain and spinal cord are forming and the arches of the face are combining. That is why we particularly see neural tube defects, brain function abnormalities and cleft palate. Many women who lead hectic lives may already be two months pregnant by the time they finally know, and that means it is too late. That is why the annual review is important Epilim is perfectly fine for a girl to use if it gives good control for grand mal seizures, but we need to flag up the fact that when she is expected to be approaching puberty, discussions need to start with her and her family. Family planning is important for all women, but for women on these kinds of drugs, which must be stopped in pregnancy, it is crucial. We need to have that discussion so that the alternatives can be considered. I echo the comment that if a woman is pregnant and did not plan for that, she should not stop the drug on her own. She should have emergency access to a specialist who is able to look at her type of epilepsy and discuss the options with her, such as whether it would be safe to take nothing or if it would be better to change to something else. It should be recognised that uncontrolled seizures in pregnancy can cause the loss of the mother and the baby. We must not have any kind of irresponsibility by not flagging that up We had a debate in this Chamber last week on baby loss. It was a very powerful cross-party debate on the anguish that people face, whether it is due to early miscarriage, stillbirth or neonatal loss. We talked about that loss and bereavement, but any of us—male and female—who have had children know of the expectation and joy that comes from waiting for a child. There is still exactly that bereavement when we know that our child will face a life of physical and mental difficulties, and of learning disabilities. We know that a child with a marked learning disability has only a 7% chance of working. For the parents, there is the stress of knowing that there will come a point when they are not there, and of wondering how their child—perhaps now a young adult—will actually survive facing a harsh world Financial support is absolutely crucial to give families peace of mind. We need an inquiry, but rather than holding multiple inquiries, we should recognise that bringing some of these common themes together into one would be a much more powerful way to get people to understand that we are talking about relentlessly repeating patterns. Let us try to reform the things that allowed this to happen and to ensure that we support the families and the children to whom, sadly, it has happened.
It really is an honour to be responding for the second time in this Chamber today on behalf of the Opposition First, I thank the right hon. Member for North Norfolk (Norman Lamb) for securing this very important debate. It really was much needed so that we could finally discuss in detail, and in the main Chamber, the issues around valproate and what the Government must do to address this injustice. He spoke with passion and obvious outrage on behalf of the thousands of women and children affected by this disgraceful scandal I, too, want to thank other hon. Members who have taken part in this debate, including the hon. Members for Congleton (Fiona Bruce) and for Eastleigh (Mims Davies), and my hon. Friends the Members for Newport West (Paul Flynn) and for Heywood and Middleton (Liz McInnes). My hon. Friend the Member for Bury North (James Frith) gave an extremely moving account of how the drug helped him as a young boy, making the point that, when used correctly, it can be a very good drug. We also heard contributions from the hon. Member for Strangford (Jim Shannon), my hon. Friend the Member for Lancaster and Fleetwood (Cat Smith) and the hon. Member for Central Ayrshire (Dr Whitford) who speaks for the Scottish National party. It has been a very good debate As we have heard, the issues of valproate and its effects on foetuses are not new. In fact, they span a significant number of years, going as far back as the 1970s and 1980s when the first cases of the effects of valproate were documented. Even recent scientific research has shown that valproate can have an impact on a child’s life, including a study finding that 10% of children exposed to valproate will be born with a major congenital malformation, with 29% requiring additional educational support and 6% being diagnosed with significant social communication difficulties, such as autism Although there has been some movement on making women aware of the risks of valproate during pregnancy through the valproate toolkit, there is still far more that should and must be done to support these women and their children who have been so seriously affected by this injustice. The scope of this issue is serious. Data from 2010 show that more than 21,500 women were prescribed valproate. Although not all those women will have become pregnant, or planned to become pregnant, it is worrying that, following the toolkit’s publication, there is still not enough awareness of the risks, with 85% of patients not receiving the booklet and 90% not receiving the pharmacist’s card. It is important that the Minister looks into this matter urgently and ensures that awareness is increased to help to address the lack of knowledge. That could save so many innocent lives from being irreparably damaged As part of that, will the Minister be minded to agree that the NHS should make it mandatory for every clinician prescribing sodium valproate to a woman or girl of childbearing age to have a conversation with her about risks during pregnancy, upon first prescribing the drug and at least yearly, before her prescription is renewed? Over the decades there have been countless opportunities for this drug to be investigated, especially when evidence from the 1980s grew. Yet the various regulatory bodies for medicines have failed to keep their eyes on it as an issue worthy of investigation, with only fleeting references in position papers and reports, and nothing substantial. This is why it is welcome that the European Medicines Agency, in one of its first public inquiries, on 26 September 2017 called together patients, carers, doctors, pharmacists and academics to look into the matter further. It will be interesting to see the outcomes of its investigation when it concludes We have a duty to set the mistakes or oversights of previous Governments right, which is why we are here today—to seek justice for the victims of sodium valproate in pregnancy and their families. The Opposition welcome calls for the Government to look into how they can compensate the families who have been so significantly affected It must be noted that, as others have said, the drug is an effective treatment. For many it may be the only drug that works for them. Nevertheless, there is a systematic failure to inform women of the dangers of taking valproate. If expectant mothers had had the risks laid out clearly for them, many children would not have been harmed, and I hazard a guess that we would not be debating this issue today For those reasons Labour promised, in our election manifesto earlier this year, that we would look into this further by holding a public inquiry if we won the general election. We now make a plea to the Government. The evidence collected by In-FACT shows that despite the Government, pharmaceutical companies and regulatory bodies knowing about the risks for 40 years, that knowledge was withheld from women, which meant they were unable to make informed decisions about their drug treatment during pregnancy. I must ask the Minister: why have we not got to the bottom of this injustice, and is it not about time that we did A lot of the issues that we must understand and investigate are historic, yet for some they are still very prominent in their present. Many families are living with the repercussions of not being given the relevant information Hon. Members may have watched “Victoria Derbyshire” in recent months, on which valproate has been discussed, including last month when Deborah Mann, who took valproate during her pregnancy, discussed how the drug had affected her daughter, Branwen. Deborah had been given a dose of valproate of 5,000 mg, five times higher than the recommended daily dose of 1,000 mg. Any dose above 1,000 mg is considered to have the largest level of risk. Branwen has had to wear splints every day since she was a little girl. She is in chronic pain every day. She has migraines and problems with her brain and eyes. At just 22, Branwen has been told that she could go blind, have a stroke or even die at any moment I recently met the inspirational Janet Williams and Emma Murphy, who a number of hon. Members on both sides of the House have paid tribute to. I now realise that they are in the Public Gallery. They set up In-FACT in November 2012 after two of Janet’s children and five of Emma’s children were diagnosed with foetal anticonvulsant syndrome. We heard in detail from the hon. Member for Congleton the extent of the appalling damage to Emma and Janet’s precious children, and all of it was preventable. Both Janet and Emma campaign tirelessly after being told—in the case of Emma, time after time after time—that these drugs were safe to take in pregnancy. These women did ask the obvious questions when the truth was already well known, and they were still told that these drugs were safe to take while they were pregnant. Can hon. Members imagine how that feels? As a mum, I would be absolutely furious—we all would. I would want answers. I would want justice, and so do Janet and Emma It is approximated that, since 1973, 7,000 children have been harmed by exposure to valproate. No doubt there will be many other families who have failed to conceive or who have had stillbirths or miscarriages—all because of this drug. That is why we must get answers, but it is also why we must look at what compensation we can give these families because of the failure of the NHS to protect and support them. The idea of compensation has been established by our neighbours across the channel, where the French Parliament has recognised the true scale of this injustice and established a fund worth €10 million to support the victims of valproate and their families Opposition Members believe that mistakes should be recognised, addressed and accordingly compensated for. We also believe that burying our heads in the sand and ignoring the demands of the victims goes against the nature of justice and righting the many wrongs of the past. These families must be supported and allowed to have a full investigation into the failures and damage they have had inflicted on them The Minister cannot ignore the scale of this tragedy and the numbers of people who have had their lives so adversely affected not through any fault of their own, but due to medication they were prescribed by the NHS. We are here today to ensure that the Government wake up to the enormity of this scandal and take immediate action More must be done to make women aware of the risks of taking valproate during pregnancy, and to ensure that the injustice that has gone on for far too long is righted, with answers found and support provided to these families, who have seen their lives turned upside down because of what can only be described as a cover-up. The Minister should and must listen to what has been said today. I hope he will assure the House that he has constructively listened and that he will start the process of righting this pernicious wrong by holding a full public inquiry and properly supporting these families. They need, want and deserve justice. They should, at long last, receive nothing less.
I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this debate through the good offices of the Backbench Business Committee. He has, as he indicated, taken a particular interest in this issue since it was brought to his attention during his time as a Minister in the Department of Health, and all tribute to him for being so persistent in that endeavour This is a very important issue. Members on both sides of the House have come together once again—for two weeks in a row, as the hon. Member for Central Ayrshire (Dr Whitford) pointed out—to demonstrate their concerns. Those are not party political; these issues affect all our constituents, irrespective of any party political alliance We have had some very constructive suggestions on both sides of the House, and we have heard a number of the personal cases that constituents have brought to the attention of Members, which has been very moving. Rather than rehearse them, I will just point to my hon. Friend the Member for Congleton (Fiona Bruce), who went into some detail, as the hon. Member for Washington and Sunderland West (Mrs Hodgson) said, about the particular circumstances of the two outstanding campaigners—I am pleased they are here to witness this debate—who have spoken so powerfully about the effects that valproate has had on their lives and those of their children. Like other hon. Members, I have very great sympathy for those families who have been affected by valproate use in pregnancy The Association of British Neurologists advises that valproate remains the most effective treatment for generalised epilepsy, and this is reflected in NICE guidelines. For some women with epilepsy, it may be the only effective treatment—the only thing that prevents a potentially life-threatening seizure. However, because of its risks, valproate should be used to treat women of child-bearing age only if other drugs are ineffective or not tolerated. This is not a clear case of use or no use, as was clearly pointed out by the hon. Member for Central Ayrshire, who speaks with authority on these matters The key challenge for clinicians is to ensure that the drug is used only by those who really need it, that they are fully informed about the risks and that their treatment is closely monitored.
Does the Minister share my aspiration that we should be aiming to ensure that every woman, wherever they live, has access to a specialist unit?
I will come on to how access—and monitoring—needs to be improved As my hon. Friend the Member for Eastleigh (Mims Davies) acknowledged, it is vital that no woman stops taking valproate, or any other anti-epileptic, without first discussing it with their doctor and, if necessary, with the relevant specialist. The Medicines and Healthcare Products Regulatory Agency is currently working with European regulators, and with experts and healthcare bodies, to decide what further action should be taken. Like many anti-epileptics, valproate has always been known to carry a risk if taken during pregnancy. However, as hon. Members have pointed out, important questions have been raised, here in the Chamber and elsewhere, about the extent to which women have been informed over the decades about the risks At the time that valproate was first marketed in 1974 for the treatment of epilepsy, animal studies had shown that there might be a risk of birth defects. Health professionals were made aware of this and were expected to weigh the benefits against the risks. Difficult prescribing decisions had to be made. Campaigners have highlighted, as did the right hon. Member for North Norfolk in his opening remarks, the minutes of a meeting of the Committee on Safety of Medicines in 1973 where the Committee concluded that it would be best not to mention the risk of birth defects in package inserts. As has been said today, this paternalistic attitude has no place in the NHS of today. Now, patients and doctors are expected to make decisions based on open communication on the risks and benefits of a treatment, which is underpinned by legislation. However, that was not always the case, and the views expressed by the CSM in 1973 were not unusual at that time, particularly in relation to life-saving medicines such as anti-epileptics I am pleased to say that medical practice has changed considerably since then. Comprehensive patient information leaflets have been a legal requirement since 1999, and warnings have been issued when new evidence on risks has become available. The MHRA issued bulletins in 1983 and 1993 to update prescribers on the risk of birth defects, and in 2003 warned about a possible risk of developmental delay in children exposed to valproate during pregnancy. Warnings were extended to include a risk of autism in 2010, and a reminder bulletin was issued in 2013. Information on the full magnitude and nature of the risks with valproate first became available in 2013, following a long term follow-up of children whose mothers had taken valproate and other anti-epileptics Given those concerns, the MHRA initiated and led a Europe-wide review which completed in November 2014. The review found that there was still a clinical need for valproate despite the significant risks to the child if taken in pregnancy, and that it should remain an option for women of childbearing potential only where other treatments had failed or were not tolerated. To mitigate the risks, the recommendation was that women should use effective contraception and treatment should be supervised by a specialist. In January 2015, the MHRA sent a letter to doctors and pharmacists about the strengthened restrictions. As well as updating statutory information, the MHRA has developed the valproate toolkit referred to by hon. Members Although I am not allowed, quite properly, to use props while I am at the Dispatch Box, I cannot resist pointing out to hon. Members that the warnings now on valproate packaging include the following very specific warning: “Warning for women and girls: This medicine can seriously harm an unborn baby. Always use effective contraception during treatment. If you are thinking of becoming pregnant or you become pregnant, talk to your doctor straight away.” In addition to that warning on the packaging, there are other elements in the toolkit. I will not trouble the House to read them out, but they include patient cards, information for patients, and information for prescribers and clinicians. The toolkit was distributed to doctors and pharmacists in February 2016. Messages sent through different channels then and subsequently have reinforced the recommendation of its use to support discussions with patients In view of the importance of the issue, in the autumn of 2015 the former Minister for Life Sciences brought together healthcare bodies to support the promotion of the toolkit and ensure that there was co-ordinated messaging to health professionals and patients. The MHRA further developed that group into a 39-strong stakeholder network of health system organisations, health professional bodies, charities and campaign groups, which include In-FACT, FACS-Aware, the Organisation for Anti-Convulsant Syndrome, Epilepsy Action, the Epilepsy Society, the Royal College of General Practitioners and the Royal Pharmaceutical Society. Our communications strategy has been informed at every step by the valproate stakeholder network, including NHS England. In response to concerns about gaps in awareness that have been identified by several Members in today’s debate, in July of this year the toolkit was redistributed to GPs and specialist prescribers, and additional materials were distributed to pharmacies. More than 100,000 healthcare professionals received the toolkit this year What are we doing beyond that? We are tracking changes in prescribing. Data show that between 2012 and 2017, there has been a decline of approximately 26% in the number of women of childbearing age treated with valproate. The decline is sharper among 10 to 17-year-olds. Although usage is declining, there has not been the step change that we would want, and, as has been mentioned today, the results of surveys of patient awareness of the risk clearly indicate that more needs to be done I am aware that campaigners have called for the use of the toolkit to be made mandatory. The MHRA and NHS Improvement sent out a patient safety alert in April 2017, which directs organisations systematically to identify women and girls taking valproate and to support them to make informed choices. MHRA and NHS Improvement are monitoring the implementation of the alert and are following up directly with relevant organisations. That action has been taken consistently across the UK and through the devolved Administrations The MHRA is fully involved in the new Europe-wide review to look into whether further restrictions are needed. An expert working group of the Commission on Human Medicines, a committee of the MHRA, has been convened to inform the UK’s position during the EU review, which is expected to conclude early in the new year. This review is also looking carefully at whether there is any evidence of adverse effects in babies whose father took valproate. I am sure the whole House was moved by the personal testimony of the hon. Member for Bury North (James Frith) about the consequences of childhood meningitis and his six years on valproate to control epilepsy I hope I have made it clear that we are taking the matter seriously. I have enormous sympathy for those families who have been affected by valproate use in pregnancy. In the short time that I have available, I want to touch on a couple of the issues raised by the right hon. Member for North Norfolk. He talked about support, and we have an established system, reinforced by the Children and Families Act 2014, to establish a new framework for local authorities and CCGs to secure services for children and young people who have special educational needs or disabilities. I will not get into the question of compensation or an inquiry here. What I will say to the right hon. Gentleman is that a meeting has been arranged for the chair of the all-party group with my Lords colleague the Under-Secretary of State for Health, and the issues that the right hon. Gentleman has raised should be brought up at that meeting. I encourage other members of the all-party group to join him in that meeting at the Department I will look at the feasibility of extending the yellow card system, as hon. Members have described. I think it is right that we shine the spotlight of transparency to improve patient safety. No Government have done more than we have to make that happen in other areas, and the victims of valproate deserve nothing less.
I sincerely thank all right hon. and right hon. Members for participating in today’s incredibly well-informed, responsible and powerful debate. This is a fight for justice. The Minister is right that we have a meeting planned for 7 December with his colleague the noble Lord O’Shaughnessy, and I hope very much that by then, the Government will have reached a view on the case for compensation. The Government have a choice: they can either deny the unanswerable moral case for treating these people properly, or they can take the moral lead and accept that the state has a responsibility to these families. I hope very much that they do the latter Question put and agreed to. Resolved, That this House notes with concern that there has been a systematic failure to inform women of the dangers of taking the epilepsy drug sodium valproate during pregnancy, resulting in thousands of children being born with congenital malformations, disabilities and developmental disorders since the 1970s as a result of fetal exposure to the drug; welcomes the launch of the Valproate Toolkit by the Medicines and Healthcare Products Regulatory Agency in February 2016 to ensure that women are informed of the potential risks of the drug, but further notes with concern a recent survey which found that 68 per cent of women have still not received these safety warnings; calls on the Government to take immediate steps to ensure that the materials in the Valproate Toolkit are distributed to all prescribing clinicians, pharmacists, and women who are being prescribed the drug; calls on the Government to require all clinicians prescribing sodium valproate to women and girls of childbearing age to discuss annually with the patient, the risks during pregnancy before a prescription is renewed; and further calls on the Government to bring forward proposals for a care plan and financial assistance to the victims of sodium valproate in pregnancy and their families.
I thank you, Mr Deputy Speaker, for selecting this debate, and I thank the Minister for her attendance. I also thank the people who have helped me to prepare for this debate, particularly at The Guardian, Bellingcat, Transparency International and Global Witness We in Britain pride ourselves on our integrity, respectability and trustworthiness. We tell ourselves that this is a country that believes in high ethical standards of behaviour in the way we conduct ourselves as individuals, run our businesses and function as professionals. We preach to developing countries about how to stamp out corruption. We sell Britain to foreign investors by telling them that they can trust us, our laws, and our corporate rules and institutions Yet last month yet another bundle of leaked documents from yet another brave whistleblower, this time about Azerbaijan, revealed—yet again—that our self-belief is flawed. Many of the revelations and the allegations of corruption associated with the Azerbaijani ruling elite, as well as much of the evidence of money laundering, organised crime, tax evasion and bribery, come back to and are made possible by how the UK and our overseas territories choose to operate our corporate structures. Our persistent lack of transparency and our appallingly lax regulatory framework have made us the country of choice for every kleptocrat, crook and despot in the world. We have become the safe haven for dirty money. We are allowing money laundering and tax avoidance to take place on an industrial scale.
Two years ago, the then Prime Minister declared that London was not “a place to stash dodgy cash” A year ago, in front of 40 Governments from around the world, the UK committed to a public register of foreign companies owning UK property to prevent those who are corrupt from being able “to move, launder and hide illicit funds through London’s property market” Yet we have seen zero progress on all that. Does my right hon. Friend agree that this is a disgrace, and that with all that has happened since, the need for a public register is stronger than ever?
I do, and I will come to that later in my speech Our corporate rules and our weak regulatory framework are a gift to villains. Far from being proud, we should be ashamed. Today, I want to try to convince the Minister and the Government to act urgently to destroy the opportunities we are allowing, which are exploited by criminals and make us complicit in their crimes. We can stop this, but at the moment we are choosing not to do so Azerbaijan is well-known as a corrupt kleptocracy. It comes 123rd out of the 176 countries assessed on Transparency International’s index of corruption. Heydar Aliyev, the father of the current President, was head of the KGB in Azerbaijan in 1967, when Azerbaijan was part of the Soviet Union, and he became a full member of the Soviet Politburo in 1982. When Russia broke up, he moved seamlessly to become Azerbaijan’s ruling President in 1993, and he cracked down viciously on all opposition voices. He passed the presidency on to his son 10 years later, and Ilham Aliyev then pushed through constitutional changes to abolish the limit on the number of times one person could stand for office and to extend each term of office to seven years.
Will my right hon. Friend send a copy of her speech to all the new delegates to the Council of Europe from this place, because there are examples in the recent past of Members of this House giving tacit support to and acting as apologists for the den of thieves that is Azerbaijan?
I welcome that suggestion and will do that Ilham Aliyev remains President to this day, and in February this year he appointed his wife Mehriban as First Vice-President, in effect anointing her his successor. According to Human Rights Watch, the ruling élite “continues to wage a vicious crackdown on critics and dissenting voices” But the Azerbaijani Government do want to be respected by the international community, in part because they want to sell us their oil and gas. That is why they worked to become full members of the Council of Europe, why winning the Eurovision song contest mattered and why hosting the European games in Baku was important. The so-called Azerbaijan laundromat that we are discussing today was a scheme designed to launder money out of Azerbaijan—money used to curry influence and bribe European politicians, lobbyists and apologists, and further to line the pockets of the Aliyev family and their cronies The scheme was revealed by the Organized Crime and Corruption Reporting Project, working internationally with newspapers, including The Guardian. The leaked documents covered payments over a two-year period from June 2012 until the end of 2014. The payments amounted to €2.9 billion.
I congratulate my right hon. Friend, who has shown her usual great resilience in identifying financial skulduggery whenever she can; we worked together on looking at financial chicanery as fellow members of the Public Accounts Committee. Does she agree that much more detailed research is needed on this topic so that every angle and element of this huge finagle is properly understood?
I completely agree with that important point Money came out of Azerbaijan—nearly half from an account held at the International Bank of Azerbaijan through a shell company linked to the Aliyev family. That bank recently filed for bankruptcy. The other main contributors were two offshore companies with direct connections to a regime insider. It is hard to believe that the money was held legitimately in Azerbaijan The money was transferred to a small Estonian branch of Denmark’s largest bank, which is where Britain comes in. The money went into the bank accounts in Estonia of four shell companies, all of which were incorporated here in the UK. Our laws that allow such companies to be established were at the heart of this nefarious scheme. Much of the money then went into the pockets of European politicians, journalists, prominent individuals in international organisations and powerful political Azerbaijani families The leaked data show, for instance, that Luca Volontè, an Italian politician who led the European People’s Party group in the Council of Europe, received over €2 million. We know that he was instrumental in lobbying to ensure that a report criticising Azerbaijan’s human rights record was rejected by the Council of Europe in 2013. Several months after the country achieved that veneer of respectability from the Council of Europe, the European Commission announced the construction of the controversial gas pipeline from Azerbaijan to Europe. Volontè is now facing charges of corruption and money laundering in Italy Eduard Lintner, a former German MP, founded the Society for the Promotion of German-Azerbaijani Relations. That organisation received €819,000 over the two years covered, and Lintner got a €61,000 cash payment two weeks after returning from observing the elections in Azerbaijan and praising them for being up to German standards. The Council of Europe said the elections marked a “step forward taken by the Republic of Azerbaijan towards free, fair and democratic elections” The reality was that the opposition alliance boycotted the elections, there was voter intimidation and the press was gagged. Lintner has denied any wrongdoing Kalin Mitrev, a Bulgarian who lives in London, received €390,000 for so-called consultancy for Azerbaijan. He now sits on the board of the European Bank for Reconstruction and Development that only yesterday agreed a loan to the Azerbaijan Government for €500 million to build a gas pipeline. While he recused himself from the decision and has denied any wrongdoing, his presence as a board member having received money from Azerbaijan makes it very murky and uncomfortable. He is being investigated by the Bulgarian authorities. At the same time, his wife, Irina Bokova, is Director-General of UNESCO. She bestowed one of UNESCO’s highest honours, the Mozart medal, on Azerbaijan’s first lady, the wife of the President, for: “merits in strengthening the intercultural dialogue.” I suppose that is an innovative way of describing the use of bribes to stifle criticism and secure international support Those people were paid from companies incorporated in the UK: Polux Management LP, Hilux Services LP, Metastar Invest LLP and LCM Alliance LLP. All were registered at Companies House. They are shell companies, sometimes incorporated through our tax haven overseas territories, that are deliberately used to disguise the origin of the money they receive. They are set up by shady and unregulated formation agents. They can engage in transactions while hiding the identity of the real beneficial owners of the company, yet because they have the UK stamp on them they command a respectable status. Our lax controls allow them to prosper and our corporate system allows money to be moved around and used without any questions being asked. That is simply shameful and it is taking place right here, right now in our country. I am particularly concerned by the trend for unscrupulous people to use Scottish Limited Partnerships—SLPs—to launder money, and to evade and avoid tax. SLPs were invented to help agricultural tenancies in Scotland. Creating an SLP allows the partnership to hold property and enter into contracts, because it gives them a legal personality. But SLPs do not need to name any “natural person”—an actual person—as partners. They can just name companies. They have limited reporting requirements —for instance, they do not need to file accounts at Companies House unless one of the partners is a UK limited company, and while they are supposed to file returns with HMRC, they do not need to pay UK tax and they do not need to have a UK bank account. Of course, HMRC does not check whether accounts are filed Our laws allow a secret vehicle to be created to smuggle unexplained wealth into the system, money that is then used for a variety of illegitimate as well as legitimate purposes. SLPs have become a byword for corruption, tax evasion and organised crime. Just look at the facts. There was a 430% increase in the creation of SLPs between 2007 and 2016. In 2016 alone—in that one year—more SLPs were registered than had been registered throughout the 100 years after they were introduced. Bellingcat has looked in detail at the 5,214 SLPs registered in 2016. Ninety four per cent. were controlled by corporate partners, not individuals, and 71% of those corporate partners were based in tax havens. Seventy per cent. were registered to just 10 mailbox addresses in Scotland. They are anonymous and untraceable obscured structures linked to corrupt jurisdictions.
Does my right hon. Friend share my concern that since the flourish of the anti-corruption summit—and David Cameron has completely left the crime scene—this seems to have been put in the too-difficult-to-think-about box? If the Government really want a global Britain, they should table the necessary legislation as soon as possible and not use the excuse of Brexit to kick this into the long grass.
I agree entirely with my hon. Friend The Government recently required SLPs to file statements about the persons with significant control associated with them. Only 23% of those registered in 2016—1,176 SLPs—have done so, and of those 1,176 only 28 are British nationals. In the two SLPs associated with the Azerbaijan story, the records state that the bank accounts and the shareholders were opened by the same man, Maharram Ahmadov. He transferred more than $1.7 billion from those accounts, yet the journalists found that he was a working-class driver living in a modest house in the outskirts of Baku. The companies were registered from the British Virgin Islands Money laundered through these structures is being spent here in the UK. We know that $50 million was paid to individuals. For instance, the documents reveal 200 of the payments made to the UK paid for education. Queen Ethelburga’s College, a private school in York, received £89,800. A tuition college, Bellerbys College, and the International School in London also received payments Azerbaijan money is also being used to buy property in the UK. Anar Mammadov, the son of Azerbaijan’s Minister for Transport, was just 20 when he bought a £2.75 million mansion in The Bishops Avenue, a house now valued at £7 million. Yunis Abasov, the son of Azerbaijan’s Deputy Prime Minister, was just 21 when he bought a £1.4 million penthouse flat in the Docklands. That is now valued at £3.3 million. In 2012, on reaching the mature age of 27, he bought an even grander property in Kingston upon Thames for £5 million, and he has also been granted British citizenship Leyla and Arzu Ilyeva, the daughters of the President of Azerbaijan, used a British Virgin Islands company to buy UK property. Leyla owns a £17 million mansion in Hampstead Lane. The property transaction was undertaken by Child & Child solicitors. It failed to declare that the buyers were politically exposed individuals but has not faced any action, despite having flouted our laws In the short time available, I have outlined just a few examples to show how the UK is at the heart of international money laundering, bribery and corruption, tax avoidance and tax evasion. I have described a part of the Azerbaijan story, but the same story could be told from the Panama papers, the Falciani papers, the Moldovan bank robbery and the Russian laundromat. These stories will keep on coming as more and more whistleblowers leak other scandals. The issues will not go away I feel deep shame and embarrassment that we in the UK are not just complicit but central to the success of these despicable practices. We seem somehow to believe that dirty money is good for the British economy, but if homes are being bought with laundered money, it just fuels house prices and adds to our housing crisis. In accepting corrupt money, we accept the lawlessness that goes with it. Ministers must act to ensure much greater transparency and to clean up the UK’s corporate structures I ask the Minister to address these points. The Government promised us a register of beneficial ownership of property in the UK. We want to know who owns our houses. Consultation on this ended in May and nothing has happened. When will the Minister act to create the register? The Government have yet to commence the legislation on unexplained wealth orders. Why the delay? The Government continue to refuse to use their powers to insist on public registers of beneficial ownership in all our overseas territories, many of them tax havens. Why not act? The Government should properly staff Companies House. At the moment, six individuals are tasked with investigating breaches of company law in a register of 3.5 million corporate structures. Such under-resourcing makes a farce of our commitment to good regulation The Government should properly investigate the allegations made publicly in The Guardian and by Transparency International and the others, some of which I have outlined today. If allegations have been made, they must be investigated by the relevant authorities. The Government have a duty to make sure that this happens on our behalf, but it is just not happening The Minister should reform our corporate structures to create a more robust and transparent system. Why not ban corporate partners from LLPs and SLPs in all but exceptional circumstances? Why not insist that corporate partners must be UK-based? Why not insist that SLPs must have a natural person? Why not require that the documents of incorporation and the “person with significant control” declarations include the address, date of birth and passport or other identity details of named individuals so that we can trace them? Why not introduce a unique identifier for directors and partners of SLPs? Why not insist that partnerships incorporated in the UK should have a bank account in the UK? Why not set proper standards for the advisers and regulators, so that we can get rid of shady formation agents and reform the anti-money laundering supervisory system to ensure high and consistent standards All that is possible if the will to clean up our act on corporate structures is there. At present it seems that Brexit has made us incapable of tackling any wrongdoing for fear of offending some other country in some other part of the world, but Britain will never get rich on dirty money. Allowing it to roam freely will simply infect our institutions, our people and our economy. It is plain wrong that we have allowed ourselves to become the leading facilitator of money-laundering, organised crime and tax evasion. The Government can act to stop this abuse, and they must do so.
I congratulate the right hon. Member for Barking (Dame Margaret Hodge) on securing this important debate, from which I have learnt the shocking truth about Azerbaijan, and on her forensic analysis The Government are committed to making the United Kingdom’s financial system a hostile environment for illicit finance. The National Crime Agency takes allegations such as those identified by the right hon. Lady seriously, and will consider carefully whether recent information would allow an investigation to proceed. The Government pursue a targeted but proportionate level of enforcement that focuses on achieving compliance from companies. We seek to counter financial crime while protecting the dynamism of the UK’s business environment.
Will the Minister give way?
I will, but I have very little time.
Does the Minister think that she has heard enough this evening to ask the authorities to launch an investigation?
I must confess that I am not entirely aware of what my powers are in that respect, but if I am so empowered, I will certainly do as the hon. Gentleman suggests We want the United Kingdom to be a trusted place in which to do business, and the best place in the world in which to set up and grow a business. The UK has high standards of business behaviour and corporate governance. The overwhelming majority of its 3.9 million companies contribute productively to the economy, abide by the law, and make a valuable contribution to society. In discussing what action to take in response to the minority who abuse the system, we must not undermine its strengths or impose more burdens on the law-abiding majority without very careful consideration The Government are active in taking action to tackle misuse. Since 2015, we have implemented a series of reforms to increase the transparency of UK incorporated legal persons and arrangements in order to prevent their misuse for illicit purposes. The reforms include, but are not limited to: the introduction of the publicly accessible register of people with significant control, which the right hon. Member for Barking mentioned; the abolition of bearer shares; the introduction of unexplained wealth orders; and the introduction of the combined register of trust and company service providers supervised by professional bodies, as well as HMRC.
Will the Minister give way?
I have a lot amount of material to cover. I will give way a little later if I have time It is too early to measure the impact of many of those reforms, but we expect them to make a significant difference in helping to prevent the misuse of companies and other entities, and in assisting law enforcement agencies with their investigations when misuse does occur The right hon. Lady mentioned Companies House. It carries out checks on all information that is received to ensue that it is valid, complete, correctly formatted and in compliance with company law filing requirements. The obligation to ensure the information is accurate lies with the company and its directors. The validation checks serve to help companies to get things right. A company commits an offence if it fails to maintain its registers and keep them up to date The UK has a robust system of publicly accessible data. The Government favour an approach that encourages transparency of information, followed by the scrutiny of company information over its lifetime. I appreciate that—
rose—
I will give way if I have time, although I might cover the points the hon. Gentleman wants to raise It might appear that the system is designed around the needs of law-abiding companies, which are the vast majority. I appreciate that it is open to abuse. Maintaining one of the most open and extensively accessed registers in the world is a powerful tool in identifying false, inaccurate or possibly fraudulent information. With many eyes viewing the data, as well as errors, omissions or worse, the information held on the register can be subject to significant policing by a variety of users Companies House is always looking at ways to further improve the quality of data. A significant recent development includes the introduction of the “report it now” function, which makes raising concerns easier than ever before If irregularities are raised, Companies House follows up with the company in question, and in most cases any inaccuracies are corrected immediately. There were over 2 billion searches of the Companies House register in 2016-17, which indicates that the data are available and under scrutiny. Companies House works closely with enforcement agencies such as the National Crime Agency in sharing data analysis to combat economic crime I will now talk about Scottish limited partnerships, which the right hon. Lady raised. I fully recognise her concerns. Over the past year or so, serious concerns have been raised about the use of these partnerships as vehicles for criminality. As a result, my Department launched a call for evidence earlier this year to collect information about the extent of the problem and how the limited partnership legal framework might therefore need to be strengthened. The Government have been considering this evidence and I can confirm that we are actively considering reform. We will announce our next steps shortly That said, it is important to mention that Scottish limited partnerships are a popular form of incorporation. I accept that their number has increased over the last few years, which gives rise to perfectly legitimate suspicions, but they are also used by many legitimate businesses across the economy, particularly in the investment and pensions sectors, fulfilling a genuine commercial need As the right hon. Lady mentioned in her letter to me at the end of last month, as of June this year, Scottish limited partnerships and a number of other legal entities were required to identify and disclose their “people with significant control”—beneficial owners—to Companies House. This information will form part of a central register that is publicly available, consistent with the requirements already placed on other forms of UK companies since 2016. Our objective is that the requirement will provide transparency over the ownership and control of Scottish limited partnerships Scottish limited partnerships are also required to submit a statement at least once a year confirming that their “people with significant control” information on the companies register is accurate. The right hon. Lady highlighted in her letter to me that many companies have yet to comply, but I can assure her that they will be chased down. As this is a relatively new requirement, the build-up of the names into the register of those who own and control SLPs is still under way. Companies House is undertaking compliance activity to ensure that Scottish limited partnerships comply with the new regulations In summary, I can confirm that the Government are actively considering options for the reform of these partnerships and will be setting out their approach soon Question put and agreed to.