Westminster Hall
(3 years, 7 months ago)
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CPTPP
(3 years, 7 months ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Philip Hollobone (in the Chair)
I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate. There will also be suspensions between each debate. I remind Members participating physically and virtually that they must arrive for the start of debates here in Westminster Hall. Members are expected to remain for the entire debate. I must also remind Members participating virtually that they are visible at all times, both to each other and to those of us here in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address. Members attending physically should clean their spaces before they use them and as they leave the room. I also remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall.
Mr Steve Baker (Wycombe) (Con)
I beg to move,
That this House has considered the UK’s accession to the Comprehensive and Progressive Agreement for Trans-Pacific Partnership.
I am absolutely delighted to serve under your chairmanship, Mr Hollobone, and delighted that the Government are seeking to accede to the comprehensive and progressive agreement for trans-Pacific partnership—something I proposed while I was a Minister. At the time there was very little interest from officials or from other Ministers. It is a shame we had to change the Government and then have a general election to get here, but least said, soonest mended.
I am personally invested in this accession, I am glad to say. CPTPP can provide a better standard of living for people in the UK and across the original member countries. It can deliver free trade plus self-government in this great age of interventionism. By preserving the right to regulate, it can allow democracies to function while delivering free trade—a point I hope to elaborate on before I finish. It is a high-standards agreement, as I will flesh out, and it can facilitate greater international co-operation, which those of us who are free market liberals should aim for.
I want to start by landing the central point: how important this debate is and how important the agreement could be. If we take the current members of CPTPP, and if the United States chose to return to the agreement, plus the United Kingdom, plus other potential accession countries such as Taiwan, it could result in a new platform free trade agreement for the world, covering more than half the global economy. CPTPP is therefore a major geostrategic agreement of relevance to the whole world, so I am really delighted to be here for this debate. It is absolutely vital that the United Kingdom is there at the start.
Colleagues will know the Prime Minister’s speech in Greenwich on free trade. It was an admirable articulation of the principles of free trade, and I wholeheartedly support the policy, which it is refreshing to be able to say.
I want to turn to the Government’s own document, “UK applies to join huge Pacific free trade area CPTPP”. It was issued when the Government formally applied. It explains:
“Joining the £9 trillion partnership will cut tariffs for UK industries including food and drink, and cars, while also creating new opportunities for modern industries like tech and services, ultimately supporting and creating high-value jobs across the UK. Unlike EU membership, joining does not require the UK to cede control over our laws, borders, or money.”
That part, of course, has now run on to the rocks. As the Government explain, it has:
“Modern digital trade rules that allow data to flow freely between members”.
It eliminates tariffs more quickly on UK exports than, for example, the deal that we have with Canada. The rules of origin are extremely important. I will not get into the detail, but they
“allow content from any country within CPTPP to count as ‘originating’.
That is extremely important in a world of free trade areas.
The Prime Minister was very proud to support the agreement. The Secretary of State put out an excellent statement. Our accession was supported by techUK, the Federation of Small Businesses and the CBI. I was very pleased to see such a wide range of support.
The reason why I originally came across the CPTPP was that when I re-founded the European Research Group, which seems a long time ago now, it was to unite the various wings of the Conservative party—ironically—and of course, crucially, to do research. We therefore sought the best expertise from outside Parliament, and one of the documents produced was by the Legatum Institute Special Trade Commission, as it then was. It was a group of visionaries led by Shanker Singham, who is now a personal friend of mine. In April 2017, it produced “A Blueprint for UK Trade Policy”, which in particular described the importance of what was then known as the TPP. It states:
“The TPP is probably the most advanced trade agreement that has been agreed by any group of countries. It is a high-standards, platform agreement that attempts to make progress on the most difficult aspects of international trade—especially behind-the-border barriers, regulatory protection, the impact of state-owned business on trade, and distortions more generally.”
It goes through some of the key factors in the agreement; possibly I will come back to those in passing.
I cannot possibly go through all the detail of the agreement and I hope that hon. Members will not test my capacity to recall and interpret the text, although I did wade through the original TPP in detail. There is a very helpful explainer on the New Zealand Government website, and I very much hope that in due course our own Government will explain the agreement, but I will just cover the key features.
The agreement covers goods and market access, including for agriculture, an issue that I wish I had enough time to get into—I hope that other Members will mention it —and services’ market access, which is of course crucial for the UK. We have a comparative advantage in financial services. We should be looking to work with like-minded countries around the world not only to participate in but to define a new global standard for financial services in particular and services in general; and the CPTPP is a great basis on which to start.
The agreement makes provision for easier travel under business visas. It raises labour standards for the region. That is of course a matter of acute interest to all Members of this House. It raises them in the region; that needs to be understood. It has environmental provisions, including ensuring that there can be no waivers or derogations, for trade advantage, from any environmental standards.
The agreement protects individual nations’ right to regulate. Of course, it does not need to be elaborated on—well, perhaps it does—that in this country the idea of using political vertical integration to deliver trade policy within customs unions with harmonised regulation has, whether people like it or not, run on to the rocks of lacking democratic consent. Now, as we come together in a spirit of good will, seeking to unite, move forward and be prosperous, that is something that we need to deal with. The CPTPP is really important because it preserves that right to regulate and preserves the independence of the member countries, while delivering free trade.
There are provisions for pharmaceuticals, investment, disputes and Government procurement, because of course Governments everywhere buy a great deal. There are provisions for intellectual property, geographical indications, trade facilitation, which I will come back to later, and state-owned enterprises, at which point I will say a word about market distortions.
One key feature of Governments’ highly regulating and, indeed, spending a large proportion of GDP is the effect that they have on market economies. It is really important as we go forward, if we are seeking to promote the maximum human welfare—I hope that, despite our disagreements, everyone in the House is seeking to maximise human welfare—that we minimise unhelpful distortions. We are not trying to create the wild west here, not under this agreement and not in any reasonable future. What we are trying to do is to have pro-competitive, welfare-enhancing regulation. Of course I am in favour of doing it under an English common law tradition; there will be Members in this debate who would like to use the Scottish tradition or whichever. But the British tradition of regulation has in some ways, I think, been suppressed by our EU membership and now needs to be rediscovered. Regulation has become altogether too prescriptive. We need to rediscover people’s capacity to co-operate to deliver high quality standards within a framework that is provided by the Government but is not too prescriptive.
As an example of how things could be done better, I refer in passing to how we regulate autonomous vehicles; I remember serving on the Vehicle Technology and Aviation Bill Committee. Our regulation sets out a framework of liability, but does not end up with the Government prescribing software standards, which personally I think would be a disaster. That is just one example of how, using the common law tradition, we can provide high-standards regulation that protects the public and is conducive not only to the enhancement of welfare, but to social progress through innovation—goodness knows we will need that if we are to drive up productivity. Those are just a few thoughts on regulation.
The Government’s document on accession sets out three reasons why we would wish to accede to TPP: first, to
“secure increased trade and investment opportunities that help the UK economy…overcome the unprecedented challenge posed by coronavirus”;
secondly, to
“help us diversify our trading links and supply chains, and in doing increase our economic security”;
and thirdly to
“help us secure our future place in the world and advance our longer-term interests.”
The Government explain that
“CPTPP membership is an important part of our strategy to place the UK at the centre of a modern, progressive network of free trade agreements with dynamic economies. In doing so we aim to turn the UK into a global hub for businesses and investors wanting to trade with the rest of the world.”
That should be a really exciting prospect for everyone in the House and across the country who understands the trajectory. It will help the UK to forge a leadership position, as the Government have set out. So the Government’s strategic vision is excellent.
The agreement also leans into a really important set of current global trends. People will complain that the idealists seek to replace our EU membership, but I do not know of any credible proposition to replace EU trade with CPTPP trade—that is not a practical proposition, and I do not think that anyone is seeking to do it. I am very pleased that the Government have a high-quality agreement in place with the European Union. It is not an either/or; it is a complementary proposition. I am very pleased that the agreement that we finally struck with the European Union facilitates the accession to CPTPP.
I draw on a Bain & Company report, which is a few years old now, on the declining cost of distance. This is not about the momentary cost of containers, but about the great global trends that have taken place in our world, driving down the cost of geographical separation. The Bain paper states:
“The catalyst for this historic shift is an array of new platform technologies that have pushed the cost of distance to the tipping point. Multibillion-dollar investments in robotics, 3-D printing, delivery drones, logistics technology, autonomous vehicles and low-Earth-orbit (LEO) satellites are giving rise to new products and services that sharply erode the cost of moving people, goods and information. As these technologies combine and converge, change will accelerate…A significant change in the cost of distance would prompt millions of economic actors to rethink their strategies and investments, and cause individuals to reassess where they work, live and raise their families.”
If the coronavirus crisis has done anything on that point, it is to accelerate the trend—here we are, debating the matter in Parliament, with hon. Members about to contribute virtually. Bain was visionary in seeing the declining cost of distance as technology advances, which plays into the accession to CPTPP.
I turn briefly to two final matters. The first is geopolitics. The world can be seen now to be polarising between the Asian authoritarians—Russia and China—and the liberal maritime democracies that believe in free trade. In a speech given to Policy Exchange, the former Canadian Prime Minister Stephen Harper said that the CPTPP would go
“from being a purely regional pact to now being the beginning of an alternative global order”.
It is a huge and extremely important vision, and the UK’s acceding to the agreement will be a key part.
Let us not forget what is at stake. We see the behaviour of China and we know that the rest of the world’s nations will need to set a better example to their people than this tendency to so control the lives of ordinary people, including persecuting some of them. That is an important illustration, in the little time that remains, of how trade is strategy today, and our accession to CPTPP is about that strategy for not merely the short run but the long run, to position the UK for success and as a global leader. I do not mean “global leader” in any unhelpful way, but in a way that says, “We are your friends and partners in a very open and equal way,” to great nations such as Japan, Australia, New Zealand, Singapore, Vietnam, Canada, Mexico, Chile and Peru.
All that grand talk of geostrategy will not mean much to many of the small businesses in Wycombe, and across the country, which are perhaps still struggling with working out which incoterms they should use to help to facilitate their trade with the EU. That leads to a wider issue of trade facilitation, which I hope my right hon. Friend the Minister will touch on. It is important that we help firms that are used to trading and exporting only within a customs union to understand that it can be relatively straightforward to export across the world. It is also important to help firms to get set up to do that. I hope that my right hon. Friend will bring his great expertise on those matters to bear through the Government, to help the firms in my constituency and across the country. There will be a huge task of simplification and explanation. The agreements are complex and their interpretation is difficult. It will be for the Government to show small firms how to take the best advantage of them.
I hope that my right hon. Friend will touch on the issue of when the Government will be able to set out their approach to formal negotiations, and that they will say more about their hopes, and what safeguards they will be looking to maintain. Perhaps there can be more about our right to continue to regulate ourselves when entering into such a large agreement. A great deal has been said about our being a small nation, but when I talk to people in Japan or, indeed, when I am inspired, Mr Brandis, the high commissioner of Australia to the United Kingdom, I find that the rest of the world does not see us as we have been encouraged to see ourselves, but as a potentially important catalyst in the new order. I should be grateful if the Minister would say something about major geopolitics, but I appreciate that that might be out of scope. However, perhaps he could emphasise how the issue is really about—I do not like to say “ordinary”—normal men and women trading in the UK, taking advantage of new arrangements around the world, the better to innovate, improve our lives, develop productivity and create a greater spirit of global co-operation around the world.
As I finish my speech, I think I should wave this great doorstop of a document that Business for Britain produced before the referendum, on the back of which is a poster, with a vision of Britain having a future with the world. The accession to CPTPP is central to that bright, hopeful future of trade and co-operation with the world, and I am delighted that my right hon. Friend the Minister is here to respond to what I am sure will be an interesting debate.
Mr Philip Hollobone (in the Chair)
The debate can last until 10.55. I am obliged to call the Front-Bench spokespeople no later than 10.22. That will be Drew Hendry first. The guideline limits are 10 minutes each for the Scottish National party and Labour spokesmen and the Minister; and Steve Baker will have three minutes to sum up the debate at the end. There are nine Back Benchers who seek to contribute before 10.22, and my aim is to get everyone in. If everyone is going to speak for the same length of time, Members will not want to speak for more than four and a half minutes. I know that Angus Brendan MacNeil, who is first, will want to show us how it is done within the time available.
Angus Brendan MacNeil (Na h-Eileanan an Iar) (SNP)[V]
It is a great pleasure to serve under your chairmanship, Mr Hollobone. As I listened to you I was promising myself I would most definitely be finished by 10.22, but now I can see that I will have to finish four and a half minutes from now. I take on board your strictures, indeed.
I congratulate the hon. Member for Wycombe (Mr Baker) on obtaining the debate, which is timely. The International Trade Committee, which I chair, is looking at the CPTPP in the international trade arena. I do not know whether there are interventions in Westminster Hall, but if anyone is willing to give it a go we can show the powers that be in the main Chamber that it can be done. I do not think that we are bold enough to do that virtually yet, but it is a possibility that I mention in passing. I will not speak for long at all, Mr Hollobone, so you can relax.
If the debate is about the economy, we have yet to see assessments being done in relation to GDP. Much is made, in prose and flowery language, of trade deals for the UK in the light of the damage of Brexit, but very little is done in numbers. Numbers inform debates that should be about business and the economy. We know that Brexit means forgoing about 4.9% of GDP—these are the Government’s own figures—yet we have had no deals to make up for this damage being done to the economy. None of the trade deals that have been signed have been new; they have all been roll-over deals. The best, probably newest-ish, deal is the Japanese deal, but of course this comprehensive economic partnership agreement has only replaced the EU’s economic partnership agreement with Japan. That will grow GDP by 0.07%, according to the Government—about a 70th of the Brexit damage that is coming—but it is actually not that because it is a replacement deal, so the GDP gain is effectively zero. That should be borne in mind.
It should also be understood what trade deals do. The best of the trade deals that the UK can get, with the United States of America, will grow GDP by about 0.2%. That is 24.5 times smaller than the Brexit damage, so we would need about 24 such trade deals to make up for that damage. Unfortunately, with the USA accounting for a quarter of the world’s GDP, to get 24 of those kind of deals we would need to go and strike trade agreements on about six and a half planets populated with Americans and to which we can drive lorries. That is not really possible.
We have to understand the numbers behind this. There is no assessment of CPTPP. When an assessment is done, it should not include Japan, because a deal with Japan has already been landed; we cannot land the same fish several times. It is with a lot of other, smaller economies—Brunei, Canada, Chile, Malaysia, Mexico, New Zealand, Peru, Singapore and Vietnam. Excluding Japan, that deal is probably approaching the level of about half the America deal, or about 0.1% of GDP; it may be a little more. If I say that the 4.9% GDP loss of the Brexit deal is £4.90, for ease of understanding, the America deal, which is worth 0.2% of GDP, would be worth 20p, the Australian deal would be worth 2p and the New Zealand deal would be worth 1p. There are very little gains to be made. That must be understood.
Distance is an important factor as well. With Ireland, the UK imports £12.4 billion of goods and exports £17.8 billion, roughly. It has a trade surplus with Ireland. With China—I use this for illustrative purposes—we import £49 billion of goods and export £30 billion. The numbers are sort of in the same ballpark, give or take £10 billion. China is 300 times larger than Ireland, but it is further away, and distance is important, as we know. The Pacific ocean, while being greatly big, is not really that close to our doorstep. Trade for people who sell, say, shellfish on lorries to the European continent is not eased with the Pacific being so far away; it does not allow for a weekly rotation of lorries.
The hon. Member for Wycombe mentioned visas. That could be changed now by the UK Government. Many a time have I pleaded with various Immigration Ministers to allow fishermen to come to help our economy, but for reasons of headlines in tawdry newpapers, they have resisted. We have seen a loss to our economy as a result.
We need to see what CPTPP can do and which supply chains will benefit from the loss of tariffs. We must also remember that CPTPP will be similar to the new deal with the European Union. It is only free trade. As with each and every other trade deal, there will be paperwork and hassle for anybody trading under the deal. In north America, some people just pay the tariff rather than trade under a deal, because things can be so difficult.
My final words, because I am aware of your strictures, Mr Hollobone, are that we need to see the assessment of CPTPP. It is nice to have the flowery language and the prose and the good intentions and whatever in the world, but it is numbers that talk. We need the bottom line. When we have just decided to burn 4.9% of GDP and have recovered none of it in return, the numbers for CPTPP—unfortunately; I would love to be a bit more positive about this—just do not stack up very far. Given that the Government have not produced assessments of that yet, I am betting that these are in the tenths of a per cent—about a fraction of the damage of Brexit unfortunately. We must be honest and frank with ourselves. I hope I did not take too much of the time and it is a great pleasure to serve under your chairmanship, Mr Hollobone.
Claire Coutinho (East Surrey) (Con)
Thank you for calling me, Mr Chairman. It is a pleasure to serve under your chairmanship. I thank my hon. Friend the Member for Wycombe (Mr Baker) for bringing this important and exciting debate. The UK has always recognised the need to get ahead of the economic curve and the accession to the CPTPP will do that on two fronts. It will be part of the ambitious push towards free trade, which I will talk about later, but also delivers on our explicit foreign policy objective of tilting towards the Indo-Pacific. The Indo-Pacific is an area that I am passionate about, and I have been delighted to serve on the Policy Exchange on this issue. It is the fastest growing region in the world, and a core amount of our maritime interests are there. It is important to our national security in defending the rules-based order and our democratic principles.
Acceding to the CPTPP will be core to free trade for multiple reasons. First, in terms of scale, it accounts for 13% of GDP. If the US joins, which is entirely possible under the Biden Administration, it will account for over a third. I come back to the point about geography, which I do not completely buy, even for physical goods, as we have seen the rise of China and how that worked with exporting to the West, but also because the future of free trade will encompass digital trade. I commend the work of the Secretary of State in this area and the amazing progress she has made in securing seven out of 11 bilateral free trade agreements with the cohorts of the CPTPP. It is important to note that it is not just the Indo-Pacific—we have countries such as Canada, Mexico, and possibly the US joining. Alongside the delivery of our tilt to the Indo-Pacific, when fully implemented, the CPTPP will eliminate 98% of tariffs. Also, one of the best things is that it will bring about a standard set of rules of origin, meaning we could integrate our supply chain with the CPTPP. One of the beneficial ways that works is that 70% of our supply chain can be accumulated in any CPTPP country to account for the preferential tariffs received.
I come back to digital free trade, something that I have written about. The UK is a services superpower—the only country that exports more services is the US. The digital economy accounts for £150 billion of the UK economy. It is growing six times faster than the rest of the economy. It is important that the UK is at the front of pushing for ambitious digital provisions. That is at the centre of the CPTPP, which makes provisions for services, intellectual property and digital trade. It was not at the forefront of EU trade, so it will be really beneficial to the UK, particularly considering the shape of our economy—80% of our economy is based in services which employ 30 million people across the nation.
The UK is making great strides in this. I think the agreement with Japan accounts for the most ambitious digital provisions in the world, particularly on data localisation that means that expensive data centres abroad are not necessary, and we can use the brilliant ones here. We all know that data will be the fuel of the future. It will fuel our incredibly rich sectors, such as artificial intelligence and FinTech, which the UK excels at, and is why the CPTPP, given its shape, its geography and its importance in our foreign policy and strategic objectives, is exactly the right thing to pursue. I commend the Government in doing so.
Jim Shannon (Strangford) (DUP)
Thank you for calling me, Mr Hollobone. It is a pleasure to speak in this debate. First, I thank the hon. Member for Wycombe (Mr Baker) for setting the scene so well and comprehensively, in a well-delivered and detailed speech. I am sometimes a wee bit in awe of his presentations because they are so well put.
The motion explains exactly what we are after: a comprehensive and progressive agreement for trans-Pacific partnership. It is undoubtedly a massive debate. In 2019, UK exports of goods and services to CPTPP countries amounted to £58 billion—8.4% of the total. Imports were £53 billion, which was 7.3% of the total. Of the CPTPP countries, Australia, Canada, Japan and Singapore are the UK’s largest trading partners. I am pleased that the Ministry of Defence has given more focus to the Royal Navy in that area, which goes to the point made by the hon. Member for East Surrey (Claire Coutinho) about defending our national security interests and our military relationships with the likes of Australia, New Zealand and Malaysia, as well as Taiwan and Japan.
I see great potential in the deal. However, I want to explain to the Minister certain concerns that have been raised. It is clear that we must get the agreement right and that the House must be aware of every detail of the deal. In that vein, I seek assurance from the Minister that we will have not just this debate today in Westminster Hall but a full debate in the main Chamber and a meaningful vote on the UK’s accession to the CPTPP, with input from every Member of the House sought in that vote. That is important. All Members should have the opportunity to feed into that. I see the benefits of the partnership, so I come to it with a positive inclination.
Distance should not be an obstacle to trade. I have a particular interest in the agrifood sector—one of the biggest businesses in my constituency—where there is incredible potential for trade to be both comprehensive and progressive. We have a special relationship with New Zealand and Australia in particular, and economic ties with Japan and Singapore. We can develop them and do more with them.
The hon. Member for Wycombe referred to the insatiable demand that China has for every mineral right in the world—every speaker who follows me will probably refer to it. They want everything for themselves, or they want to have control of it, so we need an agreement in place that can take on the Chinese, so to speak. I see the CPTPP as a method to combat China’s influence politically and from a business perspective as well.
It has been suggested to me that, environmentally speaking, although CPTPP includes investor-state dispute settlements, the UK has the option of negotiating a carve-out from the investment component of the deal through side letters. There is the option pursued by New Zealand, which signed side letters with five CPTPP members to exclude compulsory ISDS. One of my biggest mailbag issues is the environment and I am keen that we do it right from an environmental point of view today, because we have it in trust for those who come after us: my children, my grandchildren and my great-grandchildren, whenever that happens—if I am still here, of course. It has been suggested that the UK should make ISDS a red line for accession, and negotiating objectives have been published that would demonstrate the Government’s seriousness about tackling climate change and guard against the other social and regulatory risks posed by ISDS. What consideration has been given to that suggestion and what is the Minister’s response?
Finally, I ask the Minister to confirm that businesses in my constituency can buy into the CPTPP opportunities. We have a highly skilled, young, eager and energetic workforce, and I believe that in the United Kingdom of Great Britain and Northern Ireland, better together, we can do these things to the betterment of everyone.
Virginia Crosbie (Ynys Môn) (Con)
It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank my hon. Friend the Member for Wycombe (Mr Baker) for bringing forward this important debate.
As the MP for a rural constituency—Ynys Môn, with its large farming community—I am keen to see the UK develop its trade partnerships across the globe, outside the constraints of the EU. The CPTPP will offer my farmers opportunities to export more British food overseas, in particular from the beef, sheep and dairy sectors, which are the mainstay of many farmers on Anglesey—for Rob and Kim Evans, Brian Bown and Trevor Lloyd.
The CPTPP offers a wealth of opportunity across the Asian, American and Australasian continents, with potentially lucrative markets for our produce: dairy products—cheeses in particular—to Canada and Australia; pork and poultry to Vietnam; beef to Japan; and mutton to Malaysia. My discussions with the National Farmers Union and the Farmers Union of Wales highlight the value that is placed on the quality of British produce overseas, particularly in markets where food safety is a key consumer concern.
The UK’s food is safe, traceable and audited. Our animals are well cared for and our meat and dairy produce is handled with care. My farmers see great opportunities in establishing the CPTPP. However, they also have concerns about the potential opening of the UK market to cheaper, lower quality imports from overseas. They are keen that the Government follows the commitments made at the time of the Trade Bill and the Agriculture Act 2020’s passage through Parliament. We committed then to upholding our standards and not opening the floodgates to substandard products.
We need to ensure that rules of origin are considered so that large-scale imports such as milk from New Zealand do not flood our market through a back door, putting domestic producers out of work. We need to ensure that substances that are illegal in the UK on environmental grounds, such as neonicotinoids, are not permitted for use on imported products, giving foreign producers cost advantages. We need to ensure that our farmers are not disadvantaged by the economies of scale available to producers in countries such as Australia, where the cost of beef and sheep production is significantly lower due to viable herd sizes and land costs. We must make sure that animal welfare and food production standards are at least equivalent to those we enforce in the UK. That means ensuring that, for example, growth hormones are not used on imports and the animal production index is used as a benchmark of animal welfare.
I reiterate that our farming communities are keen to ensure that agreements such as the CPTPP are aligned with the Government’s proposed campaign to raise awareness of brand Britain. We need to differentiate our produce and mark it out as different from the competition. By protecting our high standards and highlighting all that is unique and special about UK produce, we can support our farmers as they explore new markets and see our country established once again on a global stage.
Nick Fletcher (Don Valley) (Con)
It is a pleasure to serve under your chairmanship today, Mr Hollobone. I thank my hon. Friend the Member for Wycombe (Mr Baker) for bringing this debate.
I welcome the UK’s accession to the CPTPP as the next step in the evolution of our post-Brexit trade policy. The agreement will strengthen the bilateral trade deals we have and our negotiation with other CPTPP members. Crucially, it will allow us to expand our increased international trade without compromising on our sovereignty. It is, above all, an economic agreement. While it requires some alignment in trading standards, as all trade deals do, it does not seek to impose political alignment. There are no common laws and where disagreements between states arise, they will be resolved by an ad hoc arbitration panel rather than permanent courts. With such a wide range of countries and economies, I do not think it could be any other way. I look forward to trading more closely with partners who understand that productive trade relationships do not require uniformity.
We will continue to have full control over our laws, money and borders, while improving access for UK goods and services around the world. Rules of origin under this agreement mean that some of our most important industries will benefit. For instance, car manufacturers in the UK can use Japanese parts; as long as the final product is 70% CPTPP-origin, it will qualify for preferential tariffs when exported to Canada. Scottish whisky, too, will see tariffs significantly reduced or eliminated, going from 165% to 0% in Malaysia.
Just as importantly, these are the economies expected to grow significantly in the coming years and decades. In just three years, between 2016 and 2019, the UK’s trade with CPTPP states grew by 8% annually. Joining the CPTPP now means that our small businesses will have preferential access to these economies, and the small and medium-sized business support included in the agreement means that they will be able to take full advantage.
However, acceding to the agreement is not purely an economic choice. Among the CPTPP members are states with whom we have increasing security ties—in particular, Australia and Japan. Close economic partnerships can only help our overall relationship with strategic partners.
Finally, the Government have shown that they are open to skilled immigration from people around the world. Through the CPTPP, business people will hopefully soon benefit from a quicker, less expensive visa process. In all, the UK has a lot to gain and to offer from joining the CPTPP, and I look forward to more trade deals with a diverse range of countries in the years to come.
Richard Graham (Gloucester) (Con)
Like others, I congratulate my hon. Friend the Member for Wycombe (Mr Baker) on securing this debate about a cause that he, as a champion of global free trade, has long been interested in. He has often thought more strategically than many of us, so I congratulate him on his prescience in pushing forward with the aim of our joining the trans-Pacific partnership.
Now is an extraordinary moment for our country. It is important that we touch on one of the elephants in the room, which my hon. Friend alluded to. The application to accede to the trans-Pacific partnership is absolutely not a substitute for leaving the European Union. It is a way of growing our trade, investment, global relationships and opportunities for constituents in ways that could never have occurred while dealing with the issue of our relationships with the European Union, and is now not just possible but the right thing to do.
Let me be clear for the record that we need our trade to succeed everywhere in the world. We do not want a huge drop in trade with the EU as a result of leaving the European Union; we want to see a significant increase all around the world. This coalition of the willing around the Pacific region, which we aspire to join, gives us a huge opportunity. As several Members mentioned, the trans-Pacific partnership is not above all about tariff benefits. In fact, we have free trade agreements with seven of the 11 members, and no doubt we will shortly have them with at least two others.
The real benefits are around that most obscure of trading details: the rules of origin. The easiest way for me to try to bring that alive, particularly for my constituents, is to highlight the challenges for a bicycle manufacturer on the edge of Gloucester, in Hardwicke, which currently imports the frames from Taiwan and adds various things from their own factory and distributes and exports the bicycles around the world. That has become very hard indeed in the European Union as a result of the new rules of origin, but should we, and Taiwan, accede to the trans-Pacific partnership, the company’s global exporting prospects will be much better. Therefore, we should welcome both the opportunities from the origin and the new rules that will come from investment, intellectual property and digital trade.
As others have alluded to, particularly my hon. Friend the Member for East Surrey (Claire Coutinho), the opportunities that come out of the Japan free trade agreement in terms of digitalisation and liberalisation set a good precedent for what can be achieved by the CPTPP, which I prefer to refer to as the trans- Pacific partnership. The advanced provisions—there may be further opportunities on services from our negotiations with Australia and New Zealand—offer greater opportunities for a nation for whom 45% of exports are services.
There is another elephant in the room: China. Let me be clear that we can and should increase our trade with China, as the integrated review spells out; given that I am a former British trade commissioner to China, no one would expect me to say anything else. I believe in increasing trade everywhere—legally, and while supporting the values we believe in and champion.
That leads me to another element of our Indo-Pacific tilt. We should not expect that it will all be plain sailing, and nor would becoming a member of the TPP in itself prevent some of the many challenges that come about in countries where the systems, levels of corruption in some cases, amount of violence in others, will constantly challenge our own commitment to human rights. We have to find a framework for standing up for our values while making sure that our businesses have the confidence to know that they can trade in the long term.
Forty years ago, I made a decision, based on an instinct, to have the adventure of going to work for a British company in the far east. It turned out to be the best strategic thing that I have ever done, as it was for other businesses that did the same thing at that time. I am quite convinced that the decision our country is making today, on a much more rational basis, will be the right strategic move for us.
I am not sure that the description of the TPP by Stephen Harper, the former Canadian Prime Minister, as creating an “alternative global order” is necessarily where we are today. However, it is true that if the US gives the support to the TPP that was given it by the Obama Administration, that would be a significant game-changer, and our joining the TPP would turn it from a regional organisation into one with a wider global reach.
For all those reasons, I am disappointed that there are not more Opposition Members joining this debate today. This move will have benefits for our constituents across the country, and it is therefore in our interests to support the Government in acceding to the TPP.
Ben Everitt (Milton Keynes North) (Con)
It is a pleasure to serve under your chairmanship, Mr Hollobone.
I start by thanking and congratulating my hon. Friend the Member for Wycombe (Mr Baker) for securing this important debate about a subject that I know has been incredibly close to his heart for a long time; the temptation for him to give the “I told you so” speech was very well avoided.
I share the enthusiasm in this Chamber for joining the comprehensive and progressive agreement for trans-Pacific partnership, which I think we all agree we should just call “the trans-Pacific trade agreement”. It is a huge opportunity for the UK and indeed for Milton Keynes. The agreement covers one of the world’s largest and most dynamic free trade areas. It removes tariffs on 95% of goods between members, accounting for 13% of global GDP, which will immediately rise to 15% when we join. As my hon. Friend the Member for Gloucester (Richard Graham) said, when we join this partnership, it will not be the Pacific partnership; it will be a global partnership.
Our businesses will then have access to the most exciting and fastest-growing markets around the world—in Asia, Australasia, South America and North America. Our partners, of course, will have access to the hub of Europe—Great Britain. We are already working on bilateral agreements with Japan, Australia and New Zealand, but joining this partnership means that British businesses would go global.
I am excited about accessing these markets because they are right in Milton Keynes’s sweet spot. We have high-tech, high-skilled jobs, which will put us in the global fast lane. We are one of the most productive and innovative parts of the United Kingdom. We have delivery robots, Formula One teams, space technology, e-scooters, driverless cars and a reality TV star building a nuclear reactor—that is definitely not worrying at all.
Milton Keynes can be the Silicon Valley of Europe. We have the people, the technology and the can-do attitude. This is my call to arms for Milton Keynes businesses—global Britain and global MK. New partnerships such as the CPTPP are huge opportunities that are there for us to seize. Plenty of support is available for MK businesses to go global. The Department for International Trade stands ready to provide assistance with customs authorities, to ensure smooth clearance of businesses’ products, and to offer advice on intellectual property and other issues, such as business continuity. Milton Keynes businesses are eligible to secure export insurance to cover markets including the EU, the US, Japan, Australia, New Zealand, Canada, Iceland, Norway and Switzerland—and after UK Export Finance expanded the scope of its insurance policy, such export insurance is easier to obtain.
Exports from the UK to these markets totalled £499 billion in 2019, accounting for 74% of all international sales from the UK. Joining this partnership will put the UK and Milton Keynes at the centre of a network of free trade deals with dynamic economies, making us a hub for international businesses trading with the rest of the world.
There are huge new opportunities in forward-leaning areas, such as digital, data and services—all the things that Milton Keynes leads in. As my hon. Friend the Member for Don Valley (Nick Fletcher) said, the CPTPP is a partnership, so—unlike the EU membership that we had—joining does not require us to cede control of our laws, borders or money. That is great news for businesses and great news for our economy.
Mission control: this is global MK. We are on the launch pad. We are ready for lift-off.
Marco Longhi (Dudley North) (Con)
It is a real pleasure to speak under your chairmanship, Mr Hollobone. I thank my hon. Friend the Member for Wycombe (Mr Baker) for securing the debate, and wish to align myself with the warm comments of the hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for Gloucester (Richard Graham) towards his good self. I followed and appreciated his endeavours well before I became a Member of this place.
Accession to the Comprehensive and Progressive Agreement for Trans-Pacific Partnership—yes, I would like to call it the CPTPP as well—will clearly strengthen our place on the world stage, giving us a truly global outlook following our exit from the European Union. Joining this free trade area, which covered some £9 trillion of GDP in 2019 alone, could cut tariffs in vital UK industries such as food and drink, and the automotive sector. To be a little parochial here, that is so important for my Dudley North constituents, the black country and the west midlands as a whole. Accession will also create new opportunities in forward-leaning areas such as digital and data, and across a whole range of services.
Opportunities for trade and collaboration now exist far beyond the confines of the EU, and I know that the British people would want us to pursue membership for the huge benefits that it could bring. It creates the conditions for growth, trade and jobs, and we are well placed to take advantage of those economic benefits, with several significant free trade agreements already in place. I commend the efforts of the Secretary of State and her wonderful team in securing them in such a short space of time.
All countries have felt the economic pinch from protecting citizens from the horrors of the coronavirus pandemic. The CPTPP will allow us to further diversify our economic resilience and supply chain to build back better. Something that has concerned me over the previous couple of decades, as we have looked at a global Britain, is the issue of onshoring, which has perhaps become of greater significance in particular key sectors of our economy.
The UK is world leading in digital advancement and research. Modern digital trade rules that facilitate free and trusted cross-border data flows remove unnecessary barriers for British businesses, facilitating even more trade, including for some of our world-renowned products. The CPTPP is a very-high-standards agreement, and the rules will have huge benefits for the UK. The reality is that UK products such as beef and lamb have been locked out of overseas markets for unfair reasons, so it is in our interests to sign up to a high-standards agreement that would benefit many of our farmers across the UK significantly.
We already have extremely ambitious standards in areas such as the environment, animal welfare, food standards and intellectual property. It is in our interests to be in agreement with similar ones, so that we can ask the same of other countries and get access to their markets. Accession will grow our economy, increase revenue and create jobs. Let us do it as soon as possible. People are listening. Businesses are listening, and this is about confidence.
Mr Philip Hollobone (in the Chair)
We now come to the first of the Front-Bench speeches, which will be by Drew Hendry from the Scottish National party, who also wins the prize for the most colourful backdrop.
Drew Hendry (Inverness, Nairn, Badenoch and Strathspey) (SNP) [V]
Thank you, Mr Hollobone; it is a pleasure to serve under your chairmanship. I congratulate the hon. Member for Wycombe (Mr Baker) on securing this important debate; it is a credit that we are getting the opportunity to speak about it. I have heard the lament about there not being more Opposition speakers; I know that he will be delighted that the SNP is always happy to provide the opposition to the Tories at Westminster.
My hon. Friend the Member for Na h-Eileanan an Iar (Angus Brendan MacNeil) pointed out that there is no assessment of CPTPP, and he made some very simple comparisons about losing £4.90, for example, from the deal with the European Union versus gaining 20p from the USA, or Australia for 2p. That is the stark reality.
Today we have heard Members across the Chamber talk about the effects on farming and dairy farmers—I will come to that shortly. We have also heard Members say that they do not want to see a drop in EU trade, but regrettably that has already happened.
There is no deal that will ever make up for what Brexit takes away from us. We simply cannot trust the Tory Westminster Government not to sacrifice protections for our NHS in negotiations to join this bloc.
By the UK Government’s own analysis, the trade deals they strike outside the EU cannot make up for the impact of Brexit on the UK economy. A trade agreement with New Zealand is estimated, to be charitable, to have a limited effect on GDP in the long run—the estimated impact is 0%. Indeed, under scenario 2 the UK Government documents state that GDP in New Zealand is estimated to see economic growth of 0.35%, but UK GDP would see a drop of 0.01%. Again, by the UK Government’s own estimates, the Japan-UK deal, which has already been signed, will add only 0.07% to UK GDP. That is really tiny, especially when we consider that we could have had a similar agreement anyway as a member of the most successful trading power in the world by far: the EU.
The EU single market accounts for 52% of all UK trade goods exports and 45% of all UK trade services exports. The EU has more agreements with more countries than any trade bloc in the world by far. In 2017, UK exports to CPTPP countries totalled just over £50 billion—about 8.5% of all UK exports. When compared with the EU trade bloc, this will do little to mitigate the damage of losing seamless access to that partner, which accounts for almost half of all trade.
People in Scotland know that rejoining the EU as a full member of the customs union and single market is the best possible option for protecting livelihoods and jobs. The UK Government’s constant—but deeply flawed—refrain is that we must instead focus on fast-growing economies outside the EU, but this is an unforgiveable act of harm to businesses and trade across the nations of the UK. It fails to acknowledge that, according to the World Bank, the EU has some of the fastest-growing economies in the world. They include our neighbour, independent Ireland, 31st; Hungary, 43rd; and even Malta, 52nd. The UK, incidentally, is 134th.
The CPTPP countries are not necessarily the fastest-growing economies in the world. In 2019, Mexico was ranked 176th; Japan, 159th; and Canada, 131st. After an absolutely terrible start to the year because of the Prime Minister’s shameful Brexit deal, joining the CTPTT would be another disastrous blow for Scottish farmers already reeling from this Government’s callous disregard for their business.
Figures from the ONS last week show that in February, wheat exports were still down 52%; fish and shellfish exports were down 54%; egg and dairy exports were down 39%; beverage exports were down 34%; cereal exports were still down 40%; and fruit and vegetable exports were still down 54%. Things are getting worse and worse for exporters, all because of the disastrous ideology of this Tory Westminster Government. On top of that, with talk of accession to the CPTPP trading bloc, farmers are genuinely and rightly concerned that existing member countries might insist that the UK lower our standards simply to join, unfairly undercutting our farming industry and again punishing our hard-working farmers here.
The National Farmers Union’s submission last month to the House of Lords International Agreements Committee’s inquiry into the UK’s accession to CPTPP stressed the importance of protecting the UK’s current high food and farming standards. This Tory Westminster Government have had plenty of opportunities to enshrine the current standards of consumer protection, including for agricultural produce. It speaks volumes that they have failed to do so at every single turn. It is clear that the Tories cannot be trusted to protect consumer standards.
Going by past experience, we cannot trust this UK Government to protect our NHS from harm in the CPTPP trade negotiations either, as it has been their policy to join trade partnerships that would allow foreign bids for public contracts through investor-state dispute settlement clauses. The Home Secretary has described Brexit as an opportunity for widespread deregulation. Given the words of many prominent Back-Bench and Front-Bench Tories, it is very easy to see why the public do not trust them. Some 85% of UK exports to the CPTPP are to Australia, Canada, Japan and Singapore, and the UK already has free trade agreements with seven of the 11 CPTPP members—courtesy of agreements made while the UK was in the EU, of course. In the CPTPP, the UK cannot decline to align on too many areas such as ISDS carve-outs for agrifoods, consumer standards and so on, and still expect to become a member. In short, if the UK joins, disastrous consequences are highly likely for some of our exporters.
It is abundantly clear that for Scotland to make the choices that it needs to protect people, protect jobs, protect standards and see that the NHS remains firmly in public hands, it must have the powers to do so. It must soon make a different choice from this Tory Brexit, little Britain approach. It must make better choices as a progressive, outward-facing and normal independent nation.
Bill Esterson (Sefton Central) (Lab) [V]
It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Wycombe (Mr Baker) on securing the debate.
There may well be positives for Britain from joining the CPTPP; there may also be negatives. The problem is that we just do not know, because the Government still have not published any of their negotiating objectives, or even an impact assessment of the deal. Last week, the International Trade Secretary said that Parliament would have full scrutiny of CPTPP through the Trade and Agriculture Commission—but the Trade and Agriculture Commission is not a parliamentary body, and its work can only supplement parliamentary scrutiny, not replace it. In the absence of any impact assessments, it falls to us to decide for ourselves, and I am sorry to say that it is not looking good for the Government.
British sovereignty, promoting British exports and jobs, protecting the NHS, agriculture, environmental standards, human rights, workers’ rights—those are just some of the challenges of the CPTPP. Let us address agriculture, environmental standards and human rights.
Farming has a proud part to play as part of Britain’s heritage. Over hundreds of years, we have developed high-quality produce with strict environmental and animal welfare standards. To continue that proud record, which is admired around the world, our farmers cannot afford for this Conservative Government to compromise on standards in trade agreements. The CPTPP could have some minor benefits to the UK’s agriculture sector but, as the National Farmers Union states,
“CPTPP includes major agricultural exporting countries”—
Australia, New Zealand and Canada.
The question for the Government is whether they will have to make concessions that will damage British farming as a price of joining the CPTPP. We do not know what increased market access CPTPP membership will provide for countries such as Australia and New Zealand, but we know that it will have potentially dire consequences for food and animal welfare standards. Will the Government be able to opt out of the parts of the agriculture chapter of the CPTPP agreement that would allow our agriculture sector to be undercut by lower standards of production? Major questions also remain over whether the UK will be able to retain current bans on the import of hormone-treated beef or chlorine-washed chicken.
Next we come to environmental standards. Palm oil is used in food products, detergents, shampoo, cosmetics, biofuel and even ice cream, but palm oil production is wreaking untold destruction on jungle habitats. Palm oil plantations cover more than 27 million hectares of the earth’s surface. The industry is pushing endangered species ever closer to extinction, and with their carbon dioxide and methane emissions, palm oil-based biofuels are estimated to have three times the climate impact of fossil fuels. Although the UK has a ban on palm oil imported through biofuels, Malaysia—a CPTPP member country—is one of the largest producers of palm oil, and Malaysian officials want the Government to scrap the protections that we already have against the import of palm oil. Palm oil is just one example, and it is emblematic of the potential dangers of signing up to a deal such as CPTPP. Will we be rule takers on imports of palm oil, or will we be able to insist on maintaining our high environmental standards? Parliamentary scrutiny would tell us.
Then we have human rights. Over the past few months, this Conservative Government have voted down amendments that sought to block trade deals with countries that commit genocide. The Foreign Secretary says that he would rather the UK ignored human rights concerns than lose out on trade agreements. Recently, the Government struck a deal with Cameroon, a country whose Government are carrying out a brutal subjugation of its English-speaking minority population. The Minister knows that even President Trump declined to sign a deal with Cameroon.
Now the Conservatives tell us that we should join the CPTPP, whose members include Chile, Malaysia, Mexico, Singapore and Vietnam, all of which permit child labour, forced labour, workplace discrimination, unsafe working conditions and the absence of trade union rights. Are the Government planning to negotiate tougher alternatives to the current clauses in CPTPP, which permit lower standards of production using exploited workers, or not? Although the Secretary of State for International Trade has said previously that the UK has no plans for a bilateral trade deal with China, does the Minister share my concern that a deal with China could take place by the back door via the CPTPP, or can he tell us whether the UK would be able to veto China’s application to join?
On human and workers’ rights, full parliamentary scrutiny and consultation with trade unions and human rights groups is essential if the Government want to build confidence that we should join CPTPP. Agriculture, environmental standards and human rights are just three of a number of CPTPP elements that urgently need to be addressed.
Businesses, workers, freelancers, consumers and the people of Northern Ireland are learning the hard way what a failure to negotiate effectively looks like under this Conservative Government. The trade and continuity agreement with the EU has left gaping holes in trading arrangements that the agreement was meant to deliver after the end of the Brexit transition. We cannot afford a repeat of the failures in the TCA with the application to join CPTPP, so will the Government reopen the 2019 CPTPP public consultation? At the time, it elicited only 55 bespoke responses from business, and the Government’s own surveys showed that only 21% of the British public knew what the CPTPP was. There is also the increasingly serious prospect that China may apply to join the CPTPP, which was not a consideration at the time of the survey in 2019.
Scrutiny of negotiating objectives, a full impact assessment and the reopening of the public consultation on CPTPP are all must-haves, as well as a guarantee that we will have at least as much time to examine the final terms of accession before a final vote in the House of Commons, just as the Australian, Canadian and New Zealand Parliaments had before their respective votes.
In the absence of scrutiny, the shadow Secretary of State for International Trade wrote to the Secretary of State, setting out 238 questions that must be answered if the Government are to have any hope of convincing Parliament that this is a good deal. Those questions included the following. Will the Government be able to negotiate exemptions from the CPTPP to address the concerns that I have raised today? What are the implications of joining the CPTPP for the retention of the UK’s current prohibitions on the import of hormone-treated beef and chlorine-washed chicken?
Will the UK have the right to impose import restrictions on products containing unsustainably sourced palm oil, and apply those restrictions to Malaysia and other CPTPP countries? How will the Government use their accession to the CPTPP to hold all member countries, including Brunei, Chile, Malaysia, Mexico, Singapore and Vietnam, to the commitments made under article 19.3 of the agreement and demand their compliance with the UK’s high standards of human and workers’ rights? Are the Government prepared either to veto any application by China to accede to the CPTPP, or to withdraw from the CPTPP, if we do not have that right, so we do not end up in a trade bloc with China by the back door?
Finally, will the Government guarantee at least the same amount of time to scrutinise the terms of the UK’s accession before they are put to a vote, as was given to the Parliaments of Australia, Canada and New Zealand?
Greg Hands (Chelsea and Fulham) (Con)
It is a pleasure to serve under your chairmanship, Mr Hollobone. This has been one of the finest Westminster Hall debates that I have attended in 16 years as a Member of Parliament. It is a genuine pleasure to be able to respond to it.
I pay tribute to my hon. Friend the Member for Wycombe (Mr Baker) for securing the debate. He made an excellent speech that made my case for CPTPP as well as I could. He gave a brilliant exposition of the benefits. He rightly points out that he was an early enthusiast for joining the CPTPP. Over the years, he has been a forceful advocate for a sovereign, independent trade policy. I know he has welcomed the FTAs that we have already agreed with 67 countries, with Serbia added to the list this week, and with the EU itself, as he pointed out.
I hope to cheer him further by outlining our plans to unleash even more of Britain’s trading potential through accession to the comprehensive and progressive agreement for trans-Pacific partnership. That is quite a mouthful and comes with the world’s hardest-to-pronounce acronym, the CPTPP—in trade, the longer the term, often the more important the content, and that is true of this agreement.
We know that 2020 was a time of unprecedented challenge on every level, but CPTPP is going to be part of the future of this country. Our accession to CPTPP will be central to our endeavour to build back better and to assist our economic recovery, and our preparations are advancing at pace. As colleagues know, on 1 February we submitted our notification of intent to begin the accession process. That was the first formal step before formal negotiations start later in the year. Joining CPTPP would give British firms access to a free trade area worth £9 trillion, made up of 11 like-minded nations that share our commitment to free trade, international co-operation and the rules-based system.
Britain is the first new country to apply to join this trade partnership since it was established in 2018, with big economies such as South Korea, Thailand and Taiwan. A good point was made by my hon. Friend the Member for Gloucester (Richard Graham), who knows the region incredibly well, as the Prime Minister’s trade envoy to Malaysia and the Association of Southeast Nations region. All of those also show interest in membership.
It is a high-standards agreement between sovereign nations, which together account for 13% of global GDP. UK membership would increase that share by nearly 20%, to 16% overall. As my hon. Friend the Member for Wycombe pointed out, we are not a small nation. Equally, nothing in CPTPP will impinge on our domestic right to regulate, which was one of his key questions.
This is very much a business-focused agreement, removing tariffs on 95% of goods traded between members and reducing other barriers to trade. The UK already does more than £110 billion-worth of trade with individual CPTPP members, and the average growth rate is 8% per annum. Some of our closest trade allies—Japan, Canada, Australia, New Zealand and Singapore—are there, as are big actual or potential markets, such as Mexico, Vietnam and Malaysia, but our membership would take those trade ties to another level, opening up even more opportunities for businesses of all kinds and all sizes across the United Kingdom, spurring growth, generating jobs, delivering prosperity the length and breadth of our country and helping us to level up opportunity nationwide.
This is good news for all regions and nations of the UK, which can strengthen their already lucrative trade ties with these markets. In 2019, for example, more than £3 billion-worth of goods were exported to CPTPP nations from the east midlands alone, together with £2 billion-worth from the north-west of England and £2.4 billion-worth from Scotland. With accession, those bonds of prosperity are set to strengthen and deepen in the years ahead.
To look at specific benefits for Britain in cutting-edge sectors that are shaping the world of tomorrow, from digital trade to tech and automation—these points were made by my hon. Friends the Members for Wycombe and for Milton Keynes North (Ben Everitt)—accession would allow us to work even more closely together with other members on the development of modern digital trade rules that facilitate free and trusted cross-border trade flows and remove unnecessary barriers to business. That point was also made extremely well by my hon. Friend the Member for East Surrey (Claire Coutinho), who spoke first in the Back-Bench contributions.
The depth and breadth of the CPTPP’s e-commerce chapter provide a platform for the UK to help to shape, together with big global players in the sector, the emerging digital trading rulebook. These markets offer exciting new opportunities for British tech innovators as we seek to bind the UK, which is after all Europe’s tech capital, ever more closely with the dynamism of the Asia-Pacific region, unlocking ever greater digital trade potential between us as we build on the nearly £19 billion-worth of digitally delivered services that the UK exported to CPTPP countries in 2019. Those points were localised really well by my hon. Friend the Member for Milton Keynes North in his “Global MK” speech, which I think will have gone down very well in his local area.
Accession would also make it easier for British business people to travel between member countries via the potential for faster and cheaper business visas—a point made very well by my hon. Friend the Member for Don Valley (Nick Fletcher). To return to a key question from my hon. Friend the Member for Wycombe, access to the agreement’s dedicated chapter on small and medium-sized enterprises will ease barriers to trade for small firms by cutting tariffs and reducing red tape, giving thousands of British SMEs greater access to these vibrant markets. A really important feature of modern free trade deals is the SME chapter. A free trade agreement can seem incredibly forbidding—a typical free trade agreement has 700 or 800 pages. Someone running an SME will not have the time, let alone perhaps the inclination, to read a 700 or 800-page agreement. The idea of the SME chapter is that it allows a company to navigate the free trade agreement and take advantage of things such as Government publicity about what is available there; it eases the passage for an SME and particularly a first-time exporter.
In addition, there is the potential for swifter elimination of tariffs on key British exports, including whisky. I look over to my friend from the Democratic Unionist party, the hon. Member for Strangford (Jim Shannon). There is that potential on whisky tariffs. Of course, everybody likes to think about Scotch, but what about Irish whiskey? I have a very good relationship with the Irish Whiskey Association, and we also always promote Irish whiskey—as well as cars, a point of particular relevance to my hon. Friend the Member for Dudley North (Marco Longhi), and the automotive industry.
We could also benefit from the rules-of-origin provisions, which mean that goods produced in any country within the CPTPP will be classed as originating in the free trade area. To give just one example, cars made in the UK could use more Japanese-made parts, such as batteries, and still qualify for tariff reductions when the completed cars are exported to other CPTPP members—for example, Canada. They would count as being of qualifying CPTPP origin. That is a win-win scenario for the British economy.
On parliamentary scrutiny, which has been raised a couple of times, this Government are committed to transparency and we will ensure that parliamentarians, UK citizens and businesses have access to information on our trade negotiations. On 7 December last year, the Secretary of State for International Trade made a written statement outlining the transparency and scrutiny arrangements that will apply to our new FTAs. I am pleased to confirm that those will also apply to the CPTPP negotiations. Before the launch of formal negotiations, we will publish our objectives, alongside a response to the public consultation that has already been held, which the Opposition Front-Bench spokesman, the hon. Member for Sefton Central (Bill Esterson) referred to, and an initial economic scoping assessment, which the Chair of the International Trade Committee, the hon. Member for Na h-Eileanan an Iar (Angus Brendan MacNeil), referred to. He seems, however, already to have made up his mind about what will be in the economic assessment, but I shall see him later, when I appear before his Committee, and perhaps we will continue the discussion at that point.
We will continue to keep Parliament and the public informed of the progress of negotiations via regular updates, working closely with the relevant Committees in both Houses. My hon. Friend the Member for Wycombe sought an explainer. That is exactly what a lot of the documentation is intended to do—to explain the potential and actual benefits from the free trade agreement. As to the point that the hon. Member for Strangford made about a full debate, I would welcome one. I welcome this morning’s debate, and in the Department for International Trade we welcome the opportunity to explain and expand on Britain’s free trading future.
Most of the questions raised by the hon. Member for Sefton Central will, I think, be answered when we publish the negotiation objectives shortly, but to deal with one of his points—the idea that CPTPP will be a back door for a trade deal with China—I cannot make it clearer that there are no plans or intentions for a UK trade deal with China. It is very unlikely that China would meet the requirements for the CPTPP at the moment, and it is worth not forgetting that it is subject to the veto of existing CPTPP members, which, as the hon. Gentleman pointed out, do not yet include the UK. However, we might ask whether China would be welcomed by the existing members of the organisation.
We heard some rather tired, familiar arguments from the SNP Front Bench. I think that the party is always much more interested in debating Brexit than the UK’s trading future. The hon. Member for Inverness, Nairn, Badenoch and Strathspey (Drew Hendry) did not like CPTPP, and I was not the least bit surprised, because the SNP has never supported any trade agreement negotiated by either the European Union or the United Kingdom. The hon. Gentleman may have a nice backdrop, but as to the content of his speech, it expounded the virtues of EU trade agreements, not a single one of which the SNP ever supported. The SNP voted against the Canada deal and it failed to support the Japan deal and the Singapore deal. Those deals were negotiated by the EU, which the hon. Gentleman now praises; so I do not think we will take any words from him. I did not for a moment expect him to support the CPTPP trade deal. The SNP is anti-trade, anti-Scotland and anti-Scotland’s best economic interests.
The hon. Member for Strangford raised an important point about ISDS. I should point out that ISDS procedures are already in place in 90 bilateral UK trade deals. We have never lost a case. We strongly believe that we have nothing to fear from ISDS, but we will shortly publish our negotiation objectives, which will include that important question.
Richard Graham
On the point from the SNP about what is really in Scotland’s best interests, does my right hon. Friend agree that it is curious that at this time, when those of us who are trade envoys to the south-east Asian region are doing so much to push for greater access for some of our great drink and food products, including Scotch whisky, the hon. Gentleman cannot see the advantages of the dialogue partner status with ASEAN and the TPP arrangements that the Minister is pursuing?
Greg Hands
Thank you, Mr Hollobone. I will not need three minutes, but I will answer my hon. Friend’s excellent intervention. I am always shocked by the insular nature of the SNP’s approach to trade and the fact that, by the look if things, it does not see any of the advantages of any trade agreements with anyone, but particularly with the far east. The potential for growth for Scottish produce, in particular, in the far east is huge—not just whisky, but also Scottish seafood produce and so on—but the SNP failed at each available opportunity, even when we were members of the European Union, to support any of those trade deals.
I go around the world battering down barriers, particularly to Scotch and Irish whiskey. I have been in Peru and engaged on its metal test. I have been in Taiwan and engaged on its lack of requirement for a lot code on bottles, which incites the counterfeiting of alcohol, and so on. We as the UK Government engage all the time on behalf of Scottish goods and services exports right the way around the world, and we make sure that Scotland’s voice is heard around the world and Scottish exports are boosted.
We have been consistently clear that the terms of UK accession to CPTPP must be right for British companies, right for British consumers and right for British farmers. We will negotiate firmly but fairly, and our red lines are well known. The NHS remains off the table, as do our world-class standards, from food and animal welfare to the environment—a data protection point brilliantly raised by my hon. Friend the Member for Ynys Môn (Virginia Crosbie).
Accession to CPTPP gives the UK the ability to foster stronger diplomatic and trading links with nations in the Indo-Pacific region, which is at the vanguard of change in the global economy and will be the engine of growth for decades to come. Joining this agreement will help us to harness the export and investment opportunities that lie before us as the world resets, recovers and returns to growth in the wake of the pandemic, and as we build back better, greener and more sustainably.
I hope my remarks have given a flavour of the vast potential that our membership of the CPTPP promises to bestow during this exciting time; its geostrategic importance, which was raised by my hon. Friends the Members for Wycombe and for Gloucester and others; the Indo-Pacific tilt, and the fact that we are doing this with some of our best friends; and the huge markets that are involved, with great potential. I thank my hon. Friend the Member for Wycombe again for securing this invaluable debate.
Mr Steve Baker
I completely agree with my right hon. Friend the Minister. Like him, I have hugely enjoyed this debate. He enjoys my unqualified support, so I will turn my remarks to some other aspects of the debate.
I thought that the best part of the contributions from the Front-Bench spokesmen for the SNP and the Labour party was their vivid illustration of the shortcomings of virtual proceedings, because we were not able to intervene on them to explode the fallacies in their speeches. I regret that they are not able to intervene on me now, and I look forward to them supporting the full resumption of proceedings in the main Chamber and in Westminster Hall, so that we can resume our normal to and fro.
I thought the Labour party were progressive, and yet this progressive agreement is one that they do not wish to support. Of course there are problems with labour standards among the Pacific rim countries, and I would very much like to see those problems addressed and standards driven up. Of course we want to get children out of child labour, and that is why I support a progressive agreement that improves labour standards in the region. If we were to listen to the Labour party, they would have us do a deal with no one who had not already met the standards of the western world, the United Kingdom and the European Union. We can see why they want to be in the EU.
The SNP, of course, is speaking entirely from its own hymn sheet. It wishes to leave the UK and rejoin the EU—that is perfectly plain from what it has said. I refer the SNP, in its pinched and miserable assessment of our economic prospects, to an article by the well-known pro-EU commentator Wolfgang Münchau—he often, of course, writes for the Financial Times—in his own Eurointelligence:
“So much for the Brexit scare stories”—
he writes—
“Apart from a short-lived disruption of trade flows Brexit has been a macroeconomic non-event…If you look at the latest IMF data and projections in the graphic above, you don't find a discernible macroeconomic effect of Brexit in the first ten years after the referendum.”
Mr Philip Hollobone (in the Chair)
Order. Members participating virtually are not allowed to intervene on any speakers in the room. If you persist, I am afraid we will cut you off.
Mr Steve Baker
Thank you, Mr Hollobone. It is only because of the manner of the speeches by the Opposition spokesmen that I am choosing to attack what they said. I look forward to them supporting the resumption of proceedings.
I have previously critiqued the computable general equilibrium modelling that is used, and I think that Opposition Members’ simplistic analysis and arithmetic shows that they, too, should look at the shortcomings of CGE models and at what can be done in the UK. Lord Lawson of Blaby has said that UK domestic settings will be dominant in our future, and that is something that Wolfgang Münchau turns out to agree with.
Turning to other colleagues, I enjoyed their speeches enormously—
Mr Philip Hollobone (in the Chair)
Order. I am afraid the hon. Gentleman will not be able to do that.
Motion lapsed (Standing Order No. 10(6)).
Covid-19 and Health Inequalities: West Yorkshire
(3 years, 7 months ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Philip Hollobone (in the Chair)
I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid proceedings. Members should clean their spaces before they use them and when they leave. Also, Mr Speaker has stated that masks should be worn when not speaking.
Jon Trickett (Hemsworth) (Lab)
I beg to move,
That this House has considered health inequalities and the covid-19 outbreak in West Yorkshire.
Thank you for calling me, Mr Hollobone. I thank everyone who has enabled me to secure this important debate so that a Yorkshire voice can make the case. I will be speaking about covid and the vaccine, so first I should like to place on record our thanks from every part of the House to everyone who helped to develop the vaccine, be they scientists, pharmacologists or all the people who have rolled it out. It has been an incredible journey, which shows humanity in a common endeavour against a disease. I congratulate all those involved.
I need not detain the House for long, but I will make a clear case for my constituency in West Yorkshire, where I have lived all my life, although there are lessons for the rest of the country, too. Let me raise two brief points before I get to the central issue. First, statistics. They talk about lies and statistics. I have confidence in the statistics that I will use, because I have been tracking what has been happening since January. They vary a bit, but I am sure that the trends I will describe are correct.
I will use comparisons between my area and the Minister’s area—not to suggest that somehow she has been neglectful of our area while protecting hers, but because the differences are extraordinary. Not for one second do I think she is anything other than someone who wants to do their best for the whole country. However, there are chronic underlying problems in the way that our country is organised. The Government have said they will begin to level up; hon. Members will see how far we have to go. If I were to draw a map of England—the health service that we are responsible for—and shade the economic-social demography, it would be clear that there continues to be a north-south divide. If I were to draw a map of covid, the same would apply. It is striking.
The averages conceal quite a bit; none the less, there has been a rapid decline in covid infections. The figures that I will quote are per 100,000. In January, there were 406 infections per 100,000; now, it is 28 per 100,000. That is remarkable.
Mr Philip Hollobone (in the Chair)
I am really interested in what the hon. Gentleman is saying. Are the figures that he just gave for West Yorkshire?
Jon Trickett
The figures were for the UK as a whole. It has gone from 406 in January to 28 now. We often hear that no one is safe unless everybody is safe. There are clear hotspots where the infection is still raging, while in other areas it has almost been eliminated. To make the areas that are already low safe, we have to tackle the hotspots.
The UK average is now 28 infections per 100,000, but in my council area it is three times higher, at 72 per 100,000. In West Suffolk, infections are 8.4 per 100,000. Infections are nine times higher in my area of Wakefield than in the Minister’s constituency. That is a staggering difference.
I represent 23 small former mining villages in my constituency. In one ward, the figure is five times higher than the English average, but 17 times higher than the figure for the Minister’s constituency. It is staggering. Across the whole of West Yorkshire, there are 20 areas with levels of ongoing infection that are at least 12 times higher than those in her area. Mine is not even the highest in West Yorkshire. The figures are stark.
Plotting a graph—clearly I cannot illustrate it here, although I would like to—shows that the rate of infection in my constituency was around the English average back at the beginning of January. Suddenly, the line on the graph takes off relative to the national average. That was within three or four days of the decision that was taken—by scientists, I presume, but with the support of the Government—to reduce the vaccine supply to Yorkshire. They halved the amount of vaccine coming into Yorkshire. The average rate in England has continued on its way, whereas the rate across Yorkshire has accelerated rapidly. On the other hand, Wakefield—my area—is vaccinating more than the Minister’s council is. I assume that it was a short-term reduction in supply of the vaccine, rather than something that is continuing through to this day, but perhaps the Minister could confirm that.
There are four underlying factors. I want to focus on one at the end of my speech, but why is it that some areas of the country have alarming hotspots, such as the ones in my area that I mentioned? The four factors all relate to socioeconomic class, stratification or however one wants to describe it. The first is deprivation. Covid is definitely a disease that feeds off poverty in deprived areas. My constituency is the 111th most deprived; the Minister’s constituency is the 417th. Added to that is the fact that I represent former mining communities, where many older men have serious respiratory problems, which obviously makes them vulnerable to a respiratory disease.
The second factor is the cuts that have happened. About 38% of our expenditure has been cut since 2010, which leaves our communities less resilient to all kinds of things, including covid, than they would otherwise be.
The third factor that I want to briefly highlight is the reduction in the number of bed spaces. There has been a kind of consensus that there were too many beds. I never agreed with that; I fought the cuts in the hospitals in my area, unsuccessfully. Some 21,000 beds—I think I am right in saying critical care beds—have closed since 2010, which is too many. We were not ready for the pandemic.
I will discuss the fourth factor before I come to the main issue that I want to raise. We have low access to car ownership in my community, and more than a quarter of households do not have access to a car. As I have already said, I represent a series of villages. The buses are not very good and there is not a frequent service—I am sure thata many hon. Members could say the same thing about their areas. It is very hard for someone to get to hospital if they do not have a car and the bus service is rubbish.
There is a problem not simply with the aggregate number of beds throughout the country, but in connection with population sparsity. I wonder whether more work has been done on this issue. I do not necessarily expect the Minister to reply to me now, but has the relationship between sparsity and access to hospital services ever been properly considered? It was in my area, because I made sure that the people who were making the decisions fully understood the implications of closing hospitals and reducing the number of beds. There are 10,300 households with no car in my constituency alone, which is a problem.
My final point, in terms of what is causing not only our area but West Yorkshire to be a hotspot, is to do with homeworking. Anyone looking at the data will see how striking it is that the proportion of the population who are homeworking varies considerably across the country. For example, in Yorkshire just over a third of people are working from home; two thirds are still working at their place of work. That compares with nearly 60% of people working from home in London. In the Minister’s region, there are 10% more people working from home than in Yorkshire.
As might be imagined, seven out of 10 people in professional occupations are now working from home, whereas in caring, leisure and other services it is only 15% and among process plant machine operatives it is only 5%. So, 5% compared with 70% shows that there is a stratification issue. Why is that relevant? Because people who are working from home are clearly less prone or susceptible to possible disease transmission at a place of work. As their place of work is their home, they are in their domestic bubble.
It is striking that homeworking or working in the workplace relates precisely to occupational structure and the character of the local economy. With an economy such as the one that we have in my area, lots of people work in small manufacturing, warehousing, care services, retailing and other forms of services. We could say that they are all key workers in one form or another because they have kept the country going, but they are working in the workplace rather than at home, so they are exposed to the possibility of workplace transmission.
I have given a lot of figures already, but it is good to get them on the record. Yorkshire has 9% of the English population, but 36% of all workplace transmissions for the whole of the country occurred there. So, it is clear that workplace transmission, reflecting the occupational structure and economic base, is a factor. So, more than a third of all workplace transmissions were in Yorkshire alone, which is an important point.
There is a second related issue, which is access to cars. If someone lives in a village and their place of work is, say, a large warehouse near the A1, then they have to get to work. There are no buses or trains, so what do they do? They share a vehicle, either a minibus or a car, with someone else who lives in the village. The possibility of transmission related to work is clear.
Another point is about the vaccine roll-out. Rightly, the vaccine roll-out tackled the oldest and most vulnerable people first. We are only now arriving at vaccinating the under-50s, but they are the people who are often working in the workplace rather than at home. The vaccine has not reached many of the people who are working in the workplace and who are obviously the most vulnerable to workplace transmission. I would not suggest that we should have done anything differently, but the Government, and we as a country, need to think clearly about the issue of workplace transmission of the virus.
I have one further point on this matter. Some people might say that we should lock down the hotspots, but that will not work. Why do I say that? Because a lockdown affects people who are not key workers. People who work in key industries, such as retailing, care or warehousing, if they are delivering important services or commodities, are still going to work. A lockdown does not protect the people who are at work, and therefore it does not prevent workplace transmission. That seems to be quite an issue for us. Again, I am not saying that the Government were wrong to do the regional lockdowns—we could clearly see that those had an effect—but at the end of the day, they abandoned them. I do not want anyone to listen to my points and say to themselves, “Well, actually there’s a bit of a problem in Yorkshire. We need to protect other parts of the country; let’s lock down Yorkshire.”
If I am right—I would be interested to know whether the Government have other statistics on this—workplace transmission is a serious issue. I spoke about that with the local GP in the most seriously affected village in my constituency, and he thought that it is now about workplaces, and car and minibus sharing. I spoke to the director of public health, who told me broadly the same thing. She said that the figures are slightly susceptible to small variations at ward level, but she still defended them. I then spoke to the chief executive of our health trust. Obviously, he was most concerned about the number of hospital admissions; although that number is now going down because of the medical treatment that we have developed, the ratio is still far too high in our area. He also thought that workplace transmission was an issue.
What do I think ought to happen? Well, the Government may well have already formed a view about workplace transmission. I read in this morning’s newspaper, which covered some of the issues that I am trying to raise, that the Government had responded by saying, “We’ve made available to employers the possibility for an enhanced test, trace and isolate service.” Although I welcome that, because there needs to be as much emphasis as possible on trying to find out who is infected and ensuring that they isolate, there are two problems. First, some people are on very low wages and will not necessarily volunteer that they have symptoms because they are worried about the financial impact on themselves and their households. Secondly, employers are variable, just like any other part of the population. Some employers are very careful, others less so.
I have been approached by a firm, which I will not name, that has a large warehouse in my constituency. It is a household name that provides goods on the high street—everybody knows the name. The workforce, most of whom live in my area, have repeatedly raised with us a sense of not feeling safe at work. I asked the council to visit the employer, and work has been done to make the warehouse a safer place and to reduce transmission. However, my point about sharing cars to and from work still stands, as people share cars if they are not on large incomes or if they live in rural areas such as mine. Also, at the start and end of shifts large numbers of workers are squashed into a small space to get in and out of the workplace, so there are lots of opportunities for workplace transmission.
The employer said to me, “Well, we have told people that if they don’t feel safe, they can go home, but we won’t pay them and we won’t furlough them.” That is not acceptable behaviour from an employer in 2021. It is simply unacceptable that they leave people feeling exposed and at risk but then say, “It’s up to them, but we won’t pay them. They can stay at home with no money.” I live in a fairly poor area, and that is not an acceptable prospect.
Here is what I hope might happen—that the Government and the public authorities accept that employers and employees have a duty and an obligation to try to eliminate covid at work and elsewhere. I do not think it is good enough simply to leave it to the employers. The public authorities need to intervene in hotspot areas and identify what is going wrong. Although the figures in my area are going down quite rapidly, as a multiple of the average, they are horrific, really. It is unacceptable that we are in this situation.
On Tuesday I spoke to Wakefield Council leader Denise Jeffery. I asked whether it was possible for her public health people to identify hotspots of transmission and move in—almost like a hit squad—to test and trace, and perhaps also accelerate the vaccination programme, although that might undermine the Government’s age-related vaccination priorities.
Will the Minister reflect on the points that I have raised and could we have a further exchange, to see what can be done to tackle this chronic problem? I thank the House for listening so courteously.
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
It is a pleasure to serve under you, Mr Hollobone. I congratulate the hon. Member for Hemsworth (Jon Trickett) on securing time for this important debate and showing that one reason why Westminster Hall is important is that it enables us to discuss the local as well as the national.
I very much associate myself with the hon. Gentleman’s thanks to those who have worked so hard to keep us safe through an unprecedented time for our country. I agree that we come from different communities, but the underlying issue is that none of us is safe until everyone is safe; I keep that in mind as I respond to his points.
In case we run out of time, I should say that I will of course meet the hon. Gentleman again because some of his points relate to key things that we want to work on. I know that directors of public health and his local authority have been doubling down on this issue because it is very important that we suppress. Although we are on a downward trajectory, we are all going to have to learn to live in a covid-tinged world, so we need to be aware of the things that he has highlighted.
Covid-19 has highlighted health inequalities across the country. As the hon. Gentleman said, his constituency was a mining community and some disease types are particularly prevalent among men there. We often see higher rates of smoking in areas such as the one that he represents. All have been a keen focus for me during the past 18 months or two years, and also for the Office for Health Promotion going forward, because all these things need to be looked at in the round.
I emphasise that as we rebuild from the pandemic, we are committed to tackling the long-term problems and levelling up. People should have the right to good healthcare, a good life and good life expectancy, wherever in the country they live. The NHS has committed to inclusive recovery from the pandemic and has set out eight actions to reduce inequality in the restoration of services. I do not cover hospital services, on which the hon. Gentleman spoke at some length, but he is free to write to the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), who looks after those. Reporting on providing services to the poorest in our areas is one of the actions.
My focus has been, and remains, tackling inequalities through the health and social care system and promoting health among disproportionately disadvantaged groups, because targeting everybody often only enlarges the gap. The hon. Member for Hemsworth highlighted several issues, and targeting and focused approaches work better.
The best way to improve life expectancy and reduce health inequalities is to prevent health problems from starting in the first place. Prevention is one of the top five areas for the health service and it is my focus, going forward. In March, we announced that the Office for Health Promotion would lead the national effort in improving and levelling up public health. That will enable a more joined-up, sustained approach and action between the NHS and national and local government. The hon. Member talked in the end about how we drive these interventions to address the wider determinants of health, ensuring that we have longer, better quality years and that we drive down health inequalities through the health and social care policy.
The West Yorkshire and Harrogate Health and Care Partnership supports some 2.7 million people and takes a place-based approach, which is totally right, to highlight the strengths, capacity and knowledge of those involved. Wakefield clinical commissioning group has developed a health inequalities prevention pathway and housing for health network—as we know, some of the determinants do not always sit within health; they sit in other areas, such as the quality of work that people have, and the homes in which they live—to support the reduction of barriers to services and deliver the recommendations from our ethnic minorities review.
That collaborative work has led to good practice being shared that saves lives and prevents illness. That includes the Healthy Hearts project, which the hon. Member for Hemsworth probably knows well. It originated in Bradford, but has been scaled up right across West Yorkshire and Harrogate, aiming to prevent 1,200 heart attacks and strokes over the next 10 years. The partnership also launched a new targeted prevention grant fund worth £100,000 to help reduce the gap in health inequalities across the area, supporting targeted, community-level preventive interventions that reduce harmful health behaviours, improve health outcomes and support those disproportionately affected by covid-19.
I wonder whether there is some targeting, because on some of the things that the hon. Member mentioned, such as people travelling in cars—I know exactly what he is alluding to, as my background is in construction—it is about ensuring that we all reinforce the messages: “If you are sharing a car, do not sit next to somebody; sit with a distance between you. Keep windows open and wear face masks.” All those things are important.
We will build on action that we have taken to limit the impact in West Yorkshire. The local teams, with national support, have managed outbreaks in many kinds of settings, and have done a brilliant job, including in care homes, meat factories, bed factories and general practice surgeries and within the professional football team. I know that covid-19 has affected some groups disproportionately. The Public Health England review last July identified age, occupation and ethnicity as particular risks. We therefore built up the community champions scheme, providing nearly £24 million to local authorities and the voluntary sector to improve communication for those most at risk.
The scheme is investing nearly £1.4 million to support ethnic minority groups across communities and faiths in Bradford, Kirklees, Leeds and Wakefield. We have mobilised 700 volunteers and are training 300 residents locally. In Wakefield, we have developed specific covid-19 and vaccine messages, working with English for speakers of other languages tutors, and community leaders such as mosque and black African church leaders. Community champions have contributed to the successful vaccination programme, as has the rolling out of information in different languages. That may also be something that we need to look at doing more effectively, but we have done a great deal of work on it. We can take that up at a further meeting.
The NHS has met the target for offering everyone in the cohorts their first vaccine by mid-April. More than a million people in West Yorkshire have received their first vaccination, in line with the national uptake rate. Vaccines were distributed fairly across the UK. It was a mammoth job. Somebody always has to be at the top and somebody not so near the top, but there is now much more balance. We have targeted the top nine groups. They are those at most risk from dying if they catch covid. That is the strategy that the Joint Committee on Vaccination and Immunisation, Jon Van-Tam and the Secretary of State have spoken about many times, explaining that we are protecting the most vulnerable.
I am aware of various barriers to vaccine uptake, but we have focused on that gap and driven it down, and it is now diminishing. We are working across Government to consider how we best support people and produce tailored outreach services, providing materials in a variety of languages and formats. We have also used outreach to approach targeted areas and communities.
There is a duty of care on workplaces to their employees to ensure that workplaces are covid-secure. It is only by us all working in lockstep that we can give everybody the same opportunity to have long, healthy lives wherever they live, wherever they work and whatever their background. Learning from the ways in which things have been done—the different deliveries—will help us going forward. I am happy to meet with the hon. Member, but the Department and I are determined to tackle both the long and short-term health inequalities that remain in Yorkshire, and to ensure that we help people.
Motion lapsed (Standing Order No. 10(6)).
Special Educational Needs
(3 years, 7 months ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Sir Edward Leigh (in the Chair)
I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate. There will also be suspensions between each debate.
I remind Members participating physically and virtually that they must arrive for the start of debates in the Boothroyd Room, and are expected to remain for the entire debate. I must also remind Members participating virtually that they are visible at all times, I am afraid, both to each other and to us in the Boothroyd Room—so you are on “Candid Camera”, but you are all very good looking.
If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks email address. Members attending physically should clean the spaces before they use them and when they leave the room. I remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall.
Mr Tanmanjeet Singh Dhesi (Slough) (Lab)
I beg to move,
That this House has considered support for children with SEND.
It is a pleasure to serve under your chairmanship, Sir Edward. I am grateful to have secured this important debate, and welcome the opportunity to discuss support for children with special educational needs and disabilities. I am pleased that we are addressing this important issue today, and want to use my contribution to amplify the voices of children with special educational needs and disabilities, and their families.
I know that Members who have come to speak in the debate, from across the House, will have heard from constituents about the difficulties that they have faced in getting access to services, support systems and schooling. They will have been approached by parents who are not sure where else to turn, as they navigate a global pandemic with a child with a disability. I hope that we can all use today as a collective opportunity to raise the concerns of those young people and their families, and push for change and further support.
Ultimately, every child deserves access to the support to which they are entitled, but currently they do not have it. The words
“forgotten, left behind and overlooked”
were used to describe the experiences of children with SEND and their families throughout the covid-19 pandemic, according to the recent report by the all-party parliamentary group for special educational needs and disabilities. It collated responses from parents and young people on the issue. Prior to the pandemic, resources for local authorities and supporting services were already stretched by a decade of needless Tory austerity, and the upheaval of the past year has only exacerbated the problem.
One of the most pressing issues that I have come across is the continued delays to treatment, diagnosis and plans for support. In my constituency I have been approached by constituents who have been waiting for up to two years for a diagnosis for their child. That is simply unacceptable. If children are unable to get a diagnosis, they are unable to get early intervention, which we know improves their outcomes later in life. Yet that window is being missed for many young people simply because of lack of funding and resources.
As the chair of the NHS East Berkshire clinical commissioning group, Dr Jim O’Donnell, highlighted to me, identifying those with SEND is just as important as ensuring that they get the support they need. In Slough, only 0.34% of our registered population are coded as having a learning disability. That is less than one-seventh of the estimated national prevalence.
The national target achievement for health checks in relation to learning disabilities is 67%. In Slough we currently reach only 61.5% of those who are coded; but since we are not yet successfully coding most of the people who, it is estimated, would have learning disabilities, health checks are in fact being delivered only to 0.21% of the population. That is, by the way, a far better figure than many of our neighbours have reached. It just goes to show how far we need to improve as a country to be in a position to ensure that people with learning disabilities receive the recognition, support and health and care services that they need and deserve.
Delays in the sector also aggravate the existing difficulties faced. In some cases this can lead to mental health difficulties for both the child and the parent awaiting confirmation of their child’s diagnosis and therefore support. At this point such delays can mean the additional issues caused are not taken into account in their education, health and care plan. It is a vicious cycle where everyone loses.
To address the backlog and delays in the initial stages of setting up support for children and parents, urgent funding and attention is needed. Delays have been seen across sectors, but for children with SEND these could have lifelong consequences. Even those who have been able to secure support and EHCPs have felt that the process has only worsened under the pandemic. The process must have compassion and the child’s needs at its heart, yet constituents who have contacted me often feel frustrated, fighting to get their views considered as the child’s primary carer, and even having to push to get specific support written into the plans.
One local family noted that their support was not quantified or specified, leaving them disappointed at the level of support as one treatment would have fulfilled their support requirements. This is a pattern. In fact, two in three parents reported that their child was not receiving the support set out by law in their plan. If parents have to fight at every single stage just to get the very basic level of support for them and their child, I am afraid the system is broken, and coronavirus has further diminished this already inadequate support. As with other vital local services, many have been stopped or reduced since March 2020.
Ambitious About Autism reported that 80% of autistic young people and their parents who responded to its survey said that support that they had been accessing before the pandemic either stopped or was reduced. 1Voice found that 58% of respondents to its survey had no care support at all between March and July. All this is in the context of a system already in crisis.
The recent Women and Equalities Select Committee report cited evidence that it received:
“the pandemic had ‘brought into focus and exacerbated widely acknowledged pre-existing systemic issues in the wider SEND system’, which was far from operating as the 2014 Children and Families Act reforms had intended”.
Although school closures have undoubtedly impacted every child in this country, it seems that for disabled children, sadly, that impact has been disproportionate. Despite many settings remaining open throughout successive lockdowns, 83% did not have access to school between March and July. As we know, attending school is for so much more than just an education. For children with SEND in particular, it is an opportunity to receive treatment and access specialised equipment, and it can be hugely beneficial for their all-round development. Yet parents were left with difficult decisions about the best outcome for their children.
Parents, local authorities, support services and schools have had to strike a very careful balance in protecting the child’s health and the health of children with SEND from the threat of coronavirus and the impact of continued isolation. Even when children have been able to return to schooling, the lack of treatment during successive lockdowns has meant that many have fallen behind on their speech, communication and motor skills. Unable to access formal therapies, assistive technologies, respite care or regular treatment, many parents have noted a decline in disabled children’s physical and mental wellbeing. As the Disabled Children’s Partnership notes,
“If young people are in pain, they will not be ready to learn.”
Devastatingly, it is not just formal support that has declined. Social isolation of disabled children and their families has also had an impact; reports indicate that they are more socially isolated than most. The removal of routine, socialisation and normality has left 90% of parents with some level of anxiety as a result. The clear disproportionate impact of covid-19 on these families surely deserves a dedicated plan to support them. Without a complete plan from Government on how to address the backlog, already stretched services will struggle for resources as we emerge from lockdown. Through no fault of their own, disabled children and their families have been left behind. They need the SEND report to address the deep problems in the system, they need to be a feature of all future pandemic planning, and they need specific funding to address the huge delays and backlogs.
I know that local authorities and charities across the country have been doing what they can to support those who need it most. In Slough, our council has been working hard to ensure better outcomes for children with SEND—in fact, the south-east’s all-age autism strategy is being launched today. It sets out the region’s ambition to ensure that autistic people and their families get the best care and support, and to reduce the health inequalities that autistic people face.
Having served as a member of the Royal Mencap Society, I am very much aware of the incredible work of the voluntary sector. Invaluable work has been done by charities and organisations such as the Disabled Children’s Partnership, which includes Mencap, WellChild, Together for Short Lives, the Children’s Trust, Scope, Sense, the National Autistic Society, Family Fund, the Council for Disabled Children, Ambitious About Autism, Contact and Action for Children, as well as by IPSEA—the Independent Provider of Special Educational Advice—and many others, but funding and support for SEND have long needed attention from the Government.
Sadly, it has taken a pandemic to reveal the true extent of the problems in the system. Can the Minister confirm that these deep-rooted problems will be addressed? Can she guarantee that the Government will not downgrade their legal duties to children with SEND as a result of the current widespread failure to fulfil them?
One parent cited in the APPG report noted that for children with SEND,
“Their worlds were already very confusing before coronavirus and are even more so now.”
We must do all we can to support them.
Sally-Ann Hart (Hastings and Rye) (Con) [V]
I welcome this important debate secured by the hon. Member for Slough (Mr Dhesi). As vice-chair of the APPG on special educational needs and disabilities, I highlight our recent report, “Forgotten. Left behind. Overlooked. The experiences of young people with SEND and their educational transitions during the Covid-19 pandemic in 2020”. Members of the APPG were keen to focus our inquiry on how the transitions that young people with SEND face had been affected by the significant changes in education provision since March 2020 due to the pandemic.
It is widely accepted that moving between education settings, either for a change of phase or for enhanced or different provision, is difficult for all children, but it is clear from the experiences we heard about that the pandemic had the most negative impact on some of our most vulnerable children, young people and their families. In 2014, the Government introduced significant reforms to the way in which children and young people with SEND are identified and supported, requiring local authorities to have greater regard to the needs of children with SEND and their parents. It is concerning and often heart-rending to hear of the difficulties that some families face in securing enough support and appropriate placements for pupils with SEND.
What is apparent is how many families have to fight for the right support for their child. That is not right. The process of applying and assessing for educational healthcare plans must be made simpler and more compassionate. It is also clear that there are regional variations in the experiences of young people with SEND. That is very concerning. For example, the National Deaf Children’s Society noted that online learning materials, transition support, early intervention support and recovery plans were available, but “not consistently across England”. Sense also spoke of a lack of consistency.
It is welcome that the Government have acknowledged that despite the important reforms introduced to improve support for young people with SEND, the system is not working for every pupil. I look forward to the cross-Government SEND review being published in the coming weeks, as one of the issues it is looking at is how to ensure that SEND provision is consistent all over the country, of high quality and integrated across education, health and care.
I am grateful to the Minister for the work she has done regarding the review and for her comments at the recent annual general meeting of the APPG for SEND in March. I welcome the recent capital funding boost of £280 million for children and young people with SEND, and investment to provide more specialist places and improve provision for SEND pupils across the country.
It is also very good news that the high-needs funding has been boosted by nearly a quarter to £8 billion in 2021-22, with an extra £780 million for local authorities this year, and a further £730 million in the next financial year. The Government are supporting local authorities and their partners to improve SEND services for every young person with an education, health and care plan. That includes the programme of inspections and interim visits by Ofsted and the Care Quality Commission to check the quality of provision, as well as direct support and challenge to individual areas.
I ask the Minister to look more closely at how central Government pass on funding to local authorities for pupils with high needs. Currently, a large proportion of funding allocated through the high-needs funding formula is based on historical spending patterns, meaning that if needs go up or down from year to year, that is not fully reflected in the local budgets. It also means that local authorities that have been responsible with spending, such as East Sussex County Council, are left short of vital funding. That may mean that a pupil in one local authority could attract significantly more or less funding than a pupil in another authority, despite having similar needs.
I would like to take this opportunity to highlight that in Hastings we will see a new SEND free school, the Flagship School, open its doors in September. I am grateful to the Department for Education for its vital support in this much-needed initiative. Lastly, I respectfully ask the Minister to give detailed consideration to the recommendations in the APPG’s report.
Clive Lewis (Norwich South) (Lab)[V]
I thank you, Sir Edward, for chairing, and my hon. Friend the Member for Slough (Mr Dhesi) for leading this important debate. One does not have to be a parent to want to live in the kind of society where every adult and child is treated with dignity and respect, regardless of their background, ability or race.
As a parent, of course, I worry about my young daughter, but not just her. I worry about the world she will grow up in, the country she will call her own and the community she will be a part of. That means I want a society for her where every person—every child and every adult—is treated with dignity and respect. That is what I see as our responsibility as lawmakers: to create the conditions where every child and adult can thrive.
Yet I am all too aware that that is currently not the case, particularly in the experience of children with special educational needs and disabilities, and their families. The parents of children with special educational needs and disabilities in Norwich South tell me about the unending barriers they face when trying to get support. Many are part of the fantastic organisation, SENsational Families.
To start, the length of time it takes to get a diagnosis for many children means that their needs are not being met from the beginning. In Norfolk, it takes roughly two years for children to get a diagnosis of attention deficit hyperactivity disorder or autism spectrum disorder. That is two years of anxiety, waiting to get a child the support they need. Even once they have the diagnosis, families find more delays in getting an education, health and care plan in place. Norfolk is one the 10 lowest-performing authorities in the country. Only 20% of EHC plans are completed within the Government’s 20-week timescale. It is appalling that 80% of EHC plans are, by the Government’s own metrics, not being completed on time.
When it comes to finding a school place for their child, there is more agony, anxiety and frustration. There is a severe shortage of specialist places available in Norfolk, which leaves many children struggling in mainstream schools or being excluded. Parents tell me they have to fight at every juncture for the rights of their children. If they do not continually fight, the children end up out of education. They also explain how it seems that parents who shout the loudest get the support. In addition, parents can speed up getting a diagnosis by paying privately, at a cost of around £1,500, meaning that we have a two-tier system where more wealth and money gets people access to better services faster. Is that really the kind of society that we want to live in? Should children be deprived of essential and life-enhancing services because their families cannot afford to fast-track their diagnoses?
The work done by the all-party parliamentary group for special educational needs and disabilities, which is chaired by my hon. Friend the Member for Sheffield, Hallam (Olivia Blake), chimes with much of what I am hearing in my constituency: young people with special educational needs and disabilities, and their families, feel forgotten, left behind and overlooked. It should not have to be this hard, and it certainly does not have to be this way.
The struggle faced by the parents of children with special educational needs and disabilities is not just about access to education or services. The lack of specialist places and delays in diagnosis are symptoms of much deeper problems caused by the failure of successive Conservative Governments to invest in creating strong social infrastructure. Those children and their parents need not only the right educational support, but safe and affordable housing, universal healthcare, a universal basic income and financial support that lessens the burdens on carers—strong social infrastructure that ensures that every person in our society can lead a dignified and fulfilling life.
I support the calls from the Disabled Children’s Partnership for an ambitious, funded covid-19 recovery plan to help children catch up on a lost year. Beyond that, we must also invest in the social infrastructure of this country, so that we have a fair and green recovery from the pandemic, which leaves no one behind. Children with special educational needs and disabilities and their parents are being failed by the system at every turn. We can do better; we must do better.
Mohammad Yasin (Bedford) (Lab)
It is a great pleasure to serve under your chairmanship, Sir Edward. I thank my hon. Friend the Member for Slough (Mr Dhesi) for introducing this much-needed debate.
For a number of years, the Bedford Inclusive Learning and Training Trust, or BILTT, has raised concerns about insufficient funding for its three special educational needs schools in Kempston: St John’s School, Grange Academy and Greys Education Centre. They are the most dedicated team of people, and they want the best for their pupils, but the current funding model means that their kids do not even get what is fair.
As hon. Members will be aware, the Education Committee’s report, “A 10-year plan for school and college funding” found SEND funding provision to be totally inadequate. Back in 2013, the Government announced funding for SEND pupils of £10,000 per place, with local authorities topping that up depending on pupils’ needs, typically via grants. Schools, like all parts of the public sector, have been affected by Government-imposed austerity over the past decade, but since 2013, mainstream schools have received funding increases from central Government. SEND pupils in Bedford, however, received no increases in either core funding or top-up funding between 2013-14 and 2019-20.
The DFE is deflecting its responsibilities for SEND pupils on to local government by suggesting that the increased funding has gone to local authorities, to be passed on to relevant schools—that has not happened. The local authority has only increased the top-up element in Bedford by 8.3%, which is the average for mainstream increases during the same period. That can be rectified only if central Government increase the core funding appropriately, so it is at least brought in line with the actual costs. As budgets have been frozen for seven years, and all costs—including staffing costs—have risen, it is impossible to balance future budgets.
As a trust, BILTT has cut back expenditure and staffing, but it cannot safely make any further savings. For the last two years the trust has set a deficit in annual budgets, but as a result of stringent financial management it has until now been able to deliver surpluses. In the Government’s extra funding offer for schools during the covid pandemic, schools with an in-year surplus were precluded from applying to cover the extra costs of the pandemic, which is completely short-sighted and patently unfair to the very children most at risk of covid complications. Reaching a surplus does not mean that the money saved is unaccounted for or not needed for planned future spending. Why are children in SEND schools being discriminated against in that way?
As the chair of BILTT told me,
“the funding situation continues to be wholly unsatisfactory, flawed and is continuously systemically discriminatory to pupils in Special Schools and Alternative Provision. These are the most vulnerable pupils in society, that are, increasingly, being underfunded by the current system.”
At a time when the Government are undertaking the long-overdue review of the special educational needs and disability system, the existing funding model for children with special educational needs is not fit for purpose. It is fundamentally unfair and needs urgent reform.
Ian Byrne (Liverpool, West Derby) (Lab)
It is a pleasure to serve under your chairmanship, Sir Edward. I thank my hon. Friend the Member for Slough (Mr Dhesi) for securing this hugely important debate.
The covid-19 pandemic has further exacerbated many issues that already existed in the Government’s system of support for children and young people with SEND—issues that families, campaigners and workers have been raising repeatedly with Ministers for many years. Covid has shone a stark light on the inequalities in society. For those children, young people and their families the inequality already faced was amplified.
Along with the injustice of inequality, another theme that is hardwired into the issues raised during the pandemic is the indifference to the seriousness of the situation shown by the Department for Education. Support during the pandemic from the Government and from the Department for Education, as the APPG for SEND summarised in its recent report, did not do enough to support children and young people with SEND. Our most vulnerable children were failed, and schools and families left to pick up the pieces.
Issues have been raised with me by Autism in Motion, a fantastic, committed, parent-led organisation in my constituency of West Derby, that provides support, advice and guidance for families in our community. I do not have time to do justice to their range of concerns in this debate, but I would welcome a meeting with the Minister to go through them in more detail.
Issues include a lack of funding and support from the Government for schools and services for children who have fallen through the gaps, such as children with SEND in mainstream schools who need that extra funding and support to thrive and maximise their educational attainment; a lack of funding for the comprehensive training needed for all teachers and school staff nationally; and the lengthy wait for vital services during covid-19, made worse by the hollowing out of NHS and local authority services through austerity and spending cuts over the past decade. We have seen how austerity measures have decimated our public services when we have needed them most during the pandemic.
I am lucky to have six SEND schools in Liverpool West Derby, which have been remarkable during the pandemic. I pay tribute to the staff. I have met with the heads throughout the period, and the following finding in the APPG’s report captures perfectly what I was told:
“The government guidance for special schools and alternative provision was frequently published later than guidance for mainstream schools. This led settings and young people with SEND to be seen as, and feel like, an ‘afterthought’.”
On behalf of my constituents and many families in Liverpool West Derby, I hope the Minister will today be able to answer these questions. What can be put in place for parents of children and young people who do not have an EHC plan and may have slipped through the net in terms of the support that is needed? Many children and young people cannot be catered for remotely and families have struggled during the last year. How will increased needs resulting from that be addressed and what support will the Minister’s Department provide? Furthermore, what plans will be put in place to assess the needs that will emerge as a result of the disruption to SEND children’s education, mental health and wellbeing caused by the lockdown?
Finally, do the Government have any plans to ensure that the views of children and young people with SEND and their families are heard at this stage in the pandemic? And if they do, what mechanisms will be employed locally, regionally and nationally to capture those views?
Sarah Owen (Luton North) (Lab)
It is a pleasure to serve under your chairship, Sir Edward.
I start by congratulating my hon. Friend the Member for Slough (Mr Dhesi) on securing this debate on an incredibly important issue, which touches the lives of around 1.4 million children across the country and, as we have heard from those who have spoken, many of us in our constituencies as well.
Today I will raise the slightly more specific issues that parents of autistic children in Luton North have raised with me. How would we feel if we were left waiting for four years to access the support or care that we needed? We all get frustrated when we are left waiting for anything; the next train might be along in 30 minutes, and if someone waited 90 minutes for a meal in a restaurant, they would probably complain. On top of that, how do we feel if we need to access a service or advice, but keep being passed from pillar to post?
So how frustrating must it be for those parents who are left waiting for up to four years for a diagnosis, while their family members are passed around agency after agency and institution after institution, and their child struggles to make friends, is not confident about communicating, is potentially non-verbal, and likes a particular routine and order in the things that they do every day? I have spoken to parents of autistic children in my constituency who are waiting for up to four years for the support that they need. I have heard from them that they feel like they are fighting against the very system that should be helping them, because at present the different agencies do not communicate with each other in the way that they should.
We know that the issues affecting how these parents and their children access care are great in number. We also know that the National Autistic Society and the all-party parliamentary group on autism—a group chaired with great diligence and commitment by the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan), who we sadly lost very recently and who was a very vocal campaigner for autistic children and their parents—found that 70% of parents of children with autism say that support for their child was not put in place quickly enough. We know all this, yet we do not see the improvements and funding that are needed.
Fewer than half of teachers say they are confident about supporting a child on the autism spectrum. The worst aspects of this situation lead to kids being put on the supposedly “too difficult” pile and left in isolation, or excluded or off-rolled by schools, whose staff do not have the training to identify pupils with autism and offer them the support that they need.
The parents that I spoke to in Luton North over Easter are brilliant and they would do absolutely anything they could to get their child the support they need. So, on behalf of those parents, I ask the Minister, does she think that waiting four years for an autism diagnosis is acceptable for children? If her answer is no, will she commit today to introducing a wait time standard for autism diagnosis and support? Will she commit to making life easier for the people that I have talked about today, by streamlining all the agencies and organisations that parents need to engage with? Finally, in the Health and Social Care Committee we have heard about the need for local autism hubs. Will any of those hubs be coming soon? I would welcome a meeting with the Minister to discuss these and other issues.
This important matter is discussed fairly frequently in this place and many MPs have constituency cases similar to those that I have outlined. However, parents and their children are still waiting for the support that they need.
I want to end on something positive. Councillor Javed Hussain, from Saints ward in Luton, has worked with the community. Despite the austerity and the cuts handed down from central Government, our councillors in Luton, such as Javed Hussain, have secured an accessible sensory play-park upgrade at Blundell Park, which is good for every child but especially good for children with autism and children who use wheelchairs. New developments such as that will make the world of difference to families and I commend the work that has been done on the park. We all know the difference that proper support for children with SEND could make to so many of our constituents. It is time that the Government turned their words into action.
Kate Osborne (Jarrow) (Lab)
It is an honour to serve under your chairmanship today, Sir Edward, and I thank my hon. Friend the Member for Slough (Mr Dhesi) for securing this important debate.
It is a pleasure to speak here today. I have a particular interest in this debate, both as a member of the Women and Equalities Committee and as the mother of a SEND child. As colleagues rightly pointed out, the support system for SEND children was already at crisis point before the start of the pandemic, but like all other existing inequalities, the pandemic has shone a light on the failures within the system that deny young people their right to an education and has shown the urgent need for increased support for young people with SEND, their families and their educational providers.
There are many issues. The long wait in obtaining a child and adolescent mental health services appointment, and the ability to access that appointment, particularly through the pandemic. The process to obtain an EHCP with little or no help or support during the process, and also the lack of support for those who do not qualify for a plan but who clearly need additional support. Schools that are struggling through lack of funding, and parents who are told, “Sorry; there is no money available to support your child further,” while all the time the child continues to struggle both at home and at school, quite often with a big impact on their mental and physical health.
The Government recently announced funding premiums to help schools and students catch up, with additional weighting for mainstream schools that have pupils with SEND. However, in the light of experience earlier this year, it is unacceptable that the catch-up premium does not include ring-fenced funding for mainstream schools, which means that there is no guarantee that school leadership teams will direct that money to SEND children, given the already tight constraints on their budgets. Just a week ago, the Women and Equalities Committee published its “Unequal impact? Coronavirus, disability and access to services” report into the impact of coronavirus on disabled people, which widely acknowledged the problems created by a lack of ring-fenced funding for children with SEND in mainstream schools and showed evidence that such pupils consistently make less progress than other pupils with the same starting point. It is disappointing that the Government rejected the Select Committee’s recommendation that funding be increased to allow mainstream schools to receive £240 per pupil with SEND, ring-fenced for catch-up support in this academic year.
Last week, in a Westminster Hall debate, I asked the Minister for Disabled People, Health and Work whether he could give me a further explanation as to why the Government rejected the report’s recommendation to commit to ring-fenced funding for pupils with SEND in mainstream schools. I did not get a clear answer from the Minister, other than an acknowledgment that the forthcoming SEND review remains a key priority for this Government. I hope that the Minister here today will be able to give her thoughts on this issue, and on whether she agrees that SEND children who go to mainstream school should have the same amount of money ring-fenced as children who go to a special school. The Government have said that it costs more to teach children in special schools. I hope the Minister agrees that it should not matter what school a child goes to, and that a lack of funding for cash-strapped local authorities results in their not being able to give their schools and pupils the additional support that they so desperately need.
This should not be a race to the bottom between mainstream and special schools. It is just a fact that local authorities continue to report the pressures on the high-needs funding block as one of the most serious financial challenges they face. Giving evidence to the all-party parliamentary group for SEND, the Local Government Association said that local authorities will be unable to meet their statutory duties to support children with SEND without additional funding being made available.
I urge the Minister to look deeper into how high-needs funding is undertaken. It is essential to the recovery from the pandemic that these long-standing issues over SEND funding are fixed. Finally, I ask the Minister when the SEND review will be published, and I ask her for a more detailed response than was given to me previously, and that was given in the report in the spring.
Matt Rodda (Reading East) (Lab) [V]
It is a pleasure to serve under your chairmanship, Sir Edward. I thank my hon. Friend the Member for Slough (Mr Dhesi), my Berkshire colleague, for securing the debate. He made a very interesting contribution. His comments were thoughtful and powerful, and I found the whole tone of the debate interesting and, in many ways, quite humbling. I agree with what has been said by many Members, including my hon. Friends the Members for Luton North (Sarah Owen) and for Jarrow (Kate Osborne), who both made excellent points.
Reading, like many other places, suffers from quite significant underfunding in this important area, as I am sure the Minister is aware, and I will talk about that in some detail later. Our borough council is ranked 132nd out of the 150 English local authorities in terms of the funding that it receives for SEND. Obviously, in an area of considerable need there is a great shortfall for many local families, who are hugely affected by that. I would like to address one particular set of challenges later.
I want to talk about the overall pressure on families at this time and, in particular, to reflect on the very difficult year that so many families have been through. I hope that the Minister will consider, in particular, what this year has meant for those families who have a child with SEND, and the intense additional pressures that those children and families have been through. I would like her to meet some of the families with me and to explore this issue further, because the very difficult issue of SEND and supporting families adequately in the system in a proper way has been exacerbated by the dreadful pandemic. I hope we can discuss that further.
I will move on to the specifics, as I realise that time is pressing. The delays in the raising and diagnosing of particular problems are significant. That has been an issue in this country for many years. We obviously need a much better supply of trained staff and support in schools and other settings. Ultimately, that means more Government spending, because the staff are highly trained graduates who work as part of a team. They need the support of their colleagues in a school or other setting. I have often heard from headteachers and others about the need for that team approach to the proper resourcing of our public sector.
I wonder whether the Minister might meet me to discuss an important issue in my constituency. I do want to go into enormous details because it is sub judice—there is a court case coming up. I would like to discuss with her in person and with a local family the transition of children with SEND from primary to secondary school. I see the Minister is nodding; I appreciate her support. There are some particular issues that our local schools and families may be able to help her to explore further. We would like some support on this issue, but I do not want to go into too much detail because of the court case.
My hon. Friend the Member for Luton North, who spoke eloquently, said that some amazing work has been done in our communities. Like her, I want to thank some local groups. There are too many to mention all of them, but it was a pleasure to help the families and staff at Redlands Primary School in Reading a few days ago with work on their sensory garden. Unfortunately, due to lack of funding, it has been provided by donations. It is a wonderful resource that the families themselves and the school have come up with, to help calm and support children in a Victorian school environment with very limited green space, through careful use of planting and attractive artwork. They are offering therapy for children in their play time, which is very valuable, and I commend them for that work.
Finally, I hope the Minister will look at the wider issue of education funding, particularly support for SEND for the lifetime of the child as they move into adulthood.
Munira Wilson (Twickenham) (LD) [V]
It is a pleasure to serve under your chairmanship, Sir Edward. I congratulate the hon. Member for Slough (Mr Dhesi) on securing this important debate.
Let me start by putting on the record my thanks to the Minister and her officials at the Department for Education for working closely with officers and councillors at the London Borough of Richmond to agree a settlement for the enormous historic funding gap in special educational needs and disability support. The local high-needs budget deficit hit a staggering £18 million and risked putting general education funding, and indeed wider council services, at risk.
When I was elected in 2019, I pledged to make adequate funding for SEND provision in Twickenham a priority, and I am very grateful for the engagement that the Minister has had with me and the council over the past year to address this important issue. I know that Richmond Council is looking forward to continuing to work with the Department to increase local provision for special needs and ensuring that our most vulnerable children receive the support that they need and deserve, through the promised annual 8% increase in funding. More broadly, I urge the Minister to ensure that the review of SEND that her Department is currently undertaking looks holistically at how the system is funded, so that the best interests and the needs of every child are at the heart of the system.
Too often, children are caught between the competing priorities of school and council budgets. Just recently, the chairs of governing bodies of local schools told me how stretched they are financially because of covid. Many costs are not being reimbursed, and they are losing thousands of pounds because income from lettings and fundraising has dried up. Those mainstream schools that are particularly well placed to provide SEND support for children are very conscious of the £6,000 that they have to find from their core budgets in order to offer this invaluable support, unless the family are able to apply successfully for an education, health and care plan, which will bring its own funding. The decision-making process on the level of support provided should not be driven by funding streams or disincentives to do the right thing, but entirely by the needs of the child.
The Minister is aware that I take a keen interest in children’s mental health and have repeatedly raised my concerns about the impact of the pandemic on children and young people’s mental health, and the critical importance of supporting social, emotional and developmental catch-up, not just academic catch-up. I know from talking to carers in my constituency that that applies even more to disabled children, who have been disproportionately affected, as we have already heard from other hon. Members, through both social isolation and lack of access to therapies. According to the Disabled Children’s Partnership, 91% of the parents it surveyed said that their child was socially isolated through the pandemic. Six in 10 parents reported observing symptoms associated with anxiety, and almost three quarters of parents report that their child is often unhappy, downhearted or tearful. There is a knock-on impact on the mental health and wellbeing of parents and siblings.
As other hon. Members have said, we need a bespoke covid recovery plan for disabled children. That must include, as well as social and developmental catch-up, additional support for the mental health and wellbeing of children and families and access to activities to overcome the social isolation that many have suffered during lockdowns. The Government recently announced a £79 million package of mental health support, but none of it was specifically allocated for disabled children and their families. Every single child deserves the best possible start in life, and that includes every child with a special need or disability.
Tulip Siddiq (Hampstead and Kilburn) (Lab) [V]
It is a pleasure to serve under your chairmanship, Sir Edward. I start by thanking my hon. Friend the Member for Slough (Mr Dhesi) for initiating this important debate. He was completely right to say that children with SEND have been forgotten, left behind and overlooked, and that their parents have had to fight at every single stage of the process to get their needs met. It is shocking that some children in Slough have had to wait up to two years for a diagnosis. My hon. Friend the Member for Norwich South (Clive Lewis) made similar points about his area and about how the system has completely failed parents, with appalling social services infrastructure and, in effect, a two-tier system for those who can afford it.
I want to take the opportunity offered by this debate to pay tribute to the fantastic staff at Swiss Cottage School and Manor School in Brent. Both are specialist schools in my constituency and have done phenomenal work in supporting children with SEND. The shadow Secretary of State for Education, my hon. Friend the Member for Stretford and Urmston (Kate Green), and I had the privilege of speaking to the headteachers of those schools and other special schools across the country in a virtual roundtable earlier this year. Many of the headteachers pointed out to me that much of the digital support that schools have been given, such as laptops, is not even appropriately tailored for the needs of children with SEND.
My hon. Friend the Member for Liverpool, West Derby (Ian Byrne) also explained how he had heard many concerns about resources when he met headteachers in his region. My hon. Friend the Member for Bedford (Mohammad Yasin) made powerful arguments about the devastating impact of coronavirus on the funding situation for special schools. My hon. Friend the Member for Reading East (Matt Rodda) also made a powerful speech about the impact of the pandemic on these services. I hope that the Minister, who has always had an open door with me, will respond positively to his request for a meeting.
As a mother of two young children, I know just how tough this pandemic and school closures have been on young people and their parents, but I simply cannot imagine how much harder it has been for those who have had their specialist support withdrawn. At the height of the third lockdown, just 16% of children with EHCPs were getting all the support set out in their plan, according to research by the Disabled Children’s Partnership. Some 21% of parents said that their children were not getting any support set out in their EHCP. Remember that this is support to which the children are legally entitled, and which all too often represents a compromise that is below the level of support they actually need.
That is just children who have already secured EHCPs. Getting an appropriate EHCP in good time has unfortunately become a postcode lottery, after a decade of cuts to local government that have been felt unevenly across the country, not to mention the impact of the relaxations on timescales misguidedly introduced last April for assessing EHCPs. My hon. Friend the Member for Jarrow (Kate Osborne) spoke movingly about the huge problem in getting EHCPs, drawing on her own experience of looking after a child with SEND. I appreciate her taking the time to contribute to this important debate.
As horrifying as some of the statistics are, the results are scarier. Half of the children with SEND have seen their conditions worsen this past year. I will focus specifically on the impact of loss of access to such therapies as speech and language therapy, occupational therapy, and physiotherapy, which a shocking 70% have been unable to do in recent months. Dan told us about his daughter Elisa, who has cerebral palsy. Elisa relies on regular physiotherapy from her education, health and care plan to manage her condition. Sadly, she missed out on that support for a year during the pandemic and her condition has worsened. My constituent Elisa has dystonia, a very uncomfortable condition where muscles contract uncontrollably. She can no longer use her wheelchair due to the worsening dystonia.
Then there is Suziie, my constituent who cares for her nephew, aged 11, who has a complex series of physical and neurological disabilities. During the pandemic, her nephew has been isolated from other children and has lost access to vital series and therapies that he needs to manage his condition. Awfully, he is now regressing and has lost vital abilities in communication and other essential life skills. He needs sensory rooms and hydrotherapy in his covid-19 recovery plan, and Suziie needs additional respite care.
Those heartbreaking cases tell a story about what has happened during the pandemic: a loss of support and declining health and social outcomes for children with SEND. As has been mentioned in the debate, the Women and Equalities Committee concludes that the Government’s catch-up package will not be enough to tackle the disproportionate impacts on children with SEND. It is all very well issuing guidance saying that they will be a priority, but unless that is followed up with targeted funding there is no guarantee that they will get the support that they desperately need.
I have previously criticised Ministers for treating children as an afterthought in the pandemic, but I believe that those with SEND have been completely left behind. That is certainly how parents feel when I speak to them. However, not all politicians have forgotten about these children. My hon. Friend the Member for Luton North (Sarah Owen) highlighted the important work that Councillor Javed Hussain and other Luton councillors are doing on local autism hubs and park upgrades, bringing benefits for those who use wheelchairs. We should be learning from them.
Although lessons must be learned from the failures that my colleagues have outlined, I want to look to the future. We need proper support for EHCP provision to be restored in full. We need a plan from Ministers to clear the backlog of assessments and health appointments. There must be a proper co-ordinated catch-up plan that goes beyond the Government’s narrow ideas about educational catch-up. We have to have targeted support for children with SEND to make up for months of lost development in communication, social skills and wellbeing.
Rather than downgrading the legal duties to children with SEND, as the Government did at the start of the pandemic, the SEND review should be an opportunity to upgrade the resources that local authorities have to deliver support, and to listen directly to families about how services can be reshaped so that they operate in the best interests of our young people.
The Parliamentary Under-Secretary of State for Education (Vicky Ford)
It is always a pleasure to serve under your chairmanship, Sir Edward. I start by joining others in congratulating the hon. Member for Slough (Mr Dhesi) on securing this important debate. I am grateful for the opportunity to discuss this important topic of how we care for our children with special educational needs and disabilities. The Government are absolutely dedicated to supporting children with special educational needs and disabilities, and their families. Our ambition for them is the same as it is for every child and young person, which is to ensure that they have access to a world-class education that sets them up for life.
The covid-19 pandemic has been extremely challenging for many families of children and young people with SEND. That is why throughout this very difficult pandemic, including during periods of national restrictions, we asked schools and colleges to remain open for those with education, health and care plans, because we know that those pupils, students and their families can be disproportionately impacted by being out of education.
I am extremely proud that we have kept our schools and colleges open for those most vulnerable children. We were one of the very few countries in the world to do so during the first lockdown. I recognise that in that first lockdown, attendance in many cases was quite low, because people were concerned about those vulnerable children, who often have other underlying health conditions. We did not know very much at that time about the impact of the virus on children.
By the end of the most recent lockdown, 99% of special schools were open and about 46%—that is about half—of children with EHCPs were attending towards the end. In fact, 58% or nearly two out of three children with EHCPs in mainstream primary schools were attending.
Throughout the pandemic, I have had very many meetings with stakeholders and have listened carefully to feedback from organisations such as the Council for Disabled Children and home care organisations, from young people themselves and from their families. I have sent many open letters to families and those who support them to answer their questions and to give them guidance and updates.
I also made many virtual visits to special schools and colleges. Those have been invaluable, especially the visits I made last autumn term to many special schools in areas with high covid rates. People might remember that schools were expected to be open, but in some areas covid was high. Our special schools across the country are absolutely committed to ensuring that children and families continue to receive high-quality education and support. I am extremely grateful for all that they are doing and I am deeply inspired by their work.
Support has to go beyond education, however, and I am acutely aware of the pressures on families. That is why we prioritise respite care. Alongside that, we provided £40.8 million for the family fund last year, which supported more than 90,000 families on low incomes who were raising children with disabilities or serious illnesses. That included £13.5 million to respond to needs arising from the outbreak. It provided items such as specialist toys, IT and other elements of equipment.
When children are not able to attend face to face, they should still receive remote education. To support that, we invested nearly £5 million in the Oak National Academy, which included funding to provide the specialist content for pupils with SEND. We also founded the National Star College to provide specialist training for teachers, leaders and SENCOs—special educational needs co-ordinators—on providing remote education for pupils with SEND.
We have been clear that where children and young people with an EHC plan need health provision, educational settings should work collaboratively with local authorities and health providers to agree the appropriate support. We made it clear that therapists and other professionals may continue to visit schools and colleges to provide that. Indeed, yesterday I met the Royal College of Occupational Therapists and the Royal College of Speech and Language Therapists to underlie how important it is that children get those therapies.
Despite all our efforts, many children and young people with SEND will be negatively impacted by the pandemic, and our focus has to be on supporting them in our recovery. Sir Kevan Collins, who has great experience in the SEND sector, as well as in many other areas of education, has been appointed as the education recovery commissioner, and he is considering how we can effectively target resources and support for those in the greatest need.
Sir Kevan is also looking at transitions, which the hon. Member for Reading East (Matt Rodda) mentioned. I would be happy to meet the hon. Gentleman to discuss that issue, but we may need to wait until after the court case. It is an issue that I shall be looking at closely. One clever thing that we did during the pandemic was to put in a special transition fund for year 11 students in alternative provision. Many young people in alternative provision have special educational needs, and that helped to support them on their journey into further education colleges last year. It was a great success. Transition is an issue that I am always interested in.
Vulnerable children are at the heart of our work in the Department for Education. The £650 million catch-up premium that we announced last June was weighted to give extra support to those in special schools. There is three times more support per pupil in special schools than in mainstream schools. That was supplemented by the additional £320 million recovery premium that we announced in March, which is helping schools to make up for lost teaching time. Head teachers decide how that premium is spent. They can prioritise particular pupils, including children with SEND.
Similarly, the recently expanded national tutoring programme provides access to high-quality tuition for disadvantaged and vulnerable children and young people, and 26 of the 33 providers that we have approved to provide the tutoring can provide tutoring for SEND. That includes the 16 to 19 tuition fund, for the support of students. Furthermore, the early language and literacy catch-up programme will benefit all children, including those with SEND. More than 40% of the primary schools in the country have signed up to the language and literacy programme.
The long summer break can bring extra pressures on families, and to address that we have expanded the holiday activities and food programme, which has provided healthy food and enriching activities to disadvantaged children since 2018. This year it will cover the Easter, summer and Christmas school holidays at a cost of up to £220 million and will be available to children across England. We are working to ensure that the programme is fully inclusive and accessible. The £200 million summer school funding will be available to all secondary schools, including specialist settings, to deliver face-to-face summer schools. Schools will be able to target what they provide based on pupils’ needs, enabling them to tailor support for those with SEND.
The hon. Member for Jarrow (Kate Osborne) mentioned mental health, as did some other Members. It is important, because children and young people will succeed only if their physical and mental wellbeing is prioritised, so we recently announced another £79 million boost to children’s and young people’s mental health support, including through further roll-out of mental health support teams. Our wellbeing for education return programme has provided training and resources to help school staff across England to respond to the wellbeing and mental health needs of pupils at this time. On top of that, we remain committed to our joint Green Paper delivery programme on mental health.
Many Members have spoken about funding, and we recognise that support for SEND has to be underpinned by the necessary funding. In addition to the recovery funding, we are investing significantly in special needs education. An additional £730 million is going into high-needs funding in this financial year. That comes on top of the extra £780 million that we provided last year, which means that in two years the high-needs budget will have grown by more than £1.5 billion and increased by nearly a quarter. We are also investing another £300 million of capital funding this year in new places for children and young people with SEND, or those who need alternative provision.
It might be worth telling hon. Members how those funding numbers affect their constituencies. In Slough, the funding for high needs has increased to £28 million—a 16% increase over last year and this. There are also 16% increases in Bedford, Reading, Richmond and Camden. Funding in East Suffolk and Norfolk is increasing by about 22%, in Luton by 23% and in South Tyneside by about 26%. In Liverpool, funding was increased by 17% last year and will be increased by a further 12% this year.
As the hon. Member for Twickenham (Munira Wilson) mentioned, we have been working closely with Richmond Council on safety valve funding, and I will pass her thanks on to the team at the Department for Education, who always work closely with councils that are struggling in this area. Luton also received almost another three quarters of a million pounds to improve children’s social care.
We know that practical support for local SEND services is really important. This year we are putting £42 million into projects to support children and young people with SEND, ensuring that organisations across the country continue their work to strengthen local area performance, and supporting families and providing practical support to schools and colleges. Crucially, that funding will help to strengthen the participation of parents and young people, ensuring that they have a voice in designing SEND policies and services as well as access to high-quality information and support.
The hon. Member for Liverpool, West Derby (Ian Byrne) mentioned autism. My Department is working closely with the Department of Health and Social Care to develop a refreshed cross-Government autism strategy. Progress has been made on autism over the years, but there are challenges and priorities for reducing inequalities, enabling autistic people of all ages to have the same opportunities as everyone else to lead happy, healthy and fulfilling lives. The refreshed autism strategy will, subject to the pressures of the pandemic, be published this spring—that is our aim.
The hon. Member for Slough mentioned local issues that he had seen. Slough Borough Council is Labour-run, and sadly it has a long history of failing children. Its children’s services were rated as inadequate by Ofsted back in 2013, and we in the Department for Education took children’s services into a trust. We have invested millions of pounds in that trust and, since 2019, the trust is no longer considered inadequate, though it still requires improvement and remains in intervention.
I was therefore very disappointed to hear the hon. Gentleman’s stories about the services that Slough Borough Council provides for disabled children. Disabled children’s services are the responsibility of the council; they do not sit within the children’s trust. We have, however, provided support through a SEND adviser and increased the high-needs budget, as I mentioned. We know that the council’s SEND services have not been inspected by the joint inspections that Ofsted does with the CQC. However, SEND inspections will recommence in 2021, so I am hopeful that we will see some more inspections and get more feedback.
I appreciate that Slough Borough Council has a significant dedicated schools grant deficit. I am pleased that it is keen to work with us to improve it, but I must point out to Members that it is possible to manage a high-needs budget and SEND services effectively. We can all learn from authorities that have had good inspection outcomes. Slough might like to look at what has been achieved in Portsmouth or indeed in Lambeth.
I turn to the SEND review. We do recognise that the current system is not delivering for some children and young people—it is not helping them to achieve the outcomes that they deserve. My hon. Friend the Member for Hastings and Rye (Sally-Ann Hart) is right that we need a consistent approach across the whole country to ensure that children get the services and support that they need. Our cross-Government SEND review is looking at ways to improve that.
We know that these issues are long-standing and complex, but we are absolutely determined to deliver a real and lasting positive change. Our ambition is to publish proposals for wider public consultation before the summer. The review’s work is broad: it covers children and young people from birth to the age of 25 and looks at improving lifelong outcomes. We want to build on the best of the current system and put families at its heart, which means ensuring that we identify and meet needs as soon as possible, including by having strong support systems within mainstream settings as well as excellence in special school settings.
I trust that this extensive programme of work makes it clear that supporting children and families, especially our most vulnerable children and children with special needs and disabilities, is right at the heart of all that this Government do, especially in this very, very challenging time.
Mr Dhesi
I thank the Minister for her response, and I thank all hon. Members for their excellent contributions to what I believe has been a very engaging and informative debate. I hope that parents and children with special educational needs and disabilities have appreciated just how seriously this important issue is being looked at by hon. Members across the political spectrum.
The hon. Member for Hastings and Rye (Sally-Ann Hart) eloquently explained the work undertaken by the all-party parliamentary group for special educational needs and disabilities, by its chair, my hon. Friend the Member for Sheffield, Hallam (Olivia Blake), and by its other members. My hon. Friend the Member for Norwich South (Clive Lewis) spoke powerfully about the barriers that children and their families in Norfolk face, and about the inherent unfairness of a two-tiered system. My hon. Friend the Member for Bedford (Mohammad Yasin) spoke cogently about his concerns about the funding model and the devastation of that system in Bedford by austerity over the past decade. My hon. Friend the Member for Liverpool, West Derby (Ian Byrne) powerfully high -lighted the issues that, as he put it, have been highlighted again and again over so many years—the pandemic has only exacerbated them, and yet we still have no solution.
My hon. Friend the Member for Luton North (Sarah Owen) described the incredible work of the late right hon. Member for Chesham and Amersham, whose incredible input into work on autism I had the pleasure of learning about when I attended a training session on understanding autism at which she spoke so movingly. My hon. Friend has highlighted the exasperating delays; I felt that the delays in Slough were bad enough, but for her constituents to have to wait for up to four years is simply unacceptable. She also delineated at length the lack of joint working.
My hon. Friend the Member for Jarrow (Kate Osborne) spoke so movingly from her own experiences. As the mother of a child with special educational needs and disabilities, she knows all too well the pressures that families feel. She explained about the inability to access appointments, the gaps in the system and the lack of ring-fenced funding, which are issues that I hope the Minister will mend.
My Berkshire colleague and hon. Friend the Member for Reading East (Matt Rodda) highlighted the pressures on families in Reading. He spoke about the inadequate funding; he also spoke with a great deal of experience, having seen it in his constituency, about the need to work on the transition from primary to secondary. I am grateful that the Minister has accepted his request to meet her in due course to alleviate some of those concerns about Reading.
The hon. Member for Twickenham (Munira Wilson) spoke about the pressures in Richmond Borough Council and how important it is to make children’s needs, rather than funding, central. She also spoke about the isolation and huge mental health problems that children and their families face.
My hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq), the shadow Minister, spoke about the effect of issues in her constituency and about the national situation. She talked about her discussions with head teachers, who are not happy with the loss of support during the pandemic, and who say that the Government package will not be enough.
I am grateful to the Minister for her response. She accepted that the pandemic has disproportionately impacted families and children with special educational needs and disabilities. She described the situation in Slough, but the Slough trust solution imposed by the Government has not worked well; indeed, as Slough Borough Council and others have highlighted during discussions, the funding has been wholly inadequate. I hope the Minister will discuss that with her colleagues in the Department for Education to ensure that funding is available in the new settlement.
The Minister explained about the family fund, the catch-up and recovery premiums and the summer school funding. Although various numbers are bandied around whenever we have discussions with Government or approach them in the Chamber, as the Minister herself stated, the need has increased significantly but the funding has not kept pace. That is a central point.
As I said in my introductory speech, funding issues and delays are the key things on which we need action, as we all acknowledge. The Minister herself acknowledged that the current system is not working. I hope that the SEND review, which will be published this summer, will alleviate some of our concerns about funding and delays.
Question put and agreed to.
Resolved,
That this House has considered support for children with SEND.
Electric Vehicles: Promotion
(3 years, 7 months ago)
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Nick Fletcher (Don Valley) (Con)
I beg to move,
That this House has considered promotion of electric vehicle usage.
It is a pleasure to serve under your chairmanship, Sir Edward. I thank the Minister for taking time to come and listen to the debate. I first refer Members to my entry in the Register of Members’ Financial Interests.
Can you hear that? No, you cannot. That is the sound of an electric vehicle. Quiet, isn’t it? Now breathe in through your nose—even those with masks on. Please breathe in, a big sniff. Can you smell anything? No. Again, there is nothing to smell. No nasty gases polluting the air we breathe; no noise polluting the sound of birds singing. Okay; we get the picture. It may be a little dramatic, but none the less it is all very true. That is our future, and it is not far away. In fact, if the Minister and the Government really want to, they can bring this vehicle revolution here within the next five years.
Now there is a stumbling block. Well, it is a few blocks that make a wall, but there really is only one wall now. You see, as time has moved on, so have the cars. Even as little as five years ago, electric cars were being produced but they were very expensive. Many listening to this debate may think that that is still the case. I am not going to tell you that they are cheap, but apparently the cost that makes a car affordable these days is around £36,000 and, thankfully, that is where we are today.
That is the lower end of the market, yes, and £36,000 is still a large amount of money, but it is at least comparable to a diesel or petrol vehicle. Many people buy these vehicles on personal contract purchase, so the actual capital cost is never paid in a lump sum, but rather as a deposit and a monthly figure which usually covers the depreciation. Electric cars tend to hold their money very well, so the monthly payments should be at least as competitive, if not better.
Electric cars are also phenomenally cheap to run. The average cost of a 100-mile journey in a diesel is £12; in an electric vehicle it is £7. Servicing costs are also much lower. With fewer moving parts, there is a lot less to go wrong. Most electric vehicles have fewer than 20 moving parts. Wherever you get moving parts, you get wear through friction. That usually means maintenance or failure, so it is obvious that the fewer the moving parts, the better. Electric vehicles brake through regeneration, too, so brake pad wear is minimal. With no exhaust, no oil to change, no filters—you get the picture.
If cost is not holding us back, what is? Is it distance? Again, that used to be the case. However, most electric vehicles do much more than 200 miles now, and although that can drop in the winter months as batteries and occupants need to be kept warm, most vehicles will easily do 130 miles. As the average journey in the UK is less than 10 miles, range is not the big issue any more.
I should like to take a minute to help everyone to recharge their electric vehicle. Electric vehicles are not like petrol or diesel vehicles, which a person would quite happily drive around with less than half a tank, and would definitely not fill up every day. However, with an electric vehicle, if you can, you should. There are two main reasons for that.
First, unlike with a petrol or diesel car, when your car is parked your EV will lose charge. That is because the batteries look after themselves with a slight amount of warmth, and there are lots of electronics that are always using power, so invariably you will lose around 1% a day. If you have to make an emergency journey or take a spontaneous day out—when we are not in lockdown—unless you are fully charged, you are not going. I think it was Elon Musk who said, ABC—always be charging. That is okay if you have a home charge unit, but if not, we need multiple fast-charging units everywhere.
Secondly, no one wants to wait three to four hours for their car to be charged, so the charging points need to be at least 60 kW, preferably 120 kW. Thirdly, I should mention the reliability of charge points; that is so important. Turning up to an EV station with a faulty or damaged unit is not fun, and unlike running out of fuel, a person cannot just call dad, as I know my daughter would, for a gallon of petrol. An electric vehicle just does not work like that—if you run out of charge, you are stuck—so charging points must be reliable.
Finally, the payment system for the charge points needs to be contactless. People need to be able to drive up, plug in, pay when ready and drive away. Contactless payment must be the way. The Government should work with stakeholders to ensure that contactless facilities are fitted to all new and existing charge points.
Those are the four stumbling blocks—the wall that is getting in the way of increased electric vehicle usage: the lack of charging points, the size of those points, their unreliability and the lack of contactless facilities. How can we overcome that wall?
Let me start by saying that we are trying—that is for sure. The announcement that no more internal combustion engines are to be registered after 2030 has definitely made the industry sit up and look at the issue more seriously. We are currently installing many charging points, but we need many more rapid units now. How can we do that?
We need to remove some of the existing incentives in the automobile sector and reinvest the money into EV charging point infrastructure. Currently, we are discounting cars and the cost of chargers at home and discounting vehicle excise duty and company car tax. Yet the cost of cars is falling, and will fall even more as the big auto companies such as Volkswagen, BMW and Ford start coming on board and producing more of their own electric vehicles.
The current voucher scheme for home charging is too complicated and does not really offer any huge savings to the end customer. Furthermore, as electric vehicles are becoming cheaper and cheaper to run, tax incentives will soon not be needed. If those moneys were redirected to further charging infrastructure projects, the automotive industry, which contributes much of our greenhouse gas emissions, could really lead the way to our net zero target.
Although I think the Government should change course slightly, I also thank the Minister for what they have done so far, and what they have already set out to do. The Government are investing £1.3 billion; £950 million of that is going directly into rapid charging projects. I know from my many meetings with stakeholders that the investment is more than welcome. The Government are investing a further £90 million into local EV charging schemes, which local councils can apply for. The financing scheme is also a massive help and I hope that many businesses use it.
Some currently say that battery technology will get even better, while others stress that, while it will take time to get the charging points installed, they will come along eventually. I cannot stress how important it is that Ministers do not adopt that attitude, and instead move much more quickly. Why? It is obvious that fewer customers are buying electric vehicles due to that anxiety and the distance between charge points. That range anxiety is what is really stopping people buying these fantastic vehicles. The answer is to have high-powered rapid charging stations everywhere.
A 300-mile-range vehicle with a high-powered charging can take as little as 20 minutes to give in excess of 150 miles’ charge. That is 75 miles in less than 10 minutes. That is obviously what we need—for EV charging points to be installed with the same frequency as petrol stations, well-lit and ideally under cover.
A perfect example is Gridserve in Essex. Its charging forecourt is clean, safe and has a lounge—not that it is really needed—shopping and a Costa Coffee. It has easy payment methods, too. Existing forecourt operators need to be taking this revolution seriously. With the Government’s backing in the initial stage, it could be great for the customer and also profitable enough for the private sector to get involved and really push it forward.
I believe that the Government should taper off grants for home charging grant schemes by the end of the year, and do the same with electric car grants. Furthermore, we should look at the slow removal of company car tax benefits and vehicle excise duty benefits. With the savings made on removing those incentives, we should redirect the moneys into furthering the rapid charging network, so that anxiety is a thing of the past.
I also urge the Government to consider a proposal from Policy Exchange for a California-style zero-emission-vehicle mandate, which would require manufacturers to sell more electric or hydrogen vehicles each year. There should also be fines for companies that poorly maintain their charging points, and contactless payment must be mandatory. If we do that, the take-up of such vehicles will be huge.
I want to mention a final issue, on which I hope to secure a debate later in the year: artificial intelligence. With electric vehicles, the public are seeing the power of artificial intelligence. I am talking about self-driving cars. This is the first real step into the future, and none of us really understands it, so I make one further ask: will the Minister discuss the effects of AI with all her colleagues as a matter of urgency? I believe that there will be many benefits from AI over the years to come, but unless it is regulated now, the positive effects might be far outweighed by the negative effects that AI has on society.
One final time: can you hear that, Sir Edward? No. Well, that is an electric vehicle.
Jacob Young (Redcar) (Con)
It is a pleasure to serve under your chairmanship, Sir Edward. I congratulate my hon. Friend the Member for Don Valley (Nick Fletcher) on securing the debate, and thank him for allowing me to contribute as well.
This is an important and timely debate, given the Government’s recent climate change commitments and the transport decarbonisation plan that is expected later this spring. In the EV conversation we rightly focus on battery electric, as my hon. Friend already has, but as the chair of the all-party parliamentary group on hydrogen, I say that we must not forget the role that fuel-cell electric can play in supporting our net zero targets. Such technology is powered by hydrogen and rapidly improves air quality, as it produces no carbon emissions. Indeed, the only waste from a hydrogen electric vehicle is water.
Hyundai anticipates that 10,000 NEXOs on the road would have a carbon reduction effect equivalent to planting 60,000 trees. The key benefit of hydrogen electric, compared with battery electric, is the consumer continuity by way of shorter recharging times and extended range, ending the road rage that my hon. Friend spoke about. On a five-minute charge, these types of cars can travel more than 400 miles, which is equivalent to any petrol or diesel car. However, the biggest barrier to these vehicles, and to those that are battery electric, is cost. We need to provide an answer to that. How can someone on a low income who drives a five or 10 year-old petrol car be convinced to switch to a zero-carbon vehicle? Net zero can be achieved only if it is accessible for everyone, so those of us who want to see a reduction in our emissions will need to answer that.
Beyond hydrogen electric cars, the most important role that fuel cells will play is in helping decarbonise our larger road transport, particularly buses and heavy goods vehicles. In 2015, the Government backed the groundbreaking Aberdeen bus project, introducing 10 hydrogen buses in Aberdeen. At the time it was the largest hydrogen bus fleet in Europe. Fast-forward five years and, according to the UK Hydrogen and Fuel Cell Association, there are over 7,000 fuel cell buses and commercial vehicles already operating globally, including almost 100 fuel-cell buses in the UK. That will be further boosted by the Government’s recent announcement of more than £10 million investment in hydrogen bus manufacturing in Northern Ireland. We are investing in greener trains, with hydrogen trains coming to Teesside tracks in the not-too-distant future; in greener shipping, with £20 million for clean maritime competition; and in greener flying, with the Jet Zero Council. I know that fuel cells will play an important part in all of that.
If I could ask the Minister to look at one area further, it would be how we can use hydrogen fuel cells in emergency service vehicles. Police stations, fire stations and hospitals often have a lot of associated land that would be perfect for the production and storage of hydrogen, converting our ambulances and fire engines to low carbon, with the added benefit of shorter refuelling times and extended range. The market is growing, and this provides an exciting opportunity to potentially support thousands of green jobs in the UK. Hydrogen will be one of the key ways that we level up the whole of the United Kingdom, and I am grateful to the Government for recognising the role that Redcar and Cleveland can play in that. I am proud that Teesside is building the UK’s first hydrogen transport hub.
If we are to meet our climate target and scale up demand for electric vehicles, we must also ensure that we realise the full potential of fuel-cell electric vehicles. That requires ensuring that the right infrastructure is in place to provide long-term certainty in order to attract investment opportunities. From speaking to businesses operating in the sector, I know that they are ready to scale up and meet the demand going forward. We can achieve that by including hydrogen refuelling station infrastructure in future funding schemes, supporting hydrogen refuelling stations and further incentivising the public to take up these zero-emission vehicles. My hope is that we continue to lead the way as a global frontrunner in clean energy and net zero transport. With the right infrastructure, investment in place and support for those who need it, I am certain that our transport system will build back not only better, but greener too.
The Parliamentary Under-Secretary of State for Transport (Rachel Maclean)
It is a huge pleasure to serve under your chairmanship, Sir Edward. I am extremely grateful to my hon. Friend the Member for Don Valley (Nick Fletcher) for securing this important debate on the promotion of electric vehicle usage. Like him, I am a passionate and keen electric vehicle driver and enjoy the peace and quiet and the clean experience it brings me. I very much welcome the opportunity to set out what the Government are doing on this important agenda.
The transition to zero-emission vehicles is critical, as my hon. Friend said, in helping us to meet our climate change obligations and in improving air quality in our towns and cities. That is why we are going further and faster to decarbonise transport by phasing out the sale of new petrol and diesel cars and vans by 2030; from 2035, all new cars and vans must be zero-emission at the tailpipe, putting us on course to be the fastest nation in the G7 to decarbonise cars and vans. On the back of the further announcement from the Prime Minister yesterday about our accelerated carbon targets, it is clear that we are playing a world-leading role in the fight against climate change under this Conservative Government.
I thank my hon. Friend for rightly pointing out all the positives of owning an electric vehicle. It is right that, overall, they are cheaper to run than the equivalent petrol and diesel car. He is also correct that range anxiety should be, and in most cases is, a concern of the past: in fact, 99% of car trips are less than 100 miles, and many of the latest electric vehicles can travel more than 200 miles on a single charge. For example, the Volkswagen ID.3 Pro has a 263-mile range, enough to drive from Westminster to my hon. Friend’s constituency, Don Valley, with 100 miles to spare—maybe stopping off in Gainsborough as well, Sir Edward.
My hon. Friend is also right to point to the stumbling blocks. I will start with the lack of rapid chargers. He pointed out that the Government are providing £1.3 billion to accelerate the roll-out of charge points on motorways and major A roads, in homes and businesses and on streets. That is part of an overall package of £2.8 billion to support industry as a whole and consumers to make the switch to electric vehicle motoring.
The UK is already a global front-runner in supporting provision of charging infrastructure. Government and industry have supported the installation of nearly 20,800 public charging devices, including nearly 3,900 rapid devices—one of the largest networks in Europe. In my hon. Friend’s own region of Yorkshire and the Humber, there are more than 1,000 publicly available charging devices, 311 of which are rapid devices. In England, a driver is never more than 25 miles away from a rapid charge point anywhere along England’s motorways and major A roads. However, I totally agree with my hon. Friend that there is much more to do, and we will come forward with a number of plans and announcements on our infrastructure strategy to deliver the charge points that we need to underpin this transition.
I agree furthermore with my hon. Friend that rapid charging is key to increasing the confidence in electric vehicles. Thanks to the Government and private sector working together, there are rapid and ultra-rapid charge points across 97% of motorway service areas in England, but we are ramping up this provision. We expect all motorway service stations to have at least six 150kW chargers by 2023, backed by investment from this Conservative Government, which means that someone should be able to charge their rapid charging-enabled car in the time it takes to get a cup of coffee, just as we would now with an internal-combustion-engine car.
It is important to recognise that slower forms of charging are important as well. Customers value the choice and flexibility to charge their vehicles at different speeds in different locations, such as overnight at home, at work or when they go shopping. I love the fact that I can go to sleep while my vehicle is charging and it is fully charged and ready to go when I wake up in the morning.
We have a comprehensive strategy to support the roll-out of charging. In addition to the £50 million we have made available this year for home and workplace charging schemes, we are proposing a number of important changes. We are refocusing our electric vehicle home charge scheme to support people living in rented and leasehold accommodation, which will level up our infrastructure roll-out. Our workplace charging scheme will be opened up to small and medium-sized enterprises and the charity sector.
We know that charging for people without off-street parking is a massively important issue. I encourage all parliamentary colleagues listening to this debate to speak to their local authorities and encourage them to apply, if they have not done so already, to our £20 million on-street residential charging fund, which was doubled last year by the Transport Secretary.
My information is that no local authority in the constituency of my hon. Friend the Member for Don Valley has applied for this funding, so I encourage him to speak to his colleagues and co-workers at his local authority so they can apply for that funding, which could benefit residents. The money has been made available; it is down to local authorities to work with the Government and get the charging infrastructure where it needs to be.
The purpose of that scheme is to increase the availability of on-street charging points in residential streets, where off-street parking is not available. Many people live in homes and streets of this type. Some 75% of the capital cost of procuring and installing charge points is covered by central Government, and the Government provide free, impartial advice through a number of sources; I am happy to direct my hon. Friend to that.
I move on to the valid point that he raised about contactless payments at charge points. We agree with him that the experience needs to improve. We recently held a consultation to make payments easier, charge points more reliable and pricing more transparent, and to ensure that the data is open and accessible. We will come forward with a response to that and lay regulations on those topics in autumn 2021, parliamentary scheduling permitting.
Let me set out the Government’s position on the vehicle grants that my hon. Friend raised. Many of these matters are for the Treasury, as he knows. As we first signalled in 2018, our intention is to move away from grants as the market matures. We have refocused our vehicle grants to target the more affordable end of the market, where we know most consumers will be looking and where taxpayers’ money will make the most difference. In response to that, many manufacturers have reduced the prices of their vehicles. For example, BMW have dropped the price of their i3S by almost £7,500, which is a great win for consumers.
Our grants are working. In 2020, battery electric vehicles made up 6.6% of the new car market. Since 2011, our plug-in grants have supported 300,000 ultra low emission vehicles. We have committed a further £582 million to support vehicle grants, so we do see our grants having a long-term role to play, alongside other support, although we will continue to keep all these policies under review.
I turn now to the points made by my hon. Friend the Member for Redcar (Jacob Young). I thank him for raising the vital subject of hydrogen and the role of fuel cell vehicles in the transition to zero-emission motoring. As he knows, our ambitions for delivering greener transport are technology neutral. We believe that a range of zero-emission transport technologies will be adopted in the future. He highlighted a number of Government plans and projects that have supported hydrogen vehicles of all types already.
I put on the record my grateful thanks to him for the role he has played in securing the first hydrogen for transport hub, which is in his area of Tees Valley. It has come with £3 million worth of funding, to enable exactly the things that he describes and enable hydrogen for transport to develop alongside its application in the industrial, energy and other sectors of the economy. We are pushing ahead with plans for the hub. It is a world-leading project, and we believe it will set out a vision for the role that hydrogen can play in transport. I am very excited to see that progressing.
In the last couple of moments, Sir Edward, I refer to the point made by my hon. Friend the Member for Redcar about artificial intelligence and driverless cars. He is right to mention that as we do not get to talk about the subject often enough, so I thank him for bringing it up. He mentions the exciting progress we have made in self-driving vehicles in this country, and the importance of understanding this new technology and its impact on society.
I believe self-driving vehicles have the potential to make journeys greener, safer, easier and more reliable. We have the opportunity to bring vast economic benefits to our country, by creating an industry and building on our existing world-leading expertise in automotive and engineering. The industry could be worth billions of pounds and could generate thousands of well-paid skilled jobs. As my hon. Friend knows very well, this Government’s intention is to build back greener, creating well-paid jobs in the industries of the future, and driving a green industrial recovery.
The introduction of self-driving vehicles to UK roads is closer than many would think. We are currently considering whether vehicles equipped with the new automated lane keeping system technology, which could enter the British market as early as the end of this year, can be legally defined as “self-driving”. [Interruption.] I hope you can hear me, Sir Edward.
Rachel Maclean
Great; I will continue. It is essential that the introduction of self-driving vehicles be supported by appropriate safety and legal frameworks. The UK has published three world-leading consultation papers on a comprehensive safety and regulatory framework for self-driving vehicles, led by the Law Commission. The final recommendations from the Law Commission are due by the end of this year, and I will be discussing them carefully with my colleagues across Government.
That is all part of the Government’s effort to make the UK the best place in the world to deploy and develop self-driving vehicles, which must, of course, be safe. The questions of safety and the role that artificial intelligence can play are at the forefront of my mind as a Minister in the Department for Transport.
I thank my hon. Friend the Member for Don Valley for this excellent opportunity to set out some of the work that we are doing in Government to promote electric vehicle usage across all parts of the UK. I agree that we need to take ambitious steps to scale up this exciting transition, for both electric vehicles and hydrogen fuel cell vehicles and hydrogen in all its forms. I assure him that we are not sitting back and letting this happen; we are actively pushing forward a number of strategies, including the transport decarbonisation plan, which is to be published later this spring and will set out a lot more detail.
With that, Sir Edward, I conclude my remarks and welcome the quiet, which sounds exactly like an electric vehicle driving.
Sir Edward Leigh (in the Chair)
They are certainly quieter than the House of Commons Division bell.
Question put and agreed to.
Stroke: Aftercare
(3 years, 7 months ago)
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Sir Robert Neill (Bromley and Chislehurst) (Con)
I beg to move,
That this House has considered the National Stroke Programme and aftercare and rehabilitation services for stroke patients.
It is a pleasure to serve under your chairmanship, Sir Edward, and bring this debate to Westminster Hall. It is an important topic in which, as will become apparent, I have a personal interest. However, it is worth setting out the national significance of stroke and in particular stroke aftercare, because over recent years we have made huge advances in public awareness of the symptoms of stroke—the messages to look out for the signs of it, and to get urgent help, have cut through. The acute treatment of stroke has vastly improved, and many more people, thank heavens, are able to survive it. All those are good things. There have been real advances in medical science and technology in that regard.
The area where, I am sorry to say, we lag behind is what happens next. The NHS is brilliant at lifesaving and acute work, but it is in the follow-up for those who survive stroke and are left with the consequences where, it seems to me, we have more to do. In this debate, I want to concentrate on that and draw it to the attention of the House—and, I hope, to the attention of the wider public too.
I mentioned that I had a personal interest in this, Sir Edward. As some hon. Members may know, in July 2019 my wife, Ann-Louise, suffered a severe stroke—15 on the national stroke scale. We were fortunate that we had brilliant acute treatment at the Princess Royal University Hospital in Bromley and some good aftercare. She came through, but the truth is that she was left with a number of impairments thereafter because of the position of the stroke. Like so many stroke survivors I have met since, she continues to fight bravely and determinedly to come back from the stroke, and to get back to where she wants to be. It can be done, but it is a long and hard road. It requires courage and patience, but also consistent professional support, and it is that last thing that I think we need to do more to achieve.
In our case, Ann-Louise was unconscious for about three days. We were fortunate that the Princess Royal University Hospital at Farnborough Common is a regional centre of excellence, as part of the King’s College Hospital NHS Foundation Trust, and therefore she received superb treatment. However, she of course needed rehabilitation, which she received at the Ontario unit of Orpington Hospital, again provided by excellent and dedicated people.
However, the sad truth was that the unit was not resourced to deliver the level of consistent rehabilitation that it would wish to provide for Ann-Louise and other patients. For example, during the several weeks she spent there, it was not possible to deliver the therapies per week to the level set out in the National Institute for Health and Care Excellence clinical guidelines. I am sorry to say that is by no means an unusual state of affairs.
Frankly, there was a difficulty with the availability of therapists because of an inability to cover maternity leave, sick leave and so on, and there were shortages, particularly of speech and language therapists. It was never possible for Ann-Louise or the other patients to consistently receive the hours for five days a week that are set out in the NICE guidelines.
In the end, we were able to get private treatment and private rehabilitation for Ann-Louise at the Wellington Hospital in London. Again, dedicated people did great work there. However, the truth is that many families are not in a position to do that. I was very struck by one lady who was in the same bay as Ann-Louise in Orpington Hospital. She was only in her mid-40s, I think. She had a 16-year-old daughter and the consequences of the stroke that she suffered were much more severe than those of Ann-Louise’s stroke. She was there when we arrived and she was still there when we left, and frankly it was not possible to see any significant improvement in her condition. It is for people like her that one worries even more, because they are not in a position to seek some of the help that we were able to seek.
Ann-Louise eventually came home the day after the general election in 2019, so we are talking about a period of some weeks. As people may know, she was then entitled to a measure of aftercare in the community—it works out at about six weeks of occupational physiotherapy, and speech and language therapy—but thereafter it stops. I think that what we manage to do very often is to get people fit enough to be discharged back to their home, and to establish themselves initially at home. However, I do not think that we deliver on what is recognised by all the clinicians and well set out by the Stroke Association and others—consistent, long-term, programmed care over a longer period of time. That is what we want to see, and it is what is envisaged in the various programmes and plans that the Department of Health and Social Care has put in place for stroke. I think that is the area that we need to draw attention to.
After a period of time in our trust, which is a well-run trust, in effect one bids for further speech and language therapy. After another period and after a referral, hopefully one will get about three sessions, spread over a number of weeks. If targets are met, one may be in a position to seek a referral for perhaps three further sessions. However, if some of the targets are not met, and not everyone can meet them the first time around, then, because the resources are limited, very often that therapy will stop. That does not seem to me to be right or fair to people who are working terribly hard to come back from a life-changing experience.
Therefore, although there are dedicated professionals—nothing I say is to take away from the dedication of the professionals involved—we are not delivering on what we set out to do. That is a tragedy, because two-thirds of stroke survivors leave hospital with a disability. Stroke is the leading cause of adult disability in the UK. It affects about 1.2 million people in this country. Nearly 100,000 strokes happen in the course of a year. It is therefore a major issue, which needs to be addressed.
We have had in the past a national stroke strategy. There is a stroke plan, as part of the national plan. And now being developed—it is the subject of this debate—is a national stroke programme. All those plans and strategies are laudable but, as I have said, we are not actually able to deliver consistently on the targets that are set out in them, and if we cannot meet what is in the current plans, the concern is how we will meet the more ambitious targets for much more integrated stroke care that are set out in the strategy beyond that.
What we are looking at, according to all the clinicians whom I have talked to over the past 18 months or more, is really this: we have to provide effective support and rehabilitation. A lot of people think, and there is of course some evidence, that improvements are made in the first few weeks and months. Those weeks and months are critical, but there is also growing evidence that people can continue to improve, and improve significantly, beyond that, and actually we can find improvements going on over a number of years. But for people to achieve that, they must have the support.
Stroke is not a simple type of brain injury, which is essentially what it is. It varies according to the severity, where in the brain it has occurred and many other factors, and it will have varying consequences for each individual. Therefore, if we are truly to enable people to recover from stroke, they must have a personalised programme of care, rehabilitation and support, and that must be long term. Long-term personalised care is essential, but at the moment that is not happening. Sadly, the Stroke Association research suggests that some 45% of stroke survivors feel abandoned after their stroke. What is important in that context is not just the physical consequences of stroke; there are real psychological consequences as well, because it is life-changing.
My wife was a professional opera singer and a director of music at her local school. One can imagine what it has been like for her to have an impairment of speech; it weighs immensely heavily. We have met many other people who have had things that have, in effect, changed the nature of who they are. If they are to get back to who they are and can be, they need the really significant help that I have described, but they also need help with morale and the psychological impacts that there can be. That is one of the areas in which we have not been able to deliver to the level that our aspirations set out.
We are to move to the integrated national stroke service model. I am told that it is to be published imminently, but I hope that my hon. Friend the Minister will update us on that. Can we know when that is signed off? Can we know when it will come into force? If there are to be pilot schemes, where will they be? How long will that take to happen? What resourcing will be made available to support that integrated strategy? What is the plan to seek to recruit more specialist therapists, from all the disciplines, to stand behind it? All those are things that we need to have, and I hope that the Minister will be able to help us on that. Otherwise, the danger is that it becomes an aspiration, rather than a reality, for stroke survivors and their families.
Clearly, early supported discharge and integrated community stroke services are the aspiration, but at the moment, in an area such as mine, people will find that some services are provided through the hospitals. If people have more than one impairment, they may have to go to different hospitals—some for ocular work, some for vocal rehabilitation and some for physical rehabilitation. Some services will be provided through the GP, the networks and the clinical commissioning group—in Bromley, we have Bromley Healthcare, which does an excellent job—but others will be provided through a different hospital trust or health trust under contract; yet others will be provided through the local authority, social services and sometimes charities and voluntary groups. We have several stroke clubs and stroke groups in our area that do great work—the voluntary sector is amazing—but we cannot and should not depend on them to deliver part of the core service.
That is quite a minefield to negotiate. If it is difficult to negotiate for a professional family such as ours, think how difficult it is for people who may not have the resource and experience of the system, if I may put it that way, that we and others in our position have to fall back on. Pulling things together meaningfully, so that there is almost a one-stop shop that people can go to as a single point of reference and where they can call in expertise, seems to me and many experts in the field to be critical.
I referred to the importance of psychological rehabilitation. The psychologists I have met believe that much more needs to be done. I also referred to the importance of meeting our targets and the difficulties in some areas, such as speech and language therapy. For speech and language therapy nationally, the figures for meeting the NICE stroke guideline of
“45 minutes of each relevant…therapy for…5 days per week”
stand at 55.2%—just over half—and in some places they fall below that. There is a huge amount more to do on that issue, and a deal more also seems to be required in supporting early discharge. The proportion of patients treated by a stroke-skilled early discharge team nationally is 41%, and in some trusts the percentage drops into single figures. That is just not acceptable, as I know the Minister will recognise. What are we going to do to get those numbers up, so that we can move on to the next stage securely?
We need to think longer-term about this. We had the great good fortune to be introduced to the National Hospital for Neurology and Neurosurgery at Queen Square in London, which does amazing work. One programme there, an intensive aphasia course, is headed up by Professor Alex Leff. It is really full on, but that proves the point—this is one of the things that our current system does not deliver—that rehabilitation has the best outcomes when it is very intensive. Spreading it out to an hour one week, an hour the next and maybe another hour in two or three weeks does not come anywhere near to delivering the level of intensity necessary to enable stroke survivors to relearn skills for the neuroplasticity that is so important for recovery of the brain to kick in. Frequent use, repetition and intensity of the therapy is so critical.
That programme is funded as part of a research project, but as far as I know it is the only one of its kind in the country. That does not seem fair. If it is that good and well documented—it is; I have seen it—surely we should seek to roll out that type of intensive treatment across the piece. Somebody should not have to go privately to get the intensiveness necessary for their loved ones to get the level of recovery that they can achieve. I hope that we can look at that, too.
I hope that that is a start to the debate. We have an hour, and I know that several hon. Members wish to participate—I am grateful to them for coming—so I hope that I have set the scene. I look forward to the Minister’s response, but I hope that once we have considered the debate we will not leave it at that. We could have a greater awareness of the topic in Parliament—I was struck by how little debate there has been in the House and how few questions have been asked on it. When I looked at the list of all-party parliamentary groups, I noticed that there is no group on stroke, although there are groups on very many other serious, life-threatening and life-changing conditions. Perhaps that is a call for hon. Members who might be interested to think about the subject and keep it in mind as parliamentarians.
Having opened the debate, I will perhaps leave it there. I might say something at the end after the Minister has finished, but I have endeavoured to stress the importance of this, because it does change lives. People with the right support can come back. So much can be got back. There is always hope afterwards, and if people have the support to achieve that hope, they can restore their lives in huge measure. It is surely our responsibility as a society to enable them properly, with the aid of the skilled clinicians that we have, to do just that.
Navendu Mishra (Stockport) (Lab) [V]
It is a pleasure to serve under your chairship, Sir Edward. I congratulate the hon. Member for Bromley and Chislehurst (Sir Robert Neill) on securing this important debate and, in doing so, helping to shine a light on the need for greater funding for our stroke services. I associate myself with his earlier comments about a one-stop shop for support for patients and families who have suffered from strokes. I also pay tribute to the work of the Stroke Association, which has done so much to tackle this issue, including vital research and support for survivors of strokes, as well as its core role alongside NHS England in delivering our national programme.
I am proud that my local hospital, Stepping Hill, has consistently been recognised for its stroke provision. Since 2015, Stepping Hill’s stroke unit has been rated the best in England, Wales and Northern Ireland on three occasions in a report compiled by the Royal College of Physicians. There are many other charities and organisations that play an important part in providing support within our communities, including Stroke Information in my constituency of Stockport, run by Nick Clarke, who set up that organisation almost a decade ago.
In England, one in six people will have a stroke in their lifetime. New statistics released by Public Health England reveal that roughly 57,000 people each year suffer their first stroke. Unfortunately, the trauma does not end there for many survivors, with around 30% of people going on to experience another stroke. Strokes are a leading cause of death and disability in the UK, and there are around 32,000 stroke-related deaths in England alone each year. Although many associate the condition with older people, Public Health England research has shown that almost 40% of first-time strokes occur in middle-aged adults—as in, those between the ages of 40 and 69.
Furthermore, the average age for a stroke has fallen by three years over the past decade and, worryingly, most first-time strokes are now occurring at an earlier age than at the same stage 10 years ago. It is highly likely, therefore, that colleagues taking part in the debate will know someone who has been affected by this condition. Indeed, a close friend of mine suffered a major stroke last year, so this is an issue close to my heart. I am pleased that he has made a full recovery, with the incredible care and support of our NHS. My special thanks go to the entire team at Salford Royal Hospital for looking after him.
Despite the ever-present threat of strokes, the reality is that for many years research has been underfunded in comparison with other devastating and debilitating conditions such as cancer. In 2016, research by the Stroke Association revealed that just £48 is spent on stroke research per patient compared with £241 on cancer research. We need more funding for both those serious conditions. The already challenging situation has now been compounded by the devastation that the covid pandemic has had on many charities’ fundraising capabilities, meaning that millions of pounds have been lost. That has reduced their ability to continue their work and carry out critical research.
Strokes are incredibly prevalent in the UK, with one striking every five minutes, meaning that it is a leading cause of adult disability. It is therefore vital that sufficient funding is in place not only to research the causes behind the condition and help to identify preventative measures, but to support our national stroke programme, including the aftercare and rehabilitation services.
Research such as the recent study announced by the Stroke Association—the largest of its kind in the world—to investigate a possible link between covid-19 and life-threatening strokes is crucial. In particular, the report states that stroke patients who have had coronavirus may be younger and experience more severe effects of the stroke as a result, including death. It is an incredibly timely and important study that will need to be supported, given that the charity’s own research director said that the research was
“just the tip of the iceberg.”
Now more than ever, the national stroke programme needs to be given the support and funding that it requires to ensure that it can continue its vital work and deal with the rising number of cases in the UK. I therefore urge the Minister to do all she can to look again at this issue and to push her Department to ensure that the national stroke programme and associated aftercare and rehabilitation services receive increased funding that will help to meet both existing and growing demand on NHS stroke provision.
Duncan Baker (North Norfolk) (Con)
I am grateful to my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill) for securing this important debate.
North Norfolk, I believe, had the highest incidence of strokes in the UK in 2019. I imagine that even on more recent data, that statistic has not improved a great deal. But why? We have the oldest constituency demographics in the country and, as we all know, stroke prevalence increases with age. That, however, is not the only issue. Our rural and isolated communities in North Norfolk, where many elderly people live, suffer from dreadfully slow ambulance response times. In the beautiful, picturesque area of Wells-next-the-Sea, we have the worst response times in the entire country.
Making a recovery from a stroke is all about getting that speed of treatment. There is no point having all the care in place if we simply cannot reach our residents in anything like a timely fashion. Early treatment not only saves lives, but results in that greater chance of recovery, as well as the likely reduction in permanent disability from a stroke.
We continue to work hard in North Norfolk, in particular on the local ambulance response time work group, to get patients to hospital in time for thrombolysis treatment, but it must get even better. Encouragingly, we have seen a research trial by the East of England Ambulance Service Trust, using a stroke ambulance which can scan and start thrombolysis if necessary. In rural and hard-to-reach areas, why can we not roll that out even further?
Even in 2021, there are about 100,000 strokes a year. It is a devastating and cruel condition. In July 2019, my stepfather, who was entirely my inspiration to become an MP, suffered a devastating stroke. To everyone who met him, he was a tower of energy, who shaped the community around him for some 45 years as a leading businessman in our close community of North Norfolk. Within a week of suffering a stroke, however, he passed away. I paid tribute to him in my maiden speech, wishing he could have been present to support me in this place. Instead, he passed just five months before we ever got to share that moment. That is exactly why I take such an interest in this debate.
My story is not unique. We need to do more to stop this happening again, and I think that we can. It is about investment in prevention, treatment and care. In my constituency and, I am sure, in many other rural areas, it would be achievable to invest in more early diagnosis and treatment. We need good prevention, so that TIAs—transient ischaemic attacks—and blood clots can be spotted early. We have to be proactive. In turn, of course, that pays for itself, because early prevention lessens the load on the NHS.
The two main issues that we have in Norfolk remain the lack of thrombectomy services and the unequal provision of post-stroke care and support, in particular affecting my constituents in North Norfolk. I have campaigned for more services at Cromer Hospital—an early diagnosis ward would help enormously—but such services could be improved in so many of our community hospitals throughout the country. There is simply little point in my constituency having an ambulance that will take more than an hour to get to Norwich. We have to put in place the processes and procedures to treat in that precious golden hour in which recovery chances are so improved. I understand that Cambridge is to receive a mechanical thrombectomy trial—why not Norwich?
I would love to see real investment in physiotherapy, occupational therapy, and speech and language therapy for early supported discharge. A lot of encouraging work is under way nationally, in the national stroke programme and in the rehabilitation space, and I thank the Minister for that. I hope that the suggestions in this debate will be helpful and driven forward, so that we may level up pockets of the country where people are behind the curve to ensure that everyone has the same level of success after suffering a stroke.
Jim Shannon (Strangford) (DUP)
It is a pleasure to speak in this debate, Sir Edward, and I congratulate the hon. Member for Bromley and Chislehurst (Sir Robert Neill) on securing it. I can remember when he requested the debate during business questions—I believe it was in January—so it is good to know that the system works. We have in place two of the participants in a Westminster Hall debate on heart valves, which I think was held on a Thursday in February. This Minister responded, and the shadow Minister also made a significant contribution. I do not want to pre-empt what the Minister will say, but I think the hon. Member for Bromley and Chislehurst will be pleased with the response, because she certainly gave me a good response to my debate on heart valves. We will take the Minister up on her invitation for the all-party parliamentary group to speak to her about these matters.
This is an issue that has become very real for me, although probably not as real as it is for the hon. Member for North Norfolk (Duncan Baker), and for people whom I know who have had a stroke. Over a period of time, I have been greatly encouraged by those who have improved. Some improve almost back to where they were—about 80% to 85%—and others not as well, which is probably to do with age and the severity of the stroke.
I want to make three quick points to the Minister, and I am quite sure that the reply will be positive and helpful. I believe there is a need to increase the availability of clot-removing treatment—thrombectomy—to enable all hospitals to carry out the procedure. We should have a target of delivering a tenfold increase in the proportion of patients who receive a clot-removing thrombectomy in order to end their strokes, so that 1,600 more people can be independent after a stroke each year. If we are to do that in reality, we have to address some of the reasons why strokes happen. Perhaps our health conditions have not been as good as they should have been, and it is about improving people’s health. Can the Minister tell us what has been done to deliver that across every region?
Back home in Northern Ireland—I presume it is the probably the same here—we have regular adverts. Chest, Heart & Stroke has an advert on UTV that tells people what to watch out for, and it is really helpful. Can the Minister confirm whether the mainland has the same number of adverts? They tell people what to look out for. To take up the point made by the hon. Member for North Norfolk, time is of the essence when someone has a stroke. It is what people do in those minutes afterwards, regardless of whether they have the qualifications or just want to do something that helps, because time is absolutely critical.
I recently watched something on TV. It was a clip of a darts match in which a player is having a stroke. His face distorts, and he loses all power in his arm. Seeing that take place in real time has shocked me, because it really brought home the issue that pertains to those who have had a stroke, as well as what can be done in that short time. We need to incorporate a greater awareness of the warning signs. Getting help quickly makes the difference between a fast recovery and a slow one. Can the Minister tell us what has been done to raise awareness among the general public?
I said that I know people who have had strokes and who have recovered quite well. Indeed, a friend of mine had one a while ago and is now back to almost 95%. It is incredible that someone can have a stroke and recover so quickly. In Northern Ireland, over a third of strokes happen to people over the age of 69, and 50% to people over the age of 60. However, it is not uncommon, unusual or unique for those under that age to have a stroke. What has been done among all those groups? Those who are most at risk must be aware of the signs and symptoms.
The hon. Member for Bromley and Chislehurst was absolutely right to refer to long-term personalised care. I am asking things that have perhaps been asked before, but I am quite sure that the Minister will be able to reiterate and to assure us on that, and on the national stroke programme and the lessons learned and the changes that can provide better protection, raise awareness and ensure that we improve health for everyone in this great United Kingdom of Great Britain and Northern Ireland. I know that the Minister has no responsibility for Northern Ireland, but I look to her, as always, for a response to the queries we have all put forward. It is important, not only for me, as my party’s spokesperson on health issues, but for all of us to know that we are improving long-term care and help following strokes for those who need it.
Rachael Maskell (York Central) (Lab/Co-op) [V]
Thank you for calling me, Sir Edward. I extend my gratitude to the hon. Member for Bromley and Chislehurst (Sir Robert Neill) and wish his wife well on her stroke journey. I was a physio in the NHS for 20 years and worked in stroke rehabilitation, so I obviously know this issue well from a practitioner’s point of view. I echo much of what I have heard in the debate as the reality of clinical practice. During the course of the debate, about 12 more people in the UK will have had a stroke, which is why urgency in getting things right is so important.
Public health measures are absolutely crucial, because smoking and poor diet and exercise contribute extensively to the risk of having stroke. Above and beyond that, once somebody has entered that journey, we need to make sure that they get the optimum care. In acute care, thrombectomy processes are improving people’s chances of good recovery, which is fantastic, but a significant postcode lottery still loiters around that, which we have to address.
My first question to the Minister is therefore whether, as the NHS goes through significant change over the next couple of years, integrated care systems will be charged to set up their own clinical networks for strokes and to ensure that they have the specialism for that acute phase of stroke placed in each one and also spread through the network. It is really important that we bring this to the fore, and that, as the NHS changes, we make sure that the right services are in place.
All too often, as patients were discharged from my care, I would fret about where they went. If they went to a specialist rehabilitation centre, I knew that all would be well, but if they went to a more generalist step-down facility, or were discharged into the community, without that specialist input—speech and language therapists, occupational therapists, clinical psychology as well as neuro physio—I would worry. It is a specialism in and of itself; indeed, neuro physio diverts into stroke rehab. Making sure that people have the up-to-date specialist skills makes all the difference. They take a long time to train, but they change the way somebody with a stroke is approached.
One challenge I always found was the pressure to get people out the hospital door and discharged quickly. To actually re-educate somebody’s mind and body to synchronise and work together in a new way takes time, and therefore ensuring that there is that investment in time is really important. We also cannot push somebody because they become tired, so we have this really delicate balancing act of timing.
It is different for absolutely every patient, but as they go through that journey, they need that specialist support. I will give an example. They may be discharged home, but we know that so many people, once they go home, will just sit in a chair, as opposed to carrying on their rehabilitation. Or perhaps, even when getting up from the chair, they will take the short cut of pulling themselves up, increasing their muscle tone, which is detrimental, as opposed to, say, using a proper Bobath method of facilitating their muscles. That makes a real difference how this issue is approached, and therefore the paucity of stroke rehab specialists must be addressed, making sure that that skill mix is there, but also with the right level of training. That is crucial.
I ask for more training around stroke rehab for GPs and in the community in particular. A community physio may deal with respiratory patients, musculoskeletal patients, neuro patients. We want neuro physios in the community through an extension of specialist rehab centres moving into the community while keeping that clinical case load. We also want the same clinicians along a patient’s rehab journey. It is not easy for clinicians to relay information about a patient simply, so following them into the community could be a different way of doing that as opposed to the silos of our institutions that we currently see.
One other thing is really important. We know that stroke is for life, and therefore we need to ensure that the services are there for a substantial amount of time. I have raised the issue of the six-month review, which is far too long to wait—an individual may plateau or even regress in their care. Regular intervention is really needed and, if someone has plateaued or regressed when they could have been progressing, they should be brought back into more specialist care, even if that is residential care, to help them take that step forward again and get that continuity that is needed. If we do not put in those interventions, clearly the impairments experienced by someone will deepen, which will create pressures that will show themselves elsewhere in the NHS or the social care system. Therefore, that investment is so important for people as they are recovering from stroke.
There is clearly so much to be done. I really welcome the call for an APPG and would be happy to serve on such a group should it arise, but as we are currently reimagining healthcare, this is a real opportunity to put the patient’s need at the centre of a stroke service and ensure that we sustain that for the rest of their life.
Joy Morrissey (Beaconsfield) (Con)
I thank my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill) for securing the debate and you, Sir Edward, for allowing me to speak. Many hon. Members have spoken so eloquently about the problems of rehabilitation and post-stroke care. I must declare an interest: a close family member had a severe stroke over the last lockdown, and I can only describe the post-rehabilitation care as a hell that I would not wish on anyone. As an educated person, I understand the pathways—we have someone there to advocate full time for this person who has had a severe and debilitating stroke—the care pathways out of hospital, however, are broken.
I cannot praise enough the wonderful doctors and the nurses—Dr Joseph Kwan is an excellent stroke specialist—and I cannot say enough good things about the hospital care we now receive through the NHS and privately; it is wonderful. However, it breaks down in rehabilitation—the post-stroke care. As any doctor, OT or speech and language therapist will say, it is how intensive the rehabilitation efforts are in those crucial months after a stroke that will determine the outcome and recovery. In those first six months, a stroke patient will need intensive speech and language OT, physical therapy and perhaps the recovery of basic skills, depending on the severity of the stroke, but it breaks down as we simply do not have the workforce capacity to manage the needs of our population. It is not the fault of anyone. It is simply that we do not have the skillset at our disposal.
Will the Minister consider meeting me and a Department for Education representative to see whether we can have a strategic recruitment drive, perhaps starting in secondary schools, to encourage young people to go into professions such as occupational therapy, physical therapy and speech and language therapy or to become a district nurse, psychologist or neuro physical therapist? We need that specialist support in so many things, but we simply do not have the qualifications or the workforce available, and yet we have young people interested in science and interested in helping in their local community. What better way, as we are restructuring and bringing new changes to the NHS, to incorporate a recruitment drive that would allow young people to enter these specialist professions? We desperately need people in those professions, to help make the difference between someone dying a terrible and painful death in their home and having the additional support they need for a recovery to make their life liveable.
I praise and pay tribute to all the silent carers of covid, who have been helping their loved ones who have suffered a stroke, and who have had to negotiate through the care pathways alone. I thank them for everything they have done. I thank all the carers and health professionals who have done everything they possibly can during covid to help those who have been suffering in silence in their homes, in out-of-hospital care.
I ask that we look at strategic, long-term recruitment for these professions to meet the needs and demands of England, and that we look at how we can develop a much more joined-up and cohesive post-stroke recovery plan, because where the process also breaks down is where someone who is in a hospital in a local authority is discharged into another local authority, where the care pathway has to pass from one council to another and from one NHS trust to another. It is very difficult to maintain a pathway that delivers and communicates that, even to your GP, so those complex pathways tend to break down at the rehabilitation level. I ask that we look at having a stroke passport that those who have recovered might take with them—a physical copy that they can take to any healthcare professional, so that they can see their records and so that there is a clear understanding of where that survivor has come from. That would ease and speed the process of recovery as new carers take on the rehabilitation of that survivor.
I thank hon. Members for being here today and for considering the complex nature of the debate. I hope that we start an all-party parliamentary group—I would have to join as well—to continue raising this important issue in the House.
Justin Madders (Ellesmere Port and Neston) (Lab)
It is a pleasure to see you in the Chair, Sir Edward. I thank the hon. Member for Bromley and Chislehurst (Sir Robert Neill) for securing the debate and for his detailed introduction. He highlighted that there is increased awareness of the symptoms of strokes, and that acute care has certainly been on an upwards trajectory. The point that he made so eloquently and so personally was that there is still a long way to go on aftercare. He spoke of courage, patience and consistent professional care being needed, and that is something that we all want to see. A number of hon. Members added their personal perspectives to the debate. I believe we always do better when we hear those perspectives.
We also heard a professional perspective, from my hon. Friend the Member for York Central (Rachael Maskell), who set out clearly the importance of specialist services. The question she asked about the future of those in the new structures was very important.
As we heard from various Members, strokes are very prevalent in this country—100,000 a year, or one every five minutes. We also know that two-thirds of stroke survivors leave hospital with a disability, and it is the fourth-largest cause of death in the UK. It is perplexing, as the hon. Member for Bromley and Chislehurst said, that it does not get more of our attention. As my hon. Friend the Member for Stockport (Navendu Mishra) said, it is also something of a mystery why the level of research funding is not as high as in other areas, even before the challenges of the pandemic that all voluntary fundraising organisations have faced.
Members will know that the national priority in the NHS long-term plan is the national stroke programme. It is intended to deliver better prevention, treatment and care. It is an ambitious programme, but if it is to succeed, it needs adequate funding. I hope the Minister will be able to set out briefly how that funding is being allocated and what progress is being made to meet the targets and aims set out in the plan. A recent report by the Stroke Association found that thousands of stroke survivors are being let down—in various ways, as we heard in the debate, but particularly in the current provision of post-stroke support and rehabilitation.
The most recent Sentinel Stroke National Audit Programme data for April 2019 to March 2020 shows that only 41% of patients received a recorded six-month post-stroke review, and just over a third of applicable patients received recommended levels of physiotherapy or occupational therapy. Less than a fifth received the recommended levels of speech and language therapy. As hon. Members put it in different ways, those figures are clearly not good enough. It needs to be emphasised that that poor record is from before the pandemic.
There were concerns before the pandemic about the shortage of specialist stroke consultants. Figures from Kings College London showed that almost half of hospitals had a shortage of specialist stroke consultants, with 48% of hospitals in England, Wales and Northern Ireland having at least one consultant vacancy in the previous 12 months or more. To pick up on the comment by the hon. Member for Beaconsfield (Joy Morrissey), the Stroke Association called on the Government and NHS England to make stroke medicine a more attractive proposition for junior doctors to specialise in, as well as the other specialities, and drew attention to the need for nurses and rehabilitation. Can the Minister update us on the number of consultant vacancies and say what steps are in place to introduce a plan to deliver the staffing levels that we so clearly need?
It is clear, from what everyone said, that we need to go further and faster to provide support for stroke survivors. Further investment is vital to ensure equitable access to services, avoid digital exclusion and improve health outcomes, to stop the kind of disparities that we have heard about. We must end the postcode lottery. It is so important that, no matter where you live, you get access to the same quality stroke support services, which are consistent with clinical guidelines. I hope the Minister will address the issues that Members have raised, and will set out what steps the Government intend to take to support more survivors of strokes.
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
It is a pleasure to serve under your chairmanship, Sir Edward. I thank my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill) not only for giving us all the opportunity to discuss this issue, but for sharing his and Ann-Louise’s journey and experience. I wish her well in her future recovery, but he articulated very well what some of the challenges are, as did many other Members.
The debate has made clear how stroke touches so many lives. I can feel an APPG coming, and I would welcome it, because the Stroke Association is a fantastic charity which does great work, and I am sure that they will be listening and keen to support an APPG. I thank all those at the Princess Royal and all those—in Stockport and throughout the country—who work in stroke services in the acute sector and out in the community. As has been articulated, it is a team game to give people the proper, consistent support so that they can achieve the optimum recovery.
I am so pleased that the friend of the hon. Member for Stockport (Navendu Mishra) made a fully recovery, but as hon. Member for York Central (Rachael Maskell) explained clearly, using her vast expertise, why it is a different journey for different people. Some people need a much more needs-based approach, which is obviously where we hope to head. That will hopefully be music to the ears of my hon. Friend the Member for Beaconsfield (Joy Morrissey). I hope to assure the hon. Member for North Norfolk (Duncan Baker) that we, too, are driving services in his area.
I do not have many minutes to speak, so if there are further questions I will be happy to go over them with individual Members. We have made enormous progress but, as many hon. Members said, that progress still needs work. We need to do better and we need to go faster. One of the ambitions of the long-term plan is the inclusion of a national stroke programme that looks to improve services, including better rehab services and increased access to specialist stroke units through a flexible and skilled workforce. We heard more than once about the challenges on the workforce front.
The prevention and treatment of stroke is a key priority for the NHS. Despite the many challenges presented by covid, the stroke programme has continued to support regional delivery. In some areas, we have accelerated implementation because it is such an important area. As of 1 April, there are now 20 integrated stroke delivery networks operating to support the national stroke service model. Those networks have patient voices and public voices, which it is quite important to let everybody know, because this does need to be patient-driven, and people need to know that they are being heard. ISDNs bring together key stakeholders in stroke to deliver a joined-up, whole pathway transformation through the integrated care systems.
I am sure that my hon. Friend the Member for Bromley and Chislehurst knows that such an ISDN is now operational in his constituency. They will be responsible for delivering optimal stroke pathways based on best evidence, which he referred to. They will ensure that patients who experience a stroke and, so very often, quite debilitating outcomes from it, receive excellent care from pre-hospital, through to rehabilitation and then life after stroke.
There is good evidence that stroke units delivering hyper-acute stroke care 24/7 enable the NHS to achieve ever-improving outcomes. Receiving high-quality specialist care in well-equipped, well-staffed hospitals is the optimum, and 90% of stroke patients will receive care in a specialist stroke unit. More patients will have access to disability-reducing treatments of mechanical thrombectomy and thrombolysis; combined with increased access to rehabilitation, that will, hopefully, deliver long-term improvement and a more seamless pathway.
As we heard from my hon. Friends the Members for Bromley and Chislehurst and for Beaconsfield, navigation of all the different systems is really part of the challenge as well. My hon. Friend the Member for North Norfolk will be pleased to hear that Norfolk and Norwich is one of the new pilot areas for non-neuroscience centres that will work towards the delivery of thrombectomy.
Delivering the right treatment quickly will lead to the best outcomes. We see that with ischemic strokes: busting the clots has become increasingly effective using the right drugs and treatments. All stroke units in the UK can deliver intravenous thrombolysis. Early diagnosis by stroke specialists, followed by early thrombolysis, has been transformative in stroke care.
Thrombectomy is a procedure used to treat some stroke patients, and there is evidence that, where used appropriately, it will reduce the severity of disability. Thrombectomy is available in 22 centres, with two further non-neuroscience centres under development, of which the Norfolk and Norwich centre is one. The expansion of these services is in the long-term plan, with plans to increase the workforce who are able to perform the procedure. Owing to training requirements, that is currently restricted to neuroradiologists, which is a challenge, so we have worked with the General Medical Council to develop a credentialling programme. That will hopefully enable the acceleration of training to a wider cohort of medical professionals, such as radiologists, cardiologists and neurosurgeons.
On rehabilitation services, if the stroke patient has had a hyper-acute treatment they will need early therapy, as we have heard from so many hon. Members. That needs to be delivered by physio, speech and language therapist specialists, and should be accessible within 24 hours. We have heard of the challenges. Long-term rehabilitation is also best undertaken locally, so that people do not face the challenges of chasing around for the service—that also supports the family, who are often vital in a patient’s journey—and to enable the assessment of the appropriateness of homes by occupational therapists and others. We do not want reviews every six weeks, every six months and annually. We want reviews to be patient-led, which I think is what the hon. Member for York Central was driving at.
The integrated community stroke service model has been developed by clinicians, experts and charities, whom I thank for the help that they have given us. To ensure that evidence-based care is being delivered, we have worked with them to address the variation across the country, which is a problem. The stroke rehabilitation pilots mobilised in 2020 are implementing an integrated community stroke service that will enhance care path- ways, including psychological support and vocational rehabilitation. Recognising that everybody’s needs are different is very important, as is delivering personal, needs-based stroke rehabilitation to every stroke survivor, in their home or place of residence.
We have funded the Stroke Association during the pandemic to provide the Stroke Association Connect service. Stroke rehabilitation pilot sites are also testing improved data collection.
The hon. Member for Stockport will be pleased to hear that we have turbocharged research, calling for more research into stroke areas, because evidence-based research is really important. Building on the rehabilitation pilot initiative, we will launch the new stroke quality improvement for rehabilitation later in 2021. Working closely with integrated stroke delivery networks, that will help address variation. Combined with funding for quality improvement projects and expansion of community data, we will then expand. In addition, the national stroke service model, due for publication in late spring, will support that service. The Government have initiated the biggest recruitment drive for allied health professionals in decades, including speech and language therapists and occupational therapists.
I want to give my hon. Friend the Member for Bromley and Chislehurst a couple of minutes to respond, but in conclusion, I hope I have demonstrated that this is a serious issue. I know the stroke community will have heard our discussion. I would welcome the opportunity to discuss the subject more fully, when there is time for me to go over some of the developments and ambitions we have to ensure that we impact the lives of people with strokes. We can give them significant benefits, we can benefit the NHS and, as my hon. Friend said, we can bring people back the best way that we can.
Sir Robert Neill
I am grateful to all hon. Members who have participated in the debate. I know that time is short. I am grateful to the Minister for the tone of her response. We will want to press her, in the most constructive way, on some of the detail of the funding, how we actually get the nuts and bolts done and how we deliver services on the ground. The aspiration is clearly there—we all share it—but we want to see that delivered. We are very happy to work with her on that; perhaps we can speak offline on how we might be able to achieve that.
I am grateful for all the expertise and the experience that hon. Members have laid out. I conclude by thanking everyone who takes an interest in stroke care, above all the carers. We ought to remember the informal carers—the families—who do so much, as well as the professionals. They need their recognition at the end of this debate too.