Westminster Hall

Tuesday 6th September 2022 Westminster Hall

Tuesday 6 September 2022

[Mr Philip Hollobone in the Chair]

Unavoidably Small Hospitals

Tuesday 6th September 2022 Westminster Hall

09:30

[Mr Philip Hollobone (in the Chair)]

Welcome to Westminster Hall, and to the debate on unavoidably small hospitals. I call Bob Seely to move the motion.

[Bob Seely (Isle of Wight) (Con)]

I beg to move,

That this House has considered unavoidably small hospitals.

Thank you very much, Mr Hollobone; as ever, it is a pleasure to serve under your chairmanship. I thank the Minister for being here, and I wish her luck in any coming reshuffle. I also thank colleagues from Yorkshire, Devon, Cornwall and other parts of the United Kingdom for being here. Indeed, we have two Members from Yorkshire—my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) and my right hon. Friend the Member for Richmond (Yorks) (Rishi Sunak). It is a delight to see them both. I saw one quite recently on the Isle of Wight, but sadly not both.

The debate was originally granted prior to the covid pandemic. Clearly, much has changed since then, but I also wonder whether the fundamentals of unavoidably small hospitals have changed. The reason why I called the debate back then, and why I want it now, is that I fear they are still the poorer cousins of larger district general hospitals.

I will make two points. Clearly, I am going to talk specifically about St Mary’s Hospital on the Island, because it is in my constituency, but there are broader points to be made about unavoidably small hospitals throughout the United Kingdom. I want specifically to ask the Minister to put as much information as possible about the funding processes for unavoidably small hospitals in the public domain. We were talking prior to the debate, and she said that some of that information rests with the new integrated care boards. That may well be the case, and that is fair enough, but they are not elected bodies. We know that the NHS can be rather top down and bureaucratic in some of its behaviours, and the more information she can put in the public domain to help Members with unavoidably small hospitals understand the situation, the better.

Before I address that further, let me put on record my thanks not only to staff at St Mary’s but to GPs on the Isle of Wight and their staff, and to the pharmacists, the dentists and all the staff in care homes, who do a no less valuable job. Some of the problems we are facing are because of a lack of integration with our adult social care system; the inability to find a home for the elderly and vulnerable that that system looks after puts additional pressure on hospitals.

Let me also put on record my thanks to the Government for the £48 million additional capital spending on the Island. Indeed, I suspect that the former Chancellor, my right hon. Friend the Member for Richmond (Yorks), deserves thanks for that, as well as for the fair funding formula reference for the Isle of Wight. I am delighted and very grateful that he did both those things. That £48 million was part of getting a better deal for the Island, which is clearly an ongoing project.

In England and Wales, there are 12 unavoidably small hospitals, which are defined as hospitals that, due to their location and the population they serve, and their distance from alternative hospitals, are unavoidably smaller than the “normal” size of a district general hospital. In the Isle of Wight’s case, we are about half the size—about 55% to 60%—of the population needed for a district general hospital.

I would argue that the pressures on these small hospitals are greater than elsewhere. They are smaller, so they are more easily overwhelmed due to their size, and they are under greater economic pressure, because the NHS funding model—we recognise that there has to be a funding model—is designed for an average-sized, “normal” district general hospital, rather than an undersized one. You cannot give birth on a helicopter or a ferry; on the Island, we need to run our maternity services and our A&E 24 hours a day, seven days a week. However, our income is based on national tariffs that do not equate to the size of our population. As the Island’s trust says,

“the Island’s population is around half of that normally needed to sustain a traditional district general hospital.”

The third pressure on unavoidably small hospitals is because they exist outside of major population centres. Without a shadow of a doubt, they are in some of the loveliest parts of England and Wales, but because they are outside of those major population centres, recruitment and retention of staff becomes more difficult, which adds pressure on the staff who are there and adds costs in terms of locums and agency staff, which can have a highly significant effect on budgets. Ferries aside—with the partial exception of the Scilly Isles—the pressures at St Mary’s on the Isle of Wight are shared by other unavoidably small hospitals. I think that helps to explain why, in the last decade, a number of unavoidably small hospitals have been put in special measures or have sadly failed, despite the best efforts of those people who work there.

Our hospital, St Mary’s, is classed as 100% remote, which is unique even by unavoidably small hospital standards, because it is accessible only by ferry—although, as far as I can see, accessibility by sea is not a factor in the definition of an unavoidably small hospital. On the Island, our need for healthcare is arguably higher than elsewhere in the United Kingdom. We struggle to get the national standard, but our need for that national standard is greater because over a quarter of our resident population is aged over 65 and, by 2028, over-65s will be one third of the population. Indeed, we have a particularly large cohort of 80 to 84-year-olds.

All the evidence and common sense suggests that that has a disproportionate effect on healthcare: older people, and especially the very old and frail, need healthcare more than young people. We on the Island are struggling—as, potentially, are other USH areas—to provide quality for that ageing population. In addition, the Island’s population doubles over the summer, because we have lots of lovely visitors. That impacts demand, which means that our A&E can be close to overflowing at times, even as efficiently run as it is.

I suggest that there is an additional factor: the impact of high levels of social isolation. People retire to the Island as a couple and one sadly dies, leaving the other isolated from family and social networks because they lived most of their life in other parts of the United Kingdom. That leads to increased reliance on statutory services.

All this has been noted. The former Health Secretary, my right hon. Friend the Member for West Suffolk (Matt Hancock), confirmed his concerns to me in July 2019, telling the House:

“As for Island healthcare costs, my hon. Friend is right to say that the Isle of Wight is unique in its health geography, and that there are places in this country—almost certainly including the Isle of Wight—where healthcare costs are”—[Official Report, 1 July 2019; Vol. 662, c. 943.]

increased.

I am not saying that we are the only place like that. There is isolation in other parts of the country, including Yorkshire, Cornwall, Devon and Cumbria, but in the Island’s case the situation is cut and dried because of our separation by sea from the mainland. In its January 2019 sustainability plan, the Isle of Wight NHS Trust estimated that the annual cost of providing a similar—I stress to the Minister that this is the critical element—standard of healthcare and provision of 24/7 acute services, including maternity and A&E, on the Island to that enjoyed by mainland residents would be an additional £9 million. These are 2019 figures.

The estimated cost of providing additional ambulance services, including coastguard helicopter ambulance services, was about £1.5 million. In the Scilly Isles, patient travel is funded out of the clinical commissioning group—now the ICB—budget. Ours is not. Our patient travel budget comes from ferry discounts and council contributions, and it was estimated to be £560,000. In total, one is looking at between £10 million and £12 million at 2019 figures.

Either because they were going to do so anyway or, hopefully, because of representations from myself and others, the Government have recognised since then that unavoidably small hospitals need a funding model that serves them, because there is no alternative but to keep those hospitals open to serve those populations in a way that is ethical and, frankly, legal nowadays.

I am proud of our efforts to highlight the plight of unavoidably small hospitals to the Government, and I thank them for listening and for trying to put in place a package of support for them. I say to the Minister that this is where I would welcome more facts being put in the public domain. I have trawled through NHS documents for the last couple of days, and the last figure I can see for the unavoidably small hospital uplift for St Mary’s on the Isle of Wight is that from 2019, when we received £5.3 million. That is roughly half of what we think we need to run a national level service, so we are grateful that the Government have recognised the need for an uplift for unavoidably small hospitals. Will the Minister please update me on how much money St Mary’s has had as an unavoidably small hospital since 2019, given that we have clearly had issues with covid?

According to page 13 of the NHS “Technical Guide to Allocation Formulae and Pace of Change” for 2019-20 to 2023-24, that money was given in 2019 due to

“higher costs over and above those covered by the”

market forces factor. I cannot see other figures in the public domain. I do not quite understand how the Government could calculate that figure in 2019 when the advisory committee said in January 2019 that it was

“unable to find evidence of unavoidable costs faced in remote areas that are quantifiable and nationally consistent such that they could be factored into allocations”.

That is from the NHS England document “Note on CCG allocations 2019/20-2023/24”.

The Government say that they cannot work out how much extra to give unavoidably small hospitals, while at the same time a different NHS document says, “We are going to do some calculations, and here is the rough calculation.” Can the Government work out the additional costs or can they not? They are basically saying the same thing in two separate documents.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

I congratulate my hon. Friend on securing this important debate. May I give an example of how the Government might calculate the figure? A hospital in my constituency in Scarborough is run by the York and Scarborough Teaching Hospitals NHS Foundation Trust, which tells me that it has to pay extra to get consultants to travel to Scarborough and stay overnight, as well as paying their hotel bills. However we factor this stuff in, we have to be able to make a calculation that allows those trusts properly to fund these hospitals.

[Bob Seely]

I thank my hon. Friend for that valuable intervention. We have exactly the same problem. I will come on to how we are trying to solve it, but we have the same issue getting consultants over from Portsmouth, although we are very close to Portsmouth and Southampton. It is difficult for a consultant with a speciality to work in a small NHS trust, because there is no opportunity to practise that speciality effectively enough to keep their ticket to do their very valuable and worthwhile job.

Although I am delighted that the previous Conservative Government recognised the additional costs and gave the Isle of Wight nearly £50 million in additional capital expenditure, my trust assesses that the funds given are roughly half what is needed. I stress that we are not just sitting on the Island saying, “We want money.” We understand that we need to sort out these problems for ourselves. Our trust was in special measures and is now rated good, due to some fantastic hard work by Maggie Oldham and other health leaders, who have come in and turned our hospital around, really helping to make a difference. I thank everybody, from the cleaning staff to the most junior nurse and the most junior doctor, for the great work they have done.

We are now rated good and have been looking at ways to provide better services on the Island, without just waiting for the Government to provide funding. We are integrating. We have deepened our relationship with Portsmouth general hospital, our university hospital, the idea being that when it hires a consultant, we share that consultant for 10% or 25% of their time. A world-leading consultant in an area of medical expertise will therefore spend some of their time looking after folks on the Isle of Wight.

We have reformed our mental health services, and we are reforming our ambulance service too, to ensure that we have more ambulances out there to treat more people, more quickly. Along with everywhere else, we are integrating adult social care as part of the Government’s plans. We want to be pioneers in that. Because of our age demographic, we want to be at the front of the queue. I have sadly learned that, if the Island is not first, it tends to be last, because it comes as an afterthought. I always want to ensure that the Island gets to the front of the queue, so that when the Government look to test pilot schemes, they come to us first.

We are looking at chances to pilot new schemes. We did it with Test and Trace, and we are adopting telemedicine as fast as we can. We are working with the University of Southampton to pilot using drones to deliver cancer care. The drone testing started during covid and, as of a couple of months ago, it is now a regular service that brings just-in-time cancer medicine to the Isle of Wight. That is a really good way to see that advanced technology is helping folks on the Island and, indeed, helping the NHS to provide a better-quality service.

I will round up, as I am mindful that other people want to speak on this issue and it is important that the Minister hears other voices. In January 2019, the NHS long-term plan set out a 10-year strategy for the NHS in England. For smaller acute hospitals such as St Mary’s, the plan stated that the NHS will

“develop a standard model of delivery”.

It would be great to hear from the Minister what has happened to that plan for a standard model of delivery. Is that now the funding formula that is included in the new integrated care boards? If so, will the Minister please outline how that funding formula works and is calculated, as my hon. Friend the Member for Thirsk and Malton and I have asked? It is in the public interest that the formula is as transparent as possible.

Will the Minister please explain why, if someone travels from the Scilly Isles to the mainland for care, it is paid for out of a central budget? If someone has prostate cancer or another form of cancer, they often need to be treated in Portsmouth or, occasionally, Southampton. That funding does not come from the Government. Why is that? Why is there a double standard that affects the Isle of Wight negatively?

Finally, the Minister mentioned before the debate that the funding formula details are held by the new integrated care boards. For the 20 Members of Parliament in England and Wales who are within the remit of an unavoidably small hospital, those figures should not be held at ICB level but should be shared between Ministers and interested Members, so that we can all see how these very important institutions in our communities are funded. By doing so, I hope that we can increase the funding for them or at least increase the Government’s understanding that just because such hospitals are the smaller cousins of larger district general hospitals, they should not be treated worse but should be given extra care and attention to make sure that folks in our communities can have the same standard of care as other people throughout the rest of England and Wales.

[Several hon. Members rose—]

[Mr Philip Hollobone (in the Chair)]

Order. The debate can last until 11 o’clock. I am obliged to call the Front-Bench spokespersons no later than 10.37 am, and the guideline limits are 10 minutes for Her Majesty’s Opposition and 10 minutes for the Minister. Bob Seely will then have two or three minutes at the end to sum up the debate. There are six highly distinguished colleagues seeking to contribute. I do not wish to impose a time limit, but if everybody limits their remarks to eight minutes, everybody will get in.

09:48

[Jim Shannon (Strangford) (DUP)]

May I say what a pleasure it is to speak in this debate? I thank the hon. Member for Isle of Wight (Bob Seely) for raising the issue for his constituents in a commendable way and with passion. He has illustrated the necessity of having a good local hospital or small hospital, as the title of the debate suggests. I share his concerns about St Mary’s Hospital in his constituency, which is completely isolated by water. It is of major importance that, for the sake of his constituency, his local hospital is funded correctly, to encourage people to use the services available there and to enhance those services, as the hon. Gentleman has suggested. I was pleased to read about recent plans to innovate and improve the service at St Mary’s; it is great to be back in Westminster Hall, in this parliamentary term, to discuss that.

May I say how pleased I am to see the Minister in her place? She has a real understanding of health issues and I am sure her response will encourage us all, and particularly the hon. Member for Isle of Wight. I am also pleased to see the shadow Minister, the hon. Member for Enfield North (Feryal Clark), in her place and look forward to her contribution.

I always give a Northern Ireland perspective: the title of the debate is “Unavoidably Small Hospitals” and I certainly have one of those in my constituency. The importance of that hospital should never be underestimated. Back home in Northern Ireland, most of our major hospitals are in the County Antrim area, near Belfast city, where the majority of the population tends to live. In my rural constituency of Strangford we have two hospitals. The main hospital in Ulster is on the edge of my constituency. It is the biggest hospital and is very important because it provides acute services and can take in almost every emergency that comes its way. The other hospital, Ards Community Hospital, is in Newtownards, where my main office is. It used to be a major hospital, but things have changed in recent times. Hospitals have centralised their services and many services that used to be provided by Ards Community Hospital have moved to the Ulster Hospital.

My three boys—they are now young men, are married and have their own families—were all born at Ards Community Hospital, so I have a fondness for that hospital and for Adair House, as the maternity section was then. The hospital has changed—I understand why—and we now have a hospital that is not able to provide all the services that it once did. I want to put on record, as the hon. Member for Isle of Wight did in respect of his local hospital, my thanks to all the staff at Ards Community Hospital, the Ulster Hospital and elsewhere for their commendable and industrious work, their energy and passion, and their commitment to making lives better. That is something we can never fully understand, but we do understand that the part they play is so very important.

I understand the arguments about isolation, in terms of both where the hospital is situated and where my constituents live. To receive some services, my constituents are referred to the bigger hospital—the Ulster Hospital—where a significantly larger number of services are available, including a cancer centre. That is very important to us in Northern Ireland, where cancer impacts nearly one in every two people, just as it does in the rest of the UK.

For my most rural constituents, in villages such as Portaferry and Cloughey on the Ards peninsula—I live between Greyabbey and Kircubbin, but they live even further down the Ards peninsula—patients seeking medical care must have the reassurance that their nearest hospital can provide them with at least a basic assessment and service, despite the size of the population where they reside. That emphasises the importance of properly funding smaller hospitals such as Ards Community Hospital. Although I understand that our health services are devolved and therefore not the responsibility of the Minister present, the principle of health treatment is the same across the whole of the United Kingdom. Hopefully, I will be encouraged by what the Minister says and can send a copy of the debate to the Minister in the Northern Ireland Assembly to ensure that they take these matters on board.

I make a plea for the air ambulance, which I asked a question about in yesterday’s statement on urgent and emergency care. In Strangford, the air ambulance deals with life and death situations every day and is so very important for our rural community. Last year, Air Ambulance Northern Ireland had its busiest year ever.

In respect of per head services, we can never predict how serious any incident may be, but I believe that we underfund smaller and more remote hospitals because of that factor. In my constituency, we have to take into account both the fishing village of Portavogie, which is an economic and industrial centre, and the many remote places across the Ards peninsula from which it is just as critical to get to a hospital in time. There are also issues with the cost of medical services, based on the location of the hospital. That means that smaller and more isolated hospitals in certain areas face higher costs due to the decreased likelihood that a particular service may be utilised.

The community services formula, which was introduced in 2019 and to which the hon. Member for Isle of Wight referred, recognised that some rural and coastal areas tend, on average, to have an older population, which means there are higher needs for community services. In the Ards peninsula, the population of older people is growing. Many people come from other parts of the Province and move out to rural villages where houses are perhaps that wee bit cheaper so they can use the money they have to buy a house. They look on the area as a place where they will be for the rest of their lives, so the numbers of elderly people are increasing in my constituency.

The need for community services was assessed in England, and I encourage the Minister to engage with Health Minister Robin Swann back home on a similar strategy for Northern Ireland, to enable improved district healthcare for communities. I would be indebted to the Minister if she would take that forward. I will do my bit, but maybe the Minister might be able to do the same with the Minister in Northern Ireland. What I love about these debates is that we can all share things from all parts of this great United Kingdom of Great Britain and Northern Ireland, and we can use those things for the betterment of us all. Today’s debate does just that.

In the short time I have left, let me say briefly that in rural areas there tends to be less access to public transport in the evenings, which exacerbates the problems with the use of hospitals. Our own local hospital and other smaller hospitals may not even be open at certain times, and sometimes not until the early morning. It is crucial that that is taken into account in the funding of smaller hospitals.

To conclude, I echo the comments of the hon. Member for Isle of Wight, who introduced the debate, and very much look forward to the contributions of others. We must ensure that small hospitals are properly funded, for the sake of our constituents, friends, families and loved ones, and avoid the clear delays in funding opportunities. The NHS is a wonderful service. We depend on it and it must be protected. We must also give thanks and gratitude to all nurses and healthcare workers in our small hospitals who do their very best to work with what they have available and to ensure that our people—our constituents—are looked after in the healthy way that they deserve.

09:56

[Kevin Hollinrake (Thirsk and Malton) (Con)]

It is a pleasure to speak in this debate with you in the Chair, Mr Hollobone. I thank my hon. Friend the Member for Isle of Wight (Bob Seely) for tenaciously following up on this very important issue, which I and my right hon. Friends the Members for Scarborough and Whitby (Sir Robert Goodwill) and for Richmond (Yorks) (Rishi Sunak) have been following closely over the years.

My hon. Friend concluded in exactly the right place. The issue is not hard numbers in terms of cash, deficits or whatever; this is about patients and patient care. We have experienced two challenges in respect of Scarborough Hospital and the Friarage Hospital in Northallerton in particular. Yes, as my hon. Friend set out, there is the issue of funding and the extra costs of delivering services in places such as Scarborough, but there is also the fact that these hospitals are run by trusts that run a number of hospitals, and the small hospitals are, of course, not necessarily their largest hospitals. Because the trusts are faced with the extra costs of running the smaller hospitals, there is a natural tendency for them to try to centralise care in one of the other hospitals. When they talk to the public—they tend to talk to their customer base before they make changes—they ask them, “Would you be prepared to travel for better health outcomes?” Who would not say yes to that? Of course! But it is a leading question.

I have a couple of examples of how it works in practice. A number of my constituents have written to me. One of them had to go to York Hospital from Scarborough. They did not have transport—they did not have a car—and they had to go for an appointment at 7.30 in the morning for treatment for a brain tumour, and were then discharged at 11 o’clock that night, without transport. It is not just that people have to travel for extra care and that they are deprived of local care for treatment that would have been available at Scarborough at one point; it is the fact that there is no real consideration of some of the challenges of living in a rural area. Some of my constituents have had to travel to York from Scarborough on the east coast—from Filey in my patch—to stay in a hotel overnight because there is no public transport to get to early morning appointments in York Hospital. Those are direct consequences of centralisation.

[Bob Seely]

The problem is clearly significant in my hon. Friend’s patch, but does he understand that when people are separated by sea from the mainland it becomes an even greater problem? There are even greater logistics if people need a car and then a ferry to the bus and so on.

[Kevin Hollinrake]

My hon. Friend is absolutely right. His challenge may be even greater than ours in rural parts of North Yorkshire.

Centralisation is a natural tendency for any organisation, of course. A person sat in a larger hospital in York will think, “Let’s have all the services over here. It is easier and cheaper to employ consultants over here.” Centralisation is easier, but it is much worse for patients. It is not fair on them, given the complexity of travel and the effect on local communities.

The principal trust that runs the hospitals in my area is the York and Scarborough Teaching Hospitals NHS Foundation Trust, which runs Malton Community Hospital, Scarborough General Hospital and St Monica’s Easingwold, which is a small cottage hospital. It is easier for the management to centralise things, and it is cheaper, given that it is more expensive to provide healthcare in more remote locations. I said earlier that because remote hospitals have difficulty recruiting people, they tend either to close services down or provide additional remuneration for the consultants who work there, so there is a double whammy of cost.

The other issue in my constituency is that it is 40 miles from Scarborough Hospital to York, and on a good day it takes an hour to travel on the A64 all the way to York as it is a single carriageway for most of its stretch and is often logjammed with traffic. The dualling of that carriageway has been the subject of many pleas to the former Chancellor, my right hon. Friend the Member for Richmond (Yorks), and many others, and hopefully we will get that in the not-too-distant future. This is serious stuff, of course, for anyone who needs emergency treatment.

The stroke unit at Scarborough was relocated to York some time ago, so if someone has a stroke in Scarborough, they have to get to York, and they might be in an ambulance for two hours on that road. It is unfair. I understand that they may get better treatment at the hyper-acute stroke unit at York, but nevertheless there are potentially direct impacts on people’s healthcare when services are centralised in distant locations.

It is not just stroke care that has been centralised in other hospitals, but outpatient physiotherapy, dermatology and pain clinics. Breast cancer oncology was moved away from Scarborough some time ago owing to the difficulties of recruitment. It is easier to employ consultants in a hospital that has more money than to incentivise them to go to more remote locations. The A&E unit at the Friarage Hospital in Northallerton, in the patch of my right hon. Friend the Member for Richmond (Yorks)—he will talk more about it—was downgraded to urgent care treatment, and we were told that one of the reasons was that it was difficult to recruit anaesthetists.

Services are being closed down. The Lambert Hospital in Thirsk in my constituency, which provided respite and elderly care, was completely closed down because it could not recruit in that location. Our suspicion was that the trust did not really try all that hard to recruit people because it is more difficult to run services in remote locations.

On costs, I can give my hon. Friend the Member for Isle of Wight a direct comparison. When the York and Scarborough Teaching Hospitals NHS Foundation Trust took over Scarborough back in 2012, it was given £10 million a year for the extra costs of providing services in that location. That ended in 2018. A small amount has been provided to make up for the loss of £10 million—£2.6 million of funding through the clinical commissioning group—but, as a consequence, services are diminishing.

There is some good news: my right hon. Friend the Member for Scarborough and Whitby and I campaigned, and the Health Ministers were very supportive. There has been £40 million of extra investment in the A&E at Scarborough, but nevertheless there are some real concerns about the services, which are reduced as a consequence of underfunding. I would like to hear from the Minister exactly what we are doing about it now and what we will do in the future to improve the situation.

10:04

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It is always a pleasure to serve under your chairmanship, Mr Hollobone. Although I may be a Liberal Democrat, if I lived on the Isle of Wight I could be tempted to vote for the hon. Member for Isle of Wight (Bob Seely), because he is assiduous in the pursuit of issues that are important to his constituents. He has repeatedly raised the issue of St Mary’s, and he has my every sympathy.

When listening to the contributions so far, I could have shut my eyes and imagined that I was standing on the high street in Wick, in the far north of Scotland—the far north of this United Kingdom—because the issues are the same there as have been outlined. Recruitment and retention is the deadly issue in the north of Scotland, much as it is on the Isle of Wight. I will say, as the hon. Member for Strangford (Jim Shannon) said, that health is devolved; as he also said, health matters to everyone in the United Kingdom. What I am about to say about the situation in my own constituency is pertinent to the rest of the United Kingdom.

Some years ago, Caithness General Hospital in Wick had a consultant-led maternity service. There was a battle to retain that and it was won by the local people. More recently, the highland health board, NHS Highland, used retention and recruitment as the reason not to have consultants located in the far north of Scotland and to downgrade the service to a midwife-led maternity service. That means that mothers have to travel more than 103 miles from Wick to Inverness to give birth. In the middle of winter, if the A9 road blocks, which it does on occasion, and the air ambulance has been called to a road traffic accident somewhere in Morayshire or West Sutherland, then what is going to happen? We are faced with a very dangerous situation indeed. I give credit to the NHS in Scotland: at long last a dialogue has started between the residents of Caithness and Sutherland and the powers that be. I hope that dialogue will eventually be fruitful.

The point has been made that there is an additional cost for locums—the stand-ins and so on. That is absolutely true, and it hits us as much as it hits the Isle of Wight or Yorkshire. There is also an issue whereby the change of locum and personnel can be disadvantageous to the patient, because they have to go back through the same old story with a new person—the patient tends to repeat themself. In the highlands of Scotland, that issue is particularly acute on the mental health front. I have heard horror stories of people having to see a variety of different professionals and repeat themselves again and again before anything can be done. That is extremely worrying.

The solution is partly money. Like the hon. Member for Strangford, I urge the Minister, or Her Majesty’s Government—as they run the health service in England—to exchange best practice, as and when we have it, with the Scottish Government. We can learn from each other about how things can best be done.

I have outlined the mental health issue. There is a final point. The hon. Member for Isle of Wight made the point that there are double standards. It was recently proposed that the maternity service in Morayshire, which is based in Dr Gray’s Hospital in Elgin, in the constituency of the leader of the Scottish Conservatives, the hon. Member for Moray (Douglas Ross), should be downgraded. There was a huge outcry about that and the Scottish Government eventually said they would look again at the situation and see whether there is a solution whereby people do not have to travel from Morayshire to either Inverness—a distance of 38 miles from Elgin—or Aberdeen.

That sits ill with what I have just described in Caithness and Sutherland. The distance from Wick to Inverness is 103 miles, yet the Scottish Government have not agreed to look again at maternity services. However, there is a dialogue now—thank heavens. I pay tribute to Caithness Health Action Team—known as CHAP locally—and to one councillor in particular, Ron Gunn, and his colleagues, who have been absolutely instrumental in ensuring that this issue is never off the top of the agenda.

It is a fact that every citizen of the United Kingdom should deserve an equal right to health services, regardless of where they live. It is a fact that unavoidably small hospitals in England face the same problems as hospitals of the same size in Wales, Northern Ireland and Scotland. The bottom line is that health matters hugely to us all. I sincerely hope that the new members of the UK Government, both in the Cabinet and as junior Ministers, can look at the issue as a matter of absolute urgency. My telephone is always switched on. Ministers can call me, and I will again and again bang the drum on behalf of my constituents in Caithness and Sutherland, who deserve rather better than they are getting at the moment.

10:10

[Selaine Saxby (North Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone, and I thank my hon. Friend the Member for Isle of Wight (Bob Seely) for securing this important debate.

My hospital is the second most remote on the list, and the most remote on the UK mainland. Obviously, as the representative of North Devon, I would not have to go to hospital by boat, although constituents of my neighbour, my right hon. and learned Friend the Member for Torridge and West Devon (Sir Geoffrey Cox), who live on Lundy do go by boat or fly to hospital. Most of my constituents in beautiful North Devon travel to hospital on a road that is described as the longest no-through-road in the country, and we are not only rural, but coastal. As Professor Chris Whitty has highlighted, coastal communities’ health outcomes are particularly poor.

I want to thank the fantastic team at North Devon District Hospital. They are remarkable, and I am delighted that the Minister has had the opportunity to come and meet some of them. We visited the first covid catch-up ward in the country. My hospital might be small, but it is pretty perfectly formed. It was the recipient of £1.9 million last December for a covid catch-up elective ward, which was opened in time for the jubilee. It is named the Jubilee ward and the staff are conducting—seven days a week—hip and knee replacement surgery with most patients going home the same day. That is a truly remarkable achievement, which was delivered by some of the Nightingale teams.

I made a plea to the Minister then that I will repeat today. My hospital is highlighted as one of the 40 that are due a rebuild. The plans are written, this is a modular build, and the team have demonstrated that they can deliver on time and on budget. They can also show the need for the improvement to the facilities at the site, so, if the Minister is not in post next week—I very much hope she is—will she leave a note on the way out to let people know that North Devon District Hospital is ready to start the building programme if the funds are released?

The facilities team at North Devon—owing to the size of the hospital and the problems with issues that have been spoken about, such as recruitment and retention, as well as the fact that the site is in need of work—is innovative and creative. We are fortunate to have linked up with Exeter, and in many ways that link has secured the site. It gave us the opportunity to establish virtual wards, which are now running, so consultants from Exeter and North Devon can share the patch among them. However, the age profile of the population, which has been mentioned, changes the nature of the hospital—for example, there is more demand for certain services, and less demand for others, such as maternity, which are used much less. Therefore, it is much harder to attract consultants in some of the specialisms.

My hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) spoke about distance to be travelled, and in North Devon people make choices about their cancer treatment based on the distance they would have to travel. Most people have to travel 60 miles to Exeter Hospital, and if they have to travel daily or weekly for radiotherapy, a journey of 120 miles might be a choice they decide not to make. As we look to how to tackle the issue of health outcomes in remote rural communities, I hope we can ensure that patients have access to the best care, rather than the care nearest to them.

The rurality of North Devon is a driver in the struggle people have to come and work there: we had a recruitment issue in North Devon long before the pandemic, and one nursing post in five is now vacant. Not only is it hard to get to North Devon; it is hard to move and live there. My hon. Friend the Member for St Ives (Derek Thomas), who represents the Isles of Scilly, and I spend a lot of time talking about housing and the housing challenges in the south-west of England, and we find that it is almost impossible to buy a house in North Devon. The rental market has also collapsed, so it is near impossible for public sector workers and those who work in many other jobs, such as hospitality, to move there.

That situation is now overlaid by the situation in social care. My fantastic hospital has more beds full of patients who could go home than it would normally have at this time of year. That is not because the social care teams in North Devon are not also fantastic, but it is just very hard to recruit, and the costs of providing social care have escalated hugely with the increased costs of energy. For those fantastic teams who travel around and look after mostly elderly people in their homes, the cost of getting there has now shot up. There are also the issues around recruitment, and we are paying far more in that sector to attract and retain those great individuals who do such valuable work.

[Jamie Stone]

The hon. Member is making a very good speech indeed. Does she agree that it might be a good idea to revisit the taxation regime that covers the remuneration for mileages for some health workers who have to drive? They have been penalised rather and perhaps the number of miles could be raised. It would not attract taxation.

[Selaine Saxby]

Indeed, I agree in many ways. My right hon. Friend the Member for Richmond (Yorks) (Rishi Sunak) and I had similar conversations in a previous life. Much could be done, and personally I want to give social care workers electric cars, so they are taken out of that and can decarbonise at the same time.

As the new Administration comes in, I hope that there will be some revisiting of how to tackle the challenges of social care without the ringfenced money if that plan is to go ahead. We need to look after everybody who is unwell in our society. When visiting a social care organisation over the recess, it was frustrating to hear that they have the work for so many extra people. They can recruit internationally and they are. They advertised six jobs and overnight they had 70 applicants. They could take all 70, but there is nowhere for them to live. Until we in northern Devon find a way to address our housing challenges, I will work tirelessly here to tackle them. As a community, we need to find a way to ensure that people who need to work and live in our community can afford to do so before the situation gets worse as we head into the winter.

Talking about the winter and seasonality, I want to highlight the remarkable work that goes on within A&E at North Devon District Hospital. Unlike many hospitals that have a big winter peak, my population increases fivefold during the summer months. My A&E is busy all year round, which has its benefits in that we do not have those peaks and troughs, but I am not sure that the funding truly reflects the seasonal influx of those visitors and the changes. Obviously, the injuries people secure on a beach are quite different to the issues that affect my elderly population. I think there is some work to be done to understand the rurality, seasonality and locality of the fabulous North Devon District Hospital. My parting comment to the Minister is that quick reminder that we are one of the 40 and we are ready to go.

10:17

[Derek Thomas (St Ives) (Con)]

I thank my hon. Friend the Member for Isle of Wight (Bob Seely) for securing this important and timely debate. As I represent a set of small islands myself, it is good to have him banging the drum with me on so many shared issues.

We understand the urgency of the subject. We have pretty much all just come back from beautiful parts of the United Kingdom—fantastic parts of the world—but they have particular challenges and sometimes there are not enough people to justify the Government’s funding formulas. We understand the pressures on urgent care, such as the ambulance delays that none of us are hidden from. My urgent care hospital has around 160 people there who have no medical need whatsoever. There is a backlog because of covid and also housing, which was mentioned in the previous speech.

The massive pressures on our bigger hospitals in the urgent care system—in my case, that hospital is in Truro—are eased by the existence and support of smaller hospitals. The debate is not only about small hospitals, but about how critical they are in helping the whole of the NHS and social care system to provide for communities, so that when we say healthcare in the right place and at the right time, we actually mean it.

Along with the others who have already thanked their nursing staff, I want to thank the NHS staff in my three small hospitals: St Mary’s on the Isles of Scilly; Helston Community Hospital—when I was a child it was Helston Cottage Hospital—which is a brilliant outfit that we spend far too little time talking about; and West Cornwall Hospital, which is an urgent care setting in Penzance that provides an important set of services to avoid people going to the centre of Cornwall. The pressing issue right now for these small hospitals is access to the NHS care workforce. The problem we have with small hospitals is that for them to fully function we need a wide range of disciplines and, as we heard earlier, that is difficult to find when the bigger hospitals try to put all their services in one central place. I understand and agree with everything that has been said so far. However, I particularly want to raise the issue of capital funding because for all the pressures and concerns about urgent care hospitals we have heard from constituents over the recess, some could have been eased if the capital programme had moved just a bit quicker.

We heard that one of the 40 hospitals is in the constituency of my neighbour my hon. Friend the Member for North Devon (Selaine Saxby). A £9.1 million fund was promised in 2019—two Prime Ministers ago now. The building work is ready to go. It should have been opened by next year, but it was paused by the Treasury. The work has all been done locally, the plans are agreed and the hospital wants to get on and build it. It will deliver a new outpatient centre, which will take patients away from the more pressured urgent centre in Truro, and refurbish the urgent treatment centre in Penzance. That work could have been under way but it is not because it was paused by the Treasury. The money—£9.1 million—was promised by Government for West Cornwall Hospital in Penzance. In west Cornwall we are all waiting for the Treasury to agree that fund, which was committed. The work has been done and huge amounts of money have been spent to get the hospital to where it is now, and we want to get it built, so will the Minister feed that back? It is not even one of the 40 hospitals; it predates that.

St Mary’s Hospital on the Isles of Scilly has enormous challenges, and anyone who has been involved in Government for a while will know the challenges we on the Isles of Scilly have had with keeping health and social care alive. The council on the Isles of Scilly runs the nursing home. For a long time, it desire has been to integrate the home with St Mary’s Hospital and collocate them on one site. In fact, also in 2019, the Government agreed to progress plans to create one single campus, put care and health services in a single building and collate primary care, community health, urgent care, mental health and adult social care all in one place. It made complete sense.

We had a Chancellor who gave us the green light—the one previous to the former Chancellor, my right hon. Friend the Member for Richmond (Yorks) (Rishi Sunak), who is in the room now—and we had a Health Secretary come over and see in detail what was being proposed. There are two reasons why the plan is such a good thing for the Government to support. One is that it integrates health and care on the Isles of Scilly, which stops people having to move or be flown out of the Isles of Scilly for no real reason to get healthcare on the mainland. While I am on that subject, a couple of comments were made about how funding is allocated for moving people from the Isles of Scilly to Penzance. If the situation on the Isle of Wight is reviewed, it would be far better to replicate what we do than to take away the great service that we have, so I ask the Minister to please go the right way when making that decision and ensure equality for the Isle of Wight.

We have a brilliant plan to do far more on the Isles of Scilly, again using the skills we have, which would enable those skills to be used more effectively and fully both in health and social care. Not only would it deliver for the Isles of Scilly, but it would provide a good blueprint for how health and social care could be delivered on the mainland, particularly across Cornwall. Again, the plan has sat with the Department of Health and Social Care for a very long time. I am told that a decision will be made before Christmas, and I urge the Minister to feed back again about St Mary’s Hospital and the integrated health hub. We urgently need a decision. Again, we were under the impression that it could have been built this year—2022. A lot of the delays that are putting pressure on the system across Cornwall and the Isles of Scilly unfortunately sit with the Department of Health.

My hon. Friend the Member for Isle of Wight made an important point about who controls funding. Unavoidably, small hospitals fall foul of pretty much every funding formula—for good reason, as public funding must deliver value for money. However, if that is interpreted as “bums on seats”, or in the case of hospitals “bums on beds”, smaller communities such as Scilly, rural Cornwall and the Isle of Wight will always be discriminated against, because they will never fully be able to compare or compete with places such as London or other vast urban masses where a hospital can deliver so many more outcomes for the local population.

On Scilly and in west Cornwall, it will always cost much more to deliver health and social care, so decisions about such areas must be taken separately to other NHS funding decisions, because care is not delivered for the same numbers of people. However, there is no reason why people living in rural and isolated areas should receive any less care. We should look very carefully at how the funding formulas are worked out. It will always be the case that an NHS funding body will prioritise the areas where we can deliver more health.

10:25

[Rishi Sunak (Richmond (Yorks) (Con)]

It is a pleasure to speak under your chairmanship, Mr Hollobone, and thank you for accommodating me at a late stage in the debate. I had not planned on speaking, but this morning I saw the Order Paper and it turned out that I had more time on my hands than I had anticipated! It is a pleasure to be here with my hon. Friend the Member for Isle of Wight (Bob Seely) to discuss this very important topic.

I am here to speak about the Friarage Hospital in Northallerton, in North Yorkshire, which is in my constituency. It is one of the smallest district general hospitals in the country, serving a rural population of over 100,000 people and covering an area of a thousand square miles, stretching from the North York Moors at one end to the central Pennines at the other, bordered by York in the south and Darlington in the north. When I was first elected in 2015 and when I was campaigning before that, I told my constituents that the hospital would be my No.1 priority.

The reason for that is simple. Of course the NHS is the country’s most prized public service but, as we have heard in all the contributions from hon. Members today, the accessibility of healthcare in rural areas specifically is an issue of acute anxiety and the pattern over several years had been in a negative direction. Indeed, as I was being elected, my local hospital had lost its consultant-led maternity unit. Shortly to follow was the loss of paediatrics. That had an enormous impact on the local community. They feared for the very future of our beloved local hospital and I committed to do everything I could to reverse the flow of services away from it to ensure a bright future for the Friarage.

As my constituency neighbour, my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), rightly pointed out, when healthcare organisations look at such things they tend to think about centralisation, because it looks very efficient on a spreadsheet wherever they might be sitting, but it does not work for our constituents. One thing I will say to the Minister is that she should send a strong message to trusts, particularly those that cover large urban centres and smaller rural hospitals in the same area, to always think about accessibility when they make their plans, which I do not believe they always do as well as they could. Secondly, I echo my hon. Friend’s recommendation about booking appointments. That is a simple, practical thing and trusts can do a good job of it when members of the public have the option to travel to smaller hospitals nearby or to others further away and to get the timing of those appointments right. That has an enormous impact on people’s ability to access the healthcare that they need.

Shortly after I was elected, I had to deal with a challenge that we have already heard about today—the downgrading of our A&E. However, that marked a turning point and I say to the Minister that what followed can serve as an example of what the future of small rural hospitals can look like. Under the leadership of Dr James Dunbar and his team, at the Friarage we pioneered an innovative new model of an urgent treatment centre that is open 24 hours a day and is consultant-led, with a clinical decisions unit. That means that it can provide a far greater range of healthcare to my constituents, including far more care for children than would typically be found. The unit is staffed superbly by nurse practitioners. It is working brilliantly and all I will say to the Department of Health and indeed to trusts where there is a similar challenge is to look at the model and see how it can be replicated around the country because, as I say, it is working brilliantly and has saved the loss of all emergency services at our hospital.

My other recommendation to the Minister and the Department is on recruitment and staffing issues, which we have heard a lot about already. It was clear during the work that I did that often the guidance from the royal colleges exacerbates some of the issues that we have heard about. My hon. Friend the Member for Thirsk and Malton said that anaesthetists are a case in point. A specialisation has occurred over decades, whereby anaesthetists used to be generalists and now we have sub-specialties. It is very difficult for small hospitals to accommodate those sub-specialties, and we need to look with the royal colleges at what safe staffing models might work to ensure the sustainability of our services.

I must commend the South Tees trust, because after repeated efforts from my hon. Friend the Member for Thirsk and Malton and me, it has focused fully on ensuring the future of the Friarage. I thank Simon Stevens for visiting the hospital in his previous capacity and understanding the challenges, and the pervious Health Secretary, my right hon. Friend the Member for West Suffolk (Matt Hancock). Since then, thanks to the philanthropy of the late Sir Robert Ogden, we have a new Macmillan cancer centre, which is providing fantastic care, a new diagnostic centre, an MRI scanner, a dialysis unit and an ophthalmology unit, all of which save my constituents a round trip of up to four hours to the much larger James Cook hospital. They are all delivering fantastic care closer to home.

I will give the Minister another example of innovation from the local team. James Dunbar came up with a new ambulatory care unit, which means that we can do emergency treatment on the same day. In the first year of its operation, it saved over 4,000 overnight stays, so it is not just a model for rural hospitals but a beacon for how the NHS can work more broadly to reduce the pressure on our bed capacity.

Most recently, I am delighted that the Government and the Minister responded to my long-running campaign to get new investment in our operating theatres. They date back to the second world war and are in urgent need of refurbishment, so I am delighted that the Government have said that they will provide £30 million of investment to refurbish all the operating theatres to the latest and greatest standards. That will have several benefits. Most importantly, it will send a very strong signal to my community about the future of the Friarage. It is very clear that the Friarage is not going anywhere and people can have confidence in its future, which helps with recruitment and retention, as we have heard. People are attracted towards working at smaller hospitals when they know that their career will be something they can bank on and that there is interesting work to do. This investment will absolutely secure that and ensure that we can attract the nurses, doctors and other staff that we need.

The Friarage also serves as a model for how we will tackle the backlogs more generally, because the hospital will be a new surgical hub with all the associated auxiliary services that are required. That means that we can now double the amount of elective surgery and do it closer to people’s homes. In the scheme of what the NHS spends, that investment will provide a very high rate of return by increasing the amount of surgical throughput. The doctors and nurses I saw just the other day—chief medical officer Dr Mike Stewart, chief surgeon Matt Clarke, and theatre nurse Sarah Baker—are all incredibly invigorated by what they can now do for our community, and that will help more broadly serve us to get the backlogs down faster, which I know is a Government priority.

I say to the Minister that it is important that small hospitals are recognised, which is something that is said very clearly in the five-year plan. It is important that the NHS continues to deliver on that. My experience locally is that that is happening, and I ask her to take on board some of my suggestions. I will close by paying tribute to the incredible doctors, nurses and staff at the Friarage, and to the Friends of the Friarage charity. I said to them when I was first elected that they would be my No. 1 priority, and they will continue to have my full support.

[Mr Philip Hollobone (in the Chair)]

We now come to the Front-Bench speeches. I call Feryal Clark for Her Majesty’s Opposition.

10:33

[Feryal Clark (Enfield North) (Lab)]

It is always a pleasure to serve under your chairmanship, Mr Hollobone. I thank the hon. Member for Isle of Wight (Bob Seely) for securing this important debate. As we have heard, small and rural communities face a range of challenges when it comes to the provision of healthcare, so I am sure that his constituents will be grateful to him for putting the issues on the agenda today and for being a champion of their needs.

I also thank the hon. Members for Strangford (Jim Shannon), for Thirsk and Malton (Kevin Hollinrake), for Caithness, Sutherland and Easter Ross (Jamie Stone), for North Devon (Selaine Saxby) and for St Ives (Derek Thomas), and the right hon. Member for Richmond (Yorks) (Rishi Sunak) for their excellent contributions. I am delighted to see the right hon. Member for Richmond (Yorks) this morning, and am glad that he is enjoying his new-found freedom.

We should never think of the provision of accessible healthcare as a luxury but, as we have heard this morning, too many people across the UK face barrier after barrier to accessing even the most routine care. For too long, the drive towards economies of scale in the NHS has left many small and rural communities without the basic services they need. In the past 20 years, more than half of England’s hospitals have been closed or merged. The victims have too often been the smaller hospitals that provide healthcare to nearly half the population in areas that are frequently more remote, more deprived and have an older patient cohort than average.

Although the NHS has processes in place to recognise hospitals that are unavoidably small due to the remoteness of the communities they serve, they often do not go far enough. North Cumbria Integrated Care NHS Foundation Trust, which has received extra funding from the NHS, has patients who have been waiting more than six months to be discharged despite being medically fit to leave.

Sites falling outside the top eight sites identified by the NHS as in need of funding adjustments have not received any additional support. The consequence is not just that local patients receive a poorer service but that lives are put at risk. In Cornwall, we saw utterly shameful scenes when 87-year-old David Wakeley had to wait 15 hours for an ambulance in a makeshift shelter that his family constructed after he fell in his garden. In 21st-century Britain, no one should have to experience what David did, regardless of where they live.

We know the problems our NHS faces. Years of underfunding and poor staff recruitment and retention have caused universal challenges across the NHS, but the nature of small hospitals exacerbates those already pressing problems. Smaller hospitals are more likely to suffer from workforce issues—as all Members have said this morning—budget constraints and an inability to provide specialist services. As Members set out, the challenges of recruitment in remote communities leave smaller hospitals with the uncertainty of having to over-rely on locum staff. If hospitals do not have consistent and stable staffing levels, patients will not receive the standard of care they need.

The Government have had opportunities to put this right, but they have sadly fallen short every time. Nothing makes that clearer than the commitment in the 2019 Conservative manifesto to build 40 new hospitals. The hon. Member for North Devon said that she hoped her area would be one of those receiving one of the 40 hospitals, but I am sorry to say that nobody believes that cornerstone of the Conservative manifesto, because it contains not even a grain of truth. The policy has been such a failure that the National Audit Office is now stepping in to investigate the scheme and conduct a value-for-money review. When even the NAO does not believe the Government’s insistence that the commitment to build 40 entirely new hospitals can still be met, what confidence can patients have? Can the Minister tell us where the 40 new hospitals are or will be?

The reason that matters so much is that the Government’s blinkered focus on an unworkable, undeliverable policy is wasting precious time that could be spent on ensuring local services are able to provide people with the care they need in their community. There cannot be a blanket approach to the problems facing small hospitals; we must look at the entire health system for opportunities to relieve pressure and get services functioning. Care must be rooted in local communities to create trust and ensure that patients can build the relationships on which good community care relies. The introduction of integrated care systems is an ideal opportunity to do that and take a fresh look at the allocation of resources and at how we can maximise access for patients, particularly in small and rural areas. The Government must not waste this opportunity.

While I am talking about wasted opportunities, I would like to draw the Minister’s attention to the health disparities White Paper, which could be another crucial opportunity to look at inequality in care across the country and at issues facing isolated and deprived communities. We have been expecting the paper for months, so I would be grateful if the Minister could update us on where it is. We need to see progress on the paper, because patients in our small and rural communities cannot afford for the Government to waste this opportunity. This postcode lottery is putting lives at risk and it is time for it to end once and for all.

Finally, on a slightly more positive note, I wish the Minister all the best and good luck in today’s reshuffle. I hope she is returned to her place. Even though we may not agree on lots of things, I know she puts in more work than any of the other Ministers I have come across, so I wish her all the best.

10:40

[The Minister for Health (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank my hon. Friend the Member for Isle of Wight (Bob Seely) for securing this really important debate. Small hospitals are often the Cinderella service of the NHS, and their value is not always recognised. We have heard cross-party support from Scotland and Northern Ireland, and if Welsh Members had been present I am sure that they too would have recognised the challenges that unavoidably small hospitals face.

I reassure colleagues that the ministerial team recognises the worth of small hospitals. As my hon. Friend the Member for St Ives (Derek Thomas) said, it is not just about the value they bring to their local communities, but the pressure they take off the wider health service in their regions, which we have seen particularly clearly in recent months and years. When we had covid hot and cold sites in the NHS, smaller hospitals were able to work and function and take some of the pressure off larger hospitals that had large outbreaks of covid. While I acknowledge that small hospitals are more expensive to run, their added value cannot be underestimated. My constituency does not have a hospital, so my constituents have to travel. We do, however, have the Lewes Victoria Hospital—it is a small community hospital, not an unavoidably small hospital—and my constituents really value its work. If they did not have it, they would have to go to the big hospitals in Brighton, Eastbourne or even Hastings, so I am on the same page as many of the Members here.

My hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) and my right hon. Friend the Member for Richmond (Yorks) (Rishi Sunak) touched on this. When trusts run a portfolio of hospitals, it is often tempting for them to move services to a much more cost-efficient, bigger site, but what then tends to happen is that, once the consultant-led maternity service goes, it becomes difficult for the anaesthetists to keep up their skills, and all of a sudden the hospitals become unsustainable. That is a risk. As my right hon. Friend highlighted, and as I saw when I visited the constituency of my hon. Friend the Member for North Devon (Selaine Saxby), there has been a resurgence in interest in small hospitals and their values. We are putting in surgical hubs and investment because we recognise that they can do specialist work, sometimes more easily than big trusts that have the pressures of big A&E departments, trauma centres and wards that are struggling with capacity.

Smaller hospitals can deliver in different ways, but there are no doubts that they face unique challenges. My hon. Friend the Member for Isle of Wight touched on the significant issue of funding. I will come back to that, but I will first touch on some of the other issues they face. On the Isle of Wight, for example, having a smaller hospital can sometimes produce better quality of care for patients. The ambulance handover delays on the Isle of Wight are minimal. The average handover for emergency conveyancing is less than 15 minutes, and their record on 60-minute breaches is often better than that of some of the larger centres.

The quality of care can also be a significant factor, but that also takes intervention and support. It is not just about the funding and the staffing, which we have also touched on, but the system itself. The recovery support programme that has evolved from the special measures programme is working with small hospitals to provide a systems-focused approach to support them and address some of those challenges. As my hon. Friend the Member for Isle of Wight has said, the hospital there went into special measures in 2017 and it is now rated as good. That resulted from a lot of support from the national systems, but also from the hard work of local clinicians and managers. It is a testament to their hard work.

Retaining workforce is difficult. We know that GPs, dentists and nurses are more likely to stay where they trained. That is difficult for smaller hospitals, because traditionally they do not have their own training programmes. People train in large teaching hospitals and often stay there and develop their practice further.

Health Education England is working on changing the traditional nature of training. Blended learning programmes use a combination of technology, online learning and the apprenticeship model to make it easier for small hospitals to train their own staff of nurses, healthcare workers and doctors. There is also the apprenticeship model, with apprenticeships now available in a number of healthcare organisations. Existing staff can take apprenticeship routes, stay in their workplaces and not have to travel long distances to universities miles away. That is important, whether it is for the registered nurse degree apprenticeship, healthcare assistant practitioners or the new medical doctor degree apprenticeship. That will make it easier for smaller hospitals to train and develop their own workforce and, crucially, to upskill the existing workforce. Traditionally, if someone wanted to take on an advanced nurse practitioner role or was an anaesthetist wanting more training, they would often have to leave their small hospital and go to a bigger teaching hospital to take such courses. The blended learning programme will make recruitment and retention easier for smaller hospitals, and will be a lot more rewarding for staff.

My hon. Friend the Member for Isle of Wight talked of funding. I am the first to acknowledge that smaller, more rural and coastal hospitals have greater expenses because they cannot get the scale of efficiency of a larger teaching hospital. A lot of work is going in to supporting the funding mechanism. NHS England is responsible for allocating funding. It goes down to the new integrated care boards, which were established in July. Funding allocations for this financial year were published earlier this year. If my hon. Friend cannot find that information, I am happy to provide him with the figures and the algorithm used to achieve them. The formula seeks to acknowledge geographic and demographic distribution, which can vary, as a number of hon. Members have said. Some areas can have an older population, and it is important that the funding formula reflects that. The discussion is between NHS England and the integrated care boards. There has been a change in the formula to take account of the higher costs of providing emergency services in particular in sparsely populated areas, with an adjustment for costs that are unavoidable due to the small nature of the hospital.

If my hon. Friend and other hon. Members feel that the changes to that formula and the relationship between NHS England and the local integrated care boards are not delivering some of the funding measures we had hoped for, I am happy to discuss that further and to sit down with colleagues so that they are clear about the funding formula and allocation. It should not require trawling through pages of documents to find that out. I am happy to help my hon. Friends with that, because it is important to recognise.

I want to touch on urgent and emergency care. It is important for emergency care to be available locally, but that can be a challenge for unavoidably small hospitals, because they see a much smaller number of trauma cases or cardiac arrests. Highly skilled staff, such as anaesthetists, with the support of their royal colleges, need a number of such cases to keep their skills in place, and we need to support them.

I want to reassure colleagues that we are committed to keeping smaller hospitals. The investment in the Friarage surgical hub is a case in point. We have also recently seen investment in North Devon. I also hear the call for the 40 hospitals programme. We are committed to that, and it is important that staff have that reassurance and patience, because it is about not just the services that are technically on a site, but the quality of care. As smaller hospitals often know their patients well, they get a quality of care that they sometimes do not get in larger hospitals with hundreds of patients coming through a department.

[Kevin Hollinrake]

One of the Minister’s predecessors wrote to me on 28 October 2019 and said that a new community services formula was being used for hospitals such as Scarborough Hospital in my constituency, and others that have been mentioned. Will the Minister write to tell us exactly what impact that has had on funding since 2019 so that we can understand what extra resources have been made available?

[Maria Caulfield]

I am happy to write to all colleagues on that. It is important to understand the difference that that formula will make and to assess whether it is working in practice, and Members of Parliament will be able to pick up quickly on whether it is making a difference locally. I also encourage colleagues to meet their integrated care boards—if they have not already done so—which will have a relationship with NHS England and will supply the information on the demographics and geographical variations that make the formula work. The integrated care boards came into force in July, and now is a good opportunity to have those conversations so that ICBs are clear that Members of Parliament and their local communities value smaller hospitals and that that must be considered when decisions on funding and services are made.

We have had a good debate. I want to reassure colleagues that small hospitals are a vital part of the NHS family: they take pressure off some of the larger services and provide good quality service for local residents, who really value them.

[Jim Shannon]

I thank the Minister for her answers. The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) and I both asked questions about health being devolved in Northern Ireland and in Scotland, and we are keen to ensure that some of the thoughts and ideas from the debate are shared with the devolved Administrations. Can the Minister confirm that that will happen?

[Maria Caulfield]

Absolutely. We need a collaborative approach because we all face the same challenges, whether in Scotland, Wales, Northern Ireland or England. I have been in contact with Minister Swann over recent months, and I am happy to work with him and the other devolved Administrations on these matters, because we all have a shared interest in ensuring that small hospitals are successful.

I can reassure colleagues that we want to support our smaller hospitals in future so that they are able to do more for their local communities.

10:52

[Bob Seely]

I thank all those who spoke in the debate. I will absolutely follow up with the Minister, both in the request for greater transparency and with regard to the integrated care boards. I will also continue to raise with her the issue of equality of funding for getting folks from the mainland, which is a specific Island issue, and to ensure that unavoidably small hospitals can offer the same level of service as others, especially—as several Members have highlighted—in the light of the seasonal nature of the pressures that they are under and, sadly, the higher health demands and greater health vulnerabilities that coastal communities can have.

Smaller hospitals tend to be special places in special communities. I am delighted that the Minister is so engaged with them. They need to be given care and attention to succeed, and that is what we all want.

Question put and agreed to.

Resolved,

That this House has considered unavoidably small hospitals.

Peterborough Station Quarter: Redevelopment

Tuesday 6th September 2022 Westminster Hall

10:54

[Paul Bristow (Peterborough) (Con)]

I beg to move,

That this House has considered the redevelopment of Peterborough Station Quarter.

It is a privilege to serve under your chairmanship, Mr Hollobone. Peterborough station is a major rail interchange on the east coast main line. Along with our hardworking residents, our location is one of our city’s biggest advantages. Our station provides a fast train to London and connections across the country. That matters for passengers and it matters for freight. However, the station needs renewal and modernisation, and the land surrounding the train station is one of Peterborough’s biggest development opportunities. We recently submitted a levelling-up fund application to the Government asking for help to transform the area, known locally as the station quarter.

Why back Peterborough? For a start, we are the largest city in the area, ahead of Cambridge and the rest of our combined authority area. We are already growing at more than twice the national average for England and Wales—over 17% between 2011 and 2021. We have major manufacturers and high inward investment. We provide employment, shopping, health, education and leisure facilities for people across a much wider catchment area; our rail lines expand that area further still. Peterborough is ideal for local commuters in east Northamptonshire, south Lincolnshire, Rutland, Fenland and north Cambridgeshire. We are the gateway to the east of England.

When all that is said, we have significant challenges and untapped potential. That is why Peterborough is identified as a levelling-up priority 1 area. We are below the national average in relation to unemployment and skills, and our score on the need for economic recovery and growth indicator shows why action is needed. That action has already begun. The first block of Anglia Ruskin University Peterborough, the city’s new university, has already opened thanks to Government support through the first round of the levelling-up fund, but that investment needs to be combined with further action to get the results that my constituents deserve.

If the new university can be regarded as the spark, Peterborough station can provide the rocket fuel. From Peterborough, someone can arrive at King’s Cross in under 50 minutes, and the journey to York takes only half an hour longer than that. There are express rail connections all the way to Scotland. Before the pandemic, the station served 5 million passengers a year, with nearly 1 million using it as an interchange for services to other destinations. Rail journeys are starting to recover now that covid is under control, and that will continue—although perhaps with more leisure travel and less daily commuting.

At present, the station has a number of surface car parks spread over a dispersed stretch of land of around 10 acres. That is high-value land; it has the potential to transform the area. If unlocked for new commercial and housing developments, it will potentially transform not only Peterborough but a much wider area. Top-end commercial and office space is particularly important, but so are new homes. Land around the city railway station is ideally suited for new housing, especially for young people—the launch pad many of them need to go on to thrive.

The station building has limited capacity to accommodate forecasts for passenger growth. Network Rail’s modelling is another reason to invest. We already have limitations and problems that should not exist at a gateway station of such importance. For example, one of our two existing footbridges is not compliant with the Equality Act 2010, with access only on one side. If someone gets to the concourse building, they will soon discover that it has only seven automatic ticket gates, which become unpleasantly congested at peak hours. A new western entrance and better footbridges to accommodate demand are vital. They would make commuting easier for many thousands of people—not least the local Member of Parliament, who lives close to the western entrance.

Congestion is becoming a significant issue. Network Rail ran a station capacity assessment this year, which showed how bad things could become in the future. In addition, London North Eastern Railway has identified operational issues with the current station layout and facilities, such as a lack of platform space and a small gateline. LNER manages 11 stations on the east coast main line and dispatches more train services at Peterborough than it does at any other station, including York and Newcastle. Over 15% of all passenger movements at Peterborough are connecting interchange services, so any disruption not only affects Peterborough station but has a significant knock-on regional impact. While manageable at present, those issues will get worse with the future projected demand for train travel that we all want and desire. In short, a significant cash injection is needed to avoid future issues on the east coast main line.

The station is located approximately 500 metres west of the city centre, defined as Peterborough town square, and 200 metres west of Queensgate shopping centre and Peterborough bus station. However, despite its proximity to those key facilities, the station feels isolated from the city centre, both visually and from an active travel perspective. That is demonstrated by the severance created by the dual carriageway, Bourges Boulevard, between the station and the city centre, and the presence of multiple underpasses to guide pedestrians between those locations. To help realise the future contribution of Peterborough train station to not only Peterborough but the entire eastern region, the city has just applied to the levelling-up fund with a bid of around £48 million, which would pay for the first phase of redevelopment of the station quarter. That bid was submitted to the Government by the Cambridgeshire and Peterborough Combined Authority on 1 August. It would be not a handout for Peterborough, but an investment in the whole region, and perhaps the whole country.

A mixture of Government and private funding would be spent on a commercial and residential development as part of the station quarter programme. It would enhance Peterborough train station and the land around it to include a mixture of flats, shops, bars, cafes and office working space, as well as better transport links to and from the station itself. That is especially important for those with disabilities and those with mobility issues. A new western entrance to the station with a car park, to create a double-sided station with a new, wider footbridge over the train tracks, would alleviate pressure on city centre roads, making it easier and safer to travel around the city. The idea for a double-sided station takes inspiration from cities that have removed traffic from their city centres, such as Ljubljana, Copenhagen and Brussels, and as a result have seen significant benefits to the local economy and the quality of life of residents. I hope Peterborough can soon be mentioned in the same breath as those great European capital cities, and it could all start with investment in our station quarter.

Such investment would enable Peterborough to transform its growing centre into a vibrant and attractive space that residents can be proud of, while stimulating businesses and providing greater economic benefit to the city. One only needs to look at the major upgrade of King’s Cross station, which ended in 2012, to see what a transformative effect an upgrade of that scale can have on the surrounding areas. Our local, historic Great Northern Hotel, which opened in 1852, would be retained as a cultural asset in the new development. The station quarter programme would also create an impressive entrance to the city of Peterborough, something that would boost tourism and repeat visits to our great city. Green areas with biodiversity and community spaces would be created, with easy and pleasant navigation routes to and from the city centre by bike and foot.

The enhancement of Peterborough train station would also improve rail passenger journeys and encourage more rail travel, which would have a positive economic impact on the city. Regionally, it would have a positive impact on train travel, as the station provides an important gateway to Cambridge, the rest of Cambridgeshire, and other key areas in eastern England and the rest of the UK. In addition, it would support Peterborough in attracting more knowledge-intensive and high-level employers through its transport links.

Peterborough is relatively low cost for office, housing and retail accommodation, and is easy and quick to reach by train. We already have one Government hub, which is about to be opened in the city. Our new university opened its doors to students this month. The university has been working with regional businesses, as co-creators of the curriculum, to ensure that students leave job-ready, with skills that are in demand by employers. The university will play a pivotal role in raising the city’s skill levels, lifting aspirations and having a transformative effect on the life chances of its students. It will increase the health, wealth and prosperity of our local people. It will provide new opportunities for the region’s promising students, including those who may have not considered a university education before.

In Peterborough, a new Hilton Garden Inn hotel will soon open its doors, and a new Odeon multi-screen cinema is ready to open later this year. If we look at the sky scene in Peterborough city centre, we see cranes, development and all signs of life springing up everywhere following covid-19. The city is pumping. We know that investors are keen to take advantage of our potential. At a recent conference, in 2020, over 90 significant investors pledged their interest in our city. The time really is now for Peterborough. We have the infrastructure in place. We have the connectivity links. We are upskilling our population.

Peterborough is the gateway to the east of England, and the station quarter is the gateway to the city. It is vital that the station quarter and the station itself are fit for purpose, not just for the Peterborough of today but for the city that it will be in the six years it will take to complete that development. The levelling-up fund bid for the station quarter represents a chance for this Government to use that prime asset to bring jobs, retail and other visitors to our city. We know that investors are interested in Peterborough. If we get it right, the levelling-up fund contribution will be supercharged, leading to hundreds of millions of pounds of private investment. All of that will benefit not only Peterborough but every town and city within a commutable distance by train.

When our outgoing Prime Minister began the levelling-up challenge, it was about using new infrastructure to improve everyday life. He wanted to increase opportunity across the city. This Government were as good as their word about getting investment into Peterborough, and I know from her campaign visits to Peterborough that our new Prime Minister is committed to that investment continuing. The station quarter bid would see that delivered. It meets the Government’s investment and transport goals. It would strengthen Peterborough’s accessibility for employment, shopping, health, education and leisure in the east of England. It would give my city another economic boost, encouraging even more businesses and private investment. That means jobs, jobs, jobs—better jobs. In short, it would level up not just Peterborough but the entire east of England. At the same time, it would address the future of the rail network.

I know that the Minister has been listening carefully, and I look forward to hearing the Government’s position. Peterborough station might be a local concern, but it is of national importance.

11:08

[The Minister of State, Department for Transport (Wendy Morton)]

I thank my hon. Friend the Member for Peterborough (Paul Bristow) for raising this important matter, and for setting out the proposed project so clearly. I also celebrate my hon. Friend’s work in campaigning for Peterborough. I know how hard he works, not only in relation to the levelling-up fund round 2 bid to develop the Peterborough station quarter, but for wider investment across his constituency. It is clear from his speech that he deeply understands the rich history and the present needs of the community in Peterborough.

This Government’s central mission is to level up the United Kingdom by spreading opportunity more equally across the country, bringing left-behind communities up to the level of more prosperous areas. I am therefore delighted to have this opportunity to set out our ambitious plans to address this and ensure the success of the whole country, realising the potential of every place and every person across the UK.

As a Government, we have already made progress towards levelling up, but, as I am sure hon. Members will agree, we must continue to focus on delivering this crucial priority. That is where the levelling-up White Paper comes in, to build on the billions of pounds already invested in local areas over the last few years. Such funding has benefitted places across the United Kingdom, including my hon. Friend’s constituency of Peterborough. This is our plan for reversing the country’s inequalities and for improving the United Kingdom.

While the strategy is set, I know that many hon. Members are interested in what it means for their local places and communities. Importantly, new initiatives announced in the White Paper will build on the success of a wide array of funding schemes that are already in progress. Through programmes such as the levelling-up fund, mentioned by my hon. Friend, the Government are already providing crucial capital investment in local infrastructure across the United Kingdom.

I will talk in more detail about the levelling-up fund and touch on what is already being done to level up local places and invest in our communities. My hon. Friend called this debate to discuss investment in infrastructure that will help to improve everyday life for local residents, and I commend him for his sincere and passionate support for the ambitions of Peterborough to develop the station quarter. As we are in the middle of assessing round 2 bids, it would not be appropriate for me to go into detail or make judgments on individual bids. However, I welcome the bid for future funding and the thought that has gone into it. We are clear that the second round of funding will look to build on the success of round 1, which saw £1.7 billion awarded to 105 successful projects across the UK.

I am pleased that Peterborough is one of the five places in the east of England that will receive a share of the £87 million awarded to 12 successful projects from the first round of the £4.8 billion levelling-up fund. In round 1, Peterborough received a significant £20 million Government investment that will help to build part of the new Anglia Ruskin University campus and really put Peterborough on the university map—I can see my hon. Friend is nodding, and rightly so. It will also boost the economy and create more than 500 jobs. The local community and 1,700 students will benefit from a new interactive science lab and education space, called the Living Lab.

Regeneration of the city centre brownfield site forms the centrepiece of the new University Quarter Cultural Hub, which is expected to attract 50,000 visitors a year. Part of the space will also be open to the public, showcasing the city’s net zero future through exhibitions and events, including festivals of ideas, immersive displays and evening classes. The project will also help to upgrade, create and connect existing and new museums, an arts venue, two theatres and two libraries in 50 acres of renewed, open green space, part of the regeneration of the river embankment that will open up a key leisure area for the city centre.

We recognise that community pride, such as that in Peterborough, is really important. This is why the levelling-up fund is focused on regenerating town centres and high streets, upgrading local transport and investing in cultural and heritage assets. These are themes that I know hon. Members and their constituents are interested in and a key part of the levelling-up agenda.

My hon. Friend will be aware that Government investment in Peterborough has been considerable. The 2017 Cambridge and Peterborough Combined Authority—the CPCA—devolution deal includes significant benefits for the communities of Cambridgeshire and Peterborough. It includes a new £600 million fund—£20 million annually for the next 30 years—to support economic growth, development of local infrastructure and jobs, and a directly elected mayor. The £6.3 million investment in the A47/A15 junction 20 eased congestion at Peterborough Parkway and unlocked community infrastructure. Peterborough City Council secured £22.9 million from the towns fund, which is delivering better sustainable transport links and connectivity for city.

Looking at transport in particular, local transport in the Cambridge and Peterborough Combined Authority has received considerable support. That includes £4.3 million of funding from the zero-emission bus regional area scheme, and a new vehicular bridge between Whittlesey and Peterborough, which opened in July after a £30 million investment, to improve travel times by replacing a level crossing. The CPCA was also awarded £1.7 million in active travel funding to support short journeys by foot or cycle. Works include widening pavements, reallocating traffic lanes to accommodate cycle lanes, and installing cycle parking. Those are just a few examples of how this Government are investing in the area, and I am sure my hon. Friend will agree that, in Peterborough, we are well on the way to levelling up the transport infrastructure and improving the experiences of residents and visitors alike.

As hon. Members may know, the levelling-up fund is competitive, with funding distributed to places across the UK on the basis of successful project selection. I know that many places, including Peterborough, have prepared applications to the fund after the launch of round 2. As my hon. Friend has outlined today, local investment really has the power to change local lives, create jobs and create further investment for places. The aim of this funding is to empower local areas to identify and bring forward genuine local priorities. It will fund projects prepared in collaboration with local stakeholders that have clear benefits to the local community and are aligned with a broader local economic strategy. I am pleased to hear that Peterborough has submitted a bid for round 2 funding, but, as I have said, this is currently being evaluated, so it would not be appropriate for me to comment on the specifics during this period of the competition. What I can say is that we look forward to announcing successful bids for the second round of the fund later in the year.

To close, I once again extend my thanks to my hon. Friend for bringing forward this debate. I am in no doubt that he will continue to be a passionate campaigner and advocate for his constituency.

Question put and agreed to.

11:17

Sitting suspended.

Employment Law: Devolution to Scotland

Tuesday 6th September 2022 Westminster Hall

[Sir Edward Leigh in the Chair]

14:30

[Angela Crawley (Lanark and Hamilton East) (SNP)]

I beg to move,

That this House has considered the potential merits of devolving employment law to Scotland.

It is a pleasure to serve under your chairmanship, Sir Edward.

The Minister will recall that I have spent many hours in this place calling for reform to employment law. She will also be aware of the backlash from unions at an employment Bill being nowhere to be seen in the most recent Queen’s Speech. Indeed, Frances O’Grady of the Trades Union Congress highlighted that vital rights that Ministers have promised, such as flexible working, fair tips and protection from pregnancy discrimination, are at risk of being ditched for good. The fact is that this Government need to get a grip on workers’ rights. If they refuse to do so, then now is the time to devolve employment law powers to Scotland to allow the Scottish Government to enact our own reforms.

The SNP Scottish Government are doing everything in their power to improve workers’ rights where they have devolved competence. Throughout the pandemic, the Scottish Government have worked to prioritise workers’ rights, calling on employers, trade unions and workers to work together during this challenging time to ensure that workers are treated fairly. The SNP Government refreshed their Scottish business pledge to align with the fair work principles, and they established a new learning network and an international fair work summit. They also published a fair work action plan in February 2019, which set out a range of measures to support employers to embed fairer working practices. That is supported by trade unions across Scotland.

Additionally, the Scottish Government published a gender pay gap action plan in 2019, bringing together a cross-Government group to approach the gendered impact of inequality in the labour market. The Scottish Government are also a champion of the real living wage, which is of the utmost importance during the cost of living crisis. There are nearly 1,500 living wage-accredited employers in Scotland, giving Scotland the highest rate of workers in the UK earning a real living wage.

With the limited powers that they currently hold, the Scottish Government have worked hard to tackle in-work poverty and support those on low incomes and, ultimately, to condemn exploitative zero-hours contracts by establishing a fair work convention to support the fair pay and conditions agenda. However, with employment law reserved to the UK Government, Scotland can only go so far; it is only able to address part of the problem. Full devolution of employment law would allow Scotland to go even further by creating fairer workplaces, increasing wages, reducing insecure work and fundamentally tackling in-work poverty head on. Shifting that power to the Scottish Government would allow them to stop the race to the bottom on workers’ rights that we are seeing in the post-Brexit UK.

Last December, the European Union delivered employee status to gig economy workers, untying them from the constraints of self-employment status and allowing them basic employment rights, such as minimum wage, holidays and sick leave. That reform of workers’ rights in the EU may well have been one of the most ambitious extensions of workers’ rights from Brussels since Britain left the EU, and we are missing out. Since leaving the EU, the UK Government have been complacent on updating employment law to tackle the injustices faced by the UK workforce.

Scotland overwhelmingly supported retaining EU membership, in no small part due to its commitment to the extension and promotion of workers’ rights. Instead, the UK Government’s approach appears to be to leave workers to appeal to the courts where they cannot access justice, as in the Uber and Addison Lee cases. Without reform of existing legislation, workers are left at the mercy of rogue employers. In 2019, this UK Government were elected on a manifesto that promised to introduce measures to protect those in low-paid work and the gig economy. That was embodied in the promise of an employment Bill that would protect and enhance workers’ rights, with the tagline, “Making Britain the best place in the world to work”.

[Chris Stephens (Glasgow South West) (SNP)]

My hon. Friend makes an important point. The Taylor review reported five years ago and recommended things that the Government should do quickly, including simplifying worker status. Does my hon. Friend share my concern that the Government have sat on that report for five years with no action?

[Angela Crawley]

I thank my hon. Friend for making that point. The Taylor report gave the Government a comprehensive list of items that they could address, but sadly they have been sleeping on the job.

Although there was no commitment in this year’s Queen’s Speech to bring forward the promised employment law reforms, perhaps the Government now have an opportunity to do so. Will the Minister tell us why we should trust this Government to treat workers’ rights as a priority when, three years after that promise was made, no employment Bill has materialised?

We have already seen the ambitions of the UK Government slip. Now we are knee deep in pandemic recovery, a cost of living crisis and a looming recession. It is imperative that the Government make a concrete commitment to improving workers’ rights.

[Gavin Newlands (Paisley and Renfrewshire North) (SNP)]

We can expect the Tories to denigrate or at the very least be uncaring on workers’ rights, but we have to be honest: the Labour party, certainly in Scotland, has questions to answer too. It denied—indeed, it fought—equal pay for women for decades, and then the minute it left office in Glasgow, it started campaigning for it; it voted against higher offers to council workers; and it stopped the devolution of employment law in the Smith Commission. Had it supported the SNP in the Smith Commission, I would not have had to introduce three Bills to outlaw fire and rehire. Does my hon. Friend agree with that?

[Angela Crawley]

I thank my hon. Friend for that intervention. It is fair to say that the Labour party, like the Government, has been sleeping on the job when it comes to protecting workers’ rights in the UK. It has failed to stand up for workers and it has often been missing on picket lines.

The pandemic has exacerbated a steady entrenchment of precarious working conditions across the UK. More people than ever before in the UK are relying on zero-hours contracts and participating in the gig economy. It is a sad fact that workers sometimes have to turn away a job because it would cost them more to drive to collect an item than they would receive to deliver it. They simply cannot afford it because the wages are so low. How is it that here in the UK wages are so low and workers’ rights are so abysmal that a worker cannot even afford to attend work to earn money in the first place? It is absolutely absurd, yet that is the position we find ourselves in, with the Labour party, which is set, potentially, to take over at the next general election, also sleeping on the job.

[Christine Jardine (Edinburgh West) (LD)]

What the hon. Lady says leads me to think that we need reform of UK employment law rather than devolution of employment law, which would create new barriers to doing business and running services across the UK. Although I would wholeheartedly support the reform of UK employment law, I worry about the implications for companies such as RBS, which has staff all over the country, and the nightmares it could cause in terms of employment rights and breaking up the single market.

[Angela Crawley]

The hon. Lady makes a number of points. Given her ardent belief in the Union, she would argue that this is the best place in the world for the protection of workers’ rights, yet we on the SNP Benches have repeatedly—in every facet, in every forum, in every piece of legislation—attempted to encourage the Government to reform employment law and they have failed to do so.

[David Linden (Glasgow East) (SNP)]

Does my hon. Friend, like me, find it rather bizarre that the hon. Member for Edinburgh West (Christine Jardine) seems to have overlooked the fact that the predecessor of my hon. Friend the Member for East Dunbartonshire (Amy Callaghan) was an employment Minister in a Lib Dem coalition? If there was such a need to reform employment law, why did the Lib Dems not do that?

[Angela Crawley]

Absolutely. There was ample opportunity when the Lib Dems were in the coalition to transform employment law, and that did not happen.

[Hywel Williams (Arfon) (PC)]

rose—

[Angela Crawley]

I want to make some progress, but I will come back to the hon. Member.

There are more and more people in insecure work, more and more people with insecure wages, and more and more people with insecure rights in the workplace. More people are under-employed, and more people are holding down multiple jobs and yet struggling to support themselves. Sadly, more and more people are struggling to invoke their workplace rights and unionise.

In real terms, that means more people have been plunged into in-work poverty and are unable to rely on stable incomes, which is invaluable to those trying to make headway through what will be a bleak winter for many families as we approach a cost of living crisis. The impact of the pandemic is clear, the impact of Brexit is clear, and the impact of this Government’s stagnation and failure to act is blatant. I call on the UK Government to either act now or let the Scottish Government do so. I would love to have every competence that this Government have to bring forward an employment Bill and transform employment rights. They have failed to do so, and they do not appear to want to.

I was deeply disappointed that there was no commitment in the Queen’s Speech to improve workers’ rights. The decision to shelve the employment Bill represents a missed opportunity for this Government to make serious progress on changing employment law. They have missed the opportunity to update policies on flexible working, carers leave and paid miscarriage leave, which I have argued for time and again. They have failed to strengthen protections against workplace sexual harassment and other equalities protections.

The Minister will recall that I have spent many hours in this place calling for the introduction of paid miscarriage leave. My hon. Friend the Member for Glasgow East (David Linden) has pursued relentlessly the right for neonatal leave and pay, and I welcome the Government’s commitment to introduce those measures. I have pursued numerous vehicles in Parliament to try to ensure that the important policy of paid miscarriage leave is introduced but, sadly, I feel I am reaching the end of the road. The policy has cross-party support, yet it has been unable to succeed because of the archaic working practices of this place and this Conservative Government’s failure to commit to legislating on the issue. That reinforces why this system will never work for Scotland. It is becoming clearer by the day that we cannot trust this Conservative Government to prioritise workers’ rights. Instead, we see the further entrenchment of socioeconomic inequality in our society.

Scotland did not vote for Brexit, Scotland did not vote for this Conservative Government—it has not done so for many years—Scotland did not vote for this latest Prime Minister, and Scotland did not vote to roll back workers’ rights and leave the European Union. Yet we find ourselves in a situation where this Government will not act, and our Government want to act but do not have the powers to do so.

[Chris Stephens]

I thank my hon. Friend for giving way; she is being very generous. Does she share my concern and that of many others that the Government seem to want to roll back trade union rights further, and are threatening trade unions that they are going to raise thresholds and make industrial action more difficult?

[Angela Crawley]

I thank my hon. Friend for that intervention. I know that the hon. Member for Arfon (Hywel Williams) wished to intervene too.

[Hywel Williams]

I will make two brief points. I find strange the argument that multinational companies are somehow unable to adapt their practices to the conditions required by individual independent countries. That is a fallacy and a fiction. Let me also point to a particular reversal of rights, which I will refer to in my speech if I am fortunate enough to be called. The Government have demonstrated their hostility by intending to scrap the Trade Union (Wales) Act 2017—a law passed by our Senedd to protect workers in Wales.

[Angela Crawley]

I thank the hon. Member for that salient point. We can be under no illusion: not only are this Government not interested in protecting workers’ rights, but they are not interested in protecting the devolution settlement in Wales, Scotland or anywhere else, and they are not interested in listening to people across the UK who are crying out for urgent action on the energy cap.

Workers in Scotland and across the UK should be under no illusion: this Government are responsible for one of the most egregious attacks on workers’ rights for over a decade, and there are no signs that that will change. Given the performance of the Scottish Government in this area, does the Minister recognise that the UK Government are hindering the Scottish Government’s ability to act to protect workers’ rights in the way that we would have done if we had remained in the EU?

It is clear that the UK Government are reluctant to take any steps necessary to overhaul employment law and catch up with the realities of work in the current decade. If the Minister remains unwilling to address the failures of this Government, will she give the Scottish Government the powers to do so? I must ask the Minister to give serious consideration to the devolution of employment law to Scotland, and to stop holding us back from delivering vital support and protections to those who need them most, especially now.

14:43

[Amy Callaghan (East Dunbartonshire) (SNP)]

I congratulate my hon. Friend the Member for Lanark and Hamilton East (Angela Crawley) on securing the debate. There are endless merits to devolving employment law to Scotland, but do not fret—I have only chosen a few to discuss today. We could look at unpaid trial shifts, fire and rehire—the list is endless—but what underpins this debate for Scottish workers is that we cannot trust the Government of the day in this place to be progressive and look out for the rights of workers, so we need to devolve employment law to ensure that Scotland can bring forward an employment Bill to look out for Scottish workers.

If employment law were devolved, Scottish workers would have the right to protection against vile tactics such as fire and rehire and unpaid trial shifts—tactics that we have seen deployed on our workforce by profit-making companies just to increase their profits that bit more. They are despicable and unnecessary. This Government and previous Governments could have done something about them, but they have deliberately chosen not to.

We can look at both the rights and the opportunities that are being denied. For example, this Government are denying people the opportunity to recover fully from ill health because the level of sick pay is so woeful that people are going back to work before they should. We are ending up with a workforce who are working while still in ill health. If we devolved employment law, I do not believe that would happen. I state on the record that we should also devolve all social security benefits to Scotland, to ensure that statutory sick pay is adequate, and that people with significant disabilities and ill health are fully supported in their return to work.

[Mhairi Black (Paisley and Renfrewshire South) (SNP)]

It strikes me as really concerning that part of the new Prime Minister’s reforms seems to be to undermine the one tool that workers have at their disposal, which is striking and industrial action. All the rights that people enjoy, including holidays and sick pay, were brought about not by kindly asking but by striking—by industrial action. Any attempt to undermine that by bringing in agency workers—more colloquially known as scab labour—is appalling and should not be allowed to pass.

[Amy Callaghan]

I thank my hon. Friend for that welcome intervention. The new Prime Minister certainly will have disastrous consequences for the workforce across the United Kingdom. Employment law should be devolved to Scotland, and we should stand up against those vile tactics—especially those against the right to strike—and ensure that our workers are protected from them.

It says a lot about a Government when they are unwilling to protect workers’ rights and, instead, their new leader has pledged to cripple them within her first 30 days as Prime Minister. That is why we need employment law devolved to Scotland.

14:47

[David Linden (Glasgow East) (SNP)]

It is, as always, a pleasure to serve under your chairmanship, Sir Edward. I pay tribute to my hon. Friend the Member for Lanark and Hamilton East (Angela Crawley) for securing and opening the debate.

It is fitting that we should be having this debate today of all days, when the right hon. Member for South West Norfolk (Elizabeth Truss) has just been appointed Prime Minister, not least because, if the rumours are to be believed, the right hon. Member for Spelthorne (Kwasi Kwarteng) will be her Chancellor. Even more worryingly, the right hon. Member for North East Somerset (Mr Rees-Mogg) is set to be Secretary of State for Business—if it was 1 April, most of us probably would not take that seriously.

Part of the reason I think it is appropriate to have this debate today is that our new Prime Minister and our new Chancellor authored a book in 2012 called “Britannia Unchained”. I do not know if the Minister has read the book; unfortunately I have read all of it, and it is pretty grim reading. It asserts that the UK has a

“bloated state, high taxes and excessive regulation”.

It then says:

“The British are among the worst idlers in the world. We work among the lowest hours, we retire early and our productivity is poor. Whereas Indian children aspire to be doctors or businessmen, the British are more interested in football and pop music.”

That is the view of our current Prime Minister and our soon-to-be Chancellor, in writing about employment legislation and regulations. That highlights why it is so important that employment legislation is devolved to the Scottish Parliament. The idea that we would have Conservatives continuing to be in control of employment legislation really is akin to leaving a lion in charge of an abattoir.

Let us look at the Conservative party’s record on employment legislation. Take, for example, the Trade Union Act 2016—the anti-trade union Act. The irony will not have been lost on most of us that that Act requires a certain threshold to be met in order for workers to withdraw their labour, yet the Prime Minister did not achieve that very threshold yesterday as she was elected leader of the Conservative party. There is a case here that what is good for the goose is good for the gander.

My hon. Friends the Members for East Dunbartonshire (Amy Callaghan) and for Lanark and Hamilton East have already touched on the fact that there has been no employment Bill. The reason that we were promised an employment Bill was that, after the Brexit referendum, we were told that Brexit was about improving workers’ rights and environmental standards. The only thing that has happened in connection to any of that is that we are now pumping raw sewage out to sea. That gives us a fairly clear indication of where the Government plan to go if they bring forward an employment Bill: it will not be to strengthen workers’ rights.

My hon. Friend the Member for Paisley and Renfrewshire North (Gavin Newlands) has done a ton of campaigning on fire and rehire legislation; shamefully, the Government talked out the private Member’s Bill that was introduced. We have seen little action on P&O Ferries and the shocking treatment of its staff, including one of my own constituents. My hon. Friend the Member for Lanark and Hamilton East has been doggedly pursuing the Government in her campaign for paid miscarriage leave, something that anybody with an ounce of compassion in their hearts—and the Conservative party like to talk about being compassionate conservatives—should support. That has not been legislated for. I would love to know the Government’s objection to paid miscarriage leave, which my hon. Friend has fought so valiantly to get on the statute book.

All of that stands in contrast to the efforts of the Scottish Government, even though they are very limited in what they can do in terms of employment. For example, the Scottish Government see trade unions very much as partners, not opponents. We see them as rightly there to stand up for workers’ rights. I myself am very proud to be a member of the Unite trade union. The Scottish Government have the view that trade unions should not be seen as the enemy, but the UK Government constantly see trade unions as some sort of opportunity to play political football. The right hon. Member for Welwyn Hatfield (Grant Shapps) was revelling in every single moment of his dispute with the RMT just recently. He saw it as an opportunity to advance his career—by all accounts, that will probably not do him much good today.

The Scottish Government already have policies that give a clear indication of the direction of travel on supporting workers. We have a clear opposition to zero-hours contracts, which I would call exploitative zero-hours contracts. We have the Scottish Government’s business pledge, which has been refreshed. We have a commitment to the living wage—not the pretend living wage that the UK Government talk about, but the living wage that is actually in line with the Living Wage Foundation and the real cost of living. We fund the Scottish Trades Union Congress with Scottish Union Learning cash.

The devolution of employment law is supported by the Scottish Trades Union Congress. I will wait with great interest to hear from the hon. Member for Edinburgh South (Ian Murray) about why the Scottish Labour party opposes the Scottish Trades Union Congress in its call for the devolution of employment law. The Labour party, I understand, considers itself to be the party of devolution, so why on earth does it oppose both the people of Scotland and the Scottish Trades Union Congress on the devolution of employment law?

There is a lot more that I would like to see done if we could devolve employment law. It is quite clear that the UK Government will not bring forward an employment Bill that will adequately improve workers’ rights, but there are a couple of things that I would like us to look at. For example, we must have a very honest conversation, particularly in this place, about the use of unpaid internships. They are absolutely rife in this place: far too many people, presumably even some in my own party, exploit young people from working-class communities by asking them to come down here and do unpaid internships. All of us collectively have to grapple with that. I would like to see a complete ban on unpaid internships and unpaid trial shifts.

I would like us to look at things such as the four-day week. We have just gone through a global pandemic in which the whole nature and world of work have changed enormously. There are a number of things that we could do by learning from the pandemic, and a four-day week is just one. I also want us to deliver proper enforcement of national minimum wage legislation. We have had national minimum wage legislation in statute since 1997, but there have been some years since when the number of prosecutions has been in single figures—if there have been any at all.

There is so much more that we could do with the devolution of employment powers, but in rounding off my speech, I want to go back to the theme I started with, which is the book that our current Prime Minister’s entire political philosophy is based on: “Britannia Unchained”. The reality is that for so long as Scotland remains chained to this failing Union, and this disgusting Conservative Government, I am afraid that we will see more policies like this. By all means, we can call for the devolution of employment law, but we could do something much better: unchain ourselves from this place with the powers of independence.

14:54

[Kenny MacAskill (East Lothian) (Alba)]

It is a pleasure to serve under your chairmanship, Sir Edward. Like others, I congratulate the hon. Member for Lanark and Hamilton East (Angela Crawley) on securing the debate. I take the view that employment law should have been devolved at the outset and should certainly be devolved now. It is an omission, and it might be worth while to consider why it has not been done to date and why, even when we have reviewed it through Calman, through Smith and at other junctures, change has not been taken.

Some of those who opposed the devolution of employment law at the outset have learned hard lessons and have correctly moved on; others will have to explain why they continue to be intransigent, as has been asked by Members. It seems to me to be an omission from the Scotland Act 1998, but that always was an Act that lacked cohesion. It was neither federalism nor logical, and there was arguably no logic to which matters were reserved. Indeed, matters were devolved summarily, which has left us with a situation whereby the economy is devolved but the fiscal levers that can operate it are not. Criminal justice—I was privileged to serve as Justice Secretary—was devolved, but firearms and narcotics were not. Show me a jurisdiction in the world in which firearms and narcotics are not the basis of criminal law or the breach thereof. We had a situation at the outset where euthanasia was devolved but abortion was reserved. We even had the absurdity that Antarctica and powers over it were devolved but foreign affairs were reserved. I do not know anybody in any political party who ever sought for Scotland to have a say over Antarctica.

[Hywel Williams]

I just want to add a pertinent comment. When further devolution was being considered for Wales, water was to be retained in London and sewerage was to be devolved.

[Kenny MacAskill]

That shows the illogicality of the current devolved set-up.

We obviously have seen changes—some have come through Smith, some have come through Calman and some have come through other ways. We now have air weapons devolved, even though firearms are reserved. We have the drink-driving limit devolved, although road traffic remains reserved. Indeed, abortion has since been devolved in order to join with euthanasia as powers within the Scottish Parliament. During my tenure as Justice Secretary, the Scottish tribunal service was established. It became the Scottish Courts and Tribunals Service, having previously been the Scottish Court Service and Tribunal Service. At the head of the Scottish Courts and Tribunals Service sits Lord Carloway, who is the Lord President and the very pinnacle of the judicial system in Scotland. Beneath that, we have tribunals being operated and run in Scotland, yet many of their most fundamental aspects—the law, legislation and regulations—are reserved to Westminster. That makes no logical sense; indeed, it is absurd.

More citizens appear before a tribunal than ever appear before a court of law, yet the tribunal that Scots are most likely to go to in order to seek recompense, change or whatever it is—some aspect of justice—is led by the senior Scottish judiciary, but the organs and levers are controlled. It should have been devolved, and it should be devolved now, because it is essential. We have a new Prime Minister, who has already laid down where she sees things going. I think that is fundamentally wrong, because we cannot go backwards.

I recently read a book about a radical MP called Joseph Hume, who had served in Middlesex, Montrose and Killarney—not in Wales. He came to fame because he opposed the Combination Acts 1799 and 1800. The Combination Acts were legislation that did not outlaw striking; they outlawed the right of workers to organise. They predated laws that came in through Keir Hardie and others. That was not in the 1930s; it was in the 1830s. Joseph Hume opposed the Combination Acts, which existed before Queen Victoria came to power, yet we have an incoming Prime Minister who, in 2022, is talking about ruling out strikes and attacking the fundamental rights of workers to organise. Under the new Administration, we are going back not to the 1930s, but to the 1830s—whether or not employment law is devolved.

Enough is enough. The Prime Minister will have to recognise that whether it comes from law changes in Holyrood, as it should, or from actions in defence to legislative changes here in Westminster, workers ain’t going to take it any more. The changes to be brought in have already seen the likes of the RMT, Unite and the Communication Workers Union out on strike. It is about not just wages, but terms and conditions of employment. We know that, in the fundamental RMT dispute, it is not simply a wage that workers are seeking—not the figures of £55,000 that are bandied about, because the average RMT worker gets nothing like that. It is also about the fundamental terms and conditions: the reduction in workers, making those who remain work longer and reducing the terms of their safety. Enough is enough. It is unacceptable.

I conclude by saying that employment law should have been devolved at the outset, and it should most certainly be devolved now. Irrespective of that, the fight is on. The current Administration may try to bring changes in and use the powers they have here, but those changes will be opposed in Scotland and across the country.

15:00

[Hywel Williams (Arfon) (PC)]

It is a pleasure to serve again under your chairmanship, Sir Edward. Apropos of the list the hon. Member for East Lothian (Kenny MacAskill) gave earlier on, in Wales, we have a legislature that does not have its own jurisdiction, as the jurisdiction is retained in England and Wales. Wales is peculiar in that respect and, possibly, unique in the world.

I congratulate the hon. Member for Lanark and Hamilton East (Angela Crawley) on securing this important debate and on her dedicated work campaigning for paid miscarriage leave. Like others, she has set out the case for devolving employment law to Scotland very effectively, and many of those arguments apply equally to the question of the devolution of employment law in Wales. I will refer to both countries in my remarks.

The tedious tit-for-tat we have seen in the last weeks and months around the Conservative leadership contest has demonstrated that Scotland and, even more so, Wales are very much an afterthought for Westminster. Our workers would be better protected by laws made in Scotland by Scotland’s Parliament and in Wales by our Senedd. As I said earlier, the situation was made clear when, in June, the UK Government announced their intention to scrap the Trade Union (Wales) Act—a law that was passed by our Senedd in Wales to protect Welsh workers. The UK Government’s response was to announce their intention to scrap it, demonstrating not only their disregard for Welsh workers, but their disrespect for devolution. We have, of course, seen moves to reverse devolution entirely consistent with the argument I am making.

In this regard, I should draw the Chamber’s attention to the Government of Wales (Devolved Powers) Bill, introduced in the other place by my friend and predecessor as hon. Member for Arfon, now Lord Wigley. This important Bill would enshrine in law the principle that powers devolved to the Senedd should

“not be amended or withdrawn without a super-majority vote”

of Senedd Members, which would introduce a safeguard—in the short term, at least—against the sorts of action proposed by the UK Government. The Bill is scheduled for Second Reading on Friday. Despite the Westminster Government’s hostile attitude to devolution, further devolution and to devolution as a process—one that, I would say, is one way, not two way—I hope that Lord Wigley’s Bill will, in due course, come before us in the Commons.

Returning to the question before us, devolving employment law to the Scottish Parliament and the Senedd would allow the introduction of an enhanced package of support for workers, which, as others have said, could include paid bereavement leave and miscarriage leave as day one employment rights, outlawing fire and rehire tactics and bringing in properly funded carers’ leave. A further priority for employment law in Wales and, I am sure, in Scotland would be shared parental leave, which is key to enabling more equal parenting, tackling endemic pregnancy and maternity discrimination in the workplace and ending the gender pay gap.

As has already been said, in 2017, amid concerns that uptake of shared parental leave was low, the UK Government indicated that they wanted to re-evaluate the scheme. On 15 July 2022, the newly appointed Under-Secretary of State for Business, Energy and Industrial Strategy, the hon. Member for Loughborough (Jane Hunt), told MPs that the Government were evaluating the scheme and would publish findings in due course. We are still waiting for those findings, so I would say to the Minister and any new Minister—devolve the power to a legislature that will act. For what is already clear is that this policy on maternity leave is failing. Using data obtained by Her Majesty’s Revenue and Customs and the Department for Work and Pensions, Maternity Action has calculated that since April 2015 just 47,000 of the 2.95 million new mothers who took statutory paid maternity leave have used shared parental leave to transfer some of their paid leave to the child’s father or other parent. That is just 1.6%. That is the measure of a policy that is quite clearly failing.

One of the main problems with the scheme, as well as the current flat rate of £156.66 per week, is that a parent must transfer the maternity leave entitlement to the partner. That transferability makes the scheme extremely complex and consequentially poorly understood by both employers and parents. There is also the question of eligibility with at least a third of working new fathers failing to meet the qualifying conditions because of their level of pay or employment type. In Wales we have a great deal of low pay and self-employment is a very common pattern. What we need, and what I believe we would get if powers were devolved, is a system based on individual non-transferable rights for each parent to have leave.

There are solutions for the problems that I and other hon. Members have identified today. What is missing is the political will to act. The incoming Prime Minister has signalled that she will restrict workers’ rights collectively to secure fairer employment. Wales’s Senedd and Scotland’s Parliament, empowered with the ability to legislate for employment law, would do things differently, and I sincerely believe that we would do things better.

15:07

[Mhairi Black (Paisley and Renfrewshire South) (SNP)]

I thank my hon. Friend the Member for Lanark and Hamilton East (Angela Crawley) for bringing the debate forward. When we think of the potential merits of devolving employment law to Scotland, the main one is that the Tories would be nowhere near it. That is the selling point for me and a lot of other people. As we leave the pandemic only to enter a cost of living crisis, it cannot be any clearer how little interest this Government have in the lives of ordinary people. The last 12 years of Tory Government have been nothing more than a project of erosion. Not only is poverty on the rise and has been for years, but in-work poverty is rising, too. People who are working all the hours that God sends still cannot afford to live. Wages have not risen. The UK has the lowest level of sick pay in the OECD, and yet we kid ourselves that we are this great nation—this great United Kingdom—and a beacon for the rest of the world. Well, the stats just do not add up.

If we compare Scotland in the UK to what is happening in similar sized independent nations, we see that it does not have to be like this. Just one example: out of all the workers in the Netherlands, only 6.4% of them are low-wage earners. Of all the workers in Iceland, 7.6% are low-wage earners. Finland has 8.6% low earners and Denmark has 8.7%. In the UK, nearly 20% of all workers are low-wage earners. The countries I just mentioned have fewer people at risk of poverty and in-work poverty. They have fewer employees working extra hours and very long hours. They have a lower gender pay gap. They have sickness benefits that actually cover their wage if they are sick—something unheard of here. They are integrating flexible working patterns and learning from the pandemic, as my hon. Friend the Member for Glasgow East (David Linden) said earlier. They are figuring out fairer working practices to move with the 21st century.

[David Linden]

I wonder if my hon. Friend could say whether those countries have “Wheel of Fortune”-style things in the morning where people have to phone in and try to win money for their energy bills? In those countries, do they have former Conservative Cabinet Ministers picking the tinfoil off their head and telling them to put it down the back of their radiators to heat their houses?

[Mhairi Black]

Fortunately, they are spared that horror but, here in the UK, that is where we are at: “This Morning” paying bills. Instead of learning from everything that has happened in the pandemic, and trying to integrate fairer work practices, we have a Government running around leaving passive-aggressive notes on desks, telling people to hurry up and get back, when the Prime Minister—sorry, the last Prime Minister—was nowhere to be seen for weeks. They have shown time and again that they cannot be trusted with workers’ rights. All the way from 1830 right through to now, they have proven time and again that they cannot be trusted.

As my hon. Friend the Member for Glasgow South West (Chris Stephens) mentioned, we had the Taylor review of modern working practices. That was five years ago, and we have heard nothing, because this Government are all about show not substance. The UK has reneged on its promise to protect EU-derived workers’ protections. During the Tory leadership race, the now Prime Minister promised to scrap all remaining EU regulations by the end of 2023. That means that hundreds of laws covering employment and environmental protections will disappear.

Despite the Government’s commitment to an employment Bill on at least 20 occasions, as we have heard from numerous people, it is still nowhere to be seen. I am not talking about little add-ons because we are nice to our workers. I am talking about fundamental rights: how long we need to work, holiday entitlement and sick pay. Those are all fundamental. The UK is being mismanaged into the ground, and has been for a long time.

We heard earlier from the hon. Member for Edinburgh West (Christine Jardine), who is no longer in her place. She asked whether these arguments meant that changes to rights should apply across the whole of the UK. That is rubbish, because Northern Ireland has devolution of employment law, so why can Scotland not have that? Secondly, there is the idea that we have to wait for reform across the whole of UK. We have been trying. In just the seven years that I have been in this place, my hon. Friend the Member for Paisley and Renfrewshire North (Gavin Newlands), who was here earlier, had the fire and rehire Bill talked out by the Government. Colleagues have tried to get rid of unpaid work trials, yet nothing has come from that.

It goes even bigger than that. Scotland has always played its part. We have not voted Tory since 1955. Yet all we get is Tory Prime Minister after Tory Prime Minister making empty promises, delivering nothing. Scotland has played its part and, frankly, I am tired of trying to tell people in Scotland who are being pushed into poverty, “Sorry, you just need to wait for the rest of the UK to get its act together.” No, not any more. If there is one thing we can see, it is that countries of a similar size to Scotland are successful and fairer. The only difference is that they are not governed by Westminster.

[Amy Callaghan]

I thank my hon. Friend for giving way. To address the earlier intervention by the hon. Member for Edinburgh West (Christine Jardine), my predecessor, as part of the Lib Dem-Tory coalition Government, slashed redundancy notice from 90 days to 45 days. Does my hon. Friend agree that we cannot rely on this place to look after our workers? Reform is not the answer; that is simply not enough. We need employment legislation devolved to Scotland.

[Mhairi Black]

I could not agree more. My hon. Friend put her point succinctly. To sum up, if you are an average person in the UK right now the chances are that you cannot afford to eat or to heat yourself. You certainly cannot afford to be sick. The one thing that you cannot afford is another Tory Government.

15:14

[Ian Murray (Edinburgh South) (Lab)]

It is great to have you in the Chair for this debate, Sir Edward. I pay tribute to the hon. Member for Lanark and Hamilton East (Angela Crawley) for securing the debate. At the start of her contribution, she said she wanted the devolution of employment law, to get it away from the Tories. That has been the thrust of the debate.

If we look at the context of where we are since 2010—a long 12 years ago—we can see that in-work poverty, low pay and financial insecurity are up for workers across the country. Incomes have stagnated for over a decade and real-terms pay today is equal to, if not lower than, 2008 levels. Wages have suffered a decade of stagnation, and will continue to do so. It is the worst it has been in over a century. The latest figures show that the level of taxation for working people in this country is at its highest in 70 years, which will result in the largest fall in living standards since records began in the 1950s—who knows when that goes back to? The Living Wage Foundation, one of the great organisations of this country, estimates that over 1 key million workers are in insecure work, lacking basic rights and protections, and that across the whole of the economy, one in nine workers is in insecure work and lacking basic rights.

This is a great debate in which to pay tribute to our trade union colleagues, particularly the Trades Union Congress general secretary Frances O’Grady, for driving a lot of the issues forward. One thing the Government tend to forget is that the most successful companies in this country are those that have good relations with the trade unions and with their employees, where Government, the trade unions, employees and employers work together as partners to create an environment that provides high-quality jobs and pay. It can be done; I say it can be done because the Labour Government that came in in 1997 transformed workers’ rights in this country. I was not in this place at the time, but many of my colleagues who were tell stories of sitting through the night, overnight—maybe you did this yourself, Sir Edward—two, three or four nights in a row, trying to get national minimum wage legislation on to the statute book. That legislation took security guards in this country, who were on the equivalent of 30p an hour, up to a national minimum wage. Of course, now, the difficulty with the national minimum wage is that for too many, it has become a national maximum wage. That is why we need to move on to something much more progressive, and we have committed to do so in the next Labour Government.

All that, alongside the cost of living squeeze—the cost of living crisis—means that things are only getting worse for working people and for the vast majority of the population. Inequality is rising, not just for the individual but across the nations and regions of the UK. When the previous Prime Minister, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), spoke in Downing Street this morning, he did not even mention levelling up; maybe that was because it was always a slogan, and levelling up does not actually exist. The new Prime Minister, as we have heard already in many of today’s contributions, has promised to outlaw the ability to strike and to break strikes by bringing in agency workers. She has called workers lazy and said that they need to graft more. A new Prime Minister is supposed to come in with a fresh broom to resolve some of the problems in our economy, but it looks like she will make them considerably worse for working people everywhere in the UK, wherever they live.

Some of today’s contributions have been absolutely correct about the consequences of those problems for working people. Everybody in the Government—including, I am sure, the Minister—said with consternation that the P&O fire and rehire was a total disgrace. They were calling in chief executives; they were in the House of Commons at the Dispatch Box. The Secretary of State for Transport derided P&O for what it was doing, yet nothing has happened on the back of that. It is correct that the private Member’s Bill on banning fire and rehire was talked out by this Government. Any reasonable Government would have done what always happens with private Members’ Bills: talk it out because they do not want it to be anyone else’s idea, and then take it on themselves and bring forward something that they could live with. However, there has been nothing on fire and rehire.

As we come out of the covid pandemic, if we set aside all the big issues around the cost of living and insecure work and look at employees and workers themselves, we see something really stark in our economy. I will not give away any confidences, but I know a lot of the British Airways staff quite well because we Members from Scotland travel up and down to London regularly. BA treated its staff abysmally—not just over covid, but for the decade before, whether it be on pension rights, pay and conditions, moving their centres of employment from Edinburgh and Glasgow to London, or consolidating all that by banning them from flying home on commercial flights.

When covid came and BA got rid of a lot of those staff, they went and got other jobs. Some have been re-employed in the industry, and when I speak to them, they tell me that they are now having a much better time working for a different employer. When covid finished and BA was desperate for staff, it went back to ask those people if they would like to be re-employed, and every single one of them said no, as we would expect. Those loyal BA staff had made that company the great British product that it is—employees always drive great products, services and businesses—but they were treated so abysmally that when the company came calling and said, “The proverbial has hit the fan. Will you come and help us?”, they said that they would not. That is partly why our airline industry is in such a bad state at the moment.

British Gas did the same with fire and rehire, so there is a litany of issues for the Government to consider.

[David Linden]

It is absolutely right that we give BA and British Gas an absolute bashing, but one organisation that started using fire and rehire quite early on was Asda, a number of years ago. In considering that litany of employers who have indulged in fire and rehire, it would be remiss of us not to call Asda out on that shameful practice, too.

[Ian Murray]

I am glad that the hon. Gentleman mentioned Asda. We could probably spend the rest of the debate coming up with other companies that have done it. There is an argument to be had about whether we should criticise the companies directly, but they are operating within the legislation. If we do not want employers to use fire and rehire—they are looking after a different set of circumstances—we need to change the legislation to stop them doing so. That is why fire and rehire should have been banned.

This a similar debate to one we had maybe five or 10 years ago about zero-hours contracts. I remember when I was in the shadow team for Business, Innovation and Skills back in 2012, we commissioned Norman Pickavance, who had been the HR director at Morrisons—the supermarkets—to write a report on zero-hours contracts. His report said quite clearly that there were ways to ban zero-hours contracts in their entirety without affecting all the issues that the Government hid behind as excuses for not doing so. Ten years later, zero-hours contracts, the gig economy and forced self-employment are rampant, and there is no employment Bill to deal with them.

Will the Minister address the Government’s objection to the Taylor review? What is their objection? Why is there no Bill to enact its recommendations, and why is the new Prime Minister not introducing one? During a cost of living crisis, workers should not be sacked; they should be made more secure, because people should have confidence that a wage will come in so that they can at least partially pay their energy bills and other bills. We will see what happens on Thursday with the cost of living crisis and energy bills, but I suspect that the responsibility for paying energy bill debt will be passed from the Government to the consumer, which is certainly not something that we support.

I agree with the hon. Member for East Lothian (Kenny MacAskill), who said that there are inconsistencies in devolution. Nobody ever said that devolution was perfect; it was never going to be perfect. Asymmetric devolution is, by its very nature, imperfect, but we have to find mechanisms to run through some of those issues. Devolution has always been a journey, as the hon. Gentleman himself admitted in mentioning Calman, Smith and others, and it will continue to be a journey, particularly for those who are committed to devolution—I am not sure that many in this Chamber are committed to it, with the exception perhaps of myself.

[David Linden]

And your colleague.

[Ian Murray]

Maybe. Well, I am not so sure if the Minister is—maybe she will tell us.

I do not want to get into the issue of bin strikes and so on—the hon. Member for Glasgow East (David Linden) mentioned the strikes—but they go to the heart of something that is infecting our politics at the moment. Our refuse collectors worked all through covid and did a marvellous job, but decided—quite rightly—to strike on the basis that they had been offered a 2% pay rise. People need fair pay rises, particularly the lowest paid. In all our councils across Scotland—it might be the same across England—we have probably the lowest-paid public sector workers out there. They are striking on the basis of pay rates.

We then had an unholy argument in Scotland about who was responsible for the strikes. Then, a few weeks later—one might reflect on adding one and one and getting maybe four, five or two—the First Minister put a funded deal on the table and the strikes were lifted. How can that not be the responsibility of the Scottish Government rather than of the Labour party in Edinburgh? That is beyond my comprehension. That is the kind of debate that we have had, rather than a sensible debate about whether employment law should be devolved to Scotland.

I know that the hon. Member for East Dunbartonshire (Amy Callaghan) has been back a while, but I have not had the opportunity to welcome her back. I wish her well in her continued recovery. Her speech showed that less is more, because she hit the nail on the head with regard to what we should be doing in employment law and getting it away from the Tories. My contention is that the best way to get it away from the Tories is to vote for a UK Labour Government, because it would be better to have a Labour Minister sitting on that side of the Chamber and putting forward Labour policies for workers’ rights.

Can I directly address the hon. Member for Glasgow East? I may misquote him here, but he said that the Scottish Labour party will have to explain why they oppose the devolution of employment law. We do not. The Scottish Labour party’s policy is to devolve employment law. I am not sure if the hon. Member for East Lothian was on the Smith Commission or whether it was his former colleague John Swinney, however, the reason employment law was not devolved was because the UK trade unions did not want that. They were concerned about devolving it without thinking through—

[David Linden]

Will the hon. Member give way?

[Ian Murray]

If the hon. Member will let me finish the point. This is the fact of the Smith Commission. They did not think through the consequences of cross-border employment and cross-border companies and whether it would make at that particular time a much more difficult framework to operate on.

[David Linden]

Can I confirm on the record that the manifesto from the British Labour party for the next general election will have a clear, cast-iron commitment to devolve employment law to the Scottish Parliament?

[Ian Murray]

It will have a clear commitment to implement what we are currently doing in terms of the Labour party’s commission. I am not going to discuss what is in the commission in a Westminster Hall debate because it is being finalised and will be launched in the early part of November. However, the hon. Gentleman will not be disappointed with some of the outcomes of that detailed work.

The commission is not about Scotland as such; it is about all the nations and regions that come under the umbrella of the UK. I know the hon. Gentleman does not believe in the UK, but we do and some of that is in there on devolution. That is the reason the Scottish Labour party, of which I am a member, is entitled to have a different set of policy perspectives from the UK party on a whole host of issues. Gordon Brown’s commission, which will be launched in November, will do some of that.

[Chris Stephens]

I thank the hon. Gentleman for giving way. His history is a wee bit wobbly. I gently say to him that not all the UK trade unions were opposed to the devolution of employment law, Unite being one of them. If I remember the exchanges I had with them during that debate, the hon. Gentleman was quoting the Trades Union Congress and not necessarily all the UK trade unions.

[Ian Murray]

I cannot recall who was and who was not, but the conversations that went on through the conduit of the TUC, which was responsible for taking those conversations forward, had come to the conclusion by speaking to their members that the UK trade unions would not want to devolve. Those positions may have moved since; in fact, I think the GMB’s position has moved since, which is hardly unsurprising given the state we have.

I am sorry the hon. Member for Edinburgh West (Christine Jardine) is not here after that rather difficult and strange intervention. In the time that I was the shadow Minister responsible for employment law, I sat across from the former leader of the Liberal Democrats, Jo Swinson, who was a predecessor, successor and then predecessor again to the Scottish National party in East Dunbartonshire. She was the Minister at the time and took that Bill through the House of Commons, which not only did a whole host of anti-trade union things but extended the qualifying period for employment rights from one to two years. The Liberal Democrats are not sitting on the fence; they are quite clearly on the other side and trying desperately to climb back across the right side. I am disappointed that the hon. Lady came out with that because it undermines her arguments about what she needs to do.

I conclude with a canter through the question of what the Labour party would do. Our deputy leader, my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner), launched our fair work policies at conference last year for a new deal for working people. Launching that, she said it was an attempt to make Britain the best place in the world to work. I think it is an attempt to do that. We did not develop those policies in a vacuum of ideology, which is essentially what the previous Government have operated on—I hope the new Government will be slightly better—but by working with our trade union colleagues and employers, and working together to come up with something that can be implemented for the benefit of the economy and workers.

We would strengthen workers’ rights from day one. We would take away that two-year qualifying period and take it down to day one. That is the right thing to do and it gives people security. It cannot be right to be able to sack someone without a reason at one year and 364 days. In fact, the argument I have always made on that is that if we wait until one year and 364 days to find out if someone is good enough, the manager should be sacked for not doing their job properly. They could find out much earlier in the process if someone is good enough for the job they have been employed to do.

We would ban fire and rehire; that is a fairly straightforward thing to do, which would protect workers in this country and create good businesses. I went on holiday by ferry this year, but I just could not travel on P&O; I used another ferry company. When I saw that big P&O sign as I approached Dover, I just felt disgusted that a firm would do what P&O did to its employees at a time when they require their jobs and their wages more than at any time in the past.

Banning fire and rehire would also make work more family-friendly by helping to balance home, community and family life. We have done that before, through the maternity and paternity pay brought in during the last Labour Government. We would extend statutory maternity and paternity pay now that we are out of the European Union. Shared parental leave is a big issue. In fact, I agree with the hon. Member for Arfon (Hywel Williams) regarding the uptake of shared parental leave, but I do not think it is a legal thing. I think it is a cultural thing and also about equal pay, because all the analysis shows that there is such a low uptake of shared parental leave because it is still the father who is the main or highest earner in a family, and sharing parental leave may be a cultural thing in terms of employers and employees asking for it. Those are some of the cultural barriers that we have to break down.

We would ban zero-hours contracts. All workers have the right to regular contracts and predictable hours, reasonable notice of changes in shifts, and wages paid in full for cancelled shifts. We would strengthen trade union rights, raising pay and conditions, and—crucially—we would use fair pay agreements to drive up the pay and conditions of all workers.

I did not want to be political in this debate, but some of my colleagues from the Scottish National party could not resist being political earlier, so I cannot resist now. One of the key things that a Government can use to drive up standards is procurement, and one of the biggest levers that the Scottish Government could pull, given the powers of the Scottish Parliament, is procurement, using it to drive up standards.

However, we have just seen £700 million of licences for ScotWind being issued to companies with no procurement specifications on wages, local employment, apprenticeships and all those kinds of workers’ rights. So, yes, devolving these matters might be the right thing to do, but my challenge to the SNP is not about the principle of devolution but to tell us what it would with it.

[David Linden]

I do not know whether the hon. Gentleman missed the point made in a number of our speeches when we talked precisely about the Scottish Government’s business pledge, which has baked within it various levers regarding how we use procurement. Which parts of the Scottish business pledge does he object to that the Scottish Government have already got in place?

[Ian Murray]

The main thing that I object to about the Scottish Government’s pledges and strategies and documents is that they tend to be launched with huge fanfare, including big front pages in the newspapers and pictures of the First Minister plastered all over the television, and then those pledges and documents go on to some shelf somewhere and sit there until they are relaunched again, about one or two years later. The proof is always in the pudding, but I am not sure that the Scottish Government even attempt to make the pudding; they just bring the recipe out now and again. That is my biggest criticism, because it happens on climate, on procurement and in other areas. If the hon. Gentleman wants me to answer the question directly, that is my objection.

There is no objection from Labour to the principle of the devolution of employment law. However, there are lots of issues to work through regarding what it would be like in practice. I want to hear what the Minister has to say about the employment practices of this country, her objection to the Taylor review and bringing its recommendations forward in a piece of legislation, and what the Government—the new Government—will do. Who knows? The Minister might be in the new Government. I see she has her phone on the table; perhaps it will ring shortly and she will have to excuse herself to run away and take a call.

Whatever the Minister’s answer to such a call is, the Government really have to look at what is happening now in the country—with the low growth, high inflation, high tax and stagnation that we have—and find a way to break out of that real problem in the economy. The best way to do that is to have a highly skilled, highly productive, highly stable workforce with career progression. Otherwise, we will end up in 20 years’ time still having the same arguments about why we have a problem in this country with productivity and why we also have a problem in this country with low pay and insecure work.

15:33

[The Parliamentary Under-Secretary of State for Business, Energy and Industrial Strategy (Jane Hunt)]

It is a pleasure to serve under your chairmanship, Sir Edward.

I congratulate the hon. Member for Lanark and Hamilton East (Angela Crawley) on securing this important debate on the potential merits of devolving employment law to Scotland. As Members can well imagine, there is an awful lot for me to respond to, so I probably will not take interventions at this stage, because I do not think there will be time for me to do so.

As the hon. Member is aware, employment matters are reserved to the UK Parliament under the Scotland Act 1998, with a few exceptions, such as the subject matter of the Agricultural Wages (Scotland) Act 1949. The Government have no intention of devolving legislative competence for employment rights matters to the Scottish Government.

The Scotland Acts of 1998, 2012 and 2016 have created one of the most powerful devolved Governments in the world. The Scottish devolution settlement gives the Scottish Parliament power over numerous aspects of its governance and strikes a good balance. The current settlement was agreed between the Scottish Government and the UK Government after extensive cross-party consultation and discussion by the Smith Commission.

We strongly believe that in order for the labour market to work most effectively across Great Britain, the underlying legislative framework concerning rights and responsibilities in the workplace needs to be consistent and must not be devolved to the Scottish Parliament. Employers and employees benefit hugely from a single, simple system where employment rights are the same across Great Britain, whether someone is working in Dunstable or Dundee. Devolving employment rights to Scotland could create a two-tier employment rights framework, with Scotland adopting different policy and legislation to England and Wales. This would create a significant burden for businesses. It would be costly for employers who operate on both sides of the border, as they would need to understand the differences between the systems and potentially implement different sets of policies and procedures.

[David Linden]

In the 25 minutes left, will the Minister give way?

[Jane Hunt]

I have an awful lot to get through, but I will allow one intervention.

[David Linden]

The Minister makes a point about companies operating over borders and having different employment practices to adhere to. She is, of course, fully aware that employment law is devolved in Northern Ireland. She mentions Dunstable and Dundee. Notwith-standing the lovely big sea border that her Government have just put down in the Irish sea, which I know some in her party are vexed about, why is it good enough for people in Larne but not people in Livingston?

[Jane Hunt]

I will get to that in a short while.

Devolving employment rights to Scotland could also disadvantage workers by suppressing the free flow of labour between England and Scotland. Having this valuable free flow of labour is essential, as it increases the chances of workers finding the jobs that will make the most of their skills and employers finding the best employees for their businesses. Office for National Statistics data from 2019 estimates that around 68,000 people work in Scotland and live in England, or vice versa. Devolving employment rights could therefore be highly disruptive for workers who work across the border.

The UK Government remain strongly committed to working together with all the devolved Administrations to ensure the UK’s institutions are working collectively as one United Kingdom. We appreciate and value our ongoing, close working relationship with the Scottish Government, while also respecting their unique devolved nature. Through this close working, we are determined to build a highly skilled, highly productive high-wage economy that delivers on our ambition to make the UK the best place in the world to work and grow a business. Ministers and officials within my Department engage regularly with their counterparts in the Scottish Government, as well as the Welsh and Northern Irish Governments, to consider various employment-related issues. I look forward to discussing employment rights issues with my Scottish counterparts too.

I would like to highlight that the UK, including Scotland, has a very strong labour market. Its strength results from balancing labour market flexibility with worker protections. The figures speak for themselves. Early estimates for July 2022 indicate that there were 29.7 million payrolled employees—around 650,000 higher than pre-pandemic levels. The unemployment rate is 3.8%, which is close to record low rates. Making any changes to the current devolution settlement could jeopardise our labour market’s success. On employment rights, the hon. Member for Lanark and Hamilton East stated that workers’ rights are being disregarded in the UK. I disagree with that. She also said that Ministers are sleeping on the job. Chance would be a fine thing—since 8 July at least!

It is not only the labour market’s strength that is exemplary. The UK’s record on employment rights is one of the best in the world, giving vital protections to workers. We have one of the highest minimum wages in the world. In April, the national living wage was raised to £9.50. In the UK, people get a minimum of over five weeks of annual leave, whereas the EU requires only four weeks. People in the UK get a year of maternity leave. The EU minimum is just 14 weeks.

I am proud that we have implemented many important changes to the UK labour market, which are benefiting workers across England, Scotland and Wales. In recent years, this Government have brought forward a raft of legislation on employment rights issues. That legislation has closed a loophole that saw agency workers employed on cheaper rates than permanent workers, and quadrupled the maximum fine for employers who treat their workers badly. We have given all workers the right to receive a statement of their rights from day one. We have given parents a new legal right to two weeks’ paid bereavement leave for those who suffer the devastating loss of a child. The hon. Member for Paisley and Renfrewshire South (Mhairi Black) mentioned the Taylor review, and the Government are making progress on a number of the recommendations it set out.

The Government supported workers throughout the covid-19 pandemic, taking steps to protect the earnings of workers through the UK-wide coronavirus job retention scheme. We also ensured that furloughed employees who were made redundant received full redundancy payments. In Scotland, a total of 911,900 employees were on furlough during the course of the scheme, and we were able to offer this unprecedented package of support through our ability to act on a UK-wide basis. Our response to the covid-19 pandemic exemplifies that we are at our strongest when we come together as one United Kingdom.

We are going still further with employment rights reforms. Numerous private Members’ Bills have been introduced on the matter of employment rights, and we are working closely with these Members on their proposals. On 15 July, this Government supported two private Members’ Bills on Second Reading. The Employment (Allocation of Tips) Bill, introduced by my hon. Friend the Member for Watford (Dean Russell), will ensure that all tips go to staff, and allow them to bring a claim to an employment tribunal if businesses do not fairly distribute workers’ well-earned tips. The Neonatal Care (Leave and Pay) Bill, introduced by an SNP Member, the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald), will allow parents whose new-born babies are admitted to neonatal care to take up to 12 weeks of paid leave, in addition to other leave entitlements, such as maternity leave. This will allow them to spend more time with their babies at what is a hugely stressful time. Our productive work with the SNP Member on this Bill goes to show just how far we can make progress on important employment rights issues by collaborating across parties, and between the UK Government and the devolved Administrations. My officials have also met their Scottish Government counterparts to discuss the private Members’ Bills, and will continue to engage closely with them throughout their passage.

As well as those private Members’ Bills, on 6 July, we laid legislation that extends the ban on exclusivity clauses in contracts where a worker’s guaranteed weekly income is below the lower earnings limit, which is currently £123 a week. That will ensure that an estimated 1.5 million people have the opportunity to pick up extra work to top up their income if they wish. Two further private Members’ Bills will be considered on Friday, including the Carer’s Leave Bill, which was mentioned earlier. Also mentioned was shared parental leave, which is exceeding the expectations in the targets set for it. The online tool is also proving successful in helping parents decide what to do for their family.

In July, we published guidance to clarify the existing employment status boundaries, making it easier for businesses to comply with existing regulations and for individuals to understand which employment protections apply to them. In April, we made sure that 2.5 million people across the UK received a pay rise by raising the minimum wage and the living wage. The largest ever cash increase to the national living wage will put over £1,000 a year extra into full-time workers’ pay packets, helping to ease cost of living pressures. We are helping younger people too by lifting the minimum wage for under-23-year-olds and apprentices. What is more, in December 2021, we named and shamed 208 UK employers who failed to pay the minimum wage, including 19 Scottish employers.

We take action where it is needed to tackle appalling business practices, such as P&O Ferries firing its employees without consultation. We reported P&O to the Insolvency Service and took an active role in ensuring it treated its workers fairly. In March this year, we announced that we will introduce a statutory code of practice on dismissal and re-engagement—so-called fire and rehire tactics. That will include practical steps that employers should follow if they are considering changes to workers’ terms and conditions and there is the prospect of dismissal and re-engagement. All that comes in addition to the UK Government’s £37 billion cost of living support package, which will benefit households across the UK, including those in Scotland. For these reasons, the Government do not support the devolution of employment rights to the Scottish Government.

Let me turn to some of the points raised during the debate. The hon. Member for Lanark and Hamilton East spoke about the Miscarriage Leave Bill. The Government recognise that losing a child at any stage is incredibly difficult, and we expect employers to respond with compassion and understanding. Because the death of a child is a particularly tragic event, we have legislated to give parents who lose a child under the age of 18, including cases where a baby is stillborn after 24 completed weeks of pregnancy, a right to take up to two weeks off work in the 56 weeks following the death of their child.

Although there is no statutory entitlement to leave for women who lose a baby before 24 completed weeks of pregnancy, those who are not able to return to work may be entitled to statutory sick pay while off work, subject to the eligibility conditions. If eligible for statutory sick pay, employees are able to self-certify incapacity for work for the first seven days of their absence, regardless of the cause. All employees are also entitled to 5.6 weeks of annual leave a year, and many employers also offer compassionate leave.

[Angela Crawley]

My ten-minute rule Bill is due for Second Reading on 16 September. Does the Minister acknowledge that it is simply unfair that a parent who loses a pregnancy or baby at 23 weeks and six days has no right whatsoever to any form of paid leave, while after 24 weeks a parent has the right to bereavement leave and pay? Should that legislation not be extended or provision not be made for parents who experience that loss before 24 weeks? Can she explain why the Government will not do so?

[Jane Hunt]

I will look at that point, because I understand the hon. Lady’s argument. However, a line has to be drawn somewhere.

The hon. Member for Glasgow East (David Linden) talked about the four-day working week. We appreciate that a four-day working week may work well for some workers and employers, but we do not believe in a one-size-fits-all approach to working arrangements. That is why rather than telling people and businesses how to work, we put individual agency and choice at the heart of our approach to flexible working.

The hon. Members for Paisley and Renfrewshire South, for East Dunbartonshire (Amy Callaghan), for Glasgow East and for Lanark and Hamilton East asked why no employment Bill was announced in the Queen’s Speech. While I know it is disappointing that it did not include one set out as a single Bill, there is an ambitious legislative programme that includes a comprehensive set of Bills that will enable us to deliver on priorities such as growing the economy. As I mentioned, numerous private Members’ Bills have been introduced on employment rights as a result of the PMB ballot in the Commons. We are working closely with those Members on their proposals, and are grateful to those from across the House who are helping us with that.

The hon. Member for Edinburgh South (Ian Murray) and others questioned why we are not banning fire and rehire. Imposing a ban would not be appropriate because in some situations fire and rehire can play a valid role, as businesses may need the flexibility to use this option to save as many jobs as possible. We are taking proportionate action to address firing and rehiring practices by bringing forward a statutory code of practice.

The hon. Member for East Lothian (Kenny MacAskill) talked about tribunals. The UK Government and Scottish Government continue to work closely on drafting the Order in Council. Once that is concluded, we will look to agree a timeline for the devolution of the first tranche of tribunals.

I thank the hon. Member for Lanark and Hamilton East for bringing this important topic to the House and enabling this debate. While the Government have no plans to devolve employment rights to the Scottish Government, I thank the hon. Members who contributed constructive arguments. We will continue to work with the Scottish Government and other devolved Administrations as we continue to build on the UK’s record on employment rights.

15:49

[Angela Crawley]

After 12 years of this Government, it is fair to say that many of the reasons for the cost of living crisis lie squarely at their door. Any Government who fail to understand why workers must have their rights protected and enshrined in law should rightly fear going to the ballot box in a general election. The Government have failed to act on employment and failed to introduce a Bill. If they will not do so and if they will not devolve employment law to the Scottish Government, it simply makes the case for us that independence is the only way for Scotland to ensure that workers’ rights are protected in the way that they should be. It is clear that an employment Bill will not come from this Government.

Question put and agreed to.

Resolved,

That this House has considered the potential merits of devolving employment law to Scotland.

15:50

Sitting suspended.

Employee Share Ownership Schemes

Tuesday 6th September 2022 Westminster Hall

16:00

[Sir George Howarth (Knowsley) (Lab)]

I beg to move,

That this House has considered reform of employee share ownership schemes.

It is, as always, a pleasure to serve under your chairmanship, Sir Edward. I thank the Chartered Governance Institute UK & Ireland for the invaluable briefing it provided to help me prepare for this debate. Despite the participation of close to 2 million people, employee share ownership plans remain remarkably low profile and poorly understood. If we are to reform employee share ownership plans, which I believe is long overdue, we need to ensure that Members of this House understand what those plans are, and the problems that they face.

Let me begin by explaining why employee share ownership schemes are unique. They bring together employees, employers and the Government into a contract, with each party making a commitment. First, employers offer their staff the opportunity to acquire shares in the company, often at a discount to the traded share price. Secondly, the Government offer tax advantages to the participant and the company, which make them more appealing. Thirdly, the employee makes a regular monthly contribution to the scheme over several years.

The arrangement is a sound one, and that is why, historically, the plans have been reasonably popular and effective. Each of the parties involved benefits. Employers gain more productive and engaged employees, the Government support businesses to perform well and encourage share ownership—a proven source of financial resilience—and employees are more aligned to the success of their employer.

The two plans I will focus on today are the share incentive plan, known as SIP, and the save-as-you-earn system, known as SAYE or Sharesave. Those are just two of the existing share ownership plans, but they are the only two that are known as all-employee share plans; that is to say, when a company offers one to its staff, it must offer one to every single employee within its company on the same terms. It is those plans that lead to participation from across the income range, and from all parts of the country. They are truly inclusive, requiring relatively modest monthly investments from participants.

However, there is a problem that has been raised with the Treasury over recent years: participation rates in the employee plans are plateauing, and in some cases falling. Rates are simply not increasing at the rate that we would hope for.

I could spend the time I have available citing the data, but I will instead point out just a few of the headline facts from the Treasury’s own data, which I am sure the Minister is familiar with. First, the number of firms in which employees were granted SAYE in 2021 was 260—a fall from 340 in 2007-08. Secondly, the number of employees granted a new SAYE option in 2020-21 was 380,000, which was a bump up from the previous two-year period of 310,000. Despite that bump, it is necessary to go back to 2011-12 to find the last time that new SAYE grant take-up was that low.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My right hon. Friend is making an excellent speech. Perhaps one reason why there has been such a long period without an increase in take-up is the way that people are employed. The nature of work is changing: more and more people are in the so-called gig economy—platform workers—where they are not on pay-as-you-earn. They therefore cannot take part in such schemes. Should the Government update the schemes so that those workers, and not just workers on PAYE, can take part in them?

[Sir George Howarth]

My hon. Friend must have read my mind. I will come on to that very point shortly.

As I was saying, the number of employees granted a new SAYE option in 2021 was 380,000, which was a bump up, but the last time take-up was that low was in 2011-12. In 2020-21, employees in 480 companies were either awarded or purchased shares, a figure that has fallen steadily over the past decade. For example, in 2011-12, there were 570 such firms. There are several reasons for that, but the problem is that SIP and SAYE, which were developed 22 and 42 years ago respectively, have barely changed in all that time and no longer reflect the modern workplace. The period that employees typically spend at a company has markedly reduced. Indeed, young people are often encouraged to move jobs more frequently to secure career advancement.

[James Cartlidge (South Suffolk) (Con)]

I have long cared about employee share ownership schemes. I recently had the privilege that the company that I set up before I became an MP awarded shares to staff that it has had for many years—the first time that the company has done so. My experience is that all such schemes are terribly complicated. Companies have to spend a lot on accountants to get them to work, especially if they are small or medium-sized enterprises. In the submissions the right hon. Gentleman received from external groups, were there any proposals to simplify the schemes? That may help to increase uptake.

[Sir George Howarth]

I am grateful to the hon. Gentleman for intervening. Simplicity is always the key to the success of any scheme, particularly in complicated financial matters. He makes a good point.

As I said, young people are encouraged to move jobs more frequently to secure career advancement. Expecting staff to make a long-term commitment to investing in share plans when they do not expect to stay at a firm for that long—the SIP, for example, requires a five-year minimum investment period to ensure maximum tax efficiency—is no longer realistic.

Employee share ownership plans operate particularly well when a significant number of employees at a company participate. Research demonstrates that where levels of participation are relatively high companies enjoy positive returns, including increased staff engagement and loyalty, enhanced financial resilience for participants and increased productivity. The fact that the Government offer tax advantages to employee share ownership plans is, of course, welcome. However, the risk, which grows greater by the year, is that without reform the plans could become increasingly obsolete.

I worry about being too prescriptive about which changes are required to stimulate an increase in interest and participation, but some relatively simple changes could be made. For example, reducing the commitment required from SIP participants from five years to three years to achieve maximum tax efficiency. ProShare, which is the body that represents the ESO sector, has proposed such a change. Its research shows that many people are put off by having to make a five-year commitment, but would be prepared to make a three-year investment. Employers say the same: more companies would offer the SIP to staff if it was three years not five. Those that offer SIPs say that participation levels would increase.

Employee share ownership has been more widely supported by diverse organisations such as the CBI, the Social Market Foundation, the TUC and the Co-operative party. The CBI states:

“The moral case for financial inclusion is a compelling one—people have a right to their dignity and financial exclusion denies them that right. But the business case also speaks for itself—with people living in the poverty zone producing five to six times lower quality work than their colleagues.”

The Social Market Foundation suggests:

“As the UK economy emerges from the Coronavirus pandemic, now is a good time for government to push for higher rates of employee share ownership. With productivity growth in the UK lagging, a shift towards ownership structures which bolster innovation, employee effort and corporate long-termism should form a key part of the economic recovery plan.”

The TUC said that it

“supports employee share ownership, subject to conditions”.

I will quote three of those conditions. First,

“shares or share revenues should be allocated free of charge and equitably to all staff to avoid share ownership reinforcing existing pay differentials and excluding the low paid (the principles expressed a preference for collective schemes)”.

Secondly,

“employee share ownership schemes are not a substitute for decent pay or collective bargaining”.

Thirdly,

“workers and their unions should be involved in the running of the scheme, which should go hand in hand with the involvement of the workforce in company decision-making”.

As we face a cost of living crisis and higher levels of inflation, we should be looking at creative solutions to support people in work. Why not free companies to support lower-income employees by allowing offers of free shares to this group only, which would relieve legitimate financial concerns?

Coming back to the point my hon. Friend the Member for Leeds North West (Alex Sobel) made earlier, why not create a one-off SAYE that lasts for just one year, instead of the current three or five years? That would enable people to make regular savings but allow them to take their savings back if they struggle to pay the bills. At the same time, it offers a potential return at the end of the year in the form of either interest or a share price increase.

There is a conversation to be had about how we can develop a new type of scheme that would allow the more than 4 million people who operate in the so-called gig economy to join a share plan and own a stake in the organisation they work for. As the Minister will know, the current plans are exclusively for those on PAYE but, as our workforce changes, we need to design new plans that do not depend on regular monthly contributions and are accessible to those in less regular forms of work. I therefore urge the Government to consider undertaking their own consultation on these plans.

As the Minister will be aware, the Treasury is already consulting about reforming two other discretionary share plans: enterprise management incentives, or EMIs, and company share options, or CSOPs. These plans are typically offered only to a relatively small group of people, usually in managerial positions. It seems the Government are looking at these plans to help increase participation and benefits to participants. “About time too,” some might say. The CSOP has not changed or been updated in any way since the 1990s but, at the very time as we are facing a cost of living crisis, the Government seem to be choosing to reform plans that are already popular and typically benefit only those on high incomes. SIP and SAYE, which benefit some of the poorest paid workers, must surely be a higher priority for reform.

I hope the Minister will address that point. It has been made repeatedly to the Treasury over recent months, so far without any satisfactory answer. There are many examples of people participating in share plans and achieving significant gains on their savings and investments. Employees of Pets at Home, mainly shop-floor staff working in retail, who participated in the company SAYE recently made an average gain of £21,000 each, which represents a healthy return on their investment and achieving the financial resilience that is going to be so necessary in the months and years ahead.

As for the SIP, the recently issued annual survey from ProShare shows that the average value of a participant’s SIP holding at the end of 2021 was £10,294, a vital financial lifeline that can be drawn on when times are tough. These stories of millions of ordinary people making regular contributions, getting into the habit of putting something aside each month, building up a nest egg to help support their families, which millions of people up and down the country have done over the last 40 years, must not be lost by becoming obsolete.

If these plans are to operate successfully in future, now is the time for the Treasury to act and to identify what is needed to ensure that they remain relevant and compelling, and to guard against them disappearing. It cannot do that alone; it must consult far and wide, speaking to experts such as ProShare and the CBI, yes, but also to people who participate, in order to understand why they do so. After all, those are the people the plans are intended to benefit, and I would like to see millions more do so.

Finally, in what I hope would be a Treasury-led consultation, I urge it to update the excellent 2007 research by Oxera, commissioned by Her Majesty’s Revenue and Customs, which demonstrates the productivity benefits of the plans. I know from my conversations with those in the industry that, when they make suggestions for the share plans reform, such as the reduction in the SIP-holding period from five to three years, they are asked to provide evidence of the impact on productivity. May I constructively suggest that the Treasury is best placed to make that assessment? I would like to know whether it intends to do so in the near future.

The Minister might not know her fate over the next 24 hours, and I wish her well. If she remains in this position, I hope she will give this matter serious consideration, or otherwise draw it to the attention of whoever succeeds her. I look forward to hearing from her.

16:17

[The Financial Secretary to the Treasury (Lucy Frazer)]

It is a pleasure to serve under your chairmanship, Sir Edward. I congratulate the right hon. Member for Knowsley (Sir George Howarth) on securing today’s important debate. I have spoken to Members across the House, and there are many supporters who know the importance of this area. I know that the issue commands cross-party support, as we can see today. I, too, want employees to share in the success of the companies they work for. I want businesses to reward and retain talent, driving even more success.

I believe that through taxation policy, including reliefs, we can drive innovation. The partnership between business, employees and Government, which the right hon. Gentleman talked about, is important. A vital part of that is the support that the Government provide to employee share ownership through tax reliefs, which were recorded at £760 million of income tax and national insurance contribution relief in the financial year ending 2021.

There are four tax-advantaged share schemes, with millions of instances of awards or share options benefiting employees every year. The right hon. Member talked about SIP and save-as-you-earn, so I will mention those first. They are designed for companies to offer a tax-advantaged option or shares to all employees on the same basis. Save-as-you-earn, which has the largest aggregate value of all the schemes, is designed to help lower earners to save, by deducting salary directly at source, and adding it to a special savings account for the scheme. At the end of their savings contract, employees can use the funds to purchase shares in their employer.

Our other all-employee scheme is the share incentive plan, which was introduced in 2000, 20 years after the introduction of SAYE. It is targeted at companies that wish to help their employees to purchase shares directly in their company, or even receive them as awards. That particularly helps low to mid-range earners.

Although the right hon. Member talked about SIP and save-as-you-earn, which rightly deserve attention of their own, there are other schemes to help companies with their growth. In turn, such schemes help the growth of the wider UK economy, so it is right that we consider the wider share schemes landscape, too. Two distinct schemes give companies choices over which employees they offer tax-advantaged options to, with specific criteria and performance conditions that can be tailored to the company. The company share option plan introduced in 1984 remains popular among many companies of all sizes, which use it to motivate and reward junior and middle management. Lastly, we have the enterprise management initiative. Unlike the other three schemes, EMI is specifically targeted at small and medium-sized enterprises, with the objective of helping them to recruit and retain key employees by rewarding them with highly tax-advantaged share options with a value of up to £250,000 per employee, which can be offered at a discount.

The schemes give companies additional ways to incentivise and reward employees for their hard work by helping them to offer committed employees a direct stake in a company. As the right hon. Member said, that helps firms to achieve a more engaged and motivated workforce by aligning employer and employee interests in the growth of businesses and motivating hard work from employees, who can benefit from their input with a tax-advantaged output, helping to make a company a more attractive place to work by offering an appealing and unique remuneration package. Further, it encourages loyalty to a company among employees, fostering an environment in which the company can increase its productivity and achieve higher and faster growth compared with companies with a less engaged workforce. Lastly, the scheme can help with wider social effects, too, by encouraging savings and investing habits. In turn, it can support better financial planning on an individual level.

The right hon. Member raised an important point about the length of the investment term. To achieve the objective of incentivising employees to stay with a company as it grows, one of the SIP scheme’s rules is that the tax advantages are available on shares awarded only once a certain period of time has elapsed. That encourages employees to commit to their employer and to put hard work into the company to ensure that it succeeds, and the tax relief enhances the reward that they can gain from maximising the company’s success. Although partial tax advantages are possible for an employee after three years, full tax advantages for SIP are enabled at the five-year mark. Unlike the other schemes, SIP enables a direct purchase of shares in the company rather than other options, and the five-year holding for the full income tax and national insurance exemption is intended to encourage employees to remain invested in their employer.

[Sir George Howarth]

Will the Minister give way?

[Lucy Frazer]

If I could just continue the point.

[Sir George Howarth]

I wanted to intervene on a point that the Minister has already made.

[Lucy Frazer]

I appreciate the points that the right hon. Member has made. Stakeholders and employees may not otherwise intend to remain with their current employer for five years, which is why the tax relief is designed to encourage a long-term commitment, but I appreciate the suggestion of a one-year SAYE and less regular contributions.

[James Cartlidge]

On that point, what the right hon. Member for Knowsley (Sir George Howarth) said is very compelling, because the labour market has changed and there is more churn. I was persuaded that a shorter qualifying period, perhaps with other conditions, would be reasonable, given that the employee may have the best intentions of staying longer but the labour market has changed.

[Lucy Frazer]

I thank both my hon. Friend and the right hon. Member for Knowsley for their interventions. I was going to say that if evidence could be presented of the impact of that on people taking up the scheme, I know that the Treasury would be very interested in looking at that. As my hon. Friend said, it is important that the schemes are as simple as possible, and I would welcome any suggestions on that point.

With its current restrictions, SIP remains popular. We see people making use of the greatly beneficial tax treatment, with a total value of £780 million in shares purchased or awarded under a SIP scheme in the financial year 2020-2021. We continue to evaluate the schemes to make sure that they are incentivising the behaviours that I have outlined. We keep these important and advantageous schemes under review to make sure that they provide value for money for the taxpayer, support the wider aims of the economy and help employers to drive commercial success.

We launched a review at Budget 2020 to ensure that the EMI provides support for high-growth companies to recruit and retain the best talent so that they can scale up effectively, and to examine whether more companies should be able to access the scheme. At the spring statement, the Government concluded that the current EMI scheme remains effective and appropriately targeted. None the less, the scope of the review was expanded to consider whether the company share option plan should be reformed to support companies as they grow beyond the scope of the specifically targeted EMI. I know that these companies might want to make use of other discretionary schemes, such as the CSOP. While our inclination is to support those companies in doing so, Members will understand that we want to build the evidence base before committing resources, which is why we have expanded our review to include CSOP.

As part of the Government’s duties to evaluate tax reliefs and their value for money on an ongoing basis, we are currently reviewing the broader share scheme landscape. We will keep these important and advantageous schemes under review.

[Sir George Howarth]

I made the point that it would be better if the Treasury carried out its own consultation exercise, rather than asking organisations to bring it forward. The Minister can reflect on that subsequently—I do not want her to answer it now, but just to take it into account.

[Lucy Frazer]

As I mentioned, the Treasury keeps these schemes under review, but of course external evidence is always welcome. We want to ensure that these schemes support the wider aims of the economy and help employers to drive commercial success. We always welcome any evidence that can be brought forward.

In closing, I reiterate that these schemes have an important place in the toolbox of taxation policies. They will help us to drive productivity—the only way to sustainably raise living standards—while fuelling economic growth.

Question put and agreed to.

16:26

Sitting suspended.

Vaccine Damage Payment Scheme: Covid-19

Tuesday 6th September 2022 Westminster Hall

[Relevant document: e-petition 587380, Reform the VDPA 1979 to improve support for those harmed by covid-19 vaccines.]

16:29

[Sir Jeremy Wright (Kenilworth and Southam) (Con)]

I beg to move,

That this House has considered covid-19 vaccines and the Vaccine Damage Payment Scheme.

It is a pleasure to see you in the Chair for this debate, Sir Edward, and I am grateful for the opportunity to present on this important subject.

My constituent Jamie Scott was a fit 44-year-old when he had his AstraZeneca covid-19 vaccination on 23 April 2021. He woke with a headache on 3 May, then experienced vomiting and impaired speech. He was taken to hospital by ambulance where he had multiple operations and was in a coma for more than four weeks. His wife Kate was told by doctors that he may not survive and that if he did, he would likely be severely disabled. The couple have two young children. Jamie was diagnosed with a cerebral venous sinus thrombosis, or CVST, and subsequently with vaccine-induced thrombotic thrombocytopenia, or VITT. I am pleased to say that he has recovered somewhat, but he is still unable to return to the life he led before. His consultant’s opinion in December was very clear:

“It is very highly likely that the vaccine was responsible for the development of his symptoms (with no other possible explanation for the development of the symptoms).”

Jamie and Kate Scott are here today listening to me describe what happened to them, because their lives were changed utterly last year when Jamie did as the Government urged him to do and received a vaccination. I should make it clear that neither I nor they are making any argument against vaccination, but we are arguing that the relatively tiny number of people who are injured by state-advocated vaccination should be properly looked after.

Of course, the Scotts’ story is not the only one. I have heard, as I know you will have done, Sir Edward, from several colleagues who cannot be here today about the similar experiences of their constituents. For example, Mrs Birch, a constituent of my hon. Friend the Member for Burton (Kate Kniveton), was left near death and immobile in hospital, and she remains significantly disabled. Mr Walker, a constituent of my hon. Friend the Member for Grantham and Stamford (Gareth Davies), is a former marathon runner and semi-professional football referee who now finds that even getting dressed leaves him breathless, and he cannot live independently. Those people also did as the Government asked of them and have been seriously injured as a result.

Of course, this is not a new problem. People have been injured by vaccinations before and the Government have responded, notably with the vaccine damage payment scheme, established by the Vaccine Damage Payments Act 1979 on the logic that injuries consequent on state-recommended vaccination need special treatment. That scheme was intended as an interim measure but no further legislation has emerged, although it is true to say that covid-19 vaccines were included in the scope of the scheme in December 2020.

[Wera Hobhouse (Bath) (LD)]

My constituent did what she believed was right by getting vaccinated, but was one of those who had a blood clot after vaccination. The clot caused her to have a stroke and now she is unable to work. Her family are very concerned that she is going to be classed as not disabled enough to get a damages payout. Does the right hon. and learned Member agree that we need to look at these rare and few cases where people have suffered but might be falling through the net?

[Sir Jeremy Wright]

I am sorry to hear about the hon. Lady’s constituent and I agree with her. It is important that we do something differently for what she rightly says is a relatively small number of cases. If she bears with me, I will come to the exact point she makes about disablement, as it seems to be a deficiency of the scheme.

I have mentioned the VDPS and, of course, all help for those injured by vaccines is welcome. However, in my view there are three things wrong with the scheme and I will say something about each of them. The first is that it simply takes too long to pay out. The VDPS is a no-fault scheme, but it requires, not unreasonably, a causative link between vaccination and injury to be established. The problem is the time it seems to take to establish that link in the minds of the scheme’s administrators, even in cases such as that of the Scotts, where consultant opinions are clear and unequivocal. The Scotts’ application under the scheme was submitted on 3 June 2021, and was finally approved on 20 June 2022. According to the latest figures that I have—it may well be that the Minister has more up-to-date figures—there are 2,407 applications to the scheme related to covid-19 vaccines, and cases are currently being processed at the rate of 13 a month. At that rate, it would take more than 15 years to process all the cases.

[Mr Richard Holden (North West Durham) (Con)]

My constituent Lisa Shaw, a BBC presenter in the north-east, died after getting a blood clot as a result of the vaccine, leaving her young son without a mother and her partner, Gareth, absolutely devastated. Gareth came to see me in my constituency surgery a very long time ago—months and months ago—and he is still waiting. A lot of the people in this situation will have huge financial commitments and maybe families; if they have not died or are disabled, maybe they are unable to work. Does my right hon. and learned Friend agree that speed is of the essence? It has taken decades to resolve recent scandals, such as the contaminated blood scandal. Is it not right that we need to learn the lessons of those scandals and get these payments out to people as quickly as possible?

[Sir Jeremy Wright]

Yes, I agree entirely with my hon. Friend, who puts it very well. It is important not just that we have the right scheme—I do not believe yet that we do—but that, as he says, when that scheme is in place, it pays out quickly. It is clear that the scheme in place at the moment is not doing that, and it simply is not acceptable or feasible for families in severe financial distress to have to wait the length of time that they are being asked to wait. And the example that he gives is a good one.

That example is also important in another respect, because there is something else that the Government need to do. In relation to those cases where vaccine injury is fatal, as was the case with my hon. Friend’s constituent, the Government need to protect entitlement to benefits, as they have done with other similar schemes but which they are currently not doing in relation to payouts under the VDPS. Whether that is universal credit or some other benefit, that post-death entitlement needs to be protected in a way not currently allowed by the law.

The second problem with the VDPS is that it requires a 60% level of disablement. The first thing to say about that is that the percentage of disablement can be hard to quantify in these cases, as Jamie Scott’s consultant made clear in her opinion. However, the second thing to say about it is that 60% is a very high bar. There can be significant injury or disablement that does not meet that threshold but is still life-changing. The VDPS is all or nothing: it pays out the full amount or nothing at all. In other words, someone adjudged to be 59% disabled as a direct result of vaccination would receive no compensation at all under the scheme. That cannot be right.

[Alicia Kearns (Rutland and Melton) (Con)]

Before my right hon. and learned Friend gets to the payment system, I want to raise the issue of support. My constituent Charlotte was a 39-year-old healthy mother of three children. I am furious and appalled after having had to approach three Government Ministers, two NHS trusts and the local GP to ask if someone can help her with the myriad health conditions she has contracted as a result of doing the right and getting her vaccination. She has not got long covid; the long covid units and clinics do not want to talk to her. No one wants to support her. Currently, she is going to Germany for treatment. Her life has been destroyed, she cannot be a mother and yet not one Minister or anyone else seems to want to make sure that this very small cohort of people have a meaningful pathway to care and support.

Does my right hon. and learned Friend agree that we need to get a grip regarding this very small number of people and that Ministers need to reach out individually to every single family in this situation, make sure that they know what support they can receive, ensure that there is a care pathway, and help MPs to help their constituents?

[Sir Jeremy Wright]

Yes. Again, I agree with my hon. Friend, who puts her point very powerfully. It seems to me that there is an opportunity for the Government to do better, and I hope that my hon. Friend the Minister and her colleagues will take up that opportunity.

We are talking about people in very great need who have done the right thing. There is no fault whatsoever on their part, and the Government are best served by helping them, not just for individual reasons but collectively because of the impact that will have on Government policy. I will come back to that point. As my hon. Friend says, the level of support currently on offer is not adequate.

The third problem with the VDPS is that payouts under it are limited to £120,000. That may sound like a lot of money, but it is certainly not enough to compensate for more serious injury and loss of earnings and amenity over lifetimes, especially for people in the 40s, like Jamie Scott, who are disproportionately highly represented among the figures of those who have suffered vaccine-related injury. I appreciate that the Minister will say that the VDPS is not designed to be full compensation but an additional payment that does not prejudice a right to pursue damages through the courts. I want to explore that argument for a moment.

The fact that VDPS payments cannot and will not constitute full compensation in many of these cases makes legal action almost inevitable. When those cases are brought, they are likely to be brought against the Government, because of the perfectly sensible indemnities given by the Government to those firms that have produced the vaccines. The cases brought will either be won by those injured or lost. If they are won, the Government will be paying full compensation for injury, with additional and avoidable legal costs added. If they are lost, people who have suffered for doing the right thing, the thing that the Government asked them to do, will not be compensated for hardship they have suffered through no fault of their own.

Win or lose, the Government should not want those cases litigated. It will seem either that compensation is being dragged out of the Government or that it is being denied in what the public are likely to think are highly deserving cases. Worse still, those cases will put incidents of vaccine injury in the spotlight. We are rightly proud of the widespread take-up in what has been a successful and ongoing vaccination programme, but that take-up relies on public confidence in the covid-19 vaccine programme—confidence that is itself based on the safety of the vaccine. It is, let us be clear, overwhelmingly safe, but it is not universally safe. No vaccine is. The cases we are discussing today demonstrate that.

The Government need people to know, surely, that if they are in the tiny minority of those injured by the vaccine that they are being urged to take, they will be looked after. If people cannot be confident of that and see that as they witness those cases being litigated, it is likely to damage uptake of the vaccine. Of course, we must recognise that the Government may need to pursue mass vaccination again in the future. It seems to me that the Government should properly compensate those injured by covid-19 vaccines for reasons of policy as well as those of morality.

The question that follows is: can it be done better? You would, of course, expect me to say, Sir Edward, that yes, it can. These are relatively few cases in number, which means that the financial liability for Government is relatively delimited. There are domestic precedents we can follow—for example, the Thalidomide Trust. There are international examples that we can look to as well. The comparable scheme in Canada is also a no-fault scheme that compensates for

“severe, life-threatening or life-altering injury that may require… hospitalization or a prolongation of existing hospitalization, and results in persistent or significant disability or incapacity, or where the outcome is a congenital malformation or death.”

Significantly, there is no percentage disablement requirement and, crucially, no upper limit to the level of compensation that may be awarded.

In Australia, the scheme covers

“a clinical condition or administration related injury…most likely as a result of receiving the COVID-19 Vaccine”,

involving hospital treatment and resulting in at least $1,000-worth of losses. Again, it is a no-fault scheme but it has no percentage disablement requirement and no upper limit to the compensation amount.

Perhaps most strikingly, the no-fault compensation scheme attached to the COVAX programme, whereby countries including the United Kingdom make vaccines available to developing countries, can award up to 12 times the GDP per capita of the claimant’s country. In the UK, that would mean an upper limit roughly three times that of the VDPS. That means that the UK Government are funding better vaccine injury compensation for people in other countries than they are for people in our own. That surely is not a defensible position.

The Government must do better, and soon. They must either reform the VDPS in order to make it more similar to the best international comparators, or find a way to settle the inevitable legal actions in these cases swiftly and fairly. They must surely do so in their own interests, because in the end, the cost to Government of failing to compensate those who have acted on Government policy will be higher than the cost of compensating them.

It is because I support vaccination that I want confidence in vaccination to be maintained. Mostly, the Government should act because the people we are talking about did the right thing at the behest of their Government. Their Government now need to do the right thing by them.

16:46

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

We are here to discuss the vaccine damage payment scheme of 1979. My interest is as chair of the all-party parliamentary group on vaccinations for all, so it is clear that I am absolutely and utterly pro-vaccination.

We can be grateful for just how rare significant side effects or damage are when it comes to vaccines as a whole. However, as the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright) has said, if we are to maintain confidence not only in vaccination in principle but in further covid-19 vaccines, it is important that people feel secure and supported and that they are not hearing horror stories of people who have been hurt in some way by the vaccine and then just left stranded. It is vital that we do that, or we will see a rise in vaccine scepticism and vaccine hesitancy, and that will be manipulated exactly as we have seen over the last couple of years.

[Alicia Kearns]

As a former civil servant, I believe that the case load is so small that it is not unfair to expect Ministers to look at each case individually. They have the capacity and are capable. The purpose of vaccination is to protect not just ourselves but others around us, and many who have had negative consequences acted in the national interest and to protect their loved ones. They deserve the bare minimum of a Minister looking individually, case by case, to see what support they need and whether they deserve the vaccine payment or some exceptional support. Does the hon. Lady agree?

[Dr Whitford]

I totally agree. The Government’s response to the petition talks of 174 cases. When I was a breast cancer surgeon and there was the scandal about PIP implants, which I knew we had never used, I still had to go through every single breast reconstruction I had done in a period of 17 years in order to absolutely verify that that was not the implant. It is absolutely possible with such numbers.

At the moment, only 11 cases have been settled. Only 2% in recent years have been successful. Whenever any kind of scheme has only that kind of return, it has to be looked at. As has been said, it is a long wait and people are left not able to work or they have family pressures and receive no support. Who is deciding the 60% disablement? As has been said, it is an absolute cut-off. Even the maximum payment has not been reviewed since 2010 and it would not cover anyone for 20 or 25 years of lost earnings and ability.

The Government say it is not compensation. I think that a no-fault scheme is absolutely right. I raised this issue with the right hon. Member for Stratford-on-Avon (Nadhim Zahawi) when he was Minister for Covid Vaccine Deployment, in December 2020, and said that if the Government were removing liability from pharmaceutical firms, they had to step in and replace them. I would like to see the VDPS improved for all vaccine users, but the covid-19 vaccine is a specific case where urgent action is needed and where it is even more important to get financial support.

We heard about cerebral venous sinus thrombosis and how catastrophic, but thankfully rare, it is. People have also had micro-thrombosis and an array of autoimmune responses to the vaccines. My constituent, who does not want to be named, suffered from Guillain-Barré syndrome, which is now recognised and mentioned in association with the vaccines. It is a neurological condition that has caused him to have partial facial paralysis and problems with balance. That may sound minor, but he worked at heights in a majorly physical job and has not been able to work since spring 2020. He, and people like him, are terrified of the 60% disablement. He imagines that when he walks into a room, regardless of his facial appearance or his balance, people will think, “Well, you’re not really that bad”, but he cannot do the job he was doing before.

It is vital that we take these cases out of the VDPS, deal with them quickly to ensure confidence in the covid-19 vaccine, and take the time to change the VDPS to make it responsive, quick and something that the public believe in. In total, there are currently only just over 2,000 cases, which is not an overwhelming number to work through if it means that we maintain confidence in vaccines and the benefits they bring to all age groups, throughout our lives, against multiple diseases.

16:51

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to speak in such debates. I thank the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright) for putting forward and illustrating such a good case. It is always a pleasure to follow the hon. Member for Central Ayrshire (Dr Whitford). She knows that I always look forward to her contributions, because I believe they are based on the evidence and facts that she knows. She expressed that very well in her contribution, which I thank her for.

For almost two years we have encouraged our constituents to be vaccinated against covid, as the right hon. and learned Member for Kenilworth and Southam, the hon. Member for Central Ayrshire and others have said, in order to do their bit to protect themselves and others. We have begun to see the impact that vaccines can have on individuals only recently. It is sad, unfortunate and devastating for families and friends who have seen the health of loved ones deteriorate or, sadly, pass away.

It is essential that we do our bit, through this debate, secured by the right hon. and learned Gentleman, to ensure the vaccine damage payment scheme is swift and accessible to those who deserve to take advantage of it. As others have said, there are not a great number of cases but they are very important. I know the Minister will respond in a positive fashion, and I look forward to hearing what she and the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), will say.

We have all heard stories from friends, family or constituents about people who may have suffered negative impacts from the covid vaccine. I am glad to say there have not been many cases, but the number is still significant and those cases need to be addressed, which is what this debate is about. These people have suffered life-changing conditions because of their willingness to do their public duty. I was glad to have the vaccine and not to have had any side effects from it, and I am glad the vaccine was able to give me and millions of other people across this great United Kingdom of Great Britain and Northern Ireland immunity to that awful disease.

Under the Vaccine Damage Payments Act 1979, first payments of the £120,000 lump sum went out in June, but many people have felt let down by the out-of-date scheme. Hundreds more people across the rest of the United Kingdom are awaiting assessments and decisions, including people in Northern Ireland. As of May this year, over 1,300 claims have been made but only 20 have been referred for medical assessment. That is not enough and it is too slow.

There is no doubt there have been issues with punctuality under the 1979 Act, and I understand the reasons for that. As always in this House, it is not about the reasons but the solutions. We look to the Minister to give us some encouragement as to where we are. Some applicants are waiting almost six months for assessments and decisions—six months! The scope allowed for qualification is to be over 60% disabled, either mentally or physically, due to adverse impacts of the covid vaccine. The Government have urged that it is not a compensation payment, but it is intended to ease the burdens caused by severe vaccine damage. Whatever the reasons and criteria, the request from the right hon. and learned Member for Kenilworth and Southam, and from others in the Chamber, is to get it done quickly and not to delay.

We have heard of instances where the AstraZeneca vaccine has impacted on a small group of people when it comes to clotting.

[Sir Jeremy Wright]

As ever, the hon. Gentleman is making a lot of sense. He will have heard me say that the Government have a choice: they can either reform the VDPS or they can deal properly with the cases that are going to come their way. Does the hon. Gentleman share my view that what we are looking at here for the Government is something of a burning platform? They will get those cases, and if they would rather litigate them in the full glare of publicity then that is an option—but they will perhaps be foolish to do so. Would it not be better if they dealt with those cases more quietly?

[Jim Shannon]

I thank the right hon. and learned Gentleman for his words of wisdom. Minister, there is an easy option sitting before us. I agree with the right hon. and learned Gentleman: in my book, I believe if we can do it the easy way then we should. Let us address the issue in a way that gives the Government less hassle, satisfies the needs and requests of our constituents, and ensures that we can move forward.

In terms of clotting, as of June this year there were 444 cases of blood clots out of 49 million doses of AstraZeneca given. There is still evidence that not all those were caused by the vaccine. Regardless of that, why should we not be speaking out on behalf of those who have been impacted? There is no amount of money in the world that can fill the void of loss—it cannot be measured in pounds and pennies—but we must do our best to ensure that the process of vaccine damage payments is timely and simple.

That is what we are asking for; I do not think we are asking for the world, but for something that can be done very easily—in my simplistic way of looking at things—by Government. They can do it in a way that can give succour right away and thus do away with the thoughts and process of litigation, which would be long, laborious and much more expensive.

[Wera Hobhouse]

Is the problem not the fact that those affected cannot go to court because of the civil immunity that the manufacturers and suppliers of the covid vaccine have received?

[Jim Shannon]

It certainly is. Things are never straightforward and there are complex issues. However, today our request is quite simply on behalf of those who have contacted the hon. Member for Central Ayrshire and each and every one of us. We have them in Northern Ireland as well; some of my constituents have been impacted. I think it is really important that we do that.

[Dr Whitford]

It is not just a matter of who they sue—whether it is a pharmaceutical company or the Government. As with contaminated blood, is the point not that people injured by vaccines—or damaged in some way through healthcare—should not struggle with some long court battle? Look at how long the contaminated blood scandal has been running—surely we do not want to put people through litigation if it can be settled more fairly.

[Jim Shannon]

As always the hon. Lady gives us a focused way forward. Since I was elected as an MP in 2010, the contaminated blood scandal has been at forefront of my mind, as it has been for the right hon. Member for Kingston upon Hull North (Dame Diana Johnson), who is the Opposition spokesperson for that issue. People have waited all that time for compensation, but there is some hope now of it coming.

However, many people in the compensation chain for the contaminated blood scandal have not yet got satisfaction. The hon. Member for Central Ayrshire is absolutely right: litigation, by its nature, is traumatic and it adds to the problems for those who are already distressed because of their physical health, and experience anxiety, depression and all sorts of other issues. If there is a way of doing it—and the right hon. and learned Member for Kenilworth and Southam has referred to what that is—then let us do it.

The Second Reading of the Covid-19 Vaccine Damage Bill is scheduled for the end of October. I would like to hear that we must do well by our constituents across the whole of the United Kingdom of Great Britain and Northern Ireland who fell victim to this particular problem. We know that the 1979 Act does not apply to many other vaccines, and we have heard so much anti-vax rumour and speculation. I, for one, am willing to put my faith in healthcare professionals to ascertain why someone has been impacted in a certain way by the covid vaccines. The hon. Member for Central Ayrshire, who spoke before me, is not here as a healthcare professional; she is here as an MP, but she still has the expertise, knowledge and understanding of that, as do many outside. I previously added my name to present the private Member’s Bill earlier in the year, and I am very happy to do so again.

To conclude, we must stand by those who have stood by us in doing their civic duty to be vaccinated. I call on the Minister and Government, beseechingly, to engage with Health Ministers in the devolved nations in Scotland, Wales and Northern Ireland, and to collectively work to ensure that the Bill can be passed with the support of others. They must ensure that those impacted by the covid vaccines have something to ease burdens past and future. Along with other Members here today, I hope that the Government will address those issues with compassion and understanding, and do so now.

17:01

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I thank the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright) for securing today’s important debate on covid vaccines and the vaccine damage payment scheme, and also for the manner in which he presented the case. I think we can all agree that it is vital that those with genuine claims are supported, and that spurious anti-vax conspiracists are not allowed to undermine legitimate claims.

It is clear that it is beyond time for the UK Government to review the compensation scheme. Although the vast majority of vaccinations do not cause serious side effects, in a tiny number of incidents there have been and will be serious side effects. Any medicine, even an over-the-counter medicine, is capable of having seriously detrimental side effects. It is a tragic reality that, although vaccination is the right course of action, and the risk of harm from coronavirus far outweighs the risk of harm from the vaccines, some people will have serious side effects, including disablement and death.

The first payment under the compensation scheme in the UK has been handed out, to a bereaved individual whose partner lost their life as a consequence of the AstraZeneca vaccination. There are serious, valid claims of harm, and they must be respected and listened to. That is also vital to maintaining faith in the UK’s vaccination programme, both now and in the future. As those claiming make clear, making claims is not about being anti-vaccine.

Anti-vaxxers have attempted, however, to abuse the scheme and undermine the delivery of compensation. At one point, it was claimed that the compensation scheme was for anyone who was not made fully aware of the health risks of the vaccine. Such actions are designed to overwhelm the system, making it harder for people with legitimate claims to be heard, which ultimately undermines faith in the system. They promote the unfounded claim that the extremely unlikely consequences of the vaccine were hidden. Similar actions were seen in America, where there were many spurious claims for compensation, including on the basis of having a sore arm after vaccination. That was the only symptom that I had, and it was similar for many of my friends; it was a regularly experienced side effect, as we know.

We must support those with valid claims, while ensuring that anti-vaxxers do not hijack the scheme for their propaganda purposes. As I stated earlier, it is beyond time for the UK Government to review the compensation scheme.

[Sir Jeremy Wright]

I understand exactly the point that the hon. Gentleman is making. Would he agree that the best gift that we could give to the anti-vaxxers would be to allow them to say that people injured by the vaccine will receive no compensation and no help from the Government?

[Martyn Day]

I absolutely agree. MPs have warned since 2015, before I was in Parliament, that the system is out of date and in need of review. Payment levels under the scheme were set in 2010, and have not been reviewed since. Lawyers specialising in vaccine injury cases have criticised the 60% disablement criterion as out of date and as not reflecting the reality of some consequences of covid and the covid vaccinations.

In the aftermath of the coronavirus pandemic and the largest mass vaccination programme in the history of the United Kingdom, it is well beyond time that the vaccination compensation scheme is reviewed. This is made even more necessary in the face of the spiralling cost of living crisis, with those who have been disabled or bereaved by vaccine injury facing higher costs and lower incomes. In conclusion, the SNP calls on the UK Government to deliver an uplift to the compensation quantity and to ensure that no legitimate cases are being denied rightful compensation.

17:05

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Edward, for this debate on covid-19 vaccines and the vaccine damage payment scheme. I commend the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright) for setting out such a compelling case for reform. As he said, the application process is painfully slow and the level of disablement is really hard to assess. Setting the level at 60%, and having a limit for compensation, really does penalise so many people who ought to benefit from the scheme. It seems crazy that the COVAX scheme is three times more generous than the scheme that we have in the United Kingdom.

I thank the right hon. and learned Gentleman for setting out those facts to Parliament, and I hope the Minister has taken them on board. I also thank him for setting out the case of the Scott family, particularly Jamie Scott—one of a number of people who have been affected by the covid-19 vaccination, whose voices absolutely have to be heard in this Parliament. Hopefully, we can address some of the concerns that he set out.

This issue is very important, and it is equally important that facts remain at the heart of the debate. From the outset, I want to make it clear that the covid-19 vaccination programme has saved countless lives and enabled us to reclaim many liberties that we were forced to forfeit over the course of the pandemic. Nearly 51 million people have been fully vaccinated in the United Kingdom and, for the overwhelming majority of people, the vaccine is safe and effective, and it protects against covid-19. However, we are here today to talk about the small number of people for whom the vaccine has had devastating consequences.

The data has consistently shown that, by comparison with the unvaccinated, the rates of death from covid-19 are lower for the fully vaccinated in all age groups. In August 2021, just eight months after the first vaccine had been administered in this country, the UK Health Security Agency estimated that over 90,000 lives had already been saved in England alone thanks to the vaccination programme. Covid vaccines went through several stages of clinical trials before being approved and met strict independent standards for safety, quality and effectiveness.

As with many medical interventions, there are, sadly, instances of serious side-effects and, in extremely rare cases, death. According to the Official for National Statistics, 49 deaths in England have had the covid vaccine mentioned on the death certificate since 2020. Although that is incredibly low, given the scale of the vaccine roll-out, every single one of those deaths is a profound tragedy, and I can only extend my utmost sympathy to individuals and their families who have been affected by rare vaccine side effects.

Although no amount of money can bring back a loved one or reverse physical damage, it is only right that those who have developed health problems, or who have lost a relative as a result of vaccination, can access a financial payment. As we have heard, the vaccine damage payment scheme was created back in 1979, and Members of all parties will agree that its principle is important and necessary. However, I have been concerned by reports of operational delays and inadequate support given to those who have suffered from rare vaccine side-effects. While I fully appreciate that identifying the causal link between covid-19 vaccinations and damage is a complex task, it is disappointing that the first vaccine damage payment related to the covid-19 vaccination programme was only made in July 2022—a full year after similar payments had been made in other countries such as Norway.

In November last year, the VDPS was administered by the Department for Work and Pensions alongside the Department of Health and Social Care. Since then, its management has been transferred to the NHS Business Services Authority, working exclusively on behalf of the Department of Health and Social Care. Given that the scale of the covid-19 vaccination programme is likely to increase applications to the scheme, can the Minister reassure colleagues that the NHSBSA and its contractor Crawford & Company will have the requisite capacity to process applications in a timely manner?

Further to that point, I note that in response to a written parliamentary question in December last year, the Minister for Health, the hon. Member for Lewes (Maria Caulfield), stated that the NHSBSA will

“review the Scheme’s processes to improve claimants’ experiences through increasing personalised engagement, reducing response times and providing general support.”

She also stated:

“The NHS Business Services Authority will also work with the Department on service improvements and further digitalisation, including an online claim form to increase accessibility.”

I would therefore be grateful if the Minister responding to today’s debate could outline how that work is progressing and what recent discussions she has had with her departmental colleagues on streamlining the VDPS. I would also appreciate it if she could set out the current average processing time from when a claim is made to when it reaches its conclusion, and whether there are any plans to improve on that average processing time.

As the Minister will no doubt be aware, payment levels for the VDPS have not been reviewed since 2007, when they were increased under the previous Labour Government. In a recent response to a written question from my hon. Friend the Member for Ealing Central and Acton (Dr Huq), the Minister stated:

“There is currently no formal plan to review the payment amount for the VDPS.”

Can she clarify whether that is still the Government’s position and, if so, what assessment her Department has made of the current level of support for those who are experiencing lifelong severe side effects, especially considering the evidence presented during the debate regarding the support available in countries that are part of the COVAX initiative?

I reference in particular a recent BBC report about Hamish Thomas. Hamish suffered from extremely rare side effects after a polio vaccination, and remains paralysed to this day. He rightly received a payout from the VDPS. However, Hamish says:

“In the grand scheme of things, especially for someone’s entire life span,”

the VDPS

“won’t cover the vast amounts of medical expenses that are needed to be paid for and the NHS unfortunately can’t provide.”

What assessment has the Minister made of stories such as Hamish’s, and will she commit to meeting campaigners to ensure that those who require support can access it, either through the VDPS or by other means?

It is vital that the VDPS is protected, but it is also vital that it is fit for purpose and has the confidence of the public at large. There is a right way of dealing with this, which the right hon. and learned Member for Kenilworth and Southam has set out, to avoid the litigation and the mistakes we have seen with other scandals, in particular the contaminated blood scandal. It is a public health imperative that people appreciate that vaccines are overwhelmingly safe and effective, but the public also deserve to know that in extremely rare cases where an individual experiences harm or damage, suitable and proportional support is available.

I want to take this opportunity to thank the Minister. Reshuffles are difficult to predict, but I wish her well in whatever comes out of the new Prime Minister’s decisions on who’s who in the Government. As this might be our last face-to-face, and I do not know what the future holds for her, I thank the Minister for her work and for the courtesy she has shown to me as I have shadowed her from the Opposition Benches. I wish her the best of luck in whatever the Prime Minister dreams up for her new Government.

17:15

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

As always, it is a pleasure to serve under your chairmanship, Sir Edward. I thank my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) for securing the debate, and I thank other hon. Members for their participation. It has been a measured and important debate. I offer my sympathies to my right hon. and learned Friend’s constituent, whom I welcome to the Public Gallery today. While my right hon. and learned Friend will understand that I cannot comment on the case itself, my thoughts are with his constituent and his family.

After clean water, vaccination is the most effective public health intervention in the world for saving lives and promoting good health. Globally, we have one of the best and most innovative immunisation programmes, with vaccine confidence and uptake among the highest in the world. That has allowed us to get covid-19 and many other vaccine-preventable diseases under control. The UK became the first country in the world to deploy an approved covid-19 vaccine, saving countless lives and helping to prevent the NHS from becoming overwhelmed. This week, the NHS will become the first healthcare system in the world to use next-generation bivalent covid vaccines.

All vaccines must go through a rigorous testing and development process before authorisation to ensure that they meet the strict standards of safety, quality and effectiveness set by the independent medicines regulator, the Medicines and Healthcare products Regulatory Agency. We are also guided by the latest clinical and scientific evidence and advice on vaccine safety and efficacy from the independent Joint Committee on Vaccination and Immunisation.

Unfortunately, in some rare instances, some individuals may sadly experience harm because of vaccination. The vaccine damage payment scheme, or VDPS, provides a one-off, tax-free payment to those individuals who have been found, on the balance of probabilities, to have been harmed by a vaccine. The NHS Business Services Authority, which has a proven track record of delivering services that support the NHS, manages the operational side of the VDPS on behalf of the Department of Health and Social Care, following its transfer from the Department for Work and Pensions in November 2021. VDPS assessments are performed on a case-by- case basis by experienced, independent medical assessors who have undertaken specialist training in vaccine damage and disablement assessments.

Covid-19 vaccines were included in the VDPS from the very start of the vaccine roll-out in December 2020. This approach is in line with most comparable countries, with similar existing schemes in the US and other G7 countries extended to cover covid-19. It allowed those whose severe disability was found, on the balance of probabilities, to be linked to a covid-19 vaccine to receive timely support through this established, tried and tested system.

My right hon. and learned Friend the Member for Kenilworth and Southam mentioned the COVAX programme, which was set up as a result of the covid-19 vaccine and provides a no-fault lump-sum compensation payment in full and final settlement of any claims. The VDPS is different: while it provides a one-off lump sum, it is not compensation and is not given in full and final settlement, leaving it open to individuals to make a claim for damages through the courts. The COVAX programme is also time-limited to 30 June 2023, which is just next year.

In June 2022, the first outcomes of covid-19-related VDPS claims began to be communicated to claimants. Given the novelty of the covid-19 vaccines, the processing of claims had to wait for scientific evidence to reach a more settled position to better understand the potential relationship between the vaccines and certain adverse events.

[Sir Jeremy Wright]

Before my hon. Friend moves off international comparisons, can I ask her about the Canadian and Australian schemes that I mentioned? I take her point about COVAX providing full and final settlement, but, as I explained, that is not the case for the Australian model or the Canadian one, neither of which has either a 60% disablement requirement or a maximum sum in compensation. If my hon. Friend is able to comment on that now, I invite her to do so. If she cannot, would she write to me to explain why the Government think those are not appropriate models to follow?

[Maggie Throup]

My right hon. and learned Friend makes a good point. What I was trying to relay is that those countries that had established schemes in place extended those to the covid-19 vaccine, and where countries did not have established systems in place, they set up new ones. I will write to my right hon. and learned Friend with further details, but that is a broad outline of where we are with that.

While evidence of a causal mechanism between vaccines and injuries reported has yet to be fully established, careful monitoring by regulators and scientists around the world has enabled certain adverse events to be identified as being linked to the covid-19 vaccines. The NHSBSA works closely with the MHRA and UKHSA to ensure that concluded outcomes reflect the most up-to- date evidence on causation and the covid-19 vaccines.

My right hon. and learned Friend raised concerns that the payment of £120,000 is not sufficient to meet the needs of individuals. It is important to note that that amount is a one-off lump-sum payment, and is not designed to cover lifetime costs for those impacted. It is in addition to the Government’s support package for those with a disability or long-term health condition, which includes statutory sick pay, universal credit, employment and support allowance, attendance allowance and personal independence payment.

[Sir Jeremy Wright]

I am grateful to my hon. Friend for her forbearance. On the point she has just made, it is true, of course, that people have access to the benefits system. However, as I said earlier, at the moment, at least, if someone is in receipt of a payment under the VDPS, that will count against their entitlement for benefits. It is possible to deal with that if the claimant is still alive; if they are not, it is not possible. Will the Government look at how that might be remedied, as it is in relation to other types of payment under other schemes?

[Maggie Throup]

Yes, we will definitely look into that on my right hon. and learned Friend’s behalf.

The VDPS payment amount has significantly increased since the original VDPS payment of £10,000 set in 1979. It has been revised several times and, as the hon. Member for Denton and Reddish (Andrew Gwynne) said, the current level was set in 2007. This will be kept under review as part of business-as-usual policy work. As my right hon. and learned Friend the Member for Kenilworth and Southam is aware, a successful claim to VDPS does not preclude an individual from bringing a claim for damages through the courts.

[Dr Whitford]

Will the Minister give way?

[Maggie Throup]

I am getting a bit short of time. Lots of points have been raised and I want to make sure that I cover them all, so I will continue.

In line with the pre-action protocol should a claim be brought, where the Government are party to any claim, they will consider whether alternative dispute resolution might enable the settlement of the claim without the need to commence proceedings. The form of any ADR would depend on the details of claims that are made.

My right hon. and learned Friend the Member for Kenilworth and Southam also raised concerns about the 60% disability threshold. That threshold was lowered from the initial 80% to 60% in 2002, and it remains aligned with the definition of severe disablement set out under the DWP’s industrial injuries disablement benefit, a widely accepted test of disability. There is no evidence at present that the current level is a significant barrier; in 2019 and 2020, just one claim out of 70 was rejected due to the disability threshold not being met. We will review the latest data as covid cases are processed, but at present, evidence does not support lowering the threshold.

Working alongside NHSBSA, our focus is now on improving the service offered by VDPS by scaling up operations and improving the underlying processes. Since taking over operational responsibility in November 2021, NHSBSA has transformed the administration of the VDPS, which was previously a paper-based system. It has significantly increased its capacity to meet the demands placed on the scheme, expanding from four to 40 caseworkers and additional support staff, with further recruitment under way. This means claims can be processed more quickly, with personalised engagement with applicants through the allocation of named caseworkers.

NHSBSA awarded a new contract to an independent third-party supplier in March 2022 to provide additional medical assessment capacity to process covid-19-related claims. That has allowed for the conclusion of the first of those claims. NHSBSA is working to digitise applications and medical records, streamlining the process. A wider modernisation project is also being taken forward to digitise the application form, to create a simpler and swifter process and allow caseworkers to manage claims more efficiently. To allow more rapid assessments and processing, NHSBSA is setting time limits for the provision of medical records, with a call-back process in place. Further approaches are being looked at to secure relevant medical documents faster, as this has been a key limiting factor in processing rates.

My right hon. and learned Friend the Member for Kenilworth and Southam raised concerns about the rate of progress of VDPS. I am sure that he will appreciate, from what I have just indicated, that there have been vast improvements over recent months. As an update, NHSBSA has 2,458 live cases, of which 1,203 claims are awaiting returns on requested medical records, 181 claims are with medical assessors, and 261 claims are awaiting requests for medical records. The average claim takes around six months to investigate and process from the date NHSBSA requests the claimant’s medical records. The timeframe varies from case to case. NHSBSA has scaled up a dedicated team of caseworkers, as I have indicated, to move claims forward and update claimants on the progress of their claims.

My right hon. and learned Friend raised an interesting question about establishing a bespoke compensation scheme for covid-19 vaccines. Establishing a dedicated, stand-alone compensation scheme would risk favouring those potentially damaged by covid-19 vaccines over those damaged by other vaccines. That could create an inequality between vaccines, which could be detrimental to other vaccination programmes.

I thank my right hon. and learned Friend again for securing this important debate. Everyone has made really sensible contributions, and we will take everything that has been said into consideration. I am pleased that a number of covid-19 VDPS claims have now been concluded, offering outcomes to claimants, with further cases being progressed. Now is not the right time to review the VDPS: our focus must be on improving and scaling up its operations and continuing to process claims. We will continue to further improve the service so that outcomes can be provided sooner, giving additional support to those who qualify.

17:28

[Sir Jeremy Wright]

It simply falls to me to thank everyone who has participated in the debate. I hope that the Minister has a sense of the degree of consensus about the need to look again at the VDPS or, if not, to look at ways in which these cases can be settled by other means. As the hon. Member for Denton and Reddish (Andrew Gwynne) put it, we cannot ignore these cases. Seeking to deal with them justly does not in any way undermine our commitment to vaccination as a public health approach; indeed, I think most of us argue that it strengthens it and makes it more coherent, so I hope the Minister will go away and think again. Like the hon. Gentleman, I do not know what the future holds for her, but I know the officials behind her will stay where they are, and I hope they will be able to talk either to her or to her successor about what more can be done on this front. The families who have been injured deserve better than they are getting, and the Government’s policy objectives would be better served if the scheme worked better.

Question put and agreed to.

Resolved,

That this House has considered covid-19 vaccines and the Vaccine Damage Payment Scheme.

17:29

Sitting adjourned.