House of Commons (21) - Commons Chamber (10) / Written Statements (9) / Petitions (2)
This information is provided by Parallel Parliament and does not comprise part of the offical record
(10 months ago)
Commons ChamberBefore we proceed to the next item of business, I would like to acknowledge that this is the last working day in the Chamber of Jim Davey, the Speaker’s Trainbearer. Before he moves on to an exciting new role within the House, I want to express my personal thanks, and those of honourable colleagues and the whole of the Speaker’s Office, to Jim, who has served as Trainbearer for the last 12 years. When I became Speaker, he made that transition into the role so much easier with his encyclopaedic knowledge of procedural matters in the Chamber and his authoritative recollection of events that have taken place here during his time in office.
In 2013, a political sketchwriter commented:
“The trainbearer will, I hope, forgive me if I report that he carries his page-boy uniform, complete with rosette…with aplomb.”
But of course, nothing fazes Jim. In his 12 years, he has seen a lot and still retained that aplomb. Of course, we all thought that Quentin Letts just did it for Members, but Jim has also had the privilege of Mr Letts’s evaluation of his proceedings.
I am sure that the whole House will join me in wishing Jim well in his next job as Senior Clerk in the Table Office. I know that many Members rely on his wise counsel, so I am pleased that we will retain his knowledge and experience, and that they will be put to good use just along the Corridor. The good news for me is that at least I do not have far to go for the benefit of that knowledge this time. So, Jim, can we wish you well and thank you for everything you have done? It has been amazing. With aplomb, thank you again.
(10 months ago)
Commons ChamberThe Government are investing nearly £600 million to introduce a £2 fare cap on single bus fares in England outside London. We had introduced it on 1 January 2023 to help passengers to save on their regular travel costs, but the Prime Minister announced recently that it would be extended until the end of 2024. Just this week, the Government also announced an indicative additional bus service improvement plan worth more than £13 million for West Yorkshire.
I warmly welcome the Government’s support, which is making bus journeys across Keighley and our wider area much more affordable. As a result of the bus service improvement plan, as from last month we have a new £1 zone in Keighley, making travel around the town much more affordable, with the K3 and K7 services becoming more frequent. Moreover, a single ticket for other journeys costs just £2, thanks to the Government. Does my hon. Friend agree that this demonstrates that our Conservative Government recognise the importance of local, affordable travel links that help to support our communities?
This Government certainly do. I thank my hon. Friend for raising our commitment to supporting bus services, not just in his constituency but right across the country. This is just a small part of the £3.5 billion we have invested in bus services, with much more to come, including our recent announcement of another £150 million for the bus service improvement plan from the money for Network North, starting next year.
The Department’s data shows that, between June 2022 and June 2023, bus fares dropped by 7.4% in England, outside London. Whereas in London, Wales and Scotland, where buses are devolved, fares have increased by 6%, 6.3% and 10.3% respectively.
Let me put this in context. In South Yorkshire, since 2010, bus passenger miles have dropped by 50%, which is a catastrophic fall in the use of our bus services. The cuts to services mean that many communities are now cut off completely.
When the Government came to allocate the recent funding, which is welcome, did they take account of the fact that South Yorkshire had previously had no BSIP funding whatsoever? Adding the current funding to the previous funding, South Yorkshire has had far less per passenger head than other parts of the country. Why have the Government so discriminated against South Yorkshire and my constituents?
I would welcome an Adjournment debate on South Yorkshire buses, if the hon. Member for Sheffield South East (Mr Betts) were to put in for one.
I spoke to the Mayor of South Yorkshire just this week, and he said that the authority will need around £8 million next year to put back all the services that have been removed over the past few years. In our Network North allocation, it is getting £67.8 million next year. On top of that, he is getting another £3 million in BSIP funding next year. With all the extra cash this Government are providing, he should be able to provide exactly what the hon. Gentleman suggests. That is in addition to the “Get Around for £2” fare scheme, which will benefit any of his constituents who can use a bus.
Before I answer this question, Mr Speaker, may I put on record, on behalf of the Government side of the House and myself, that I share your congratulations to Jim on his service so far and still to come. It sounds like Quentin Letts was rather kinder to him than he often is to many of us.
As the cost of HS2 has increased, the relative benefits have dwindled. Every penny of the £36 billion that would have been spent on phase 2 of HS2 will be reinvested into local infrastructure and transport schemes across the country, including £20 billion on projects across the north. That investment will support thousands of new jobs, on top of the thousands already supported by the construction of phase 1 from Birmingham to London Euston.
We know how vital rail infrastructure is for economic growth, connectivity and inward investment. Eighty-five per cent of the projects announced in Network North were previously promised, committed to or subject to approval. If those projects have not been delivered in the 13 years that this rabble have had in government, why should my constituents trust that this is not a case of the north, yet again, having to choose and getting neither, while London gets HS1, HS2, Crossrail 1, Crossrail 2 and a fully integrated and Department for Transport-subsidised public transport system?
I think the hon. Lady is missing the fact that every single penny that we are not spending on phase 2 of HS2 in the north is being—[Interruption.] No, she raises a good point. Every penny of what was going to be spent in the north is being spent in the north, and every single penny that was going to be spent in the midlands is being reinvested in the midlands. It is the money that has been freed up from our more ambitious development project at Euston that will be spent in the rest of the country. The north of England is getting exactly the same amount of money, it is just being spent on transport projects that are better fitted to what people actually need, rather than phase 2 of HS2.
In a recent episode of the “Green Signals” podcast, the former chair of the Strategic Rail Authority, Sir Richard Bowker, claimed that no Government included in the business case for HS2 the economic value of additional passenger and freight services that would run on the classic lines, enabled by HS2. May I ask my right hon. Friend to investigate whether this is the case and, if it is, why it has not been properly evaluated?
I thank my hon. Friend for his question. The phase 1 benefit-cost ratio process for HS2 captured some of the benefits of released capacity, including new demand for existing services. It did not include all the benefits from new services, but I know that the rail Minister will be happy to meet him to discuss that in more detail.
A new city centre station and a fast rail connection to Manchester are vital to unlocking Bradford’s economic potential, and I welcomed their inclusion in the Government’s Network North strategy. However, the Prime Minister has since stated that many projects in the strategy are not final but illustrative. So will the Minister confirm that this Government will, at long last, firmly commit to a new high-speed, high-capacity line, without interchanges, between Manchester and Bradford?
Yes, I can confirm that. The day after the party conference I went to Bradford and met the leader of the council and the West Yorkshire Mayor to talk about our plans for the station at Bradford, their ambitious plans for the growth of Bradford and the new rail lines. They very much welcomed the plans we have made. I hope that the hon. Gentleman does too, and it would be nice if the Opposition Front Benchers shared the same views as their party colleagues.
I welcome the almost £1 billion that Tees Valley will receive from Network North. What advice can the Minister give me to ensure that Darlington secures the £160 million for the northern link road and £10 million for the North Road station?
My hon. Friend is a great champion for transport schemes in his constituency and I welcome his recognition of the funding we have allocated to the Tees Valley Combined Authority under Network North. I encourage him to raise the issue of those schemes with the combined authority, which will be able to use the money allocated to it to focus on the transport projects that matter most across the combined authority, particularly in his constituency.
In June 2019, Ministers were reportedly told by the new chairman that HS2 was billions over budget and years behind schedule, yet as MPs in this House debated the Third Reading of the High Speed Rail (West Midlands – Crewe) Bill on 15 July none of that was made clear to parliamentarians. Does the Secretary of State agree that if the true cost was hidden from Parliament, that would represent an outrageous breach of the ministerial code? Will he say right now whether that was the case?
First, let me welcome the hon. Gentleman to his position on the Opposition Front Bench. Obviously, at the time he mentions I was not in the Government. I am sure that all of my ministerial—[Interruption.] If the hon. Member for Sheffield, Heeley (Louise Haigh) would allow me to answer the question rather than chuntering from a sedentary position, that would be welcome. As I say, I was not in the Government at that time, but I am sure that all of my ministerial colleagues, both past and present, are well aware of their responsibilities under the ministerial code and that they gave truthful answers to Parliament at the time.
Many of us question this Government’s moral compass, but the Network North plans give rise to concerns about their actual compass, with the provisions for Plymouth and Bristol. The first recommendation in the “Union Connectivity Review” backed
“investing in the West Coast Main Line north of Crewe to properly use HS2 and its faster journey times and capacity to serve connectivity between Scotland and England”.
Yet Network North justifies continuing with HS2 phase 1
“as it provides the most effective solution to…constraints on the congested southern end of the West Coast Main Line”.
So when will the Secretary of State deliver the upgrades north of Crewe to unblock the bottleneck to the Scottish economy and that of the north of England, including Chorley?
The hon. Gentleman will know that we have made it clear that we are going to make sure that high-speed trains can still continue past Birmingham on to the west coast main line. We have already had a debate in this House, and I believe we had this debate at length when I made my statement after the House returned last week, about the capacity on the west coast main line. The southern section is the most congested part, which is why we are continuing with phase 1. There is a debate to be had and people can have different views about where demand will go over the next 20 years. The view we have taken is that the priority is to focus on the transport needs of people now—[Interruption.] Well, in the north of England we are reinvesting £20 billion of the £36 billion we have saved, so we are putting the money where it would have been invested but on transport projects that are more relevant to people’s everyday needs.
The Network North announcement included commitments to rail improvements at Ely and Haughley junctions, which is a key priority for the east and also for railfreight. We are also committed to the A10 scheme north of Cambridge. The east will also benefit from the £8.3 billion announced for highways maintenance funding across England.
I warmly welcome the commitment to upgrade Ely Junction, which will boost passenger services to King’s Lynn in my constituency, as well as freight. I am sure my hon. Friend will ensure that the scheme now proceeds as rapidly as possible. May I also urge Ministers to approve the business case submitted by Norfolk County Council for the A10 West Winch housing access road, which is essential to unlock housing, reduce congestion and boost growth?
As ever, my hon. Friend is bang on when it comes to the Ely project. It is a superb project, which really delivers for freight and ensures that freight can travel from Felixstowe across the midlands, rather than having to go south. So I can assure hon. Members that we will be on that project and getting it delivered.
On my hon. Friend’s point on the A10, which I welcome, officials are currently assessing the outline business case submitted by Norfolk County Council, and will be providing advice to Ministers in due course. We will ensure that we are in touch with my hon. Friend as soon as a decision has been made.
The Government are committed to accelerating the transition to zero-emission vehicles. Last year, 16% of new cars and around 6% of new vans sold were fully electric. To continue to support the uptake of zero-emission vehicles we are, as the House knows, introducing a world-leading zero-emission vehicle mandate. That will support the future supply of zero-emission vehicles by setting a minimum percentage of manufacturers’ new car and van sales to be zero-emission each year from 2024. I am delighted to say that this week we have laid the new public charge point regulations to facilitate charging for electric vehicles.
I thank my right hon. Friend for his answer. As he knows, in South Derbyshire in the Toyota factory we have groundbreaking hydrogen technology, so I would ask, what is the Minister doing to ensure that the charging infrastructure is in place across rural areas, for both electric and hydrogen vehicles?
My hon. Friend knows that the Government have supported the use of hydrogen in road vehicles for over a decade, including the installation of hydrogen refuelling infrastructure where there is sufficient demand. I should also say that notably, Toyota recently announced the tremendous progress that it appears to have made in commercialising solid-state batteries. That is a very encouraging sign across the piece, not just for hydrogen but for electric.
We have already heard that the uptake of electric vehicles is closely linked to charging points. When will the Government close the gap in charging costs between those who have the ability to charge at home and those who rely on a public charging point?
As the hon. Lady knows, there is wide and differing experience across the charging network. Many people are able to charge at home and many people are able to charge through the increasingly large public network. The way in which electricity prices have changed has tended to dominate changes overall, but she will, I am sure, share my pleasure that the new charge point regulations mean that we can now have a much more competitive market for charging across all the different forms of infrastructure.
Using the savings from HS2, we will extend the £2 bus fare right across England until the end of December 2024. This means that the Government have committed over £600 million to cap bus fares. We have also announced that the Government will continue to provide increased financial support to community transport operators, to help them protect key services by uplifting their bus service operator grant by 60%.
I thank the Minister for that reply, and for his recent visit to Southend West. He is very aware that last year, elderly residents were left stranded, literally overnight, when First Bus withdrew the No. 21 service, cutting them off from Southend Hospital, from Leigh Broadway and from many community groups. Despite successfully working with First Bus to reroute the No. 3 bus, this is not good enough; it only runs once every two hours. Will he meet me and First Bus to make sure that Southend City gets the best bus services possible?
I was delighted to visit my hon. Friend, and also my hon. Friend the Member for Rochford and Southend East (Sir James Duddridge). I would be very happy to meet her and representatives from First Bus. Her work to champion her constituents’ local transport needs is second to none. I was delighted to see that that additional piece of bus funding of almost £1 million from central Government to Southend to help protect and enhance local bus services is going through, but I will happily meet her to see how we can best ensure that it is spent in a way that protects her residents.
It is not possible for people in Tamworth to reach Burton hospital by bus if they need to do so. Will the Government commit to supporting Labour’s take back control Bill, which will devolve the running of bus services to local authorities, so that bus routes that communities need can be delivered by the people who know where they are needed most?
I welcome the hon. Lady to her place. This Government have put in unprecedented amounts of support for bus services, including £150 million for the midlands and the north in the past week alone. The Bus Services Act 2017, which we passed, allowed franchising to be expanded across the country. It is this Government who are delivering on that greater reach for local authorities, whether it is via franchising or enhanced partnerships. I urge her to speak to the county council in her region and try to get it to allocate some of that money to support local services. This Government are putting in the money, but it is up to the local authorities to deliver.
On Monday, the Government pledged to deliver 25 million more bus miles, but what they failed to tell the public was that this was just a drop in the ocean, compared with the 175 million bus miles that they have slashed over the past five years. In fact, never before on record have bus routes fallen by as much as they have over the past year, and this from the same party that promised buses so frequent that we would not need a timetable. Does this not show that, while the Tories and their broken bus system remain in place, communities will continue to see this record-breaking decline in the bus services on which they depend?
The hon. Member does not seem to recognise the facts of the situation. There have been huge amounts of extra cash going in, whether that is through the City Region Sustainable Transport Settlement that we are seeing right across the country—in some cases, that funding is being tripled for some local authorities—or the bus service improvement plan. On the statistics that those on the Labour Front Bench trot out, the one they seem to forget is that, in Wales, bus services have declined by more than twice as much in terms of mileage than the rest of the country, and it does not have the “Get Around for £2” fare scheme or any of the other support that the Government in England are putting into services, because it is making the wrong decisions.
The Government’s Network North announcement included £2.5 billion of investment for the West Yorkshire mass transit system, building on the £200 million already provided to the West Yorkshire Combined Authority, which is developing the business case. I look forward to reviewing that and bringing the benefits of mass transit to the West Yorkshire region.
Less than 40% of the population of Leeds can now reach the city centre by public transport within 30 minutes. We have been promised and promised a public rail-based transport system by this Government for years, and yet we still remain the largest city in Europe without one. Will the Minister tell the people of Leeds why we should believe him this time?
I will take that as a welcome for the £2.5 billion commitment in Network North. As the hon. Member rightly says, Leeds would no longer be the largest city in Europe without a mass transit system. What we are looking to do with the West Yorkshire Combined Authority is create a network of up to seven lines, which will eventually connect Leeds with Huddersfield, Wakefield, Bradford and Halifax. Work is going on, because £200 million has already been committed. I had a meeting with the Secretary of State for Levelling Up, Housing and Communities and the West Yorkshire Combined Authority to discuss the plans and proposals. The combined authority is working at pace and we are going to fund it.
Nottinghamshire previously submitted a levelling-up bid for a new Toton link road but narrowly missed out. The project—
Order. One of us is going to have sit down, and it is not going to be me. The question was on Leeds, unfortunately. Is the hon. Gentleman’s supplementary linked?
The Government remain committed to improving rail access to Heathrow airport, and recognise the importance of the improved rail connectivity that a western rail link could provide. We need to ensure that projects that we take forward reflect the changed shape of rail demand and are affordable. I understand that, as a consequence, the promoters of a western rail link are updating their proposal.
You will be aware, Mr Speaker, that I have long championed a western rail link to Heathrow, which would connect 20% of the UK population to within one interchange of our nation’s main airport. The Government committed to it over a decade ago, yet not a single spade has dug into the ground. Sadly, the Government have more of a reputation for cancelling rail links than for building them. Perhaps the rail Minister, who kindly met me recently about the issue, will have better news for us today. What meetings has he had with Heathrow airport, Thames Valley chamber of commerce and other stakeholders to progress this vital 4 mile rail link between Slough and Heathrow?
May I first thank the former shadow rail Minister for the times that we had together? It is true that he has been a champion of this project, and indeed pretty much every other rail project that I have gone to an all-party parliamentary group for, where he had already agreed to pre-fund it. I assume that now he is a shadow Treasury Minister he might be cancelling some of his previous decisions in a bid for fiscal credibility.
This particular project was due to be funded 50:50, but things have changed post pandemic for Heathrow, so it is right that it goes back to the drawing board. We will always support rail investments that can be paid for by private enterprise. That is what our Network North project is all about.
I regularly meet with Network Rail and train operators to discuss rail performance and services. Twickenham has seen positive results. In the past 12 weeks, an average of 88.1% of trains across the lines serving Twickenham have arrived within three minutes of the stated time.
I thank the Minister for that answer. If we want to encourage more people to use our railways we need to ensure that our stations are properly staffed so that they are accessible and safe for all, and that all complex tickets can be purchased easily, yet the Government are backing South Western Railway’s plans to slash staffing hours at stations across my constituency, in some cases by up to 80% in very heavily used stations. Will the Minister heed the advice of the Transport Committee, which has said this week that ticket office closure plans are moving “too far, too fast”, and his own statement that he does not expect a material reduction in hours, and stop these plans in their tracks?
I always take onboard the advice of the Transport Committee, because it does a great job and always has done. On ticket offices, these are industry proposals, which, pursuant to the process set out in the ticketing and settlement agreement, are currently being consulted on between the train operators and the passenger bodies. We expect that consultation stage to conclude shortly. I have made it clear at this Dispatch Box, and the Secretary of State has also been clear, that this should be a redeployment and multi-skilling of staff exercise to enhance the passenger experience.
Serious overcrowding persists on Chiltern railway services serving my constituents, particularly at rush hours and weekends. The long-term solution is whole-fleet renewal, but there are some short-term fixes that Chiltern is asking for, such as being permitted to bring its extra set of Class 68s back into use. Can my hon. Friend assure me that he is doing everything possible at pace with Chiltern to improve rail services for my constituents?
My hon. Friend is another excellent member of the Transport Committee, and he always champions the need for more capacity on his busy railway lines. He is accurate: overcrowding is becoming an increasing concern for Chiltern, which is assessing options to mitigate the issue, such as further utilisation of the Class 68 units in and out of Marylebone to maximise capacity. There are issues with the diesel fleet, but we want to ensure that we can continue to provide the service for his Chiltern customers. In the longer term, I know that Chiltern is working with the rolling stock company providers to assess hybrid trains, with an aim to moving away from diesel.
Fresh from slashing and burning HS2 while in Manchester and spouting crank conspiracy theories, the Secretary of State announced Network North. However, that dodgy sounding 1970s ITV franchise does not have a single project with an approved business case, and plans are valued at 2019 prices. There was no promise to my hon. Friend the Member for Bradford East (Imran Hussain) a minute ago. Network North is literally not worth the paper it is written on, is it, Minister?
It most certainly is. When the Prime Minister announced Network North, it was clear that we were going to see a plethora of rail projects and, indeed, wider projects. We will better connect the major cities of the north, we will invest £2 billion so that Bradford can finally get the new station that it deserves and, as I have stated, we will add £2.5 billion to the West Yorkshire mass transit system. There is a huge amount of projects that we should all be celebrating, across parties. It is interesting that the Opposition seem to be knocking these opportunities to better connect cities across the north and the country.
When it comes to business cases, the Ely and Haughley project, for example, has an outline business case of 4.6. We know that business cases are stronger when there are local transport opportunities. My question back to the Opposition Front-Bench team is whether they support these proposals, in which case they should ride behind them and be positive about them—or do they not want better transport networks across the north, the midlands and the rest of the country?
My Department takes road safety for all road users, including those using rural routes, extremely seriously. We are currently considering how best to address the specific safety issues that may arise on parts of the local rural network. As part of our work on road safety, my officials regularly meet Home Office officials to discuss issues of mutual interest. I also recently met my right hon. Friend the Minister for Crime, Policing and Fire to discuss these and other matters relating to road safety, including more ways to tackle drink and drug driving.
On the subject of speeding and rural safety, the entry into one of my primary towns in North Norfolk—Sheringham, a tourist town on the Norfolk coast—has a fast-flowing road that is becoming more and more congested year after year. What it really needs is a roundabout, which the Minister knows all about. All in my community support it. Unfortunately, the county council does not have the money—not as much as the Minister now has, certainly. Could he please find me a funding pot to bid into to build the Sheringham roundabout?
My hon. Friend is a real champion for a Sheringham roundabout; in fact, he has dragged me there to visit the A148 junction with Holway Road. I was delighted to do it, and I will be happy to go down and see it again. I understand that Norfolk County Council is continuing preliminary design work and confirming costs and planning requirements, which should put Norfolk in a strong position to make a bid. Although there are no immediate sources for this specific scheme, I encourage the council to continue to work with the safer roads fund, because a new opportunity will arise next year.
Through Network North, we announced £8.3 billion for road resurfacing—the largest allocation of money for local road maintenance ever—and an extra £4 billion for local road schemes. In addition, the plan for drivers set out 30 new measures we are taking to make motorists’ lives easier, from restraining the most aggressively anti-driver traffic management interventions to stopping councils profiting from moving traffic enforcement. Our plans show that the Government are on the side of drivers.
Across the country, the Department for Transport and local administrations have had great success in reducing the impact of roadworks on everyday motorists through lane rental schemes. Unfortunately, Greater Manchester is not one of the areas making use of that highly effective tool. Will my right hon. Friend take steps to ensure that Greater Manchester adopts a similar scheme to tackle the massive disruption caused by roadworks?
I entirely agree with the point made by my hon. Friend. I am pleased to report that, following his very effective representations and those of others, the Mayor of Greater Manchester’s Bee Network committee recently endorsed a decision to develop a proposal to introduce lane rental in Greater Manchester, and discussions are now taking place with local authorities.
I welcome the UK Government’s £1 billion investment to electrify the north Wales main line, but for my Ynys Môn constituents, the best connectivity for motorists would be a third Menai crossing to take the pressure off our two lovely but old bridges and to make the most of Anglesey freeport and of Holyhead, the second busiest roll-on roll-off port in the UK. Will my right hon. Friend see what the UK Government can do to make that a reality for north Wales, now that the Welsh Labour Government in Cardiff have banned new road building?
The UK Government recognise the importance of Ynys Môn to the UK economy. Decisions about the Menai crossings are the responsibility of the Welsh Government. That emphasises the damage, both to the Welsh economy and the UK economy, being done by Labour’s decision to ban all new road building, which I very much hope it will revisit.
Petrol prices in Barnsley are significantly higher than in neighbouring areas. Indeed, it is often cheaper to buy petrol in central London than it is in Barnsley. I do not think that motorists in Barnsley should have to pay a petrol price premium. Does the Secretary of State intend to include in the King’s Speech legislation on a fuel watchdog to help motorists in Barnsley?
I hope that the hon. Lady will have noted the announcement that we made earlier this year about PumpWatch, as well as the work that the Government have done to ensure that the Competition and Markets Authority looks carefully at the way in which the fuel market operates, to ensure that it does so in the interest of consumers, as we all want.
Some 50-plus years ago, when I first took my driving test, there was one other thing we had to do: be able to afford a car. I can remember pinning all my £165 to buy a wee Mini car, but that was 50-plus years ago. Today, one of the issues for people who want to drive and be on the roads is that they just cannot get a practical driving test. What has been done to address that so that young people who have a car and insurance can take a test and get on the road?
The hon. Gentleman makes a fair point. The wait times for theory driving tests are within target. He is absolutely right to draw the House’s attention to the fact that there is currently a longer waiting time for practical driving tests. That is why both I and the roads Minister, the Under-Secretary of State for Transport, my hon. Friend the Member for North West Durham (Mr Holden), have tasked the Driver and Vehicle Licensing Agency, which has a plan to get back within target in the next few months, exactly to help those constituents of the hon. Gentleman who are keen to get their practical test and get on the road, so that they can take advantage of the freedom that being able to drive offers.
Pothole repairs halved since 2016; insurance premiums up; fuel prices up; electric charge point roll-out 10 years behind schedule; £950 million EV charge point fund still not open three years after being announced; 10% trade tariffs threatening consumers and manufacturers—which of those is not an example of where this Government have failed drivers over the last 13 years?
The hon. Gentleman had a number of things that he purported to suggest were facts. Let me just pick one of them: the roll-out of EV charging. That is absolutely on track according to the independent assessment from the National Infrastructure Commission. The number of public charge points is up 43%. As the Minister of State, my right hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) set out, we have published and laid before the House the legislation to implement our zero-emission vehicle mandate, which gives the industry the confidence to invest in and roll out those charge points, to drive the roll-out of electric vehicles. We are absolutely on track to do that, and I am surprised that the hon. Gentleman does not welcome it.
As the House will know, Parliament has voted in principle to support a third runway at London Heathrow, but the Government have always been clear that that expansion remains a private sector project. To go ahead, it would be required to meet strict criteria on air quality, noise and climate change, as well as being privately financed. It is for any scheme promoter to decide when it submits a development consent order application as part of the statutory planning process.
I thank the Minister for that answer. Regional airports such as Leeds Bradford have an important role to play in delivering the levelling-up agenda, with more point-to-point destinations. However, does the Minister agree that to deliver true global connectivity, we need more slots from regional airports into our national hub, which will ultimately mean more tarmac on the ground at Heathrow?
I agree with my right hon. Friend, who has enormous experience in this area, that regional airports are vital to the UK and support thousands of jobs across the regions, as well as acting as a gateway for international opportunities. It nevertheless is the case that as Heathrow considers its expansion plans, it will need to decide when to take those forward, and when it does so, I hope it will bear the very important issue of regional connectivity in mind.
The UK has one of the most ambitious decarbonisation programmes of any country in the G7. In March this year, the Government published a globally unprecedented level of detail on their plans to meet emission reduction commitments, including those from road transport. The carbon budget delivery plan sets out the policies and quantified carbon reductions needed to meet carbon budgets 4 and 5 and the vast majority of reductions needed to meet our commitments into the 2030s.
On heavy goods vehicle road transport in particular, the start of the zero-emission road freight trials is welcome, but where is the low-carbon fuel strategy? Such fuels can cut emissions by 80%. The strategy will be crucial for shaping the investment plans of logistics companies, so why is it nearly a year late, and when are we going to see it?
I am grateful to the hon. Gentleman for raising the issue of HGVs. As he acknowledges, last week the Government announced the four winning projects of the £200 million zero-emission HGV and infrastructure competition, which will roll out 370 zero-emission HGVs and around 57 refuelling and electric charging sites. This is part of a much broader strategy, which is about developing different fuel alternatives. The technology continues to change very rapidly. We have already heard some fascinating news about the development of solid-state batteries, and the Government are tracking and following all these developments closely.
I am still astonished at the Secretary of State’s claims that the English EV charging network is on track—absolutely no one thinks that in this country.
Pushing back the date for the ban on petrol and diesel cars by five years, combined with removing what was already one of Europe’s worst EV purchase incentive schemes, means that this Government are sending all the wrong signals to consumers. Mike Hawes of the Society of Motor Manufacturers and Traders said that consumers required
“a clear, consistent message, attractive incentives and charging infrastructure that gives confidence rather than anxiety. Confusion and uncertainty will only hold them back.”
I have no doubt that this decision was thoroughly assessed, so can the Minister tell us how many extra millions of tonnes of carbon will be emitted due to this Government’s back-pedalling on net zero?
Was it P. G. Wodehouse who said that it was not difficult to see the difference between a ray of sunshine and a Scotsman with a grievance? How true that is in this case! The truth of the matter is that there has been enormous progress in this area. Let me remind the hon. Gentleman that £6 billion of new private investment is being planned by ChargeUK. That has not been affected. One of the leading global mandates has been laid. We have just done this excellent work on charge points, and I am pleased to say that the independent National Infrastructure Commission of this country has stated that if the roll-out continues to grow at the current rate, we will meet our target of 300,000 public chargers by 2030.
This Government have made the long-term decision to reinvest every penny of savings from High Speed 2 into the local journeys that matter most across the country, so from next week, passengers on our buses will keep saving money with the £2 fare cap, and from next year, £150 million of redirected HS2 funding will go to bus services across the north and midlands. That is part of £1 billion of new funding to improve Britain’s most popular form of public transport.
It means supporting local authorities to introduce cheaper fares, more regular services and new routes, all backed by investments that would not have been possible without our decision on HS2—a project that would not have been completed until the 2040s. Governing is about making choices, and by prioritising everyday local journeys, we have chosen to be on the side of the majority of the British people.
Thank goodness Santa travels by sleigh, not train! Avanti has just released its new timetable, with London to Holyhead services up to Christmas slashed. It is certainly no Nadolig Llawen for my Ynys Môn constituents, who like me are fed up with this service. Avanti has a new contract; what assurance can my right hon. Friend give to my constituents that he is doing everything he can to restore the number of direct trains from London to Holyhead to pre-pandemic levels?
The Rail Minister and I continue to hold Avanti to account for matters within its control, and I know the Rail Minister recently visited my hon. Friend’s constituency to talk about services to Holyhead. The temporary changes she referred to are necessary to accommodate Network Rail engineering works to improve and maintain the network and minimise unplanned, short-notice cancellations due to train crew shortages as Avanti trains more drivers. In the spirit of my hon. Friend’s question, given that she has mentioned Christmas, I hope she is grateful for the early Christmas present from the Prime Minister of £1 billion to electrify the north Wales main line.
We now know that High Speed 2 was billions of pounds over budget, Parliament may have been misled, and the Government are about to waste hundreds of millions more on the fire sale of the land. Why, then, did the Prime Minister choose to dismantle the ministerial taskforce that was literally designed to oversee the cost and delivery of HS2 when he entered No. 10?
The Prime Minister made the right long-term decision to reinvest every penny saved from HS2 in the north and midlands back into transport projects across the north and midlands, which will benefit more people in more places more quickly. I know this must be a difficult time for the hon. Lady as her party leader, the right hon. and learned Member for Holborn and St Pancras (Keir Starmer), casts her views aside, admitting that the Prime Minister was right and saying that he would follow his lead. I can only thank the right hon. and learned Member—I can only think he was disappointed that the Prime Minister did not go further and follow his suggestion of cancelling the station at Euston, given his long campaign against it.
Neither the Secretary of State nor the Prime Minister were paying attention, were they? They have fatally undermined confidence in HS2 and its delivery, which is why no one has confidence in Network North. The Rail Minister failed to respond to my hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) about the fact that dozens of projects in Network North are unfunded because they are valued in 2019 prices. Will he publish the delivery plans and up-to-date costs, or can we all conclude that Network North is not worth the paper it is written on?
I am very surprised that the hon. Lady is not welcoming the massive improvement Network North will make across the country, including for her own constituents. I am shocked, Mr Speaker, that she is not taking this opportunity to welcome the electrification of the Hull to Sheffield line, the upgrade of the Sheffield to Leeds line, the electrification of the Hope Valley line or the reopening of the Don Valley line. That is just on rail, the only mode of transport that the hon. Lady ever raises with me; it is not to mention the £500 million—
Order. Secretary of State, I am being generous, but such long questions and answers need to come earlier, not in topicals.
I thank my right hon. Friend for his question. I recently met with my right hon. Friend the Member for Bournemouth West (Sir Conor Burns) and some members of the local council, and this issue is something I would be happy to discuss further with him.
It is certainly not in the “too hard to do” pile—it is something we are looking at. It is one of the biggest responses we have had on any issue, with tens of thousands of responses, so it is only right that the Government take our time to ensure we get the position right. In the meantime, any local authority across the country can put in place a traffic regulation order and ensure those changes happen on a local level.
Details of how that £8.3 billion of funding will be allocated to local authorities will be published in due course, and I hope we will be able to make an announcement about that in the not-too-distant future to give my hon. Friend that reassurance. It will be for each individual local highway authority to decide how to spend that money and to focus on the most important parts of their network. They have the local knowledge to do that and we trust them to spend that money wisely, and I am sure my hon. Friend will make representations to them about which parts of his constituency that money should be targeted at.
I do not think that, for the reasons we have described, there is anything to complain about in relation to the progress we are making across England. Charge point roll-out remains very rapid—43% in the last 12 months —and there are 49,000 public charge points at the moment and 400,000 private and business ones, and new regulations and a new mandate have just been laid.
I am very happy to meet my hon. Friend. Chalkwell, Ockendon and Southend East remain within the Access for All programme. We have delivered 230 stations and we will deliver those three as well. We had an issue with the contractor putting in a cost estimate that was about double what I would expect; that is why we have had to look anew, but I will very happily meet my hon. Friend to discuss this further, and she has that commitment. We will deliver it.
It comes down to choices. We could have chosen to continue with HS2, which would not have delivered the value we need, with time overrunning, or we could have done as the Scottish National party did when it built two ferries at a shipyard that had been nationalised, going four times over budget and running seven years late. Alternatively, we could have done as it did on the tram—described by the Edinburgh tram inquiry as a “litany of avoidable failures”. When there are choices to be made, the SNP ploughs on regardless.
I thank my hon. Friend for everything he does to push for more open access. It is something the Secretary of State and I are keen to do. I met this week with the Office of Rail and Road chief executive, our regulator, and we discussed what he can do to allow more open-access applications, and what we can do, and we then met with another bidder. There is another service planned with regard to Wales on the western line, and there is also one in the offing that could work on CrossCountry, plus one for the channel tunnel. I hope my hon. Friend will keep on working with me. We want to deliver them.
The Government’s mishandling of HS2 was and is absolutely staggering, but their attempt to pull the wool over northern eyes with Network North is a farce. Does the Minister really believe the people of the north-east are falling for his fag-end fake network to nowhere?
I just do not accept that at all. I gave a run through of a list of the £36 billion that is being put back into local projects, including £1.8 billion extra for the north-east. That could, for example, be an option for the Leamside line to be reopened. I would have thought that, rather than stating that none of this is going to happen, the hon. Member would be holding us to account to make sure it does, and that she might actually support investment. There will be as much investment—indeed, more—in all areas.
I certainly am delighted to praise Dudley Council for its new approach, spending that money wisely but also implementing preventative measures for the future. Well planned road maintenance is essential, and on 4 October the Prime Minister announced that Network North would include £8.3 billion for local highway maintenance right across the country. The allocations of that cash will be announced very soon to help Dudley, but also every other council right across the country, to ensure it has the highest quality roads.
I am not quite sure that answer was as linked as it should have been.
The Government have said that every penny that would have been spent on HS2 will now be reinvested in local and regional transport infrastructure. To be clear, and so that South Yorkshire can get organised, may I ask the Minister to confirm that the city region sustainable transport settlements round 2 uplift for South Yorkshire will be £543 million, and that he will work with the Mayor and others to maximise the benefit of that investment?
Yes, I can give the hon. Gentleman that assurance. It is indeed £543 million of extra funding for the South Yorkshire mayoral combined authority. We have already had conversations with the South Yorkshire Mayor about the funding and his plans. I and my team will continue to do so, and our officials will work with his to make sure we can deliver those plans.
With the global AI summit coming up next week in Milton Keynes, it seems topical to ask: what steps is the Department taking towards the regulation of autonomous pavement delivery robots?
Of course, I have visited the technology that my hon. Friend is describing and seen it in action. We must balance the safety of patients and vulnerable road users with the potential benefits of this new technology, but I am very pleased to confirm that the Department will be funding research to advance our understanding of the impacts of this technology. The results will be published once the research has concluded.
Heavy goods vehicles cause a disproportionate number of cycling deaths. To cut the number of deaths of cyclists by illegal freight operators in other places, will the Department look at the successful London scheme and encourage partnerships between local authorities, the Driving and Vehicle Standards Agency and police forces to address this problem?
I am always happy to look at measures to improve road safety, including the measure the hon. Lady has suggested. I regularly meet the head of the National Police Chiefs’ Council on this, as well as the police and crime commissioners’ lead. We have already updated the highway code to put that priority of road users there, but I am happy to look at any measures we can implement to further this.
Nottinghamshire submitted a levelling-up fund bid for a new Toton link road, but narrowly missed out. The project is desperately needed to ease congestion and unlock the huge potential in my constituency of Broxtowe and our wider county. Will the Secretary of State meet me to discuss this £40 million, ready-to-go project, especially as the east midlands has the lowest amount per head spent per year on transport?
With the extra £1.5 billion in the CRSTS announcement coming to my hon. Friend’s new mayoral combined authority, I am sure there will be plenty of opportunities to look at really important road schemes, but I would also be delighted to meet him as soon as possible.
When a memorandum of understanding on HS2 to Scotland was agreed by the then Transport Secretary, Philip Hammond, HS2 planners claimed that reducing journey times between Scotland and London to three hours could boost passenger numbers by 4 million and increase rail’s share of passengers making that journey from 29% to 75%, reducing air travel emissions. What is the Secretary of State’s new prediction for rail passenger numbers making that journey?
I will happily write to the hon. Lady with the details she requires, but I restate that it comes down to choices. The choice that this Government have made is to go forward with transport projects across the entirety of the country that can deliver faster and better benefits and that have a better business case. That is why this decision has been made.
Does my right hon. Friend think that people of the Jewish faith are safe on the London underground? I have to tell him that many Jews in London do not feel safe. Does he agree that London Underground employees who misuse Transport for London equipment to take part in intimidatory acts should not only be disciplined for gross misconduct, but considered for prosecution for causing harassment, alarm and distress under the Public Order Act 1986?
I am familiar with the case that my right hon. and learned Friend raises. I was in contact with British Transport police about it after seeing the disturbing footage at the weekend. They have publicly said that a member of staff has been suspended, but he will understand that because the British Transport police are investigating whether a crime has been committed, it would not be right of me to go into details. I hope he is reassured that the incident is being taken seriously by both British Transport police and London Underground, and that that will reassure both him and the Jewish community.
The huge importance of local bus services to communities such as mine in Blaydon has been emphasised by a dispute between Go North East and its employees. I very much hope that a negotiated settlement can be reached quickly. Is not the reality that we need better, more streamlined franchising models to give communities a greater say on their transport offer?
I am sure the hon. Lady, my neighbour, welcomed the news yesterday evening that Go North East and Unite the union have managed to reach a settlement in the north-east. That is quite good news. I am sure she will also welcome the £163.5 million that we have put into bus service improvement plans, which include the option to do bus franchising. This Government have been happy to make that available to all local authorities.
The reopening of the Skipton to Colne railway line, which is about 11 miles of missing track, will be fundamental in linking Lancashire and Yorkshire back up. Will the Minister consider progressing this line to the next phase of the rail network enhancements pipeline, which includes drawing up a full business case for reinstatement? Will he meet me and Members including our right hon. Friend the Member for Pendle (Andrew Stephenson) and our hon. Friend the Member for Burnley (Antony Higginbotham) to discuss it further?
I would be pleased to meet my hon. Friend and all right hon. and hon. Friends. The Department has been working with Transport for the North, Lancashire County Council and the Skipton East Lancashire Rail Action Partnership campaign group to strengthen the case for reopening that line, but we will meet up and discuss that further.
In answer to the hon. Member for Sheffield South East (Mr Betts), the bus Minister, the hon. Member for North West Durham (Mr Holden) said that the Mayor of South Yorkshire had asked for £8 million to restore bus services. In fact, the Mayor asked for £8 million to restore bus services to 2022 levels—so just restoring those cut in the past year. Will the Minister take this opportunity to look again at the level of funding that South Yorkshire requires?
That is exactly what they said, and that is exactly what I said, too. As I said, we are seeing not only £1.6 million this year, but £1.6 million next year, and almost £8 million on top of that, but that is to ignore the huge amount—half a billion pounds—of city region sustainable transport settlement funding going to South Yorkshire for this period, which will almost triple for the next period, too. [Interruption.] The hon. Lady can shout at me from a sedentary position, but the truth is that she is just adopting our new position. It is not really opposition anymore; it is just “adopt the Government’s position”, including on HS2.
When do Ministers anticipate being able to give LNER the go-ahead to extend the King’s Cross-Lincoln services through to Cleethorpes?
I am afraid I will have to give my hon. Friend the answer that Ministers often have to give, which is that I hope to make an announcement shortly. I also hope that when an announcement is made, he will be able to welcome it.
According to the Department’s own regulations, it should have reported on medical licences for fisherman this week, but it has not, so when will the Department publish the review? More important, when will it start listening to fishermen, who are out of pocket, worried about their livelihoods and at risk of becoming uninsured?
I am grateful to the hon. Lady for raising that question. In fact, I met representatives of the National Federation of Fishermen’s Organisations just yesterday to talk through the issue in some detail. We will be able to make some announcements on policy very shortly. Obviously, I will keep the federation informed, as I will Members of the House.
My constituents very much value access to the travelcard scheme, which in particular enables visitors, friends and family to make the most of a trip to London. They were concerned to hear the Mayor of London, Sadiq Khan, announce his plans to abolish the travelcard. They were equally puzzled to hear that the Mayor has now apparently intervened to save the scheme from his own plans. Can my right hon. Friend help me explain that conundrum to my constituents?
Like my hon. Friend, I was surprised that, having proposed to cancel the travelcard scheme in the first place, the Mayor of London is now trying to take credit for cancelling his own cancellation. From my point of view, those hon. Members who so stridently raised concerns about the Mayor of London’s latest plans to increase costs for the travelling public and the Department of Transport officials who worked with Transport for London to find an alternative deserve the lion’s share of any credit.
I declare an interest in that I sold my house in North West Leicestershire to HS2 in 2015 for considerably less than I paid for it in 2011. What does the Secretary of State make of the evidence given to the media by Andrew Bruce, the former head of land acquisitions for HS2, that people were short-changed and not given full value for their properties up and down the route?
There are rules that specify how the safeguarded land will be returned. Those who sold their property will be offered it back at the current market value. We expect those matters to take place towards the summer. With regard to the hon. Member’s allegations, I will discuss them further with him so that I am fully furnished of the case.
Last year, my constituent was having a drink with his son, having attended a Manchester City match, when his son was glassed in the face in an unprovoked attack. The assault took place in a pub outside Manchester Piccadilly within the jurisdiction of British Transport police. Since then, despite CCTV capturing a clear image of the suspect, no arrests have been made. My constituent feels disappointed that the transport police have not got justice for his son, who suffered life- changing injuries. Will my right hon. Friend meet me to discuss this distressing case and, more widely, to consider the remit and resourcing of British Transport police?
I am sorry to hear about that incident; it must have been incredibly distressing for my hon. Friend’s constituent. I will raise that case specifically with British Transport police, and I would be pleased to meet my hon. Friend to discuss it further.
Thank you, Mr Speaker. While the Tories get excited about “Get around for £2”, under 22s in Scotland get around for free, because their fares are funded by the Scottish Government in a strategic paradigm shift to get people modal-shifting over to public transport. Will the English Government provide that same support to commuters in England, or are they too proud to follow Scotland’s lead?
The hon. Gentleman could do well to recognise that fares in Scotland are up by over 10 % on an annualised basis, whereas in areas of England they are falling. There is also no fare cap in Scotland for those over the age of 25, whereas my constituents—many of them in low-paid work or looking to go to work and get jobs—can get a £2 bus fare. On a recent visit to Scotland, I saw people paying £8 or £9 to travel between some major towns. Actually, the Scottish Government would do well to follow the English Government’s example.
(10 months ago)
Commons ChamberOn a point of order, Madam Deputy Speaker. You have had notice of this. In Prime Minister’s Question Time yesterday, the hon. Member for Edinburgh North and Leith (Deidre Brock) asked the Prime Minister about compensation for those infected and affected by the contaminated blood scandal. The Prime Minister responded:
“What I would say is that extensive work has been going on in Government for a long time, co-ordinated by the Minister for the Cabinet Office, as well as interim payments of £100,000 being made to those who were affected.”—[Official Report, 25 October 2023; Vol. 738, c. 830.]
That is factually incorrect, and I hope that the record can be corrected as not all those affected have received interim payments. A parent who lost a child or a child who lost a parent in the scandal has received no such interim payment, despite clear recommendations from Sir Brian Langstaff, the chair of the infected blood inquiry, that such payments should be extended immediately.
That confusion by the Prime Minister and his officials is deeply hurtful to those who are still waiting for the Government to respond to Sir Brian Langstaff’s second interim report on compensation published in April. Sir Brian made it clear that the compensation scheme should be set up now and should begin work this year. We are nearly in November, very close to the end of 2023, and there is still no clarity from the Government. We have no idea what progress the Government have made on their work, despite being told repeatedly that it was at pace and they were working towards the original November deadline for the publication of the final report, which is now due out in March. Surely they have some progress to report to the House.
The Government have also failed to explain why victims of the infected blood scandal are being treated differently from the victims of the Post Office Horizon scandal, who rightly have received compensation before the public inquiry into their scandal has concluded. If the Government are determined to needlessly delay justice to victims of the infected blood scandal, that makes the need to extend interim payments to bereaved parents, children and siblings—as recommended by Sir Brian—even more critical. The clue is in the word—they are interim payments, to be made before the final compensation payments. That is why what the Prime Minister said yesterday is so wrong. There has been not one word on whether the interim payments will be extended. I wonder whether you might be able to assist me, Madam Deputy Speaker, in getting the Government to tell the House of Commons what they are doing in relation to Sir Brian’s final recommendations on compensation.
I thank the right hon. Lady for her point of order and for giving notice of it. I know how hard she has campaigned on this issue and that it is a matter of concern to Members on all sides of the House. She has raised a number of issues, some of which are ongoing and, I am sure, will be raised in other ways.
First, she said that she thought the Prime Minister had perhaps made an incorrect statement. She will know that Mr Speaker is always very anxious that, if any incorrect information has been said inadvertently, it should be corrected at the earliest opportunity. She has also raised a number of issues about when the Government might come forward with further information. Fortunately, we have the Leader of the House here, who was listening closely to the right hon. Lady, and I think she wishes to respond.
Further to that point of order, Madam Deputy Speaker. I will be brief. I am sure that, if there were business questions, the right hon. Lady would have asked that question. I thank her for the work that she and her all-party parliamentary group on haemophilia and contaminated blood have done. The position that she set out is correct. I was here yesterday, and I do not think that the Prime Minister sought to state that it was otherwise. Given we do not have a business statement today, I will write to the Minister for the Cabinet Office and Paymaster General, my right hon. Friend the Member for Horsham (Jeremy Quin), on the specific issue of those affected who have not received interim compensation payments, to ask that he consider what she has said today and update her and the House at the earliest opportunity.
I would stress that the compensation study was set up to be concurrent with the inquiry, so that we could move swiftly to make amends for this appalling injustice. I know, because I had meetings with my officials yesterday, that that is very much the view of the Minister. He is determined to make progress on these things quickly and on the practical things that we can do in the interim. The right hon. Lady has my assurance on that. My involvement is to ensure that, if any legislation is needed, we are ready to do that. I reassure the House—and thank her for the opportunity to do so—that this Government, which set up the inquiry, are determined to ensure that all people infected and affected have justice.
I thank the Leader of the House for her statement. I am sure that the right hon. Lady will follow up and there will be some liaison about how to go forward.
On a point of order, Madam Deputy Speaker. I provided advance notice of it to Mr Speaker earlier.
A few days ago, The Sunday Times reported on its front page that a “Hamas fugitive” who
“‘ran the group’s terrorist operations in the West Bank’”
lives here in London. Muhammad Qassem Sawalha is designated by Israel as a senior Hamas operative in Europe and accused of fleeing the country with fake documents. He is now believed to hold UK citizenship. Zaher Birawi lives in Barnet not far from Sawalha. He was designated by Israel in 2013 as a senior Hamas operative in Europe. He is listed as a trustee of a UK registered charity, Education Aid for Palestinians. A publicly available video shows him hosting a 2019 event in London titled “Understanding Hamas”.
Two weeks ago, Hamas launched the deadliest terror attack the world has seen since 9/11. This House rightly voted to proscribe Hamas in its entirety in November 2021. It is therefore a serious national security risk for Hamas operatives to be living here in London, especially where at least one appears to have done so through the use of fake documents in obtaining British citizenship. Madam Deputy Speaker, can you advise me on how I might raise this with the Government as a matter of great urgency and ask if you have had any indication of a Minister seeking to come to the House to provide an urgent update on this matter?
I thank the hon. Gentleman for notice of his point of order. I hope that he will understand that I cannot comment on individual cases. I have had no notice of a statement, but he has put the issue on the record and those on the Government Benches will have heard his point.
Deputy Speakers
Ordered,
That, further to the Orders of 30 January and 23 February 2023, paragraphs (1) and (2) of the Order of 19 December 2022 relating to the appointment of Sir Roger Gale as Deputy Speaker and to the exercise of the functions of the Chairman of Ways and Means shall continue to have effect up to and including 31 March 2024.—(Gagan Mohindra.)
(10 months ago)
Commons ChamberI beg to move,
That this House has considered the matter of the menopause.
I thank the Backbench Business Committee for granting my hon. Friend the Member for Swansea East (Carolyn Harris) this important and timely debate in October, which is World Menopause Awareness Month. Regrettably, she is unable to attend or open the debate, so she has asked me, as a member and the treasurer of the all-party parliamentary group on menopause, to open the debate in her place. I am pleased and privileged to do so. I hope to do justice to her work, and that of the APPG and its supporters in this vital area affecting the lives of millions of women.
The hon. Gentleman says that this affects millions of women but, as the husband of a menopausal woman, I feel it is incredibly important that men, in their role as colleagues, friends or family members, have a deep understanding of the challenges of menopause, so that they can best support the women in their lives. Does he agree?
The hon. Member is absolutely spot on. That is why the APPG is working across so many areas to develop people’s understanding of menopause—not just women but, importantly, men as well.
The days of whispering the word “menopause” and keeping the changes in women’s bodies a secret and just getting on with it, so to speak, are thankfully beginning to be a thing of the past. The “Manifesto for Menopause” was launched last week at a celebratory breakfast in Parliament to mark World Menopause Day. Alongside the publication of the group’s “Manifesto for Menopause”, the reception featured new findings from a recent survey by Menopause Mandate of over 2,000 women. It found—it is important to get this into context—that 96% of menopausal women’s quality of life suffered as a result of their symptoms and almost 50% took over a year to realise that they might be peri or menopausal.
My hon. Friend is making a great contribution. Women have told me that, when they experience symptoms such as itchy skin, aching bones, depression and anxiety, their GPs advise them on how to treat those symptoms, although the cause could be the menopause. Does he agree that extra training and support could help GPs to recognise menopause symptoms better, and could therefore help many women across the country?
That is a valid point and I shall be touching on it later.
According to the survey, only 12% of menopausal women were diagnosed by healthcare professionals, with a huge 60% discovering through their own research that they might be menopausal, and only 20% having had a positive GP experience. Among working women, 64% said that the menopause had a negative impact on them, but only 29% of their employers had a menopause policy.
I commend the hon. Gentleman for raising this issue. It is a massive issue for my constituents and the personal experience through my own wife is very clear. Given that 10% of women leave work during the menopause, saying that they feel and have felt unsupported and unable to continue—which really should not be the case—does he agree that there should be a greater obligation on businesses to help women?
That is another point that I will touch on later, but the hon. Gentleman is spot on.
Anyone who happened to be in Westminster Hall on Wednesday last week will be able to testify to the work that the APPG has done. More than 100 Members and others gathered for a photograph to mark and celebrate World Menopause Day. My hon. Friend the Member for Swansea East said she was not sure that visitors to Westminster Hall were ready to see so many women parliamentarians and others doing impromptu exercise squats. However, she also said that, if it was a good enough location for Henry VIII to play real tennis, it was certainly good enough for a group of menopausal women to highlight the benefits of exercise to their physical health and mental wellbeing.
The fact that those influential women, grassroots campaigners and clinical experts were brought together in Parliament showed the world that Westminster was listening; but listening alone is not enough while women continue to suffer. Listening will not help them get a diagnosis or access to treatment, or find the support they need. That requires action, and on World Menopause Day the APPG, which is chaired by my hon. Friend the Member for Swansea East, launched the menopause manifesto. Based on evidence that the group gathered by speaking to those affected by the menopause and experts in the field, the manifesto sets out seven recommendations, which we are urging all parties to adopt in their own manifestos ahead of the next general election.
I cannot stress enough how important it is to the 13 million women in the UK who are currently perimenopausal or menopausal, and to all around them who are indirectly affected—the hon. Member for Strangford (Jim Shannon) raised that point—to know that those in power will support them. The first recommendation in the manifesto is for health checks. Every time that is mentioned in conversation, people are genuinely surprised that it does not already happen. Many will remember receiving, on turning 40—along with the cards, gifts and the good wishes—an invitation to a 40+ NHS health check. Those “MOTs” monitor our weight and blood pressure, and are used to assess the risk of developing conditions such as diabetes, heart disease and strokes. What they do not include for women, at present, are any questions about, advice on or reference to the menopause, which is at best a surprise and at worst quite shocking.
There is strong evidence showing that many women are accessing primary care and being treated for individual symptoms because neither they nor their clinicians are recognising the root cause of those symptoms—a point raised earlier by my hon. Friend the Member for Blaenau Gwent (Nick Smith).
By raising awareness among medical professionals, who can, in turn, help to educate women at their 40-plus health checks, we can reduce the number of extra visits that women make to surgeries and prevent further misdiagnosis and inaccurate prescribing. We can also dramatically increase the number of women who get prompt and correct diagnoses and access to treatment pathways. We know that this would save the NHS money in the long run.
Many healthcare providers are now starting to include menopause in their standard packages, having identified the fact that patients are being sent for appointments in secondary care for an array of symptoms that have not been correctly diagnosed as menopause. By including menopause treatment as standard, they are reducing the cost to the NHS of these unnecessary appointments.
The second recommendation of the APPG’s manifesto is a national formulary for hormone replacement therapy. Although HRT is not the answer for all women, millions across the country rely on this treatment to manage their symptoms. We know that, in a 10-minute consultation, prescribers do not have the capacity to go searching for alternative treatments if a patient’s usual product is out of stock, and we have seen a supply shortage for many of these products. A national formulary would resolve this issue, as all eligible products would be easily accessible on surgery systems, thus eliminating the postcode lottery and regional variations that women are currently experiencing.
The hon. Gentleman is most gracious in giving way. He mentioned that there are sometimes disparities from, say, county to county. There are also regional disparities. I know he accepts that, and the Minister has taken note too. When it comes to providing better treatment, a recommendation has to be that every part of the United Kingdom—England, Scotland, Wales and Northern Ireland—should have an agreed strategy for helping women. Does he agree that there should be the same policy, the same strategy and the same response everywhere?
I agree with the hon. Gentleman. It is crucial that women are able to go to any surgery and, although there may be marginal differences in treatment or access to treatment, the substance is that they should ultimately get more or less the same access and the same treatment, depending on their needs.
The third recommendation also relates to prescribers. The manifesto calls for the inclusion of menopause as an indicator within the GP quality and outcomes framework. This change would help to balance the deficit in knowledge and understanding among GPs by incentivising improvement in diagnosis levels and treatment provision within primary care. If clinicians were better informed, they would be more confident in discussing menopause with patients at their health checks and in prescribing appropriate treatment, which would greatly benefit patients who visit their GP to seek support.
Moving away from healthcare, I am proud to say that, earlier this year, Labour committed to the fourth recommendation: mandating that all companies with more than 250 employees introduce menopause action plans to support those experiencing symptoms. That goes some way to addressing the points raised by hon. Members.
Alongside this, the APPG would like to see the provision of specific guidance for small and medium-sized enterprises and the introduction of tax incentives to encourage companies to integrate menopause in their occupational health plans. There are great examples of companies embracing the issue, and there are some excellent tools available to help, such as the British Standards Institute’s menstruation, menstrual health and menopause in the workplace standard. With research showing that one in 10 women are leaving the workforce and thousands more are reducing their hours or avoiding promotion, it is vital that more is done to address the impact of menopause on women’s economic participation.
The APPG is not asking for women to be given special treatment; we are asking merely for an understanding that working arrangements and environments may need to be flexible. This willingness to incorporate flexibility will benefit businesses, boost the economy and give women the confidence to progress in their career.
The manifesto’s fifth requirement is about the licensing of testosterone for women. It has always struck me as odd that when women reach menopausal age, which is different for everyone, they become deficient in three hormones—oestrogen, progesterone and testosterone—yet only the first two are available to women when they are prescribed hormone replacement therapy on the NHS. As my hon. Friend the Member for Swansea East has noted previously, if a woman wants the third hormone, they have to pay for a private prescription. The all-party group is calling for an evaluation of female-specific testosterone treatments, with a view to their being licensed by the Medicines and Healthcare products Regulatory Agency.
In the sixth recommendation, we are calling for better funding for research into the potential links between menopause and other health conditions, as well as the varying experiences of women from different backgrounds and ethnicities—that is very important. We know from the evidence that the APPG has received that those with conditions such as autism and attention deficit hyperactivity disorder can struggle more with their menopausal symptoms, and that those who have been treated for cancer often experience early menopause. So it is vital that much more is done to better understand the different journeys that women from different backgrounds are experiencing. In the past week, my hon. Friend told me said that she had been lucky enough to visit two universities, one in London and the other in her own home city of Swansea. Both are keen to do more to support their staff and to bridge the significant gaps in understanding around more complex menopause experiences.
I thank the hon. Gentleman very much for the scene he is setting. Small and micro-businesses are predominantly male-owned, so the issue for them is understanding how to put over the requests on behalf of ladies who are going through the menopause. Does he feel that the Government and the Minister should take that on board as well, to ensure that those businesses have the relevant information and guidance to do that within the small workforce that they look after?
The hon. Gentleman makes a good point and sets out an excellent idea. I am sure that the Minister, as part of the expansion or integration of the manifesto, can take it on board.
As I was saying, my hon. Friend was delighted that Swansea University announced last Friday that it would be introducing menopause into the curriculum for all of its medical students, as well as launching a menopause clinic for staff and students. I truly hope that it will be the first of many universities to do this. Future policy in this area, and an improved women’s health strategy, will be possible only if more funding is dedicated to this vital research.
The seventh and final part of the manifesto calls for a review of the demand for specialist menopause care. We need to look at existing provision, evaluate where increased secondary care is needed and assess other ways in which women could seek help. That might, for example, include access to specialist nurses in primary care and pharmacists, to ease the demand on GPs. That is another simple recommendation that would be easy to achieve, while having a significant impact on the care and support that women are able to access.
Nothing in the all-party group’s manifesto is difficult to achieve; no big contracts or big budgets are needed to make the changes that will significantly improve women’s experiences. The only thing that is needed is a commitment to prioritise this area of women’s health. We need a commitment to improve support, diagnosis and access to treatment for all those who need it. Who would not want that? I know that every Member of this House would want it. We need a commitment to show the 51% of the population who will directly experience menopause that they matter—that they really matter.
It is an absolute pleasure to follow my good friend the hon. Member for Bootle (Peter Dowd). I was originally excited to see that the hon. Member for Swansea East (Carolyn Harris) was going to be opening the debate, simply because her enthusiasm for this subject is contagious and draws people in, but he has done incredible justice to the opening of the debate.
It is marvellous to see a number of male colleagues in the Chamber. I grew up in a house with five brothers and an Irish Catholic mother, and the word “menopause” would in no circumstances ever have crossed her lips. I then went to an all-boys school and went on to do civil engineering at university. There were no girls at my school and just two women on my civil engineering course, in the whole of the department, so my exposure to women was somewhat limited until I finally got off the building site and into a traditional workplace. There I found that men whose experience was not as sheltered as mine had no greater knowledge or understanding of this topic, although I felt they had far less excuse.
So when my wife began to experience the symptoms of the menopause, originally neither she nor I, nor her GP, fully understood what was going on—certainly, menopause was not the initial diagnosis. That highlighted for me how difficult and challenging it must be for some women: they present to their GP, the GP misdiagnoses or misunderstands their symptoms, and then the problem is protracted because the appropriate treatment is not identified quickly enough.
With an understanding of that and as an MP representing the good people of Willenhall, Bloxwich and Walsall North, it was important to me to engage as much as possible with people who could help. We found a place for a menopause café—somewhere where women and men could come and sit down and talk about this topic, over a cup of tea and a slice of cake, in a relaxed environment. I think it is beholden on us, particularly male colleagues, in our role as MPs, to do everything we can to ensure that everybody is as well informed as possible. As I said in my intervention, in our male roles as family members, friends and relatives, it is incredibly important for us to first understand the symptoms and the range of appropriate treatments available, so that we can fully provide the necessary support.
The hon. Gentleman has mentioned families, groups and work colleagues. Does he agree that women who go through early menopause may find it difficult to discuss the subject with their employers? Those conversations need to be had, to ensure that women of any age are supported and enabled to engage fully in all aspects of their workplace instead of being excluded, perhaps unintentionally.
I thank the hon. Gentleman for that intervention. Given that my wife, myself and her GP did not fully understand what the symptoms were and at what age they could arise, it is completely understandable that an employer might be challenged in terms of providing such support. That is why it is vital that we do our best to ensure that everybody is as well informed as possible, because, exactly as the hon. Gentleman says, such symptoms might start to appear at any age, so it is important that their root cause is identified quickly and people can provide that support.
I am delighted to say that, now that my wife has a very senior role in her company, it is easier for her to drive that ethos throughout the company. I pay credit to phs Group for its work countrywide. I have invited the hon. Member for Swansea East to come and speak at one of its offices in the south of Wales—I hope we can arrange that soon.
I pay tribute to all colleagues in the Chamber today, particularly the men in our role as champions, fighting side by side with the women to ensure that this topic is completely understood by as many people as possible, so that we can all provide the support that is so well deserved.
It is a pleasure to speak in this debate, with my hon. Friend the Member for Bootle (Peter Dowd) stepping in to lead it so ably, showing that menopause is not just a woman’s issue, but a health issue that affects more than half the population. As such, it should be of concern to us all, as was so ably highlighted by the hon. Member for Walsall North (Eddie Hughes), whom I am pleased to follow in this debate.
I thank my hon. Friend the Member for Swansea East (Carolyn Harris) for all her hard work in this area, which is well known right across the House. I congratulate her on securing this debate. I am only sorry that she is unable to be in her place today, but I know how dedicated she is to this issue and I am sure that her important work will be reflected throughout the debate, because, as many of us know, there is no stopping her when she gets going.
This is a timely debate, which I will use as an opportunity to draw attention to the link between osteoporosis and the menopause. The menopause is an important time for bone health. When women reach the menopause, oestrogen levels decrease, which causes many women to develop symptoms, such as hot flushes and sweats. The decrease in oestrogen levels also causes loss of bone density, so the menopause is an important cause of osteoporosis.
While one in five men develop osteoporosis in their lifetime, half of all women over 50 will have to learn to live with it. This summer, the all-party parliamentary group on osteoporosis and bone health, which I chair, has worked in partnership with the Royal Osteoporosis Society to run the Better Bones campaign. Our campaign calls for a timely diagnosis for the 90,000 people—most of them women—who currently remain undiagnosed and untreated. I am calling on the Government to introduce universal access to fracture liaison services, the world standard for fracture prevention. We know that osteoporosis is one of the world’s most urgent health issues. Seventy five per cent of 90,000 people missing out on anti-osteoporosis medication are women. That is why the Fawcett Society and the British Menopause Society are among the many charities and organisations supporting the Better Bones campaign.
Everyone loses bone density and strength as they get older, but women lose bone density more rapidly in the years following menopause, often losing up to 20% of their bone density during this time. With this loss of bone density comes reduced bone strength and a greater risk of fractures. When treated, people can expect to live normal, healthy lives. Sadly, as it currently stands, a quarter of women have to endure more than three fractures before receiving the diagnosis that they so desperately need. Placing osteoporosis at the forefront of menopause care is paramount to ensuring that women maintain good health throughout the menopause period and beyond.
In 2021, the all-party parliamentary group produced a report highlighting the benefits of fracture liaison services in ensuring quick diagnosis and access to safe, effective medication, which can then strengthen patients’ bones. Their proven success is why the FLS model is the world standard for fracture prevention, used in more than 50 countries. However, in this country, only 57% of the eligible population have access to fracture liaison services. I am using this debate to call on the Government to provide 100% fracture liaison service coverage for people living in the UK, ending the postcode lottery once and for all.
In August, the Health Minister publicly stated that the Government would make an announcement on establishing more fracture liaison services by the end of this year. Then in September, in the other place, a Government Minister stated that the autumn statement would include a package of prioritised measures to increase the number of FLSs and their quality. I understand that, since then, there has been a walking back on this commitment, but, on behalf of the 90,000 people missing the life-saving and life-changing medication, I ask the Government to hold their nerve and to act quickly.
Full FLS coverage would cost £27 million per year in additional funding, with a total benefit of £440 million over five years. FLS delivers a return on investment of more than £3 for every £1 invested, and 100% FLS coverage would also prevent 74,000 fractures within five years, releasing 750,000 hospital bed days. Therefore, placing osteoporosis at the forefront of menopause care is essential for the future of women’s health in this country, ensuring that women going through menopause can continue to live healthy and fulfilling lives.
The decision to provide full FLS coverage in England not only is fiscally responsible and right, but would be an historic leap forward in women’s healthcare in this country.
I thank my hon. Friend the Member for Swansea East (Carolyn Harris) for securing this important debate during World Menopause Awareness Month, and my hon. Friend the Member for Bootle (Peter Dowd) for his powerful opening speech.
When I first came to this place, I never imagined that I would be standing here talking about menopause, but I am delighted to say that tomorrow in my constituency of Merthyr Tydfil and Rhymney we are hosting a menopause in the workplace workshop. This is the third event of its kind in south Wales, following on from others in Swansea and Cardiff, and I am thrilled that I am able to help local businesses in our community to better understand what they can do to support the people who work for them.
As my hon. Friend the Member for Bootle mentioned, in its manifesto for menopause, launched last week, the all-party parliamentary group on menopause called on all political parties to commit to supporting those experiencing the menopause in their own manifestos ahead of the next general election. One of the calls was for future Governments to mandate companies that employ more than 250 people to introduce menopause action plans—something that Labour has already said that it will commit to.
Almost half of the UK working population are women, and those over 50 are the fastest growing group in the workplace, which highlights why this issue is such a priority. We need to retain the skills and experience that those women have and support them so that they continue to thrive in their careers as they grow older, but evidence suggests that there is a lot of work to be done. With one in 10 women leaving the workforce because of their menopause symptoms, and thousands more reducing hours and avoiding promotion, it is vital that employers are given the tools to support those women and to change that.
There is no one-size-fits-all answer. Working environments differ greatly, as do women’s experiences. With more than 40 possible symptoms, from hot flushes to brain fog, and insomnia to anxiety, women will all have their own individual needs when it comes to support at work, so we need businesses to commit to putting an action plan in place that works for them and their employees. It might include flexible working hours, if women are having to travel on busy public transport; alternative uniforms that are considerate of the symptoms that women may experience; a guaranteed desk near a window that can be opened; or the introduction of support groups, menopause champions, or management training in the business.
We need a guarantee from employers that they will support staff who are experiencing symptoms to remain in work and to progress in their careers. As I mentioned, tomorrow in my constituency of Merthyr Tydfil and Rhymney we are welcoming a host of businesses to an event at Merthyr town football club, to give them guidance on what more they can do. I am delighted to do my part to help with that, and I am grateful for the support of my hon. Friend the Member for Swansea East in making it happen. The whole House will know just how powerful an advocate my hon. Friend is. I can think of no one better to be a menopause champion than her. I pay tribute to her for all the work that she has done, and continues to do, on this and many other topics.
We have come a long way in recent years, breaking down the barriers and making the menopause something that we are now all talking about. There is still lots to do in terms of raising awareness, but a start has been made. Attending a session of menopause word bingo with my hon. Friend was not something that I had thought I would do, but it helped to raise my awareness, which in turn will help me to advocate on behalf of the constituents I represent. Now we need to take the next steps to ensure that women are supported and given the help that they need in the workplace and beyond.
I commend the APPG on bringing this important issue to the House, and I thank the Backbench Business Committee for granting today’s debate. The menopause is a time of change for every woman. For some, it can be completely debilitating. Big physical and emotional changes in one’s body can be extremely unsettling. Some 51% of our population are women, who all go through the menopause, yet the experience of the menopause remains shrouded in mystery and stigma. That means there are far too many barriers to support. Too often, women must fight before their symptoms are taken seriously, which adds insult to injury.
The culture of silence that surrounds menopause makes bearing and dealing with symptoms even harder. Research by the Fawcett Society found that only 22% of people who experience menopause disclose it at work, because they are worried about the stigma they may face. Why should women feel too ashamed to talk? The Government’s appointment of the first menopause employment champion is a step in the right direction to start this much-needed conversation. However, it has taken far too long and there is still much to do.
As we have heard, many women choose to leave the workforce prematurely because they feel unsupported by their employer during the menopause. That is not new information: the Chartered Institute of Personnel and Development found in 2019 that almost 900,000 women in the UK had left their job because of menopause symptoms, and we have made little progress since. Women with years of experience are still forced to sacrifice their career, retire early or choose not to put themselves forward for promotion. Not only does that contribute to an absence of women in executive positions, but it lessens workplace productivity.
Eight out of 10 women say that their employer has not given them adequate support. I am pleased to hear of good examples in this space; it is important that we share them, because there are still far too many bad examples. Such support could include a menopause absence policy to help women balance their career with the major life changes associated with the menopause.
I welcome the Government’s commitment in the women’s health strategy to ensuring that employers are well equipped to support women during the menopause, but the Government have shown little interest in trialling menopause leave in England, despite the evidence presented by the Women and Equalities Committee that it would make considerable savings. The private sector is beginning to understand the economic benefit of menopause leave. The Government should explore all avenues to best support women experiencing menopause, including a trial to see the benefits of menopause leave.
Alongside difficult everyday symptoms, those who experience menopause face risks to their health. During menopause, the body produces less oestrogen, which can increase the risk of coronary heart disease, heart attack and stroke. Women also face greater risk of osteoporosis—I am pleased that the hon. Member for Bradford South (Judith Cummins) talked extensively about that—caused by the loss of bone density in the first few years after the menopause.
I am proud that the Royal Osteoporosis Society is based in Bath, and I congratulate it on its campaign with the Sunday Express for greater access to fracture liaison services and a good standard of services across the country. We have heard today about the Better Bones campaign. I hope that everyone in the Chamber will champion it and help it along, because we really need that gold standard across all hospital trusts. The Royal Osteoporosis Society has a very helpful helpline that everyone can access. Just by googling the Royal Osteoporosis Society, every woman can access advice, which is so necessary.
We have also heard extensively about hormone replacement therapy, which can lessen the health risks from menopause. HRT is a welcome treatment for many struggling with menopause symptoms. It can reduce hot flushes and protect cardiovascular health. However, it remains out of reach for many women across the UK. Women face a postcode lottery when it comes to accessing vital HRT treatment. A report conducted by the APPG on menopause last year found that there is a stark socioeconomic divide between women who can access HRT and those left without it. Financial struggles should not be a barrier to healthcare. I commend the APPG on menopause for all seven of its recommendations. The call for all parties to include those recommendations in their manifestos is a good one.
We Liberal Democrats welcome new measures to ensure that women in England pay less for repeat HRT prescriptions. However, the list of exemptions for prescription charges is out of date: it has not been fully updated since 1968 and contains many anomalies. The current prescription charge system is grossly unfair and must be urgently reformed.
Menopause currently affects 13 million women. We cannot continue to allow a common health issue to force women out of their jobs. It is unacceptable that accessing vital healthcare is still a postcode lottery. I have not actually experienced any adverse symptoms from menopause, but I was still completely uncertain about what to expect, and that in itself is very unsettling. Young women know what to expect when their period starts, but why are older women not given at least some advice by healthcare professionals about what to expect when the menopause starts, what the symptoms are and so on and so forth? It is very unsettling for every woman that complete mystery still surrounds the menopause, and that definitely needs to change. I hope that the debate will help to break the culture of silence and end the stigma.
I commend the hon. Member for Bootle (Peter Dowd) for setting the scene so well. I have made a few interventions, but I will add a few words to put on record my support for the motion, as I am here on behalf of my party.
The hon. Member for Walsall North (Eddie Hughes) made an interesting point to which I subscribe from a personal point of view. My wife Sandra went through this, and it was quite difficult for her, not just physically but emotionally. The hon. Gentleman put forward some incredibly helpful ideas: better understanding in the home, better understanding in the family and better understanding in the workplace. I employ seven girls and one fella in full-time and part-time roles, and although I am not better or more knowledgeable than anyone else, I do understand some of the issues that are apparent in the office. That understanding has to start with me and end with everyone in the staff to ensure that the right things happen.
Over the last period, we have had a menopause support group in Northern Ireland. It was created for one reason. The hon. Member for Walsall North referred to a private place. Sometimes people need a private place where they can discuss their experiences and talk about what is happening with others, sharing information on the perimenopause, the menopause and any hormone-related issues. I know the knowledge that women will be able to give each other in those private circumstances and discussions. That is so very important.
The hon. Member for Bradford South (Judith Cummins), who has the Adjournment debate on osteoporosis, reminded us all of the increased risk of osteoporosis, fractures and brittle bones through menopause. She clearly and helpfully reminded us that when it comes to understanding those things better, the health sector needs to be a bigger part of the picture.
It is important that everybody understands that osteoporosis leads to many premature deaths. That is why we need to talk more about it. I am glad that we have all been talking about osteoporosis in connection with the menopause. Does the hon. Gentleman agree that we need to raise awareness of it, because it leads to many premature deaths?
I thank the hon. Lady for her intervention. I referred to the groups in Northern Ireland because, in many cases, we find that it is the women themselves who are initiating the private support groups and ensuring that things are happening. I ask the Minister, is there any help from Government to ensure that these advice groups are available?
To go back to the subject of osteoporosis, the hon. Member for Bradford South is right. In my office, I have a staff member specifically tasked with looking after benefit issues, and the work for that lady is enormous; she is probably working the equivalent of a five or six-day week. She tells me that, in many cases, the issue is access to personal independence payments. I know that this does not come under the Minister’s Department, but is there a process in place to help ladies understand and apply for that benefit, which is there for a purpose? Government have created the benefits system, and people should never feel that they should not apply for a benefit if it is there for them, which I believe it is.
When people are drained and emotionally raw, which many are, and when the sweats mean they have to shower several times a day and they need prompting to eat and take care of themselves, we need a system, and we need someone there to help along the way. I am my party’s health spokesperson, and I want to add my support to all those who have spoken.
The Government need to be proactive and ensure that guidance is given to businesses, so that they can do things the right way. Some 45% of women felt that menopausal symptoms had a negative impact on their work, and 47% said they needed to take a day off work due to the menopause. That underlines the need for support.
With that, I will conclude, ever mindful that we are fortunate to have a shadow Minister, the hon. Member for Erith and Thamesmead (Abena Oppong-Asare), who will add her support to the debate—I look forward to hearing from her—and a Minister who well understands our requests. I am very confident that we will have the help we need, not for us, but for our constituents, for the women who contact me, for my wife and for all the other women who find it very hard to deal with these issues.
I congratulate my hon. Friend the Member for Swansea East (Carolyn Harris) on securing this important Backbench Business debate; I am sure we all agree that she has been a fantastic champion on this issue. I would also like to thank my hon. Friend the Member for Bootle (Peter Dowd) for opening the debate. I can say with certainty that he did this debate justice, talking powerfully about the concerns of my hon. Friend the Member for Swansea East, as well as referencing where improvements need to be made and the newly launched “Manifesto for Menopause” by the menopause APPG. They have done fantastic work.
I thank those who have contributed to today’s discussion. It has been particularly uplifting to see male colleagues also speaking in the debate. It is important that we all discuss this issue and that it is not just on the shoulders of women to raise it. As the hon. Member for Walsall North (Eddie Hughes) said, our role as MPs is to inform people, and particularly men, who have a powerful role to play in providing the support that is needed. He also talked about the phs Group, which has been doing great work on this issue.
I thank my hon. Friend the Member for Bradford South (Judith Cummins), who highlighted really well the fact that menopause is not just a women’s issue but a health issue for everyone. My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) talked about how companies can play a role by ensuring that employees are supported through the menopause and about Labour’s plans for the workforce. He highlighted the fact that over half of the workforce are women, and with one in 10 women leaving work because of the menopause, we need to do more to retain their skills. The hon. Member for Bath (Wera Hobhouse) powerfully explained how women have to fight before symptoms are taken seriously, and the hon. Member for Strangford (Jim Shannon) talked about how his wife went through menopause and how it is important to understand this issue at home. I thank him for sharing his personal story.
As we all know, for far too long women’s health has been a marginalised issue, and when it comes to women’s health, the issue of menopause is critical. It affects every woman, yet time and time again, we in this country have neglected doing the right and obvious thing: to support women experiencing the menopause. I will not be presenting any groundbreaking information today, since all Members present are aware of the inadequate quality of care and support that women currently receive. For instance, there is the staggering finding—which has been highlighted —that nearly one in 10 women must consult their GP on 10 separate occasions before receiving proper guidance and support regarding the menopause. Of those women who did eventually receive treatment, 44% waited at least one year, and 12% waited more than five years. I am sure Members agree that those statistics are staggering.
One in 10 women have quit their job because of menopause symptoms, despite the fact that menopause affects every woman. As my hon. Friend the Member for Swansea East has mentioned on previous occasions, although women are 51% of the UK population, only 59% of medical schools included mandatory menopause education in their curriculum. Further important findings were released last week by Menopause Mandate reinforcing the inadequacy of support. Those findings confirm that not only do nearly all women experiencing the menopause find that the symptoms have a negative impact on their quality of life, but the vast majority face negative experiences at their GP and significant barriers at work. The finding that only 24% of women have a positive experience at their GP is surely a damning indication of how much further there is to go.
I warmly welcome the release of the manifesto by the APPG on menopause and the important words that have been spoken by Members today. It is one step further in this positive campaign, and in the work my hon. Friend the Member for Swansea East has done to put the menopause on the map and act on an issue that has been in the shadows for far too long. She is a trailblazer, and I am privileged to have the opportunity in my new brief to work more closely alongside her on these issues and make sure we realise many of the changes she has been fighting for. Education on the menopause is the first important step towards progress: when seeing our GP, we rely on their knowledge and guidance, yet too often, we hear stories of women who go to their GP again and again without proper diagnosis. Some women have said that it is a gamble whether their individual doctor prescribes them the treatment they need, which has been echoed in some of the contributions to this debate.
It is therefore essential that we seek to improve the education and training of healthcare professionals across the NHS with regard to the menopause. As well as looking at those who are training now, we must look at those who are currently practising—those whom we currently rely on to diagnose and assist the millions of women experiencing the menopause today. Furthermore, as with all health concerns, early detection is essential. When it comes to menopause, early detection can prevent much unnecessary pain and suffering. That is why Labour has been so focused on making our health and care services deliver a prevention first revolution that would support our NHS, our economy and, importantly, women. If we fail to progress on awareness, early detection and prevention, we are surely failing at the first hurdle.
Turning to the availability of hormone replacement therapy products, I want first to commend the progress that has been made, and again praise the work of my hon. Friend the Member for Swansea East. It was her private Member’s Bill and her determined campaigning which, two years ago, saw the Government finally commit to reducing dramatically the cost of HRT prescriptions for women in England. I commend her on not giving up—on raising awareness and constantly pushing for change on this issue. It is also important to acknowledge the positive steps we are introducing, with a dedicated page on the NHS website for women’s health. I hope this becomes an invaluable source for women to access the latest information and advice on menopause, HRT and all women’s health issues.
But while progress has been made on access to HRT, the Minister will surely be aware that women face an HRT postcode lottery, and, as with so many health issues, those in the most deprived areas are least likely to receive support. It is important that we tackle the structural inequalities that contribute to poor health for disadvantaged groups.
Additionally, we must not forget the serious failures that have led to the continued shortage of HRT drugs. Women seeking to access HRT are still being failed by the system, with drugs unavailable and alternatives out of reach. This has left so many women with debilitating symptoms, extending unnecessary pain and suffering. Education and informing clinicians are no good if we do not also improve access to HRT and end shortages. As my hon. Friend the Member for Swansea East has said, it is a very bad sign when only 14% of the 13 million women experiencing the menopause in this country are getting treatment. I hope the Minister can update the House on the Government’s actions on ensuring that shortages of these essential treatments do not happen again and improving access to HRT for women.
Fundamental to progress for women experiencing menopause would be progress for women in the workplace. As my hon. Friend the Member for Oxford East (Anneliese Dodds) has announced, a Labour Government would advance this issue by bringing in menopause action plans for large employers and publishing guidance for small businesses to support women suffering with menopause symptoms. These important steps are part of our plans for a new deal for working people and will make Britain work for working women. These reforms will give hope to women and significantly help all who work so hard to hold their jobs and care for their children and families while experiencing the challenges and symptoms of menopause. This is the right thing to do for these women, but it is also good for employers and the economy as a whole.
It is a tragedy that one in 10 women experiencing menopause leave their jobs and 14% reduce their hours due to lack of support in the workplace. That means hundreds of thousands of women are reducing their hours, giving up promotions or quitting their jobs because of the menopause. Labour is on the side of these women, wherever they work, and unlike the Government, we have committed to take the required action. Does the Minister not agree they are failing women in the workplace and damaging the economy as a result?
I finish by praising all who took part in the menopause revolution in our country. I am sure the whole House will agree that not only has this revolution begun but that it will continue to grow. Central to the revolution is my hon. Friend the Member for Swansea East, whom I congratulate again on championing this cause. If we get this right, the difference we can make for the millions of menopausal women will be life-changing, benefiting them and all future generations of women, so that no woman has to suffer in silence again.
I congratulate the hon. Member for Swansea East (Carolyn Harris) on securing this debate, and I am sad she is not here to join us this afternoon because we have held this debate on almost an annual basis and have made huge progress in achieving some of her asks. She is a tireless voice for women in this place, always raising awareness and inspiring action, and I am very proud to be working with her as co-chair of the menopause taskforce. One key piece of work by the Government has been to respond to one of her asks and reduce the cost of NHS prescriptions for HRT. Of course, there is much to be done. Our women’s health strategy has made the menopause a key priority area. For far too long, women’s health was a secondary consideration. This Government have put it top of the agenda—menopause, fertility, baby loss, dementia and osteoporosis are now priority areas for this Government—and we are the first Government to do so.
There has been a menopause revolution here this morning. I really thank the hon. Member for Bootle (Peter Dowd) for presenting the debate. We have heard from four male colleagues—the hon. Members for Merthyr Tydfil and Rhymney (Gerald Jones) and for Bootle, my hon. Friend the Member for Walsall North (Eddie Hughes) and the hon. Member for Strangford (Jim Shannon)—which is twice the number of women Back Benchers contributing. It is absolutely positive news that we have made so much progress that the menopause matters to men as much as it does to women. In my own Department, to mark World Menopause Day we organised a session during which officials tried on the world’s first menopause simulator, so that men could experience some of the side effects. It was a great success, and many male colleagues went away with an enhanced appreciation of women’s experience of the menopause. I also thank the all-party parliamentary group for its important work. It does a huge amount to shine a light on the issues, particularly with its manifesto for menopause.
I hope the House will give me some time to update it on the progress we have made since our last debate in the Chamber. First, a number of Members have mentioned the HRT prepayment certificate. It has been rolled out since April, and women can pay less than £20 a year for all their HRT prescriptions for 12 months. Many women are on multiple products—they are often on dual hormones—and each of those has a prescription cost. However, just to reassure colleagues, about 89% of all prescriptions are not paid for and there are no charges, and for HRT about 60% pay no prescription charges at all. For those who do, the £20 a year absolutely makes a difference, and it could save women hundreds of pounds on the cost of their HRT. In the spring, we launched a successful campaign to alert women to these changes, and I am really pleased to say that, as of the end of September, well over 400,000 women in England had purchased a HRT prescription prepayment certificate. For anyone who has not got one yet, they can be purchased online, but they can also be purchased in some pharmacies.
The shadow Minister, the hon. Member for Erith and Thamesmead (Abena Oppong-Asare), mentioned HRT supply, which has been an issue over recent months. We have seen a huge wave of women coming forward asking for HRT from their GP, and GPs have been much more comfortable in prescribing HRT, which did put pressure on supplies. There are over 70 products available in the United Kingdom, and in fact the majority of them remain in good supply. We have held six roundtables with suppliers, wholesalers and community pharmacists to discuss the challenges they were facing, and these have delivered results. Since April last year, there were 23 serious shortage protocols for HRT—relevant to 23 products—but as of today only one of those remains in place. That means that at the moment there is only one product for which there is a serious shortage protocol, meaning alternative dispensing or reduced dispensing occurs. We are holding a seventh roundtable later this month, and manufacturers are confident that, in producing and securing more, there will be supplies to be used. That is a real success story, and when women have their prescription, they can be confident that their prescription will be available at their pharmacy.
A key part of our menopause taskforce has been talking about research into the menopause and management of the menopause. The National Institute for Health and Care Research has conducted an exercise to identify research priorities, which concluded in January. I cannot remember which hon. Member mentioned testosterone, but research into how testosterone can alleviate menopausal symptoms has been identified as a gap. It is not licensed for use in the menopause because there is not currently the evidence base for the Medicines and Healthcare products Regulatory Agency to allow a licence. Having that research into testosterone and the improvements it could bring is a crucial step towards any licensing of that hormone. That is why it requested bids for organisations to come forward with research proposals in this area, and we expect an update in December. I am also pleased to update that between April last year and July this year, the NIHR has invested £53 million to support women’s health. On World Menopause Day, it funded the James Lind Alliance to launch its menopause priority-setting partnership. That is crucial in developing the evidence base for better management of the menopause.
I will just touch on a number of other points that were raised. First, on health checks, I have asked the NHS health check advisory group to review the case for including the menopause in the NHS health check alongside its broader future considerations on the health check, following the delivery of the digital check next spring. I will keep the House updated on that work, particularly the hon. Member for Swansea East, as co-chair of the menopause taskforce, because it is crucial that it is included.
We have started the process to set up women’s health hubs across every ICB in the country, because our ambition is for women and girls to access services for women’s health more generally in the places where they live. That is why we are investing £25 million to expand women’s health hubs across England. Hubs will deliver a range of healthcare experiences, but we would expect the menopause and advice on it to be covered by women’s health hubs. We are meeting ICBs shortly to get an update on progress.
One other point raised was about conducting a review into specialist menopause care. It is important to remember that specialist menopause care is not funded by central Government, but is commissioned by integrated care boards and implemented at a local level. They have a statutory responsibility to commission healthcare that meets the needs of whole populations, including for the menopause, but we know that is not always happening on the ground.
I acknowledge that the Government are making good progress on this topic, and I thank the Minister for that. Having said that, my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) spoke from the Labour Front Bench about training and development for GPs on supporting women with menopause symptoms. Can I press the Minister to tell us more about the Government’s plans to boost training and development for clinicians to help women experiencing the menopause?
The hon. Gentleman makes a valid point, and I will come on to that in a moment, because we are making huge progress there. If I may, I will touch on specialist support for the menopause. We will be working with ICBs, and when we meet shortly to ask for updates, we will be looking at the progress being made at the local level in providing that support. We have tried to ensure that information for women is as accessible as possible. We launched our dedicated women’s health area on the NHS website recently, where there is advice and support on the menopause, as well as for other health conditions. That will be updated regularly. Women now have a trusted source to go to for healthcare and advice. That includes a new HRT medicines hub, providing information about the different types of HRT and other options, because HRT does not work for every woman, and sometimes women have to try several types to get one that works for them.
Workplace support has also come up. As Employment Minister, my hon. Friend the Member for Mid Sussex (Mims Davies) has made huge progress. In March, we appointed Helen Tomlinson, who is the menopause employment champion. This month, she published a report with a four-point plan to improve menopause support in the workplace. Organisations such as Wellbeing of Women offer support to businesses, small and large, on how to improve their offer to women. Many of the suggestions that have been made in this place are being taken up, and they do make a difference. We hear from women all the time about the difference they make. This month we launched a new space for guidance on the helptogrow.campaign.gov.uk website. Large or small, businesses can get advice there about the difference they can make in the workplace not only in retaining women, but in having open conversations in the workplace. Flexible working is a key part of that.
To touch on the GP point, we are looking this year to consult on the future of the quality and outcomes framework, which is one of the measures used to look at health conditions, to see whether the menopause should be included. We fully recognise the importance of ensuring that GPs ask the right questions so that women get the right support. We intend to have those conversations with GPs about the QOF framework.
We are also, rightly, looking at staff training and developing education and training materials for healthcare professionals across the board, not just GPs, so that healthcare professionals have better awareness of the menopause. My hon. Friend the Member for Walsall North and the hon. Member for Strangford pointed out that women often go and ask for help, but their signs and symptoms are not recognised as being related to the menopause. Our women’s health ambassador, Professor Dame Lesley Regan, is doing crucial work on engagement in this place. We are also ensuring that GPs are assessed on menopause as a measure in their training. From next year, all medical students will have to complete a module that includes menopause so that doctors, whether GPs in primary care or in secondary care, have better awareness of the signs and symptoms and management of the menopause, so that when women approach for help, they will be better supported.
I thank all hon. Members for their contributions to the debate. We have taken great strides in the last 12 months in supply of HRT and reducing the cost, rolling out women’s health hubs, but I know that there is more work to be done. I know also that the hon. Member for Swansea East will be back to hold my feet to the fire, and I look forward to working with her as co-chair of the menopause taskforce.
I thank all hon. Members who took part in the debate. I also thank my hon. Friend the Member for Swansea East, who regrettably cannot be here. I hope that I have been able to do justice to the points she raised with me.
I thank the hon. Member for Walsall North (Eddie Hughes) for relating his personal experiences and reinforcing the need to provide the support that women so rightly deserve. I also thank my hon. Friend the Member for Bradford South (Judith Cummins), who has done sterling work in relation to the Better Bones campaign and the inextricable links between osteoporosis and menopause.
My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) is, as ever, working in his constituency. He referred to his menopause workshop. I am really interested in the word bingo. I am intrigued about that and will speak to him about it in due course. The hon. Member for Bath (Wera Hobhouse) referred among other things to the review of the prescription regime, which is really needed. As ever, the interventions by the hon. Member for Strangford (Jim Shannon) were spot-on, clear and precise. I am pleased to have his party’s support on this matter. My hon. Friend the Member for Blaenau Gwent (Nick Smith), who intervened a couple of times—once on me—was focused on the key element of clinical awareness.
I thank the shadow Minister, my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare), for her response, particularly in relation to Labour’s workplace charter. I am pleased about the reaffirmation of that. I also thank the Minister for referring to the four-point plan for the workplace that is in progress, to the QOF review and to training in menopause.
We have covered a wide-ranging area. The seven recommendations or asks in the manifesto are out there for all to see. No doubt, we will return to this matter time and again. I hope that in the next 12 to 18 months we can make even more progress than we have in the past couple of years.
Question put and agreed to.
Resolved,
That this House has considered the matter of the menopause.
Petition
(10 months ago)
Commons ChamberI am grateful for the opportunity to raise once again the importance of osteoporosis provisions and support. As many hon. Members know, I have campaigned on this issue for many years. Today’s debate is an important opportunity to highlight the deficiencies in support for a health condition that affects so many women and a large number of men in this country.
Historically, osteoporosis has been a condition shrouded in mystery. I have chaired the all-party parliamentary group on osteoporosis and bone health for some time now, along with Lord Black of Brentwood. Today’s debate coincides with our very first national media campaign on osteoporosis, co-ordinated by the APPG and the Royal Osteoporosis Society—the Better Bones campaign. I encourage all hon. Members to give their support to this important campaign.
Support for the Better Bones campaign has been staggering. It shows the public, professional and political demand for change, because nearly 250 parliamentarians, 44 charities, seven royal medical colleges, business leaders and trade unions are collectively calling on the Government to end the postcode lottery on access to crucial osteoporosis services in this country.
The hon. Lady is making a critical speech on osteoporosis treatment and support, and on absolutely the right day as well, when her campaign goes national. Is she aware that one in three people over the age of 50 who break a hip die of that injury or related complications within a year? That is a terrifying statistic. A large proportion of those fractures are osteoporotic, so does she agree that prevention and screening are key? There is groundbreaking work going on in Southend. The fracture clinic at Southend Hospital, which I had the pleasure of visiting a couple of weeks ago, is to launch a new fracture liaison service next spring, with the support of Mid and South Essex Integrated Care Board. It will be the first FLS screening service in the UK to offer consistent screening support across a whole region.
Order. If the hon. Lady wishes to make a speech, I think there may be time, but she is making an intervention.
The hon. Lady raises some important points. I agree that screening and prevention are key to tackling osteoporosis, and I congratulate her and Southend on getting their FLS up and running. It will make a real difference to the lives of people in Southend.
My hon. Friend is doing a fantastic job in this policy area. Given only half of NHS trusts have a fracture liaison service, does she agree that it is vital that that 50% figure grows week in, week out, to ensure that everyone gets get that service?
My hon. Friend makes a valuable intervention. He has been a staunch advocate for those suffering from osteoporosis and has backed the Better Bones campaign, for which I am very grateful. I agree that this issue is all about ensuring equity in access to NHS services, including FLS.
I am lucky enough to represent a constituency with a fracture liaison service, which can identify 91% of fragility fractures, but other constituencies are not so lucky. Does the hon. Lady agree that a modest transformation fund would make such a big difference?
I welcome that intervention and I absolutely agree. The whole tone of the campaign and my speech will address those very issues, because it is so important that we recognise that prevention is key to tackling osteoporosis. We cannot prevent the condition unless we ensure first that people are diagnosed. Osteoporosis receives too little attention, given the scale of numbers affected by the condition: half of all women and one in five men over 50.
The hon. Lady makes a point about statistics and the distribution of those who are affected. Just last weekend, I was grateful to attend a training workshop at Sacred Heart church provided by a guy called Sherwin Criseno, who explained to men and women over 50 the impact of this dreadful condition. Does she think it is really important that men are better informed about the impact of the condition, so they prepare accordingly and perhaps change their lifestyle?
I thank the hon. Gentleman for that important intervention. The condition predominantly affects women, but it does affect men as well. Small changes to lifestyle, as well as detection and prevention, are very, very important.
Osteoporosis often develops during menopause, when a decrease in oestrogen can lead to a 20% reduction in bone density. A loss of bone density affects people of all sexes as they age, but women lose more bone density more rapidly than men.
I thank the hon. Lady for securing the debate. I referred to this point earlier in the debate on menopause, but my staff and I deal every day of the week with benefit issues relating to osteoporosis. It is clear that the understanding and capacity that maybe should be there in the health sector is not there. Mindful that the Minister is not responsible for the Department for Work and Pensions, does she think that within the Department there should be a better understanding when assessing those with osteoporosis to ensure they can gain the benefits in the system that the Government have set aside and have a better quality of life?
I thank the hon. Gentleman for that important intervention. Osteoporosis suffers from some mystery, and any light that we shine on the condition is welcome. It is entirely possible for someone with osteoporosis to work and have a very full life, given detection and treatment.
Fracture liaison services are integral to that. They are essential because throughout our lives our bones continuously renew themselves in a process called bone turnover. With osteoporosis, bone turnover becomes out of balance. Bones lose strength and become more fragile, bringing an increased risk of fractured bones time and time again. The FLS can identify osteoporosis at the first fracture through methods including DEXA scanning, and offer treatment that can reduce the risk of further fractures. The FLS also systematically monitors patients after an osteoporosis diagnosis to ensure they get the best out of their treatment plan. With the FLS, patients who would otherwise face a fracture or multiple fractures can continue to lead healthy and fulfilling lives.
With osteoporosis designated as the fourth most consequential health condition when measured in terms of disability and premature death, we have to question the Government’s current record on assessment, treatment and prevention. There is a postcode lottery for access to these vital life enhancing and lifesaving services, with only 57% of the eligible population in England currently having access to the FLS. What we desperately need is a central mandate requiring integrated care boards to invest in established FLS for everyone.
Let me stress not only the moral imperative of acting on this issue, but the clear financial argument for establishing 100% FLS coverage in England. One million acute hospital bed days in England alone are taken up by hip fracture patients. Research shows that FLSs reduce the refracture risk by up to 40%. Applying that to the national picture, we find that a staggering 750,000 bed days would be freed up over five years, saving the NHS £665 million. This would have a significant and positive impact on the social care system. For every pound invested in FLS, the return is more than threefold. With the NHS in crisis, the Government must be bold and recognise the value of services such as FLS.
The future of the NHS lies in prevention, but this argument extends beyond the NHS. Every year, 670,000 people of working age suffer from fractures due to osteoporosis, and a third of those will leave the workplace permanently owing to the impact of chronic pain. We also know that every year 2.1 million sick days are taken in England as a result of disabilities caused by fractures. Any Government would surely understand how consequential this is for our economy. A new analysis provided for the Treasury shows that universal access to FLS can prevent up to 750,000 sick days every year, and that is why trade unions, the TUC, the Federation of Small Businesses and other business groups have joined the campaign to extend FLS access to everyone aged over 50.
It is clear that the Chancellor cannot succeed in addressing labour shortages without taking decisive action on FLS. To provide this vital support—to provide 100% FLS coverage in the UK—would cost an estimated £27 million per annum, which is less than 2% of the UK’s current expenditure on hip fractures. Preventive osteoporosis treatment not only presents a sound financial case for the NHS, but presents a strong business case by ensuring that so many women can continue to work. Improved osteoporosis treatment does not just mean that people can work for longer; it means—perhaps much more important—that those living with osteoporosis can enjoy a higher quality of life beyond their work.
It is time to do away with the stigma because, with people in the UK living to an older age than ever before, 50 has become the new 40. Osteoporosis is no longer an old person’s condition. We have allowed it to become accepted as a natural part of ageing, but it does not have to be. In this country, we have a choice: to diagnose and treat it, or to simply continue to ignore it. This is an opportunity to address old prejudices. Osteoporosis is one of many conditions, mostly experienced by women, that have historically been swept under the carpet. In the 19th century, during the period of its earliest identification, studies crudely described the condition in terms of women tripping over “their long skirts”. Even today, people refer to osteoporosis in crude and demeaning terms such as “a dowager’s hump”. Raising awareness of this long-overlooked condition is essential, and I am grateful for the opportunity provided by today’s debate to further demystify osteoporosis as a health issue which affects so many people across this country.
After centuries of inattention in the world of medicine, we now have revolutionary new technologies and systems such as DEXA scanning and FLS. These services have the potential to transform the lives of so many women throughout the country—women who have so much to offer, who should not be left undiagnosed, but whose quality of life is left literally to crumble along with their bones; women who are left to suffer in pain when treatment can and should be made available. The decision to provide full FLS coverage is not only fiscally responsible and right, but it would be an historical leap forward in terms of women’s healthcare. Today, two thirds of those who need anti-osteoporosis medication are left untreated. That is roughly 90,000 people, every year, missing out on necessary treatment due to Government inaction. This is life-changing medicine. As many people die from osteoporosis-related issues as die from lung cancer or diabetes, so FLS and fracture prevention need to be part of the mandated NHS core contract. We must establish new guidelines to support the establishment of FLS across England.
In August, the Minister publicly stated that the Government would make an announcement on establishing more fracture liaison services by the end of this year. In September, the Minister in the other place said that the autumn statement would include
“a package of prioritised measures to expand the provision of fracture liaison services and improve their current quality.”—[Official Report, House of Lords, 14 September 2023; Vol. 832, c. GC241.]
I understand that, since then, there has been a walking back of this commitment. On behalf of the 90,000 people missing out on life-saving, life-changing medication, I yet again ask the Government to hold their nerve and act quickly.
Now is the time for this Government to turn their back on outdated attitudes towards osteoporosis, now is the time to protect women whose quality of life would otherwise be left to crumble along with their bones, and now is the time to commit to 100% FLS coverage across England. By ensuring that every person in the UK has access to fracture liaison services, we have the power to make this vision of life-saving early intervention and prevention a reality.
I congratulate the hon. Member for Bradford South (Judith Cummins) on securing this debate. She has made a brilliant speech on a critical topic. As she brilliantly points out, osteoporotic fractures can be prevented and screening is the first step. If we could stop these breaks in the first place, not only would we save lives but we would save the NHS money and enable all our residents and constituents to live longer, healthier lives.
As I said earlier, the statistics are truly terrifying. One in three people over the age of 50 who break a hip go on to die of that injury within a year. We are talking about saving lives. The hon. Lady rightly mentioned that FLS is the start of this. The first FLS to roll out a consistent screening and prevention process across an entire trust will launch at Southend Hospital next spring. It is estimated that the service will prevent 550 fractures in mid and south Essex, saving the trust approaching half a million pounds and, critically, 1,300 bed spaces each year. If that were rolled out across the entire country, we would be looking at preventing 74,000 osteoporotic fractures, saving three quarters of a million bed days and hundreds of millions of pounds, to which the hon. Lady rightly referred.
The hon. Lady is right that this is the future of the NHS—we should be aiming at prevention—and that stopping women, in particular, suffering these osteoporotic fractures has to be done by rolling out FLS across the whole country. I hope the Minister will agree that other regions should follow Southend’s example. It is an exemplar and I thank him and the hon. Lady for giving me this opportunity to speak.
I commend the hon. Member for Bradford South (Judith Cummins) for bringing this issue to the House’s attention. As chair of the all-party parliamentary group on osteoporosis and bone health, she has long been a champion for those with osteoporosis. She will know that many of the points raised today echo arguments made in the other place only last month. As ever, she articulately and eloquently made a powerful and persuasive case, and I very much look forward to working with her and the charities that specialise in this area to improve service provision and support for those with osteoporosis.
As the hon. Lady set out in her speech, osteoporosis represents a growing challenge in this country as our demographics shift, particularly for older people. It is estimated that in the UK more than 3 million people have osteoporosis, including approximately one in 10 women aged 60 and one in five women aged 70, with more than 500,000 fragility fractures occurring each year. As she rightly pointed out, this silent disease does not just affect older people. Many people of working age suffer preventable fractures, with an estimated 2.6 million sick days taken every year in the UK due to osteoporotic fractures. Studies suggest that over 22% of the population aged 50 to 64 will suffer a fracture.
Impassioned calls have been made of late for increased Government support for FLS, both within Parliament, not least from the hon. Lady, and in the media. I thank colleagues across both Houses and the Sunday Express, which has led on this issue, for helping to raise the profile of these important services, which have long been recognised as best practice for secondary fracture prevention by both the Department of Health and Social Care and NHS England. Indeed, in our “Major Conditions Strategy: A case for change and strategic framework”, published this summer, we made it clear that we would continue to explore supporting the provision of FLS.
As the hon. Lady will know—indeed, she raised this in her speech—fracture liaison services are locally commissioned. My hon. Friend the Member for Southend West (Anna Firth) rightly pointed out, first in her intervention and then in her short speech, the importance of FLS. I thank her for drawing attention to and championing the service in Southend, which is an exemplar that we hope other integrated care boards will follow.
For local systems requesting support to review and improve their secondary fracture prevention pathways, NHS England is producing system-level data packs, which include data from a variety of sources. That includes the FLS database to highlight where there may be unwarranted variation; the impact of, and upon, existing health inequalities, which we should always be concerned about; and where there are opportunities for transformation. The Royal Osteoporosis Society outlines that, for every £1 spent on FLS in the UK, the taxpayer can expect to save £3.28. So by levelling up provision to cover everyone over the age of 50, we could prevent just under 5,700 fragility fractures every year. If that is the case, it is only right that NHS England continues to support ICBs to develop their secondary fracture prevention services. As the hon. Lady rightly pointed out, the benefits are clear and I trust that commissioners will be exploring how best to support the needs of their patients in this important area.
The major conditions strategy is not the only headline workstream that we are taking forward to improve osteoporosis care. The first ever Government-led “Women’s Health Strategy for England” was published in July 2022, marking a reset in the way in which the Government are looking at women’s health. As part of that work, we are investing £25 million in women’s health hubs, with each ICB set to receive £595,000 over the current and next financial year to establish a women’s health hub within their system. As we have outlined in the women’s health hubs core specification, specific services will vary depending on population health needs, the existing set-up of services and the workforce skills in a local area. The core specification outlines osteoporosis assessment and care. For example—the hon. Lady rightly alluded to this —DEXA bone density scanning or FLS are areas that local systems could consider when establishing their hub.
As important as FLS is, it is not the only way in which we can ensure that people with osteoporosis receive the care they need. NHS England’s “Getting it Right First Time” programme has a specific workstream on musculoskeletal health and is exploring how best to support integrated care systems in the diagnosis and treatment of osteoporosis. There is also, alongside that, a range of NICE guidelines to support equity of care for people with osteoporosis, which healthcare professionals and commissioners should absolutely note.
As we know, the economic burden of fragility fractures can be significant. That is why in this year’s spring Budget we announced a package of measures to support individuals at risk of, or experiencing, musculoskeletal conditions to live and work well. Those include: making best use of digital health technologies to support people to better manage symptoms and increase mobility; designing and scaling up MSK community hubs, expanding access to community-based services delivering physical activity interventions; and alongside that, integrating employment advisers into musculoskeletal pathways, building on the success of the NHS talking therapies programme.
Finally, I would like to highlight some of the exciting work that we are supporting on the future of osteoporosis care, and that is about research. Valuable research into MSK conditions such as osteoporosis is being funded by the Department of Health and Social Care, through the National Institute of Health and Care Research. NIHR has awarded £173 million for research into MSK conditions in the last five years. That includes studies into understanding and improving patient experience of diagnosis for vertebral fracture, physiotherapy rehabilitation for osteoporotic vertebral fracture and other treatments for MSK conditions.
In addition, in 2021-22 alone over £30 million has been spent on NIHR infrastructure supported studies and, alongside that, trials into MSK conditions, and six of the NIHR biomedical research centres have MSK conditions as a research theme. NIHR, in collaboration with Versus Arthritis—I referenced earlier some of the fantastic charities working in this space—also funds a dedicated UK musculoskeletal translational research collaboration, which aligns investment in MSK translational research and creates a UK-wide ambition and alongside that a focus to drive cutting-edge research and improve outcomes for patients.
I do not for a second underestimate how painful and debilitating this silent disease is, but I am confident that real advances have been made. I know that we have further to go, but I am confident that, working together, such advances will continue to be made.
This Government are committed to improving the provision of osteoporosis treatment and support. I once again extend my sincere thanks to the hon. Lady for bringing forward this really important debate, and I especially thank the individuals, and indeed the charities and other organisations, who do so much to support people with osteoporosis.
I have to acquaint the House that the House has been to the House of Peers where a Commission under the Great Seal was read, authorising the Royal Assent to the following Acts:
Online Safety Act 2023
Worker Protection (Amendment of Equality Act 2010) Act 2023
Energy Act 2023
Non-Domestic Rating Act 2023
Procurement Act 2023
Levelling-up and Regeneration Act 2023
Economic Crime and Corporate Transparency Act 2023.
I have further to acquaint the House that the Leader of the House of Lords, one of the Lords Commissioners, delivered His Majesty’s Most Gracious Speech to both Houses of Parliament, in pursuance of His Majesty’s Command. For greater accuracy I have obtained a copy, and also directed that the terms of the Speech be printed in the Journal of this House. Copies are being made available in the Vote Office.
The speech was as follows:
My Lords and Members of the House of Commons,
My thoughts turn first to My beloved Mother, the late Queen. I wish to thank you for the sympathy and support that have been extended to my family and myself from across both Houses of Parliament, the nation and beyond. My Mother set an example of selfless dedication and devotion to the United Kingdom and the wider Commonwealth during her long reign; an example to which I re-dedicated my own life of public service at my Accession a little over a year ago. I remain deeply grateful for the expressions of loyalty which were offered at that time.
My Government has taken action to bring down inflation, deliver better paid jobs and reduce the national debt burden on taxpayers. As households have faced rising prices in the aftermath of the pandemic and Russia’s invasion of Ukraine, my Ministers have made energy price support available to every household and provided cost of living support to the most vulnerable in society.
ECONOMY AND TRADE
Legislation was passed to drive forward growth and create a more open and dynamic economy. My Government brought forward legislation to enable a more sustainable and technologically advanced financial services sector, and introduced measures to encourage innovation, competition and productivity in digital markets, while protecting consumers.
Legislation inherited from the European Union can now be more easily amended so that regulation can be better tailored to the needs of businesses. Unnecessary retained legislation will be revoked at the end of this year, and the public sector procurement regime has been simplified to provide new opportunities for small businesses and to safeguard national security.
Legislation was passed to deliver greater resilience in the economy. Laws were passed to advance the transition to cheaper, cleaner and more secure energy. Measures have been brought forward to encourage agricultural and scientific innovation at home, unlocking landmark innovations in food production to improve food security.
My Government has implemented free trade agreements with Australia and New Zealand. It also strengthened ties with some of the most dynamic economies in the world through reaching agreement to accede to the Comprehensive and Progressive Agreement for Trans-Pacific Partnership. Laws were passed to streamline inefficient import controls to ensure that future trade is faster, simpler and more sustainable.
CRIME AND JUSTICE/ SMALL BOATS
My Government has delivered legislation to tackle dangerous and illegal Channel crossings, and to break the business model of criminal gangs. The Police have been empowered to make streets safer and protect the public from serious disruption caused by protesters. New measures have been brought forward to ensure victims are better supported as they engage with the criminal justice system. My Government took action to reduce economic crime, tackle illicit finance and help businesses grow.
FOREIGN POLICY AND DEFENCE
Legislation has ensured that the police and security services have the powers they need to respond to new and evolving state threats to the United Kingdom, including from overseas investment in critical national infrastructure. This builds on previous measures to ensure investments in critical national infrastructure and other sensitive parts of the economy do not harm national security.
My Government continues its steadfast military and humanitarian support of Ukraine in response to Russia’s illegal invasion and has demonstrated the United Kingdom’s continued commitment to the NATO alliance. My Ministers have made record investment in defence in support of our gallant Armed Forces and updated the Integrated Review of Security, Defence, Development and Foreign Policy to reflect the new challenges posed by growing volatility on the global stage. New initiatives have been launched to ensure that veterans are supported as they transition out of the Armed Forces.
The Queen and I were pleased to welcome His Excellency President Cyril Ramaphosa of South Africa last November. We were also delighted to visit Germany and France.
DOMESTIC
My Ministers have invested in public services and have set out a long-term workforce plan for the NHS in England. This will ensure that more doctors and nurses are trained, responding to the healthcare challenges faced by this generation and those to come. Legislation was delivered to make it quicker for those nearing the end of their lives to get the support that they need.
Laws were passed to protect freedom of speech and strengthen academic freedom in universities. My Government took action to make online platforms safer for children, whilst protecting freedom of expression. My Ministers ensured that the public can access essential public services, keeping people safe and reducing disruption. Measures have been brought forward to enable minimum service levels to be maintained in key areas, including rail services, ambulances and border security.
Legislation was passed to fulfil the commitment to level up opportunity in all parts of the country and empower local leaders to deliver for the communities they represent. My Government took action to ensure that those living in unsafe social housing will be better supported by the regulator, delivering better- quality, safer homes for those who need them.
My Ministers have progressed domestic reforms to protect the economic and national security of the United Kingdom, strengthen ties across the Union and give greater decision-making powers to cities. Legislation has been passed to address the legacy of the troubles in Northern Ireland and provide better outcomes for victims and survivors. My Government continues to work to encourage the restoration of power sharing in Northern Ireland and ensure public services continue to function.
Members of the House of Commons, I thank you for the provisions which you have made for the work and dignity of the Crown and for the public services.
My Lords and Members of the House of Commons, I pray that the blessing of Almighty God may rest upon your counsels.
The Commission was also for proroguing this present Parliament, and the Leader of the House of Lords said:
“My Lords and Members of the House of Commons, By virtue of His Majesty’s Commission which has been now read, we do, in His Majesty’s name, and in obeisance to His Majesty’s Commands, prorogue this Parliament to Tuesday the seventh day of November, to be then here holden, and this Parliament is accordingly prorogued to Tuesday the seventh day of November.”
End of the Third Session (opened on 10 May 2022) of the Fifty-Eighth Parliament of the United Kingdom of Great Britain and Northern Ireland in the Second Year of the Reign of His Majesty King Charles the Third.