Oral Answers to Questions

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Tuesday 18th April 2017 Commons Chamber

[Ms Margaret Ritchie (South Down) (SDLP)]

With particular reference to that, does the Minister recognise the additional disadvantage faced by the tourism industry in Northern Ireland, particularly in border constituencies such as mine, given that the VAT rate on tourism in the Republic of Ireland sits at 9% and ours sits at 20%?

[Jane Ellison]

We explored those issues when I gave evidence to the Select Committee on Northern Ireland Affairs, so I know what the hon. Lady is alluding to. One example is that the Government’s decision in last year’s autumn statement to focus on investment in infrastructure will result in an increase of more than £250 million to the Northern Ireland Executive’s capital budget, which gives them the means to boost productivity and promote regional growth in Northern Ireland.

HMRC Estate

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Tuesday 10th January 2017 Commons Chamber

[Jane Ellison]

As my hon. Friend knows, I am familiar with all the localities that he mentioned. I know that Bradford was disappointed not to be the site chosen for the regional centre, but it is equally true that with a railway station in Shipley, my hon. Friend’s constituents are merely 10 minutes from Leeds on the train. I hope that it will prove to be a realistic project for his constituents to move to Leeds if they want to. I shall reflect on what my hon. Friend said and will write to him if I can provide further detail. HMRC has provided detailed responses, explaining the criteria used to select locations and thus explaining why Leeds was chosen over Bradford. I know that there has already been a good deal of correspondence on this issue.

[Ms Margaret Ritchie (South Down) (SDLP)]

The Minister will be aware that some HMRC offices have already closed in Northern Ireland, not only causing consternation to the staff who have had to be redirected to Belfast, but preventing accessibility for local businesses and ordinary people who are trying to deal with their tax affairs. In view of the NAO report, will the Minister please pause any further closures, as they simply cause chaos and upheaval?

[Jane Ellison]

I am not sure that I recognise the description of chaos and upheaval, given what I have said about improved average customer service times at the moment. There are good standards now, which does not align with what the hon. Lady said. I recognise that changes of this scale can be extremely difficult for the people affected by them, but I would like to pick up one point about how people interact with HMRC. We live in a different world from the one that obtained when the estates were last looked at on this sort of scale. The vast majority of taxpayers, both individuals and businesses, interact with HMRC digitally or on the phone. We have to adjust to the way the world is now rather than what it was like some decades ago.

Oral Answers to Questions

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Tuesday 29th November 2016 Commons Chamber

[Jane Ellison]

As my hon. Friend mentioned, we touched on this earlier. Making tax digital is an important reform. I have mentioned already that some important concessions were made during the summer, by taking many very small businesses out of making tax digital, but it has much to offer small businesses. I am looking carefully at all the responses that have been made, and as he knows, I have listened carefully to the points that he has made on a number of occasions.

[Ms Margaret Ritchie (South Down) (SDLP)]

T10. Will the Chancellor confirm that the devolution of corporation tax, which is conditional on the Northern Ireland Executive’s finances being on a sustainable footing, is not a vehicle for the Treasury to interfere in Northern Ireland’s devolved policies?

Oral Answers to Questions

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Tuesday 5th July 2016 Commons Chamber

[Ms Margaret Ritchie (South Down) (SDLP)]

Will the Minister responsible for public heath confirm when a statement on contaminated blood will be made to the House, and in particular on the response to the consultation that closed in April?

[Jane Ellison]

I am not in a position to be specific about when we can make a statement, but I can give the hon. Lady and other interested Members the absolute assurance that we continue to look closely at the issue. We have read every single response that we have received. I was at a well-attended all-party group meeting on 25 May and gave people a sense of the direction of travel of our analysis. I hope to keep the House updated.

Oral Answers to Questions

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Tuesday 9th February 2016 Commons Chamber

[Jane Ellison]

The challenge of being serious about prevention is one for the entire health and social care system. We acknowledge that, like many parts of government, public health grants have had to absorb some of the fiscal challenge. We are dealing with the problems we inherited at the beginning of the coalition Government. Despite that, local authorities will receive £16 billion in public health grants alone over the spending review period, but that is not the only way we invest in prevention. On my many visits, I have seen some of the great work being done to work with local authorities, and I am confident of the great things they can do with that money.

[Ms Margaret Ritchie (South Down) (SDLP)]

19. Given the report by the Crisp commission, released in the last few days, on mental health provision and treatments, can the Minister provide any assurance about the equitable treatment of physical and mental health to ensure an equal allocation of funds?

[Jane Ellison]

There is rightly a great deal of attention on this area—more tier 4 beds have been commissioned, for example—but I want to stress what is being done in my area of public health. Right at the heart of our new tobacco strategy, which we are beginning to work on, is a concern for the inequity facing people suffering from mental ill health in terms of smoking levels. I can reassure the hon. Lady that across the piece we are considering how we can do more for those who suffer with mental health problems.

Victims of Contaminated Blood: Support

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Wednesday 16th December 2015 Commons Chamber

[Jane Ellison]

We aim to consult, and we want to make sure that the final shape of the reformed scheme is informed by that consultation. As I have said, we look to start transitioning to a reformed scheme in the spring. At this stage, however, it is a little difficult to be more precise. We are working hard to ensure that aspects of the transition are being planned and thought about, and this will be informed by the final outcome of the consultation.

[Ms Margaret Ritchie (South Down) (SDLP)]

The Minister wrote to me on 6 November and stated:

“The shape and structure of a new scheme will be decided following the consultation process that will begin by the end of this year as previously committed”—

as it had been committed in an Adjournment debate on 9 September. I am deeply disappointed today that neither that scheme nor that consultation is in place. My constituent, Brian Carberry from Downpatrick in South Down, whom my Adjournment debate was about, has told me in the last few weeks that he now has a form of cancer, with four tumours identified, as a result of the connection with contaminated blood. Will the Minister give me and the House an undertaking today that a full and final settlement will be in place before the end of this financial year.

[Jane Ellison]

I have already made my comments about the timing of the consultation, and I cannot add to what I said in response to the hon. Member for Kingston upon Hull North (Diana Johnson), who put the urgent question. I have often spoken to the hon. Member for South Down (Ms Ritchie) about this and I responded to her Adjournment debate. I think that the language she uses is applicable to circumstances before this exchange. I have already explained the issue of compensation and the principles that we shall try to apply to the reformed scheme. I cannot really add to the comments I made in my response to the hon. Member for Kingston upon Hull North.

Contaminated Blood Products

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Wednesday 9th September 2015 Westminster Hall

[Jane Ellison]

I do intend to touch on new treatments, because that is one aspect of the landscape in this policy area that has changed profoundly for the better in recent years. I am also always happy to follow up on any issues with colleagues.

I know how much interest there is in this issue, as demonstrated by the presence of so many Members today. Many Members have heard from constituents, as have I, of the significant and devastating impact of this tragic matter on their lives. Successive Governments of all complexions have looked at and wrestled with this difficult issue. I have spoken directly to affected individuals and families and I read many letters—every single one that is sent to me—detailing people’s concerns and frustrations with the current schemes of support and the situation in general.

I assure Members that the matter of infected blood and the reform of the payment schemes continues to be a priority for me. I meet regularly with my officials in the Department of Health, including over the summer, to maintain progress towards a better outcome. As I indicated in my statement before the recess, the Government are considering the provision of future financial assistance, and other support for those affected, within the context of the spending review and in a way that is sustainable for the future. It does need to be sustainable.

We will be consulting to help develop the shape and structure of any new scheme. Members know that, and we have said that before. I appreciate and share the frustration that we have not been able to move to publish a date. I cannot give Members a date today, but we still intend to consult as soon as possible.

[Ms Ritchie]

It is vital that the Minister gives us a date for the commencement of the consultation today. We are talking about a life and death issue for many, many people. I know the Minister appreciates that, but she has to understand that a date is the most compelling requirement, along with the compensation and access to drugs.

[Jane Ellison]

I am well aware of that fact, and I do not casually say that I cannot give a specific date today. The consultation will take place before the end of the year, as we have previously committed to. We are working on the detail of that, but I cannot give Members a specific date today. It is an absolute priority to bring it forward. The area is complex, both legally and in its proximity to the spending review, but we have made that commitment.

Ovarian Cancer (Gene Testing)

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Tuesday 4th November 2014 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I thank the hon. Member for South Down (Ms Ritchie) for bringing this important issue to the House today. She has a long-standing interest in health issues and she has made the case very well for why we need to look closely at this important disease. I will come back to her after the debate on any point that I am not able to respond to now, particularly the technical aspects. I want to give the House a bit of the picture on what else is happening on ovarian cancer, as well as addressing the specific issues that she raised.

As the hon. Lady said, ovarian cancer is the fifth most common cancer for women in the UK. The current five-year survival rate is 44%, but we know that if we get the critical early-stage diagnosis, up to 90% of women survive for at least five years. We know that we could save 500 additional lives each year if we matched the best European survival rates. The debate comes at a poignant time for me, because I lost a very dear friend to ovarian cancer less than three weeks ago. I am well aware of the pressure that the disease brings to bear on the families of those affected. We are investing an additional £750 million over four years in England to improve early diagnosis, and I will discuss the details of that and of treatment later.

The hon. Lady’s speech focused on testing and the BRCA1 and BRCA2 genes. As she rightly said, a family history of cancer is one of the most important risk factors for ovarian cancer, with about one in 10 ovarian cancers being caused by an inherited faulty gene such as the two to which she referred. Incidentally, the genes also increase the risk of breast and prostate cancer. We know that women with a mother or sister diagnosed with ovarian cancer have three times the risk of ovarian cancer of women without such a family history.

NICE’s most recent guidelines recommend offering genetic testing to people with a 10% risk of carrying a BRCA mutation, which is lower than the 20% risk previously recommended. I remind hon. Members that NICE clinical guidelines represent best practice and that we expect NHS organisations in England to take them fully into account when designing services to meet the needs of the population. As a result of their complexity and the different states of readiness for implementation in the NHS, clinical guidelines are not subject to the same statutory funding regulation as technology appraisals. Clinical guidelines therefore have a slightly different status, but it is none the less important that NICE has revised them. NHS England is considering the new recommendation in developing and publishing a single national clinical commissioning policy to confirm the routinely funded NHS threshold for testing.

Like the hon. Lady, I thank Ovarian Cancer Action for all its work in this area. The recently released report on BRCA testing raises important issues, some of which were aired in the hon. Lady’s speech and in interventions. NHS England has said that moving to routine testing at a 10% risk would require a significant capacity and funding investment in genetic testing, diagnostics, counselling and treatment. NHS England is currently considering the potential for funding a revised 10% testing threshold in 2015-16 as part of its annual funding prioritisation process. I will draw NHS England’s attention to the strength of feeling in this debate and to the interesting points that my right hon. Friend the Member for Sutton and Cheam (Paul Burstow) and the hon. Member for South Down made about cost-effectiveness. I will also stress that Parliament continues to have considerable interest in the subject.

The hon. Lady touched on groundbreaking techniques, which provides me with an opportunity to refer to the 100,000 genomes project. We can see the potential of genomics to understanding cancers and rare illnesses and finding new treatments. In 2012, we launched the 100,000 genomes project, through which 100,000 whole genomes from NHS patients will be sequenced by 2017. The project will focus on patients with a rare disease and their families, as well as patients with cancer. Ovarian cancer is in the programme’s scope, and it will hopefully enable us to continue our record of groundbreaking cancer research here in the UK.

I will update hon. Members on the two major screening trials for ovarian cancer taking place in the UK. The first is looking at two possible techniques: trans-vaginal ultrasound and a blood test for cancer antigen CA125. Both of them are being tested as part of the UK collaborative trial of ovarian cancer screening. The study is being funded by the Medical Research Council and Cancer Research UK, with the Government funding the NHS costs of the study. The first phase of results was promising for both techniques, and the final results are due in January 2015. The UK National Screening Committee, which advises the Governments of England, Scotland, Wales and Northern Ireland on screening matters, is preparing to assess the results of the trial against its internationally recognised criteria for a screening programme and to make a recommendation on that basis, which could be a significant move forward. A second study, the United Kingdom familial ovarian cancer screening study, which began in 2005, is also looking to develop an optimised screening procedure for ovarian cancer in high-risk women, such as those to whom the hon. Lady referred.

Returning to early diagnosis, there is cause for encouragement, but we must continue to consider early diagnosis at every possible moment. The hon. Lady is right to draw attention to the impact of early diagnosis on survival rates. The Government have committed £450 million to achieving earlier diagnosis and improving survival. The funding supports improved direct GP access to four key tests, including non-obstetric ultrasound, to help with speedier diagnosis of ovarian cancer. Those tests are being used; in June 2014, GPs requested more than a quarter of all tests that may have been used to diagnose cancer under the direct access arrangements. The test with the highest proportion of GP referral was ultrasounds that may have been used to diagnose ovarian cancer, 46% of which were requested by GPs.

I also want to update the House on the “Be Clear on Cancer” preventive work in England. We want to improve outcomes for women, which is what Public Health England is working towards. With the Department and NHS England, it ran a regional “Be Clear on Cancer” ovarian pilot campaign early this year to raise awareness of the symptoms of ovarian cancer. Like other cancers with poor survival rates, many of the early symptoms can be similar to those of benign conditions, making early diagnosis difficult. The next step is to assess thoroughly the data from the regional pilot, which will help us make informed decisions about which cancer and symptom-awareness campaigns to take forward in 2015-16.

On research, the National Institute for Health Research’s clinical research network is currently recruiting patients to more than 30 ovarian cancer clinical trials and studies. In partnership with Cancer Research UK, the NIHR is also funding 14 experimental cancer medicine centres across England, six of which have a focus on ovarian cancer. A good amount of research is ongoing.

In addition to giving some sense of where NHS England is on BRCA testing, I hope that I am also providing a rounder picture of what else is going on in the field, including screening, diagnostics and awareness campaigns. It is important that the matter gets this level of attention.

[Ms Ritchie]

Has the Minister had any discussions with the NHS in Wales and in Northern Ireland? Like her, I have personal experience from knowing people who have died. Perhaps their situation could have been made easier had they had much earlier diagnosis.

[Jane Ellison]

Although the decision is one for NHS England, the debate has highlighted the fact that interesting work is going on in Scotland. The scale of the challenge is smaller in numerical terms, but I am interested in finding out more about what is going on. I will certainly initiate a conversation to understand what is going on in the four countries of the United Kingdom. I have regular conversations with Health Ministers from other nations for other reasons, as the hon. Lady knows. It may not be possible to raise this specific issue in those conversations, but I will ask for more information to see whether lessons can be learned and to understand the points identified in studies about the cost-effectiveness of early testing, in order to ensure that we have bottomed that out.

I hope that this short debate has served to highlight the issue’s importance. I am always grateful for an opportunity to discuss such important issues and to ensure that the House expresses its interest in making better progress on cancers with the poorest survival rates. I hope I have also updated the hon. Lady and other interested Members on what else is going on to try to improve outcomes for family and friends and to achieve better results in future. I thank for bringing the debate to the House today.

Oral Answers to Questions

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Tuesday 10th June 2014 Commons Chamber

[Jane Ellison]

We all appreciate the wonderful work done by cancer charities such as Macmillan Cancer Support and Cancer Research UK, and the Department works closely with those charities. We want outcomes for cancer patients in England to be among the best in Europe. As I said, we know we are not there yet, but a great deal of effort and money is going into getting there. The NHS is treating more cancer patients than ever. Since 2009, we have seen numbers rise by 15%—that is 1,000 more patients with suspected cancer referred to a specialist every day. That is the success of some of the early diagnosis and awareness raising activity. Of course we want any local dips in performance to be addressed, but let us give credit where it is due to clinicians who are diagnosing more cancers and catching them earlier, because that is the key to treating cancer successfully.

[Ms Margaret Ritchie (South Down) (SDLP)]

5. If he will meet the chair of the College of Emergency Medicine to discuss A and E units.

Oral Answers to Questions

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Tuesday 14th January 2014 Commons Chamber

[Jane Ellison]

I can confirm that the Department of Health is investing an additional £250 million over the next two years in A and E, with NHS England also allocating an additional £150 million for the current year. Milton Keynes has been allocated £2.8 million to support local initiatives to relieve pressures on A and E, and I know that, as a great champion for his local hospital, my hon. Friend will welcome that additional support.

[Ms Margaret Ritchie (South Down) (SDLP)]

Given the ongoing crisis in A and E units in the UK, particularly in the area I represent in Northern Ireland, will the Minister confirm whether the Health Minister in Northern Ireland has had discussions about possible solutions to finding and recruiting extra doctors?

Universal Credit

Debate between Baroness Ritchie of Downpatrick and Jane Ellison

Wednesday 6th March 2013 Commons Chamber

[Ms Margaret Ritchie (South Down) (SDLP)]

I acknowledge the good work that my hon. Friend the Member for Aberdeen South (Dame Anne Begg), the Chair of the Work and Pensions Committee, has done on benefits and the implementation of universal credit, particularly the impact on vulnerable people. The Committee highlighted the fact that vulnerable people are usually benefit claimants and so will be subject to the overhaul of the benefits system, and that many communities, and particularly those who will need it the most, will be deeply impacted by the online universal credit—admittedly, a telephony service will be available—because they will have great difficult accessing it.

It is important that the DWP can implement the IT system. Back in 2008, in my former life as Minister for Social Development in Northern Ireland, I introduced a parallel system for household fuel payments. It was outside the benefits system, but it required the help of the DWP and was an extremely difficult job. There were people who fell outside it who should have been eligible, but because of the nature of the IT system things proved difficult. I say that by way of warning. Also, owing to topographical difficulties, some claimants might not have broadband access, which raises issues about payment methods, and then there is the question of passported benefits.

My party has been against the introduction of universal credit from the outset. It is a misguided and draconian change to the benefits system that will neither save money nor encourage people into employment nor protect the most vulnerable. We are for welfare reform, but not for unfair reform. We recognise the need for a simpler, more accessible benefits system, but these reforms are an attack on the most vulnerable and will actually end up costing the taxpayer more through transition and administration costs.

I am extremely concerned about the long-term impact of the tone that the Government have taken throughout this and previous debates on welfare reform. The persecution of those on welfare—labelled “skivers”—is socially divisive and acts to marginalise and ostracise many people suffering disability, illness and impairment. It is casting down the very people whom the Government claim to be encouraging into work.

As the Minister will be aware, social security provision is devolved to Northern Ireland and implemented under a separate system known as parity legislation. In a previous life, I had to implement some of it. Under that system, we normally have little scope for variation, which means that we will be subject to the worst elements of these measures. I welcome the flexibility arrangements the Government introduced in Northern Ireland enabling split payments—two payments a month, rather than one—and payments to be made directly to landlords, rather than to the claimant, but the core of the changes remains and will be extremely damaging for our people and economy.

We need additional flexibility, owing to our high level of disability—a throwback to the troubles, which left people scarred by violence and terrorism—and higher percentage of people dependent on benefits. I ask the Minister and his colleagues to work with the Minister for Social Development in Northern Ireland to introduce that flexibility. Earlier today, I asked the Minister of State in the Northern Ireland Office about this subject in Northern Ireland questions, but his reply left me aghast: he said we should be getting more people into work. That is fine and laudable, if the work opportunities are there, but they are not, so let’s get real. We need to support these people, not marginalise and persecute them. These measures are likely to push more people into poverty and, in doing so, increase the welfare budget.

[Jane Ellison]

I am clearly not as familiar with the situation in Northern Ireland as the hon. Lady, but I do not recognise her description of persecution, marginalisation and ostracism. The Committee accepted that there were definitely some people about whom we were far more worried than others, but we took the general view that the system had a reasonable chance of working for the majority of people, even allowing for implementation issues. I just do not recognise her description of the system.

[Ms Ritchie]

I was saying that there were particular circumstances prevalent in Northern Ireland that perhaps did not exist in other parts of the UK because of the higher number of people who were more vulnerable and dependent on benefits. We are coming out of a conflict situation and, as a result of that legacy of conflict, more people rely on benefits and are, through no fault of their own, unable to access or find work. Those job opportunities, which might exist here in Britain, are not there.

[Jane Ellison]

rose—

[Ms Ritchie]

I would like to finish this point and move on. The third report by the Work and Pensions Committee states:

“We consider that the implementation timetable is ambitious and that there is significant further work to be carried out to ensure that the needs of the most vulnerable claimants can be met.”

Let me turn to the cost of universal credit. The rationale given by the Government is that the legislation is about making work pay and helping people into work. However, the driving motivation appears to be cutting costs, with those on welfare easier to scapegoat than the tax avoiders in society. Moreover, the figures suggest that, rather than saving money, the changes will increase the welfare budget. The Government’s own impact assessment suggested that £2 billion was set aside to fund the transition to universal credit in the 2010 spending review period and that net transfer payments from the Government to households would be around £0.3 billion higher once universal credit was fully implemented and transitional protection exhausted, while the Institute for Fiscal Studies has valued the long-run cost of universal credit at around £1.7 billion in 2014-15 prices. Furthermore, it has been stated that £18 million—£13 million in resource and £5 million in capital—will be delivered to Her Majesty’s Revenue and Customs to cover the costs associated with implementing universal credit

That suggests that the new system will be not just ineffective, but expensive. Experience suggests to me that the costs of such a project are likely to go up rather than down, once the projections meet the reality, as was the case with the change from incapacity benefit to workplace capability assessments. That has been a difficult issue in Northern Ireland and a traumatic experience for those who have been put through it. The resulting volume of appeals—a high proportion of which were successful—illustrates just how ineffective the changes were. I feel—I suppose I say this with a certain level of temerity—that the Government do not seem to be heeding that lesson. I fear that there will be an even more catastrophic impact when universal credit is fully introduced.

I have made it clear that I am against the substance of this welfare reform and its introduction, and I am dubious that it will actually save any money, but I also feel that there are likely to be a number of technical and administrative issues that could be extremely problematic and that we could run into financial problems as the system is rolled out in Northern Ireland in April 2014. I ask the Minister to look at those. I would also ask the Chair of the Committee to look into this and perhaps work with the Social Development Committee in the Northern Ireland Assembly to see whether these issues can be worked through. The project has already been delayed because of IT problems, and I have had very little reassurance that that will not happen again.