Hospice Funding

Debate between Jim Shannon and John McDonnell

Monday 22nd April 2024 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Hastings and Rye (Sally-Ann Hart) for setting the scene so well, as well as all those who have made substantial contributions. Hon. and right hon. Members have been incredible in their joint efforts to support hospices across this great United Kingdom of Great Britain and Northern Ireland, and I want to add my bit from a Northern Ireland perspective.

There will be no Member in this House who has not had some form of contact with hospice care, either through our roles as Members of Parliament or in a more personal nature, as many of us have. I will tell the House a quick story about that. We cannot talk about hospice care without acknowledging the level of care that is provided by the world- class staff in hospices. Every one of us knows that, having dealt with those who give that care. Having seen the work that they carry out and the compassion with which they do so, I know that it is certainly a calling, because money could not pay enough to deal with the emotional toll of this work.

I knew a lady who worked as an occupational therapist in the national health service, and we got on quite well. She went on holiday to Greece one September, and she came back and went to the hospice. She was not feeling well, and the doctor told her that she had only four weeks to live—she had cancer of the liver. I remember going to see her at the Marie Curie hospice care headquarters on Knock Road, Belfast; it was my first introduction to hospice care. I said to the girl on the desk, “Would you tell Anne that I came to speak to her?” And the lady said, “Just a minute, and I’ll go and see if she wants to speak to you.” I said, “No, don’t worry about that, because it’s not important—just tell her I called.” I realised that day that Marie Curie hospice care is incredible, having seen what it did for Anne and her family.

As I said in my intervention on the hon. Member for Hastings and Rye, I believe that faith and family are important whenever our heart is breaking and our world is falling apart. The Marie Curie hospice in Belfast makes sure that people have faith to help them through those difficult times, which is important.

From offering light-hearted banter while helping people in embarrassing situations to being the scapegoat for anger or frustration, to being the last person to hold a person’s hand when their family do not make it in time, being a care giver in a hospice is more than a job. From the bottom of my heart, and from the bottom of all our hearts, I thank all those who do what most of us could not do—love and serve to people’s last breath, day in and day out. I thank every healthcare attendant, every nurse, every doctor, every porter and every pharmacist, and the entire team who provide the best end of life care and offer a support system to lost and grieving families.

[John McDonnell]

The shops that do the fundraising for our hospices have been mentioned, but an unmentioned group of heroes are the shop volunteers who provide a wonderful service in my constituency—a wonderful recycling service, as well—and funding for many of our hospices.

[Jim Shannon]

That is good to remember. I will mention the volunteers.

The hon. Member for Walsall North (Eddie Hughes) is no longer here, but he mentioned a sponsored walk and encouraged the right hon. Member for Hayes and Harlington (John McDonnell) to be involved. Like the right hon. Gentleman, I could not run a marathon, and I probably could not walk it, but he and I could probably dander it—that is the third category. We are danderers. I could do 26 miles, but it would be at my own pace. I am sure everyone else would be on their way home whenever he and I crossed the line—that is a story for another day.

We cannot pay hospice workers enough, but we have a responsibility to ensure that there is enough money to pay them. I do not feel we are currently doing enough, as other Members have said very clearly. The consensus is that we all want to see them paid better, and we want to see the care continue.

Northern Ireland Hospice provides specialist palliative care for more than 4,000 infants, children and adults in Northern Ireland with life-limiting conditions. The charity, which includes the only children’s hospice in Northern Ireland, says that it faces a number of challenges,

“not least of which is the ever-growing cost of this service. Government funds approximately 30% of service costs”.

The hon. Member for Darlington (Peter Gibson) spoke about Foyle hospice, which has to find 65% of its service costs. Well, every other hospice in Northern Ireland has to find 70%, relying on the

“goodwill and generosity of voluntary donations and other fundraising activities.”

Balochistan: Human Rights

Debate between Jim Shannon and John McDonnell

Tuesday 20th February 2024 Westminster Hall

[John McDonnell (Hayes and Harlington) (Lab)]

I beg to move,

That this House has considered human rights in Balochistan, Pakistan.

This debate is about the human rights abuses in Balochistan. We have had a discussion already, before the debate started, about the pronunciation, and I am sure that those constituents attending the debate will advise us. I apologise if we have, collectively, got the pronunciation wrong today.

I will briefly give some background for those who are listening or want to read the record of the debate later and are not familiar with the area. Balochistan is situated at the eastern extremity of the Iranian plateau and is currently divided nearly equally between Pakistan’s Balochistan province and Iran’s Sistan and Baluchestan province. Additionally, certain parts of Afghanistan’s Nimruz, Helmand and Kandahar provinces historically belong to the Balochistan region.

The strategic significance of Balochistan, both geopolitically and geostrategically, has often placed it at the forefront of major global events, and its location offers the potential to provide access to the energy-rich regions of central Asia, making it vital to the whole south Asian area. I will briefly give its history. The name “Balochistan” is drawn from the Baloch people, who have been its inhabitants for centuries and who predominantly speak the Balochi and Brahui languages. In antiquity, the region found itself part of the Persian empire. The foundations of the modern Baloch state can be traced back to the 17th century when Mir Ahmed Khan established the khanate.

The Kalat state, characterised as a princely state, persisted until the British invaded in 1839. Kalat became an associated state of the British, and by 1877 the establishment of the Balochistan Agency signalled direct British rule over the northern half of Balochistan, including Quetta, the capital. With the British departure from the subcontinent, Balochistan was briefly declared an independent nation on 11 August 1947. Although Pakistan’s founding leader, Jinnah, had supported an independent Balochistan, he underwent a change of view and perspective, and the Pakistan army invaded and forced the accession of Balochistan into Pakistan.

Since then—we have debated this over a number of years—there has been a saga of struggles for independence, marked by persistent resistance and repeated insurgencies. The trigger for the renewed phase was the murder of Nawab Akbar Khan Bugti, a prominent Baloch leader, in 2006. That event sparked widespread unrest, leading to growing momentum for the Baloch independence movement.

The campaign for self-determination has been fuelled, I have to say, by the suppression by the Pakistani state of Baloch culture and language. Balochistan’s rich cultural heritage is woven into the fabric of its society and reflects its history, traditions and way of life. The Baloch people, with their distinct cultural identity, have maintained their unique traditions and customs over centuries. However, the vitality of their culture faces significant challenges, due particularly to the suppression of their language. The Baloch people speak the Balochi and Brahui languages, both of which are integral to their cultural identity. Despite the importance of those languages in preserving Baloch culture, they have faced marginalisation and neglect by official institutions. In Pakistan-occupied Balochistan, the Balochi and Brahui languages are not recognised as official languages, despite being the mother tongues of the local population. Education in those languages is limited, and their use in the media and official communication is minimal. That undermines the Baloch people’s ability to express themselves and, yes, maintain their cultural identity.

There are also concerns about the hard facts of what is described as dispossession. Balochistan’s vast natural resources—natural gas and minerals—have made it a region of strategic importance, yet its inhabitants face significant economic challenges, including extensive poverty. The exploitation of the province’s resources has not translated into prosperity for the local population. Despite the abundance of those resources, Balochistan remains one of the poorest areas in the region, which feeds discontent and uncertainty about the future for many people.

In addition, in recent years, the imposition of major development projects without the consultation or consent of the Baloch people has led to widespread discontent and feelings of dispossession. The China-Pakistan Economic Corridor, or the CPEC, is a flagship project that has raised concerns about the potential displacement of local communities and about the lack of transparency on the distribution of the benefits of these projects.

[Jim Shannon (Strangford) (DUP)]

I thank the right hon. Member for Hayes and Harlington (John McDonnell) for bringing us this debate; I congratulate him for always bringing us important issues. I would go a stage further than the right hon. Gentleman. We have all heard of the historic march of the Baloch women to demand an end to the practice of enforced disappearances, extrajudicial murders, military operations and state brutality against the Balochs in Balochistan by the Pakistan army. These shocking atrocities must immediately be stopped. Does the right hon. Member agree that we need to use every possible diplomatic tactic to highlight the fact that respect for women must be a priority right and that it should not dismissed as a western ideal?

[John McDonnell]

I absolutely concur with the sentiment of that intervention and am grateful for it. Let me move on to that issue of human rights now that it has been raised. We must recognise that the situation in Balochistan is marked by severe human rights violations that demand the attention of this Parliament and the international community. Evidence of systematic abuses and disregard for human rights is mounting. A number of human rights organisations that all of us have worked with over the years, including Amnesty International and Human Rights Watch, have documented and condemned the widespread abuses taking place in the region. They have also highlighted the impunity enjoyed by the security forces responsible for these violations, and they have called for accountability.

The hon. Gentleman made reference to this: one of the most alarming aspects of the situation is the frequency of abductions and enforced disappearances. Activists, intellectuals, students, lawyers, journalists and other individuals have been subjected to what can only be described as horrific practices, which are often carried out by the Pakistani security forces. These individuals are often taken without any due process, held incommunicado and subjected to torture. Tragically, many of the victims that have been forcibly disappeared are later found dead, their bodies bearing signs of torture. This brutality—what is described as the “kill and dump” policy—has left families shattered and communities traumatised. It has created an atmosphere of fear and silence in many areas.

The other aspect of human rights is freedom of expression and assembly, and they have also been severely curtailed. Journalists face violence, censorship and threats, which inhibits their ability to report on issues affecting the province. People are denied the space to peacefully assemble and express their grievances. Recently, a historic and powerful long march was led from the capital of Quetta to Islamabad by Baloch women, as the hon. Member for Strangford (Jim Shannon) said. That purpose of that march was to demand an end to the practice of enforced disappearances, extrajudicial murders and the state brutality of the Pakistan army. The marchers faced violence by the state authorities and were abused and arrested after reaching Islamabad. During a 32-day sit-in to demand that those who had been forcibly abducted were produced in courts, the marchers, mainly women and children, faced threats, intimidation and harassment on a daily basis. They were forced to return to Quetta after this level of intimidation and harassment from state agencies, and now the families who participated in the march are receiving threats and cases are being registered against them. Dr Mahrang Baloch, who led the march, is receiving serious death threats and her life is in danger. There has been a recent increase in enforced disappearances—in fact, the tragedy is that enforced disappearances of Baloch political activists, students and teachers has almost become the norm now. Dead bodies of the forcibly abducted are constantly being found as a result of these extrajudicial murders.

Breaking Down Barriers to Opportunity

Debate between Jim Shannon and John McDonnell

Wednesday 8th November 2023 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate and a pleasure to follow the right hon. Member for Hayes and Harlington (John McDonnell). He always focuses on child poverty in these debates, and that is the right thing to do. What he refers to in his constituency is replicated across the whole United Kingdom. On food banks, for instance, just last week in my Strangford constituency there was a front-page article about food banks. There has been not a 16% increase in the use of food banks, but a 72% increase. That is incredibly worrying. It is not just those on low incomes who are finding it harder and harder to pay their bills; it is also those on middle incomes. He is right to make those points and I support him entirely.

Thank you, Madam Deputy Speaker, for allowing me to speak. What a poignant first speech delivered by His Majesty the King in his role. It was a privilege to be a part of that audience yesterday, to witness his instructions for the delivery of the Government’s aims, and to today represent the good people of my constituency of Strangford, his loyal subjects, as we seek to ensure that the needs of our community are met within those aims. Watching the pomp, pageantry, tradition and history—the whole procession and the King’s Speech for the start of Parliament—makes me feel incredibly proud to be British.

I very much welcome the apprenticeship scheme that the Secretary of State outlined. I also welcome the measures on childcare provision—good news. It might be low-hanging fruit, but the tobacco legislation is also to be welcomed. It may not be earth-shattering as such, but it is important because it will, hopefully, make a change. I also welcome the increase in Ministry of Defence spending. My request within that Government commitment is that perhaps we could look at recruiting more Territorial Army personnel in Northern Ireland. The reserve forces in Northern Ireland are well-recruited. There are opportunities and I believe we should be doing more, legislatively, to ensure that people can join the Royal Navy, the Army and the RAF in Northern Ireland.

I want to make three points, so I will call it a Presbyterian sermon. I am not a Presbyterian, although I am married to one—I am a Baptist—but a Presbyterian sermon is in three parts.

[John McDonnell]

There is a hint of Catholicism there.

[Jim Shannon]

The right hon. Gentleman always has a good point to make.

The title of today’s debate, “Breaking Down Barriers to Opportunity,” resonates with me in a few ways. I seek assurance from the Government that their commitment to breaking down barriers extends to Northern Ireland. I secured a Westminster Hall debate before Prorogation on contracts for difference, and the hon. Member for Bath (Wera Hobhouse) has just spoken about the importance of having them in place. I know the Minister will forgive me for raising the matter again so soon, but this is a new Session with new goals and, I hope, a new approach. Contracts for difference are much wider than simply an energy issue; they are also about the Northern Ireland economy.

I am a great believer that the United Kingdom of Great Britain and Northern Ireland is better together and, for me, it is important that we all feel the benefits of the King’s Speech by making sure that Northern Ireland plays its part in the economy of this great nation. It is about building a Northern Ireland supply chain, and Northern Ireland’s desire to contribute to the Government’s net-zero target and to reaching that target together equally across this great kingdom. It is about jobs. It is about science, technology, engineering and maths opportunities for ladies and women. It is about new skills, as the Education Secretary said, and it is about Northern Ireland’s desire to be an integral part of providing support for low-carbon delivery across the four nations of this great United Kingdom of Great Britain and Northern Ireland.

I love history, and it is no secret that I love this place. It always resonates with me that the four nations become one in Central Lobby, which is what I hope for. The barriers to opportunity must be torn down, and I look to the Government to make sure that happens through the contracts for difference scheme.

I know the Government intend to commit over £1.6 billion to the green climate fund—the biggest single international climate pledge that the UK has ever made—yet I feel there is a barrier within the UK, which can be brought down to help achieve our climate pledge while improving the local economy in Northern Ireland. Extending contracts for difference to Northern Ireland is an essential component of that work, and I hope Northern Ireland’s barrier to opportunity will be broken down. Green energy can deliver job opportunities, so we must break down that barrier.

The obvious barrier to opportunity in Northern Ireland is the Irish sea border. That physical barrier is detrimental to all in Northern Ireland. Unfortunately, the Prime Minister made only a fleeting reference to Northern Ireland yesterday, and the fact is that this issue has not been resolved. He referred to the Union, but he did not go into any details. As someone who believes in the Union, I would have loved to hear more from the Prime Minister.

The barrier to democracy erected by the European Union is still fully in place, as my constituents are subject to laws created by a process in which they have no elected representation. My hon. Friend the Member for Belfast East (Gavin Robinson) is also here, and we both recognise that local representation makes an important difference. At the moment, we are denied that representation. The barrier remains, as the DUP remains unable to take its place in devolved authority at Stormont until further steps are taken to restore our opportunity to operate as a fully functional member of this United Kingdom of Great Britain and Northern Ireland.

I now move on to the third part of my Presbyterian sermon. I say this respectfully to the Minister—I always try to be reasonable in my comments—but the Government continue to bury their head in the sand on child benefit thresholds. This is DUP policy, and we moved a ten-minute rule Bill on this subject before Prorogation. I have raised this issue over and again, and I will continue to do so until the Government acknowledge that the 10-year freeze equates to a reduction in child benefit thresholds. It has created barriers to opportunity, and to much-needed extra funds, for working families, which is unacceptable. It is a barrier not only for us in Northern Ireland, but for us all in this great United Kingdom of Great Britain and Northern Ireland; it is a barrier in Scotland, Wales, England and Northern Ireland.

Another barrier to opportunity for working families throughout the UK is that they are afraid of accepting small pay rises for fear of dealing with His Majesty’s Revenue and Customs, and that while prices have escalated, their wage is stagnant. Something has to break and it must not be, and never can be, the working family. The right hon. Member for Hayes and Harlington referred to that clearly and I am saying the same thing. For them, I ask the Government to include this matter in the list of priorities for this coming year.

I am coming to the end of my speech, within the timescale that you asked us all to adhere to, Madam Deputy Speaker. However, let me highlight that all of us here have the tools not only to build barriers in society, but to break them down. Let us break them down together and make sure that we make the right choice, prioritising our economy, our Union of the United Kingdom of Great Britain and Northern Ireland, and our working families in this new Session. May God bless the King, and this Government, as they deliver his and their goals and aims in this year.

Podiatry Workforce and Patient Care

Debate between Jim Shannon and John McDonnell

Tuesday 20th June 2023 Westminster Hall

[John McDonnell (Hayes and Harlington) (Lab)]

I beg to move,

That this House has considered the podiatry workforce and patient care.

The background to this debate is a meeting I had with a number of local podiatrists representing the Royal College of Podiatry, so let me thank them for the briefing that the royal college has sent me. I want to talk about the development of a workforce strategy for podiatry.

To explain for those who may take an interest in the debate, podiatrists are highly skilled healthcare professionals. They are trained to assess, diagnose, prevent, treat and rehabilitate complications of the foot and lower limbs. They manage foot, ankle and lower-limb musculoskeletal pain, and skin conditions of the legs and feet. They treat infection, and assess and manage lower-limb neurological and circulatory disorders. They are unique in working across conditions and across the life course, rather than on a disease of a specific area.

A podiatrist’s training and expertise extends across population groups to those who have multiple chronic, long-term conditions, which place a high burden on NHS resources. The conditions largely relate to diabetes, arthritis, obesity and cardiovascular disease. In addition to delivering wider public health messages in order to minimise isolation, promote physical activity and support weight-loss strategies and healthy lifestyle choices, podiatrists keep people mobile, in work and active throughout their life. They contribute to the wellbeing of our economy and workforce.

Podiatry is intrinsic to multiple care pathways too, and podiatrists liaise between community, residential, domiciliary, secondary care and primary care settings. They specialise in being flexible and responsive, ensuring focused patient care, irrespective of the clinical setting. Podiatrists are at the forefront of delivering innovation in integrated care. They deliver high-quality and timely care, as well as embracing safe and effective technologies that lead to improved patient outcomes.

The role of podiatrists in managing diabetic foot complications is key. They play a vital role in the prevention and management of diabetic foot complications, which, at the last estimate, cost the NHS in England £1 billion a year. In the three-year period from 2017-18 to 2019-20, there were over 190 minor and major amputations per week in England. Of the people affected, 79% will be confined to one room within a year, with 80% tragically dying within five years. That is a shocking outcome for patients, and it is even worse than the outcomes for the majority of cancers we seek to deal with.

The impact of lower-limb amputations on patients’ quality of life and chances of survival are shocking, so we must do everything we can to prevent diabetic foot complications. We have to act in a timely and targeted manner to ensure that people have the best possible chance of living long and fulfilled lives.

It is estimated that by 2025, 1.2 million people with diabetes in the UK will require regular podiatry appointments if they are to remain ulcer, infection and amputation free.

[Jim Shannon (Strangford) (DUP)]

I declare an interest as a diabetic, so I understand exactly what the right hon. Gentleman is saying. I am aware of the silent but vital work carried out by podiatrists throughout the United Kingdom. In my constituency of Strangford, a nursing home where funded podiatry appointments were cut was still visited by a podiatrist. He was able to attend, but he treated people without taking any money. Does the right hon. Gentleman not agree that access to podiatry for the elderly in care homes should be fully funded and that they should not have to rely on family or kind-hearted podiatrists to get their health needs taken care of?

[John McDonnell]

What I have discovered on my journey of finding out about podiatry, which I knew very little about before I met podiatrists in my constituency, is that of course people need professional care, and that care needs to be properly funded. There are volunteers, but we should not have to rely solely on volunteers; we need professionals leading the way. Podiatrists are skilled and trained in the prevention and management of diabetes-related foot complications. That is why many of us believe that they must be at the heart of the NHS plan to eliminate unnecessary amputations and the consequent avoidable deaths.

As I said, the broader cost of diabetic foot ulcers to the NHS is more than £1 billion per year—the equivalent of just under 1% of the entire NHS budget. Effective and early intervention for diabetic foot complications prior to ulceration could save thousands of lives and millions of pounds each year.

The situation in my area in Hillingdon exemplifies what is happening elsewhere in the country, which the hon. Member for Strangford (Jim Shannon) has mentioned. Hillingdon’s community podiatry service is part of the Central and North West London NHS Foundation Trust. It is suffering from severe workforce issues, which is having a detrimental effect on the people delivering the service and those suffering from foot ulceration, infection and amputation.

The service is currently failing to meet its timescales for seeing patients at high risk of developing a foot ulcer. What should be a team of 13 clinical podiatrists is now just 3.5 full-time equivalents and three support workers. The immediate concern is the pressure that puts on the staff who remain and the impact it has on the patients who need a minimum of weekly wound re-dressings to enable healing and prevent infection and life-changing amputation. The opportunities to prevent life-changing and life-threatening complications are minimised by the shortage of staff.

We also have concerns that support workers are being asked to triage and treat people beyond their scope of practice due to the staff shortage. That is not a criticism of them, but it is the reality. We should be filling the service with professionals who are fully trained to deal with the range of complications that they might come across. The workforce challenge facing podiatry is the real issue.

There is a need for focused recruitment. As I said, it is estimated that by 2025, 1.2 million people with diabetes in the UK will require regular podiatry appointments if they are to remain ulcer and amputation free. In the absence of that, there will be a greater risk of premature disability and death. There are currently just under 10,000 podiatrists registered with the Health and Care Professions Council. That is just one per 5,500 residents in England, and that number is due to decline as a result of demographics.

Following the removal of NHS bursaries for student podiatrists in 2016, the number of undergraduates studying podiatry has declined by 38%. Prior to that, the student bursary was set at £9,000 a year and it covered the cost of tuition for a year. In 2020, in a welcome move, the Government reintroduced student bursaries, but at £5,000. That has caused a slight improvement in recruitment to the profession, but it falls far short of ensuring the future of the podiatry workforce that will be required to deal with the oncoming wave of severe diabetic complications coming out of the pandemic.

Another issue is that the average age of podiatry students on graduation is 32. The majority of students are pursuing a second degree, and the need for a second student loan is having a damaging impact on universities’ ability to recruit undergraduates to train as podiatrists. By leaving it up to the market, we face the prospect of not training the workforce required to meet the needs of an ageing population.

The other issue raised with me is the limited career progression in NHS settings. Of the podiatrists currently qualified in England, approximately 40% work in the national health service. It is projected that many of those podiatrists not heading for retirement are likely to move to work in the private sector in the next five years. The reasons cited for that include lack of career development opportunities; repetitive workloads, with limited skill mix; and high demand and low capacity to meet it, leading to what people consider are unsafe staffing levels and to staff burnout.

Expansion of the podiatric workforce across primary, community and secondary services may address some but not all of those issues. Support for workforce growth is critical, but support for those already qualified to progress to advanced clinical practice and consultancy is also critical to workforce retention and ensuring adequate capability in senior clinical, leadership, education and research roles.

We need policy to ensure closer working across providers and the delivery of a foot health strategy. There is significant opportunity to expand the foot health workforce to include non-registered roles, supported by qualified, expert podiatrists. There is also opportunity to consider alternative workforce models that are inclusive of podiatrists working in private practice or the wider foot health workforce in the third and voluntary sectors, for example. A clear workforce strategy is desperately needed now. It needs to explicitly underpin how the foot health workforce is optimally configured, funded, implemented and trained and what the core outcomes of foot health services must be to meet the needs of our future population.

Currently, there is no workforce strategy, no clear statement of aim, and no standardised set of core outcome measures informed by public health or policy. Clear foot health policy is urgently needed to maximise all the benefits that podiatry can offer across an integrated care system, before the profession becomes—as we predict it will—unsustainable, with staffing levels even more unsafe and avoidable patient harms, amputations and deaths relating to lower-limb disease rising dramatically.

I therefore have three key asks. First, I ask the Government to reinstate the £9,000 bursary for student podiatrists. If podiatrists are to be able to support the millions of people who will require their expertise, the Government must reinstate the full podiatry student bursary of £9,000 a year. That is essential if the workforce is to be secured and expanded for future generations. In the absence of long-term funding confidence, allied health professions such as podiatry are unable to commit substantial and consistent investment towards maximising recruitment and retention, both of which will be crucial in securing the future viability of this vital profession.

My second ask is for national collection of podiatry vacancy rates and inclusion of podiatry in workforce planning. Publishing a national workforce plan that considers future need for allied health professionals such as podiatrists must be a priority for the Government. That plan must take into account current trends in recruitment and retention and, for future needs-based public health, comorbidities and their impact on disease prevalence. A national workforce plan will also act as a crucial evidence base for the allocation of long-term workforce funding.

My third ask is for the guidance on integrated care system membership to be strengthened to include allied health professionals. The absence of national guidance or recommendations regarding which organisations and individuals should be included in integrated care partnerships has resulted in a patchwork of involvement for allied health professionals, including podiatrists, in integrated care decision making. Without their meaningful engagement in those discussions, there is a danger that the invaluable contribution podiatrists can make to the delivery of care might simply be overlooked. Strengthened national guidance on the make-up of integrated care partnerships, to include representation of allied health professionals such as podiatrists, should be developed and implemented at the earliest opportunity.

I conclude by thanking the professionals who work in my constituency, as well as those who work nationally. I recognise the pressures they are under and the valiant way that they cope with them.

Social Security and Pensions

Debate between Jim Shannon and John McDonnell

Monday 6th February 2023 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate and add a Northern Ireland perspective, as I always try to do both here and in Westminster Hall. Right hon. and hon. Members have set out well the state of the country’s finances for many people. I wish to put on record, and I think it is right that I do so, my thanks to the Government, and the Minister in particular, for coming forward with proposals that help.

I want to make four points in my contribution. A Presbyterian sermon is three points, and I will make four; I am not sure whether that makes my speech a sermon, but it is Presbyterian plus one.

[John McDonnell]

I think that makes you a Catholic, Jim!

[Jim Shannon]

You be careful, boy.

I am very pleased to add my contribution to the debate. Inflation and the cost of living are really hurting people in Northern Ireland. The right hon. Member for Hayes and Harlington (John McDonnell) set the scene when he referred to child poverty and adult poverty in Northern Ireland, and he was right. I have a staff member who deals with nothing else but benefits, five days a week, and other staff members fill in. That gives an idea of the poverty and disability issues in Northern Ireland and why it is important for me to sow into this debate.

While I thank the Government, and the Minister in particular, for what they have put forward, and it is good to have that, I must first make the point from a Northern Ireland perspective that—as has probably become accepted in this House after so many debates—the Northern Ireland protocol has increased our outgoings substantially more than those anywhere on the mainland UK. The haulage costs and the prices of covering payroll have lessened the numbers of suppliers who will ship to Northern Ireland. That being the case, it becomes much harder to source competitively priced items. While this debate is about how we can help people on social security and improve their standard of living, we must recognise that costs in Northern Ireland are higher than anywhere else.

I read an interesting report back in October in the Belfast Telegraph that stated:

“Average weekly grocery spend is the third highest in the UK for shoppers in Belfast and Derry, according to new research by financial hub Admirals Group.

Shoppers in Northern Ireland’s two biggest cities are reportedly paying £77.70 on average for their weekly grocery shop in 2022, forecast to rise to £179.06 by 2030”—

well over twice the price. The report added:

“Only shoppers in London and Southampton are said to be paying more for their weekly shopping”.

That illustrates clearly that we in Northern Ireland are paying more. When it comes to social security and the benefit cap, we must register our concern that it is more costly to live in Northern Ireland than in other parts of the United Kingdom.

The lowest prices were said to be in Leeds and Sheffield—so at least they will have some benefit—and the same report stated:

“In 2021 the average British household spent £69.20 on groceries each week…If inflation were to remain constant at 11%, by 2030, the average grocery shop for a UK household could cost £177.02 per week, £771.28 per month and £9,204.84 per year.”

Those on benefits in Northern Ireland face a real anomaly. It is dearer to live in Northern Ireland; it is dearer to warm our homes and it is dearer to buy our groceries. That means that someone on benefits in Northern Ireland cannot expect their money to go as far as someone in one of the other constituencies in the UK represented in this House today.

While it is right and proper that benefits are uplifted to enable people to buy the bare necessities, the protocol means that those are not even covered by this uplift. The girls in my office referred almost double the number of people to the food bank coming up to Christmas this year, an indication that for many people any additional pressure on finances, such as to buy a small gift or a special meal, just cannot be managed.

The first Trussell Trust food bank that ever came to Northern Ireland came to Newtownards in my Strangford constituency. It has found a place and it is doing excellent work, and I support it very much, as indeed does the community. I am one of the referral points, so when it comes to understanding why people are going to food banks I can categorically state that it is not just those on the minimum wage, but those in the middle class, who I refer to as the working poor. The extra referrals, and we have had somewhere in the region of 30% or 35% extra just this last Christmas, tell me not only that the work of the food bank is important, but that there are different people going there. Again, that comes down to the cost of living, especially for those on benefits in Northern Ireland.

I am thankful for the food bank and to the social supermarkets, which are also doing fantastic work in seeking to help people make their money stretch further by teaching budgeting and different ways of purchasing. However, money is not elastic—it can only stretch so far. It is clear that the Government must bridge the gap, and by the same token we must lower the threshold to allow more people to access the help they are entitled to.

Having posed my first question to the Minister on behalf of the citizens of Northern Ireland about how they are finding it harder to beat the inflation that makes foodstuffs and heating more expensive there, I have a second question for him. For example, someone who is £5 above the threshold for universal credit will have missed out on the cost of living payment and will need the same help to pay the same amount for groceries as someone who is just below that threshold. We often find people who fall between two stools, and clearly those people do, so I want to make the point, as others in have in this debate, that they need help. I know the Minister always tries to respond, so I look forward to his response.

My third point is that I will hopefully bring a ten-minute rule Bill to the Floor of this House at some stage in the near future to make meaningful change to the child benefit threshold. Those disingenuous thresholds, which bear no relation or relevance to the cost of living and life, must be reviewed, and the same consideration must be given to the benefits threshold. We had a debate in Westminster Hall last Thursday, led by the hon. Member for Linlithgow and East Falkirk (Martyn Day), in which he raised a clear issue: two people in one house can earn £49,000 each, or collectively £98,000, and their child benefit will not change. However, one person in another house who earns £52,000 and whose partner earns £10,000, so that they earn £62,000 collectively, will see their child benefit change. There is clearly an anomaly in the threshold, and there needs to be a change of direction and some clarity to ensure that those who find themselves disadvantaged in that way are taken care of.

I make a special request, as others have done. Last week, we had a Westminster Hall debate on cystic fibrosis and living costs. Those with disabilities, such as those with chronic obstructive pulmonary disease or those who need oxygen 24/7, have higher costs. I quote some figures from that debate:

“People with CF have higher food bills because they need a higher calorie intake to maintain a healthy weight, and higher energy bills because they need to keep their homes warm to stave off lung infections and they may need to power an additional fridge to store sterile medications or essential medical devices such as ventilators.”—[Official Report, 2 February 2023; Vol. 727, c. 169WH.]

While this 10% increase is welcome, I ask the Minister very respectfully what can be done for those people with disabilities who are feeling the pain more than most.

In my opinion, and I believe others agree, a society is always marked by how it looks after those who are less well off. Our job in this House is to ensure that those who are finding these times particularly difficult—there are many of them across the whole United Kingdom of Great Britain and Northern Ireland—are looked after. That is my fourth request of the Minister.

While I welcome the increase, we are missing out those middle-of-the-road working people who are struggling and scraping by, week to week. I ask the Government to make their next priority the squeezed middle class, and those who need help and just cannot get to the level they would expect.

Global Vaccine Disparities

Debate between Jim Shannon and John McDonnell

Wednesday 13th July 2022 Westminster Hall

[John McDonnell (Hayes and Harlington) (Lab)]

I beg to move,

That this House has considered disparities in the global distribution of vaccines.

I submitted a request for this morning’s debate because I want to draw attention to the grotesque inequalities in the distribution of vaccines to tackle the covid crisis. When we convene for these debates, often it is to seek more information from the Government or to make a request for changes in policy. Now that there will be a change of Prime Minister and potentially a rearrangement of the Government, including of Ministers responsible for this area in particular, this is a particularly opportune moment to place all the issues on the agenda and hopefully see some change. It is also worth using these debates to record one’s position, because when our children and grandchildren look back in decades to come on the Government’s performance, I think they will ask why we did so little to intervene effectively when there was such a huge scale of human suffering across the globe.

The global vaccine story is one of gross inequality. I heard the Prime Minister when he made the statement that it was greed that brought us the vaccine. It was not greed; it was public money. Very significant public resources went into all the vaccines. However, greed was certainly responsible for the obscene inequality that followed.

Over the last year, the richer an economy was, the more likely that country was to have vaccines. At the top end, it would likely have had far more than it needed, and at the bottom of the scale, many countries had almost none at all. Still today, just under 20% of people across the African continent as a whole are fully vaccinated, and only 16% of people in low-income and poor countries are vaccinated. The Prime Minister has talked about vaccine hesitancy being the main factor accounting for that. That is simply untrue. Studies have shown that there is far more vaccine hesitancy in the United States than in most African countries. However, the way that the giant pharmaceutical corporations—big pharma—and richer countries have behaved has certainly fuelled that scepticism, which should worry us all.

The problem is not simply a lack of solidarity or generosity, although that is shocking in itself. As my hon. Friend the Member for Birmingham, Edgbaston (Preet Kaur Gill), the shadow Minister for international development, recently uncovered, a year ago the Prime Minister promised to share 100 million surplus vaccines with the world’s poorest countries. That is a very small amount, but at least it is something; yet a year later, barely a third have been delivered.

Those are the doses that we had already bought and were otherwise going spare. They would have been thrown away if they had not been distributed, yet they counted against the aid budget. In fact, it gets worse: we charged the aid budget double what the UK was widely reported to have paid for those doses. The Government had charged around £4.50 per dose versus the £2.30 per dose that they paid, as reported by The British Medical Journal. Yesterday, we discovered that over 1 billion doses are believed to have been wasted around the world. That would have been sufficient to vaccinate everyone in the poorer countries.

[Jim Shannon (Strangford) (DUP)]

I commend the right hon. Member for securing a debate on this issue, which has concerned me as well; indeed, it concerns us all across this House. Is he aware that Eswatini, a little country that borders Mozambique and South Africa and one of our Commonwealth family members, was hit hard by coronavirus? I have to say that whenever I raised this matter with the Government, and with the Minister in particular, they did respond. It is a country that I have a particular interest in because of the churches and the missionary groups there, and the Government deserve our thanks.

Does the right hon. Member agree that one of the difficulties—he has already outlined some of them—is that smaller countries have no one to advocate for them internationally? We need to be more proactive in our responsibilities, first to Commonwealth countries and then to those that have no one to advocate for them. I think he is also saying that we need someone to advocate for them and ensure they get the vaccines that are available. We should be doing that.

[John McDonnell]

I thank the hon. Gentleman for his intervention and for his dogged pursuit of the issue in Parliament and with Ministers. There is an issue about the strength of the voices of individual Commonwealth countries, and a real concern about some not being listened to. As a result of that, interventions are not taking place effectively in those countries, but it is invaluable that the hon. Gentleman has consistently raised individual issues with regard to particular countries in which he has an interest through the Christian movement. That adds to the pressure on Government for more effective action, and I am grateful for that.

The situation is worse than just failure to donate at scale. We did not donate as we promised on the scale that we promised, but we also worked to stop others producing the vaccines in their own countries. Around the world, factories offered to produce the vaccines, and one factory in Bangladesh said at the start of the pandemic that it could turn out 600 million doses a year. Compare that to the 35 million doses that the British Government have donated. More than 100 factories around the world could have been safely producing mRNA—messenger ribonucleic acid—vaccines, but were unable to do so because the trade-related aspects of intellectual property rights, or TRIPS, agreement locks that knowledge, which is often publicly produced, behind a wall.

The TRIPS agreement allows huge corporations and their shareholders to profit while preventing us from taking the action that we need to take to protect our own society, as well as people around the world. It is good for the big pharmaceutical companies, and Pfizer predicts $50 billion revenue for its covid vaccine—an anti-viral pill—in 2022 alone. These are the most lucrative drugs in history, and more than one Moderna executive has become a billionaire off its publicly funded and publicly created vaccines, but this situation is bad for us because it has not only created massive inequality, but allowed the virus to go unchecked in many parts of the world, mutating in a way that risks undermining the medicines we already have.

Elections Bill

Debate between Jim Shannon and John McDonnell

Consideration of Lords amendments
Wednesday 27th April 2022 Commons Chamber

[John McDonnell]

Two things on that: first, the hon. Gentleman is right to make us wary of putting even more responsibility on local government given its financial situation; and secondly, those cards have to be applied for, which is another process to go through that becomes costly. The hon. Member for Gedling intervened; it looks as though only 70% of people will actually do that, so we are still looking at a number of people dropping out of the system altogether.

That is why, with other colleagues, we are looking at what else people will have that they could use and why I thought that the list in Lords amendment 86 was constructive. There might be elements of that about which the Government think, “Well, that’s a bit iffy,” but I would rather that they had come back and said, “Well, let’s rule these ones out but accept the others.” They did not, which for me undermines their argument that they are trying to construct a legislation that will work effectively to ensure maximum democratic participation.

I am trying to be ultra-reasonable here, because people can lose their temper about this sort of legislation. My view is that whatever ping-pong takes place now, the two elements that we are talking about could be easily remedied. I want them to be dropped altogether, but if the Government will not drop them, then on the statement we should use a super-affirmative resolution process, and on the voter ID stuff they should at least look at some of the mechanisms and the list that the House of Lords has put forward, because several of the items are perfectly valid for their use. I will leave it at that.

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to contribute to the debate. I wish to speak to Lords amendments 106 to 109, as they pertain to local elections in Northern Ireland and elections to the Northern Ireland Assembly. I totally agree with what the Minister said earlier, in particular about photographic ID. We have had that in Northern Ireland for a number of years, and it has proven to be successful. I understand exactly the principles of why it is important. All a polling card confirms is the name and address on it; it does not confirm anything else. That is why I believe photo ID is critical.

In Northern Ireland, someone can use a passport, a driving licence, a SmartPass or a war disablement pass, because they all contain someone’s name and address and also their photograph. The Minister is absolutely right that those are methods of doing this. We also have another method—it goes back to what the hon. Member for Lichfield (Michael Fabricant) mentioned in his intervention on the right hon. Member for Hayes and Harlington (John McDonnell)—and that is electoral identification. Because we have an election coming up in Northern Ireland, people are coming in almost every day of the week to be registered so that they can use that electoral ID, with a photograph, which is recognised and issued by the Electoral Commission in Northern Ireland. It is done not by local government but centrally, by the Electoral Commission. Those are examples of why voter ID is important—because it works.