Assisted Dying

Tonia Antoniazzi Excerpts

Monday 29th April 2024 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

I beg to move,

That this House has considered e-petition 653593 relating to assisted dying.

It is an honour to serve under your chairship, Sir Robert.

It is no secret that I grew up as a Catholic and attended Catholic schools. One of the most engaging lessons was religious education, where topics such as abortion and assisted dying, or euthanasia as some may wish to call it, were hotly debated. I admired my teachers who, with firmly held views, always encouraged debate—that is how I remember it, anyway. I have taken, and still take, the same attitude in my work as a Member of Parliament. For this place to have integrity, we must disagree agreeably and have the skills to debate and amend legislation that we may not agree with. Assisted dying is one such subject.

There is no set definition of assisted dying so let me clarify at the outset that here we are referring to the involvement of healthcare professionals in the provision of lethal drugs intended to end a patient’s life at their voluntary request, subject to eligibility criteria and safeguards. That includes healthcare professionals prescribing lethal drugs for the patient to self-administer, and healthcare professionals administering lethal drugs.

The petition calls for the Government to allocate parliamentary time for assisted dying to be debated in the House of Commons and to give members of this House a vote on the issue. More than 207,000 people have signed the petition so far, 272 of them from my constituency of Gower. The petition remains open, so the numbers are probably ticking up as we speak.

The petition was started by Hanna Geissler, the health editor at the Daily Express, and is supported by Dame Esther Rantzen, who is named in the petition. Hanna and the Daily Express have been campaigning on the issue for about two years, but Dame Esther’s public comments marked a change in the public perception of assisted dying, leading them to launch this petition. I pay tribute to their dedication and tenacity.

As people across the House know, this is not the first time I have opened a debate on this topic on behalf of the Petitions Committee. In July 2022, this House considered e-petition 604383, which asked Parliament to legalise assisted dying for terminally ill, mentally competent adults; that petition had more than 155,000 signatures. The fact that, in less than two years, we have had two petitions debates on this subject clearly indicates to me and to others that this issue is one that our constituents are highly engaged in, and I have no doubt that Dame Esther Rantzen has contributed to the heightened awareness of assisted dying. By her own admission, made in our discussion, she did not realise that speaking out about her personal choice would have had the impact that it has.

Whatever our own views, we must recognise that public opinion on assisted dying has shifted in one direction. Polls by Dignity in Dying have shown overwhelming support for changes to the law, with safeguards in place. Membership of Dignitas held by UK citizens has increased to 1,900, with a 23% rise during 2023.

In preparation for this debate and the previous one, I met a wide range of voices on assisted dying. Before this debate, as well as speaking with Hanna and Dame Esther, I spoke with Dr Matthew Doré, the honorary secretary of the Association for Palliative Medicine of Great Britain and Ireland; Dr Andrew Green, the deputy chair of the British Medical Association’s medical ethics committee; and Jonathan Blay from the Royal College of General Practitioners. Such conversations are always welcome and challenge my stance in this debate. The more evidence and sunlight that we can bring to these debates, the better, and we must never dismiss concerns, but consider them fully.

[Mr Alistair Carmichael (Orkney and Shetland) (LD)]

Is not the truth of the matter that the debate will continue whether we have it here or not? My colleague Liam McArthur has a Bill going through the Scottish Parliament at the moment. Similar legislation is being considered in the Isle of Man and in the Channel Islands. This issue will have to be addressed. Either we do that in our own time, with our own measured, reasoned debate, or we risk having decisions made for us.

[Tonia Antoniazzi]

I fully accept the right hon. Gentleman’s point that the law is changing in other countries and in parts of the UK. It is important to consider that, and to look at what is done well and not so well. It is for us in this place to consider this matter fully when the opportunity arises.

“Choice” is a key word for Dame Esther and for many of those who have signed the petition. This is about having the choice to die under their own conditions, with dignity and without struggle.

[Alex Davies-Jones (Pontypridd) (Lab)]

My hon. Friend is making an excellent speech. I was here for the last debate that she introduced on the issue and I am pleased to see this debate overwhelmingly supported today. The fact of the matter is that people can have a good death if they can afford it and are physically able to fly to Switzerland. That is grossly unfair. This is completely out of reach for the vast majority of my constituents in Pontypridd and the vast majority of people in the United Kingdom, so it is absolutely right that we have the debate, because if people can afford it and are physically able to do so, they can have a good death.

[Tonia Antoniazzi]

I thank my hon. Friend for her intervention, particularly because she raises a very valid point about the cost of that option for those who can afford to travel, and the discrepancy that there is in our healthcare system.

[Sir Edward Leigh (Gainsborough) (Con)]

That was a perfectly valid intervention, but surely one way to approach this problem is for us to get much better palliative care in place throughout the country. Everybody should be entitled to a dignified death. On this point, under the law of double effect, it is perfectly proper for a qualified doctor to relieve pain with very large amounts of morphine as long as his or her primary purpose is not to kill the patient.

[Tonia Antoniazzi]

I really value that intervention, because two thirds of palliative care in the United Kingdom is actually funded by charities. It is a postcode lottery. Excellent palliative care is what I would hope to have, but I would like to have the choice to have assisted dying and palliative care. I will go on to discuss that further in my speech.

[Caroline Lucas (Brighton, Pavilion) (Green)]

On that point, will the hon. Member give way?

[Tonia Antoniazzi]

I will, but I am very aware of the time and the contributions that need to be made.

[Caroline Lucas]

I will be very brief; I am grateful to the hon. Member for giving way. Does she agree with me that, actually, assisted dying can be a catalyst for more resources to go into palliative care? That is exactly what we have seen under many Administrations around the world.

[Tonia Antoniazzi]

I thank the hon. Member for her intervention. She makes a valid point.

How your family remember you and those last, dying hours with them is also what worries people such as Esther Rantzen. So often, it is the struggle that sticks in the mind of family members when they lose a loved one.

One thing that we can agree on is that this choice must be the choice of the individual and one that is well informed. There are always intended and unintended consequences to any legislation, and it is perhaps naive to suggest that any change in the law would not have wider consequences in society, beyond the individual making the choice. Safeguarding is a huge issue among the voices who oppose a change in the law. In 2023, the Danish ethics council concluded that the existence of an offer of assisted dying would decisively change ideas about old age, quality of life and dying, and that there was too great a risk that it would become an expectation aimed at certain groups in society. How do we prevent vulnerable people from experiencing coercion at a time when they are afraid and ill? It is about conversations and decision making.

[Sir Julian Lewis (New Forest East) (Con)]

I am so grateful to the hon. Lady, for whom I have the highest regard, for allowing me to intervene. Can she explain one thing to me? I do understand the idea of safeguards against coercion, but this is where I have a problem with the notion of assisted suicide: how do we set a safeguard against the person themselves feeling that they have to accept that they will die by their own request rather than be a burden to others? We can protect them from the pressure of others. We cannot protect them from the pressures that they will put on themselves, even though they do not really want to die.

[Tonia Antoniazzi]

I thank the right hon. Gentleman for his intervention, because those are exactly the conversations that we need to be having. We need to see how this has worked in other countries, look at data, be specific and take our role as legislators seriously. We may fall on a different side of the debate, but we need to consider it and engage in the arguments. The work that has been done in this House by the Health and Social Care Committee reflects the importance of having the debate and taking the evidence. I hope that evidence will emerge if we get to debate the issue on the Floor of the House.

The Association for Palliative Medicine of Great Britain and Ireland and the Royal College of General Practitioners oppose any law changes, while the British Medical Association holds a neutral stance. I was very interested to see what the BMA had suggested. Unfortunately, I do not have time to go into that now, but everyone I spoke to agreed that no medical professional should be forced to assist patients to end their lives. That stance is an interesting one, which we should consider.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

I am grateful to my hon. Friend, who is making an excellent speech. She has pointed out the opinion polls and the international examples—Switzerland, Spain, Portugal, Austria, the Netherlands, Belgium, Luxembourg and so on—and mentioned the BMA’s neutral stance. Does she agree that some of us are massively conflicted on this issue? When it comes to abortion I am very pro-choice, but last time we voted on this subject I actively abstained—voted yes and no—and was relieved that the status quo was upheld. Does my hon. Friend agree that some of us are relieved that there is no vote today? With the Hippocratic oath and other things, we are just massively torn on this one, despite the opinion polls.

[Tonia Antoniazzi]

I appreciate my hon. Friend’s contribution. I am going to make progress, because I said that I was going to speak for only 10 minutes, but she makes a very valid point, which will be noted. I thank her for it. This is not an easy debate to have.

In their response to the petition, the Government said:

“It remains the Government’s view that any change to the law in this sensitive area is a matter for Parliament to decide…If the will of Parliament is that the law on assisting suicide should change, the Government would not stand in its way, but would seek to ensure that the law could be enforced in the way that Parliament intended.”

There has not been a vote on this subject in Parliament since 2015, but that does not mean that this House is ignoring the issue. In February this year, the Health and Social Care Committee published its report on assisted dying, as I mentioned. The report did not make any recommendations on law changes; rather, the aim was for the report to serve as a basis for discussion and further debate in Parliament.

A common theme in the evidence submitted to the Committee’s inquiry was what many respondents called “a good death”. I want to make it abundantly clear that assisted dying should not be discussed as a replacement for palliative care; we must also have frank discussions about how palliative care can be improved, so that we can give people the most comfortable end of life possible. Last Monday, there was an engaging Backbench Business debate in the House on funding for hospices; in the interests of time, I recommend that Members and other interested people read it in Hansard. We have to think about some of the recommendations that the Health and Social Care Committee did make around palliative care. It recommended that the Government

“ensure universal coverage of palliative and end of life services”,

give a funding uplift to hospices that require assistance, commission research into how better to provide mental health support and guidance after a terminal diagnosis, and

“establish a national strategy for death literacy and support following a terminal diagnosis.”

That was a point raised by Dr Doré during our conversation. I was struck by the issue of funding. As I mentioned, about two thirds of the funding for palliative care comes from charitable organisations, and I really do not see how that is good enough.

Should the law on assisted dying change and any services be covered by state funding, what message would that send? Should Parliament vote in favour of a law change, there are important questions to consider, some of which I hope I have highlighted this evening. These questions are difficult, but as legislators it is our job to assess the evidence and to try to answer them. The topic of assisted dying is so broad that there are many areas I simply do not have time to cover, such as the current situation in the Crown jurisdictions, the pursuit of prosecutions for family members, or the many individual stories I have heard.

I have previously spoken about the death of my father, over 12 years ago. My family have been supporting my lovely mum, who has had a very tough year—since December, there have been a few times when we did not expect her to pull through. Many friends and colleagues in the House have offered prayers, and I have to say that my mother is our little Easter miracle—the Catholicness never leaves you—and she continues to make good progress. During this time, I have personally wanted to talk about death and consider how I want my death to be. The experience of being in a hospital where there is death all around makes you reflect. It seems harsh and even simplistic, but when such emotion and heartbreak is all around you, you just want your loved ones to be out of pain, however that looks.

We have been lucky that my mother has gotten better, although her life has changed greatly. In my personal view, if someone has a terminal diagnosis and is mentally sound, should they not have the choice to take themselves out of suffering? That is the choice Dame Esther Rantzen talks about. Whatever comes from today’s debate, I would like everyone to consider bringing up the subject of their death with their loved ones now, before it is too late, because two things are certain in this world: we are born, and then we die.

[Several hon. Members rose—]

--- Later in debate ---

[Tonia Antoniazzi]

I thank the Minister, who has rightly set out a measured response to the petition. Obviously, it is difficult for her to commit to a debate on the Floor of the House, because there is an impending general election and much business to do, so I hope that an incoming Labour Government will have that opportunity.

I also thank the petitioners, the petition’s creator, Hanna, and Dame Esther Rantzen. Today has shown our ability to come to this place with a range of strongly held views and have a debate in an informed manner. I thank the hon. Member for Strangford (Jim Shannon), who has sent me a note commenting on the balanced tone of my introduction to this debate on assisted suicide. His comments mean the world. Haven’t we done a sterling job in this House today? That is what we are here for, and that is why we are voted in. I feel strongly about that, as I have said before.

The hon. Member for Aberconwy (Robin Millar) talked about the voiceless and the people who do not have a voice in this debate. I am very good friends with the Paralympian Baroness Tanni Grey-Thompson and Baroness Ilora Finlay, who hold different views on this matter. They are well informed and well spoken and have been in the media on the matter. That does not mean that this House cannot give any potential legislation the sunlight that it deserves. It is incumbent on us to do so. We do so from a place of privilege, because we are elected to this House.

On that note, I thank everybody. I thank the petitioners and campaigners, and I thank you, Mrs Latham, for chairing the debate.

Question put and agreed to.

Resolved,

That this House has considered e-petition 653593 relating to assisted dying.

Angiolini Inquiry Report

Tonia Antoniazzi Excerpts

Thursday 29th February 2024 Commons Chamber

[James Cleverly]

I recognise the frustration that the hon. Lady expresses, and I can only restate my personal commitment. With regard to the Metropolitan police’s implementation of decisions made by this House, she should recognise that that is a decision for the political head of policing in London, the Labour Mayor of London. I am more than happy to take this matter up with him, if she has not already done so.

[Tonia Antoniazzi (Gower) (Lab)]

Dame Angiolini’s finding that there is nothing to stop another Wayne Couzens operating in plain sight worries me, because he had been operating in plain sight since 2002. The Home Secretary has used many words today, which he will be held to: “systemic issues in policing”, “trust in policing”, “attitudinal change is needed”, “change is needed”. Actions speak louder than words, Home Secretary. The police vetting, standards and misconduct systems need to be looked at now, so will he meet me to discuss the Police (Declaration) Bill, which I introduced as a ten-minute rule Bill only a few weeks ago, and how a register of memberships of secret societies should be publicly available? We need to rebuild trust in our police.

[James Cleverly]

I will ensure that either I or one of the Ministers in the Department gets the details of the points that the hon. Lady has brought forward.

I am more than happy to be held accountable for the words I have said at the Dispatch Box and the words I have said throughout my political career on this issue, because I am not going to lose focus on it. I can assure the hon. Lady and the House of that. As I have said, for the whole time that I have authority and jurisdiction over these areas, I will maintain this issue as a priority and demand that others—whether in uniform or out of uniform, operational police officers or those in the political leadership of police forces—take it as seriously as it should be taken. It is totally unacceptable that women and girls are not able to live their lives fully in our society because of fear, not only of criminality but of a lack of response from policing when these issues are brought to light.

Oral Answers to Questions

Tonia Antoniazzi Excerpts

Monday 27th November 2023 Commons Chamber

[Laura Farris]

The specialist sexual violence support project is now under way in Crown courts in Leeds, Newcastle and Snaresbrook. It is at an early stage but is due to report in early 2025. However, my hon. Friend should be aware that any victim of rape or sexual assault may now take advantage of section 28 procedures, which have been rolled out nationwide to allow people to give their evidence privately and ahead of trial. We are also engaging close to 1,000 independent sexual violence advisers in the system to accompany victims every step of the way through the criminal justice system. As a result, rape prosecutions are higher today than they were in 2010 and sentences are approximately 50% longer.

[Tonia Antoniazzi (Gower) (Lab)]

Can the Minister tell me how many forces are still not providing domestic abuse training to their officers?

[Laura Farris]

I do not have that answer. I will have to go back to the Home Office and write to the hon. Member.

Contest: UK Strategy for Countering Terrorism 2023

Tonia Antoniazzi Excerpts

Wednesday 19th July 2023 Commons Chamber

[Suella Braverman]

As the Contest strategy refresh makes clear, a broad range of ideologies and narratives draw people into supporting terrorism. That includes, as I have said, Islamist terrorism, which is by far the largest proportion of MI5’s case load, but there is also an increasing threat from extreme right-wing terrorism that we must confront, eliminate and do everything in our power to stop. Wherever it comes from, and however people are radicalised into extremist and violent behaviour, it is unacceptable, and we take a robust approach, ultimately, to keeping the British people safe.

[Tonia Antoniazzi (Gower) (Lab)]

In June this year, the borders inspectorate said that not every arrival into the UK at Manston was having security checks done as part of their interview or having their property checked. Can the Home Secretary guarantee now that every arrival is being fully checked, and if not, why not?

[Suella Braverman]

Having visited the reception centres at Western Jet Foil and Manston, and having been working closely on ensuring that the right facilities, resources and mechanisms are in place to ensure that those who arrive illegally are appropriately accommodated, I can say that we ensure that those who arrive are checked. They go through biometric checks and any other appropriate checks, and then they are put through our processing centres, generally at Manston. They are then put on a track, effectively, to other onward accommodation if they have an asylum claim. That is the general scheme that we have been carrying out for some time.

Metropolitan Police: Casey Review

Tonia Antoniazzi Excerpts

Tuesday 21st March 2023 Commons Chamber

[Suella Braverman]

It is precisely because I take violence against women and girls seriously that I added it to the strategic policing requirement, so that it is set out as a national threat for forces to respond to alongside the other threats listed there. I am very proud of the range of tools and powers that the Government have introduced, such as stalking prevention orders, sexual harm and sexual risk orders, and forced marriage and female genital mutilation protection orders—a whole range of legislative measures that are empowering the police to respond more robustly to victims of abuse and domestic abuse.

[Tonia Antoniazzi (Gower) (Lab)]

Baroness Casey’s finding of a “boys’ club” is sadly not a surprise to many of us—and let us not pretend that that culture is purely confined to WhatsApp groups in the Metropolitan Police. The report has shown the urgent need for action to make policing and police forces more transparent. When public trust in policing is at its lowest, it is unfathomable that serving police officers are not obliged to declare their affiliations with and memberships of societies such as the Freemasons. I urge the Home Secretary to bring in legislation to address that lack of transparency.

[Suella Braverman]

Vetting standards are set by the College of Policing via its statutory code of practice on vetting, and the inspectorate has looked in depth at whether those standards are being properly applied. We are strengthening the statutory code of practice for police vetting and making the vetting obligations on all forces stricter and clearer. That is action that we are taking, but of course we need chief constables to take the requisite action at their end.

Illegal Migration Bill

Tonia Antoniazzi Excerpts

Tuesday 7th March 2023 Commons Chamber

[Suella Braverman]

My hon. Friend is right. We are at unsustainable levels of people coming here illegally. It is putting unsustainable pressure on our accommodation, our public services and our resources. That cannot continue. That is why we need to adopt a different approach when it comes to dealing with asylum cases.

[Tonia Antoniazzi (Gower) (Lab)]

The Prime Minister stood at the Dispatch Box last week and committed that the Government

“will remain a member of the ECHR”—[Official Report, 27 February 2023; Vol. 728, c. 594.]

because leaving it would break the Belfast/Good Friday agreement. Does the Home Secretary agree?

[Suella Braverman]

We are clear that the measures in the Bill comply with our international law obligations. We are pleased to be proceeding with it and I encourage the hon. Lady to back it.

Change of Name by Registered Sex Offenders

Tonia Antoniazzi Excerpts

Thursday 2nd March 2023 Commons Chamber

[Tonia Antoniazzi (Gower) (Lab)]

My huge thanks go to my hon. Friend the Member for Rotherham (Sarah Champion) for bringing this important subject to the Chamber and to national prominence—her role in this has been extraordinary. I also thank women such as Della who have waived their anonymity to expose the serious failures in the DBS system, and to ensure that the law is changed to keep people safe.

As colleagues will no doubt have seen in their constituencies, most people’s reaction to hearing about this loophole is one of utter disbelief—disbelief that simple changes, such as the deed poll asking if the applicant has a criminal record, have not been made; disbelief that a system that so many of them have encountered—anywhere from their children’s school to local sports clubs—features such a fundamental flaw; and disbelief that, despite years of warning from campaigners, the name change loophole still exists and is treated as an administrative headache, not a serious risk.

I take this opportunity to highlight a concern that the hon. Member for Telford (Lucy Allan) and the hon. and learned Member for Edinburgh South West (Joanna Cherry) have already mentioned. Good intentions have not been balanced with the risk of leaving another avenue to be exploited and that is so dangerous. The DBS grants enhanced privacy rights to individuals who change their gender when changing their identity. Those are exceptional rights that are granted only to individuals from that group. The result is that identity verification is compromised, meaning that there is no guarantee that the information returned during the check and displayed on the certificate will be accurate or complete.

Those exceptional privacy rights also allow an applicant who has changed gender to request that all their previous names are withheld from the DBS certificate that is issued. That right to conceal previous identities is not given to anyone else: disclosing previous identities is a key component of safeguarding, and DBS certificates issued to all other individuals display all other names that the applicant has used.

Applicants who change their gender are also permitted to conceal their sex, and the DBS certificate issued will display their acquired gender instead. That right is not granted to any other individual: the importance of sex to safeguarding means that the sex of all other applicants is always displayed. There cannot be any exceptions in safeguarding. For the system to work, it must apply the same standards to everyone. Sadly, it is simply naive to think that loopholes in the system will not be exploited.

The system relies on the honesty of sex offenders to ensure that it functions as it should, but as the hon. Member for Mole Valley (Sir Paul Beresford) said, they are not to be trusted; they are not honest. Data obtained by the BBC from police forces highlights just how flawed this approach is. Between 2019 and 2021, more than 5,500 offences were committed by sex offenders of failing to comply with notification requirements: offences such as not telling the police they were living in a household with a child. The Disclosure and Barring Service found that 2,190 applicants for checks had criminal records and had supplied incorrect or missed out personal details such as past names or aliases. A total of 6,740 prosecutions began over the past three financial years for offences by sex offenders of breaches of a sexual harm prevention order or interim order. The system is broken and we must fix it. We have plenty of damning evidence as to why we should.

After being released from prison only three years into his six-year sentence for indecent assault, following a string of sexual assault convictions against children, Timothy Cuffy changed his name to Timothy Barnett. His new name allowed him to hide his criminal past, including from his new partner and three children. As Timothy Barnett, he answered the door to 13-year-old Sandy Hadfield, who knocked looking for her friend. After giving her vodka, he lured her to a quiet area of the woods, where he attempted to have sex with her before slitting her throat. Owing to his name change, his background went undetected, even after two encounters with Lincolnshire police and one encounter with social services. A system that means a convicted child sex offender is not identified, despite encounters with the police and social services, is one that is fundamentally broken and that led to the most tragic of outcomes in that case.

Sex offenders are not just changing their name post trial to hide their convictions; they are also changing their name at trial, or just before, to protect their name on their birth certificate. That has been highlighted in the high-profile case of Department for International Development worker Peter Davis, who became James Robert Harris before trial, allowing him to keep all records of his birth name clean should he decide to use it again.

This loophole gives sex offenders and abusers, many of whom rely on their ability to manipulate in order to carry out their crimes, an opportunity to hide their criminal history and pass the very checks that are meant to keep the most vulnerable safe. This loophole renders not only the DBS redundant but the domestic violence disclosure scheme, the sex offenders register and the child sex offender disclosure scheme. It seems absurd that we are discussing this 20 years on from the Bichard inquiry, which identified that the ability of serial predator Ian Huntley to change his name by deed poll to Ian Nixon, successfully severing the link with his existing police records, meant that no alarms were raised, and he was employed as a school caretaker. That this loophole still exists, allowing—indeed, enabling—serial predators to create new identities, is a scandal.

We are in this place to be legislators. We are in this place to make decisions and to ask the questions, “What if?” and “How?” We have to safeguard the most vulnerable people in society from these bad actors in all legislation. I pay tribute to everybody in the Gallery today and my hon. Friend the Member for Rotherham for her outstanding work on this issue.

[Mr Deputy Speaker (Mr Nigel Evans)]

I call the SNP spokesperson to wind up the debate.

Immigration Fees for Healthcare Workers

Tonia Antoniazzi Excerpts

Monday 30th January 2023 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

I beg to move,

That this House has considered e-petition 604472, relating to immigration fees for healthcare workers.

It is an honour to serve under your chairship, Mr Sharma. It is a privilege to introduce this petition and give voice to the thousands of healthcare workers for whom this discussion is an opportunity to raise an issue that has not only a significant detrimental impact on their lives and careers, but a huge impact on the availability and quality of healthcare in the United Kingdom. Although the petition is focused on changes that are within the remit of the Home Office, to understand the reasons behind it and why this is such an important issues for the petitioner, Mictin, and tens of thousands of his NHS colleagues, we have to understand that the most British of institutions, the national health service, would collapse without staff who are not British nationals.

According to the House of Commons Library, about 16.5% of NHS England staff are not British nationals. Of those 220,000 staff, more than half—just under 120,000—are from outside the European Union. Let me break that down a bit. Figures from the General Medical Council tell us that in 2021, more than half of new doctors working in the NHS came from overseas. There are 146,664 internationally trained professionals on the Nursing and Midwifery Council register—almost one in five of the nursing workforce. The Royal College of Radiologists’ recent workforce census found that in England, 27% of the clinical radiology consultant workforce and 20% of clinical oncology consultant workforce gained their primary medical degree in non-European economic area countries.

The list goes on across roles and specialisms, and that is before we even get to the healthcare workers who work in social care and provide support as home carers or in nursing homes.

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

Although it is welcome that the scheme has been extended to care workers under a 12-month trial, they are some of the lowest paid in the sector. The at-home care area of healthcare is facing some of the biggest difficulties of any across the UK. Does the hon. Lady share my concern that the costs are completely unaffordable for care workers?

[Tonia Antoniazzi]

I agree with the hon. Lady. The scheme has been extended by 12 months, but care workers are the lowest paid, and these are some of the biggest costs.

The numbers tell only part of the story. Although it is essential that we know the facts and figures, I would like hon. Members to think about what those numbers translate to for patients. Those clinical oncologists are helping to reduce the backlog of patients awaiting checks, scans and treatment, and are delivering life-saving care to cancer patients. Those midwives are guiding mothers through pregnancy and helping to bring their children into the world. Those doctors and nurses gave so much during the covid pandemic, worked all hours, did not see their own families, saved lives and comforted those who could not be with their families in their final hours.

[Janet Daby (Lewisham East) (Lab)]

During the pandemic, I was involved with GMB’s campaign for NHS cleaners and carers to be granted indefinite leave to remain after the sacrifices they made. Does my hon. Friend agree that we need to lower the cost of indefinite leave to remain and show the same level of gratitude to health workers who had to work during one of the most severe crises that our NHS has experienced?

[Tonia Antoniazzi]

It is true that these have been the most challenging of times, and indefinite leave to remain is one way of addressing that.

As we discuss the petition, I urge hon. Members to remember that when we talk about health and care workers, we are not talking in the abstract. We must remember the very real impact that Government decisions have on people’s health and wellbeing. There is little argument that workers from overseas are not essential to the running of our healthcare system. In fact, NHS trusts actively recruit from around the globe.

The health and care worker visa we are discussing was introduced to speed up processes to ensure that much-needed health and care staff could work in the United Kingdom. Despite broad agreement that there is obvious need in our overstretched health and care sector for overseas professionals, the current system is failing to retain these key workers. The expensive, drawn-out indefinite leave to remain process is pushing many key workers away, creating financial and bureaucratic barriers for those who wish to stay and to continue working in this country.

A greater number of healthcare workers settling in the UK would only benefit the health system. Not only does better access to ILR make the UK more attractive to the international workforce; better staff retention provides employers with greater long-term security for workforce planning, which I know at first hand is a key issue. Indefinite leave to remain allows for greater mobility between sectors and employers, as well as greater flexibility to deploy internationally recruited workers where need is greatest, rather than being hamstrung by restrictive visa requirements.

The financial barrier is high. The Migration Advisory Committee has highlighted the general high cost of these fees compared with other countries. The cost to apply for ILR sits at £2,404 per person. However, the latest visa and transparency fees data suggests that the estimated cost of an ILR application is just £491. In the context of a decade of pay erosion and the cost of living crisis, ILR fees may simply be unaffordable for many healthcare workers.

In the online survey of petitioners run by the Petitions Committee, respondents said they found it difficult to save up for indefinite leave to remain fees because of low salaries and a high cost of living, especially where they would need to pay ILR fees for multiple family members. One nurse who answered the survey said,

“I work as a deputy sister. I’m a single mum and my 2 kids have recently joined me in the UK. I cannot afford the ILR fees for me and my 2 children. With the salary of nurses and the cost of living here, a single mum like myself cannot afford it.”

A medical practitioner who responded said,

“As with current pay and cost of living crisis, it’s impossible to save this much. I am forced to buy used and second hand items only. I buy the cheapest groceries. Try and only use heating when absolutely required…I am forced to work weekends to save. I am hardly spending time with family. My mental health is affected. It feels like I’m a slave forced to labor…I don’t understand why the government would keep a fee that would force workers to leave NHS and UK…I survived through all waves of covid and staffing pressure. Had multiple illnesses because of my work. I don’t think I’ll survive this one. I believe these fees will break me.”

The fee is not the only cost; it is in addition to other substantial visa fees paid in the years prior to eligibility.

Workers without ILR are also subject to the no recourse to public funds policy. The cost of living crisis brings into sharp focus the potential financial hardship that internationally educated workers who are unable to access public funds could face. Members of the Royal College of Nursing consistently report the negative impact that the policy has had on their lives and the lives of their families. The covid-19 pandemic has exacerbated the challenges that individuals with no recourse to public funds were already facing, with these families identified as being at high risk of living in insecure and crowded housing.

Making the ILR process more accessible would bring significant benefits to individual workers who report that their mental health is suffering as a result of the financial pressures they are facing to try to meet the costs of ILR. A healthcare assistant who responded to the Committee survey said

“With the ever rising cost of living, [saving for ILR] becomes mentally draining for an already overwhelmed health worker. Reducing the cost shows the government care about the wellbeing of health workers and promotes work life balance because families have to work odd hours to meet up with the fees.”

The RCN also reports that nurses sponsored under the health and care visa often have difficulty reducing their working hours because of the minimum salary threshold —£20,480 per annum—that is applied to their visa. Given that there is no provision for that to be applied pro rata for part-time staff, the RCN understands that the policy often conflicts with nurses’ caring responsibilities.

Better settlement pathways can help to tackle abusive labour practices, reducing the ability of predatory employers to use immigration status to tie staff into exploitative situations. This is particularly relevant in the care sector, where the director of labour market enforcement has identified workers as being at high risk of exploitation. The RCN is aware from member reports that employers will, on occasion, use threats of deportation to coerce staff into paying extortionate repayment fees should they choose to leave employment early.

The current policy means that the UK is already losing overseas healthcare staff to other countries.

“I couldn’t raise the money [for ILR] for the last 2 years to apply, so I’ve gotten a better salary offer in New Zealand…so I’ll be leaving the UK.”

Those are the words of one nurse who responded to the petition. A trainee doctor told us:

“With paying for exams and training, I don’t have enough money to apply for an ILR, which makes me think to leave the UK and work in Australia after I qualify as a GP.”

The petition is not simply asking for a reduced fee for those health and care workers seeking ILR; it is asking for a joined-up approach from Government, and for a better system that will improve the lives of those using it and enable us to provide a strong and sustainable health sector.

Earlier, I told hon. Members that it was essential to remember that behind the figures, statistics and costings, we are talking about people, so I will finish by telling hon. Members about the person who kicked this all off—the petitioner, Mictin, who is here today with his family—and why he started the petition. Mictin was actively recruited to the NHS from India, as NHS trusts use local agents to recruit for them. Of the 23 other overseas workers who started with him when he came to Leicester, only six are still working in the trust. The costs of pursuing ILR were too much for many of them and some have found new work abroad—skilled workers who have left the United Kingdom because we have made it too difficult to stay.

We ask people to make the choice to come to the United Kingdom, but we have not ensured that we have a system that makes that choice an easy one. We force difficult choices on the workers we need. Mictin and his wife have made the choice to stay, but we have not made it easy for them. Mictin’s parents-in-law have never seen their grandchild, because the cost of taking him to India would mean greater delays in applying to ILR. Mictin started the petition because he knows he is not the only one making these difficult choices. While our health sector desperately needs more Mictins, we have to ask why we are making the choice to stay so difficult.

--- Later in debate ---

[Tonia Antoniazzi]

I thank the Minister for his remarks, but they are disappointing. I share the concerns of the hon. Member for Delyn (Rob Roberts)—this is probably the only time that I have shared his views—about the cross-subsidisation of the cost. I understand the theory behind it, but I do not think it makes Mictin and his family, and others like them, feel any better. I know the Minister cannot respond now, but the fact that £140 million has been spent on the Rwanda scheme, which is not even up and running, sticks a bit. When people learn that that money is cross-subsidised, it hurts—I know it will hurt those listening to the debate.

I appreciate the Minister saying that he and his officials will listen to what has been said today, but good governance would be to reflect and amend, if possible, the current legislation. I appreciate what has been done, but more can be done. I have listened and spoken to Mictin and his family, so I know it is about the cumulative cost of everything. It is about the ongoing financial pressure that those people face when their families are settled here. The United Kingdom is a great place to live and grow up, and it is where we want people to live their best lives. Those who have served in the NHS—I use the word “served”, because to work in the NHS as a healthcare worker, especially given what we have been through in the past few years, is a duty—deserve better.

Question put and agreed to.

Resolved,

That this House has considered e-petition 604472, relating to immigration fees for healthcare workers.

Migration and Economic Development

Tonia Antoniazzi Excerpts

Monday 19th December 2022 Commons Chamber

[Suella Braverman]

What is essential is that we introduce, consider and pass legislation that will be robust and resilient and actually deliver on our stated political objectives. That will require an exhaustive analysis of the legal methods but, simply put, we are in the process, we are in the sausage machine, as they would put it, so it is not a pretty sight, but nothing is off the table.

[Tonia Antoniazzi (Gower) (Lab)]

The Home Secretary said over the weekend that she is considering leaving the European convention on human rights in order to prevent people from claiming asylum. Is it possible to do that without breaking our commitments in the Belfast/Good Friday agreement?

[Suella Braverman]

What I think is clear is that there are evident challenges with the way in which international conventions and agreements relating to migration are working in the 21st century. I think there are legitimate questions that, at an international level, all nation states are grappling with; I have seen that at first hand when I have spoken to my counterparts in the Calais group or other international partners. There is an unprecedented scale of illegal migration and there is unprecedented pressure on domestic resources. I think that looking at how we can forge a new set of agreements to work better together is definitely a reasonable approach.

Police Service: HMI Report

Tonia Antoniazzi Excerpts

Thursday 3rd November 2022 Commons Chamber

[Tonia Antoniazzi (Gower) (Lab)]

The report states that hundreds, if not thousands, of officers who should have failed vetting are now working in police forces across the country, including mine. What measures will he take to identify those individuals and take action?

[Chris Philp]

There is already a process of periodic re-vetting of serving police officers. One of the 43 recommendations in the report published yesterday is to do that re-vetting more frequently, and that is with police chiefs as we speak.