Antimicrobial Resistance

Debate between Will Quince and Jim Shannon

Wednesday 17th April 2024 Westminster Hall

[Will Quince]

I thank my right hon. Friend for bringing that to my attention; it was not something that I was aware of. Given the gravity and seriousness of the situation that we face not just here in the United Kingdom but globally, I think that we need to look at all potential tools in the arsenal to tackle this issue, so I hope that the Minister has heard the case that my right hon. Friend has made very powerfully, and I would be happy to meet with him afterwards to find out more about it, because it sounds incredibly interesting.

My right hon. Friend is right—although I want to focus for some time on the international effort—the battle is not won here in the UK, we have far more to do, and the Department of Health and Social Care and NHS England have important roles to play. I know from first-hand experience, including when representing His Majesty’s Government at the World Health Assembly and the United Nations General Assembly when I was Minister of State, the global leadership that the UK shows through the World Health Organisation, especially in partnership with Sweden. During my time, I was proud to be able to announce an investment of £39 million into research through the global AMR innovation fund to help to tackle what is a silent pandemic. I understand that £24 million of that has been awarded to bolster the UK’s partnership with CARB-X, which is a global AMR research initiative that supports the continued early development of invaluable new antibiotics, vaccines, rapid diagnostics and new products that combat life-threatening, drug-resistant infections, as well as prevent death and disease across the world.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for bringing the debate forward. The issue has been in my mind for some time, and I have a number of questions about antibiotic use, which, as I understand from the stats and from questions to the Department and Ministers, has been increasing greatly. Does the hon. Member agree that during covid a standard was set whereby many GPs and out-of-hours practices had to prescribe antibiotics without seeing patients? We need to return to the prescription of antibiotics after an examination that determines whether they are absolutely necessary. We cannot keep on giving them out willy-nilly; we have to do it under strict control.

[Will Quince]

The hon. Gentleman makes a valuable point; he is absolutely right that we need to readdress our approach to antibiotics. Yes, there is a role for clinicians in that. A 10-minute slot is not a lot of time to diagnose. Lots of people will go to see their doctor and the first thing they will say is, “I have an infection; I need antibiotics.” That may not be the case, and we have to trust clinicians. The Government’s new Pharmacy First initiative, which pharmacists take seriously, has strict controls and surveillance around the use of antibiotics; the UK Government and the Department of Health and Social Care take that incredibly seriously.

The hon. Gentleman is absolutely right to allude to the fact—and this is what worries me—that, in many countries around the world, antibiotics are available off the shelf, in the same way that paracetamol or ibuprofen are. I will not name the country, but I spoke to the Health Secretary of a particular country in Africa, who said that people routinely keep antibiotics in their medicine cupboard at home; if they feel unwell, they will take a few. That causes huge problems. We need an enormous awareness campaign and education piece around antibiotics, because their use may be harming us all in the medium to long term.

I also want to touch on the Government’s Newton fund, which has supported more than 70 research teams to conduct crucial research on strategic areas, including AMR. Through the brilliant Fleming Fund, the Government have invested £265 million to support countries around the globe to generate, share and use data on AMR. I am proud that that is the world’s single largest aid investment in AMR surveillance. I also must not fail to mention the role played by Dame Sally Davies, who is the UK’s special envoy on antimicrobial resistance. At the WHA and the UN General Assembly, I saw at first hand Dame Sally’s global leadership and how widely respected she is on the world stage on this issue. We are very lucky to have her.

Internationally, there is movement. I welcome the landmark 2015 WHO global action plan on AMR, which was followed in 2016 by the historic UN declaration on AMR and, more recently, the one health global leaders group on AMR, founded just a handful of years ago to provide leadership and maintain political momentum on the issue. But I believe the issue is so serious that more urgent and immediate action needs to be taken. As I said to the hon. Member for Strangford (Jim Shannon), we know there are countries where antibiotics are routinely kept in cupboards and medicine drawers at home and taken when people feel unwell. We know there are countries where antibiotics can be purchased over the counter or online without seeing a doctor or physician. My question to the Minister is what action could and should we be taking?

I think we need a significant domestic and international awareness and understanding campaign on AMR. We need the Governments in our respective nations to understand the risks of failure. We need the public to understand the impact on them and their families, and the urgency of the situation: we want them to be the ones calling for action. We need to do more to promote appropriate and adequate global surveillance for AMR to detect and strengthen our knowledge and evidential base. Incidentally, doing that will also help with identifying potential future pandemics, so there is a dual benefit.

We need to work towards an international agreement on common evidence-based goals, and support other countries to deliver against them. We have to use our official development assistance—our overseas aid budget —to help reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures. To the best of our ability, we need to use the UK’s political positions on international platforms and our soft power, including our ODA spend, and of course the formidable Dame Sally Davies and our UK expertise, to continue to provide global leadership on AMR. I hope the Minister will commit to supporting and continuing to fund the work of the World Health Organisation on AMR.

I hope that in the short time available to me—I appreciate that it was shorter because I was racing to get here in time following the votes—I have been able to set out why antimicrobial resistance is the issue that concerned me most when I was Minister of State at the Department of Health and Social Care and why it continues to concern me on my glide path out of politics. I genuinely think it should greatly concern us all. I hope the Minister and future Ministers will continue to keep the issue front of mind and treat tackling it with the urgency and seriousness it deserves.

Wine Duty

Debate between Will Quince and Jim Shannon

Tuesday 5th March 2024 Westminster Hall

[Will Quince]

My right hon. Friend and constituency neighbour is absolutely right to raise that issue, and she has long championed cutting the red tape and bureaucracy that British businesses face. As my right hon. Friend the Member for Stevenage (Stephen McPartland) said, this unintended consequence means that business faces not just extra cost but the significant administrative burden that comes with cost and time. My right hon. Friend the Member for Witham (Priti Patel) is right to point out that the new system is not simpler or fairer and that it has a huge cost implication.

[Jim Shannon (Strangford) (DUP)]

First, I commend the hon. Gentleman for securing this debate. James Nicholson Wine in Crossgar, which is in my constituency, is one of those excellent wine businesses that draws lots of people, not just because of the quality and wide variety of its wines but because it has also become a bit of a tourist attraction. It does lots of things. When it comes to the retention of jobs, does the hon. Gentleman share my concern that the Government’s proposed changes will undoubtedly—though I hope not—have an impact on job creation and job retention?

[Will Quince]

The hon. Gentleman is right to intervene on that point, because job creation and retention, including in his constituency, is important, as is our flourishing tourism sector. The growth in wine production across our country is something that we should celebrate; we should be proud of that and support it.

This debate is timely because we have some time on our hands. Obviously, the sooner we give notice to industry that the easement can continue, the lower the cost and administrative burden borne by industry. We have until 1 February 2025 to address this issue. I will have an ask for the Minister in a few moments, which I hope the hon. Gentleman will agree with.

I will just touch on one other element first, which is why wine is different. The easement recognises that wine is different from other categories of alcoholic drink. Wine cannot be made to a predetermined strength; the alcoholic strength of wine is determined by climate. I know that I do not need to teach anyone in this Chamber to suck eggs, but wine from warmer climates tends to be higher in alcohol than wine from cooler climates. Wine is not like beer or cider. And wine is subject to strict production rules, so in that respect it is also unlike beer and cider. As a consequence, there is very little that wine makers can do to lower the alcohol content.

It is estimated that there are over 100,000 different wines on the UK market. By comparison, there are less than 1,000 different ciders. Different vintages of wine can vary in strength, as is the case with some wines from the same year. Of course, that is one of the great pleasures of wine; wines from around the world are unique, while different vintages from the same vineyard can differ in strength and taste.

Taxing alcohol by strength, with lower rates for lower-strength products, might seem simpler on paper, but it takes absolutely no account of how different alcoholic products are consumed, including in what quantities and whether the product is diluted. This new system is much more complicated to administer for wine businesses and it penalises wine from warmer climates.

The differences between wine, spirits, beer and cider will remain if the easement ends. In practice, if the easement is abolished as planned, there will be 30 different payable amounts for wine in the 11.5% to 14.5% ABV range.

Middlewick Ranges

Debate between Will Quince and Jim Shannon

Tuesday 12th December 2023 Westminster Hall

[Will Quince (Colchester) (Con)]

I beg to move,

That this House has considered the future of Middlewick Ranges.

It is a pleasure to serve under your chairmanship, Sir Charles. This is my first debate since rejoining the Back Benches, which I hope demonstrates how serious this issue is to me personally and to my constituents. I am grateful to my hon. Friend the Minister for responding; I have a huge amount of time and respect for him, and I know he will take seriously the points I make.

I have been consistently outspoken about the future of Middlewick Ranges throughout my time as the Member of Parliament for Colchester. I have consistently raised the future of the site with ministerial colleagues in writing, orally in the House and in various meetings since the site was designated for disposal. The Minister will be aware that it was announced in April 2017 that the Ministry of Defence had earmarked the Middlewick Ranges site for sale, because it wanted, for operational reasons, to consolidate on one site in Colchester. Despite Colchester being home to a large garrison, I do understand the rationale and I do not challenge the validity of the argument to invest in one range in the area—Fingringhoe. That is arguably more suited, given the security and exclusion zone requirements for live firing.

[Jim Shannon (Strangford) (DUP)]

As a former reservist addressing a serving reservist, I am conscious of the importance of having ranges available for reserve forces— the Territorial Army, for instance. Will the removal of this range restrict the ability of reserve forces to train and to gain the experience they need?

[Will Quince]

The hon. Gentleman raises a good point, and it does concern me. However, I am not overly concerned, having looked into the detail with those at the garrison. The MOD intends to invest significantly in the Fingringhoe ranges site but, to the hon. Gentleman’s point, I gently suggest to the Minister that, given the size of the garrison and the relatively small capital receipt that could theoretically be achieved, based on a developer being willing to take the site on, it would be prudent at the very least to mothball the ranges or to use them as an alternative training area for reservists or regulars, in case they are needed in future.

After the site was earmarked for sale, Colchester Borough Council, now Colchester City Council, designated it for 1,000 homes and in 2022 it was included in Colchester’s local plan. That was rushed through, despite considerable opposition and the compelling scientific and ecological evidence presented. Last month, the site was released for sale on the open market, which is why I called the debate today. I have raised my significant concern in writing with the Secretary of State for Defence. Although the response from the Minister for Defence Procurement was helpful, in that it clarified the Department’s position on the ecology and the size of the parcel of land for sale, it was none the less disappointing.

By way of background, Middlewick farm was first purchased by the Government in 1857, to be used as a training area and rifle range. For centuries, the Wick has been enjoyed and used by residents of Colchester for walking and leisure. It is a vital green lung for suburban Colchester and it is adjacent to the Roman river valley site of special scientific interest. The site was designated as a wildlife site in the 1990s and was redesignated in 2015.

I hope the Minister knows me well enough, as a near constituency neighbour, to know that I am not a nimby. Colchester has been a high-growth urban centre for decades. I completely understand and get the need for housing, and particularly affordable homes and homes for social rent. It is important to note that Colchester City Council consistently and regularly exceeds its annual housing targets. However, the impact of such a large housing development has to be considered. The infrastructure of any area will inevitably be tested, and my constituents are understandably and rightly worried about the impact this development would have on their access to medical care and schooling and on the local road network.

Rapid growth in the northern part of Colchester has been supported by land set aside for future rapid transit routes, whereas the Middlewick development would almost certainly be car-dependent. Any active travel or rapid transit routes into the centre of Colchester would involve retrofit infrastructure, with its inevitable compromises. The site is, effectively, landlocked by well-established 1950s urban sprawl. Any movement to the centre of Colchester, or even west to the A12, will not be possible by rapid transit or active travel, by nature of the site being, effectively, infill.

The Minister will certainly be aware that Colchester is one of the largest garrisons in the country and is proudly home of 16 Air Assault Brigade, the UK’s rapid reaction force. Should Middlewick be retained, I have no doubt that it could and would be used as a training area. Although I understand the argument for rationalising the estate and consolidating on to one range to serve the garrison, it seems short-sighted for the Ministry of Defence to sell a prime parcel of land that has been a training area for almost 200 years and that serves an established garrison that is likely to grow further.

Important as all of the above is, I want to spend the rest of my speech focusing on one critical argument against the sale and development. Ecologists have told me that developing the site would go down as one of the worst cases of eco-vandalism that our country has ever seen. Middlewick is a site of huge ecological significance. It is one of the few remaining areas in England that contains rare acid grassland, which is a UK biodiversity action plan habitat. The Essex Wildlife Trust has previously stated:

“Middlewick Ranges is one of the most important and valuable Local Wildlife Sites in the Colchester borough. It is exceptionally valuable for its areas of acid grassland habitat and diverse invertebrate populations, which include a substantial number of rare and threatened species.”

I hear colleagues say various things when they oppose developments, but let me be absolutely clear: over 1,400 invertebrate species rely on the site, including 167 with conservation status. That includes red list species such as the necklace ground beetle, the fastest declining beetle in the UK. In terms of invertebrates, the site is one of the most valuable in the country. This rare acid grassland has up to 25 plant species per square metre, and the habitat has in part been developed because of the site’s use as ranges and because the public have not had access with dogs, vehicles and other things.

I want to quote Stephen Falk, an experienced entomologist and ecologist. He is one of Britain’s leading experts on pollinators and their identification, ecology conservation and management. It is a long quote, but a valuable one:

“I am astonished and disturbed by the claims that high quality acid grassland can be recreated on unsuitable soils elsewhere simply by adding Sulphur. I would suggest there is a basic misunderstanding of what acid grassland actually is! It is not ‘acidic’ grassland, or ‘acidified’ grassland (i.e. any grassland treated with acid to produce a lower pH). Acid grassland is a complex ecological ‘community’ of plants, insects and fungal communities, often of great antiquity. It is a grassland that often features a long historic continuity of key microhabitats (such as bare, sandy ground and boggy ground) and unusual plant assemblages. The invisible soil profiles of acid grassland (hidden from the eye but formed over many centuries if not millennia by rainwater leaching) cannot be recreated by simply adding Sulphur. But those rare and precious soil profiles (mostly now lost by modern farming practices or development) are the vital foundation for all that lives above. To suggest that simply adding Sulphur can recreate an ancient soil profile, an ancient seed bank, or ancient (and isolated) plant, invertebrate and fungal communities, is one of the most controversial claims I’ve encountered during my many years working in nature conservation. It should be treated with the utmost suspicion”.

I stress that rare acid grassland has never been recreated anywhere else. The idea that it can be is based on one study, based on arable sandy land. In the opinion of experts, it is practically impossible, and any theory that it can be done is based on bad science. I am told that the concept of replacing irreplaceable habitats that are hundreds of years old, such as this, is deeply flawed.

Let us be clear what the proposed sale and development actually means. It means replacing the rare acid grassland on adjacent or alternative land. That means taking the current rich, tall grassland, ploughing it up and adding sulphur in what will be one of the UK’s biggest ever science experiments—an experiment that, I need not remind the House and the Minister, is at the expense of a priority habitat and that is displacing 1,400-plus invertebrate species, 167 of which have conservation status. We are fooling ourselves if we think that, once this grassland is built on, it will ever be recreated. This will mean a huge loss to the ecology of not just my constituency but the entire country.

Hon. Members should not just take my word for it. The Royal Society for the Protection of Birds carried out a study at its Minsmere reserve in Suffolk, which was a strict habitat creation project with a conservation objective to create suitable habitat from farmland of low biodiversity value for breeding. This is where it gets interesting. That single case study has been used in the ecological evidence base report by Stantec to justify the compensation or mitigation proposals for the Middlewick Ranges site, but the RSPB feels so strongly that this work is not theoretically possible that it recently wrote to Colchester City Council to advise that it does not wish its work at Minsmere to be used in any way to legitimise or justify the destruction of the rare acid grassland or heathland—both priority habitats—at Middlewick. The RSPB says that it is not comparable or analogous and that it does not consider that any mitigation or compensation could be suitably bespoke, deliverable or effective.

The Minister will know that the Government recognise the importance of biodiversity and have published guidance on how to comply with biodiversity duties. The guidance states that public authorities in England must consider what they can do to conserve and enhance biodiversity. The Minister’s Department has the opportunity to put a stop to this, and I hope I have gone some way to making that case.

I want to send a clear message to the following people, who I hope are also listening. To the leadership of Colchester City Council, I say this. The local plan is currently being reviewed, with a call for sites. That is an opportunity to correct the mistake that has been made and to remove Middlewick Ranges from the local plan. If that cannot be done now, the council can signal its intention to do it when the plan is reviewed, which I understand must be done no later than early 2026. The council has the power to stop this act of eco-vandalism.

To any developers that are considering making an offer for the site, I want to be absolutely clear that, should they obtain planning permission, my constituents and I will hold them to account, and indeed the Ministry of Defence, to ensure that they deliver against all—every single one—of the ecological and financial conditions placed on them, no ifs, no buts.

To come back to the Minister, I am not one to make an ask without positive, practical alternative suggestions. He can retain the land as an MOD training area or mothball the site for future use by an expanding garrison. He can explore the potential for biodiversity credits. He can look into partnerships with local authorities to deliver a country park with revenue-raising potential. Building on the Wick is not something that my constituents or I ever want to see, and it is not too late to save this beautiful Army training area and ecological system. I strongly urge my friend the Minister to listen and act.

Childhood Cancer Outcomes

Debate between Will Quince and Jim Shannon

Tuesday 17th October 2023 Commons Chamber

[Will Quince]

I am very happy to take both those questions. First, in relation to childhood cancer research specifically, my officials in the Department are working really closely with the National Institute for Health and Care Research to set up an expert roundtable on childhood cancer research. Many trials will be applicable to both adults and children, but by their nature, some will need to be childhood cancer-specific. I welcome that important initiative, which is designed to encourage more research into cancers affecting children.

The Government do not, in effect, commission research directly. Bids are made to NIHR; around £1 billion a year is spent directly on research through NIHR, but it is reliant on those bids. That is why it is so important that we get more bids for research into childhood cancer coming forward.

[Jim Shannon]

I thank the Minister for his response and also for his clear understanding of the issue. We appreciate his words. On Saturday past, we had our party conference. There were a number of stalls, including for a cancer charity. It has a charter, and at the top of that was a target that 70% of those who have cancer will survive and heal. Can the Minister indicate whether he and his Department have the same ambition to secure 70% of people with cancer surviving and being cured, especially children?

[Will Quince]

Where I very much agree with my hon. Friend is that research is so much at the heart of this matter. The hon. Member for South Shields asked specifically how much funding is going directly into childhood cancer research, and my understanding is that over the past five years, the National Institute for Health and Care Research specifically has funded 38 projects relating to childhood cancers and has spent just under £14 million on research specifically into childhood cancers. She is absolutely right that children’s cancer risk factors are not very well understood, as this group of cancers is rare and diverse—I think it makes up around 1% of all cancers. That is why the expert roundtable on childhood cancer research is so important, and I will continue to consider with colleagues across the House what more we can do on this important matter to get more bids for funding specifically for research into childhood cancers to come forward.

A handful of months ago, the Government published the NHS long-term workforce plan. Although it does not go into specific detail on speciality or cancer services, we are working closely with cancer charities and others to determine what the requirement would be going forward. To ensure that we get it right, I would be happy to meet the hon. Lady and any others with an interest in this area to feed into the team looking at implementation of the NHS long-term workforce plan.

I again thank the hon. Lady for tabling this vital debate, and I thank all Members who have contributed today. Families who have been affected by childhood cancer have a right to know that the Government and everyone across this House stand with them. I assure the House that improving childhood cancer outcomes is a top priority for this Government and for me personally. I will continue to work with the NHS to ensure faster diagnosis, further and broader research and greater access to groundbreaking treatment. I assure you, Mr Deputy Speaker, and the House that we will leave no stone unturned in our mission to beat cancer.

Question put and agreed to.

Podiatry Workforce and Patient Care

Debate between Will Quince and Jim Shannon

Tuesday 20th June 2023 Westminster Hall

[The Minister for Health and Secondary Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Mr Dowd.

Let me say first how grateful I am to the right hon. Member for Hayes and Harlington (John McDonnell) for raising this important issue. He said that he did not know a huge amount about podiatry. I must say that I did not either, because I am not the Minister with responsibility for primary care, but I do have responsibility for the workforce. One of the powerful aspects of debates of this nature is that they force not only Ministers but the Department to focus on a particular issue and give Members from across the House—including the Minister —a crash course in it. As a result of my research ahead of the debate, I know far more about podiatry than I did yesterday. I thank the right hon. Gentleman for that.

I know having undertaken that research—and, indeed, from my constituency inbox—that podiatrists are a hugely important part of the workforce. They are an invaluable part of our NHS, as the right hon. Gentleman eloquently set out. I join him in saying how hugely grateful I am for their vital work supporting patients day in, day out across our NHS. The Government know that personal care that is responsive to people’s needs is essential and the service that podiatrists provide to local communities is important in helping people maintain their mobility, independence and wellbeing.

As the right hon. Gentleman rightly pointed out, early identification of foot problems helps to prevent or delay the onset or exacerbation of long-term conditions, thereby reducing the risk of wounds, infection and, ultimately, amputation. He also pointed out that foot problems have a significant financial impact on the NHS through out-patient cost, increased bed occupancy and prolonged stays in hospital. Working mainly at the heart of primary care, podiatrists are well placed to ensure patients receive a quality foot screening service, as well as the appropriate onward referrals for foot and lower-limb interventions.

The right hon. Gentleman correctly pointed to our ageing population. That is not exclusive to us; it is a global problem, certainly in the western world. I say “problem” but, actually, it is a great thing that people live longer. However, it is a challenge for health systems, because people are living longer with long-term conditions and complex needs that we need to ensure we can support and manage as a society. As the right hon. Gentleman pointed out, the need will continue to grow.

The right hon. Gentleman raised a number of issues but, with his permission, I will focus mainly on the workforce rather than on podiatry more generally. I recognise that the workforce remain under sustained pressure, having worked tirelessly throughout the pandemic to provide high-quality care for those who need it. I recognise that podiatrists’ role in supporting our NHS is as important as ever. It is vital that we support the workforce both now and in the future.

[Jim Shannon]

The right hon. Member for Hayes and Harlington (John McDonnell) referred to volunteers. I have them in my constituency, and if it were not for the volunteer podiatrists who give their time every day of the week, free of charge, I believe the NHS would be suffering even more. That is why we need to push for the recruitment that he referred to.

[Will Quince]

I thank the hon. Member for his intervention, and I pay tribute to all those who volunteer. This is not the only area in our national health service where volunteers play an important role, but it is important that they are add-on and add value—supporting professionals as opposed to replacing professionals. That is why, at the heart of this debate, we must ensure that we have the podiatry workforce that we need across all four nations—although this debate is specifically focused, understandably, on England.

As the right hon. Member for Hayes and Harlington pointed out, demand for the NHS continues to grow. That is why we have already done a significant amount to invest in the education and training of our future workforce. NHS England—until recently, this was done by Health Education England—has worked extensively to enhance and modernise the podiatry profession. One central factor, which the right hon. Gentleman alluded to, is the development of the foot health standards for the education and training of the foot health support workforce.

However, I am certainly conscious that we have more to do. As part of that process, we developed the podiatry apprenticeship, which is a degree apprenticeship, and supported the implementation of that route into the profession. The numbers are still small, but they are growing, which is great to see. We are keen to promote that route into the profession, not least because it comes with significantly reduced costs for those taking part in the training.

With the promotion of more podiatry apprenticeships, we are offering a more diverse number of training options for students. Furthermore, the learning support fund, which the right hon. Member for Hayes and Harlington pointed to, provides all eligible nursing, midwifery and allied health professional degree students—including podiatrists—with a non-repayable training grant of a minimum of £5,000 per academic year. I say “minimum” because there is an additional hardship element to that of up to £3,000 per year, and additional support is available for childcare, dual-accommodation costs and, where appropriate, travel. The right hon. Gentleman specifically asked for an increase; there are no plans for that at present, but I will of course take that away and have a look at it.

Obesity and Fatty Liver Disease

Debate between Will Quince and Jim Shannon

Thursday 8th June 2023 Westminster Hall

[Will Quince]

My hon. Friend is absolutely right; we are constantly learning more. At the moment, I do not think there is a definition of an “ultra-processed food”. There has been a lot of work. We are learning more and more about the issue and it has recently exploded into the public domain. We need to ensure that more people are aware of and being educated about what is actually in their food, and that they are looking at labels. If we go back 20 years, we were all very much alive to E numbers —does everyone remember E numbers?—which no one looked at before. Now, we often look over the back of the packaging to see the number of E numbers in our products. The more that the public are educated and informed so that they can look out for these things, the better. My hon. Friend the Member for Harborough will be happy to discuss this further with my hon. Friend the Member for Erewash. I know that ultra-processed foods are an issue about which the public are concerned, and we certainly have more to do on food labelling.

[Jim Shannon]

The Minister always brings good responses. The SNP spokesperson, the hon. Member for Linlithgow and East Falkirk (Martyn Day), made a comment that I endorse totally, because it is something that I hear from my constituents every week. With respect, many people can look at the labels and see what they mean, but what do they look at first? They look at the price, because they are trying to make a meal for their family. What drives them will be, “What can I afford to do?” I am conscious that the Minister has been very constructive in his responses, but there must be a wee bit of reality as well.

[Will Quince]

I thank the hon. Member for that intervention. He is absolutely right; not everyone has the luxury to make choices, and they will often have to go for the cheapest products or products that are available in their area when others might not be. That is why it is so important that we continue the work with industry on reformulation.

Personally, I have been more of a convert to Government action in this area. The soft drinks industry levy has been hugely successful. The industry was already doing a lot of that work. Nevertheless, the levy has nudged and pushed it further in the right direction—but there is more work to do.

I would push back ever so slightly on a couple of the comments that have been made today about industry not wanting to do this. It is not moving at the pace that we want, expect and need it to, but it is doing it. The sugar content of cereal is down by about 15%, and it is down by about 14% in yoghurts and fromage frais. We need industry members to go further, but they are doing it because they are responding directly to what their customers and consumers are telling them they want, and to people actively choosing healthier products. However, we have more to do on reformulation and working with industry.

We will also introduce restrictions on the advertising of less healthy products before 9 pm. I will answer the question on that from my hon. Friend the Member for Erewash in just a moment. The major conditions strategy call for evidence is open, and, as I said, my hon. Friend the Member for Faversham and Mid Kent will gladly meet colleagues to discuss that.

There is also the piece of work around supporting people with weight management, such as the NHS digital weight management programme, the weight loss drug programme and pilot that we announced yesterday, which I just spoke about, and the better health campaigns—including the NHS weight loss app Couch to 5k, which, if anyone has not tried it, is a great way of getting into running, and Active 10. There is also the NHS health check, which includes checking on BMI, encouraging people and giving them the tools to take control of their health.

Then there is the research piece. As I say, this is one of our healthcare missions. Obesity is right there at the top; we want to see the newest and most innovative products and medicines coming forward and being used first in this country.

The hon. Member for Bristol South is absolutely right that this cannot just be an issue for the Department of Health and Social Care; it must be a cross-Government issue. I remember when I was the Children’s Minister and had responsibility for school sport: looking at school sport investment and premiums, at the upskilling of primary school PE teachers in particular, and at the holiday activities and food programme, which was specifically targeted at children in receipt of free school meals.

I remember visiting some eye-opening educational programmes. In one example—I would love to get a number of parliamentary colleagues to try this experiment—there was range of soft drinks, from a Monster energy drink through to flavoured water, and a big box of sugar cubes. The children were asked to put against each product the number of sugar cubes they thought it contained. You would be amazed, Mr Hollobone, how many children put six cubes against the water and very few against the Monster or the full-fat Coke, despite the can of Coke containing something like six cubes of sugar. In schools, we are also promoting the daily mile, the healthy schools programme and healthy school meals. That is all important work, but do we need to do more? Of course we do.

My hon. Friend the Member for Erewash asked about the delay to policies, specifically to the restrictions on advertising and promotions. I understand her frustration but the delay to advertising restrictions allows the Government and regulators to carry out certain processes necessary for the robust implementation of the restrictions. Those processes include carrying out consultations, appointing a frontline regulator, the laying of regulations and the drafting of guidance. She asked specifically when that is coming in; it will be in October 2025. She also asked about the volume price promotions ban, which was delayed due to the unprecedented global economic situation. I do not know the answer and I do not want to mislead her. The legislation states October this year, but I do not know latest position, so I will ask my hon. Friend the Member for Harborough to write to her.

Epidermolysis Bullosa: Drug Repurposing Trials

Debate between Will Quince and Jim Shannon

Tuesday 9th May 2023 Commons Chamber

[Will Quince]

If I am available I would be happy to do that. I thank my hon. Friend for his support for that charity, which is based in his constituency but works nationwide. The support that constituency Members of Parliament provide to charities through this place should not be underestimated. If I am able to attend, I will.

[Jim Shannon]

When we spoke earlier, I was quite sure that the Minister is truly a compassionate man. He has given us the answers that we wish to hear, and I thank him for that. He talks about the possible cures for EB. Will that information be shared with all devolved Administrations? I think he said that it would be, but I wanted to check.

[Will Quince]

Absolutely. We work on clinical and medical research across our United Kingdom, and rightly so. We work very closely across all four nations.

I am conscious of time, and I want to pick up on the final question from my hon. Friend the Member for Orpington about generic versus branded medicine and the MRP. Branded medicines are potentially eligible for the medicines repurposing programme. I understand that the eligibility criteria state that the programme can support generic, biosimilar and branded medicine. I would be happy to look at my hon. Friend’s list.

In closing, I give my thanks again to my hon. Friend for securing today’s important debate, and to all Members who have contributed. I also pay tribute to the whole EB community and charities such DEBRA and Cure EB, which I know work tirelessly to improve the lives of people affected by the condition. They are fortunate to have my hon. Friend in this place as their champion.

Question put and agreed to.

NHS Strikes

Debate between Will Quince and Jim Shannon

Monday 6th February 2023 Commons Chamber

[Will Quince]

First, let me agree entirely with what the hon. Gentleman said about NHS staff and how we all owe them a debt of gratitude for the service they have given, not just to us but to all our families. Again, he may have missed it when I asked that if any Opposition Member was going to raise the same question, they might also stand up and say exactly where each block of £700 million would come from, out of my £150 billion budget. [Interruption.] The hon. Member for Brent Central (Dawn Butler) says, “Show us the books.” She knows exactly where the NHS funding goes. I want to ensure that we have an open and honest dialogue. I have been having those conversations with the unions and I have set out exactly the challenges we face. Any pay has to be affordable not just to the NHS but to the wider budget. It has to recognise and reward those who work in the NHS. Of course I want to retain and attract the very best, but it also has to be fair to taxpayers, and that is the point I think the hon. Gentleman and others are missing.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his answers. For nurses and many others in the NHS, striking is not what they want to do: all they want is dialogue and to try to move forward with an agreed wage structure. They have been left vulnerable by understaffing on the wards, and the pressure that adds is repugnant to them. The Government must move from their entrenched position to find a workable solution. Will the Minister commit to reopening dialogue and looking at the situation, not from the angle of enshrined principle but from a safety angle, which concerns us all?

[Will Quince]

I thank my hon. Friend for his question. We accepted in full the independent pay review body’s recommendation this year of 4.75%, which was over and above last year’s figure of 3% when the rest of the wider public sector was frozen. He asks about dialogue. Of course I am happy to have dialogue with the unions; my door has always been open and it will continue to be so. What I am not going to do is reopen this year’s pay review. We have the independent pay review body process and we accepted that recommendation in full. What I am willing and happy to do is to have that dialogue about next year’s independent pay review body recommendation. Let us not forget that it is in only two months’ time that the new financial year starts, and we have to get that right. I hope that he will encourage unions and others to take part in that process so that we can get it right, because we all want to ensure that NHS staff get the right pay rise that recognises the huge service they give.

NHS Industrial Action: Government Preparations

Debate between Will Quince and Jim Shannon

Monday 12th December 2022 Commons Chamber

[Will Quince]

We have already been clear that we would be very happy to meet the unions, and I understand that a meeting is being organised, but let me reiterate the point about what exactly the Royal College of Nursing is asking for: an uplift that is 5% above RPI inflation. Uplifting pay for all staff—this is based on 19.2%, within the agenda for change—would cost approximately an additional £10 billion. The hon. Member for Rhondda (Chris Bryant) talked about things like test results; the £10 billion that we would spend on such an uplift is £10 billion that would come out of the NHS budget. That is £10 billion that we would not be able to spend on hugely important issues such as tackling the elective backlog.

[Jim Shannon (Strangford) (DUP)]

I was on the picket line with NHS staff in Newtownards in my constituency this morning. I do not expect to be reprimanded for that, by the way—I am quite sure I will be okay.

I want to ask the Minister a positive, constructive question. All the men and women want who were on the picket line at Ards Community Hospital in Newtownards this morning is a wage that helps them to survive. The women and men I talked to this morning are not surviving; they are visiting food banks. It is not just the nurses: it is the porters, it is the ward staff, it is everyone. Will the Minister and the Government go just that wee bit further to get a settlement?

[Will Quince]

I understand why the hon. Gentleman is asking that question, and I am sorry to sound like a broken record, but we accepted the independent pay review body’s recommendations in full. As a result, more than 1 million NHS workers were given a pay rise of at least £1,400. For newly qualified nurses, it was a 5.5% increase. Those on the lowest salaries, whom the hon. Gentleman referred to, are seeing a pay rise of up to 9.3%. Again, that is on top of 3% last year, when public sector pay was frozen.

Nobody wants to see industrial action go ahead. My message to the unions is “It’s good to talk—let’s talk. I know the meeting is being set up. Let’s do all we possibly can to avoid industrial action this winter.”

NHS Staffing Levels

Debate between Will Quince and Jim Shannon

Tuesday 22nd November 2022 Westminster Hall

[Will Quince]

The hon. Gentleman is right that that is happening and I will come on to that matter in more detail. I would be happy to meet him, because it is an issue that I know needs gripping not just at the national level but by local integrated care boards too.

As hon. Members have pointed out, training the doctors, nurses and allied health professionals of the future takes time. We have to plan for the next decade now, as the hon. Member for York Central (Rachael Maskell) said. Despite the challenges, we have a growing NHS workforce. We have record numbers of staff working in our NHS. There are record numbers of doctors and nurses. The NHS now has over 1.2 million full-time equivalent staff. In the last year alone, there were over 15,800 more professionally qualified clinical staff in trusts, and 129,800 more hospital and community health service staff than in 2019. Nursing numbers are 29,000 higher than in 2019, which means that we are on track to meet the 50,000 extra nurses manifesto commitment.

However, as the hon. Member for Wirral West pointed out, we face challenges. There are over 132,000 vacancies, including, as she rightly said, 40,000 nursing and midwifery vacancies, and vacancies for around 10,000 doctors. As the hon. Member for South Antrim (Paul Girvan) rightly pointed out, that means an over-reliance on bank and agency staff. They have their place, but they come at a significant cost, of which we have to be mindful.

We have a long-term workforce plan, which is an NHS England-commissioned project that will set out what workforce we need across the next five, 10 and 15 years. As the Chancellor said in the autumn statement, it will be independently verified. It will look at recruitment, retention and productivity. It will look at where the challenges and the gaps are. As the hon. Member for York Central, who is no longer in her place, rightly asked, what do we need the NHS to look like? Do we need specialists? Do we need more generalists? Do we need a mixture of skills, where people are specialists but also retain generalist skills so that they can do other work? The plan is for the project to report back by the end of this year—very soon—and that independent verification process will then take place. Integrated care boards will need to do the same, or a similar, piece of work at local level.

I am also aware that there are specific challenges. The hon. Members for Strangford (Jim Shannon) and for Westmorland and Lonsdale rightly raised mental health services. An extra £2.3 billion is going in, and our plan is to recruit an extra 27,000 staff, but it is a challenge, which is why we have the advanced bursary in that area. We have increased staff in the area by an extra 5.4%. I know that is not enough, and I know the challenges on local mental health services, so we have to do more.

There is a similar challenge in rural and coastal communities, which the hon. Member for Westmorland and Lonsdale has raised with me many a time. We have to look to expand the apprenticeship route and blended learning programmes so that people do not have to travel to big towns and cities to undertake their training. That work is being done, and there is an extra £55 million for additional placement capacity.

Investment in training is also important. We funded an extra 1,500 medical school places—a 25% increase—last year and this year. That was an investment in five new medical schools. The £5,000 non-repayable grant for nursing, midwifery and allied health professionals has been in place since 2020. There is also additional funding for certain courses, and for things such as support for childcare, dual accommodation, and costs and travel.

[Jim Shannon]

Will the Minister comment on what the Royal College of Psychiatrists has said about staffing shortages?

Oral Answers to Questions

Debate between Will Quince and Jim Shannon

Tuesday 1st November 2022 Commons Chamber

[Will Quince]

I thank my hon. Friend for her question. She is a passionate campaigner on this issue. I recently responded to a debate on this issue led by her. She also chairs the all-party parliamentary group on rural health and social care. She is right, and we have developed an apprenticeship route for almost all professions in our NHS, allowing people to join the health and care sector immediately on an earn-as-you-learn basis. We continue to work hard to develop pathways into health and care professions, including via our groundbreaking blended online learning programmes.

[Jim Shannon (Strangford) (DUP)]

In terms of district nursing and community midwifery, is the Minister aware that there are real security concerns about entering homes alone, and that that plays into resignations in many rural areas? Will he address that by providing security devices so that rural, isolated nurses and staff know that they are not alone and are safe?

[Will Quince]

The hon. Gentleman raises an interesting point. It is not something that has come across my desk in the two days I have had this portfolio, but I will of course meet local integrated care system leaders, and if it is something that they are calling for, I will look to see what we can do to assist.

Edenfield Centre: Treatment of Patients

Debate between Will Quince and Jim Shannon

Thursday 13th October 2022 Commons Chamber

[Will Quince]

We are absolutely fully committed to attracting, training and recruiting the mental health workforce of the future. Through our plans set out in “Implementing the Five Year Forward View for Mental Health” and “Stepping Forward to 2020/21: the mental health workforce plan for England”, we have expanded and diversified the types of roles available. The hon. Lady asks us for our plans. Our aim is an additional 27,000 mental health professionals in the workforce by 2023-24 to deliver the transformation of mental health services in England that we all want to see.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his answers, and I welcome him to his place. Having seen a very similar issue with the treatment of vulnerable patients in Muckamore Abbey Hospital in Northern Ireland, it would appear that how we balance the safety of staff with the treatment of patients needs an overhaul, and that must be UK-wide. Will the Minister make contact with the devolved Administrations, in particular the Northern Ireland Assembly, to ensure that lessons learned can be lessons shared for the safety of patients, but also for staff who have to deal with these things throughout the whole of the United Kingdom of Great Britain and Northern Ireland?

[Will Quince]

The hon. Gentleman is absolutely right. There is no monopoly on best practice and where it does exist, we have to ensure it is shared. Where we identify the very poorest practice, we must ensure the lessons are learnt not just in England, but across our United Kingdom.

Free Period Product Scheme for Schools

Debate between Will Quince and Jim Shannon

Wednesday 15th December 2021 Westminster Hall

[The Parliamentary Under-Secretary of State for Education (Will Quince)]

It is pleasure to serve under your chairmanship, Ms Rees, especially as it is my first Westminster Hall debate as a Minister for the Department for Education.

First, let me congratulate the hon. Member for Brentford and Isleworth (Ruth Cadbury) on securing this very important debate. She has been a passionate campaigner on this issue for a long time. She articulated the case very eloquently—far better than I ever could—for this scheme and the need for it. I will try to cover as many of the points and questions that she raises but, as ever, I am happy to meet her at a later date to discuss the scheme in detail.

Let me begin with the point that she made at the beginning of her speech about stigma and taboo, because it is very important. We all have a part to play in this, and I will come on to it later in my contribution. The first thing to say is that we are committed to providing a world-class education, training and care for everyone. No young person in our country should be held back from reaching their potential because of their gender or background. There may be people listening and watching this debate thinking, “What does this middle-aged bloke know or care about period products?” But I do care passionately about this issue. I am passionate about ensuring that women and girls are supported in education and beyond.

The hon. Lady may not know this, but I was one of the architects of the tampon tax fund. Some £90 million has gone to women’s health charities as a result of that scheme, and now VAT has been removed from products. I am also the father of two young girls, one of whom will soon—very soon, I think—be in this position, so I have a personal interest, too. I want my girls and every girl in this country never to have to worry about period products being available in their school, and I want them to feel comfortable speaking about that with their teachers, peers and, I hope, their parents, and indeed their father.

As the hon. Lady rightly pointed out, we launched the period product scheme in January 2020, and I am delighted that we are extending it until August 2022, the end of the summer term. She made this point clearly, but I emphasise that the scheme has significant benefits. Schools and colleges can continue to use the scheme, and all will receive new spend cap allocations for the remainder of the academic year. That will be announced on 4 January. The hon. Lady pushes me to announce a further extension. All I can say at this stage is that any further extensions or new contracts will be announced in due course. I want to ensure—I think the hon. Lady knows how passionate I am about this subject and how committed the Government are to it—that schools and colleges are given as much notice as possible in order that they can place orders.

[Jim Shannon]

The Minister will be aware that Northern Ireland Education Minister Michelle McIlveen said:

“No-one should miss out on their education because they cannot afford or access these essential products. Providing free products will help pupils manage their periods confidently at school, reduce anxiety and stress and enable students to focus on their learning.”

Northern Ireland’s three-year, £2.6 million scheme will also tackle the lack of understanding and the stigma to which hon. Member for Brentford and Isleworth (Ruth Cadbury) referred. That might be an incentive for the Minister to try to follow Northern Ireland.

[Will Quince]

The hon. Gentleman is right, and all the points he raises are fair and accurate. We work closely, particularly at official level, with devolved Administrations to develop schemes of this nature, to make sure that, as much as possible, there is some synergy. In September this year, Northern Ireland launched a three-year pilot scheme to address period poverty in schools, which we very much welcome. I suppose it is telling that all Governments across our United Kingdom are aligned on this issue. We recognise this need. I have to pay credit to the hon. Lady and the APPG for driving this agenda.

We are absolutely clear that organisations should have products available should learners need them. Many schools and colleges have benefited from charities over recent years, as the hon. Lady rightly points out, and we very much thank those charities for their support. Schools and colleges do not have to use the national scheme to purchase products. If they prefer to use an alternative route, they can of course do so, although costs are only met through the use of the Department’s scheme. With that in mind, our supplier, phs, will proactively contact organisations that have accessed the scheme so far. Organisations that have already ordered products should continue to use their existing account and log-in details. Schools will potentially be listening to the debate, so I refer them to phs’s contact details and more information about the scheme being clearly set out in guidance on gov.uk.

The hon. Member for Brentford and Isleworth rightly referenced take-up. Since the period product scheme launched in January 2020, it has been fantastic to see how many schools and colleges have used it. Importantly, the scheme remained in operation throughout the partial school and college closures as a result of the pandemic in 2020 and 2021. We had fantastic examples of organisations ensuring that young people continued to receive that support, even when they were learning from home. The hon. Lady referenced these figures, and it is really encouraging that 76% of secondary schools and 79% of colleges ordered products from the scheme during 2020. We continue to encourage those who have not yet accessed the scheme to do so. It is really important that they do, and that they recognise that that support is there. We intend to publish updated statistics from the scheme early next year. Although I cannot say much about that, I hope, I think and am confident and optimistic that the hon. Lady will be pleased when those new figures are published. She rightly raises the take-up of primary schools. I take up her offer to meet at a later date to discuss some of her ideas to improve that.

The hon. Lady also rightly referenced the environment. We continually monitor the ways in which we can make our scheme and others like it more environmentally friendly, such as by setting a minimum order value based on the organisation’s budget—for an average secondary school, that is about £1,500—in order to limit deliveries and reduce traffic and all those things. Importantly, we continue to include a range of sustainable and environmentally friendly products for schools and colleges to select, as I think the hon. Lady would hope. Our supplier reports that, over the past few months—I suspect driven in part by COP26—orders for environmentally friendly products increased significantly in the weeks up to and after COP26.

The hon. Lady rightly pushed me on range. Range is important, and she has raised the issue with me in private. I am looking very closely at additional period products, such as period pants, that we could potentially include in the product range for 2022. There are limitations as to exactly what we can include in the current contract, but I certainly commit to the hon. Lady that I will take this issue away and explore what further products we could include in the scheme.

Universal Credit: Court of Appeal Judgment

Debate between Will Quince and Jim Shannon

Thursday 25th June 2020 Commons Chamber

[Will Quince]

My hon. Friend is absolutely right. It was this Conservative Government who introduced our modern, dynamic, agile new benefits system, tailored for the claimant’s personal circumstances. The fact it is online means we have been able to process the claims of more than 3 million people, getting them the support they desperately need as quickly as possible. Just imagine for a moment, Mr Speaker, the chaos that would have ensued had we been relying on Labour’s broken legacy benefits system alone. Thank heavens for universal credit.

[Jim Shannon (Strangford) (DUP)]

I have had many similar cases over the years, so I am really pleased first to see the court decision, but secondly to see the Government and the Minister in particular responding in a very positive fashion. The judge referred to common sense; it is about not just common sense, but the practical effects on families at a time of financial stringency over Christmas and the new year. Can the Minister confirm whether he will retrospectively correct the mistake, which quite simply boggles the mind and common sense? He referred to solutions, and I can give him one very quickly. Will those who have had to take out loans to cover the month where they lost full payment receive help to pay the interest on those loans? Some took out loans with tremendously large interest rates. It is important that people have help right now.

[Will Quince]

I am happy to meet the hon. Gentleman to discuss those cases in more detail. As I said, I am absolutely committed to finding a fix. The court has not mandated any specific fix or action, but I am committing us to finding a solution, and I will do all I can to do so. The court dismissed the appeal on the grounds of discrimination. He mentioned families. The Department is absolutely clear in its firm support for all claimants. We continue to support families with things such as childcare costs, and I stress that childcare support under universal credit is far more generous than the old legacy benefits system, with the ability to claim back 85%, as compared with 70%. I would be very happy to meet the hon. Gentleman to discuss those concerns in further detail.

Universal Credit: Delayed Roll-Out

Debate between Will Quince and Jim Shannon

Tuesday 4th February 2020 Commons Chamber

[Will Quince]

I believe I answered this question a little earlier today. I am looking at the issue, and I will invite the hon. Gentleman, along with other colleagues who have an interest in this area, to the Department to raise it with officials. We are looking at solutions. It is not potentially an easy or quick fix, but if we can address this, of course we will.

[Jim Shannon (Strangford) (DUP)]

I see the delay as a wise step by government to reassess, and I congratulate the Minister on not enforcing a transfer to UC on people, who know it will see them in a five-week freeze. Will he use this delay to introduce a smoother, more workable transition period, to prevent people from getting into debt?

[Will Quince]

I thank the hon. Gentleman for that question. The important point here is that when we talk about the £500 million cost, we are talking about £500 million that will go into the pockets of claimants up and down the country, including some of the most vulnerable and disadvantaged people in our country, who previously would not have received that transitional protection under the legacy benefits system or in their transfer over under natural migration.