World AIDS Day

Danny Beales Excerpts

Wednesday 27th November 2024 Westminster Hall

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I beg to move,

That this House has considered World AIDS Day.

It is an honour to serve under your chairmanship, Sir Mark. I am proud to have been elected on a manifesto commitment to end new cases of HIV in this country. Indeed, that goal, which crosses political divides, was a clear commitment from the last Government too. Only 20 years ago, that ambitious target would have been completely unthinkable. It has the power to change countless lives.

That such a goal is even possible is a testament to the long, hard work of thousands of activists and researchers, going back over 40 years. We are living in an era when HIV is no longer a death sentence, transmissions can be prevented and people with HIV live long, happy and healthy lives. We all stand on their shoulders.

[Jessica Morden (Newport East) (Lab)]

I apologise for intervening so early. Quite rightly, there will be many important policy asks in this debate, but on the point that my hon. Friend raises, can we take a moment to pay tribute to the grassroots campaigners who have been part of the history of the fight against HIV and AIDS? I am hugely privileged to have Martyn Butler, the co-founder of the Terrence Higgins Trust, as a constituent. He used his own home phone line as the first helpline for AIDS. As my hon. Friend rightly points out, we should pay tribute to those people.

[Danny Beales]

I definitely pay tribute to Martyn Butler and to everyone like him who has tirelessly campaigned for change. It is the perfect example of progress being made through the sheer determination of those affected by HIV and of their loved ones—those who unfortunately they left behind. My hon. Friend and I have had the pleasure of meeting many tireless campaigners and fantastic organisations such as THT.

Before entering Parliament, I worked for the National AIDS Trust, another fantastic organisation in the sector, campaigning to end new transmissions of HIV and improve the lives of those who are already living with HIV. That included working on a campaign for equal fertility rights for people living with HIV. I was delighted that just last month the law was finally changed to allow equal access to fertility treatment. That life-changing development means that people I met during that campaign can now have a family. It is not often that we can say that children will be born because of a statutory instrument, but in this case it is true. I thank the Minister for his swift leadership and action on the issue and every single person who campaigned to make that possible—thank you.

The first project that I worked on at the National AIDS Trust was a collaboration with the Elton John AIDS Foundation and the Terrence Higgins Trust: the independent HIV Commission. It heard from experts and from those with lived experience and toured the country to look at good practice. Its recommendations laid out a framework for turning into a reality the goal of ending new HIV cases in England by 2030. One of the independent commissioners was a little-known, shy and retiring Back-Bench Labour MP who is now my right hon. Friend the Member for Ilford North (Wes Streeting). He went on to somewhat bigger and better things in the world of healthcare.

A lot has changed since 2021 when the report was launched. Unfortunately, when it comes to progress on ending transmissions, a lot has not. To their credit, the last Government should be proud of the investment that they made in piloting opt-out HIV and hepatitis testing in emergency departments in London, Manchester and Brighton—the one key action in the last HIV action plan that was delivered on. That investment has changed many, many lives. In my constituency, opt-out testing at Hillingdon hospital has picked up 15 new cases of HIV, 28 of hepatitis C and 140 of hepatitis B. Those are people whose lives have been changed and who now have access to vital treatment. The story is the same across all the hospitals delivering that amazing programme.

The programme is working, but it is facing a funding cliff edge. I welcome the commitment to expand the programme further to other towns and cities, but I hope that the Government will commit to continuing the pilot where it is already in place and working.

We now know for certain that opt-out testing works. We cannot find everyone with undiagnosed HIV if we rely only on a system of people thinking that they may be at risk and then actively seeking out a test, navigating the complex system and overcoming the stigma of HIV to ask for a test. Instead, we must test, test, test. We need an opt-out testing programme that goes right across the health service and into primary care.

Unfortunately, the reality is that despite the success of the testing programme, overall progress towards ending HIV transmissions has been far too slow. Recent figures suggest that this year we are potentially moving backwards. Recent data showed an increase in cases; we have seen poor outcomes around late diagnosis; and the disproportionate outcomes for women and people from black and Asian backgrounds continue. The gap has not closed.

[David Burton-Sampson (Southend West and Leigh) (Lab)]

My hon. Friend is quite right: a disproportionate number of black, Asian and minority ethnic individuals are becoming infected with HIV. Does my hon. Friend think that it is right to raise awareness of things like PrEP in communities that may be disproportionately affected, so that we can put them in the same position as the majority of the country, whose infection rates are declining?

[Danny Beales]

I thank my hon. Friend for that vital point. HIV is a condition that knows no boundaries. It does not affect any one type of person: there is no one community that is alone affected by HIV. It knows no boundaries; it affects everyone.

After 14 difficult years for the health service, we are not on track to reach the 2030 goal. At every single stage of the HIV treatment process, we are missing critical opportunities to get people on PrEP, test for HIV and ensure that everyone living with HIV has the support that they need.

Pre-exposure prophylaxis—we can see why it is called PrEP for short—is an incredible advance in HIV prevention. It is a simple daily pill, now in generic form and therefore incredibly cheap, that prevents HIV completely if taken correctly. I have spoken before about how life-changing a drug it is in removing the fear and stigma of HIV. As a gay man who grew up in the 90s and noughties, the legacy of HIV has always weighed on me and, I am sure, on many others like me. Our sense of self, our sexuality and our relationships were always intertwined with the stigma and presence of HIV. Being able to take PrEP is game-changing, and not just for the individual and their wellbeing: it has a massive public health benefit. It has driven the significant falls in new transmissions, particularly among gay men, who have largely been the people who have accessed the drug to date.

It is unacceptable that the drug is not being accessed by everyone who could benefit. The average wait list for this preventive medicine is 12 weeks. We know from research that people have acquired HIV while waiting to access the drug. That is a significant failure that I hope the new HIV action plan will address, as well as turbocharging access outside sexual health services—the only place where it can currently be accessed. It is entirely wrong that NHS silos are holding back access to PrEP in primary care, including in pharmacy and other settings.

It is also unacceptable that people cannot get a postal test for HIV and sexually transmitted infections in 30% of rural England. It makes no sense that my borough of Hillingdon—not so rural, but on the edge of London—has a completely different postal testing system from the 30 other London boroughs that have their own system. Far too often, the patient is left to navigate complex systems. What test they get will vary depending on where they live. In vast swathes of the country, there is no option to test at home, although sexual health services are often inaccessible and chronically overwhelmed. Far too often, the individual has to fight for an appointment, and only those with the sharpest elbows, or persistence, get access to the sexual health services that they need.

[Lloyd Hatton (South Dorset) (Lab)]

I thank my hon. Friend for making such an eloquent speech. The point he makes is really important: in rural and coastal communities, testing services and public health awareness can often feel particularly remote. Looking at how we use primary care, particularly community hospitals and GP surgeries, will be essential to improving testing and public awareness. Does my hon. Friend agree that pushing this out into communities is essential to ensuring that take-up is just as good in a rural or coastal community as it is in a big town or city?

[Danny Beales]

I completely associate myself with my hon. Friend’s comments. Particularly in rural settings, if getting to a sexual health service means travelling for miles and sometimes for hours, a lot of people, especially on the lowest incomes, will put off getting the test until another day. Unfortunately, we are seeing persistent rates of late diagnosis and of undiagnosed HIV outside major cities. I completely agree with my hon. Friend.

What about those who make it through the complex online systems—the 8 am call queues, only on a Thursday—and actively go out and seek a test, or those who are fortunately now being found in our amazing opt-out testing pilot? If they are diagnosed with HIV, they are not always getting the support that they need to access HIV treatment in the long term.

We have some of the best—if not the best—HIV treatment and specialists in the world. HIV is now a treatable long-term health condition. “U = U. Undetectable = untransmittable.” We need to say that over and over again. In simple terms, it means that when someone is on HIV treatment, they cannot pass HIV on. That is a powerful and life-changing message. Despite the advances, 14,000 people living with HIV in England are essentially lost to the health system. They have been diagnosed with HIV but are not being seen by their clinic because of stigma, poverty and other barriers that are holding them back from getting that life-changing treatment.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

I thank my hon. Friend for calling this debate and for his powerful speech. Does he share my concern that the communities that we need to come forward are the very same communities that are not accessing treatment because of that stigma? Organisations like the Fast-Track Cities network, Sophia Forum and One Voice Network are doing fantastic work reaching black women and other black and minority ethnic groups.

[Danny Beales]

I thank my hon. Friend for that comment and for her leadership on the all-party parliamentary group on HIV, AIDS and sexual health, on which I know she has been championing that issue and many others; I think she helped to host the important meeting and discussion about the recent report on disproportionality by the One Voice Network and the National AIDS Trust. If we look at the figures, the disproportionality of HIV is stark. We have made so much progress, including in access to PrEP, testing or treatment, but not all communities are benefiting in the same way. Particularly among black African and Caribbean communities in the UK, the rate of late diagnosis is far too high and the rate of accessing PrEP is far too low. It is completely unacceptable. We have to take on that disproportionality, those inequalities and the stigma that persists in holding people and communities back from accessing those vital measures.

From a public health perspective, the people who are not accessing successful treatment are potentially also passing on HIV and are at risk of getting seriously ill. Many already are. The rates of people not in treatment and not going to their clinic appointments have increased through the covid period. I hope that the future action plan will fill in the gaps in the last plan. One major omission was action on that very challenge.

There are already lots of examples of successful local projects that we can learn from, such as amazing outreach services with nurses going out to find patients lost to care. The value of consistent peer support comes through, time and again, from people living with HIV. We must ensure that every HIV team is proactively finding everyone lost to care and supporting them in a holistic way to overcome the barriers to continue with HIV treatment.

All of this, it must be said, takes place against the backdrop of a wider crisis in our national health service, which is putting historic strain on health services and affecting outcomes across the board. Our task is an immense challenge, but it is not insurmountable. Although we are not on track, it is still possible to end the epidemic in this country by 2030. We already have all the tools we need. This week, my old colleagues at the National AIDS Trust released a report with THT and the Elton John AIDS Foundation with some clear recommendations for the new HIV action plan in England. I am pleased that the Minister has already engaged with them, welcomed them and attended the report launch, which I am sure was much appreciated. It is a clear sign of leadership on the issue.

None of this is rocket science. We are talking about simple, deliverable actions. First, there should be a nationwide, year-round online HIV and STI postal testing service, which would be cheaper than the current patchwork of services that vary from place to place. Secondly, opt-out testing in all emergency departments should be expanded to other health settings, such as GP practices and termination-of-pregnancy services, and elsewhere so that we can find everyone living undiagnosed with HIV. Thirdly, we should broaden access to PrEP beyond sexual health services, starting with a digital service to ensure that those on long-term prescriptions get timely access to the medication. That will then reduce demand on sexual health services for appointments. Fourthly, we need an NHS England programme to find everyone already living with HIV and support them back into care, with proper care co-ordination, peer support and appropriately trained staff. None of this is unprecedented: it is happening or being piloted somewhere. We have all the tools we need; we must now implement them everywhere consistently.

I emphasise that it would be an incredible achievement to meet our 2030 goal and become the first country in the world to end new HIV cases. Of course, that achievement would occur in the context of a deeply concerning global picture—with 1.3 million new cases in 2023 and 650,000 deaths from what is now a treatable long-term condition, as has been said. Much more work clearly needs to be done on the international front, so international development funding is vital.

Ending new cases in England would make a remarkable contribution to the global effort to eradicate HIV by providing a replicable road map to prevent transmission elsewhere—learnings that can be exported and shared. It would also simply show that it is possible. Britain has historically been a world leader on HIV treatment and sexual health. Now let us be a world leader on this too.

One of this Government’s key missions is to rebuild our NHS so it is there for everyone when they need it. Fixing HIV care and ending new transmissions must be an integral part of that vision. I am pleased that the public health Minister is already working on a new HIV action plan. I have seen at first hand the passion and determination of those working to make this happen—from campaigners to clinicians and MPs across the House. We now need that same determination from the new Government. The Government have a unique opportunity to make history, and I hope that they will seize it.

[Several hon. Members rose—]

--- Later in debate ---

[Danny Beales]

Thank you, Sir Mark. I will be brief, because I have to be. I thank the Minister and everyone who contributed. It is clear there is cross-party support for this action. The Minister will have our full backing in taking this plan forward.

Question put and agreed to.

Resolved,

That this House has considered World AIDS Day.

Income Tax (Charge)

Danny Beales Excerpts

Tuesday 5th November 2024 Commons Chamber

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

The last few years have been incredibly difficult for our constituents and our national health service. Public services are on their knees, a £22 billion black hole has been left in our public finances and there have been real-terms falls in incomes and living standards. The Conservatives, as we have heard today, are still labouring under the fantasy that no problem exists, and that they are sitting in opposition—well, a few of them are sitting over there—through no fault of their own, but through some sort of electoral dysfunction. They are entirely unwilling to say what they would do to fix the broken services and our NHS, and what they would do to close the financial gaps that they have left.

I am pleased that we have taken the tough and necessary decisions on spending and taxation to put our NHS back on a firm footing—tough decisions that any Chancellor and any Government would have to make. The Conservatives have continually shirked those tough decisions. This Budget ensures that no one will see higher taxes on their payslip; there are no increases to employee national insurance, income tax or VAT. Those are promises that I made to my constituents when going door to door, and promises that we are keeping today. The necessary tax rises in this Budget rightly fall on those with the broadest shoulders; we are asking the wealthiest and largest businesses to pay their fair share to help rebuild our NHS and public realm.

This Budget is fundamentally pro-growth, and is focused on investment in our country’s future. We have heard Conservative Members today continually make the tired argument that it is the private sector alone that drives growth. As Members have rightly said, economic growth relies on a strong public and private sector. Without a functioning public sector, businesses cannot thrive. If trains are late, people cannot get to work. If staff are off sick, they cannot pay tax and cannot contribute. If workers do not have the necessary skills, productivity and growth stall. This Budget addresses those issues and those determinants of growth, and that is why I am proud to support it today.

Over 14 years, the Conservatives have starved our NHS of vital funding, but today we are talking about a vital £25 billion investment in our NHS—the biggest investment in it since the last Labour Government, excluding the covid years. This investment is transformative. I hope that some of this spending will be made available to primary care and to community pharmacy—the desperately underfunded front door of our NHS. I am really pleased that in recent days we have heard a commitment from the Front Bench health team of a further £2.5 million to support the development of proposals for Hillingdon hospital. I am sure that I will return to that issue and discuss it with the team in the days ahead. In summary, this Budget delivers on our promises on tax, on growth and on the NHS, and I am delighted to support it.

Access to Primary Healthcare

Danny Beales Excerpts

Wednesday 16th October 2024 Commons Chamber

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

The fundamental promise of our NHS is that it is there for all of us whenever we need it, no matter how much we earn, where we live, who we are or what part of the health system we need to access. Unfortunately, after 14 years of Conservative government, that promise has been broken. It was particularly disheartening not to hear any contrition or reflection from the shadow Minister.

Despite the hard work of NHS staff, waiting lists are at record highs and patient satisfaction is at record lows. The NHS is near breaking point. We all knew this going into the election, as we heard it from our constituents— I certainly heard it from mine in Uxbridge and South Ruislip. Even so, the findings of the Darzi review are still incredibly shocking.

Primary care, as Liberal Democrat Members have said, is the front door to our NHS, but that front door is increasingly being slammed shut in the face of our constituents, and the effects are being felt. Fifty years of progress on cardiovascular disease is in reverse, progress on cancer outcomes has stalled, and cancer survival rates in the UK are falling behind comparable countries.

There is a lot to do, and it will take time to do it, but I am reassured by the Minister’s comments that this Government are taking the matter incredibly seriously. I welcome the Secretary of State’s focus on the three critical shifts needed to modernise our health service, and particularly primary care: from analogue to digital, from hospital to community, and from sickness to prevention. These shifts will not only improve value for money in our health service but will ensure that everyone in our communities lives a longer, healthier life.

We have heard today of the importance of GPs, particularly family GPs. GPs are seeing more patients than ever before, yet the number of qualified GPs relative to the population is falling. This strain will only be exacerbated as populations grow and age. I welcome the Government’s commitment to GP recruitment, with £82 million being invested in 1,000 more GPs.

The shadow Minister spoke about the capital investment pressures on the Government, and we certainly want to see capital investment in hospitals—including Hillingdon hospital in my constituency—but primary care capital investment is also needed to unleash potential capacity.

We have heard from Liberal Democrat Members, as well as Members on the Government Benches, about dental deserts and the need to improve access to dentistry. I welcome the Government’s commitment to engage with the British Dental Association. I know one of the Secretary of State’s first meetings was with BDA, and I look forward to hearing the outcome of those discussions.

Lastly, on community pharmacies, I met representatives of local and national pharmacy groups in my first few weeks as an MP. Pharmacies are incredibly well placed to take the pressure off GP services. Pharmacists are trained, professional and ready to go. I welcome the Government’s plans to create community pharmacist prescribing services to utilise the skills of pharmacists.

I will end as I started: there is a lot to do to rebuild and reform our NHS, so that it is there when we all need it. We have done it before and we must do it again.

Oral Answers to Questions

Danny Beales Excerpts

Tuesday 23rd July 2024 Commons Chamber

[Wes Streeting]

Despite my best efforts, the hon. Gentleman is back. I congratulate him through gritted teeth.

I was very impressed by what I saw at King’s Mill hospital, and I am proud of the last Labour Government’s record of delivering the shortest waiting times and the highest patient satisfaction in history. As I said during the election campaign, we will build on that success and learn from some of our shortcomings, too.

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

T9. I welcome the honesty and urgency of reviewing the new-build hospitals programme. Residents in Uxbridge and South Ruislip are sick and tired after 14 years of broken promises on a new hospital. Board minutes have revealed that no business case was agreed under the last Government. No funding was released for a new hospital, and not a brick has been laid. Does my right hon. Friend agree that urgent investment is needed at Hillingdon hospital? Will he come back to the hospital, a year later, to visit staff and discuss their plans?