Cancer Drugs

David Simpson Excerpts

Tuesday 19th January 2016 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Thank you, Mr Streeter. You have put me on a sticky wicket. I congratulate the hon. Member for Mid Derbyshire (Pauline Latham) on securing this debate. It is good to be here and to be involved. About six months ago, I had a similar debate on the availability of cancer drugs, at which I think she was present. We hoped that six months later we might be back to say that things were better or had advanced, but unfortunately that is not so, or not in the way that we would like.

I would just like to mention the many organisations that are helpful, because every one of us will have some cancer organisations close to their heart. Mine are Cancer Research UK, Macmillan Cancer Support and Marie Curie, because I have a very good friend, Irene Brown, who is terminally ill and she is in the Marie Curie centre in Belfast. The treatment that Marie Curie gives is second to none, and people only have to be there to be part of that family that helps.

The Macmillan charity says that 2.5 million people in the UK were living with cancer in 2015. It says that 5% of our total adult population are affected, which shows the problem is enormous. For many of us, cancer is not simply something that others talk about; it is something that affects each and every one of us every day. My father was a survivor of cancer on three occasions. I put that down to the skill of the surgeon, the prayers of God’s people—something that many of us here would understand—and the care of the nurses. He survived and lived for another 36 years, dying just last year, at the ripe old age of 85. The marvellous steps that modern medicine has taken are fantastic.

Moves such as the removal of drugs prevents thousands of cancer sufferers across England and Wales from being able to access the quality treatment they deserve. Thousands of people are disadvantaged, thousands of people lose out and thousands of normal people are in despair. That is the reality of not having access to cancer drugs. I do not know what it is, but I have more people coming to my office suffering from cancer than I can ever recall. I know that there is a 50% survival rate today for those with cancer, which is fantastic—what a step forward—but I see more people with cancer than ever before. I am not sure whether it is due to diet or lifestyle, or whatever it is, but cancer is certainly a greater issue for me than ever.

[David Simpson (Upper Bann) (DUP)]

We understand that, from April, NICE will have the overall say on what drugs and treatments people will receive. We know that we have to be prudent with money, but surely finance should not be the overriding factor when it comes to people’s lives.

[Jim Shannon]

I thank my hon. Friend for saying that. Over the last few months and before Christmas, I had the opportunity to meet some of the pharmaceutical companies, and I have to say—and to be careful what I say—that they are not terribly happy with NICE and how it has responded to them. Some of those pharmaceutical companies have reduced their prices and still NICE does not respond in the positive fashion that we would expect it to. That is one of my concerns, certainly.

I would put Queen’s University Belfast up there as one of the universities working in partnership with medical companies, including companies from China and from across the United Kingdom. The partnerships that the university has developed and the innovative drugs that it is coming up with, as well as the investigations and trials that take place there to find new drugs, are impressive. We have new developments in Northern Ireland in cancer research, and we need to see a national strategy. Perhaps the Minister could respond to that point—let me apologise to him again, having already done so beforehand, for not being here for his response to the debate.

My party colleague Simon Hamilton is a Member of the Legislative Assembly and the Minister for Health, Social Services and Public Safety. Health is a devolved matter in Northern Ireland. We have a number of Members from Northern Ireland—there are five here today—which shows the interest in this issue in Northern Ireland. Simon Hamilton has taken the initiative to release £1.5 million to fund specialist cancer drugs. That will allow some of the NICE-approved cancer drugs and treatments to go ahead this year.

That move in Northern Ireland will go some way towards enabling the health service there to reach the cancer target. Each day in Northern Ireland, 23 people are diagnosed with cancer and 11 people die of it. There were more than 331,000 new cases of cancer in 2011 across the United Kingdom, and 161,823 deaths from cancer in 2012. The enormity of cancer—how it afflicts people and how many people die—cannot be underlined enough.

The latest delisting of drugs from the Cancer Drugs Fund looks like a step back rather than a step forward in the fight against cancer. I know that we cannot be completely resistant to change—the Minister knows that and, as elected representatives ourselves, we also know it. If drugs are proving ineffective, they should be delisted, but at the same time, if drugs are effective, let us get them on the list and make them available to those who need them most. We should be here to commend, I hope, the addition of a new form of effective treatment.

To conclude—I am very conscious of what you said earlier, Mr Streeter—the hon. Member for Mid Derbyshire mentioned Abraxane, and here is the postcode lottery. Those living in Northern Ireland do not have any access to Abraxane whatsoever. Those living in England had access to it in March 2014, but not now. People in Scotland have had access to Abraxane since January 2015 and will still have it. In Wales, people have been able to access it since September 2014, but now it looks like that might be affected as well. That is the postcode lottery for cancer drugs. It is completely unacceptable, and I commend the hon. Member for Mid Derbyshire for securing this debate.

Cystic Fibrosis

David Simpson Excerpts

Tuesday 8th December 2015 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Sir Edward. It is also nice to see the Minister in his place again—whatever the debate might be, there are few for which the Minister and I are not in the same room at the same time.

I thank the hon. Member for Dudley North (Ian Austin) for bringing this important issue to Westminster Hall. It affects my constituents and I am here to speak on their behalf—this is the place for us to do that as elected representatives. As he mentioned in his introduction, in Northern Ireland we have had some good news, with money set aside for rare diseases. Any approach to such diseases needs to be innovative and to take into account all those who contribute, be they academics, researchers or hard-working charities who provide support for those suffering from cystic fibrosis and their families.

I also commend the right hon. Member for Chesham and Amersham (Mrs Gillan) and the hon. Member for York Central (Rachael Maskell) who have spoken. They are doughty campaigners on behalf of those who have Duchenne and on many other issues. It is good to see them in their places and making valuable contributions.

We are surely duty-bound to support and fund those who fight for the sufferers and those developing new treatments. The debate is very much about how we develop new treatments and move forward.

[David Simpson (Upper Bann) (DUP)]

I also congratulate the hon. Member for Dudley North (Ian Austin) on bringing the debate. Does my hon. Friend agree that pharmaceutical companies need to be sent a message that their work in research is not about large profits; it is about curing rare diseases? We saw that difficulty whenever we approached pharmaceutical companies on meningitis B: some companies held out for large profits at the expense of people who were suffering.

[Jim Shannon]

I thank my hon. Friend for focusing on the pharmaceutical companies. They can do a great deal and there is also a role for Government and the NICE guidelines, which direct the direction in which pharmaceutical companies will proceed. The companies are driven not always by profit or margins; criteria also indicate to them what to do.

We should be ever mindful that people are suffering through no fault of their own, so we need to help them move forward. It is good to see facts and figures that show that, on average, a child born in the 21st century with cystic fibrosis will live for more than 50 years. There have been tremendous advances. The innovation and hard work done by charities and researchers is too often forgotten, but it has brought about real results, with new precision medicines treating not just the symptoms, but the underlying cause of the condition. We must go further in that direction. To be fair, cystic fibrosis is one condition that we are probably treating rather than solving at the moment, but we need to see a future where everyone with cystic fibrosis can live a life unlimited, which the facts show is more achievable today than ever before.

Unfortunately, precision medicines are expensive and, as my hon. Friend the Member for Upper Bann (David Simpson) said, it is difficult to predict the cost-effectiveness of new treatments. However, we need to get those treatments and try them out to move forwards. I understand that the Government are considering how we can speed up access to innovative treatments, which I think comes under the NICE guidelines. Will the Minister respond to that in his speech? There are proposals to approve new drugs provisionally while using real-world data to assess their benefits. I welcome that and look forward to seeing more of it.

May I put on record my thanks to the Northern Ireland Rare Disease Partnership under the chairmanship of Christine Collins, who happens to be one of my constituents? We have worked together over the years on this matter. Indeed, in the previous Parliament we spoke to the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), in a private meeting. She was supportive and allowed us to make positive progress. As everyone knows, health in Northern Ireland is a devolved matter. The Minister there, my colleague, Simon Hamilton, has set aside about £3 million for the partnership, which shows there are positive approaches in Northern Ireland and a positive way forward. Perhaps that could be emulated across the whole of the United Kingdom of Great Britain and Northern Ireland.

It is estimated that one in 2,500 babies in the UK will be born with cystic fibrosis and there are more than 9,000 living with the condition. The facts are stark. It most commonly affects white people of northern European descent—it is much less common in other ethnic groups. Those are the facts, which in my constituency means that we are looking at virtually the whole populace. Other constituencies will have similar demographics, so it is concerning to hear that, but it is encouraging that research has advanced so much that we can pinpoint such factors so that we know where problems could arise.

Babies are screened for cystic fibrosis at birth using a heel-prick test as part of the NHS’s newborn screening programme. The NHS and Ministers responsible are taking correct steps to diagnose such conditions at an early stage. Treatment for cystic fibrosis is not curative, but it seeks to manage symptoms. Medications including steroids, antibiotics, insulin and bronchodilator inhalers are often used. Nutritional advice and physiotherapy for airway clearance are commonly part of management.

Cystic fibrosis patients may also be suitable for lung transplants. NICE provides a number of guidelines on specific treatments for cystic fibrosis, which it is currently updating. They are due to be published in 2017. On organ transplants, I believe that we should all be considered to be donors unless we say otherwise. The Welsh Assembly has taken steps to bring in that in Wales and such legislation is pending in other regions of the United Kingdom as well, but whenever we see stories about those who are managing but no more and for whom a lung transplant would be the beginning of a new life, perhaps we should emphasise the organ transplant system and find a method to make progress on that.

The hon. Member for York Central rightly referred to families. We focus on those who have cystic fibrosis, but let us also focus on those who support their loved ones at times of hardship and difficult health symptoms. I will also plead the case for Prader-Willi syndrome. I have a number of constituents who have it, but that is not unique by any means to my consistency; it is seen across Northern Ireland. We do not hear much about this, which is another muscular wasting disease and also an eating disease—it is an obsessive disease.

The right hon. Member for Chesham and Amersham talked about Duchenne muscular dystrophy. I have constituents who suffer from that and I have attended events just across the way with people from across the UK with it. It comes in different levels and types, but, as she said, there have been advances in medication. The Minister may refer to those in his reply, but we also need to focus on how we can help those families.

Recent developments show that innovation is working in advancing treatment of cystic fibrosis. I commend the Department for its work. I will also mention the hard work done by universities in partnership with private business and enterprise to come up with innovative ideas for new drugs. We can never underestimate the importance of what they do. Just as others speak highly of their universities, I do so of Queen’s University Belfast and Ulster University which are bringing forward innovative ideas for advances in medicine and other things. We could work well together with them on this.

I spoke earlier of the hidden or forgotten sector: the voluntary charities, of which there are many. Where would we be without them and their dedicated researchers? Such people often dedicate their lives to helping humanity overcome disease. The Cystic Fibrosis Trust is just one example. It is the largest charity funder of cystic fibrosis research in the UK. Last year it invested more than £3 million in groundbreaking research and it plans to invest a further £3.5 million by the end of this financial year. By adding our support and funding where possible, we can add to the great work being done and make a real life-changing difference for those with cystic fibrosis and their families.

Cancer Drugs

David Simpson Excerpts

Tuesday 20th October 2015 Westminster Hall

[David Simpson (Upper Bann) (DUP)]

I congratulate my hon. Friend the Member for Strangford (Jim Shannon) on securing this debate. On a more humorous note, I heard him mention that he has never missed a debate that the Minister has participated in; I think we could safely say that he has not missed any debates in the past five or 10 years. He is a champion in his own constituency when it comes to cancer research and pushing for cancer drugs, and I congratulate him publicly today on his work and his effort.

I welcome the opportunity to participate in this debate. In recent days, our newspapers, TV screens and social media have been flooded with reports about cuts to cancer treatments. One of the latest reports I read indicated that 5,500 patients could miss out under the Government’s plan to reduce the availability of cancer drugs.

Today, cancer is a word that has become all too familiar in our households. As we come together to debate the availability of drugs, some 2 million people are battling cancer. They are husbands, wives, mothers, fathers, sons or daughters. The impact of cancer is much greater and much more widespread than it might appear if we consider only those who are statistically labelled.

Recently I had the opportunity to visit the state-of-the-art facilities at the Queen’s University Centre for Cancer Research and Cell Biology in Belfast. It is making fantastic headway in understanding cancer: how it is formed; how it develops; and ultimately how we can slow down its growth, and eradicate faulty genes and molecules in tumours. The centre was recently awarded almost £4 million to continue its work in research and in developing cancer treatments.

I am proud that Almac, a pharmaceutical company that is a world leader in cancer drug discovery, has its headquarters in my constituency of Upper Bann. Its founder, the late Sir Allen McClay, was so dedicated to improving patient care that he donated much of his wealth to the Centre for Cancer Research and Cell Biology. However, while all this work is going on and new drugs and treatments are being identified, we consistently hear reports that there are plans to remove life-prolonging drugs for various cancers, including breast cancer, prostate cancer and bowel cancer, to name just a few.

[Lady Hermon]

One of the greatest concerns is about the cost of these drugs. The hon. Gentleman said that one of the famous manufacturers of cancer drugs is based in his constituency. How often does he have the opportunity to meet people from that company? Would it be helpful for a cross-party delegation to meet the senior management of that company, to persuade them to reduce the cost of their drugs? I am sure that they could; where there is a will, a way will be found.

[David Simpson]

I welcome that intervention—the hon. Lady makes a very good point. If Sir Allen were alive today and witnessing the cuts in the availability of these life-prolonging drugs, which were once in the headlines as good news stories, he would come out with his old statement: “Bang your heads together and get a resolution to this.” It is a good idea to have such a delegation. I meet Almac staff on a regular basis. Almac is a pioneer in this sector; it is working with Government very closely; and I understand that the pricing of its drugs is not ridiculous.

However, I will make a parallel point. Well over a year and two months ago—perhaps more—it was announced at the Budget that the Health Minister would introduce funding so that a vaccine for meningitis B could be given to children. It took a year and two months—perhaps even more time—for that policy to be implemented, because the pharmaceutical companies were holding out for more money than the Government could afford to pay. They were asking ridiculous prices, because they had the sole remedy for a complaint, so could exploit that situation.

The message needs to go out to some of the pharmaceutical companies that we are dealing with life here. And as one hon. Member said earlier, even if there are only two or three months of life left, people want to hold on to that life as long as they possibly can, because where there is life there is hope, and hope is what people want to hold on to.

A number of weeks ago in this House, I attended an awareness day for secondary breast cancer, and I was shocked to learn that the Government do not keep data on people who are living with this incurable disease, which is remarkable. In the other House, Baroness Morgan of Drefelin has highlighted the issue: because the Government, the NHS and the pharmaceutical industry have again failed to agree realistic prices for new drugs, some women will die sooner than they should.

Bowel cancer is the fourth most common cancer in the United Kingdom. Experts say that around two thirds of those who seek NHS treatment for advanced bowel cancer treatment are likely to face an earlier death under the plans to scale back spending. That is wrong. Like many Members, I regularly meet—possibly on a weekly basis—constituents who are battling cancer or who have just been diagnosed with cancer. I recently met a family who told me of their agonising fate as their father had been diagnosed with lung cancer. Like many families, they have carried out their own extensive research and confirmed with their oncologist that there are drugs out there that could prolong his life. Millions of pounds have been spent on developing these drugs, which could perhaps either save people’s lives or prolong them. However, that family were told, “Sorry, but we can’t give it to him, because it’s just too expensive.”

Where do we draw the line when it comes to someone’s life and life expectancy, and the family who are left behind? I realise that the Government have very hard decisions to make. I appreciate that, but anyone in Westminster Hall today who has either suffered from cancer or known a family member or a loved one suffer from cancer would go to the ends of the earth to try to help them and to resolve this issue, because life is precious. As I say, the Government have hard decisions to make, but I do not think that anyone here today would or should put a price tag on a loved one’s life.

More needs to be done. Families living with cancer need all the help they can get, through the Government, through counselling, through drugs or through whatever help they can find. I trust that the Government will consider that when it comes to the funding of these drugs.

Drugs: Ultra-rare Diseases

David Simpson Excerpts

Tuesday 16th June 2015 Westminster Hall

[David Simpson (Upper Bann) (DUP)]

My hon. Friend mentions research. As he will know, I am involved in a campaign in Northern Ireland and across the United Kingdom on complex regional pain syndrome. The condition affects children, but it mostly affects adults from the age of 50 onwards, and people can lose limbs to it. One in every 3,000 people is affected, and many lives have been destroyed. We need more research to find a drug to cure this condition, and research funding needs to be put in place so that that research can be done.

[Jim Shannon]

I thank my hon. Friend for his intervention. That is a message that I, too, believe in, and I am sure the Minister will respond positively.

Leaving aside all the statistics we have heard today, we need to imagine the emotional strain these things put on people and their families, and we have had examples of that. Only 35% of patients are aware of a licensed treatment for their condition. There is something wrong when that is the case. How come only 35% of people know there is something there for them? How are the Government addressing that? I am not attacking the Minister—that is not how I work—but how do we move things forward in a positive fashion? Of that 35%, 89% are able to access the treatment, but 11% are not. Therefore, 65% of people are not aware of the drugs, and of the 35% who are, a proportion are not able to get them.

Like others, I want now to touch on Duchenne muscular dystrophy. If Translarna is given at the correct time, we can prolong the sufferer’s mobility. My constituents deserve to have access to that drug as soon as possible, and that is what I would like to see happen. The effects of long waiting times and uncertainty are widespread, and although ultra-rare diseases affect the few, their effects for those who suffer from them are an inescapable reality and should be treated with the utmost seriousness.

Families deserve a solution to the continual failure to establish a lawful, robust and transparent commissioning service that enables the rare disease community to access new drugs in an equitable and timely manner and to avoid situations such as those we have spoken about, where crucial windows of opportunity pass by. This is a crisis—it cannot be described as anything else. People are in trouble, and they need our help now.

Let me quickly pay tribute to the lady who looks after the Northern Ireland Rare Disease Partnership, Christine Collins. Last year, we met the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), to discuss these matters. We were clearly moving forward, and the Minister was very responsive. The background information for the debate says that, in November 2013, the UK Department of Health and the devolved Governments published the UK strategy for rare diseases. In June 2014, the Northern Ireland Assembly endorsed it and gave a commitment to publish an implementation plan, and last year’s meeting provided an opportunity to underline the need for that to happen. Perhaps the Minister can give us some idea today of what discussions he has had with his fellow Minister to move things forward so that we can deliver on that commitment.

The debate has dealt with access to drugs. It has also given us an opportunity to bring out the gaps in the patient experience. Let us remember the patients, the families, the children and all those who suffer. They require a co-ordinated response from not only the health service and the social services, but research bodies and the relevant charities. I hope that the common experiences we have described signal the urgent need for access to these vital treatments. I remind all those in a position to have a tangible impact on drug access that while we are debating these issues, somebody else is falling into the trap and will, unfortunately, be unable to access the necessary drugs. I urge the Minister to respond positively, and I thank the hon. Member for Leeds North West again for giving us all a chance to speak about this issue.

Health and Social Care

David Simpson Excerpts

Tuesday 2nd June 2015 Commons Chamber

[David Simpson (Upper Bann) (DUP)]

Does my hon. Friend agree that although we welcome the legislation on legal highs we must ensure that we have proper enforcement? We have not had much success with the other illegal drugs, so we need proper enforcement.

[Jim Shannon]

I thank my hon. Friend and colleague for that intervention. He clearly outlines the case, and I want to make a comment about that as well. A young constituent of mine from Newtownards, Adam Owens, a 17-year-old boy, died some six weeks ago because of psychotropic substances, or legal highs, as we all know them. Our community is rightly angry at this loss of the life of a young man and we put on record our concerns for the family and everyone else.

We must address the issue of what is classified as legal, particularly when a young man has lost his life. I have spoken to the Police Service for Northern Ireland, to the Department of Health, Social Services and Public Safety and to the Department of Justice to ask for urgent legislative change. They all said that the change would have to come from this place, so I welcome the Government’s commitment in the Gracious Speech.

Women Entrepreneurs

David Simpson Excerpts

Wednesday 18th March 2015 Westminster Hall

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I am delighted to open this debate on the important topic of women and entrepreneurship. I grew up above my parents’ shop in Osterley, just half a mile from my constituency, and I have spent time self-employed and running my own business. I have visited women’s business centres in America and the UK and I passionately believe in the need for an ambitious strategy to support women-led enterprise. I would like to acknowledge the work Hounslow chamber of commerce does in my constituency and across Hounslow to support women-led enterprise. A number of women have set up and started their own businesses in the community, making a huge difference to the local economy.

Women’s entrepreneurship has great potential for growth, creating jobs and wealth while reducing gender inequality. Women-led small and medium-sized enterprises already add £70 billion to the UK economy, yet women are only half as likely as men to start their own business. According to the findings of the Women’s Business Council, chaired by Ruby McGregor-Smith, CEO of Mitie, it is estimated that if women were concentrated in entrepreneurial activity at the same rate as men, there could be an extra 1 million female entrepreneurs. Indeed, according to the most recent OECD data, there is a gender gap of almost 50% in entrepreneurship in the UK: total entrepreneurial activity, defined as the percentage of the working-age population either in the process of starting a business or running a new business, among working-age women was 7.5% in 2014, lagging behind the rate for men, which was 13.5%. In the US, the rate is 11.2% for women, compared with 16.5% for men.

There are real challenges, therefore, in realising the economic benefits that can come from women-led enterprise, but that should not be the case. Research published last week by the business software group Xero, for example, found that women-led start-ups tend on average to lose less money and to have more success in winning new contracts. Emerging findings from research being undertaken by the Centre for Entrepreneurs suggest that, although women have entrepreneurial and growth ambitions, men seem to be better than women at realising those ambitions. Continuing to understand and to deal with the barriers to women’s entrepreneurship needs to remain a core part of our economic policy.

A review of that policy area in the UK shows a growing focus on women entrepreneurs since 1997. The then Department of Trade and Industry formed a women’s enterprise policy team in its Small Business Service, and in 2003, the then Labour Government published “A Strategic Framework for Women’s Enterprise”, which was the first policy response of any kind from a UK Government on the potential for economic growth if women were encouraged to start their own businesses in a similar way to men. The report set out targets, and the women’s enterprise panel was formed to advise the Government.

[David Simpson (Upper Bann) (DUP)]

I congratulate the hon. Lady on bringing this debate to Westminster Hall. If I did not speak in it, my wife would be very angry, because she has been an entrepreneur for many years and has been very successful. Does the hon. Lady agree that to encourage young women to start up businesses or whatever, we need to start at the very root, in further education colleges, schools and universities, to encourage them to come out and use their skills?

[Seema Malhotra]

I thank the hon. Gentleman for his intervention. He is absolutely right. Although the Government have made some progress on increasing enterprise education, we have a long way to go. One finding from research that I undertook last summer was that women who were starting their businesses later in life wished that they had had that education earlier. Women never know at which stage in their life they will be starting a business. It is increasingly common for both very young women and those who may have taken time out of the workplace to have children to become returners to start enterprises and suddenly find that they do not have the support or knowledge they need. I therefore thank the hon. Gentleman for his wise comment.

The Women’s Enterprise Task Force, established in 2006, took forward some of the work. Although not a delivery body, the WETF provided input to Government on key policy areas that affected women’s entrepreneurial uptake. The WETF produced several recommendations and directed and implemented Aspire, a £12.5 million women’s co-investment fund to support high-growth, women-owned enterprises. In 2008, policy developments taken forward included Government provision of enterprise support focused on women through the regional development agencies and Business Link.

In recent years, there has been a slow-down in support for women-led enterprise. Although the Women’s Business Council, formed in 2010, has done very important work, Prowess, the UK advocacy network for women in enterprise, has been scaled back to, in effect, a newsletter service, and the regional women’s ambassador programmes have been disbanded. For the recently published Burt report, a survey was done of local enterprise partnerships. The author wrote to ask all 39 local enterprise partnerships about their current engagement with women entrepreneurs, but only seven responded; of those, none had more than one female director for every three male directors and none had a strategy for promoting women in enterprise.

I remain extremely concerned that activity is being scaled back instead of pushed forward in the way the Government have reallocated resources for development programmes across the regions. The Department for Business, Innovation and Skills small business survey in 2014 suggested that women-led businesses fare less well over time than equally led or entirely male-led businesses. In 2014, 24% of one-year-old businesses were female- led and 45% were male-led, but of four to five-year-old businesses, only 14% were female-led and 49% were male-led.

I mentioned research on women and entrepreneurship that I undertook some months ago. Through a series of seminars and public meetings, I looked at three dimensions of the gender gap in entrepreneurship in the UK: the rate of business start-up, the sustainability of enterprises, and the speed of growth of female-led versus male-led enterprise. Findings from our focus groups research suggest that there is greater support for starting up an enterprise, as well as perhaps at the top end, but a lack of support for established women entrepreneurs in the middle who are looking to grow their enterprise and are struggling to find support and advice on how to do so. Access to finance can be harder to come by, with investors and banks assessing some women’s businesses as more risky. Indeed, one woman I met, who had set up a child care business in Reading, was turned down for investment by her bank because it could not understand her business model—frankly, it did not understand the business of child care. She remortgaged her house to put her own finance into the business, and went on to increase her turnover and to employ about 20 people.

The needs of this group of women are not being met, so their economic potential is not being realised. The key question that emerges is what more needs to be done by the UK to bridge the gender gap not just in start-ups but in growth and sustainability. Closing the gap means understanding better the circumstances and gender differences in entrepreneurship, so I will spend a few minutes talking about motivations and barriers.

We know that although women have the ambition to set up businesses and grow them, different motivations make entrepreneurship attractive to them. They can include pursuing social goals, a personal passion or a niche in the market, or seeking a work-life balance, flexibility or more control over one’s life. It is positive that young mothers are leading an entrepreneurial surge in new business start-ups—the high cost of child care and the easy availability of technology that allows businesses to be started and run from home contribute to that surge—but if our current statistics are anything to go by, those businesses will need support to survive and grow. A new breed of business women, dubbed “the returners”, has made an excellent contribution to the increase in the proportion of small and medium-sized enterprises run by women from 14% a few years ago to 20% today. The number of women over the age of 30 seeking start-up finance and mentoring has increased by a third in recent years. In some measures, therefore, we see some positive trends, but the research suggests that women-led enterprises have less of a chance of surviving and growing.

Barriers to growth may be encountered by female and male entrepreneurs. According to emerging research by the Centre for Entrepreneurs, all groups express concerns about cash flow and about getting the right people and skills, but women are more likely than men to identify child care and supporting their partner’s career as barriers that affect their own enterprise. They were also more likely to want specific business education—a point made by the hon. Member for Upper Bann (David Simpson)—face-to-face contact, and good mentors, in contrast with men, who specified that they sought advice.

That may shed some light on another gender-specific barrier: lower self-belief, as identified in research by Xero. A third of women said that a lack of self-belief had been the biggest barrier standing in the way of launching their small business, and it was the single reason most often given. In my research, I found that access to support and advice remains a problem. Women want forms of business education that are better tailored to their needs, and they raised with me the need for enterprise education in schools, so that young people can build entrepreneurial skills. We do not know who will become the entrepreneurs of the future, and that door should be open to children from a very young age.

In Liverpool, I saw an excellent example of networking and advice tailored to reach women when I visited the outstanding Women’s Organisation. Simply by moving the sessions to more family-friendly times, the organisation ensured that the number of women who attended business support events increased. The classic timing of business events and drinks right after work at 5.30 pm clashes perfectly with the time when kids are at home, or at after-school clubs, and dinner needs to be made.

Confidence can also be a significant factor in personal risk levels that may guide or limit the decisions that women make. Women may calibrate risk and confidence differently in taking tough decisions; they may also be less likely to see themselves as entrepreneurs than as business owners or founders, which may affect how they perceive and respond to marketing campaigns.

The Government have introduced some strategies, but there is still a long way to go. The Government published the Burt report, “Inclusive Support for Women in Enterprise” in February. That was helpful, but it is unfortunate that when the role was established, it was aimed at promoting and supporting female entrepreneurs, focusing on raising awareness rather than producing sound, evidence-based policy recommendations. The report recognises some initiatives such as StartUp loans, the enterprise allowance and local growth hubs, but it also suggests that there have been deficiencies in the way support has reached women, because it has been extremely patchy, rather than universal.

The report recognises the need to change some of our language around support, so that it looks and sounds more accessible and relevant to women entrepreneurs, who may search for it online. I am often struck by the huge contrast between the US Small Business Administration website, which has mainstreamed women’s business support and which feels customer-centric and targeted towards small business, and the website of the Department for Business, Innovation and Skills, which I believes serves Ministers more than it does those who seek access to services.

I welcome the fact that the Government have recognised the need to give diverse businesses diverse support. They have extended the types of support that may need to be provided to businesses set up by different people—for example, young people and those from ethnic minority backgrounds—to ensure that there is access and guidance for mentoring, networking and sources of finance. However, women have told me that they feel the Government’s support is located in a range of places and those who are looking for support find it hard to join up; they also find it difficult to identify what is really relevant and where to get the quality help they need. A page for women-led enterprise is attached to the GREAT Business website, but it feels like an add-on and a collation of bits and pieces. It could be far more integrated. I would be interested to know why the Aspire fund, a £12.5 million fund that makes equity investments of between £100,000 and £1 million on a co-investment basis, has so far invested only £4.7 million in women-led enterprises. It is certain that problems remain. As David Prosser wrote in The Independent last week:

“There is certainly a problem to tackle here. Government statistics suggest that fewer than one in five smaller companies are led by women. That’s not enough—not just because social justice demands equality of opportunity, though of course it does, but also because there is every reason to expect women-led companies to outperform.”

I will close with a few questions for the Minister. First, what cross-Government work is going on to integrate support for women-led enterprises at start-up and growth stages, and which Departments are actively involved? Secondly, what consideration have the Government given to putting the Women’s Business Council, which has done some important work, on a statutory footing so that it remains part of our business and policy-making infrastructure? Thirdly, why has the Aspire fund, which is designed to invest in women-led enterprises, invested only a third of its intended funds? Fourthly, which Minister is accountable for closing the gender gap in entrepreneurship, and whose dashboard is it on?

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate, which I thank the hon. Member for Feltham and Heston (Seema Malhotra) for securing. I note that my party, the Democratic Unionist party, has the most Members in this debate. I am sure that is not a reflection on the other parties’ interest in this matter, and I am sure everyone would be down here if they did not have other things to do. Those of us who are here underline the importance of supporting women entrepreneurs.

I recently read an article on nibusinessinfo.co.uk stating that:

“If as many women as men were thinking of setting up a business in Northern Ireland we would have over 28,000 more entrepreneurs.”

To put that in perspective, if it created 28,000 new jobs—it would probably create more—there could in theory be zero unemployment in Northern Ireland. That is a possibility, and it would have a dramatic and positive effect on the local economy. That idea is not far-fetched. We must encourage ladies in Northern Ireland to be entrepreneurs, and we must ensure that they have a chance to do so. The article continues:

“The Global Entrepreneurship Monitor (GEM) report shows that women in Northern Ireland have a very positive view of entrepreneurship as a career choice.”

Entrepreneurship is not alien to women in Northern Ireland. They do not find entrepreneurship strange; they want to sign up to it.

“The report indicates that increasing the level of entrepreneurial activity among women will make a huge contribution to the diversity and success of the local economy.”

The Library debate pack has made me aware of one negative. It refers to:

“better support structures for women—think mentorship and networking”.

On the other hand, there is a problem with such an approach. If women are not starting businesses because they lack the confidence to do so, singling them out as a group in need of special treatment risks undermining that confidence even further. So there is a negative, and there needs to be a balance. At a women’s networking event at Middlesbrough football club in 2000, one of the award winners was south Wales-based Christine Atkinson, who said:

“Lack of confidence is so pervasive.”

Again, we cannot ignore that.

[David Simpson]

I am sure my hon. Friend will agree that the retail sector in the United Kingdom is vastly run by females. Within the commercial industry, there has to be opportunity as well.

[Jim Shannon]

I thank my hon. Friend for that intervention. His business expertise is good for this Chamber and for the House. He will not mind my saying this, but a part of his success is his wife. I mean that genuinely. My hon. Friend and his wife have a business partnership and they both work equally hard. The success of that business is due to the efforts of both of them. He and I know that, and his wife knows that as well.

When women take it upon themselves to launch businesses, often it is to beat the high cost of child care. Perhaps the Minister will address that issue. Child care costs are a big factor in whether ladies are able to start their businesses and move forward.

It is always good to give an example. A retired lady comes to my office. She does craft work and makes bits and bobs to help to raise money for orphan projects in Africa. I am amazed at her ingenuity at times. For example—my colleagues will know this—I am apt to give out business cards. As Members will know, they come in wee plastic boxes. Given the amount of business cards that I have given out over the past five years—and long before that—there are a lot of those wee plastic boxes. She has turned those wee boxes into memory boxes and she fills them with little cards with a poem on them or a thought for the day. She does that for her Elim church mission to raise money for Africa. She has used her skills as an entrepreneur and her skills in crafts to create a business of sorts. If that did not come under charitable purposes, I have every certainty that she could make enough money to live on with all the crafts and things that she sells. That is what an entrepreneur does—that is what it is all about—and that is a lovely example of what can happen.

Local Pharmaceutical Services

David Simpson Excerpts

Tuesday 3rd March 2015 Westminster Hall

[Caroline Nokes]

My hon. Friend has accurately outlined the situation in her constituency, which I am sure is mirrored across the country. I have received representations from community pharmacists, who have said that they are struggling with short time scales and no certainty from their NHS area teams.

[David Simpson (Upper Bann) (DUP)]

I think the hon. Member for Truro and Falmouth (Sarah Newton) may need to go to the pharmacy. Is the main problem for smaller pharmacies purely the finance, or is it the facilities that they have?

[Caroline Nokes]

I thank the hon. Gentleman for that intervention. I will move on to finance, but it is not my contention that finance is the problem; we just require the local area teams to manage these contracts and get them in place before the deadline of 31 March is reached.

As I was about to say, the contract for Wellow pharmacy, in line with those for every essential small pharmacy across the country, will expire on 31 March. When the contract comes to an end, my constituent Mr Sharma is gravely concerned that his pharmacy will not be able to continue providing these services, unless the local NHS area team decides to renew it, making specific arrangements under the local pharmaceutical services scheme. As yet, he has not received a decision.

Many other pharmacies are similarly affected, and I know that the Secretary of State for Education, my right hon. Friend the Member for Loughborough (Nicky Morgan), who cannot be here today, has expressed concerns about the pharmacy at Loughborough university and the one in the village of Wymeswold. I think that perfectly illustrates the diverse localities that these pharmacies serve. It is not just small village pharmacies under threat, but one serving a university campus, where young people are living away from home for the first time and might be in a position to benefit most from the sage, experienced advice of a pharmacist for their front-line health care needs.

I completely understand the need for NHS England to have devolved these contracts to local area teams, but the reality is that 31 March is now exactly four weeks away and for many pharmacists, there is still no certainty. According to Pharmacy Voice, had NHS England renewed the contract, there would have been procurement and tendering issues, so it was devolved to the areas, but we now face a problem where few have confidence that when we get to the end of this month, they will have a new contract.

What are their options? Well, they are pretty stark. They can close immediately, with no notice to the local community, because the contract will have expired and therefore no notice period is necessary. They can try to struggle on, returning to the pharmaceutical list but facing an immediate drop in income, which was previously agreed by all to be necessary to enable them to provide essential services. Or, and I am sure that this is the option most will follow, they can continue to pursue the NHS area teams to prove their value and worth, when in fact that was already established a long while ago.

For small pharmacies, there is a real challenge in viability. Using Wellow pharmacy as an example, it currently issues in the region of 2,200 prescriptions a month. That is pretty close to the 2,400 prescriptions a month that would trigger what is known as an establishment payment, but it is not quite there. It has worked hard to increase business, but in small communities it is incredibly difficult to push numbers above that threshold. My constituent Mr Sharma describes the additional prescriptions needed as a gulf that he has been struggling for years to cross and has never yet achieved.

I do not intend to delve into the issue of dispensing GPs and what is often perceived as a conflict between pharmacies and those GPs who can dispense. That is quite separate from the immediate time pressure faced by these pharmacies, which have already been deemed essential. What my constituent and the other pharmacists who have contacted me have emphasised is the chasm between the number of prescriptions that they routinely issue and the number that they would have to reach in order to receive the establishment payment. For some, the gap is greater than for others, which means that the impact of losing the essential scheme will be felt differently by various pharmacies and that some might be forced out of business faster than others.

Most members of the scheme are already doing significant work to make sure that they are as accessible as possible to patients, including collection of prescriptions from nearby surgeries and free delivery of medicines to patients. As Mr Sharma puts it:

“This pharmacy is the only health care provider in the area of any type, and the nearest other pharmacies are over five miles away in Romsey. If a patient was to need an over-the-counter medicine, require a medicine free of charge for a child, need support for self-care, or have a minor injury, there is a significant risk that without the availability of my pharmacy, they would attend either the GP surgery in Romsey or the accident and emergency department of Southampton general hospital.”

What he wants, in common with pharmacists from across the country who have been in touch with me, is some certainty going forward.

As Has Modi, of Deanshanger in the constituency of the Economic Secretary to the Treasury, my hon. Friend the Member for South Northamptonshire (Andrea Leadsom), has said:

“These contracts have been left to the discretion of the area team of NHS England, to whom we are required to make a formal proposal.”

The primary care contracts manager of the area team is adamant that the proposal will not be supported unless it can be proved “value for money”. Without the financial support that that entails, this small pharmacy will undoubtedly have to close because the normal funding mechanisms are massively stacked against small pharmacies. It does not even receive various basic fees—which can be substantial—that are available to average and larger pharmacies. This is why the ESPLPS arrangements were put in place to safeguard small but essential pharmacies in the heart of the community.

I appreciate that the current arrangements cannot continue, and that because the Secretary of State has devolved the contracting of primary care services to NHS England, a further extension to the scheme is not possible. He has already extended it once, from 2013 to 2015, and he cannot devolve responsibility for commissioning and then interfere with how that same commissioning operates. Therefore, no extension will be forthcoming and I accept that.

As my hon. Friend the Member for Truro and Falmouth (Sarah Newton) has said, many pharmacies are actively negotiating with their area teams, but concerns have been raised about the responses they are receiving, including time-limited support, and requirements to demonstrate that they are providing value for money. However, those area teams with an essential small pharmacy service are receiving a top-up on their allocations, so the funding is already there and is ongoing from the global pharmacy sum. Any amounts allocated have to be spent on pharmacy services and cannot be redistributed to any other purpose.

Effectively, if the essential small pharmacies are not supported, the moneys will simply go to other pharmacies in locations that have not been deemed to be of such an essential nature. Presumably, they might be redistributed to the larger existing pharmacies, many in high street locations, some distance from the village where there once was a supported, critically important pharmacy.

Essential small pharmacies are working hard to ensure that their “pitch” to the area teams is as robust as possible. Many, such as Wellow pharmacy, are garnering support from the local community, from appreciative patients and from borough, county and parish councils. Local residents are filling in surveys, outlining the services that they use at the pharmacy and identifying what impact closure would have on them personally.

It seems to me a relatively simple proposition: if these pharmacies are essential, and successive Governments have agreed they are, what more can we do to make sure they are retained? I have three things that I wish to ask of the Minister today. First, we need some clarity over what constitutes an essential small pharmacy. Some 90 pharmacies historically receive payments under the scheme. It would be helpful if they could point to an incredibly robust set of criteria, so that it would be easy for the pharmacists then to identify to the area teams why they need the support that has been forthcoming for, in at least the case of Wellow, 25 years.

Secondly, we need some encouragement to NHS England area teams to ensure that the outstanding contracts, which are believed to be the majority of them, are resolved before 31 March, so that pharmacy services are not simply forced to stop in these communities. I know that some are resolved and that others are working very actively to make sure that they are in place before the contracts—and therefore the payments—expire, but from my e-mail inbox, I am acutely aware of how many are simply in a state of limbo, having no idea whether their business will be viable 28 days from now. I would welcome the Minister considering how best she might convey that urgency to NHS area teams.

Finally, we need closer investigation of what role NHS England could play in making sure, within the procurement rules, that pharmacies deemed over decades to be essential can continue to receive support, via the pharmacy global sum, so that there is no additional cost to the NHS area teams and that the top-ups that area teams receive remain in place. However, it should also be made very clear that those can only be used for pharmacy services and not distributed among the wider health care community.

As I said at the beginning, we all appreciate the very important role pharmacists play in our health care provision. They dispense advice and knowledge, as well as drugs. In those of our communities remote from other health care providers, 100 or so of them have been deemed to be essential—and we need to keep them.

Drugs (Ultra-rare Diseases)

David Simpson Excerpts

Tuesday 20th January 2015 Westminster Hall

[Greg Mulholland]

Absolutely. It is a pleasure to be working on this issue with the right hon. Lady and other right hon. and hon. Members from both sides of the House. This is a personal issue for me, too. My attention was drawn to the issue when Simon and Katy Brown came to see me with their son, Sam, in 2012. Sam was then four, and he is now six. Sam is receiving Vimizim, which is the only drug that clinically works for Morquio. Both drugs have been shown to have a very significant impact on the health of these individuals, changing what they are able to do with their lives, which is crucial.

[David Simpson (Upper Bann) (DUP)]

I thank the hon. Gentleman for giving way. I congratulate him on securing this debate. Is the supply of drugs purely down to finances, or is it totally bureaucracy? What is it? Why is there a hold-up on such an important issue?

[Greg Mulholland]

That is a good question, and it is the nub of the issue. It is not finances. Finances are clearly an issue, but it is important to get the message out that they are not the cause of the hold-up. There is an element of bureaucracy in the process, which I will address. I know that the Minister is seeking to ensure that we have a proper process, but ultimately we have to make decisions based on the effectiveness of the drugs. In this case, both drugs have been shown to work and are licensed and used by health systems in other countries.

Care Workers

David Simpson Excerpts

Wednesday 5th November 2014 Westminster Hall

[Mr Smith]

My hon. Friend’s point is well made. We are undoubtedly talking about a United Kingdom-wide problem. A Freedom of Information Act request from Unison this year showed that a staggering 93% of councils in England and Wales—I dare say that the situation is not so different in Scotland and Northern Ireland—do not make it a contractual condition that the home care providers that they commission must pay home care workers for their travel time.

[David Simpson (Upper Bann) (DUP)]

I congratulate the right hon. Gentleman on obtaining the debate, and I declare an interest because my wife is a carer. One of the biggest problems, certainly in my constituency in Northern Ireland, is the recruitment and consistency of staff. They are under so much pressure because of their terms and conditions, but at the end of the day, they save the Department of Health and the Government a lot of money.

[Mr Smith]

Yes, indeed. The hon. Gentleman makes a good point, and I will say more about that later. Of course, there will be massive increased need for these workers in the future. One reason recruitment and retention are so difficult is that terms and conditions are often so poor.

Let me develop my argument further. Only 21% of councils have ever asked to see documentary evidence relating to the pay of care workers employed by their contractors. In the face of that and the other evidence I have cited, it is appalling that the Government are doing so little to uphold the legal rights of home care workers. It is indefensible that HMRC has stopped carrying out proactive investigations of national minimum wage compliance in home care, despite having revealed the extent of the breaches itself.

Ovarian Cancer (Gene Testing)

David Simpson Excerpts

Tuesday 4th November 2014 Westminster Hall

[Ms Ritchie]

Again, it is a pleasure to serve under your chairmanship, Mr Caton. I am pleased that the Minister is here to respond on this delicate, critical and vital issue for women.

Ovarian cancer is most common in women who have had the menopause, but it can affect women of any age. Notably, the symptoms can be difficult to diagnose, as they are common to many other less serious ailments. Sadly, that leads to many women not getting the treatment they need quickly enough. It is the most aggressive gynaecological cancer. Only about 40% of women are still alive five years after being diagnosed, according to research in the British Medical Journal.

[David Simpson (Upper Bann) (DUP)]

I congratulate the hon. Lady on securing this debate. As she knows, I do a lot of work in my constituency with the Mandeville cancer unit. When I visit it, I see a lot of younger women who have the disease. Hospital staff tell me that early intervention is one of the ways that it can be resolved, so I fully support the hon. Lady in her bid today.

[Ms Ritchie]

I thank the hon. Gentleman his intervention. I agree that it is all about early diagnosis. Women who are diagnosed in the early stages of ovarian cancer have a 90% chance of surviving the next five years, but if the cancer is found at a later stage the five-year survival rate is reduced to 22%—quite a startling statistic. Clearly, early diagnosis and treatment is vital.