Double Taxation Treaties (Developing Countries) Bill

Debate between Jane Ellison and Mark Durkan

2nd reading: House of Commons
Friday 16th December 2016 Commons Chamber

[Jane Ellison]

My hon. Friend is right. The OECD’s BEPS project is really important in addressing some of the issues the hon. Member for Kirkcaldy and Cowdenbeath talked about. The UK has played a leading role in that project and will continue to do so. A large number of countries have come on board with those principles and we will continue to move forward on them.

It is worth restating that the UK became the first G7 country to meet the UN target of spending 0.7% of gross national income on international development. The way in which we tackle the challenges in developing countries is very much in the spirit of what has been discussed in this debate. We understand the idea of helping people to develop capacity and independence so that they are not dependent on aid. At the heart of what DFID and the Government are doing is the idea of strengthening people so that countries can move forward and develop.

We help people to strengthen their economies and reduce their reliance on aid in a range of ways. Last year—I am particularly proud of this because it involves HMRC working closely with DFID—we committed to doubling the funding for tax projects in developing countries through the Addis tax initiative. HMRC has set up a specialist tax capacity-building unit, which deploys staff to developing countries to provide technical tax expertise. It is working closely with DFID on that.

Bilateral tax treaties can play a part. Treaties are important in encouraging private sector activity in a partner country. We know how powerful a force that can be in driving up employment, providing quality goods and services, and raising crucial tax revenues, which finance public services in those countries. We have about 130 treaties with countries across the globe, including several with developing countries, to support and sustain cross-border trade and investment by tackling double taxation and clamping down on cross-border avoidance and evasion.

The treaties are reached through negotiation by experienced officials from HMRC and are highly technical documents. Let me provide assurance on the specific points the hon. Member for Kirkcaldy and Cowdenbeath made about who is involved and the process that goes into those documents. They follow consultation exercises that help to establish appropriate priorities. That process includes the consideration of representations made by UK businesses, NGOs, other Departments including DFID and the UK’s missions based in developing countries. The approach to these treaties is very collaborative and open so that we reach the right priorities that work for both parties. Decisions on the negotiation or renegotiation of a tax treaty are taken on the basis of a range of factors, including the results of HMRC’s periodic review of the tax treaty network and the role of treaties in promoting development. The Government already strive to take wider issues, including development, into account and align our tax treaties with our wider development policies.

I know there are some concerns about the treaties, and some have been alluded to today. Let me be very clear that the UK never ties our wider assistance or investment to such treaties. We cannot impose tax treaties on other states, including developing countries, and we never try to do so. Every tax treaty we negotiate is necessarily a reflection of the interests and priorities of both states as equal partners. That of course will mean some trade-offs. Sometimes developing countries face a trade-off between reducing their tax rates and rights to encourage investment and maintaining those rates and rights and so risking losing investment. That is their judgment to make. Before engaging in a treaty negotiation any country would think about what its priorities are.

[Mark Durkan]

I have noted all that the Minister has said, but she must recognise that there is a concern that some of these treaties work more as double evasion treaties than as double taxation treaties. Beyond the treaties, in the last Parliament, against the grain of what the Government say they are about in the BEPS process, the controlled foreign companies rules were changed unilaterally and at the expense of developing countries’ exchequers.

[Jane Ellison]

There are two things I would say. First, our work on double taxation treaties cannot be seen in isolation from the wider work we have led through the OECD on the BEPS project and a lot of the legislation we have passed. Since just 2015, there have been more than 30 different measures that will come into effect on avoidance and evasion.

My second point, to reiterate what I was saying before I took the hon. Gentleman’s intervention, is that these are mutually agreed treaties. If a country is not comfortable with anything being proposed—not that the UK would propose anything close to what he suggested—the treaty is mutually agreed and it is right that we respect the balance developing countries wish to strike in negotiations as much as we would respect any country’s position. Our network of treaties with developing countries demonstrates that. We have no power to force a developing country to sign a treaty that is against its interests, and would never try to do so. If the UK and a potential treaty partner cannot come to an agreement that satisfies us both, the treaty simply will not go ahead.

I turn to some of the specific issues that the Bill would entail for any Government negotiating such treaties, because while we respect and agree with the thrust of the Bill’s intent, we do not think we could, from a technical point of view, carry out some of the analysis that the Bill suggests.

Let us take, for example, the idea of assessing the impact. Given the long timescales, the complex and shifting interactions with domestic law and the lack of a reliable comparator, we believe it is simply not possible to produce meaningful estimates of the revenue effects of a tax treaty in the sort of timeframe that the hon. Member for Kirkcaldy and Cowdenbeath is suggesting. These are long-term projects with partner countries. Successive Governments have never attempted to produce assessments of the effect on the UK, let alone for a partner country. To attempt to do the latter—to assess the impact for the partner country—would very likely not be welcomed by that country, as it would essentially represent the UK’s uninvited judgment of its tax policies. I entirely endorse his comments about mutual respect. However well intentioned, the idea of our passing judgment on another country’s tax policy runs counter to the key principle of mutual respect.

[Jane Ellison]

I understand the hon. Gentleman’s point, but I still cannot agree with him. He asks how we can show benefits. I repeat that countries enter into these agreements willingly. We have over 130 of them, and there are more in the process of renegotiation, particularly those that are outdated. Countries would not be seeking to renegotiate or enter into that bilateral discussion if they did not feel there was mutual benefit in their doing so.

I have recently signed several such treaties—we have recently exchanged treaties with Colombia and Lesotho—and had the opportunity to talk to countries about why they do it, and it is clear they believe it is to our mutual advantage. Over time, these bilateral relationships must be to our mutual advantage. It is also worth noting that countries can rescind treaties. If countries did not think it to their advantage, they could rescind the treaties. We have not locked countries into these arrangements; they are entered into by mutual agreement, and countries can exit from them.

The Bill also asks us to assess the benefits of foreign direct investment, but again that would be very difficult, if not impossible, on the basis that FDI depends on such a wide range of factors. Investors will consider all sorts of things, including: existing and planned infrastructure; changes to the country’s legal system; political stability—often critical in the developing world; the education level of the workforce; and access to markets. The idea that we could assess in isolation the direct contribution of a tax treaty is impracticable. It would be part of a mix that moves a developing country from poverty to greater wealth; during that journey, all those things, and more, begin to fall into place to produce an environment in which wealth can be created to the benefit of the country because people want to invest there. To analyse one of those things in isolation, however, would be an extremely difficult proposition.

[Mark Durkan]

On the Minister’s point about mutuality and the nature of any treaty discussions, would she agree that when bilateral trade deals are negotiated post-Brexit they should be accompanied by new tax treaties, negotiated at the same time, in the spirit of mutuality she has talked about?

--- Later in debate ---

[Jane Ellison]

Brexit is a bit of a red herring in this regard. These agreements are bilateral, and the vast majority are outside the EU, although we have them with EU member countries too. I am happy to respond to the hon. Gentleman with further details, but his point is not directly relevant in the way he suggests.

[Mark Durkan]

rose—

[Jane Ellison]

No, I will not give way again. To be fair to the hon. Member for Kirkcaldy and Cowdenbeath, the promoter of the Bill, I want to deal with a couple of his other points.

Parliamentary scrutiny was mentioned. We have a system whereby tax treaties are subject to parliamentary scrutiny and debate before they can enter into force. That means scrutiny through a Delegated Legislation Committee. There is a gap of several months between signature and debate, which gives hon. Members ample time to acquaint themselves with the contents of a treaty and to inform robust debate. There is also both the power and the precedent for referring treaties to the Floor of the House. That has not been done since 1984, but I would be delighted to discuss any of these on the Floor of the House if Members were moved to bring them forward.

I thank the hon. Gentleman for championing this issue and for the constructive approach he has taken. It has given us the chance to put on the record what I believe is an admirable track record in this country.

I will mention one more thing that might be of interest to the House. The Department for International Development is supporting the OECD’s new “tax inspectors without borders” initiative, which has raised more than $260 million of additional revenue in developing countries to be spent on public services. Again, this is a record we can be proud of across parties.

While we fully support the principles of the Bill, many of its provisions are already in place, and where they are not that is due either to the technical difficulties involved or to the unintended and undesirable consequences that such measures would involve.

The debate has served to highlight a number of things, particularly the role that tax treaties can play in providing certainty and stability for increased investment in developing countries; the importance of our tax treaties being tailored to meet the individual tax policies of our partner countries; and the considerable impact that the success of these treaties can have on sustainable economic development.

Although we do not support the Bill, I would like to thank the hon. Member for Kirkcaldy and Cowdenbeath for securing the space to consider these issues—

Concentrix

Debate between Jane Ellison and Mark Durkan

Wednesday 26th October 2016 Commons Chamber

[Sammy Wilson]

rose—

[Mark Durkan (Foyle) (SDLP)]

rose—

[Jane Ellison]

No. I really must make some progress—you may not indulge me too much more, Mr Speaker, if I give way again—but I will see whether I can take further interventions later.

As hon. Members should be aware, anyone who wishes to challenge any changes made to their tax credits has a right to request a mandatory reconsideration of their case. As of the start of this week, HMRC had received more than 26,000 such requests. Staff have already reviewed and resolved more than three quarters of them, and they are up to date with the Concentrix reviews. As I have said, that means that the cases have been resolved in accordance with the facts; it does not necessarily mean that there was a problem in each case. However, at least such cases have been resolved, and closing the remaining cases will of course be a priority.

That gives the House a sense of the necessary steps being taken to fix the immediate problem: restoring quality customer service, resolving people’s claims and checking that the right decisions have been made. But I know that hon. Members have been worried about people falling into hardship if their claim has been incorrectly withdrawn or reduced due to errors. That has quite rightly been the source of many of the questions we have been asked. I reassure Members that a system is in place to support anyone who contacts HMRC in such circumstances. They will be helped to request a review of the decision taken—the so-called mandatory reconsideration that I have just mentioned. Those in hardship will then receive a payment of £100, normally on the following day, while their review is being handled.

--- Later in debate ---

[Sammy Wilson]

Will the Minister give way?

[Mark Durkan]

Will the Minister give way?

[Jane Ellison]

Not just at the moment—I must make some progress.

Particular individuals in particular circumstances are more prone to error. Over the years that tax credits have been running quite a substantial picture has built up of where error is more likely to exist.

Small Charitable Donations and Childcare Payments Bill

Debate between Jane Ellison and Mark Durkan

2nd reading: House of Commons & Money resolution: House of Commons & Programme motion: House of Commons
Tuesday 11th October 2016 Commons Chamber

[Jane Ellison]

I have already mentioned HMRC’s outreach work, which I will certainly be encouraging. More promotional opportunities are planned, and I know that the Minister for Civil Society will say more about that at the end of the debate. It is a fair point and we want to make it easier, but obviously there are people who just do not know about this and still perceive barriers, so everything we can do to challenge that is welcome. We are extremely keen to hear thoughts from across the House on how we can do that, so we are always listening. I am very happy to put those suggestions to HMRC, and I know that my ministerial colleague will be happy to consider that in his Department as well.

Let me clarify the anomaly and how we are addressing it. The anomaly in the original legislation allows some charities to claim more than others, based only on how they are structured. The Government welcome the supportive and constructive approach adopted by the Church of England, the Roman Catholic Church and other religious groups during the recent consultation on the change.

The Bill also considerably relaxes the rules on where charities can receive donations that are still eligible for the gift aid small donations scheme. Currently, the scheme’s so-called community buildings rules mean that charities can claim top-up payments only on donations received during charitable activities that take place within the community building. However, we know that many local charities, although based in community buildings, carry out most of their activities in the local community, away from the building itself, which means they are unable to benefit fully from the small donations scheme. The Bill therefore relaxes the rules to allow charities based in community buildings to claim top-up payments on donations received outside the building but within the local community area. Colleagues will be delighted to know that, among the many small, local civil society groups, the scouts and guides, the air and sea cadets and other local uniformed groups, in particular, will benefit significantly from this change and will be able to receive the support they deserve for the vital work they carry out in our communities.

Taken together, this package of reforms has the potential to provide a real boost to many charities, particularly the up to 9,000 new charities that apply for recognition by HMRC each year. Based on provisional estimates, these changes are expected to benefit charities by £15 million a year, a significant increase that underlines the Government’s commitment to supporting a greater number of charities and a greater number of donations. The final figures will be certified by the independent Office for Budget Responsibility as part of this year’s autumn statement.

So far I have talked about the changes that will further support our charities. Let me turn briefly to the tax-free childcare aspects of the Bill, which will help us ensure that it is easier for hard-pressed parents to receive the support they need. In the previous Parliament we legislated to introduce tax-free childcare. That will provide up to £2,000 of Government support for childcare costs per child a year, which parents can use with any childcare provider they choose. The idea is that they can simply apply online to open an account for each child, and that for every £8 a parent pays in, we will pay in an additional £2. The system will be trialled later this year and then gradually rolled out to parents from early next year.

During our user testing of the system to date, we have found a couple of minor technical issues that we need to resolve in order to make it as straightforward as possible for parents. The Bill therefore makes two minor technical amendments to ensure that the scheme operates as intended. The first technical change relates to the duty of parents to confirm that they remain eligible to receive tax-free childcare each quarter. The Bill will allow greater flexibility over when parents are asked to make this confirmation. It will mean that once a quarter parents can confirm their eligibility for all their children at the same time, rather than having to do it separately for each child if they registered them at different times.

The second technical change will mean that parents can use a standard online form if they want to query a decision. That will make the process much more straightforward and convenient. We still want to ensure that everyone can ask for a review, so anyone who would struggle to get online will still be able to raise their queries in other ways.

[Mark Durkan (Foyle) (SDLP)]

Can the Minister confirm that what she has said is that credits will be available for each child, and that there will not be a two-child limit, as is proposed for working families tax credits? Can she compare the regime that will be offered under this Bill, which has shown great consideration to parents, with what would be the case for families on working families tax credits?

[Jane Ellison]

I might have to come back to the hon. Gentleman on the latter point about the comparison, because it is not really within the scope of the Bill. I can confirm that we are proposing only two changes—everything else is unchanged from the original legislation, and we are not proposing that there should be any other changes in the Bill.

As I said at the outset, the changes made through the Bill are relatively minor and technical, but they are important, whether they are making it easier for more of our charities to claim extra funding to support the fantastic work they do up and down the land in our constituencies, or whether they are making sure that hard-working parents can access tax-free childcare in the most simple and efficient way possible when it is introduced. The Small Charitable Donations and Childcare Payments Bill delivers against both those objectives, and I therefore commend it to the House.

Tax Credits: Concentrix

Debate between Jane Ellison and Mark Durkan

Wednesday 14th September 2016 Commons Chamber

[Jane Ellison]

I am sorry to hear that the hon. Gentleman had that difficult experience. I cannot agree with his general point about there being no role for the private sector in this regard. I refer again to the amount of money that has been saved for the taxpayer. There is a lot of error and fraud in the system, and it is important that we bear down on that. We do not want money to go to people for whom it is not appropriate, in particular in relation to the nature of people’s households. Much of the fraud does rest in that area. As he highlights, this is a particularly difficult and sensitive area to investigate, but we need to continue to investigate it because the amount of fraud in the area of tax credits is considerable.

[Mark Durkan (Foyle) (SDLP)]

We can all share the stories of our constituents’ anguish and the frustration for our offices in dealing with this debacle, but we should remember that HMRC is itself not an innocent agent. It designed the contract. It put customer hostility and suspicion into the contract, and into the standards of performance and practice. It was, of course, HMRC that provided the names targeted by Concentrix. This has happened against a backdrop of the Government persistently running down the capacity and character of HMRC. Will some of those bigger policy misguidances also be looked at, as well as the enjoyment we are all having today in scapegoating Concentrix itself?

[Jane Ellison]

I return to the answer I gave a moment ago. We need to continue to bear down on fraud in the system. There is a considerable amount of error and fraud. I am afraid it would be naive to think that all of this is error. There is fraud in the system and there is a lot of error, which the original design of tax credits makes easier. We need to continue to bear down on fraud, but clearly we need to do that in a way that does not make it difficult to assist the most vulnerable.

Oral Answers to Questions

Debate between Jane Ellison and Mark Durkan

Tuesday 22nd March 2016 Commons Chamber

[Mark Durkan (Foyle) (SDLP)]

When will we have a decision on the future of the human papilloma virus vaccination programme? Will it be clear, and is there due engagement with the devolved counterparts?

[Jane Ellison]

As the hon. Gentleman knows, two programmes are going on. There is a very large-scale piece of modelling work going on with regard to the HPV vaccination for boys, and that work, as I have previously told the House, will look to report in 2017. We already have guidance on HPV for men who have sex with men from the Joint Committee on Vaccination and Immunisation, and we are working through it in some detail to see how we can take it forward in practical terms.

Infected Blood

Debate between Jane Ellison and Mark Durkan

Thursday 21st January 2016 Commons Chamber

[Jane Ellison]

That is clearly the hon. Gentleman’s view and I invite him to submit it to the consultation. This is exactly why we are consulting. We have made some proposals, but some of the questions are very open, and we will look at what comes back from the consultation. I urge him and other Members to take part in the consultation.

[Mark Durkan (Foyle) (SDLP)]

I welcome the statement and commend the shadow Minister’s tone. Victims in Northern Ireland share the compound frustration that we have heard from other Members on behalf of their constituents, but maybe feel more pointedly the contrast with their friends in the south of Ireland, who have had a path of justice available to them over many years. I know the Minister is absolutely sincere in her commitment to the issue of treatment, but will she give assurances that the effort she is putting into making sure people can be made well will not detract or distract from the obligation we still have to make good this travesty that people have suffered?

[Jane Ellison]

I thank the hon. Gentleman for that question and his sustained interest over such a long time, speaking on behalf of people from his area. Based on our previous conversations, I recognise there might be aspects of the proposals that the hon. Gentleman does not feel meet his own aspirations, so again I invite him to respond to the consultation. I will take note of his—and all other Members’—views. These are our proposals. Some of the questions are very open and people can give us their views. I recognise that something different happened in the Republic of Ireland, and it is down to another Government to make those decisions. The circumstances were different for reasons I have gone into previously from this Dispatch Box.

Victims of Contaminated Blood: Support

Debate between Jane Ellison and Mark Durkan

Wednesday 16th December 2015 Commons Chamber

[Jane Ellison]

I cannot right the wrongs of 30 years; I can only try to do what I can in the circumstances, and with the money that we will allocate. We will present plans for a reformed scheme, and I invite the hon. Gentleman and his constituents to respond to them. In developing those plans, I must look to the future, and ask what we can do to support people with a reformed scheme. In particular, I must ask how we can respond to some of the ways in which the circumstances in which we address this terrible, difficult tragedy have changed, and ensure that our response reflects those new circumstances.

[Mark Durkan (Foyle) (SDLP)]

The Minister may recall that when the all-party group met her in early November we warned her that any slippage would be greeted as slipperiness by people who had suffered delays for too long. Does she appreciate that people will worry about the possibility that the extra time has been taken to ensure that the consultation is more controlled and options are sealed off? Will she also address the underlying question that people want to ask? Why, if liability could be admitted by the Irish health service on the basis that the risk was known, can liability not be admitted by the NHS, and why cannot compensation be forthcoming?

[Jane Ellison]

Payments made by the Republic of Ireland are a matter for the Republic, and they were made in response to circumstances in Ireland relating to the use of blood products. We have covered that before, in debates.

Of course I understand the hon. Gentleman’s frustration—I spoke to him informally last night to alert him to the fact that there was some delay—but I reiterate that it is better for us to produce a scheme into which we have had a chance to put more effort and a little more detail than, for the sake of a few weeks, to rush out something that would not give people any real sense of what was being consulted on. Although the delay is frustrating, as I have acknowledged a number of times, I think that it will give rise to a better and more meaningful consultation.

Secondary Breast Cancer

Debate between Jane Ellison and Mark Durkan

Wednesday 21st October 2015 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I congratulate all colleagues on an excellent debate. It is a shame that time has slightly beaten us. I fear it will beat me as well: if I am to allow a minute or so for my hon. Friend the Member for North Warwickshire (Craig Tracey) to respond at the end, I might not have the chance to make some of the points I would like to have made. Nevertheless, this debate in Breast Cancer Awareness Month is very timely for all the reasons mentioned. There have been some important contributions. I always enjoy listening to the hon. Member for Central Ayrshire (Dr Whitford); she brings incredible experience to debates of this nature.

As the cancer drugs fund was debated in this Chamber only yesterday with my hon. Friend the Under-Secretary of State for Life Sciences, I will not touch on that so that I save a little time. As others have said, we want to do a lot better in tackling cancer, and our aim is to lead the world. Survival rates are getting a lot better: for people diagnosed between 2011 and 2015, we are on track to save a projected 12,000 more lives a year. But we do want to go further. Nevertheless, as we ask what more we can do, we should acknowledge that we are making progress, although much of the rest of the world is too.

In January, NHS England asked the independent cancer taskforce to draw up a five-year strategy. It was published in July and recommends a range of improvements across the cancer pathway. Some Members were present in the House in July when the chair of the taskforce, Harpal Kumar, presented its conclusions to us. The strategy is an excellent bit of work and, as our manifesto made clear, we are working with the NHS, charities and patient groups to deliver it. It is important to tell the House that to support the delivery of the strategy, NHS England has appointed Cally Palmer, chief executive of the Royal Marsden NHS Foundation Trust, as NHS national cancer director. While continuing in her current position, she will lead the implementation of the strategy, alongside work to test new models of care at the Royal Marsden hospital and University College London hospital, in partnership with Manchester Cancer. Those are important developments.

The importance of secondary breast cancer was acknowledged in the taskforce report, which noted that all NHS trusts should now be recording recurrent and secondary breast cancer patients, but we acknowledge that uptake has been variable thus far, as highlighted in the opening speech. I made the importance of data collection one of the strategic priorities in my letter to Public Health England earlier this year, so we know that we need to do better.

Following a 2012 pilot managed by the National Cancer Intelligence Network, all breast units have been required to submit information on all patients diagnosed with a new recurrence or metastatic disease through the cancer waiting times process. For breast cancer cases, that now includes a data item on cancer recurrence. Data have been submitted monthly since January 2013, but collection remains challenging because relapsed patients may re-present in many different ways and through many referral routes, as the hon. Member for Central Ayrshire mentioned. For example, they might re-present through a routine follow-up appointment, by contacting their GP with renewed symptoms or by presenting with another unrelated condition, at which point secondary breast cancer has been diagnosed. There are some practical barriers, but we do need to do better.

To drive up the quality and completeness of the data, trusts are sent monthly reports so that they can benchmark themselves against other trusts, which has been effective in driving up performance in other areas of cancer care. Over the next year, those reports will include data on recurrence of cancer. In addition, more work is being scoped by NHS England and Public Health England based on the recommendation from the cancer taskforce to establish robust surveillance systems to collect relevant data. We know there is more to be done on the detection of secondary breast cancer, which can be diagnosed many years after primary breast cancer, as other Members have said. Although survival rates are improving, the breast cancer clinical reference group of NHS England is determined to ensure that everything possible is done to reduce the risk of secondary breast cancer. The group is in the final stages of producing a guideline on breast cancer services to improve information given to patients about the risk of secondary breast cancer. Such information is currently variable and sometimes inadequate, as highlighted by my hon. Friend the Member for Bury St Edmunds (Jo Churchill).

[Mark Durkan (Foyle) (SDLP)]

Will the Minister give way?

[Jane Ellison]

I will take the briefest of interventions.

[Mark Durkan]

The Minister touches on a point that reinforces the fact that, as a basic rule of thumb, policy makers and service planners should know the numbers and the needs. She addressed the numbers when she spoke about data. Knowledge about needs is best developed by listening to the patients themselves, who expressed those needs forcefully in the five-point bucket list from Breast Cancer Care.

[Jane Ellison]

I am sure we would all agree with that important point.

I will finish by discussing the new guideline that the clinical reference group is developing. The guideline will state that all patients with primary breast cancer should have a consultation with a clinician at the end of treatment that will include advice on spotting signs and symptoms that might indicate secondary breast cancer. That information will be delivered together with an assessment of the patient’s physical, psychological and social needs—I am interested in the distress thermometer that the hon. Member for Central Ayrshire mentioned, as well as in the contribution of the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron). The overall recovery package is being developed in partnership with Macmillan Cancer Support. The evidence is that that work is very effective where it has been done well. The advice that has been given will be recorded in the records of every breast cancer patient so that we know it has happened and so that we can track it.

NHS England hopes to publish the new guidance as a cancer resource on its website in the next few weeks. We will promote that guidance through the usual channels, but we would appreciate it if hon. Members with a particular interest, and particularly my hon. Friend the Member for North Warwickshire—I congratulate him on his appointment as co-chair of the all-party group—could draw this important document to people’s attention.

The clinical reference group will also consider how the care and support of patients diagnosed with secondary breast cancer can be improved, including through the provision of clinical nurse specialists. Of course, we agree that clinical nurse specialists play an important role. The number of patients reporting that they have been given the name of a CNS rose from 84% in 2010 to 89% in 2014, including 93% of breast cancer patients. We are doing a lot better, but hon. Members are right to highlight that, in the case of secondary breast cancer, we have some distance to go.

Members have said that we need to step up on palliative care, particularly in the light of last month’s debate—the hon. Member for Central Ayrshire made an important speech in that debate. We are committed to ensuring that everyone has access to high-quality, personalised palliative care. Breast Cancer Care’s new report, “Too little, too late”, is an important contribution to the debate about what we need to do. The Government have introduced five new priorities for end-of-life care—those are five important new principles—and my ministerial colleagues will be taking that forward. Nevertheless, I welcome Parliament’s new focus on palliative care and quality end-of-life care, which is important.

In the few seconds that I have remaining, I want to give people confidence that a lot of research is going on in this area. There is more research into cancer than any other disease in terms of National Institute for Health Research funding. In particular, the NIHR’s clinical research network is currently recruiting patients for nearly 100 trials and studies in breast cancer. One is a global trial that aims better to control secondary breast cancer using a drug called a dual mTOR inhibitor. I am delighted to say that the network recruited the first patient in the world to this trial, which I hope is an indication of the importance of our research infrastructure.

Contaminated Blood Products

Debate between Jane Ellison and Mark Durkan

Wednesday 9th September 2015 Westminster Hall

[Jane Ellison]

I have done my best to ensure that the House and individual Members are kept informed at all times. I have had a number of individual Member meetings. I will touch on this again, but I will of course look to keep the House informed on all important timelines, as we have to date. The all-party group, to whose comprehensive report my hon. Friend rightly referred, has informed our thinking, but there has never been a public consultation on any aspect of scheme reform. No Government have done that before, so this will be the first time that any formal public consultation has been undertaken.

[Mark Durkan (Foyle) (SDLP)]

Will the Minister give way?

[Jane Ellison]

No. I will touch on the issue of drugs, and if there is time afterwards, I will take another intervention.

Many Members are aware that a new generation of promising drug treatments is emerging that has the potential to offer an effective cure for many patients with hepatitis C. The National Institute for Health and Care Excellence issued guidance recommending two of the drugs earlier this year, and those are now routinely available on the NHS for eligible patients. NICE is developing guidance on three further treatments and has recently consulted on draft guidance. NHS England announced in June that it has made £190 million available this year so that patients with confirmed cirrhosis from hepatitis C can benefit from the new treatment options. In previous debates, I have offered advice to Members on how constituents who are worried that they are not getting access to those options, yet meet the clinical guidelines, can get access. In particular, it is important that patients to talk to their hepatologist.

We estimate that around 550 individuals infected with hepatitis C through historical treatment with NHS-supplied blood and blood products can now access the new treatments under the NHS’s interim commissioning policies. As the Secretary of State committed to on 25 March, the Department of Health is continuing to work to bring transparency to the matter of infected blood. The documents covering the period from 1970 to 1985 have been published in line with the Freedom of Information Act, and are available on the National Archives website. The Department is completing the transfer of the documents that we hold for 1986 to 1995 to the National Archives. Once those have been handed over, the National Archives will need to take the records on to its systems and make them available on its “Discovery” website. As to the precise date, we had hoped that it would be this summer, but for technical reasons the National Archives has indicated that it anticipates the documents being made available on its website after the January 2016 releases. I stress that that is only for technical reasons associated with the transfer of the documents.

I appreciate the House’s frustration and I am sorry that I will not be able to let the hon. Member for South Down back in to respond at the end. I understand the sense of urgency and the need for change. In hoping to reach a conclusion as soon as is practicable, I have, through the hon. Member for Kingston upon Hull North (Diana Johnson), offered parliamentarians a meeting ahead of the consultation so that I can hear their concerns and suggestions and so that they can contribute to shaping scheme reform.

Motion lapsed (Standing Order No. 10(6)).

Early Childhood Development

Debate between Jane Ellison and Mark Durkan

Thursday 30th January 2014 Westminster Hall

[Jane Ellison]

The hon. Lady will understand that that is not in my portfolio, but I am happy to draw her concerns to the attention of colleagues in whose portfolio it rests. I undertake to do so after the debate.

The Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich, has asked Public Health England to commission a rapid review of the evidence base for the Healthy Child programme, with a focus on primary prevention. The Department of Health is also working with the WAVE Trust, which was instrumental in developing the evidence base for the manifesto, with the Early Intervention Foundation and with others to explore how valuable work in prevention can be built upon. We will be interested in the outcomes of that evaluation.

[Mark Durkan (Foyle) (SDLP)]

The Minister has referred to looking at the issues by drawing on data and evidence that are available in the English context. As well as sharing that, importantly in this context, will she ensure that questions in the “The 1001 Critical Days” manifesto are addressed at the level of the British-Irish Council? That would enable all eight Administrations throughout these islands who face such challenges in common to share their experience, good practice and piloting. The work could be elevated to that level rather than all the different Administrations trying to do the same things back to back.

[Jane Ellison]

The hon. Gentleman makes a good point, and I have regular dialogue on matters in my portfolio with Members of the devolved Administrations. I am happy to look into that point after the debate, because some of the lessons to be learned are universal across different countries in the UK.

There has been a lot of interest in health visitors. They and their teams lead the delivery of the Healthy Child programme, and of course they are the bedrock of our children’s public health services. They are often the first professionals to recognise that a mother is depressed or that parents are struggling with the negative effects of many sleepless nights; we have had a few descriptions of those from colleagues in this debate. Through their work, health visitors can have an impact on the well-being of the whole family. Because of their vital preventive role, the Government are committed to growing the health visitor work force by 4,200 by the year 2015 and to transforming health visiting services to improve outcomes and reduce inequalities in the nought-to-five age group.

Taking up the point about whether recruitment is on track, and weaving in the point made by my hon. Friend the Member for South Northamptonshire, we believe that we are on track. There have been a couple of challenges in one region, to which we are now responding, but the rate of increase in health visitors will increase. It is determined by training intakes, which determine the rate of qualification and entry into the profession. We are happy that that is on track. I give that assurance to the shadow Minister. The latest health visiting work force data that we have, which are from October 2013 and were published this month, show that the total number of health visitors nationally is 9,770 full-time equivalents. Overall, there are 1,678 more health visitors than the May 2010 baseline of 8,092. That is a growth of 21%, but we intend to grow that number more, as we have said, because we think it is so important and crucial to the aims of the manifesto.

On troubled families, we know that some families have multiple problems and cause problems in the community around them. I will not go into a lot of detail, but there is clearly relevance and read-across from some of the early years issues that we have been discussing in this debate. In particular, I have seen the Troubled Families programme in my area encouraging critical working together and getting everyone around the same table to consider people and families as a whole.

That programme will have done a great deal of good to embed that idea and approach as good practice for many local authorities. There is a strong read-across to the other things that we are discussing about earlier years, and in some cases, of course, they will be the same families, depending on the nature of the family. I have certainly seen in my area, and in lots of the other pilot areas, how services have embraced the opportunity to stop working in silos and consider a whole family’s needs instead. I hope that that will become orthodoxy in how we move forward with Government policy in numerous areas and in the local government approach to things.

The Government are increasing local authority budgets by £448 million over three years on a payment-by-results basis to support troubled families across England. Again, my ministerial colleague is meeting those involved in the Troubled Families programme to discuss the health contribution to this valuable programme, and he can then address some of the points to which I will draw his attention as a result of this debate.

I do not have time to go into much detail, as I am aware that I have already made a long speech, although I am drawing to the end of it. I have many points to respond to, but I wanted to touch on the points about social mobility made by my hon. Friend the Member for East Hampshire (Damian Hinds), which I have heard him articulate before. He discussed how to support parents. I think that my hon. Friend the Member for South Northamptonshire was present when Alan Milburn, presenting his most recent social mobility report, urged Government and politicians generally to break what he called one of the “last taboos” of public policy, which is telling people how to be good parents and supporting them to be good parents. That is an interesting challenge for us all to consider and respond to, because it is undoubtedly difficult terrain for both Governments and individual politicians.