(8 months ago)
Commons ChamberI thank the hon. Gentleman for giving me the opportunity to put to bed completely the idea that there has been any change in our policy. We have always signposted that support. The only thing the DWP has done is brought in a new slip to replace the one used previously. There is no change to the existing policy, but the new slip allows us to improve our existing practices and to comply with our departmental responsibilities under GDPR. Our jobcentres continue to provide customers with guidance to find that additional support, including signposting to emergency food support where appropriate. We stand ready to help people when they are most in need.
The hon. Gentleman mentioned the two-child policy. The latest statistic that we have for households in receipt of universal credit is that the majority of families—some 78%—have fewer than three children. Surely it is right that all families, whether in receipt of universal credit or not, should face the same financial choices when deciding whether to grow their family.
While our actions have shown that we remain committed to a strong welfare safety net—particularly during challenging economic times—we know that the best way we can help is through support to move into work. That approach is based on clear evidence on the role of full-time work in substantially reducing poverty. The latest statistics show that working-age adults in workless households were about seven times more likely to be in absolute poverty after housing costs. Children living in workless households were more than six times more likely to be in absolute poverty after housing costs than those in families where adults work. There are now over 1 million fewer workless households in the UK than in 2010—that is 680,000 fewer children growing up in a home where no one works. That is a cause for some gratitude.
There are more than 900,000 vacancies across the UK, and through our core job centre offer we are firmly supporting people to get into work. We support them with travel costs through the flexible support fund, with face-to-face time with work coaches, and help with interviews. The voluntary in-work progression offer is in all jobcentres across Britain, providing an estimated 1.6 million low-paid workers on universal credit with access to personalised work coaches.
We have also reduced the taper rate from 63p to 55p in the pound. We provide childcare costs, capped at £1,000 for a single child and more than £1,700 a month for larger families. We can even help with the advance.
To ensure that work pays, we have put the national living wage for people aged over 21 up by over 9.8% to £11.44 an hour, as the hon. Member mentioned. That makes sure that people are rewarded for the work they do, and it means an extra £1,800 for someone working full time. We are also providing a tax cut for 27 million people by further reducing the main rate of class 1 national insurance contributions.
Our focus continues to be on providing opportunities for people to be supported and to succeed in work, based on our firm belief that this is a sustainable way of tackling all forms of poverty. At the same time, we understand the challenges that people face, and we will continue to work across Government and party to ensure food security and that the broader welfare system will support those who need it.
Order. I wish to inform the House that the message to the Commons from the Lords is that the Lords do not insist on their amendment to the Safety of Rwanda (Asylum and Immigration) Bill to which the Commons disagreed.
Question put and agreed to.
(10 months, 3 weeks ago)
Commons ChamberIt gives me great pleasure to confirm that the Government give their full support to this private Member’s Bill. I thank my hon. Friend the Member for Tewkesbury (Mr Robertson) for bringing forward what he said was a small and limited piece of legislation, but we have heard over the past hour and a bit how important these small changes will be to those affected. I thank my hon. Friend the Member for North East Bedfordshire (Richard Fuller), my right hon. Friends the Members for East Yorkshire (Sir Greg Knight) and for Ludlow (Philip Dunne), and my hon. Friends the Members for Stoke-on-Trent Central (Jo Gideon), for Shipley (Philip Davies) and for Aylesbury (Rob Butler) for their contributions.
My hon. Friend the Member for Shipley explained why the alignment is ultimately a good idea. As we have heard, a life-limiting illness can cause unimaginable suffering for the patient and their loved ones—and that is just at diagnosis, yet alone across the trajectory of the disease. Many people have said that they feel as though they have been hit by an emotional tsunami, and we should do anything we can to help and support those nearing the end of life. My hon. Friend the Member for Stoke-on-Trent Central poignantly outlined some of the challenges that people can face at this stage in their life.
Many charities have been mentioned, but I pay particular tribute to Marie Curie, which often provides nurses who sit with people as they near the end of life. It is an incredible service for our constituents, and ensures that people do not die alone. Its work is incredibly important—its motor neurone disease campaign has been mentioned—but we must also thank people in the hospice sector and more broadly across the NHS, particularly those who work in end-of-life and palliative care.
We have heard much about the Social Security (Special Rules for End of Life) Act 2022, which changed the special rules process to allow simple and fast access to financial support through the benefit system. The changes made in the Act covered the disability living allowance, the personal independence payment and the attendance allowance, and ensured that people at this most difficult of times could receive their support more quickly and easily. The special rules were then extended to universal credit and employment and support allowance through secondary legislation that came into force on 4 April 2022. Under those rules, claims are fast-tracked and a medical assessment is not required. No waiting period is applied, and in the majority of cases the highest level of benefit is awarded. Since 1990, eligibility under the special rules had been limited to those who had been diagnosed with a condition that meant that they were unlikely to live for more than six months. The changes that the Government made in 2022 meant that people receiving certain social security benefits who were thought to be in the final year of their life were shown additional compassion and were able to receive that vital support six months earlier.
When the 2022 regulations came into force, they were welcomed by key end-of-life charities such as the Motor Neurone Disease Association, whose chief executive said at the time:
“I welcome the announcement that changes to the Special Rules will come into force next month. This change will enable more people living with complex and unpredictable terminal illness like motor neurone disease to access the support they need swiftly and sensitively. This is an important first step and we hope that this positive change can be enacted for other applicable benefits as soon as possible.”
Marie Curie also welcomed the changes, saying that they would
“make it easier for terminally ill people to access support quickly”,
and that
“the scrapping of the six-month rule for fast track access to benefits is a significant step forward.”
Macmillan Cancer Support said:
“Patients deserve better co-ordination of care into the last year(s) of life and this change gives us a brilliant opportunity to help them benefit from end of life financial support while having treatment, so they can make the most of the last year(s) of life.”
This Bill takes a further step in supporting those with a terminal illness by extending similar support through compensation payments made by the Pension Protection Fund and payments under the financial assistance scheme. As my hon. Friend the Member for Tewkesbury explained, the Pension Protection Fund pays compensation to members of eligible defined benefit pension schemes if the sponsoring employer became insolvent on or after 6 April 2005 and the scheme has insufficient assets to meet its pension liabilities. Members can claim their compensation payments before their scheme’s normal pension age, generally from the age of 55. The financial assistance scheme makes payments to members of qualifying schemes that are unable to meet their pension liabilities in full.
Currently, members of the PPF who are not yet entitled to receive compensation may make an application to their scheme for a terminal illness payment if they are expected to live for six months or less. Terminal illness is currently defined in legislation as
“if... the person’s death in consequence of that disease can reasonably be expected within 6 months.”
The Bill amends that definition to ensure that members with a life expectancy of up to 12 months can now receive the payments. It will restore the original policy intention of alignment between the social security special rules and the Pension Protection Fund. The same definition applies to the financial assistance scheme, and the Bill therefore amends that definition as well. The financial assistance scheme differs from the PPF in that a terminal illness diagnosis allows payments from the financial assistance scheme to be put in place immediately, rather than a specific lump sum being provided.
My right hon. Friend the Member for East Yorkshire and my hon. Friend the Member for North East Bedfordshire asked what consultation we had carried out. As I think my hon. Friend the Member for Shipley mentioned, we have consulted general practitioners, consultants, specialist nurses and other medical professionals.
Some may argue that the Government should take a more open-ended approach and not put any time limit on the payments. That argument, as we have heard, may be particularly pertinent for those who have conditions such as motor neurone disease, chronic obstructive pulmonary disease, Parkinson’s disease and a plethora of other conditions that can make it exceedingly difficult for clinicians and doctors to accurately predict how much time a patient has until the end of their life.
Unfortunately, there is not a clearcut, correct answer on how terminal illnesses should be defined, so as my hon. Friend the Member for Tewkesbury said, that should be left to the professionals. In recognition of that, the 2022 Act was preceded by an evaluation in which the majority of clinicians who responded said that a 12-month definition was preferable, as it would bring the special rules for benefits into line with NHS practice and NHS initiatives, such as the gold standards framework. The Department agreed, and the 2022 legislation aligned the definition of terminal illness with that used in the NHS, providing consistency for clinicians and tying the special rules into the NHS long-term plan to provide proactive, personalised and well co-ordinated care for all those in their final year of life.
This Bill builds on the previous legislation by aligning the definition used for the Pension Protection Fund and financial assistance scheme payments with that used more widely in the Department for Work and Pensions and the NHS. The Government believe that the 12-month timeframe is appropriate for defining the period for serious ill health payments in tax law. For an individual to meet the definition of a person in serious ill health, evidence is required from a registered medical practitioner that the individual is expected to live for less than one year.
The Pension Protection Fund may be a compensation scheme, rather than a pension scheme, but in many ways it is treated as a pension scheme for taxation purposes. That means that the Pension Protection Fund terminal illness payment falls under the category of a serious ill health lump sum. That allows it to be paid without triggering unauthorised payment tax charges on either the individual or the Pension Protection Fund. Extending the definition of terminal illness to longer than a year would open up members to significant tax charges on their terminal illness payments, which is not what the Government want at all.
My hon. Friend the Member for North East Bedfordshire asked about the impact on the levy. We believe that the cost to the Pension Protection Fund will be marginal. Most members will simply get their payments earlier. He also asked about pension funds having a 12-month provision. The benefits provided will depend on scheme rules. We do not know how many schemes have such a provision, but we believe that many schemes already provide early access to lump sums for terminally ill members, or those with a life expectancy of 12 months or less, because that is allowed under tax law.
My hon. Friend the Member for Shipley and my right hon. Friend the Member for East Yorkshire asked about commencement. As with any Bill that passes through both Houses, it will come into force on a day appointed by the Secretary of State. It is the intention for that to be as soon as practicable after Royal Assent, to ensure that all measures relating to the Pension Protection Fund and financial assistance scheme come in at the same time.
I heard that my right hon. Friend the Member for Ludlow had written to the Secretary of State, and I will make sure that an answer comes to him in a timely way. He asked who makes the decisions; the answer is clinicians, medical assessors and specialist nurses. In response to my right hon. Friend the Member for East Yorkshire, let me say that one can obtain a second opinion, and that goes for all the illnesses that I mentioned.
I thank all hon. and right hon. Members for their contributions, and for the sensitive way in which they have approached this matter. I appreciate the “time-bound” argument that my hon. Friend the Member for Shipley put forward, but these matters are always a challenge for clinicians. I agree with him and my hon. Friend the Member for Stoke-on-Trent Central that a better conversation about end of life, and how we treat issues as we move forward into that stage of our life, would be a very good thing for us all. We should be a lot more discussive about it.
I thank my hon. Friend the Member for Tewkesbury for bringing forward the Bill and all right hon. and hon. Members for their contributions. These changes will make a significant, positive impact for people nearing the end of their lives by ensuring that most pension fund members will be able to receive a payment at an earlier stage. That will give them the financial support they need at a most difficult time for them and their families, as well as help them plan more effectively to get the most out of the finances they are due. These changes send a message about end of life: that the conversation must be alive and vibrant for us all, so that we do the best we can. I am pleased to support the Bill and wish it a speedy passage through both Houses.
I call Mr Laurence Robertson to wind up, with the leave of the House.
(3 years, 11 months ago)
Commons ChamberI beg to move, That this House agrees with Lords amendment 1.
With this it will be convenient to discuss the following:
Government motion to disagree with Lords amendment 2.
Government motion to disagree with Lords amendment 3.
Lords amendments 4 to 10.
Lords amendment 11, and Government amendments (a) to (d) thereto.
Government motion to disagree with Lords amendment 12.
Government motion to disagree with Lords amendment 13.
Government motion to disagree with Lords amendment 14.
Lords amendments 15 to 21.
Lords amendment 22, and Government amendments (a) to (c) thereto.
Government motion to disagree with Lords amendment 23.
Government motion to disagree with Lords amendment 24.
Government motion to disagree with Lords amendment 25.
Lords amendments 26 to 29.
Government motion to disagree with Lords amendments 30 and 31.
Lords amendment 32, and Government amendments (a) to (c) thereto.
Lords amendments 33 to 39.
Government motion to disagree with Lords amendment 40.
Lords amendments 41 to 47.
Government motion to disagree with Lords amendment 48.
Government motion to disagree with Lords amendment 49.
Government motion to disagree with Lords amendment 50.
Government amendments (a) to (c) in lieu of Lords amendments 2, 3, 12 to 14, 23 to 25, 30, 40 and 48 to 50.
Lords amendments 51 to 56.
I am extremely pleased to be back at the Dispatch Box to speak to this Bill. It is a changed Bill since we last looked at it but one that still has the patient at its heart. I am pleased that it comes back to us with the same spirit of consensus and collaboration that it left us with.
Since we had the Bill’s Third Reading, the pandemic’s evolution and the importance of the regulation of clinical trials, the roll-out and regulatory approval of a vaccine, and the ability of healthcare professionals to get medicines into patients has bought into sharp focus precisely how essential this Bill is. The Government made a number of amendments to the Bill through the other place in response to Committees of the House, the report of the independent medicines and medical devices review, led by Baroness Cumberlege, and, importantly, as a result of genuine, cross-party discussions on how to make this Bill better.
I am glad to say that the Bill still—and for those who know me, this is my passion—puts patients first: patients who will have the opportunity to trial new treatments; patients whose safety is paramount; patients who need to see quick and effective action from regulators in the event of an emergency. The Bill that left us on Report had a new change to it, anticipating Baroness Cumberlege’s report. The medical device information system, which will transform post-market surveillance of medical devices and improve the ability to track down patients and prevent harm, followed talks across this House and in the other place. I reiterate my thanks in particular to the hon. Members for Washington and Sunderland West (Mrs Hodgson) and for Central Ayrshire (Dr Whitford) for their contributions to that effort.
We said on Report that we awaited the conclusions of the Cumberlege review and that we would take steps when the review was published. I can tell the House now that we have, and Lords amendment 1 establishes a Patient Safety Commissioner—a champion for patients in relation to medicines and medical devices. I pay tribute to all those who have spoken here and in the other place of the impact of harm on patients and on women—those who have not been listened to whose stories are difficult and heart-wrenching. Much was said during the Bill’s passage in the other place about the whole system change to enshrine the voice of patients at the heart of the process and our commitment to it. The Patient Safety Commissioner will act within and outside the system. They will be an advocate for patients and ensure that the patient voice is primary. The commissioner will be able to seek information, make reports without fear or favour and expect responses, and, more importantly, get change.
Lords amendments 1, 41, 47, 54 and 56 together provide for both the appointment of a Patient Safety Commissioner and regulations to support this appointment. I congratulate Baroness Cumberlege and her team, and thank her and others who contributed to getting this into the Bill so quickly after her report.
Lords amendment 31 provides for a small but important change that was also recommended in that review: a power to put the devices expert advisory committee on to a legislative footing.
I am very conscious of the passion and commitment shown by the hon. Member for St Helens South and Whiston (Ms Rimmer) when we were last discussing the Bill. She has shown admirable determination. I am pleased to draw her attention to Lords amendment 8, which the Government were happy to support in the other place. That important amendment provides for provisions about the origin and treatment to be made in relation to the regulation of human medicines.
We have had two reports, one from the Delegated Powers and Regulatory Reform Committee and one from the House of Lords Constitution Committee.
(4 years, 6 months ago)
Commons ChamberI thank the hon. Gentleman for his contribution. These are unusual times, so it was my pleasure to work with the hon. Member for Central Ayrshire (Dr Whitford) to do what we could to ensure that the Bill proceeded with a degree of consensus, as it was to work with her on access to off-licence drugs some years ago.
Our consideration of the Bill has been led by good sense and common ground, and by general understanding and consensus about its purpose. I am grateful to everyone who contributed along the way. I think the themes we heard today and in Committee—the paramount importance of patients; the need to ensure that we carefully consider and scrutinise legislation and that it is made after consultation; and the use of data to underpin better regulation and improve safety—were the right ones for us to consider. Although it is not necessarily part of regulatory scrutiny, I am grateful to the hon. Member for St Helens South and Whiston for raising the important issue of the UK’s continued promotion of human rights and ethics.
I am grateful to the Clerks for their help; these are unusual circumstances, but I have felt no less supported and, working towards ensuring that we can make progress in the other place, we will continue to use imagination. The Bill is a framework for where we want to go. It will allow us to ensure that the regulation that governs critical areas that matter for us all and are likely to affect us all indirectly is up to date and supports the thriving life sciences sector and patients. To that end, I commend the Bill to the House.
Question put and agreed to.
New clause 1 accordingly read a Second time, and added to the Bill.
Clause 14
Fees, information, offences
Amendment made: 1, page 8, line 35, leave out “efficacy” and insert
“performance, including the clinical effectiveness,”.—(Jo Churchill.)
This amendment clarifies the matters relating to medical devices the recording of information about which may be the subject of provision in regulations under Clause 12(1).
Clause 35
Offence relating to information
Amendments made: 2, page 18, line 36, at end insert—
“(2) A person to whom information is disclosed under regulations under section (Information systems) commits an offence if the person uses or discloses that information in contravention of those regulations.”
This amendment and Amendment 3 provide that a person who discloses information in breach of regulations made under the new clause inserted by NC1 commits a criminal offence.
Amendment 3, page 18, line 37, after “subsection (1)” insert “or (2)”.—(Jo Churchill.)
See the explanatory statement for Amendment 2.
Clause 38
Power to make consequential etc provision
Amendment made: 4, page 21, line 41, leave out “and 12(1)” and insert
“, 12(1) and (Information systems)(1)”.—(Jo Churchill.)
This amendment enables regulations made under the new clause inserted by NC1 to make consequential and other provision.
Clause 40
Consultation
Amendments made: 5, page 22, line 11, leave out
“sections 1(1), 8(1) or 12(1), or paragraph 9 of Schedule 1”
and insert
“a provision of Part 1, 2 or 3”.
This amendment and Amendment 6 have the effect that the Secretary of State is required to consult before making regulations under the new clause inserted by NC1.
Amendment 6, page 22, line 29, after “section 12(1)” insert
“or (Information systems)(1),”.—(Jo Churchill.)
See the explanatory statement for Amendment 5.
Clause 41
Procedure
Amendments made: 7, page 22, line 32, leave out
“section 1(1), 8(1) or 12(1), or paragraph 9 of Schedule 1,”
and insert
“a provision of Part 1, 2 or 3”.
This amendment has the effect that regulations made under the new clause inserted by NC1 are to be made by statutory instrument.
Amendment 8, page 22, line 42, leave out
“section 1(1), 8(1) or 12(1)”
and insert
“a provision of Part 1, 2 or 3”.
This amendment and Amendments 9 to 17 enable regulations under powers in the Bill which are subject to negative procedure to be combined in a single statutory instrument with regulations under powers which are subject to affirmative procedure, or with regulations under powers in other legislation which are subject to negative procedure.
Amendment 9, page 23, line 12, leave out
“to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 10, page 23, line 13, at end insert
“if the only regulations under a provision of Part 1, 2 or 3 that it contains are regulations to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 11, page 23, line 14, leave out
“to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 12, page 23, line 16, at end insert
“if the only regulations under section 1(1) or 8(1) that they contain are regulations to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 13, page 23, line 18, leave out
“to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 14, page 23, line 23, at end insert—
“, if the only regulations under a provision of Part 1, 2 or 3 that it contains are regulations to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 15, page 23, line 24, after “to” insert
“—
(a) ”.
See the explanatory statement for Amendment 8.
Amendment 16, page 23, line 36, at end insert
“, and
(b) regulations under paragraph 9 of Schedule 1”.
See the explanatory statement for Amendment 8.
Amendment 17, page 23, line 37, leave out subsection (10).—(Jo Churchill.)
See the explanatory statement for Amendment 8.
Clause 43
Commencement
Amendment made: 18, page 24, line 15, at end insert
“, and
(d) section (Information systems)”.—(Jo Churchill.)
This amendment provides for the new clause inserted by NC1 to come into force two months after the Bill is passed.
Bill read the Third time and passed.
I will now suspend the House for three minutes.