Leasehold Reform (Ground Rent) Bill [Lords]

Debate between Justin Madders and Mark Tami

2nd reading
Monday 29th November 2021 Commons Chamber

[Justin Madders]

My hon. Friend makes an interesting point. There is clearly an imbalance. We have already talked about how some enthusiastic first-time buyers who just want to get into their new homes put their trust in the people who have been assigned to deliver the legal niceties such as putting a value on the property and doing the conveyancing. They put their trust in those people, and sometimes that trust is betrayed through the egregious injustices that we have talked about.

[Mark Tami]

My hon. Friend has mentioned management fees, which I see as the next scandal coming down the road. People who bought their properties and were being charged perhaps £100 or £200 a year will have thought that that was okay, but that might now have gone up to £500 or £600 and there are often additional charges because, for example, fences or certain parts of the ground are not covered. People have told me that they feel they are paying their council tax twice. That is how they see it, and it is totally unfair.

[Justin Madders]

I thank my right hon. Friend and neighbour for his intervention, which leads me beautifully into the next section of my speech, in which I shall talk about exactly that.

I will never accept that it is right for developers to choose not to pay a sum to councils to adopt the communal areas, and that they instead save themselves money by passing on that cost to the homeowners and then make even more money from the homeowners by charging them for things that ought to be coming out of their council tax. Like my right hon. Friend, I worry that this trend will be accelerated because the ground rent gravy train is coming to an end, and that we will hear more and more stories of homeowners having no choice but to pay inflated annual service charges that, given the choice, they would prefer to pay through their council tax.

Historical Stillbirth Burials and Cremations

Debate between Justin Madders and Mark Tami

Thursday 6th February 2020 Commons Chamber

[Mark Tami (Alyn and Deeside) (Lab)]

We all agree that the woman, and indeed the whole family, should receive that psychological support if they need it, but just saying it does not mean that this help is getting to the people it should be reaching. In many cases, people find it almost impossible to get that support.

[Justin Madders]

I thank my right hon. Friend for his intervention, as he raises the very point: the support is not consistent across the piece. We rightly raise that issue when we discuss these matters, because we need better support, better funding and better delivery of these specialist services. As he says, this is a difficult issue and support is needed at the right time.

NHS Funding Bill

Debate between Justin Madders and Mark Tami

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Justin Madders]

The hon. Gentleman makes an important point. We have all heard horror stories of workers in the health service having to turn on seven or eight different computer systems and use fax machines and pagers— there were so many fax machines in the NHS I used to think the previous Health Secretary was sponsored by Rank Xerox. It is a serious point though. If we are to improve patient outcomes, we will need to move with the times and get the benefits of technological improvements.

[Mark Tami (Alyn and Deeside) (Lab)]

My hon. Friend will agree on the importance of the Countess of Chester Hospital to his area and mine. It is quite a unique hospital, in that it was built to serve the people of Deeside in north Wales as well as Chester and the surrounding area, so is it not strange that, although many in my area rely on it, I will not be allowed to vote on the Bill today?

[Justin Madders]

My hon. Friend makes a pertinent point. Both my parents are residents of north Wales but on occasion use the Countess of Chester Hospital. This process does not take account of the reality on the ground. As I said before, the fact that there will be Barnett consequentials from the Bill suggests that we have made a serious error in not allowing those from the devolved nations to vote on it.

We know what some trusts have told us about the lack of capital investment and what that means on the frontline: Morecambe Bay has said it has “unsuitable” environments for safe clinical care that have led to the closure of its day case theatre; the Queen Elizabeth Hospital in King’s Lynn has warned of a direct risk to life and patient safety from the roof falling in; and at the Royal Derby Hospital, a failing emergency buzzer system in the children’s ward means that staff would be unable to warn colleagues if something went seriously wrong. That is not acceptable.

The capital maintenance backlog will not be addressed unless the Government take note of what NHS Providers says in the report that came out this morning. It talks about the need for the NHS to have a multi-year capital settlement and a commitment from the Government to bringing the NHS capital budget in line with those in comparable economies, which would allow the NHS to pay for essential maintenance work and invest in long-term transformational capital projects of the kind we have touched on. One of our criticisms of the Bill is that capital allocations have not been included in the figures in clause 1, so in order to protect those allocations we have tabled amendment 3, which we hope to push to a vote, to stop the Government’s continual sticking-plaster approach.

I move now to performance targets and our new clause 4. We all know about the record investment and record patient satisfaction levels that the last Labour Government bequeathed to the Conservatives, but another part of their legacy was the NHS constitution, introduced as part of a 10-year plan to provide the highest quality of care and services for patients in England. It included a clear statement of accountability, transparency and responsibility, and standards of care for accessing treatment. These are the figures we often trade across the Dispatch Box.

Only last month, across this very Dispatch Box, the Prime Minister gave us assurances on performance. He said:

“We will get those waiting lists down”—[Official Report, 15 January 2020; Vol. 669, c. 1015.]

We would all like to see that, but we should remind ourselves of the Government’s sorry record: the target for 95% of patients being seen within four hours in A&E has not been met since July 2015; the target for 92% of people on the waiting list to be waiting fewer than 18 weeks for treatment has not been met since February 2016; the target for 1% of patients waiting for more than six weeks for a diagnostic test has not been met since November 2013; and the NHS has not met the 62-day standard for urgent referrals for suspected cancer treatment since December 2015. I fail to see how the Prime Minister can drive down waiting lists when the level health expenditure he is proposing is not enough to meet existing demand.

Health Service Medical Supplies (Costs) Bill

Debate between Justin Madders and Mark Tami

2nd reading: House of Commons & Programme motion: House of Commons
Monday 24th October 2016 Commons Chamber

[Justin Madders]

I thank my right hon. Friend for his intervention and pay tribute to him for his great work on diabetes. It is a matter that he consistently raises in the House, and he is right to do so. Of course he is right that there are many ways in which the diabetes bill can be tackled, and some of the shocking statistics that I have seen on the level of take-up of education courses is something on which we can do much better.

We support the broad aims of the Bill and of what the Government are trying to achieve, but we have a number of concerns, which I hope the Minister will address when this debate is drawn to a close, both about what is in the Bill and about the Government’s policies more widely on access to treatments.

Historically, the technical mechanisms used by the NHS to control expenditure on medicine have not set the public’s imagination alight, but in June we were all appalled to read reports that a small number of companies were exploiting loopholes to hike up the cost of medicines. In the past few years, we have also seen headline after headline about one effective treatment or another being denied to patients in desperate need on the basis of cost. I will address each of those issues after briefly touching on the Government’s proposal to harmonise the statutory and voluntary schemes for price control and on the new reporting requirements.

As we have heard, there are currently two schemes for controlling pricing: the voluntary scheme, the pharmaceutical price regulation scheme, which applies to the vast majority of suppliers; and the statutory scheme, which, in 2014 covered around 6% of branded medicine sales in the UK.

The voluntary PPRS scheme is based on companies making payments back to the Department of Health based on their sales of branded medicines to the NHS. By contrast, the statutory scheme operates on the basis of a cut to the published prices of branded medicines. These different approaches appear to have produced different results. Since 2014, the statutory scheme has delivered significantly lower savings than those of the PPRS, partly as a result of companies either switching individual products or switching wholesale into the statutory scheme, which is one reason why we have seen a significant reduction in the level of the rebate. Therefore, we support the rationale behind aligning the two schemes, which will create a more level playing field between companies and also give us a better chance of delivering greater savings to the taxpayer.

However, as we have heard, this Bill extends beyond closely aligning the two schemes and adds a new provision, giving the Secretary of State the power to require all medicines manufacturers and suppliers to provide information relating to prices.

[Mark Tami (Alyn and Deeside) (Lab)]

My hon. Friend will know—I am sure that we all know this—that there is a difference between the list price that is advertised and the price that the NHS actually pays. That is a very important point, and we have to be very careful that, in gaining all this information, we do actually bring down the cost for the NHS. Those companies may well charge other people higher amounts, and we need to put that in context.

[Justin Madders]

My hon. Friend is absolutely right. That is one reason why we must tread carefully, and hear what regulations the Government produce for consultation.

Some of the measures did not form part of the initial consultation, and there is a feeling that they have been added to the Bill at the last minute. Given the damaging cuts to the community pharmacy sector that were announced only last week, there is an anxiety about what costs could be created by any additional administrative burden.

--- Later in debate ---

[Justin Madders]

We will not get very far with this Government on corporation tax. They have been going in a direction that we would not have chosen. They have decided on the measures in the Bill as the best way to control prices and we will see how they get on. Will the Minister confirm that if it becomes clear in a few years that we have opened up another set of loopholes, we can expect the Department to take the lead and to be proactive in its investigations, rather than relying on a team of journalists to expose the problem?

We know that in Scotland the rebate that has been generated has been used to create a dedicated fund to give patients access to new medicines. Will the Minister consider investigating similar models and ensuring that the benefits of the scheme are used for the purpose of improving our frankly poor record in allowing patients to benefit from new medicines? We accept that there will always be challenges in matching funding to new drugs, but there is at least a degree of logic in allowing savings made in the drugs bill to be reinvested to enable new products to reach patients more quickly.

We welcome today’s report by the Accelerated Access Review, which sets out an ambitious plan that could see patients accessing new lifesaving treatments up to four years sooner. We hope the Minister will take this opportunity to give financial backing to the aims of the review by committing to using future rebates from the pharmaceutical sector to improve access to treatments. I ask the Government to seriously consider this, as there are growing concerns about access to new drugs and treatments in this country, and particularly about the widening gulf between the UK’s record on developing new drugs and the ability of the NHS to ensure that all patients benefit sufficiently.

The “International Comparisons of Health Technology Assessment” report published in August by Breast Cancer Now and Prostate Cancer UK shows that NHS cancer patients in the UK are missing out on innovative treatments that are being made available in some comparable countries of similar wealth. This is at the same time as a number of medicines have been delisted by the Cancer Drugs Fund after it overspent its budget, and the failure to extend this scheme to innovative treatments as well as medication. There was a report in The BMJ in July entitled “A pill too hard to swallow: how the NHS is limiting access to high priced drugs”. It came to similar conclusions when looking at new antiviral drugs that held out a real prospect of eliminating hepatitis C but which were very expensive.

[Mark Tami]

Does my hon. Friend agree that we have to be careful not to discourage drug companies from doing research, particularly into those rarer illnesses, because they would not see a financial return?

[Justin Madders]

My hon. Friend is absolutely right. We must be careful of the law of unintended consequences with this piece of legislation. Commercial decisions will be taken on investment if the return is not sufficiently high, so we have to get the balance right between encouraging investment and getting value for money for the taxpayer.

The BMJ report showed how NHS England, having been unable to budget for broad access to the drugs I mentioned, sought to alter the outcome of the National Institute for Health and Care Excellence process and, when it failed, defied NICE’s authority by rationing access to those drugs. There was also widespread controversy over attempts by NHS England to avoid funding anti-HIV pre-exposure prophylaxis by passing on responsibility to local authorities at the same time as cutting the public health budget allocated to councils. If we are to strive to create a level playing field for drugs companies, we should look to do the same for patients and their ability to access treatments.

Labour established NICE to speed up the introduction of clinically proven and cost-effective new medicines and procedures. An order was made by Parliament in 2001 to mandate the funding of healthcare interventions approved by NICE through its technical appraisal process. They were intended to be available to patients three months after publication of the appraisal. However, subsequent orders have chipped away at that, culminating in the current consultation by NICE and NHS England, which will again potentially delay or deny access to important treatments. Therefore, as well as looking at ring-fencing the payments received under this scheme, will the Minister look more widely at access to medicines? Successive studies have demonstrated that there is relatively low take-up of new medicines by the UK compared with other high-income countries. Not only does that let patients down, but it could impact on the future of the pharmaceutical industry in the UK, particularly given the sector’s concerns about the relatively small value of sales in the UK, compared with other countries, and given the uncertainty surrounding the future of the European Medicines Agency following our decision to leave the European Union.

I am sure Ministers are aware of the concerns that have been raised about that and of the need to ensure that the country is still seen as a leader in the research sector. The Prime Minster has said:

“It is hard to think of an industry of greater strategic importance to Britain than its pharmaceutical industry”,

and the Opposition agree, but we cannot be complacent about the state of UK pharma, particularly as investment decisions are often made by parent companies based in other parts of the world. I hope the Minister will take seriously the interrelationship between decisions about access to treatments and the future of pharmaceutical research and development in the UK, particularly when we know that other countries across Europe are using the current uncertainty as a result of Brexit to eye up opportunities to steal a march on our own industry.

To conclude, the Opposition support the broad aims of the Bill and what the Government seek to achieve in terms of better controlling the cost of medicines. In Committee, we will seek to explore in more detail the new information powers and the details of the impact of those new powers on the supply chain. We will also continue to hold the Government to account and ensure that patients are able to access the best available treatments without any unnecessary delay.