Internationally Recruited Health and Social Care Staff: Employment Practices

Kwasi Kwarteng Excerpts

Wednesday 31st January 2024 Westminster Hall

[Kwasi Kwarteng (Spelthorne) (Con)]

I beg to move,

That this House has considered employment practices for internationally recruited health and social care staff.

I am very pleased to introduce this very important debate on a very important issue, which in the hubbub of the emotional conversation around immigration has not, as far as I am aware, been thoroughly discussed or even addressed; it relates to the critical work undertaken by people in the health service and particularly in social care. What I have noticed, and what has been brought to my attention, is that because of high levels of immigration, we have brought in people who are recruited to work in our health and social care system who have often, though not always, been badly treated and poorly paid.

We all know that the health and care worker visa has been exempted from the increase in the earnings threshold for skilled workers, so a lot of the people underpinning our social care and healthcare earn very little income; they are also often very vulnerable and not particularly fluent in English. Given the concern felt by everyone in the House about human trafficking and modern slavery, there is also a real concern that a large number of healthcare and social care workers are being exploited in a way that none of us wants to see.

There is a particular issue with regard to workers who leave their contract before an agreed period. The code of practice allows for this, but there has to be a reasonable expectation; fees owed as a result of workers leaving their contracts early should be reasonable. I have heard reports of fees in excess of £10,000. That is completely unacceptable. In that situation, the contracted employee is being exploited—and it very much has the look and feel almost of extortion. I am sure that the Minister is very concerned about this issue. In the midst of a very charged debate around immigration, it is something about which any Government professing humanity, and looking after our people, should be concerned.

On top of all the exploitation, and in the context of staff who are often highly vulnerable, there are reports that rogue international recruitment agencies have extorted —that is a word I use with some degree of caution, but they have extracted payments—from people. That is really a form, dare I say it, of trafficking. Often when the workers find themselves in the UK, perhaps because of language barriers or a lack of knowledge, they find themselves with no recourse; their employment conditions are often deplorable, but they cannot find a way to push back against some of the more extreme demands. I mentioned repayment clauses, and anecdotally I hear that there is often a lack of understanding of what exactly people are signing up to.

We all understand that we need people who can operate in our social care system and support us in maintaining the health of an ageing population, but that employment needs to be regulated. One statistic that particularly horrified me was that between January and September last year there were something like 76 reports and referrals with modern slavery and human trafficking indicators in the care sector alone. That is a couple a week, and of course that could be just the tip of the iceberg. I am very pleased to be able to have this debate, and I look forward to hearing what the Front Benchers—particularly the Minister—have to say.

I have spoken about the problem and outlined the situation broadly. I think we all feel a measure of concern about it, but we have to look forward and think about ways we can improve the situation. I have spoken to friends, and liaised with people I know at the Royal College of Nursing and some of its officials, and a lot of what they say is eminently sensible: there should obviously be standards for induction; the Department of Health and Social Care needs to establish pastoral and professional support; and there needs to be some sort of structure by which we can monitor potential exploitation and even trafficking in this area.

From what I have heard, we know very little about this phenomenon: we know very little about the number of people whose lives are blighted by exploitative practices. We talk all the time—in this House and outside—about immigration. We talk about the scale of immigration, but we rarely talk about the types of immigration that we are seeing, and I am not aware that we have dealt with this specific issue.

There is a code of practice for the international recruitment of health and social care personnel in England, which was last updated in August 2023, but what is a code of practice? It seems to me that it is really only a start in investigating the seriousness of what is being alleged. Publicly available hard evidence is difficult to come by, but we all know of reports; in my constituency, I have heard pretty hair-raising stories about the conditions in which many such workers find themselves.

I think there is a question about the code of practice. We should always be trying to get the best standards. I am sure that the Minister is fully aware of that, given her experience. We must always be interrogating ourselves, and ensuring that our guidelines and codes of practice are fit for purpose and up to the job. Given reports of rising numbers of exploitation cases, there is a broader question about whether the code of practice for international recruitment is really up to scratch. I know that colleagues and friends in the RCN have questioned whether the current code is really doing its job.

I am afraid to say that the issue of human trafficking and modern slavery will always be associated with immigration and bringing people into the UK. It is a very negative side-effect of seeing huge numbers of people coming into the UK about whom we know very little. I appreciate that the Minister is here today to represent the Department of Health and Social Care, but it is an issue not just for that Department; there are wider agencies of Government and more Departments involved. I will be very interested to hear what she says and, if at all possible, about the work that her Department is doing across Whitehall, with Treasury and Home Office colleagues, to get a better measure and a firmer grip of this chronic and increasing problem.

--- Later in debate ---

[Kwasi Kwarteng]

We have had a wide-ranging and generally quite even-tempered discussion, although people have occasionally strayed into the political stuff. The point of these debates is to have a broad and tempered discussion, and the spirit with which we have debated this matter does the House proud.

This issue has not had the attention that it deserves, and it is clear that Members on both sides of the House and from all parties are concerned about it. It is also abundantly clear that, whoever the election decides will form the next Government, it will be even more important and critical that this issue has our focus, whether that Government is Conservative or Labour. I am delighted that the Minister spoke at length, showing her understanding and experience. This is only really the beginning, and I look forward to more debates in the future on this sensitive and difficult subject.

Question put and agreed to.

Resolved,

That this House has considered employment practices for internationally recruited health and social care staff.

Sudden Unexplained Death in Childhood

Kwasi Kwarteng Excerpts

Tuesday 17th January 2023 Westminster Hall

[Kwasi Kwarteng (Spelthorne) (Con)]

I beg to move,

That this House has considered sudden unexplained death in childhood.

It is a great honour for me to give my first speech as a Back Bencher in about six years on this vital subject. We are here to discuss something that is incredibly difficult to deal with, emotionally very taxing, and one of the most serious medical phenomena in our country—something that has not had the public attention it deserves: sudden unexplained death in childhood, or SUDC.

This vital subject was brought to my attention while I was still in Government. Julia and Christian Rogers came to see me at the beginning of October, when I was still Chancellor of the Exchequer. In that role, I would not have been able to raise this vital subject personally. I pay tribute to my constituency neighbour, my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), for his diligence in pursuing the subject while I was still in Government. Luckily, as a matter of privilege to me, I can now raise it myself. I cannot think of a better, more urgent subject to raise in my first Back-Bench debate for many years.

When Julia and Christian came to see me in October 2022, they told me the story of their son, Louis, who tragically passed away in 2021 before he reached the age of two. Julia and Christian lived with Louis in Shepperton in my constituency, and they loved their little boy with all their hearts. Of course, no occurrence is more tragic than the death of a small child. It was particularly disturbing that they knew very little about the illness that took away Louis’ life. One can only imagine the horror of discovering one’s child lifeless, and the sheer bewilderment of trying to understand the causes of that tragedy.

Julia and Christian introduced me to other bereaved parents who had gone through this heart-wrenching occurrence. The national charity SUDC UK does vital work to promote more understanding and sensitivity around a subject that, as I said, has drawn too little attention in the past. SUDC is among the leading categories of death in England and Wales for children aged between one and four. As a community, we have to engage more vigorously with this phenomenon.

Technically, SUDC is the sudden and unexpected death of a child between one and 18 years of age. Those deaths, by their definition of sudden and unexpected, often remain unexplained after a thorough investigation, including a post-mortem. This is one of those areas that modern medical science has still not really got to the bottom of, despite the great advances we have made.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

It is good that we can unite and collaborate to address some of the issues raised by SUDC. Christian’s aunt is my constituent, so I learned about Louis from her. Many of us here are parents, and this issue is deeply worrying. Like the hon. Member for Runnymede and Weybridge (Dr Spencer), I was a public health consultant and have come here from working in the NHS. This issue has not had the profile it needs—just 50 research papers, compared with 12,000 on sudden infant death syndrome. I hope we can do some joint working on the issue to raise the profile of risk factors and so on.

--- Later in debate ---

[Kwasi Kwarteng]

I am very pleased to join the hon. Lady in raising the profile of the condition. This category of death has never really gathered the attention it deserves. As far as I know, this is the first time it has been debated on the Floor of the House in this Parliament.

[Andy Carter (Warrington South) (Con)]

I pay tribute to my constituents, the Grogan family, in particular Sarah, a teacher at Cobbs Infant School in Appleton. She has been in touch with me to tell me about her experience with Frankie, her little boy, who died at the age of three. Sarah has helped to inform medical professionals, including GPs, through the videos she has made. I have learned a tremendous amount from her, and I am sure my right hon. Friend will join me in paying tribute to her for her work on this important topic.

[Kwasi Kwarteng]

I am delighted that my hon. Friend has made that contribution. I must press on to the end of my remarks and look forward to what other hon. Members have to say on this sensitive, moving and tragic subject. The silver lining is that we will be able to make more progress in the years ahead.

It is vital to get on the record an undertaking from the Minister and his Department to encourage consistent medical education and training—there is currently very little—to help prioritise research into this category of death. Our urgent, immediate request is an undertaking to increase public information about this tragic phenomenon. How will the Minister help to prioritise scientific research to better understand this phenomenon, and to work out ways we can prevent and reduce the tragic deaths such as those experienced among many of our friends and wider communities?

I have written to the chief executive of the NHS to ask for more and better public information. The website should be updated. I urge the Minister to engage with NHS officials and managers through a commonly agreed platform, on which we can progress.

The initial response to this debate has been incredibly heartwarming and impressive. In the last few days, dozens and dozens of people have written in. They have outlined their experiences and told us about their own tragedies and their families, which have been torn apart and devastated by this phenomenon. It would be invidious of me to talk about those responses individually, but common themes run through all the submissions in this overwhelming response—in all the evidence we have accumulated in the last few days.

The thing that comes out most tragically and vividly to me is the sense of utter bewilderment about the cause of death. Many of us in our lives have dealt with personal tragedy and the passing of loved ones. In most of those instances, we have understood the nature of the illness, and there has been a degree of timing and ability to adjust to an appalling series of events. But let us imagine the death of a child who has all of his or her life in front of them and it is suddenly ended. If we can imagine that for one of our own children, we get a sense of how tragic and difficult that occurrence is. I commend the many people here who have gone through that heart-wrenching experience, who have had the courage to reach out to come and speak to MPs, and who work incredibly hard to make sure this goes further up the agenda.

The other principal thing that I have noticed is that there is not only bewilderment and the initial horror and confusion around the event, but a marked degree of ignorance about this phenomenon among the wider public. People do not know about this. We used to read and hear about what was called cot death, which was technically applied to children under the age of one, but, for the age group between one and four and for older children, there was not even a word or a phrase to describe what happens. If this debate can start a wider conversation about SUDC, I will feel that we have done a bit of our job. This is not the end; this is just the beginning of a wider debate on a deeply tragic occurrence.

Finally, because we do not have much time, I want to thank Nikki Speed, the chief executive officer of SUDC UK, who is here, and Julia and Christian Rogers for bringing this important subject to my attention and enabling us to have a wider debate. As I have said, I think it is the first time that this has been discussed, certainly in my experience as an MP of 12 years, in these precincts. I hope we can continue to work together to find adequate solutions and improve outcomes for people in this country.

We have had successes on the phenomenon of cot death—we made huge strides with that—and it is vital now that we turn our attention and expertise to SUDC. I thank Members from across the House who have listened with real respect not to me, but to the gravity of the debate. I am very interested to hear what my hon. Friend the Minister will say in response to our speeches.

[Derek Twigg (in the Chair)]

May I remind Members that they should bob if they wish to be called in this debate? There are five standing, so I must limit speeches to five minutes or so to get everybody in. I am sure you will all work together to try to achieve that before the wind-ups. I call Tim Farron.

--- Later in debate ---

[Kwasi Kwarteng]

Thank you, Mr Twigg. We have heard some fabulous and heartfelt speeches from across the House. In many years in Parliament, both on the Front Bench and on the Back Benches, I have debated many issues of national importance, but I do not think that any of the issues I have ever spoken about has had such emotional impact on the people affected. I was particularly struck by the concordant note—the note of agreement—from Members of all parties. It seems to me that there are a number of things on which we all agree—a number of important issues where there is broad consensus, and on which we will be challenging the Minister and his colleagues to make progress.

Undoubtedly, research is the key element. We heard that there are something like 13,000 papers on SIDS, by contrast with 50 on SUDC. That balance has to shift somewhat if we are to get improved outcomes on SUDC. Clearly, public awareness has to be a big part of getting better results. Hon. Members have mentioned the NHS website, and I feel very strongly that it should be improved to incorporate many of the things we have discussed today.

Finally, it is really important that we continue to revisit this issue. On many occasions, I have had debates here in Westminster Hall or in the main Chamber where we have said lots of warm words, but we have had very little in the shape of follow-through. On an issue of this kind, which is so important and has touched everyone emotionally, we have to be able to follow through. I urge the Minister to meet Nikki, other families and people involved in SUDC UK’s vital work, so that we can have a dialogue and achieve much better outcomes than we are currently seeing today.

Question put and agreed to.

Resolved,

That this House has considered sudden unexplained death in childhood.

National Security and Investment Bill

Kwasi Kwarteng Excerpts

Report stage & 3rd reading & 3rd reading: House of Commons & Report stage: House of Commons
Wednesday 20th January 2021 Commons Chamber

[The Secretary of State for Business, Energy and Industrial Strategy (Kwasi Kwarteng)]

I beg to move, That the Bill be now read the Third time.

First, I would like to pay tribute to my immediate predecessor, my right hon. Friend—my very good friend—the Member for Reading West (Alok Sharma), who took the Bill through on Second Reading. I pay tribute to him for being such a motivating force behind this Bill, and also for providing excellent leadership in our Department up to only a couple of weeks ago. I wish him well, and I am sure he will continue the excellent work that he has already started as president of COP26, which I am sure will be a brilliant and vital success.

I would like to return to the very core of why we need this Bill. As my right hon. Friend told this House, the UK remains

“open for business, but being open for business does not mean that we are open to exploitation. An open approach to international investment must also include”—

has to include—

“appropriate safeguards to protect our national security.”—[Official Report, 17 November 2020; Vol. 684, c. 205.]

This Bill provides those safeguards.

Subject to the debate in the other place and the views of the other place, the Government will be automatically informed of certain acquisitions in key sectors and will be able to scrutinise a range of others across the economy. The Government will also be able to look at deals involving assets, including intellectual property, whose acquisition might pose a national security concern. There will be no thresholds for intervention, as there are currently under the Enterprise Act 2002. This means that acquisitions involving emerging innovative businesses will also be covered by the Bill. All this adds up to a significant upgrade to our abilities and powers to reflect the sweeping technological, economic and geopolitical changes across the globe over the past 20 years.

I would like to make further acknowledgement of the work done so ably by those from across the House and in my Department that has got us to this point. I thank the Under-Secretary of State for Business, Energy and Industrial Strategy, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), and the Bill team for their fantastic work to date. He even managed to convince me. I know he is working flat out to ensure we can all return to normal before too long. I thank those who have ensured that the proceedings of this House continued without any disruption in the meantime. I therefore place on record, Mr Deputy Speaker, my thanks to you, to Madam Deputy Speaker, and to all the House staff who have ensured that today’s proceedings and previous stages of the Bill were undertaken with exemplary smoothness—no mean feat in the circumstances.

I also thank the members of the Public Bill Committee from across the House for their keen and diligent scrutiny of the Bill, and particularly its Chairs, the hon. Member for Halton (Derek Twigg) and my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady). I also thank all those who contributed to this very important debate. We heard from eminent Select Committee Chairs. My hon. Friend the Member for Tonbridge and Malling (Tom Tugendhat) is no longer in his place, but I have known him for a very long time, and I was very pleased to hear his able contribution to this debate. I thank my right hon. Friend the Member for New Forest East (Dr Lewis), the Chair of the Intelligence and Security Committee. His expertise is widely acknowledged across the House and was brought to bear in the proceedings.

In addition, we heard from Members from across the House, including my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes), and my hon. Friends the Members for Beckenham (Bob Stewart), for Isle of Wight (Bob Seely), for South Ribble (Katherine Fletcher) and for Arundel and South Downs (Andrew Griffith). The right hon. Member for North Durham (Mr Jones) is an acknowledged expert, and devotes himself to these highly important issues. There were also contributions I noted from the hon. Members for Aberavon (Stephen Kinnock), for Ilford South (Sam Tarry), for Liverpool, Riverside (Kim Johnson), for Warwick and Leamington (Matt Western), for Caithness, Sutherland and Easter Ross (Jamie Stone) and for Strangford (Jim Shannon). I thank all those right hon. and hon. Members for their important contributions.

Although there have been one or two differences, I have above all been struck by the broad consensus that has emerged across the House on the Bill, and by how important it is that we all agree that the Government should act in this area. There is a degree of debate about the details of the Bill. I thank the Opposition Front Benchers—the right hon. Member for Doncaster North (Edward Miliband) and the hon. Member for Newcastle upon Tyne Central (Chi Onwurah)—and the SNP spokesperson, the hon. Member for Dundee East (Stewart Hosie). All have acknowledged the need for this crucial legislation. Broadly, they have approached the Bill in a constructive manner. For that, my right hon. Friend the Member for Reading West and I are and have been extremely grateful.

Returning to what my right hon. Friend the Member for Reading West said on Second Reading, this country has always been a beacon for inward investment and a champion of free trade. The Bill does not change that. It does not turn its back on that history, but it feels very apposite for me to say that prosperity and security should go hand in hand. The Bill really captures that insight and represents a proportionate approach to the threats we face in today’s world. On that basis, I commend the Bill to the House.

[Mr Deputy Speaker (Mr Nigel Evans)]

As this is the first time I have been in the Chair since your promotion and appearance at the Dispatch Box, I congratulate you on your new role.

Oral Answers to Questions

Kwasi Kwarteng Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Sir David Evennett (Bexleyheath and Crayford) (Con)]

10. What steps he is taking to increase the rate of early diagnosis of cancer.

[Kwasi Kwarteng (Spelthorne) (Con)]

11. What steps he is taking to increase the rate of early diagnosis of cancer.

[The Secretary of State for Health and Social Care (Matt Hancock)]

Britain is world leading at treating cancer when it is discovered, but we do not diagnose it early enough, so we will radically overhaul our screening programmes, roll out rapid diagnostic centres for people with early symptoms, and expand mobile lung screening units. Our ambition is to ensure that three quarters of cancers are diagnosed at stage 1 or 2 by 2028, up from half today.

[Matt Hancock]

Yes. Focusing on early diagnosis will help to save lives. Indeed, the cancer survival rates have never been higher than they are now. About 7,000 people who are alive today would not have been had mortality rates stayed the same as they were in 2010. However, we want to use the most cutting-edge technologies in order to save more lives.

[Kwasi Kwarteng]

In respect of early screening, how does my right hon. Friend expect the measures that he has introduced to move the service forward in the way that we want to see?

[Matt Hancock]

Absolutely central to this is ensuring that we address cancer at the earliest possible opportunity. The earlier the diagnosis is made, the greater is the likelihood of survival, so we want to see more cancers diagnosed earlier across the board.

Oral Answers to Questions

Kwasi Kwarteng Excerpts

Tuesday 24th July 2018 Commons Chamber

[Matt Hancock]

I value every person who works in the NHS and in social care, because everybody plays a part in improving the wellbeing and the health of the nation. I care deeply about that. On the question of sleep-in shifts, I saw the decision by the court and I have already had conversations with the Department for Business, Energy and Industrial Strategy, which leads on this regulation, to ensure that we can get the rules right for the future.

[Kwasi Kwarteng (Spelthorne) (Con)]

10. What plans the Government have to improve support for the children of alcohol-dependent parents.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

Alcohol addiction has a devastating impact on individuals and their families, and it is unacceptable that children bear the brunt of their parents’ condition. That is why we are investing £6 million over three years to support vulnerable children living with alcohol-dependent parents. I pay tribute to the former Secretary of State and to the shadow Secretary of State for their leadership in making this happen.

[Kwasi Kwarteng]

I thank the Minister for his answer, but this is obviously a much wider problem, affecting more than just the children of alcohol-dependent parents. Will he tell the House what more can be done to ensure that people in the wider community can access that kind of help?

[Steve Brine]

We are working on an alcohol strategy, which is being led by the Home Office, and I have spoken to a number of stakeholders in the last two weeks at the various roundtables I have been holding. On the question of alcohol-dependent parents with children, we are working through local authorities, which is important, but as part of the investment that I have mentioned, there is also £500,000 going into expanding the helpline provision for children who find themselves in this position. I have heard time and again when talking to children affected by this that being able to say that they are not alone in this is often a great place to start. The helpline will be very important in that regard.

Neuroblastoma

Kwasi Kwarteng Excerpts

Tuesday 23rd January 2018 Commons Chamber

[Kwasi Kwarteng (Spelthorne) (Con)]

I am honoured to be called to speak in this Adjournment debate. It is a great honour, as a Member of Parliament, to be able to make representations in this House on local cases, and this particular case is something I have been very much affected by. I have met the parents of the young boy concerned, and I would be grateful if the House allowed me to explain the nature of the case I am here to plead this evening. I wanted to hold this debate on funding for the treatment of children who are diagnosed with neuroblastoma, a specific form of childhood cancer. It is very debilitating, arises in immature nerve cells and is the third most common type of childhood cancer, affecting about 100 children every year in Britain.

Members may be familiar with the case of Bradley Lowery, a young boy from Sunderland who struck up a friendship with the England footballer, Jermain Defoe, after appearing as a Sunderland mascot. Bradley suffered from neuroblastoma and his cheerfulness and great courage touched the hearts of so many people. Very sadly, Bradley passed away last year. He was only six years old, but in his short life he touched the hearts of millions.

It can be very difficult to spot the early symptoms of neuroblastoma, as they can be vague and mistaken for other childhood conditions. There are options to deal with the illness, but the case I briefly want to describe involves a young boy, Alfie Ward, who is now 15, and who lives in my constituency in Ashford. He is now battling this disease for the third time. The problem we have is that the NHS, under its current dispensation and policy, funds treatment only in the first instance. However, as Alfie started nursery, having battled the disease and survived this appalling affliction, it became apparent that it had come back.

At this point, I want to make the case for the NHS to review its policy on not funding relapses. As I understand it, about half the people who suffer from this appalling illness relapse, if they recover. It seems very harsh to adopt a policy whereby people can be funded the first time that they are affected by the illness, but not for subsequent relapses. In Alfie’s case, he has been denied treatment. As I said, this is the third time that he has had the illness. Now he, his family and his parents are under the extreme pressure of having to raise something like £600,000 so that he can get treatment.

In wrapping up my remarks, I want to say that £600,000 is a huge amount of money. It is to their eternal credit that Alfie’s parents, who I have met—

[Jim Shannon (Strangford) (DUP)]

rose—

[Kwasi Kwarteng]

I am happy to give way to the hon. Gentleman.

[Jim Shannon]

I could not let the debate go by without commenting on a young gentleman in Northern Ireland. Some things in Northern Ireland cross the barricade, and one of those was the touching story of young Oscar Knox, whose battle with neuroblastoma touched people from every part of the Province and in whose memory I stand in this House today. Does the hon. Gentleman agree that we must do more to fund the treatment of this cancer in the United Kingdom of Great Britain and Northern Ireland, instead of parents having to try to raise money to help their children? We must look towards more treatment options as well. Does he agree with that? I know the answer.

[Kwasi Kwarteng]

I am delighted that the hon. Gentleman has made representations from his part of the country. People face this problem across the country. It is not widely known, because the absolute numbers are not great, but the suffering is severe. We absolutely have to try to think of a way to reach an accommodation on funding, because £600,000 is a huge amount to raise.

[Mr Jim Cunningham (Coventry South) (Lab)]

I congratulate the hon. Gentleman on bringing this very serious issue to the House, and I am sure that many people in Coventry and the west midlands would support him too. It is tragic to pick up a newspaper and read about families trying to raise money for treatment abroad that they cannot get in this country. We wish him well in his endeavours to get some justice for his constituents.

[Kwasi Kwarteng]

I am touched by the hon. Gentleman’s remarks. It is delightful to see cross-party agreement on this. It is a great honour to raise this issue—it goes to the heart of what one does as a constituency MP. I have met Alfie’s parents and have been incredibly impressed by the way they have conducted themselves, and by their bravery and courage. They are totally devoid of self-pity. They have just got on with it and raised a great deal of money, and I am hopeful that they will reach their target.

In the case of relapses, however, the obligation should not fall on the shoulders of parents and friends to go through what is a very stressful experience. We have all raised money for various causes in our time, and it is a stressful and time-consuming endeavour. As a society, we have to consider ways in which the NHS or the National Institute for Health and Care Excellence can fund treatment for relapses so that the parents of young boys such as Alfie Ward do not have to go through that kind of suffering and pressure simply to give their son a fighting chance of life.

I am grateful to have secured this debate, on an issue that has been raised by other people, and it is a privilege to have raised it in this forum. I look forward to hearing what the Minister has to say.

NHS Pay

Kwasi Kwarteng Excerpts

Wednesday 13th September 2017 Commons Chamber

[Kwasi Kwarteng (Spelthorne) (Con)]

It is a great honour to have been called in this serious debate. I am pleased by the way in which it has been conducted, as we have heard some very good speeches, in particular the maiden speech by the hon. Member for Portsmouth South (Stephen Morgan). It was an amusing, entertaining, heartfelt and serious speech, and I have no doubt that the hon. Gentleman will make valuable contributions in this Parliament and in years to come. It was a salutary speech because it gave one faith in the House of Commons.

Having been a Member for seven years, I have seen many debates—and some yah-boo politics—in which people apportioned blame for the crisis. Labour says that the Tories cut too much and that it was all the bankers’ fault that we had a deficit of £160 billion—the largest peace-time deficit in our history. The right hon. Member for North Norfolk (Norman Lamb), who was a Front-Bench member of the coalition Government for their full five years, will remember clearly the context in which we came up with the difficult policy of the pay cap. It was not a whimsy, and we did not do it for the hell of it to put people under pressure. The pay cap was a serious response to a difficult and chronic problem—the deficit.

I do not want to apportion blame, and I echo my right hon. Friend the Secretary of State in recognising that the global crash was not entirely Labour’s fault—I am willing to give it that—but the history of the public finances from 2001, eight years before the financial crisis happened, shows that we ran a deficit in every single one of those years. To borrow a phrase—a mantra—from a departed colleague, Labour did not fix the roof while the sun was shining. The Labour party had a record of fiscal incompetence, and it was against that backdrop that public sector pay restraint became an issue. It is important to look at the history to explain why the pay cap was instituted in 2011.

[Eleanor Smith]

The hon. Gentleman talks about eight years, but Andrew Lansley’s Bill basically destroyed the NHS. That is why we are in this state with the pay cap. I think the hon. Gentleman has forgotten about that.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I would like to allow the hon. Lady to speak early on, and there is nothing wrong with intervening, but we do need short interventions. That would be great. I need to know if Members will be giving way, too. I would like to get all speakers in, but the more interventions we have the less chance there is that I will be able to do that.

[Kwasi Kwarteng]

That was a fair intervention, but I completely disagree with the hon. Lady’s point. The deficit had nothing to do with the then Secretary of State for Health. It was not the previous Secretary of State for Health who caused the £160 billion deficit the Government inherited in 2010. Naturally, when running a huge deficit—I think it was something like 12% of GDP—one has to find savings in the budget. The question I pose to Labour Members is, how would they find the extra money? There are only two ways to do that: the Government can either raise the money through taxation, or the Chancellor has to borrow the money. It is very unclear to me what the Labour party proposes to do to increase the pay of public sector workers. No doubt it will have a plan to increase it by 5% or 10%—I do not know by exactly how much it wants to put up public sector pay—but it would have to fund that. I looked at the Labour election manifesto and I think it spent the tax on people earning over £80,000 about 10 times over to fund their various projects and policies.

We cannot go on kidding ourselves and kidding the British people. I very much like the point made by the right hon. Member for North Norfolk about the fact that we have to be serious about how we are going to fund the NHS and social care provision. He described the current model as—his word—unsustainable. I do not share that view—I think we can fund the NHS adequately for the rest of the Parliament—but his general message was right. It does not make any sense for Labour Members to scream, holler and shout about Tory cuts without having a serious proposal.

[Norman Lamb]

To work together in a constructive, rational and mature way requires the Government to agree to do it. We are still waiting. I met the Prime Minister in February. Please make a decision.

[Kwasi Kwarteng]

I am not privy to the conversations the right hon. Gentleman has had with the Prime Minister—that is something he might wish to take up with her—but this is a serious debate. As he said, we cannot be honest with people on this issue if we are simply screaming and shouting across the Dispatch Box.

Conservative and Opposition Members have made the point that we have extremely impressive professionals across the public services. The level of public service provision here in Britain is right at the top of the global rankings. I have spent time in Europe, Africa and across the middle east. The public services we have in Britain are really world class and we must never lose sight of that in these discussions. The nature of the debate has been very fruitful and we have had a measure of courtesy, but it does not make sense simply to holler “Tory cuts.” That is what I have heard in seven years of trying to address what are very serious problems.

NHS Sustainability and Transformation Plans

Kwasi Kwarteng Excerpts

Wednesday 14th September 2016 Commons Chamber

[Kwasi Kwarteng (Spelthorne) (Con)]

It is a great honour to be able to speak in this important debate. We have heard some very interesting contributions, and some contributions which were, perhaps, less constructive. I will not state publicly which are which, but I would like to take up what was said by the right hon. Member for Newcastle upon Tyne East (Mr Brown), who spoke of Labour’s commitment to meeting the OECD’s health spending average in 2001.

I think it perfectly acceptable, in a discussion of this kind, to point out that in 2001 the Labour Government had succeeded in running a balanced budget for four years, more or less, and we thought at the time that we had the money to meet that commitment. Having been a member of the Labour Government, the right hon. Gentleman will recall that over the next nine or 10 years we ran consecutive deficits, and as a consequence of policy that I happen to believe was misguided in many instances we had a deficit of £160 billion when the coalition Government took office in 2010. Given the circumstances, it was inevitable that there would be a constraint on finance, and that is something that we have to speak about.

If I recall correctly, the hon. Member for Central Ayrshire (Dr Whitford), whose speech I enjoyed very much, said that we kept talking about finance, and that it should be the third consideration. I wish it were as easy as that—I wish we could relegate finance to a subordinate, back-burner role—but I do not think that that would be fair to the country, or to our constituents.

[Dr Philippa Whitford]

Will the hon. Gentleman give way?

[Kwasi Kwarteng]

Forgive me; I cannot. The debate is very constrained now, in terms of time.

The right hon. Gentleman talked, obviously, about the budget constraints, but he also talked about the fact that we were not spending enough money. I think that the STPs present the opportunity for a serious engagement with what all Members recognise is an ongoing problem. We have a growing population and an ageing population, and inevitably, whether we like it or not, issues of finance and resources will become increasingly important.

I am pleased to learn that local consultation will be at the centre of the draft proposal, because that is essential, and it is what our constituents want. There are two hospitals in my area; one is just outside my constituency but many of my constituents go to it, while Ashford hospital is in the centre of Spelthorne. A number of the facilities have been downgraded—it has been a difficult time—but the borough council and I, as the local Member of Parliament, always tried to explain to residents what was driving the decisions and the changes that we sought to make, and they were broadly very understanding. I think that people throughout the country are very sensible when we explain to them and carry them with us, and that they take a measured view of health services. They realise that the old NHS of Nye Bevan and 1948 has had to evolve. I believe that they are much more open to evolution and change than many Members of Parliament.

The last point that I want to make is slightly negative. I have attended many debates of this kind—not necessarily on the health service, but on the economy and welfare—and all that I hear from Labour Members is the same old mantra: “Stop the cuts, more money.” That seems to be their sole solution to every single problem that we face as a country. It is said that to a man with a hammer, every problem is a nail. Labour Members seem to think that “Stop the cuts, more money” is the answer to everything, and I consider that entirely unconstructive. I find it very disappointing to hear no constructive ideas and no proposals for reform, and to observe no appetite for fresh thinking and absolutely nothing in the way of intellectual engagement with the real problems that we face as a nation. I find it very disappointing to take part in yet another debate and hear the same old mantra: “Stop the cuts, more money.”

Phenylketonuria (Kuvan)

Kwasi Kwarteng Excerpts

Thursday 1st December 2011 Commons Chamber

[Kwasi Kwarteng (Spelthorne) (Con)]

I am grateful for the opportunity to raise the issue of access to Kuvan for sufferers of phenylketonuria. I believe that the most important part of our job in the House is to represent our constituents as conscientiously as possible. It is also our job to bring forward issues of national interest that, even though they might come to us initially as matters of individual complaint, relate more widely to national concerns. In raising this issue of access to Kuvan, I hope to fulfil both these important functions.

I want to raise this issue tonight for one simple reason: a constituent of mine, Mandy Macedo Box, who lives in Shepperton, has a six-year-old son who suffers from PKU. Mrs Macedo-Box’s son, Charlie, happens to have a particularly severe form of the illness. PKU is a relatively rare and unknown liver disease. Its sufferers have to restrict all protein-containing food in their diet in order to survive and to avoid damage to both the brain and the nervous system. About one in every 10,000 people has PKU. Sufferers can never eat food that has a high protein content, such as meat, dairy, bread and cakes, while foods containing lower amounts of protein, such as vegetables, can be eaten, but only in small amounts. Only fruit can be eaten safely.

To maintain this low-protein diet, sufferers have to work out a complex diet of “exchanges”, which often includes prescription products, such as imitation rice or protein-free bread. As well as this very restrictive diet, sufferers often have to take a number of supplements to help their bodies function normally and to reduce their appetite. I am sure that Members can imagine how restrictive and detrimental to the quality of life this can be, especially for children and their families.

There is now a drug on the market that has been developed to help with the treatment of mild and moderate cases of PKU. This drug, Kuvan, enables sufferers to double the amount of protein that they can tolerate, which obviously means an increase in the amount of real food that can be ingested. I am sure that you can imagine, Mr Deputy Speaker, the huge improvement in the quality of life that such a drug would bring to many sufferers of PKU. Unfortunately, however, as is often the nature of these things, the drug is not guaranteed to work in Charlie’s case. It has therefore been proposed that Charlie take the drug for a trial period of one month so that doctors can determine whether it can help his condition.

The drug company that manufactures Kuvan has offered to make the drug available to Charlie’s local health authority, NHS Surrey, on this trial basis on the understanding that should the trial be successful, NHS Surrey would agree to fund the drug for patients with PKU in Surrey in the future. I understand that similar arrangements have been offered to other primary care trusts. However, the crux of the problem is that in Surrey the local area prescribing committee is simply unwilling to make this undertaking because—it claims—there is

“limited evidence of ongoing clinical effectiveness, and lack of cost-effectiveness”

of the drug.

To put it simply, we are now in the absurd position where the drug company will not commit to a trial period unless the PCT can guarantee future funding should the trial be successful, while, on the other hand, the PCT will not commit to a trial period because it cannot guarantee future funding because it is not sure that the drug will work. While this stand-off continues, the quality of life for a young boy in my constituency and many other sufferers of PKU continues to be seriously impaired simply because they have no access to a drug that might help to alleviate the symptoms of the disease.

To make matters even more frustrating for Charlie and others like him who are desperate for some non-dietary treatment, we know that Kuvan, although not available to many PKU sufferers in the UK, is routinely made available to patients in European countries such as France, Germany, Italy and Spain. It simply does not seem right that, despite the many miracles that we all know the NHS performs every day, British patients should be disadvantaged in that way, compared with their peers on the continent. It is in that context that I feel that a solution to the impasse must be found. Why can British sufferers of this disease not access the drug on the national health service? An answer might lie in the fact that the National Institute for Health and Clinical Excellence has not yet positively approved the drug. If that were to happen, some progress may well be made.

Finally, I find it quite striking that in an area where we are supposed to be supporting a great British business—pharmaceuticals—we should not be able to provide funding for the drug, thereby restricting the opportunities of many thousands of people in this country.

I am grateful to the House and to you, Mr Deputy Speaker, for the patience that you have shown in this debate—and, in fact, for your consideration in granting it. This may seem a small issue, but it has a massive bearing on the quality of life of those affected—both the sufferers and their families. It is quite right that it should be aired in the highest possible arena, which is what this House represents. I urge the Government to do all they can to find a solution to this grave dilemma.