Agenda for Change: NHS Pay Restraint
Lady Hermon Excerpts(7 years, 4 months ago)
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Catherine McKinnell
The hon. Gentleman makes an incredibly powerful point, which I hope the Minister has heard.
Lady Hermon (North Down) (Ind)
I congratulate the hon. Lady on leading this debate, despite the other debates going on elsewhere. I rarely find myself in agreement with the hon. Member for Kettering (Mr Hollobone), but I fully agree with him. Hundreds of nurses across Northern Ireland feel desperately demoralised by the pay freeze, which has gone on for such a long time. When we got a new Prime Minister, on 13 July last year, who talked about a fresh beginning and new opportunity, they were encouraged, as many of us were, and thought that this would be an ideal opportunity for her Government to show that they mean what they say and that they care about removing pay restraint.
Catherine McKinnell
I thank the hon. Lady for that intervention—I think that many of us are surprised that we agree so entirely with the hon. Member for Kettering (Mr Hollobone). She raises an important point about the concern that many people up and down the country feel about some of the Prime Minister’s early actions in her time in office.
There are real concerns that the continuation of pay restraint in the NHS threatens to undermine the very benefits that Agenda for Change was supposed to bring to employers and staff. A centrally imposed cap on pay rises limits employers’ ability to respond to recruitment and retention problems while compromising the extent to which skills and competencies acquired by staff throughout their careers can be properly recognised and rewarded.
The extended nature of the pay restraint imposed first by the coalition Government and now by the Conservative Government also throws up this question: what is the point of having an independent NHS Pay Review Body, given that the Minister is clearly content to impose a figure on NHS Employers and staff each year? Indeed, the Royal College of Midwives has warned that the policy
“undermines the integrity of the system; and will cause lasting damage to the morale and motivation of staff, worsening the staffing crisis in the NHS.”
Despite the widely promised but yet to materialise extra £350 million a week for the NHS, we all know that our health service faces real and significant challenges in financial terms, both now and in the years ahead.
Dr Philippa Whitford (Central Ayrshire) (SNP)
It is an honour to serve under you, Mr Evans.
We seem to have been in this place before. We had a lot of debate about the nursing bursary, and these things are connected, because it comes down to how we are treating people and valuing them, as has been said. In Scotland, we also have a pay cap of 1%, but one difference is that that is being paid each year, whereas for three of the last six years, nurses in England have faced a freeze—an award of 0%. What they are told is, “Well, your increment gives you a rise.” The increment is how people move through the Agenda for Change structure, so if they are not getting any cost of living rise, the increment structure of Agenda for Change is being undermined.
The Scottish Government are a real living-wage employer and are recognised and registered as such, so people earning less than £22,000 get £400 to keep them above the real living wage. Starting in the next financial year, 2018-19, those in the lower bands in England will fall below the national minimum wage; they do not come anywhere close to a proper living wage. We know the Government’s living wage as “the pretendy living wage”, because people cannot actually live on it. That term should not be used because it is confusing. The result is that at band 1 or 2, a nurse or healthcare assistant in Scotland will earn £881 more than their equivalent in England. The common band for a nurse graduate is band 5, and at the top of that band, the nurse in Scotland will earn £284 more than the nurse in England.
Scotland has had no compulsory redundancies since the crash. In England, there have been 20,000. That seems bizarre when we are short of nurses. The vacancy rate in England is 9.5%; in Scotland it is 3.5%. We get what we pay for. If we treat people badly, eventually they go away, or, if they are approaching retiral, they do not go on working; they finish, because frankly they are burnt out. Nursing is a hard, heavy and stressful job. Nurses in Scotland feel stressed because of the gap caused by vacancies, the increased demand, the ageing population and the complexity of the cases they look after, so we can only imagine what it must be like in hospitals in England, with almost 10% of places not being filled and having to be covered by agency staff, which, as we have heard, is just a circular, self-defeating argument.
Lady Hermon
On the hon. Lady’s point about how difficult and wearisome the work of a nurse is—it is hard work—those nurses born in the 1950s who are affected negatively by the Government’s pension policy cannot now retire until they are 65, 66 or, indeed, 67. Has there not been a double whammy for those nurses who want, for the love of the job, for the love of the patients and for the love of service of the community, to stay in post? The Government have an opportunity to recognise that contribution. If they will not do something on pensions—I hope that they will change their mind on that—they could at least remove the pay freeze.
Dr Whitford
The whole message that is sent by nurses, particularly those who are in their late 50s and approaching 60, is that they are burnt out; they do not feel valued. When they have to work hours and hours beyond their shifts, doing what is frankly heavy labour—coming from that background, I can vouch for its being heavy physical work—they will of course leave as soon as they can manage to do so. The problem is that that exacerbates the pressure on all their colleagues, and that is what we are seeing with the huge shortage of thousands of nursing posts across England.
We have to recognise that we will face more increased demand and more complexity as our population ages. When patients in their early 70s were coming to me with breast cancer, they had multiple morbidities. By that stage, they had had a heart attack, were type 2 diabetic, had a bit of kidney failure and were severely immobile from arthritis, obesity or one of the many other conditions that people are getting. The nurses were trying to deal with all those things. Going forward, we will face more cases of dementia and Alzheimer’s, which is a particularly challenging morbidity for patients and the staff looking after them. Working in that environment, where everyone around them is having a bad day at the same time that they are having a bad day, means that people do not enjoy going to work. If there is any chance to get out, they are going to take it.
We need to attract more nurses to deal with demand. As was mentioned earlier, approximately a third of nurses are due to retire within the next 10 years, and we need to prepare for that. Some of that relates to the expansion that we had under Labour; when there is a big expansion in a profession, a whole lot will tend to retire at the same time. Unless succession planning is ongoing and established, we will reach an absolute crisis.
That brings us to the other difference: the nursing bursary. In Scotland, we still pay a nursing bursary of more than £6,500. We also have free tuition, which is equivalent to £27,000. We have additional funding for nurse trainees with additional support needs. They tend to be older—they are around their late 20s and early 30s —so they get more than £2,000 for childcare, a dependency allowance if they have either an adult or children dependent on them and a single-parent allowance.
The Scottish Government know that we have a challenge to recruit and retain nurses to grow the nursing profession, and they are putting that money in. They are not putting it in by giving high pay awards each year, but they are the only Government that actually accepted the independent review body’s recommendation of 1% on top of any steps within Agenda for Change. What is the point in doing all the work around a review body, if the Government do not bother listening to it?
I suggest that the Government need to show nurses that they are valued. They need to look at the decision to get rid of the nursing bursary, because we already know from NHS England that there has been a decrease of 20% to 25% in applications, so it is having exactly the opposite effect than the Government talked about. We know from the Nursing & Midwifery Council that registrations from the EU have dropped by 90% since last July. That means that whole source is drying up, regardless of rules, because people do not want to take the risk of moving here. We cannot shut down every possible source for having enough nurses. A lot of this is about calling on the Government to change their attitude and realise that this is a difficult job. We need to attract people into it and we need to retain people for as long as we can. Nurses are worth every penny they are not being paid.
Mr Dunne
I will come on to agencies shortly. I am not denying that there are vacancies within the NHS, but my point is that there has been and continues to be a significant investment in increasing the number of people working in the NHS, which was not the impression that other hon. Members gave.
Lady Hermon
I have listened very carefully to the Minister, but I have to tell him that nursing staff, midwives and others in the nursing profession—certainly those in Northern Ireland who have contacted me—feel very demoralised by the attitude that the Government have held for several years. People in the nursing profession do a wonderful job and perform a great service for us all and for our families and friends when we have accidents or are ill, and the Government really must recognise their sense of demoralisation. If the Government will not change their policy on pay restraint—the Minister has already hinted that they will not—what steps will they take to address the serious problem of low morale in the nursing profession?
Mr Dunne
Obviously I cannot speak about circumstances in Northern Ireland, because we do not have responsibility for that. As I develop my remarks, I will go on to explain some of the things that we are doing to ensure that people who work in the NHS feel valued, as the hon. Lady asked, and get the kind of motivation that encourages them to get out of bed every morning and come into work day in, day out.
Mr Dunne
I will make some progress.
We recognise that the NHS faces a number of very challenging pressures: not just the ageing population, but the expectations of the public, who rightly demand quality personalised care at home or in hospital every day, not just from Monday to Friday. Those pressures will not be resolved just through pay, but by engaging with staff as they adapt and respond to new ways of working, including by introducing change that comes with scientific development and by supporting them through appropriate training and development.
We know that inflation is increasing. We continue to rely on the independent pay review bodies, which for decades have applied their expertise and objectivity in making recommendations to Government, and we have huge respect for their important work. The hon. Member for Newcastle upon Tyne North and the hon. Member for Torfaen (Nick Thomas-Symonds) referred to the NHS Pay Review Body’s 2014-15 recommendations. Last year the Government accepted its recommendations for 2016-17. We have provided our evidence to the current round—as have others, including trade unions—and we expect its recommendations in the coming weeks.
Mr Dunne
No, I am afraid I am going to make some progress.
Hon. Members need to recognise that there is clearly a balance between pay and jobs in the NHS and across many public services. I note that the Opposition spokesman was full of recommendations about what not to do but had none, as far as I could calculate, about what should be done in relation to the delicate balance between pay and jobs. If pay were increased beyond the proposal from the NHS Pay Review Body, or beyond what the Government intend to pay, clearly there could be an impact on the number of jobs that can be afforded in the NHS within the financial envelope that we have.
Mr Dunne
The hon. Lady refers to ambulance staff. In recent weeks—just before Christmas, in fact—the Department agreed a deal with trade unions whereby paramedics working in ambulances would have their banding increased from band 5 to band 6, phased in over two years so that they can demonstrate they have the increased skill competence required. That represent a significant increase in reward for paramedics; some 12,000 paramedics will receive a higher pay award, precisely to address recruitment challenges for that specific profession. So we are listening and we are doing something about this issue. I will try to give the hon. Lady other examples of where we are responding to specific pressures.
Mr Dunne
No. The hon. Lady has had a fair crack. I will make a bit more progress.
I was challenged in this debate to refer to what the Government are investing in the NHS and I obviously take some relish in responding to that challenge. We are investing an additional £21.9 billion in nominal terms, which is equivalent to £10 billion in real terms, to fund the NHS’s own plan for the future. By doing so, we believe that we are playing our part, through the measures announced over the last 12 months or so, to help the NHS achieve its five year forward view. It needs to do that not only by realising benefits from the Carter review to improve productivity, but by clamping down on rip-off staffing agencies and encouraging employers to use their own staff banks for temporary staffing needs, so that they can invest in their permanent workforce. That has been referred to by a number of right hon. and hon. Members.
Agency and bank working provide an opportunity for NHS staff to engage in more flexible working to suit their own circumstances, so I would not want to characterise all agency working as bad. What is challenging is when NHS organisations need, in some cases, to go out to external agencies beyond their immediate bank and pay significantly higher rates. That is why the Department introduced, a year ago, a number of measures to start to limit the ability of agencies to charge the NHS such high fees, and we have had some success in that. In the period for which I have figures—roughly the middle of last year—the agency costs to the NHS had been reduced by 19% over the equivalent period the year before, so we are doing something about those fees. We are apprised of the problem and are bringing down the cost to the NHS of employing agency staff.
This issue is not just about pay. NHS staff, like many people, work hard to improve our public services. They have families and commitments, and they deserve to be rewarded fairly for what they do. However, as has been said, pay alone will not necessarily persuade the skilled and compassionate people that we need to choose a career in the NHS. It would be wrong to see the NHS employment package as just about headline pay. NHS terms and conditions have been developed over many years, in partnership with trade unions, and they recognise that it is a combination of pay and non-pay benefits, which need to keep pace with a modern, changing NHS, that help to recruit, retain and motivate the workforce.
Junior Doctors’ Contracts
Lady Hermon Excerpts(8 years, 7 months ago)
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Mr Hunt
They are not fines; they are perverse incentives to doctors to work unsafe hours. We want to go one better than that. We propose to stop hospitals requiring doctors to work five nights in a row or six long days in a row, and to bring down the maximum number of hours that hospitals can ask a doctor to work in any one week. On top of that, we have imposed the toughest hospital regime of any country anywhere in the world that comes down very hard on hospitals that are not providing safe care.
Mr Hunt
It applies to all doctors working within the legal limit. If they opted out of the working time directive, it would apply up to 56 hours. For people who are working more than the legal limits, even after opting out, the right answer is to stop them working those extra hours because it is not safe for patients. But yes, that is the commitment to people even if they have opted out.
Mr Hunt
I am going to make some progress, if I may.
As well as reducing the maximum hours a doctor can be asked to work from 91 to 72 in any week—a significant reduction—and banning hospitals from requiring doctors to work five nights in a row or six long days in a row, as hospitals can currently make them do, we propose to ban the routine use of fixed leave arrangements that mean that some doctors have to give up to three months’ notice before taking leave, meaning that they miss out on vital family or personal occasions.
We did not, and do not, seek to impose a new contract; rather, we invited the BMA to negotiate a new contract so that we could end up with a solution that was right for doctors and right for patients. However, because we had recently won an election in which a seven-day NHS was a manifesto commitment, we said that having tried to negotiate this unsuccessfully for two and a half years, we would ask trusts to introduce new contracts if we were unable to succeed in negotiations.
Lady Hermon
I have a specific point about Northern Ireland. Of course, health is devolved to the Northern Ireland Assembly, but I can assure the Health Secretary that junior doctors in Northern Ireland are absolutely furious about the proposed changes to their contracts. It would help if he could confirm that he is in regular direct dialogue with the Health Minister in the Stormont Assembly, Simon Hamilton MLA. I ask him not to reply that officials talk to each other regularly, because “Minister to Minister” is what I would like to hear.
Mr Hunt
We do have regular dialogue. I suggest that the reason doctors in Northern Ireland might be angry is that they have been listening to misinformation about what the Government in England are proposing, which has, very disappointingly, made doctors all over the UK very angry. I hope that the assurances I am giving, which I gave to the BMA last month and the month before, face to face and in letters, will encourage the hon. Lady to report to the doctors she mentions that the right thing for the BMA to do is to come and talk to the Government. Regrettably, the BMA’s junior doctors committee has refused to negotiate since last June. Instead, it put up a pay calculator on its website that scared many doctors by falsely suggesting that their pay could be cut by between 30% and 50%. It has now taken that pay calculator down, but the damage to morale as a result of it continues.
Cancer Drugs
Lady Hermon Excerpts(8 years, 8 months ago)
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Jim Shannon (Strangford) (DUP)
I beg to move,
That this House has considered the availability of cancer drugs.
As the turnout this morning indicates, the subject of the debate is of concern to us all. There are more Members from Northern Ireland present than usual, but that may be an illustration of the concerns of our constituents across Northern Ireland on this matter.
I did some background research before I came down to the Chamber, and I discovered that in September 2013, the British Medical Journal asked:
“Which way now for the Cancer Drugs Fund?”
In July 2015, the Health Service Journal said:
“Cancer commissioning overhaul could save 30,000 lives”
and The Daily Telegraph on 4 September led with the headline:
“Thousands of cancer patients to be denied treatment”.
On 5 September, The Independent reported:
“NHS cuts to drugs fund mean thousands of cancer patients in England will be denied life-extending treatments”.
Finally, The Guardian stated on 23 September:
“UK NHS cancer patients denied drugs due to inflated prices”.
All those headlines highlight a clear problem when it comes to cancer drugs, which is of the utmost importance and which is, unfortunately, too close to home for many of us. There are many organisations that help those affected, but I would like to mention Macmillan Cancer Support, which is very much in my mind. The charity stated that 2.5 million people in the UK are living with cancer in 2015. The fact that that is slightly less than 5% of our total adult population indicates that this problem is enormous. It is hard to find anyone whose life has not been touched by this horrendous disease in some way.
My father, who passed away this year, had cancer on three occasions. He survived all three of them and lived to the ripe old age of 85, having first been diagnosed some 36 years ago. I have always said that the skill of the surgeons, the care of the nurses and the prayer of God’s people saved him on those three occasions. For many of us, cancer is not simply something that others talk about; it is something that affects each and every one of us.
My father is only one example. In my office every week, people come to me who are suffering from cancer. Some are also in the throes of benefits problems; very often, in addition to the trauma of health issues caused by their cancer, people have to deal with benefits difficulties. We have to work out how to get them into the benefits process and take the financial pressure off them at such a crucial time.
Lady Hermon (North Down) (Ind)
I congratulate the hon. Gentleman on securing the debate, which concerns the availability of cancer drugs throughout the UK, not simply in Northern Ireland; I am surprised that more Members are not present. Greater availability of off-patent drugs would help in the fight against cancer and reduce cost to the NHS. Will the hon. Gentleman support that call and the private Member’s Bill on the topic?
Jim Shannon
I thank the hon. Lady—my hon. Friend—for her contribution, and I am happy to add my support. Indeed, I attended a meeting of the all-party group on off-patent drugs last Thursday, and it is important that we support its campaign.
David Simpson (Upper Bann) (DUP)
I congratulate my hon. Friend the Member for Strangford (Jim Shannon) on securing this debate. On a more humorous note, I heard him mention that he has never missed a debate that the Minister has participated in; I think we could safely say that he has not missed any debates in the past five or 10 years. He is a champion in his own constituency when it comes to cancer research and pushing for cancer drugs, and I congratulate him publicly today on his work and his effort.
I welcome the opportunity to participate in this debate. In recent days, our newspapers, TV screens and social media have been flooded with reports about cuts to cancer treatments. One of the latest reports I read indicated that 5,500 patients could miss out under the Government’s plan to reduce the availability of cancer drugs.
Today, cancer is a word that has become all too familiar in our households. As we come together to debate the availability of drugs, some 2 million people are battling cancer. They are husbands, wives, mothers, fathers, sons or daughters. The impact of cancer is much greater and much more widespread than it might appear if we consider only those who are statistically labelled.
Recently I had the opportunity to visit the state-of-the-art facilities at the Queen’s University Centre for Cancer Research and Cell Biology in Belfast. It is making fantastic headway in understanding cancer: how it is formed; how it develops; and ultimately how we can slow down its growth, and eradicate faulty genes and molecules in tumours. The centre was recently awarded almost £4 million to continue its work in research and in developing cancer treatments.
I am proud that Almac, a pharmaceutical company that is a world leader in cancer drug discovery, has its headquarters in my constituency of Upper Bann. Its founder, the late Sir Allen McClay, was so dedicated to improving patient care that he donated much of his wealth to the Centre for Cancer Research and Cell Biology. However, while all this work is going on and new drugs and treatments are being identified, we consistently hear reports that there are plans to remove life-prolonging drugs for various cancers, including breast cancer, prostate cancer and bowel cancer, to name just a few.
Lady Hermon
One of the greatest concerns is about the cost of these drugs. The hon. Gentleman said that one of the famous manufacturers of cancer drugs is based in his constituency. How often does he have the opportunity to meet people from that company? Would it be helpful for a cross-party delegation to meet the senior management of that company, to persuade them to reduce the cost of their drugs? I am sure that they could; where there is a will, a way will be found.
David Simpson
I welcome that intervention—the hon. Lady makes a very good point. If Sir Allen were alive today and witnessing the cuts in the availability of these life-prolonging drugs, which were once in the headlines as good news stories, he would come out with his old statement: “Bang your heads together and get a resolution to this.” It is a good idea to have such a delegation. I meet Almac staff on a regular basis. Almac is a pioneer in this sector; it is working with Government very closely; and I understand that the pricing of its drugs is not ridiculous.
However, I will make a parallel point. Well over a year and two months ago—perhaps more—it was announced at the Budget that the Health Minister would introduce funding so that a vaccine for meningitis B could be given to children. It took a year and two months—perhaps even more time—for that policy to be implemented, because the pharmaceutical companies were holding out for more money than the Government could afford to pay. They were asking ridiculous prices, because they had the sole remedy for a complaint, so could exploit that situation.
The message needs to go out to some of the pharmaceutical companies that we are dealing with life here. And as one hon. Member said earlier, even if there are only two or three months of life left, people want to hold on to that life as long as they possibly can, because where there is life there is hope, and hope is what people want to hold on to.
A number of weeks ago in this House, I attended an awareness day for secondary breast cancer, and I was shocked to learn that the Government do not keep data on people who are living with this incurable disease, which is remarkable. In the other House, Baroness Morgan of Drefelin has highlighted the issue: because the Government, the NHS and the pharmaceutical industry have again failed to agree realistic prices for new drugs, some women will die sooner than they should.
Bowel cancer is the fourth most common cancer in the United Kingdom. Experts say that around two thirds of those who seek NHS treatment for advanced bowel cancer treatment are likely to face an earlier death under the plans to scale back spending. That is wrong. Like many Members, I regularly meet—possibly on a weekly basis—constituents who are battling cancer or who have just been diagnosed with cancer. I recently met a family who told me of their agonising fate as their father had been diagnosed with lung cancer. Like many families, they have carried out their own extensive research and confirmed with their oncologist that there are drugs out there that could prolong his life. Millions of pounds have been spent on developing these drugs, which could perhaps either save people’s lives or prolong them. However, that family were told, “Sorry, but we can’t give it to him, because it’s just too expensive.”
Where do we draw the line when it comes to someone’s life and life expectancy, and the family who are left behind? I realise that the Government have very hard decisions to make. I appreciate that, but anyone in Westminster Hall today who has either suffered from cancer or known a family member or a loved one suffer from cancer would go to the ends of the earth to try to help them and to resolve this issue, because life is precious. As I say, the Government have hard decisions to make, but I do not think that anyone here today would or should put a price tag on a loved one’s life.
More needs to be done. Families living with cancer need all the help they can get, through the Government, through counselling, through drugs or through whatever help they can find. I trust that the Government will consider that when it comes to the funding of these drugs.
George Freeman
The hon. Gentleman makes an important point. I will be discussing the matter with the Minister for Universities and Science and the Medical Research Council. We need to make sure that we move to a more networked and collaborative model of science funding. Traditionally, we have tended to fund established centres of excellence, which is important, but we also need to make sure we build networks. Cancer networks in research and treatment have been incredibly powerful in driving the advances that we have discussed. He makes a very good point. I was delighted to see the leadership of the Queen’s centre recently recognised by Cancer Research UK with a £3.6 million grant.
I want to talk about the wider landscape of cancer treatment and then turn to the drugs question.
Lady Hermon
I am grateful to the Minister for allowing me to intervene on him before he moves on to a different point. I am pleased that Her Majesty’s Opposition have made it clear in the debate this morning that they are going to support the Off-patent Drugs Bill, a private Member’s Bill. It would be helpful to many MPs who have had emails from constituents, as I certainly have, to find out what the Government’s attitude is to the Off-patent Drugs Bill. I encourage the Minister to say, “Yes, the Government will support it,” although I do not want to put the exact words into his mouth.
George Freeman
I will come to that important point as I deal with some of the questions that have been raised.
On the wider issue of cancer treatment, I want to highlight the announcement that the Secretary of State recently made on setting out our cancer strategy and the work of the cancer taskforce. We have set out important measures on a wider treatment regime for cancer. By 2020, NHS patients will be given a definitive cancer diagnosis or the all-clear within 28 days of being referred by a GP. This will be underpinned by an extra £300 million a year by 2020. We are launching a new national training programme that will equip another 200 staff to develop the skills and expertise to carry out endoscopies by 2018. We have a commitment from NHS England to implement the independent cancer taskforce’s recommendations on molecular diagnostics. This will mean that around 25,000 additional people a year will have their cancers genetically tested to identify the most effective treatments.
I have been absolutely insistent since day one when we launched the genomics programme that this deep science project should be embedded in NHS England. Patient recruitment for the project comes through the 11 genomic medicine centres in NHS England, and NHS England is now developing an infrastructure for doing genomic and molecular diagnostics in the mainstream NHS. We want the NHS to be the first health service in the world to launch genomic medicine for all as part of our universal 21st-century offering. A lot of work is going on at the moment on how we build the infrastructure for molecular diagnostics.
Our aim is that, by 2020, everyone diagnosed with cancer will benefit from a tailored recovery package, individually designed to help each patient. We are also committed to empowering patients and giving them much more information, so that those who choose to do so will be able to access personal health information, such as their test results, diagnosis, treatment history and their cancer recovery package, online. By 2017, there will be a new national quality of life measure to help to monitor how well people live after their treatment has ended, enabling priorities for improvements to be identified. We will continue to work with NHS England, charities and patient groups to deliver those commitments. It is important to remember that as people live with cancer—hopefully, more people will live with it—we will need to invest in the support network for how they live with it, and how we continue to monitor and support them and deliver post-treatment care.
I want to emphasise the importance of the role of NICE. Nothing I am about to say in any way undermines our commitment to its independent role and expertise in guiding and supporting decision making on drug access with the latest evidence and health economic leadership. In no way do we want to undermine its position. NICE has led the world. That is a great tribute to it and to the UK’s system. We are clear that if a drug is recommended by NICE, the NHS is legally required to fund it. Over the years, many thousands of people in England have benefited from the cancer drugs that NICE has recommended. These include Herceptin, Yervoy, and Zytiga for prostate cancer.
Most recently, hon. Members will have seen that NICE published final guidance on 7 October that recommends Keytruda, or pembrolizumab, for the treatment of advanced melanoma, after disease progression with Yervoy. I urge NICE to embrace the new technologies. I will talk about that in a moment. I am particularly pleased to be able to announce that in the early access to medicine scheme, which we launched last year as the beginning of the new landscape and which I have asked my accelerated access review to look at beefing up and developing, the first drugs have come through. They have been fast-tracked.
I am delighted to confirm to the House that NHS England has now undertaken routinely to fund the use of NICE-recommended early-access-to-medicine products within 30 days of NICE guidance being published. Colleagues will know that the scheme was established so that an innovative drug may be designated a promising, innovative medicine, and if there is no alternative mainstream therapy, the treatment can be fast-tracked into patients, with their consent, and rapid assessment carried out. The link to NHS England commissioning had not been established, but it is now in place. I am delighted that the first drug has gone through that system, and we hope that more will follow.
George Freeman
The hon. Gentleman tees me up perfectly for the next section of my speech, because I want to deal with access to drugs and the Cancer Drugs Fund. We all recognise, not least the Prime Minister, that access to drugs is essential in this landscape, which is why he personally led the launch of the Cancer Drugs Fund—I thank the shadow Minister for paying tribute to that leadership. We have now committed just over £1 billion to the Cancer Drugs Fund—a substantial investment—and just under 80,000 patients have benefited from treatments that otherwise would not have been approved. They are largely treatments that NICE has turned down and the Cancer Drugs Fund has then stepped in to fund.
Because of the cancer field’s leadership in this new model of drug discovery, the rate of new drugs coming through is increasing and going to a targeted patient base. The smaller patient catchment for which industry must recover costs has driven it to raise prices and costs. In many ways, it has challenged NICE’s traditional £30,000 per quality-adjusted life-year model. It is driving huge pressure on our traditional model of health-economic reimbursement.
As Members have said, and as the National Audit Office report recently highlighted, the CDF was originally established as an interim measure to ensure that cancer patients were not denied drugs while we fixed the landscape. Although I have been in post only 15 months, I hope colleagues can see that the reviews of accelerated access and the CDF are not accidentally aligned. We are currently looking at how we make sure we support access to innovative medicines. Where cancer has led, other therapeutic areas will follow.
The genomic and informatics revolution will require NICE to change how it works. The explosion of progress in this field is what has put so much pressure on the CDF. Ever more treatments are coming online, but NICE is turning down ever more treatments on very well respected health-economic grounds. Those are difficult judgments about what represents health-economic value for the system and for patients. The CDF does not have a built-in discounting mechanism: it effectively takes the price on the basis of which NICE has rejected the drug and agrees to pay it. We want to look at whether we might use our extraordinary purchasing power to use the fund in a more productive way to get earlier access and, in return, discounts. That is what the accelerated access review is all about.
It is important to confirm that if NHS England decides to de-list a drug, any patients who have received a drug through the cancer drugs fund will continue to receive it. Where patients, particularly those with rarer cancers, are unhappy with a recommendation to de-list and their clinicians advise it, they can initiate individual cancer funding requests, an important avenue that many patients are successfully using.
I want to discuss the accelerated access review and respond to some of the questions that have been asked. I launched the review this time last year, asking and challenging the system to answer three big questions. Given the NHS’s extraordinary position as a universal, single-payer health system with leadership in genomics and informatics, the review is about asking what we can do to accelerate how we get innovation to patients. I have asked three specific questions. First, what can we do to shorten the time, cost and risk of getting innovation to that all-important moment of first use in patients? How can we make things quicker both for the patients who need it and for researchers, so that they can get those all-important human clinical data?
Secondly, what can we do to help NICE to embrace new flexibilities and pathways and to use genomics and informatics to update its systems, in order to deal with the issues raised by a number of colleagues relating to the end of the one-size-fits-all blockbuster model so that, in the 21st century, NICE has more tools at its disposal and more adaptive pathways—to use the jargon—to open up those flexibilities?
Thirdly, I have asked the accelerated access review to look at what barriers we can knock over and what incentives we can put in place to speed up the roll-out of innovative drugs and device diagnostics across the system. Unfortunately, there is great variation in the pace at which innovation is rolled out. In many ways, the CDF has pioneered on the very problems with which the system is now confronted. I am convinced that the CDF will be part of the solution. I cannot prejudice NHS England’s consultation, but I can reassure Members that, through the accelerated access review and the comprehensive spending review, we are looking at what we might be able to do to ensure that our commitment to funding innovative cancer medicines through the CDF also supports the broader landscape for innovative medicines. We will have to wait to hear the detail in the comprehensive spending review and subsequent announcements at the end of the consultation.
I want to deal quickly with one or two of the points made in the debate. The hon. Member for Upper Bann (David Simpson) made an important point about the different parts of the United Kingdom co-operating. As the UK Minister for Life Sciences, I am very conscious of leadership in Scotland, Wales and Northern Ireland, and would be interested to follow up on his point about using the broader network.
The hon. Member for Scunthorpe (Nic Dakin) asked me about NICE looking at exceptional circumstances. The accelerated access review is looking at whether we can give NICE more freedoms and flexibilities. The hon. Member for Motherwell and Wishaw (Marion Fellows) made an important point about the Scottish model—the innovative medicines fund there, the Scottish Medicines Consortium and the importance of patient voice, of which I am very conscious. She also discussed health inequalities, which are important.
Various colleagues asked about Abraxane. NICE is in the process of developing guidance on Abraxane for pancreatic cancer, which it expects to publish very shortly. The hon. Member for Strangford made an important point about data. We recognise that we need to be much better at gathering and using the data from the CDF. A data-sharing agreement between NHS England and Public Health England was signed in July.
In closing, I thank the shadow Minister for his support for the cancer drugs fund. We are intent on it remaining focused on access to drugs; we are tackling the wider treatment regime through the cancer strategy I have set out.
Jim Shannon
Thank you for chairing the debate, Mr Hollobone. I thank all right hon. and hon. Members who participated. A vast array of excellent knowledge was on display today from those who gave speeches and made interventions. Some great ideas were put forward, particularly that of the hon. Member for Foyle (Mark Durkan) about combined purchasing power. The Minister and shadow Minister were both on to that; it is something we can use better to develop the existing innovative drugs policies across the whole United Kingdom. I draw particular attention to the advances being made at Queen’s University Belfast, which we should combine with progress in the rest of the United Kingdom.
The contributions from each and every Member were valuable, detailed, informative and compassionate. It is important that we put on the record our thanks to the charities and other contributors. We are all moved by the e-petitions, which show that there is clearly a deep interest in the best way to fund cancer drugs. We have tried to ensure that patients at their weakest are the focus of the debate. I thank the Minister for his comprehensive reply. We look forward to helping our constituents across the whole United Kingdom of Great Britain and Northern Ireland.
Mr Philip Hollobone (in the Chair)
Order. I encourage Lady Hermon to grab the Minister and the hon. Member for Strangford (Jim Shannon) on the way out.
Question put and agreed to.
Resolved,
That this House has considered the availability of cancer drugs.
NHS (Five Year Forward View)
Lady Hermon Excerpts(9 years, 6 months ago)
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Mr Hunt
I thank my hon. Friend for his long-standing support for the importance of transparency in driving up standards in health care. He has championed that for his own hospital, which has had particular issues on that front, but also through his role in this House, and he is absolutely right to do so. On his substantive point, we will get CCGs to do what he suggests through the reforms that I have announced, which will encourage them to take a holistic view of the health care received by the patients for whom they are responsible. In particular, we have got to move away from commissioning care piecemeal—commissioning a certain number of hips or a certain number of mental health consultations—and start looking at patients and all their needs in the round. If we commission in that way, we can avoid a number of the human tragedies that have come to light.
Lady Hermon (North Down) (Ind)
Will the Secretary of State kindly confirm that the Chancellor will include in his autumn statement on Wednesday an obligation on the Northern Ireland Executive to ensure that if, as we expect, further funding for health is devolved to Northern Ireland, it is ring-fenced so that it is spent exclusively on health? In that way, GP beds in community hospitals such as mine in Bangor—in North Down, not north Wales—can be reopened. Those beds were closed today, 1 December, causing enormous trauma and distress to the patients and staff there.
Mr Hunt
The system involves Barnett consequentials. As a result of today’s announcement, extra money will go to the devolved Administrations and we hope that they will use it for health purposes, but they do have a choice. The hon. Lady has just made the case extremely elegantly for that money to be put into health. She mentioned north Wales, and I know that Members on this side of the House will be hoping that the Welsh Government will also use the extra money for the NHS, given the profound problems in the Welsh NHS.
Mitochondrial Replacement (Public Safety)
Lady Hermon Excerpts(9 years, 9 months ago)
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Dr Huppert
The hon. Gentleman is absolutely right, but I would improve the motion in a number of ways. I would not try to characterise Lord Winston’s position as being fundamentally different from what it is. I would also say that we need to have these regulations so that the tests can be done and so that we can go ahead with clinical trials and find out what happens in humans. I hope that the Government will introduce the regulations promptly. It has been useful to have this airing of views, but it will be helpful when we have the regulations before us to have that debate. This House will then be able to vote on whether or not to adopt the regulations.
Lady Hermon (North Down) (Ind)
May I assume—I am sure I am right in doing so—that this technique has already been trialled on mice and that the hon. Gentleman will know whether those trials have been successful? It would help the House if he could enlighten us about the success or otherwise of using this technique on mice.
Dr Huppert
I do not have a list of the organisms it has been tested on, but it has been widely tested on a number of organisms—I assume that mice are one, but I could not be absolutely certain—and has been successful. Obviously, if it was not successful on any other organism, it would be perverse to want to go ahead with it. However, I do not have details on the experiments with me.
I understand and appreciate that some people have genuine religious or ethical objections about interfering with an embryo. They are entirely welcome to make that case, but they should not claim other reasons as a cover for that. People are welcome to their ethical opinions—that is fine—but to say that we should not do this because we should wait indefinitely for more and more tests, so that we can be more and more sure before we ever try it in a human is simply to condemn more children to more pain and more anguish. That is not the right way to go. We do need to do more tests; there is much more to do before this will become a regular thing on the NHS and people can be saved—there is no doubt about that. But for that to happen, it has to be tested in humans—it has to be tested in children. We will help at that point, and I hope we will have children who do not have the sort of hideous problems we see now. I urge the Government to get on with this. We have to reduce the number of children who have these hideous conditions. The Government have the chance to reduce it and they should act promptly.
Jane Ellison
That was one area of detail covered in the draft regulations and the responses to the consultation on it, and I will write to my hon. Friend with a detailed response. A wider point is that we should surely not reduce the notion of parenthood to genes. Many Members who have spoken in the debate, particularly my hon. Friend the Member for Congleton, who moved the motion, have often spoken in other contexts about parenthood being more about loving, nurturing and so on. It cannot be reduced simply to the donation of genes—I worry that that, in itself, would be a slippery slope.
Mitochondrial donation is supported by both the chief medical officer, Professor Dame Sally Davies, and many clinicians and IVF experts, including, I am pleased to say, Professor Lord Winston, who has been quoted a number of times in the debate. Among other comments, he has made it clear that he supports the draft regulations and would vote for them.
This is undoubtedly a really difficult area in which to gauge public opinion, because it is complex and technical and a lot of people know nothing about it. Some Members who have seen e-mails going around the House asking them to attend this debate have told me that they did not know what it was about. That means that the exercise of engaging the public needs to be carried out in a thoughtful and comprehensive way. That was exactly what the Government did—we tested the public acceptability of introducing these techniques through a comprehensive dialogue process commissioned by the HFEA and led by external experts. It included events such as workshops and focus groups, and it showed that when the process of mitochondrial donation was fully explained to them, the majority of people supported its use provided that it was carefully regulated. The Department of Health’s consultation was on the draft regulations, and those who commented on them broadly supported them. I urge people to be mindful of the way to go about testing public opinion on the matter. We have to ensure that it is done on the basis of facts.
Jane Ellison
I am really sorry, I just do not have the time to give way. I am not being discourteous.
Successive Governments have responded to advances in science that were controversial in their day. Time does not permit me to go into them in as much detail as I would have liked, but many Members will cast their mind back to the debates about IVF. I suspect that there are Members in the Chamber today who were extremely wary of IVF techniques but who have written to me in the past year asking me to help infertile couples in their constituency. We were told in the debates on IVF that the proposal for limited research on embryos, up to a maximum of 14 days’ development, was a slippery slope and that the 14-day rule would become 20 days, 50 days or even six months. Today, 25 years on, the Rubicon remains uncrossed and the important provision that research cannot take place on embryos more than 14 days old, which Parliament put in place, remains firmly in place. I hope that that gives Members some reassurance.
Mitochondrial donation will enable people to have their own, genetically related children, free of serious mitochondrial disease. The proposed donation techniques will allow unaltered nuclear DNA to be transferred only to an egg or embryo that has unaltered healthy mitochondria. I could not have put it more eloquently than my right hon. Friend the Member for Havant (Mr Willetts) did when he talked about the difference between nuclear and mitochondrial DNA.
On the issue of three parents, I mentioned—as have others—that we cannot reduce parenthood to a matter of 37 genes from a donor. It is about so much more than that, and our draft regulations refer to some of the safeguards in place.
There is no cure for mitochondrial disease, nor is there one on the horizon. The families of children born with severe mitochondrial disease face the prospect of having to watch their child suffer dreadfully, and in many cases die at an early age. Many Members have met constituents in recent months—as have I—who are facing that heartbreaking situation, and I pay tribute to the Lily Foundation for its work in helping us all to connect with those constituents.
This has been a thoughtful debate, and it is vital that Parliament discusses such matters openly and considers all the issues. For those who are not opposed in principle, we must consider all the evidence alongside the benefits that this treatment can bring, and make that consideration in a rational way. The Government will, of course, continue to consider the expert advice we have received and how that influences regulations before they are brought before Parliament for further debate. We believe that this is an important scientific advance that holds out great hope for families in this country and around the world.
Cross-border Health Care (England and Wales)
Lady Hermon Excerpts(10 years, 11 months ago)
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The Parliamentary Under-Secretary of State for Health (Anna Soubry)
I congratulate my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) on securing this debate. He has raised a number of important topics—notably, the difficulties of people resident in England who are registered with a local GP whose service is deemed to be in Wales, even though the surgery may be in England. I am fully aware of my hon. Friend’s keen interest in local health matters affecting his constituents and his tireless work to support Hereford hospital. The whole House will agree that we would all expect good quality patient care, regardless of which part of the country we live in.
As my hon. Friend knows, I am very sympathetic to the concerns he has raised about English residents who are unable to access English hospital care because they are technically registered with a Welsh GP practice—even when, as I said, for a small number of patients, that GP surgery is physically situated in England.
I am told by my officials that the NHS services that any patient can access, and their NHS rights, are determined by their GP’s country of registration. As we have heard, that is formulated through protocol between NHS England and the Welsh Assembly; it means that, legally, a person has to be registered with an English GP practice to access English NHS services.
I am very concerned that despite an English border patient’s right to register with a GP practice on either side of the border, that is not always possible in practice. I recognise that, in rural communities, patients often do not feel a choice is available, given that the most accessible practice is a Welsh one. I also recognise that many people are registered with a local GP in England but the main practice is over the border in Wales. Those people may not want to change their GP practice. Why indeed should they? We could understand why they might, because in Wales people unfortunately do not get some of the excellent access to services that we enjoy in England. I am very concerned about this. I am told by NHS England that it has asked its legal advisers to review their earlier advice on the protocol signed between it and the Welsh Government with reference to the specific concerns that Ministers—that is, me—and the Welsh Secretary have raised.
Lady Hermon (North Down) (Ind)
It is very kind of the Minister to take an intervention at this stage. Will she kindly confirm that when she invites her officials to look at this issue they will take up the suggestion made by the hon. Member for Strangford (Jim Shannon) and look at the valuable lessons that have been learned in Northern Ireland about the useful co-operation across a land frontier with the Republic of Ireland and a key, integral part of the United Kingdom—Northern Ireland?
Anna Soubry
I am grateful for that intervention and for the wise words of the hon. Member for Strangford (Jim Shannon), who, as ever, brings a great depth of experience to these matters. Yes, we will certainly take that on board.
All this came about because of a meeting between me and my officials, the Welsh Secretary and my hon. Friend the Member for Forest of Dean (Mr Harper). As a result of that meeting, I have asked NHS England to work locally with GP practices in the border counties to review their practice boundaries with the aim of providing additional choice of GPs to those who do not currently have it. I am keen that all English patients are able to access an English GP if they wish or that they can register with a Welsh GP if that is their choice and they are aware of the impact of that decision. I have also asked NHS England to review the protocol as it currently stands.
I have asked the Welsh Government to review their policy on out-of-area treatments to consider an exception for English residents—specifically, that GPs operating from branch surgeries in England should be exempt from the requirement to seek prior approval for English resident patients to be referred to hospitals in England. These are all matters of concern not only to constituents of my hon. Friend the Member for Hereford and South Herefordshire but to others. We have heard about that from my hon. Friend the Member for City of Chester (Stephen Mosley) and my hon. Friend the Member for North Herefordshire (Bill Wiggin), and of course I know of the concerns of my hon. Friend the Member for Forest of Dean.
I am informed that since the meeting with the Welsh Secretary and my hon. Friend the Member for Forest of Dean, NHS England has had several further meetings with colleagues in the Welsh Government and local health boards based in Wales to discuss these concerns so that they can be addressed. There have been constructive discussions with Aneurin Bevan local health board, which has confirmed that it will undertake a review of the application of its policy on out-of-area treatment. I understand from NHS England that work will continue on this review over the next few months, and I will of course keep everybody fully informed and up to date on any progress.
Suicide Prevention
Lady Hermon Excerpts(11 years, 4 months ago)
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Norman Lamb
One of the things that I am determined to do while I am in this job is give mental health services, and access to them, the real priority that they deserve. Our first mandate to the NHS Commissioning Board gives mental health a much higher priority than it has ever had before. In establishing the principle of parity of esteem, we have asked the board to pay particular attention to access to mental health services in order to ensure that people with those problems have the rights of access that people with physical health problems have had for some time. Every life taken by suicide is one too many.
Lady Hermon (North Down) (Ind)
I am grateful to the Minister for taking a second intervention so soon after the first. He has rightly paid tribute to the work of the Samaritans, who undoubtedly prevent a huge number of people from taking their own lives and who do tremendous work in Northern Ireland. What public funding do groups such as the Samaritans, who do such tremendous work, receive from the Government?
Norman Lamb
I cannot give the hon. Lady precise figures here and now, but I will write to her and make sure she gets a full response to that legitimate point.
This debate serves as a timely reminder that suicide continues to be a major public health issue, particularly at a time of economic and employment uncertainty. The suicide rate in England is relatively low on international comparisons, and good progress has been made in reducing the rate in England over the past 10 years. That is something to be proud of, but it must not be the end of the struggle. We must be vigilant. About 4,500 people took their own lives in England alone in 2011, an increase on the previous year of about 6%. Although the three-year average suicide rate has remained steady since 2005-07, the rise in the number of people dying by suicide in 2011 is deeply worrying.
We know that suicide rates vary across the UK, and the hon. Member for South Antrim made the point that the suicide rate in Northern Ireland is higher than in England. In fact, it is the highest in the United Kingdom, and Scotland and Wales also have their own very real challenges. The coalition Government are working with the devolved Administrations to share evidence on suicide prevention and effective interventions. Suicide is still a major taboo. The hon. Gentleman highlighted the importance of our collectively speaking up about the subject. The way to reduce the number of suicides is not to comply with that taboo and keep it under wraps; on the contrary, we must tackle the problem and the surrounding issues head on.
We published a new suicide prevention strategy for England in September last year. It was written to help to reduce the suicide rate and it prioritises the importance of supporting families, so that those who are worried about a loved one know where to go for help, and supporting those who are bereaved as a result of suicide. They must receive help. There are excellent organisations such as Cruse Bereavement Care—I should declare an interest as my wife works for it—that provide support for people who are bereaved.
The strategy is backed up by up to £1.5 million for research, and it highlights the importance of helping the groups at highest risk of suicide by targeting interventions in the right way and at the right time. In-patient services are getting better at that. The most recent national confidential inquiry into suicide and homicide shows that the long-term downward trend in patient suicides continues.
Giving greater priority to mental health services is also critical. We are championing parity of esteem for physical and mental health, and through our improving access to psychological therapies—IAPT—schemes we are treating more people than ever before for mental health problems. Through the Government’s NHS mandate, we have gone much further than ever before in emphasising the priority the NHS must give to mental health. The mandate also makes specific reference to the need for mental health services to seek to reduce the suicide rate among users of their services, although I take on board the point made by the hon. Member for Bridgend (Mrs Moon): we must also be acutely aware that many people—I think she gave the figure of 75%—who take their own lives are not known to the statutory services. It is very important that the statutory services do everything they can, but that is not the whole problem; there is a very significant issue beyond that.
We also need to make sure there is enough information about treatment and support, and that it is freely available to those who need it, including those who are suffering bereavement following a suicide. A lot of that planning and work will happen locally, with local agencies deciding on how best to reduce the suicide rate and support families. Our recent strategy is not an instruction manual; it is more a tool to support local agencies in working out what is needed.
Suicide prevention will also be a priority for the new public health system. The public health outcomes framework has the suicide rate as an indicator. That is a horrible piece of jargon, but this project addresses what outcomes and results the whole system is trying to achieve, and one of them is the need to reduce the suicide rate. A shared indicator with the NHS outcomes framework also focuses on reducing the number of premature deaths of people with serious mental illness—such deaths also, of course, include suicides.
We are tackling stigma in relation to mental health, which the hon. Member for South Antrim rightly mentioned, with the brilliant Time to Change programme led by the charities Mind and Rethink Mental Illness, which is designed to reduce stigma and break isolation. A few months ago, we had a brilliant debate in this House when Members talked about their own experiences of mental health. That, in itself, was very important in bringing the issue out into the open and recognising that successful people, as well as many others, suffer from mental health problems and it is nothing to be ashamed of.
Children and young people have an important place in the new suicide prevention strategy. The suicide rate among teenagers is below that in the overall population, but that does not mean it is not a problem. For example, suicide is still the most common cause of death in young men, as I mentioned earlier. In addition, about half of mental health problems begin to emerge by the age of 14.
Norman Lamb
I thank the right hon. Gentleman for that constructive intervention, and he is absolutely right.
The suicide prevention strategy also recognises that the media have a significant influence on what children do and think. As well as promoting responsible reporting in the media, the strategy emphasises the importance of working with the industry to tackle websites that encourage suicide. That is, in a sense, at the heart of the motion and of the points raised by the hon. Member for South Antrim.
Misuse of the internet to encourage vulnerable people to take their own lives is utterly wrong. It is deeply worrying that young people can easily be exposed to such pernicious material, but we should not dismiss the internet as a source only of harmful material. It also provides an opportunity to reach out to vulnerable people who might otherwise refuse support or information, including those young men who might not come forward. It is worth remembering that when used well the internet can be an incredibly valuable way of helping vulnerable people.
Only last week, I convened a meeting bringing together internet security companies, charities and Departments to explore how to protect children and young people from harmful suicide-related internet content. The industry representatives at the meeting told me about some of the good work they are already doing. For instance, McAfee informed me that it has valuable learning to share from its work with the Australian Government on an online safety campaign in schools. I think my right hon. Friend the Member for Bermondsey and Old Southwark (Simon Hughes) will be interested to hear about that. McAfee has campaigned to get the message out to schools in Australia so that youngsters have information about how to seek help. There is a lot we can learn from that.
At that meeting—
Lady Hermon
I am grateful to the Minister for giving way; it was terribly rude of me to interrupt and I apologise. Will he reassure us that when he convened that critical meeting with those who provide internet services, representatives from the devolved Administrations and from the Health Departments in Northern Ireland and Scotland were invited to attend? When we debate the United Kingdom, even though we have a devolved Administration in Northern Ireland I like to know, as someone who feels passionately about remaining in the United Kingdom, that we have joined-up government.
Norman Lamb
I am very grateful to the hon. Lady for her intervention. Those representatives were not invited to the meeting, but let me make a clear commitment that we will work with the devolved Administrations. I mentioned that earlier and it is in all our interests that we tackle the problem together.
At that meeting, I urged the security companies, such as McAfee and Symantec, to work collaboratively with interest groups who were present, such as Samaritans and BeatBullying, and internet service providers to sign up to a concordat that would help to speed up the process for reporting harmful content and the blocking of harmful websites. They gave me positive assurances that they would explore such a concordat, and in turn we as a Government would be willing to facilitate and support such an initiative however we can.
The UK Council for Child Internet Safety is already making parental controls more accessible so that children can access less harmful content. The Under-Secretary of State for Education, my hon. Friend the Member for Crewe and Nantwich (Mr Timpson), who is the Minister responsible for children and families, will explain more about the work his Department has been doing when he sums up.
As I said at the outset, this is one of the issues that unite us all.