(1 month ago)
Commons ChamberI commend my hon. Friend for raising this issue. It is true that the steps we are taking owe much to the work of the Union of Shop, Distributive and Allied Workers, the Co-op, the British Retail Consortium and the Association of Convenience Stores. Everyone has a right to feel safe at work, but the March statistics show a 30% increase in shoplifting offences, many of which are violent, over 12 months. We welcome the operational commitments made by the police in the retail crime action plan. I know that the Minister of State, Home Department, my right hon. Friend the Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson) has heard my hon. Friend’s request and that she will be happy to visit Ipswich with him.
(4 months ago)
Commons ChamberThe truth is that not only have apprenticeship starts plummeted since 2017, but new data shows that the overall achievement rate has dropped since 2020, with level 2 apprenticeships hit hardest. Almost half of apprentices do not complete their courses, which is simply not good enough. Employers are calling out for reform, but this Government have their head in the sand. Is this not yet more evidence that, far from tackling barriers to opportunity and boosting Britain’s skills, the Government are failing our young people and our businesses, and that only Labour has a plan to turn this around?
(8 months, 3 weeks ago)
Commons ChamberShockingly, results last summer revealed that one in three students dropped out of their T-level course, which is higher than for earlier cohorts. Something is going very wrong. In April, the Education Committee raised major concerns about T-level roll-outs, regional variations and falling employer engagement. Access to opportunity really matters, so should the Minister not now pause and review the defunding of alternative qualifications, as Labour would, and urgently bring forward the 2023-24 T-level action plan in order to address concerns raised by the Select Committee and Ofsted and bring much-needed clarity and support for colleges, employers, parents and students?
(10 months, 2 weeks ago)
Commons ChamberIncreasing the take-up of higher technical qualifications is desperately needed, with low take-up leading to persistent skills gaps and holding back economic growth. Colleges, which we were proud to celebrate during Love Our Colleges Week, tell us of issues affecting take-up, including a lack of quality careers advice, challenges with stable staffing and late course approvals. With the UK seeing only 10% of adults whose highest qualification is between level 3 and level 6—the sixth lowest rate in the G7—should not the Government address their cuts to careers advice, as Labour will, so that young people do not miss out because they hear about opportunities far too late?
I congratulate the hon. Lady on her new position, but I genuinely do not know what planet she has been living on these past few years. We introduced higher technical qualifications and are transforming qualifications across the country. We introduced T-levels and spent £90 million to transform careers advice. Ninety per cent of schools are in a careers hub, and we have the National Careers Service. We are doing a lot of work to support careers, and we are spending something like £3 million to ensure that apprenticeships and skills are taught in schools up and down the country—more than 2,000 schools and 680,000 pupils. We are doing huge amounts on careers, and we are the people who transformed skills in our country.
(1 year, 2 months ago)
Commons ChamberThe truth is that in the year stated, exports to the EU fell as a proportion of total trade. Last month it was not inflation that halved, but exports of fruit to the EU. The British Chambers of Commerce has reported that more small and medium-sized enterprises are seeing exports falling than rising, and Britain has the lowest export rates in the G7. When a business tells me that it used to take three days for its products to reach shelves in Germany and now it takes 30, is it not fair to conclude that the Government have failed on the economy, have no plan to make Brexit work and are making businesses pay the price?
(1 year, 5 months ago)
Commons ChamberOur great British businesses are being let down by 13 years of Tory failure, with little to help but sticking-plaster policies. The Minister may not be aware, but insolvency numbers are at their highest level in four years, which is perhaps no surprise when we look at this Government’s record on small businesses, with Help to Grow: Digital ditched, energy bill support slashed and business investment the lowest in the G7. It is no wonder that the Federation of Small Businesses says that the Budget has left many businesses feeling “short-changed”. It is clear that for this Tory Government, small businesses are an afterthought, so will the Minister follow where Labour leads—reform business rates, boost skills, make Brexit work and make Britain the best place to start and grow a business?
(1 year, 7 months ago)
Commons ChamberMaintaining the universal service obligation as affordable and accessible for all, ensuring a fair deal for workers and improving the service by Royal Mail are what it will take to ensure the quality of postal services that our constituents need and deserve. Astonishingly, last year the International Distributions Services board led the company to losses of £1 million a day, just six months after reporting huge profits and paying out £567 million in dividends and the share buy-back, putting at risk the stability needed to modernise and keep Britain’s Royal Mail competitive. Is this not so clearly the result of mismanagement at the highest level, and is it not now time for an inquiry into the actions of the board and the CEO and the risks facing the postal service?
(1 year, 9 months ago)
Commons ChamberI grew up in a small family business. Labour is proud to be supporting Small Business Saturday and its 10th anniversary, and to have supported last week’s family business week.
Small and medium-sized enterprises are indeed the lifeblood of our economy, but they have been hit hard by 12 years of Tory failure and staggeringly low growth. Even after three Prime Ministers this year, the Government have no answers—and the House should not just take that from me; the Federation of Small Businesses judged the autumn statement as being
“low on wealth-creation, piling more pressure on the UK’s 5.5 million small businesses”.
If the Government are really serious about helping small businesses to grow, is it not time they adopted Labour’s plan to reform business rates, back our high streets, make Brexit work, and make Britain the best place in which to start and grow a business?
(1 year, 10 months ago)
Commons ChamberIn recent weeks, having crashed the economy, the Conservatives have increased the barriers facing small firms, with spiralling costs making it harder than ever to do business. Last week, the Federation of Small Businesses reported business confidence falling to its lowest levels since the pandemic. Yet, as almost half of small businesses reported falling revenues this quarter, the Secretary of State spent the weekend saying it was “Boris or bust”. Surely recent Government chaos shows that, for small businesses, it is Labour or bust. If the Secretary of State really wants to reduce the cost of doing business, will he back Labour’s call to raise the small business rate relief threshold for this financial year, saving local firms up to £5,000?
(2 years, 7 months ago)
Commons ChamberTory failures on the economy now show all too clearly that the Tories are no longer the party of business. Business taxes and costs are rising, revenues and profits are falling, and businesses face a cliff edge in March as support is withdrawn. Yet when hospitality businesses were losing, on average, £10,000 a week, the Chancellor was in California, with the Business Secretary nowhere to be seen. Does the Minister agree that hospitality businesses, hit hard by covid and Government chaos, need more than the one-off grants finally announced, and will he now back Labour’s calls for the Government to consider extending the VAT discount for hospitality?
(3 years, 3 months ago)
Commons ChamberMay I say that this is going to be my last DWP questions in this role and thank the Minister for the constructive way that she has developed the relationship? I will be handing—
I am sorry, Mr Speaker, but I will be handing over to my hon. Friend the Member for Middlesbrough (Andy McDonald), on whose behalf I ask this question.
Last month’s data shows kickstart helping less than 4% of 16 to 24-year- olds who have lost their jobs over the last year. The scheme is nowhere near matching the scale of the challenge and, even worse, the Department, as has just been confirmed, still plans to end the scheme just as unemployment is set to peak. Employers speak of delays of weeks for vacancies to be approved and then advertised. It is almost a year since the Chancellor announced kickstart. There is no excuse for long-term unemployment becoming a legacy of the pandemic, so when are things going to change, and will the Secretary of State now urgently review the December kickstart end date in line with calls by Labour, the Confederation of British Industry and the Youth Employment Group, so that employers can also plan ahead?
(4 years, 3 months ago)
Commons ChamberOur economic recovery will depend much on public confidence, yet polling this morning found that almost half the population believe that the Prime Minister has gone too far. Many have deep concerns that they could put themselves and family members at risk if they cannot properly social distance when they return to work, and it is clear that the workforce and management must agree safe arrangements that people will trust. Will the Government adopt the TUC’s proposals for employers to publish covid-secure risk assessments and urgently increase funding for the Health and Safety Executive, which the Minister knows has been cut by a third since 2010, to enforce these measures?
I thank the hon. Lady and welcome her to her place. I am very interested to hear her policy priorities, ideas, thoughts and views, and I am keen to meet to discuss what the Department for Work and Pensions is doing. It is absolutely right that, as people look to return to work, we have published our plan—a cautious road map—this afternoon. We recognise that this is not a short-term crisis. I can tell her that our Secretary of State has been engaged in broader support for the HSE, which has done a magnificent job—
(4 years, 10 months ago)
Commons ChamberI finished questions earlier, but you have certainly put that point on the record.
On a point of order, Mr Speaker. May I ask your advice about what may happen during the parliamentary Dissolution? I am particularly concerned about how I may raise the case of Mr Benjamin Williams from my constituency. A wheelchair-bound young man with degenerative spine disease, he has had great difficulty getting the services he needs from Shepherds Bush Housing Group, which seems to have been obstructive in every respect in relation to leaks, the fact that his windows do not close and other matters. Can you give me some advice about how I can raise this issue further, particularly to make sure that he gets the support he needs prior to Christmas?
You are quite right to raise such an issue on behalf of a constituent, but we can still write to Ministers during that period. I think you need to make sure you get your letter off today, but I do hope they have already been listening.
(4 years, 10 months ago)
Commons ChamberI am not going to enter into speculation. I have been very clear, and I have made the point. I am not going to change any more.
Further to that point of order, Mr Deputy Speaker. Further to some of the comments that have been made, may I seek your advice about the accountability of the Prime Minister? Truly, he is accountable to the Liaison Committee as well as to the House, and in other matters—
Order. I have been down that road already, and I am not going to change what I have said.
(4 years, 11 months ago)
Commons ChamberThe hon. Gentleman makes a point that I will come on to about how the decisions need to be made on the medical evidence and with the voice of the consultants being clearly heard by those making the decisions.
There is no cure for this condition, but two years ago my consultant’s neurologist advised that Maraviroc had had a positive effect on patients suffering from PML in relation to her condition, immune reconstitution inflammatory syndrome in multiple sclerosis. An individual funding request was submitted by my constituent’s consultant, national expert Professor Ciccarelli at the National Hospital for Neurology and Neurosurgery. The application was refused and a subsequent appeal was also unsuccessful—this process went on through 2017 and 2018—seemingly on the same basis as was given to me in writing in October by NHS England, which was that the
“use of Maraviroc for this condition is currently seen as experimental as the current evidence is limited to very small observational studies. NHS England has concluded that there is not sufficient evidence to support the routine commissioning of this treatment for the indications listed.”
The effect on Amarjit was heartbreaking. I met Amarjit and her friend and advocate Kartik. She had a wheelchair and a walking stick, and even the most basic activities were a struggle. She had decided to fund the drug privately from her savings. Maraviroc had remarkable results for her—importantly, that was also the opinion of her consultants—without any side effects. Other treatments that the NHS had sought to prescribe, such as MRIs and monthly steroids, were not just neutral but net negative. Amarjit and Kartik explained the impact that Maraviroc had had on Amarjit’s health and quality of life. I was just staggered when she told me:
“I can talk. I can walk. I can go to the bathroom on my own”—
things that we take for granted. Clinically, the PML lesion appeared inactive and there was a reduction in the inflammation around her brain.
The drug costs around £480 a month, but by the end of June this year Ms Rai could no longer afford to pay for it herself, so she has since been without it. Although her health has been stable so far, such is the condition that it could dramatically change at any time.
Aside from the issue of funding, I have been surprised over the past year by inconsistencies in NHS policy and advice. We all believe in an NHS that is free at the point of need. This is a situation where the patient, leading neurologists and all involved in her care agree that she should have the drug. In November 2018, consultant neurologist Dr Michael Gross, who was also supporting Amarjit’s care as an expert advocate, wrote to Kartik:
“Thank you for confirming further information about Amarjit Rai... Professors Johnson and Ciccarelli agree that this is the appropriate treatment for Amarjit. Long term steroids have already generated severe osteoporosis in 2016 and are not her choice.
You will have already proved in what is an N=1 trial that her treatment would appear to be effective. There will almost certainly never be the size of trials in this rare disorder that would allow a definitive statement by a funding organisation.
I think we have to ask who is making the decision, given that there are now three senior consultants confirming this is the right decision… Quite frankly I am appalled by the lack of humanity that is being demonstrated here.”
In November 2018 I wrote again to the Minister. I received a response from Lord O’Shaughnessy in the other place, who helpfully said the following:
“Maraviroc is not licenced for the treatment of symptoms of PML. There are clinical situations when the use of unlicensed medicines or use of medicines outside the terms of the licence, known as off-label, may be judged by the prescriber to be in the best interest of the patient on the basis of available evidence. The responsibility for that falls on healthcare professionals.”
Sadly, this made no difference.
Following the lack of progress, I wrote again to the Secretary of State in March 2019. I quoted the helpful response that I had received from Lord O’Shaughnessy. The Health Minister in the other place, Baroness Blackwood, responded in May and referred again to the individual funding request process. She stated that the IFR can be considered only if the patient can be demonstrated to be clinically exceptional. She said that
“an IFR can only be considered if the patient can be demonstrated to be clinically exceptional compared to the wider group of patients and is likely to derive greater benefit from the treatment.”
At face value, all of this would appear to be true for my constituent, but the use of Maraviroc is an area where policy appears to be in some confusion.
In response to a parliamentary question I asked in July about the assessment that NHS England has made of the availability of Maraviroc to patients with PML, a third Health Minister, the hon. Member for South Ribble (Seema Kennedy), wrote:
“We are informed by NHS England and NHS Improvement that it does not commission Maraviroc for progressive multifocal leukoencephalopathy… NHS England and NHS Improvement have published a do not commission policy for ‘Natalizumab-induced progressive multifocal leukoencephalopathy in relation to immune reconstitution inflammatory syndrome in multiple sclerosis.’”
That response seems to contradict earlier responses and advice. First, “does not routinely commission” is different from “does not commission”. Secondly, it made no reference to the IFR process, which two Ministers had previously mentioned.
I tabled a further parliamentary question last week to ask what assessment the Secretary of State had made of the effectiveness of Maraviroc in patients with PML. A fourth Health Minister, the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries), responded to my question. The response I received today was mind-boggling:
“Maraviroc is currently authorised for the treatment of patients who are infected with HIV type 1. The Medicines and Healthcare Products Regulatory Agency which is responsible for the regulation of medicines in the UK is not aware of any application for use in patients with PML and therefore cannot comment on the efficacy of this drug in patients with PML.”
It might be helpful if I highlight for the Minister findings from wider medical journals that the House of Commons Library has helped me to compile. In December 2016, the American Academy of Neurology published an article entitled “Severe early natalizumab-associated PML in MS: Effective control of PML-IRIS with maraviroc”. A summary of a case involving a 55-year-old Caucasian HIV-negative man diagnosed with relapsing, remitting MS in 2013 shows that that led to a subsequent diagnosis of PML. Clinically, the patient deteriorated rapidly, according to the article. Oral Maraviroc was initiated six days after his admission. Eight days after Maraviroc initiation, MRI follow-up revealed stable PML lesion size. Over the following weeks, the patient improved continuously. After 25 weeks of Maraviroc treatment, the John Cunningham virus DNA was no longer detectable. Maraviroc was continued and well tolerated at a stable dose. The patient survived both PML and IRIS.
A subsequent article was published by the American Academy of Neurology entitled “Maraviroc as possible treatment for PML-IRIS in natalizumab-treated patients with MS” in December 2016. It cited a 34-year-old man treated with Natalizumab for three years without previous immuno-suppression. After a period of time, the patient was admitted with seizures, headaches, and impaired memory, and an MRI scan subsequently confirmed PML. Twelve months after diagnosis with PML and six months after the start of Mariviroc, PML-IRIS lesions were resolved, and no new MS disease activity was detectable.
An article in 2017 by Steiner and Benninger published by the American Academy of Neurology built the medical explanation for why Maraviroc had been effective in cases of PML in MS sufferers. In summary, the condition for which the cause is believed to be the John Cunningham virus, which infects the central nervous system in patients with low immune conditions, became more prevalent and was observed in around 5% of patients with HIV prior to the availability of highly active antiretroviral therapy, or HAART. The article goes on to describe how the era of
“monoclonal antibodies for immune-mediated conditions such as Natalizumab for MS and Crohn disease heralded another context for PML. As of November 2016, there have been 698 reported cases of PML under natalizumab.”
The research goes on, and it is true that some research such as that published in The Journal of the Neurological Sciences in July 2017 confirms that it does not work in all circumstances, and steroids may be more effective in some patients. However, an article in Neurology Times in January 2018 states that in PML treatment options are limited. Maraviroc has been used successfully in some PML patients to avoid IRIS, although not all patients respond to Maraviroc. It recommends further research and testing in identifying patients at risk of IRIS and tailoring treatments accordingly.
In that context, let me make reference to the urgent clinical commissioning policy statement on Natalizumab-induced PML, which was published by NHS England in March 2018. It said:
“It has been assessed that the development of a full policy is not needed at this time as there is currently little evidence into its effectiveness for this indication”.
I do not believe that that policy statement takes account of all the research available or indeed that which has appeared subsequent to its publication. The research is more nuanced, the medical benefits for my constituent are undeniably clear, and the denial of funding is inexplicable to her and renowned experts in the country.
Maraviroc, or Celsentri, as defined by the European Medicines Agency—formerly in London, it is now based elsewhere in the European Union—is a medicine that is routinely prescribed for HIV. Although it does not cure HIV infection or AIDS, it may hold off the damage to the immune system and the development of other infections and diseases.
Medical research has identified that the JCV most associated with HIV patients with low immunity has found another context in patients with PML. My constituent’s condition is incredibly rare, affecting, potentially, 10 or fewer people in the country. Given that very few options are available, she is not the only patient for whom, in anecdotal studies, the drug Maraviroc has shown remarkable results. With no other options available, my very ill constituent has been paying £500 a month privately for the past year to fund Maraviroc herself, but she can no longer afford to do so. Amarjit’s consultant neurologist and other specialists support her receiving the treatment. There is an irony in the fact that more is potentially being spent by the NHS in a month on treatment and tests that do not benefit her as much, and have damaging side-effects. The IFR system in the NHS should be able to review and respond to that situation on the basis of medical need, and I cannot see how that has been done in this case.
Will the Minister tell me how her Department liaises with and challenges NHS England on cases such as this, and how well-researched the Department’s responses to me have been? Will she tell me with what medical advice the treatment has been refused, although three of the leading experts in the country support it in this rare case, and whether their advice can be shared with my constituent and her consultant, Professor Ciccarelli? Will she also agree to a meeting with me, my constituent and her consultant, and a senior member from NHS England to discuss the IFR process?
This is a matter of £500 a month, and of demonstrable medical benefits to my constituent. I should be grateful for the Minister’s response, and her advice on how we can move forward.
I welcome the Minister to the Dispatch Box. I believe that this is her first outing. She is obviously held in high esteem, given that so many Whips are present at once.
(5 years, 5 months ago)
Commons ChamberI thought it was available, and it should be available. If not, it is still being done. I think the problem we have got is that with the tight timescale, we are trying to play catch-up a little bit. That is why I am trying to help.
On a point of order, Sir Lindsay. Thank you for repeating the list of amendments that have been selected. Could I ask you to repeat them again a little bit more slowly, because we could not get through the amendment paper fast enough?
(5 years, 8 months ago)
Commons ChamberI thank the Minister for giving way again. He is being extremely generous in taking interventions. The Speaker said earlier that there was no cap on repetition in the Chamber, but I think that he has won the award today.
My I gently say to the Minister that publishing documents day after day is not preparing this country? We are coming up to Christmas, and in three months we will leave the European Union. Businessmen are busy running their businesses and employing people, and we are approaching the end of the road. The Minister has said that it is not Government policy to extend article 50, but does he agree that it is legally possible to extend or, indeed, revoke it?
Order. Many Members want to speak, and we are running out of time. The debate must finish at 7 pm, so please, let us be courteous to everyone.
(6 years, 10 months ago)
Commons ChamberWill the Minister confirm that the list of sectors was not published directly to the House in a ministerial statement, despite more than 120 MPs calling for its publication? Will he also confirm that Parliament’s votes in October and December last year, to which he referred, were on Opposition day motions?
Before I bring the Minister back in, I just want to let those Members who wish to speak know that there will be a five-minute limit after the Front-Bench speakers.
(6 years, 10 months ago)
Commons ChamberOn a point of order, Mr Deputy Speaker. Last week in his evidence to the Exiting the European Union Committee, the Secretary of State for Exiting the European Union told us that the list of sectors for which an analysis of the impact of Brexit was completed would be made available imminently. He said:
“I have signed a letter to the Lords committee on it, which includes the list. If it has not gone yet, it will go soon.”
On Thursday, when I inquired of Department for Exiting the European Union Ministers, who were then giving evidence, about the list, they said: “I know as much as you do in terms of what the Secretary of State said yesterday. I know that there is a list, and as I think he said it has been signed off to go, so it should be with both your Committees before too long, I suspect.”
A couple of hours ago the list finally arrived in the Lords, buried in a 25-page document, but it has not been sent to the Commons Select Committee for Exiting the EU, as promised. In fact, it only received it after being sent the document from my office.
Given that the publication of this list has been promised “shortly” at least since June in this House, including by the Prime Minister in October; that over 120 MPs wrote to the Secretary of State requesting it just some weeks ago; and that the overwhelming interest that Members of Parliament will have, for businesses and families in our constituencies, in the studies the Government are undertaking on the impact of Brexit on our economy, would it not have been in order for the list to have been, at a minimum, published in a written ministerial statement, so that it is equally and easily accessible by all Members of this House?
That is not a matter for the Chair, but it is definitely on the record now. I am sure people have heard what the hon. Lady had to say, and hopefully they will respond as they have done for the Lords.
(8 years, 11 months ago)
Commons ChamberI am unclear—[Laughter.] I am unclear about why the hon. Gentleman wishes to make this an issue about the Labour party, and not an issue about why his Government have presented the House with a measure that will have a negative impact on his constituents as well. He will have to account to his constituents for the decision that he chooses to make today when they come to his surgery, knowing that—[Interruption.]
Order. I certainly want to hear the shadow Minister, and I would expect Conservative Members to want to hear her as well. If they do not, I am sure that the Tea Room awaits them.
Thank you, Mr Deputy Speaker.
As I was saying, this measure is ideologically driven, it is cynical, and it will directly increase levels of poverty in Britain.
I thank the right hon. and learned Gentleman for his intervention. He may first want to explain why he voted against the national minimum wage when it was put to this House. We agree about people needing to come off tax credits, but we would do that through an increase in wages and in productivity.
The Government have sought to argue that working people will be compensated for the cuts by the increases in the minimum or living wage. That is contested by the Institute for Fiscal Studies, which says that it is “arithmetically impossible”. Although we welcome the increase to the personal allowance and the introduction of the so-called national living wage, as the Low Incomes Tax Reform Group has stated, any gains from those measures will not negate the impact of these tax credit cuts from April 2016. The IFS recently concluded that families will lose over £1,000 a year on average from cuts to tax credits, while they will gain between £100 and £200 a year at most from the proposed national living wage, and even that is seen as optimistic.
The IFS analysis has also shown that those on the lowest incomes are hit hardest by the Government’s tax and benefits changes. The reduction in annual income over the next five years is most marked for the poorest four income decile groups, highlighting the regressive nature of this Government’s fiscal choices.
(12 years, 1 month ago)
Commons ChamberOn Tuesday, a piece appeared in The Guardian about the difficulty that my disabled constituent Ray Bellisario has had accessing buses in his permissible wheelchair, often when going to and from hospital. Despite repeated letters on the issue to the disabilities Minister, Maria Miller, over the past 18 months, he had received no reply. Miraculously, however, a letter appeared in The Guardian from Maria Miller—
Order. We should not use personal names. If we refer to a “Minister”, that will be fine.
Thank you, Mr Deputy Speaker.
Miraculously, however, a letter appeared today from the Minister for disabled people, suggesting concern at Mr Bellisario’s plight. A citizen in a wheelchair should not have to take or to threaten legal action to get a response. May we have an urgent debate about the needs of people with disabilities when accessing public services, including transport, and the Government’s effectiveness in addressing those issues.