Oral Answers to Questions

Debate between Maria Caulfield and Caroline Nokes

Wednesday 20th March 2024 Commons Chamber

[Mr Speaker]

I call the Chair of the Women and Equalities Committee.

[Caroline Nokes (Romsey and Southampton North) (Con)]

The issue is not just the gender pay gap; there is also the gender pension gap, the lack of women on boards, and the importance of making sure that we have a pipeline of talented women at every level. Yesterday, I was with the community interest company, Women on Boards, and its clear message to the Minister is, “Please can we have more action and fewer initiatives, to ensure that we make real progress in getting women in our companies, at every level?”.

[Maria Caulfield]

We absolutely are taking action. We are planning to introduce the pay transparency pilot, because in high-paid jobs, salaries are often not advertised, and women end up being paid less than men for the same role. It is such action that will make a difference to women across the country.

International Women’s Day: Language in Politics

Debate between Maria Caulfield and Caroline Nokes

Thursday 29th February 2024 Commons Chamber

[The Minister for Women (Maria Caulfield)]

I start by thanking my right hon. Friend the Member for Basingstoke (Dame Maria Miller) for securing this important debate, and all hon. Members for their contributions. The use of language, particularly in politics, is such an important topic. Members have shared very personal experiences, including the hon. Member for Pontypridd (Alex Davies-Jones), my right hon. Friend the Member for Aldridge-Brownhills (Wendy Morton), the hon. Member for Newport West (Ruth Jones), and the hon. Member for Swansea East (Carolyn Harris), who has been criticised for her hair colouring. My criticism is that my hair looks like it was borrowed from my hon. Friend the Member for Lichfield (Michael Fabricant), so I share her frustration at that abuse.

Why does this abuse matter? My right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) put it very eloquently: it stops women from speaking freely, not just women in this place but women in our communities. At the moment, we have very toxic debates around issues such as biological sex, with people losing their jobs and facing prosecution just for wanting to have an honest debate. I am pleased that Members on all sides of the House have said this afternoon that it is important to have a sophisticated level of debate on very sensitive issues, but also about the general level of abuse that women face up and down this country. As the hon. Member for Bath (Wera Hobhouse) said, what is classed as banter by some people is very much abuse for others.

The hon. Member for Brent Central (Dawn Butler) always campaigns very hard on the issue of how abuse of women is reported in the media. We have met to discuss this, and I am frustrated that progress has been slow. I can assure her that I have met ministerial colleagues, but also the Domestic Abuse Commissioner, and I will follow up after this debate. It is really important that when women are murdered in our communities, it is not reported as a crime of passion. It has to be reported as it is: it is murder and abuse. That language makes a difference to how those crimes are then treated.

It is true—this was the focus of what my right hon. Friend the Member for Basingstoke set out—that the situation has an effect on our democratic accountability and who stands for election. We want more women, and more women from the real world, standing for election. However, the Fawcett Society found that 93% of women MPs said that online abuse or harassment has had a negative effect on how they act as Members of Parliament. It stops talented women coming forward for all parties, and we are losing good hon. Members. My hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) is one example of a woman leaving this place. We heard earlier in this parliamentary term from Rosie Cooper that the reason she stood down early was the abuse and threats she received. We have lost good Members such as her, which is very sad for Parliament.

We are potentially in an election year, so it is as important as ever that our language is measured—in this place, and in our political parties. Every single political party can play a role, and nobody standing for election should suffer intimidation for holding or aspiring to hold elective office. We have introduced measures to try to make the experience fairer. Since 2022, anyone who intimidates a candidate, campaigner or elected representative can be barred from elective office for five years. It is great that we are passing legislation like that in this place, but it needs to be enforced, because abuse is too often seen as something that just goes with the job. No one—not my hon. Friend the Member for Finchley and Golders Green (Mike Freer), nor my right hon. Friend the Member for Bournemouth East (Mr Ellwood)—should have their office burned or people protesting outside their home simply for representing their constituents.

The debate reflects the wider debate in society about violence against women and girls. Sadly, the hon. Member for Birmingham, Yardley (Jess Phillips), had to read out her list again this year, and one of the women she mentioned was my constituent Chloe Bashford, who was murdered in horrific circumstances in Newhaven. The hon. Member for Vauxhall (Florence Eshalomi) commented on two tragic deaths in her constituency of women who were also on that list. We have made significant progress, having published the tackling violence against women and girls strategy and the tackling domestic abuse plan, but that is not going fast enough. We all have a role to play, not just the Government; it is the role of all agencies, from the police to the courts, to absolutely make sure that femicide is taken seriously and dealt with when people come forward to give evidence and share their stories.

Our Domestic Abuse Act became law in 2021. That legislation is making a difference. Abusers are no longer allowed to directly cross-examine their victims in the family and civil courts, and victims have better access to special measures in courtrooms. However, conviction rates are still too low. We also supported the Protection from Sex-based Harassment in Public Act 2023, and the hon. Member for Bath brought in the Worker Protection (Amendment of Equality Act 2010) Act 2023, which addresses harassment in the workplace. That is for everyone, but we know that women are affected by that in more ways than most.

The final piece I want to address is the role of the media, given the upcoming election. It is really important that debates and votes in this place are reflected fairly. One example is the sewage vote, which was an attempt to end the use of sewage outflows in this country. We Conservative Members voted to dismantle our sewage system and have a long-term plan to end sewage discharges, but that was often portrayed in the media as voting against stopping any restrictions on sewage, which has resulted in multiple death threats and abuse for Conservative Members. When journalists ask why MPs are abused so much, I would say that journalists’ language, and the way that they portray what happens in this place, is as important.

[Caroline Nokes]

I will not get the Minister to say this, but I will say it for her. Can we also look at those who write Commons sketches? I am particularly thinking of Quentin Letts, who is a bit prone to going after people like me for being too pony club posh, and my hon. Friend the Member for Gosport (Dame Caroline Dinenage) for having pink nail varnish. The list is endless, and it is never about what we say, but about what we look like.

[Maria Caulfield]

Absolutely. We need to remind each other that we all have a role to play—not just MPs but wider society. The fundamental issue is that if female MPs are being targeted and harassed, that will be reflected for women up and down this country; if it is seen as okay to target elected representatives for what they look like or what they say or how they vote, that will be reflected in wider society. There is a democratic system in this country: if people are not happy with who represents them, they go to the ballot box and they decide. What is not acceptable is for Members of Parliament, local councillors, police and crime commissioners, Members of the Senedd, the Scottish Parliament, the Northern Ireland Assembly and others, even down to school governors, who are taking difficult decisions, which would have been taken long before if they were easy, to be intimidated in how they vote. If that is tolerated, violence against women and girls will be tolerated, perpetuated and accepted too.

I thank everyone for such a positive debate. We have got to speak up, we have got to stand up and we have got to take part and not let the haters win.

Black Maternal Health Awareness Week 2022

Debate between Maria Caulfield and Caroline Nokes

Wednesday 2nd November 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Gray. I thank the hon. Member for Streatham (Bell Ribeiro-Addy) for securing this debate. As she highlighted, we had a similar debate recently. I hope that my comments reassure her that we are taking action and making progress in this area.

I take the issue of maternal disparities very seriously; that is why when I was in post previously I set up the maternity disparities taskforce, which has brought together a range of specialists and campaigners. We have heard from groups such as Five X More and the Muslim Women’s Network to hear their views on what is going wrong right now, what systems we need to put in place to improve outcomes and also the experiences of black women in maternity services.

The data shows the disparities in black maternal health. We have heard about them clearly this morning, and I do not think anyone is in any disagreement about the scale of the problem we are facing. As the hon. Member for Streatham said, it is harrowing to hear those figures. The MBRRACE annual surveillance report shows that women of black ethnicity are four times more likely to die from pregnancy and birth compared with white women. I do not think there is a dispute about that; we fully acknowledge it and we want to reverse that trend as quickly as possible.

[Caroline Nokes]

I want to make a quick point about MBRRACE and the data. Data collection remains tricky, with some hospitals not reporting women’s deaths—not necessarily maternal deaths—until up to 500 days after they have happened. Then there is a delay with the medical records and notes, which might indicate the reasons for that. What reassurance can the Minister give that she will work to reduce those times?

[Maria Caulfield]

My right hon. Friend is absolutely right. Although Five X More does its surveys about the experience of women, the data on outcomes is very delayed. When we put measures in place, we cannot see the difference they make until the data comes through, roughly 18 months to two years later, as my right hon. Friend said. That lag does not help us determine whether the measures we are putting in place are actually making a difference. Getting that on track is a key priority for me so that we can accurately measure what is happening.

From the data that we do have, The Lancet series in April last year found that black women have an increased relative risk of 40% of miscarriage compared with white women, and the stillbirth rate in England for black babies is 6.3 per 1,000 births, compared with 3.2 per 1,000 births for white women. That is completely unacceptable, and as the hon. Member for Streatham said, we cannot come back here, debate after debate, without seeing those figures move. One potential cause for optimism is that we do not have up-to-date data on the benefits of the interventions that we have put in place, so it might be better than we think. However, we absolutely need that data, not only to measure what is happening, but to know whether we are heading in the right direction if we set targets in the future.

To reassure Members, I want to clarify the point about not setting a target because the problem is too small. I do not agree that the problem is too small; it is a significant problem. Even if it is affecting one or two women, it is a significant problem, so that is not a reason not to set a target. As the hon. Member for Putney (Fleur Anderson) pointed out, there are multiple factors in why black women often face poorer outcomes in pregnancy and birth, and for their babies. It is a mix of personal, social, economic and environmental factors. Air quality, which the hon. Member touched on, also has an impact on overall health. The maternity disparities taskforce found that being in a lower socioeconomic group has a significant effect on maternal outcomes, and black and ethnic women are often in those groups and so face a double whammy in terms of their likely outcomes.

We cannot just fix this in isolation at the Department of Health and Social Care. That is why I am pleased that in my role for women’s health—I am also the Minister for Women, across the board—I can bring in other Departments, because we need to take a cross-Government approach to this issue. Whether it is the Department for Environment, Food and Rural Affairs on air quality, the Department for Levelling Up, Housing and Communities on housing, or the Department for Work and Pensions on employment, we need to work together so that all the factors affecting black maternal health are addressed in tandem to address this issue.

We know from a health perspective that pregnant black women are more likely to suffer from some chronic diseases that will affect their maternity outcomes, and in particular cause poorer mental health. There are health initiatives that we can put in place to ensure that we improve the outcomes for black women, but that cannot be done in isolation from the other factors that also negatively affect them.

Given the risks that such conditions pose in pregnancy, there is a need for safe personalised care for black women and women from ethnic backgrounds, because the needs of women from each and every community are so different. Just nationally introducing blanket systems will not address some of the problems; there is no one single solution that will improve the statistics and improve the outcomes for women.

The issue is not just the outcomes from maternity services. As we heard from the hon. Member for Streatham, the Five X More survey also reflects the general experience by black women of the healthcare system. Although black women are often at a more difficult point to start with, when they engage with health services they often have a very negative experience. We have seen that in the recent publication of the East Kent maternity report and in the Ockenden maternity review, which highlighted that there is racial discrimination present in some parts of the maternity services.

We cannot allow that to continue, because if we want black women to come and engage with services and to come forward when they have concerns, if they feel that they are not being listened to or if they raise concerns and they are dismissed, why would we be surprised when they do not engage with services in the future? Regarding the East Kent report in particular, I will look at the calls for action on how we improve black women’s experience of the healthcare system and considering how we can address those issues as urgently as possible.

When we consider the actions that we are putting in place, and I will touch on some of the ones that have already started, I am very much a supporter of Professor Marmot’s idea of proportionate universalism, whereby we introduce good services across the country but then we target those people who are most in need; in the case of black maternal health, that is clearly women from the black community. We need to go to them rather than expecting them to come to the health service: we have a universal offer, but ensure that it is targeted specifically at those who do not experience the best outcomes.

On targets, as my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) touched on earlier, we have an issue with data collection across the board in health services, including in maternity services. Black women often experience the worst outcomes, although some of the data that we are seeing is from 2020. For some of the initiatives that we have put in place in the last year or 18 months, we are not yet seeing the benefit of those initiatives in terms of outcomes. I am being very candid here: we have not got a handle on what is making a difference, or on which parts of the country are doing well—as was acknowledged by the hon. Member for Bolton South East (Yasmin Qureshi), the shadow Minister, there are some very good practices in place—and which parts of the country are still not supporting women in the way that women want.

We are working with NHS England, the Office for National Statistics, MBRRACE-UK and the National Neonatal Research Database, because there are also multiple sources of data. We need to pull all the data together and get it as close to real-time data as we can, so that when we introduce interventions and measures we can know whether they work.

As part of the maternity disparities taskforce, I am also keen to make sure that we include black women more in the national patient survey, because the shadow Minister was quite right that we had over 100,000 responses to the women’s health strategy but only a small percentage of those responses came from black and ethnic minority women. That illustrates the problem that we are talking about—that black women do not feel represented, or do not feel engaged with the process. So we have to change things and work is being done to address that situation.

We are introducing some measures. First, we have set guidance that each local maternity system is now working in partnership with women and their families and their local areas to draw up equity and equality action plans. For each local maternity system’s local area, there has to be a plan in place about how to improve the outcomes for women. The plans are agreed by the local maternity systems and the new integrated care boards, which were set up in the summer. They were published last week, so I encourage hon. Members to look at their local action plans to see what they are putting forward and to challenge them if they feel that they are not meeting local community needs. That is why they are done on a local basis: what is appropriate in my constituency of Lewes may be different to what is needed in Streatham, Putney, Leicester East, or Romsey and Southampton North. It is really important that we look at those action plans to make sure that they address the problems that we are concerned about. Every plan is being reviewed by NHS England, which will identify areas of good practice and the support that is needed to drive them forward.

In addition, we have also commissioned 14 maternal medicine networks covering the whole of England, which will ensure that women have access to specialist management. We know that black women are more at risk of high blood pressure, diabetes and sickle cell anaemia and yet many of those risk factors for their pregnancy and birth are not dealt with or managed. The maternal medicines network will bring in specialists so that, at an early stage of their pregnancy, those women can access those specialists to help them manage their pregnancy. They will also be offered pre-conception advice for further pregnancies. We have never done that before. We are targeting the risk factors of black women, and all women who are at risk, to make sure that they get the medical support and advice that they need during and after their pregnancy.

The Department also launched the £7.6 million health and wellbeing fund last year, which is supporting 19 projects throughout England to try to generate best practice guidelines that we can introduce to help reduce disparities. These projects include supporting expectant young black fathers in child development and providing perinatal mental health support for black mothers. If we can get some evidence-based best practice, we can look to roll that out across the country in the coming months and years. There is a lot of work going on.

I will touch on the issue of racial discrimination. It is clearly unacceptable that black, Asian and ethnic minority women feel that the health service is not accessible or not responsive to their needs. There is education and training for NHS staff on health disparities to eliminate bias and racism in obstetrics and gynaecology. The Royal College of Obstetricians and Gynaecologists’ race equality taskforce has developed e-learning cultural competencies. They now form part of the colleges’ members continuing professional development. The Nursing and Midwifery Council is also looking at how to promote and embed equality and respect in professional practice, so that they can create an environment where everyone feels that they can access the services they need. We will obviously continue to look at this with the maternity disparities taskforce, which is bringing in campaigners, experts and professionals to try to drive momentum on this issue.

Data is the key. I can give a commitment here that has been highlighted already. We need that data. We cannot be working with data that is two years old to see if we are making a difference because, if we are, we will not know about it for two years and will not be able to roll out good practice in other parts of the country. In my brief as the Minister for Women, I am aiming to bring that across other Departments as well.

I hope I have reassured hon. and right hon. Members in today’s debate that I am committed to continuing the work to tackle the disparities in outcomes to ensure that everyone has the opportunity to live a long and happy life. I am happy to work with the APPG on black maternal health, which is chaired by the hon. Member for Streatham, because it is only by working together to identify good practice and raising it when things are not working well that we can eliminate the disparity: it is unacceptable that black women are four times more likely to die during pregnancy simply because they are black women.

Oral Answers to Questions

Debate between Maria Caulfield and Caroline Nokes

Wednesday 8th June 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Women and Equalities Committee, Caroline Nokes.

[Caroline Nokes (Romsey and Southampton North) (Con)]

Endometriosis South Coast does brilliant work supporting women suffering from endometriosis, but it is seeking reassurance from the Minister that, when the women’s health ambassador is appointed, she will be a real champion for those affected by this condition and other women-only conditions that are so impactful on their to continue work. Can the Minister update the House on when the women’s health ambassador will be announced, given that we have been expecting the post since December?

[Maria Caulfield]

I can reassure my right hon. Friend that the women’s health ambassador will be key in driving change, not just by raising awareness and confidence among women in coming forward for help, but by improving the services women receive, and she will have to wait only days, rather than weeks, before we release the name.

Cumberlege Report

Debate between Maria Caulfield and Caroline Nokes

Thursday 3rd February 2022 Westminster Hall

[Maria Caulfield]

I will come to that point. The Government have apologised on behalf of the health and care sector for the time it took to listen and respond. We are doing more than apologising: we are changing the healthcare system so that it responds to women in a much better way.

As the hon. Gentleman has just raised the issue of redress, I will touch on it now. It is not just these cases where it is often difficult for patients to get redress and compensation. I gave evidence to the Health and Social Care Committee this week on the issue of clinical negligence. This week, we announced a fixed recoverable costs scheme, meaning that, for low-value claims, we can speed up the claims process, reduce legal costs and ensure that, whatever clinical negligence they have experienced, patients are able to get compensation as quickly as possible. The findings of the Cumberlege report highlight mesh, Primodos and sodium valproate. However, across the board, it is very difficult for patients to get redress, regardless of the clinical negligence they have suffered.

[Caroline Nokes]

I do not want to be too difficult, but I do not think it is any excuse to say that because it is difficult for everyone to get compensation, we should not try here.

--- Later in debate ---

[Maria Caulfield]

Specifically on Primodos, there is pending litigation so it is difficult for me to comment while that is in progress, but, depending on the outcome, the Government will respond to that.

[Caroline Nokes]

I will go for valproate, because there is not pending legislation about that. Have I understood the Minister correctly? Is she saying that if the Primodos case is successful, the Government will review it, and the women who have had mesh implants or who are the victims of sodium valproate will not be expected to have to go down that legal route?

[Maria Caulfield]

If I touch on the points in my response, hopefully I will be able to reassure colleagues on the progress being made.

Oral Answers to Questions

Debate between Maria Caulfield and Caroline Nokes

Wednesday 24th November 2021 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con)]

One of the times that women most engage with healthcare services is when they are pregnant. My constituent Michelle, a qualified midwife, has contacted me, talking specifically about the importance of retention in midwifery and highlighting the crisis that she says there is. What is my hon. Friend doing to make sure that qualified, experienced midwives stay working at the frontline where we need them?

[Maria Caulfield]

I thank my right hon. Friend for raising this important issue. Maternity care is a top priority for the Government, and earlier this year NHS England announced a £95 million recurrent funding package to support the recruitment of 1,200 midwives and 100 consultant obstetricians. Maintaining both the skill mix and the numbers is key to retaining experienced midwives, who often have to take the pressure when there are staff shortages.

Immigration and Social Security Co-ordination (EU Withdrawal) Bill (Ninth sitting)

Debate between Maria Caulfield and Caroline Nokes

Tuesday 5th March 2019 Public Bill Committees

[Caroline Nokes]

I certainly welcome the Bar Council’s views feeding into this debate. However, very few countries have a time limit as short as those proposed in these new clauses. While some have time limits, recognising the practical challenges in effecting successful returns, some are looking at the issue again.

For example, the European Commission has recently proposed a new detention time limit of at least three months to give member states sufficient time to carry out return operations. In comparison with other countries, the UK performs well in achieving the removal of individuals who have no right to stay. I agree with Stephen Shaw when he said that he had yet to see a coherent account of how a proposal for 28 days had been reached. That different time limits have been proposed in different amendments shows that identifying an appropriate time limit might not necessarily be a simple exercise.

[Maria Caulfield (Lewes) (Con)]

My hon. Friend the Minister is saying that there seems to be a growing cross-party consensus on the issue of a time limit. Does she not agree, therefore, that it would be wise to take this back to the Floor of the House before making a final decision on a time limit that could be accepted?

[Caroline Nokes]

I thank my hon. Friend for that intervention. I suspect that she is correct that, ultimately, we might decide this matter on the Floor of the House. It is important that we reflect carefully on the evidence and weigh our own practical and legal considerations. While I am as one with Stephen Shaw when he makes his commentary on 28 days, I have heard representations from Members in this Committee and more widely as well. We have heard reference to my right hon. Friend the Member for Meriden, who has been forceful on this issue, and to the right hon. and learned Member for Camberwell and Peckham (Ms Harman), who had me before her Committee towards the tail end of last year. We had a useful and constructive conversation around detention.

It is well documented and reported in the media how much I enjoy a Select Committee appearance—that one I actually did. I felt it was constructive, Members had given the issue significant thought, and we had a constructive conversation. I am aware of the amendment tabled by the right hon. and learned Member for Camberwell and Peckham that has been supported by many Members from this side of the House with much enthusiasm and determination.

Immigration and Social Security Co-ordination (EU Withdrawal) Bill (Eighth sitting)

Debate between Maria Caulfield and Caroline Nokes

Thursday 28th February 2019 Public Bill Committees

[Caroline Nokes]

I am grateful to the hon. Members for Cumbernauld, Kilsyth and Kirkintilloch East and for Paisley and Renfrewshire North for tabling these amendments on migrants’ access to healthcare in the United Kingdom. I am also grateful to the hon. Member for Wolverhampton South West for tabling her new clause. Given their similar effects, I will consider them together.

The Government have been very clear in everything we have said since the referendum that, although the United Kingdom will be leaving the European Union, we are certainly not leaving Europe. Our relations with the European Union and the whole of the EEA will continue to be close and cordial. As part of that, immigration from the EEA will certainly continue. We want EEA citizens, who have contributed so much to our society, to continue living and working in the United Kingdom. While they are here, they will of course need access to healthcare. We are fortunate in this country to have a world-class health system, thanks to the NHS. The proposals, in different ways, would exempt EEA and Swiss citizens from the requirement to pay for healthcare in the UK. However, they are unnecessary.

Amendment 37 and new clause 12 are also technically deficient, because they do not reflect the nature of devolved health legislation. Entitlement to free-of-charge NHS care is not, and should not be, based on nationality. It is based on a concept of ordinary residence in the United Kingdom. For EEA nationals, that means living in the UK on a

“lawful…properly settled basis for the time being.”

I thank hon. Members for their comments on specific proposals, and I will make a number of points. Operating fair and proportionate controls on access to the NHS is not about outsourcing immigration control; it is about protecting a vital taxpayer-funded service from potential misuse. The Department of Health and Social Care’s policy of up-front NHS charging for non-urgent treatment for overseas visitors was upheld by the courts in a judicial review last year. Treatment for specified public health conditions, such as the infectious diseases mentioned earlier, is not subject to overseas visitor charges.

The hon. Member for Wolverhampton South West asked whether it was fair that EEA nationals should pay the health charge, given that they would pay for the NHS via taxes and national insurance contributions. Whether EEA nationals pay the health charge following the introduction of the new skills-based immigration may depend on the outcome of our negotiations with the EU about our future relationship. The health charge currently applies only to non-EEA temporary migrants. Although some non-EEA nationals will pay tax and national insurance contributions, they will not have made the same financial contribution to the NHS that most UK nationals and permanent residents have made or will continue to make over the course of their working lives. It is therefore fair to require them to make an up-front and proportionate contribution to the NHS.

When we debated this in Committee some months ago, the issue of the level of contribution was raised, and it has been again this afternoon. The Department of Health and Social Care undertook a careful study with NHS England of the NHS resources that temporary migrants to this country generally used over the course of a year. It came out in the region of £470 per individual. I hope that hon. Members will note that the immigration health charge is set below that level at £400 per person, or the reduced rate of £300 per year for students and those on youth mobility schemes.

The hon. Member for Stretford and Urmston raised maternity care. The Department of Health and Social Care is responsible for guidance on overseas visitor charges in England. Maternity care is always urgent and must never be withheld pending payment. That is clear in the Department of Health and Social Care’s guidance. However, charges are applied to protect maternity services for those entitled to live in this country.

The hon. Lady asked whether I would speak to DHSC Ministers about the review of charges, which I understand has not yet been published. I am happy to make that representation to my fellow Ministers.

[Maria Caulfield]

I thank the Minister for giving way; I know I have made a number of interventions now. Does it sound fair that Opposition Members are asking low-paid UK taxpayers to underpin the NHS services for EEA migrants, given that they often struggle to pay their tax and national insurance? Does she agree that, given that the health service is struggling to pay for drugs such as Orkambi for cystic fibrosis patients, it cannot afford to take on free healthcare for EEA nationals too?

[Caroline Nokes]

My hon. Friend makes an important point, which underpins the immigration health surcharge. The Government took the view, and in successive general elections made it very clear, that we would continue to implement and, indeed, increase the immigration health surcharge. As I said, this is a matter for EEA nationals and is still for negotiation as part of our future relationship.

Immigration and Social Security Coordination (EU Withdrawal) Bill (Fifth sitting)

Debate between Maria Caulfield and Caroline Nokes

Committee Debate: 5th sitting: House of Commons
Tuesday 26th February 2019 Public Bill Committees

[Maria Caulfield (Lewes) (Con)]

Will the Minister confirm that that is also the case for Irish citizens in Northern Ireland, under the spirit of the Good Friday agreement?

[Caroline Nokes]

My hon. Friend is right to emphasise that point, and that is absolutely the case in Northern Ireland. We take the provisions of the Belfast agreement very seriously indeed.

This clause supports the citizenship provisions in the Belfast agreement that enable the people of Northern Ireland to identify and hold citizenship as British, Irish or both. The Bill makes no changes to the common travel area or to how people enter the UK from within it. Section 1(3) of the Immigration Act 1971 ensures there are no routine immigration controls on those routes. Given the unique and historic nature of our relationship with Ireland, and our long-standing common travel area arrangements, I am sure that Members will agree on the importance of the clause as we bring free movement to an end.

Question put and agreed to.

Clause 2 accordingly ordered to stand part of the Bill.

Clause 3

Meaning of “the Immigration Acts” etc

Question proposed, That the clause stand part of the Bill.

Immigration and Social Security Co-ordination (EU Withdrawal) Bill (Fifth sitting)

Debate between Maria Caulfield and Caroline Nokes

Tuesday 26th February 2019 Public Bill Committees

[Maria Caulfield (Lewes) (Con)]

Will the Minister confirm that that is also the case for Irish citizens in Northern Ireland, under the spirit of the Good Friday agreement?

[Caroline Nokes]

My hon. Friend is right to emphasise that point, and that is absolutely the case in Northern Ireland. We take the provisions of the Belfast agreement very seriously indeed.

This clause supports the citizenship provisions in the Belfast agreement that enable the people of Northern Ireland to identify and hold citizenship as British, Irish or both. The Bill makes no changes to the common travel area or to how people enter the UK from within it. Section 1(3) of the Immigration Act 1971 ensures there are no routine immigration controls on those routes. Given the unique and historic nature of our relationship with Ireland, and our long-standing common travel area arrangements, I am sure that Members will agree on the importance of the clause as we bring free movement to an end.

Question put and agreed to.

Clause 2 accordingly ordered to stand part of the Bill.

Clause 3

Meaning of “the Immigration Acts” etc

Question proposed, That the clause stand part of the Bill.

Immigration and Social Security Co-ordination (EU Withdrawal) Bill (Sixth sitting)

Debate between Maria Caulfield and Caroline Nokes

Tuesday 26th February 2019 Public Bill Committees

[Caroline Nokes]

The hon. Lady makes an important point that we have heard in our sectoral engagement on the proposed temporary workers route, and that I expect to hear reinforced over the coming months. She is right to point out that we want people engaged in such employment to have stability, so that they can build relationships with the people they care for, but we should also reflect that the sector already has instability and problems with retention. It is important that we work hand in hand with the Department of Health and Social Care to address those issues, as well as looking at routes to enable continuity.

[Maria Caulfield (Lewes) (Con)]

Care agencies in my constituency that take on personal assistants and have a high turnover of staff have highlighted how long Disclosure and Barring Service checks take—another issue that adds to recruitment problems in the care sector.

[Caroline Nokes]

My hon. Friend makes an important point about DBS checks. I welcome her contribution: she has a lot of experience in the health and care sector, and she knows that one of the big challenges is instability and high turnover. Together, we have to find ways to address that, which will be partly within and partly outside the immigration system.

Leaving the EU means ending free movement, with full control of our borders, and introducing a new immigration system that works in the interests of the UK, while being fair to working people here by bringing immigration down to sustainable levels and ensuring that we train people up here at home. As I have indicated, the Government intend to provide for a single future immigration system based on skills rather than on where an individual comes from. We want to ensure that there are only limited exceptions to that principle.

There is no doubt that the EEA nationals who are already working as personal care assistants make an invaluable contribution to the lives of many vulnerable adults in the UK with care needs. We have already been clear that we want the 167,000 EU nationals who currently work in the health and social care sector—including those who work as personal assistants, and other EEA nationals who are already here—to stay in the UK after we leave the EU. We have demonstrated that aim with the launch of the settlement scheme.

I hope that the hon. Member for Stretford and Urmston agrees that it is right that the Government continue to listen to businesses and organisations across all sectors of the UK economy over the next 12 months, and that it is too early to provide for exemptions to a salary threshold that is yet to be determined. I therefore invite her to withdraw her amendment.

--- Later in debate ---

[Caroline Nokes]

I thank the hon. Gentleman for his comment. I am sure, like me, he welcomes the fact that some of the most recent immigration statistics show more people coming to the UK with a confirmed job to go to, rather than simply looking for work. That is an important trend. I am sure he would also acknowledge that, as the Secretary of State for Exiting the European Union pointed out—he was a Minister in the Department of Health and Social Care when he did so—there are more EU citizens working in the NHS today than there were at the time of the 2016 referendum. I would not want anyone to misunderstand me and think I was being remotely complacent, because I really am not, but I must emphasise again the Government’s recognition and appreciation of the great contribution made to the UK by EU nationals working in health, social care and our important medical research sector. I think it was on the day we published the White Paper that I went to the Crick Institute in London and spoke to some of the research teams there. They were not simply from the EU or the EEA, but were global research teams. That point was made to me by Cancer Research UK, which I visited at the tail end of last year. We will continue to engage with the sector.

The hon. Member for Scunthorpe made an important point about roundtable events and talking to all sectors, and I am absolutely determined to do that in the area of medical research. I assure him that I have a busy programme over the next six months.

[Maria Caulfield]

One example is those coming to this country to do medical research, particularly cancer research. If they are doing that for their PhD, it can take a number of years, and the current visa period is just not long enough. They go to other English-speaking countries and do their research there. We are missing out on some valuable expertise.

[Caroline Nokes]

My hon. Friend is right to point out that we do not want to miss out on expertise. We want to continue to attract the very brightest and the best to the UK, to work not only in medical research, but across the economy and all sectors of academia. We heard evidence from Universities UK, which often comes to talk to me about the importance of being able to attract not only researchers from the EEA, but students and academic staff. As I am sometimes inclined to point out, they cannot open their doors if they do not have people available to clean the lavatories. I am conscious that there is a wide breadth of individuals, skills and talents that we will need to continue to attract to the UK post Brexit.

We are in absolutely no doubt about the continuing need in the UK for those working to tackle terrible diseases, such as cancer. We want the existing EU workforce to stay, and we want to continue to attract other international workers in the field. We recognise that the research, as the hon. Member for Scunthorpe pointed out, goes way beyond fiscal benefit. It is about the contribution to the health of the UK population and to the world, because research in this country does not stop at our own shores.

Even under the existing immigration system, special provisions apply for those coming to work in the UK as doctors, nurses and researchers, including in important scientific and medical fields. The provisions include, but are not limited to, being outside the scope of the annual cap that applies to the main skilled work route under tier 2 and not being subject to the resident labour market test. There is also provision for special salary exemptions from the minimum £30,000 threshold for experienced workers. I assure the Committee that the Government take seriously the impact on the UK economy of the proposals we have set out in the immigration White Paper. Together, the proposals are and will be designed to benefit the UK and ensure that we continue to be a competitive place, including for medical research and innovation.

As the hon. Gentleman will be aware, the Bill is designed to provide for the arrangements by which free movement will end for EEA nationals, delivering the commitment that the Government made. It is not designed to set out precisely how the future immigration system will apply, and the power in clause 4 is to make consequential changes as a result of the end of free movement. It is not the place where we will set out the details of the future system.

As stated in the impact assessment published alongside the Bill, the details of the future immigration arrangements that apply to EEA nationals and their family members from 2021 will be set out in immigration rules. It is not yet possible to set out the quantitative and wider benefits of that future system, but the White Paper proposals published in December were supported by a full and detailed economic appraisal, which was published in an analytical note in annex B of the White Paper.

As the Committee will know, the Government intend that the proposal in the White Paper will provide the basis for a national conversation with a wide spectrum of business organisations and sectors. As I have said several times today, over the next 12 months we will listen carefully to various sectors and their concerns before taking final decisions. As the hon. Member for Scunthorpe will appreciate, it is right that the Government assess the full costs and benefits of ending free movement once the future policies have been finalised.

I therefore suggest that the regulations, which are primarily intended to cover the transition from free movement to the future system, are not the right place to set out a detailed impact assessment of the end of free movement on individual sectors. I can reassure the Committee that it is our intention that the immigration rules for the future system will be accompanied by relevant impact assessments, once the arrangements have been finalised.

Accordingly, I believe that the amendment is not appropriate at this time, because it is attached to the wrong provision, but I accept and welcome the spirit of what the hon. Member for Scunthorpe seeks to achieve. I assure him that appropriate impact assessments will be provided.