Oral Answers to Questions

Mark Pawsey Excerpts

Tuesday 29th January 2019 Commons Chamber

[Mark Pawsey (Rugby) (Con)]

In its report on small business, the Business, Energy and Industrial Strategy Committee drew attention to the need for consistency of advice for small businesses and those starting small businesses. In Rugby, that is provided by the growth hub, as part of the local enterprise partnership. Does the Minister agree with me that it is important that these bodies are properly resourced?

[Robert Jenrick]

We do agree with that. All the evidence suggests that small businesses would benefit from better quality advice across a range of areas. Recently in the Budget, we have supported extra funding for networks, to bring businesses together, and we are working across the Government to think about ways in which we can improve the quality of advice and increase competition within business advisory services.

Oral Answers to Questions

Mark Pawsey Excerpts

Tuesday 6th November 2018 Commons Chamber

[Alex Burghart (Brentwood and Ongar) (Con)]

7. What fiscal steps he is taking to support the high street.

[Mark Pawsey (Rugby) (Con)]

9. What fiscal steps he is taking to support the high street.

[The Financial Secretary to the Treasury (Mel Stride)]

As my hon. Friends will know, in the Budget, we allocated £1.5 billion to supporting our high streets, including £675 million for our future high streets fund, and reduced business rates for smaller retailers by one third for the next two years.

[Mel Stride]

I am also giddy with excitement about this, and giddy with excitement to be able to inform my hon. Friend that up to 90% of smaller retailers, many of them in our high streets, will benefit from this package. That is in complete contrast to Labour’s policy of putting up taxes on small businesses. That is no way to support our high streets; it is Labour’s way to destroy business and jobs.

[Mark Pawsey]

On 1 December, I will be visiting retailers in Rugby town centre to support the Federation of Small Businesses’ Small Business Saturday. These businesses are in a tough and fast-changing environment. Does the Minister agree that the business rate incentive that he mentioned will go some way towards levelling the playing field between those retailers and those who operate online?

[Mel Stride]

I certainly agree. These changes will boost our high streets, and the FSB is to be congratulated on Small Business Saturday. I shall be in Ramsgate with my hon. Friend the Member for South Thanet (Craig Mackinlay) speaking to some of his retailers about this. I extend a non-partisan invitation to Labour Members to join us: we will go up our high streets talking to retailers about reducing their rates, and they can talk about the tax increases that they have in store for them.

Alpha-1 Antitrypsin Deficiency

Mark Pawsey Excerpts

Wednesday 31st October 2018 Westminster Hall

[Mark Pawsey (Rugby) (Con)]

I beg to move,

That this House has considered treatment for alpha-1 antitrypsin deficiency.

It is a pleasure to serve under your chairmanship, Mr Hollobone.

Hon. Members might wish to know what alpha-1 antitrypsin deficiency is. It is a rare and complex hereditary illness, and those who suffer from it simply refer to it as alpha-1 and to themselves as alphas. Some people affected by alpha-1 are in the Public Gallery today.

I will explain the condition: alpha-1 antitrypsin, or AAT, is a protein produced in the liver. In healthy people, it is released into the blood circulation to protect the body from the effects of inflammation, but for those with alpha-1 the protein does not function properly and is trapped in the liver. That can cause damage to the liver and, because the protein is unable to circulate around the body, the lungs lack the protection they need from the damaging effects of pollutants and infections. Those with alpha-1 are particularly susceptible and sensitive to cigarette smoke, for example.

Alpha-1 affects both children and adults, and the condition is chronic and progressive. It can affect life expectancy and lead to disability, leaving sufferers dependent on the health service and carers. The damage it can cause to the liver can lead to jaundice, sickness and tiredness, and those with the condition are more prone to chest infections, often leading to a swift deterioration in health. In extreme cases, patients can require an organ transplant.

In the early stages, it is common for alpha-1 not to be properly diagnosed, and sufferers are often thought to have asthma or chronic obstructive pulmonary disease, more widely known as COPD. In many instances, they are treated for those conditions for a number of years before a correct diagnosis is given. As with most conditions, the earlier diagnosis takes place and appropriate treatment can begin, the better someone’s chances of managing the condition.

I became aware of the condition in 2012, when a constituent of mine, Sarah Parrin, attended my constituency advice surgery and brought along her son, Stephen Leadbetter. Stephen’s case was characteristic of many others across the country. He had been thought initially to have severe asthma; he had suffered with lung problems since the age of 14 and had undergone several surgeries due to pneumothoraxes. Those occur when small sacs of air collect in the pleural space between the lung and the chest wall, creating pressure on the lungs that can lead to lung collapse.

Stephen was 22 when I met him, and had only just been diagnosed with alpha-1, eight years after he had really started to suffer. The thing I remember most about his mother’s bringing him to see me was her telling me how things would have been so much better if Stephen had been diagnosed earlier and been able to access specialised services. If that had been the case, his health might not have declined so rapidly during his teenage years.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this matter to Westminster Hall for consideration. As my party’s health spokesperson, this is something that I have responsibility for, so I appreciate it. While AATD can cause a lot of conditions, such as COPD or liver disease, it is a separate condition. If treatment for it was available in the UK, that could prevent the development of other lung and liver conditions, as he has said. Surely the prevention of other diseases would be of long-term benefit to the national health service. I say that to the Minister in particular. While there are some lifestyle changes that people can make, AATD is inherited and if a person has inherited two ZZ genotypes they are likely to develop further issues.

Does the hon. Gentleman agree that time must be given to clinical trials involving AAT augmentation therapy? If he does, perhaps the Minister would like to respond positively to that.

[Mark Pawsey]

The hon. Gentleman anticipates two of the asks that I will come to later; I thank him for that helpful contribution.

Going back to Stephen’s condition, he suffered very seriously from chest infections. In fact, at one point he suffered with his lungs collapsing, and Birmingham Children’s Hospital, which was treating him at the time, took the decision to staple his lungs to his chest wall. As I say, it was eight years after first presenting with the issues that Stephen’s own general practitioner tested him for alpha-1 and that was found to be the condition he was suffering from.

The British Lung Foundation estimates that approximately 25,000 people in the UK suffer from the disease, and while many can live relatively normal and healthy lives, others such as Stephen suffer from the condition. Interestingly, I was contacted only today by a colleague here in Parliament, who told me that they suffer from the condition and that, as one of three siblings in a family of six, they were involved in a study based at University College London in the 1970s. That was someone we would not recognise as being a sufferer, which exemplifies the fact that not everybody shows the symptoms that so many people have.

It is rarer for children to suffer, which explains why the doctors who treated Stephen did not test for alpha-1 initially, but we can be grateful that by 2012 he was finally correctly diagnosed. Stephen’s mother Sarah was very concerned about the lack of awareness of the condition and became involved with the Alpha-1 Alliance, a charity formed in 1997 to support those suffering from the condition and their families, carers and friends. We are joined today by members of that group and affiliated organisations, as well as Professor David Parr, who is head of medicine and clinical director for cardiothoracic services and a consultant respiratory physician at University Hospitals Coventry and Warwickshire.

Both Sarah and Stephen, who suffers from alpha-1, have told me that they found the support from the Alpha-1 Alliance and the alpha-1 support group invaluable. When I met them back in 2012, they asked me to get more involved, learn and understand more about the condition, and do what I might as their Member of Parliament to raise awareness here in Westminster. To that end, I raised the condition with the Leader of the House in business questions in December 2012; I understand that was the first time that the condition alpha-1 had been mentioned in the House. We then arranged a seminar and a report was brought to Parliament, and there I met Professor Parr, whose hospital, UHCW, happens to serve the residents of my Rugby constituency.

At that time, there was a sense that the work of the Alpha-1 Alliance was gaining traction and starting to raise awareness. We had a meeting with the then Secretary of State, my right hon. Friend the Member for South West Surrey (Mr Hunt), and Karen North and Margaret Millar of the alpha-1 support group came along to explain a little about the condition and how the treatment for it could be improved.

Testing for this condition is a relatively straightforward process, requiring a simple blood test. Many organisations, including the World Health Organisation, have made recommendations on who should be tested for the condition, such as anyone who suffers from emphysema, COPD or chronic bronchitis; people with a family history of liver disease; and certainly blood relatives of a person diagnosed with alpha-1. Perhaps also newborns and children with unexplained liver diseases should be considered as potential sufferers from alpha-1.

[Tonia Antoniazzi (Gower) (Lab)]

I welcome today’s debate, as I also have a constituent, Tina Walker, who has alpha-1. She travels from Swansea to the clinic in Coventry twice a year. Last night, I also had an email from an ex-pupil who I used to teach in Wigan, whose daughter—she must be just a small child—also has the condition. I feel strongly that we parliamentarians should be working together. Does the hon. Gentleman agree that it would be wise of us to urge the Government to run a UK-wide campaign to raise awareness? As he says, this involves just a simple blood test.

[Mark Pawsey]

Part and parcel of our efforts today is to achieve precisely that. I am delighted that the hon. Lady’s constituent comes to Coventry and is being treated by the excellent services at University Hospitals Coventry and Warwickshire.

Unfortunately, alpha-1 is not yet curable, and no specific treatment for the disease is freely available in the UK; it is a matter of treating only the symptoms with the appropriate therapeutic methods. The hon. Member for Strangford (Jim Shannon) referred to intravenous AAT protein augmentation therapy, which involves replacing the missing AAT protein. That treatment is available in the United States, Spain, Germany and Italy, for example, but it is not yet available in the UK.

The National Institute for Health and Care Excellence—the Government body that produces guidelines on which treatments to make available—only last month published draft guidelines that rejected the use of the only licensed augmentation therapy product in the UK, Respreeza. It has had a UK licence since 2015, but was unfortunately deemed by NICE to be too expensive to be made available on the NHS. We acknowledge that it is expensive; lifelong therapy costs around £60,000 per patient per year. NICE continues to evaluate that and will make its final recommendations next year. The entire alpha-1 community has been heavily involved in pressing the case for patients across the country to be prescribed the treatment.

Only the symptoms of alpha-1 sufferers are treated, often by inhaled medications developed for people suffering from asthma and COPD, rather than specific treatments for the lung damage caused by alpha-1. The other issue is that those who suffer from alpha-1 become susceptible to chest infections, which was certainly the case for Stephen Leadbetter, and it is vital that they are treated quickly with antibiotics at the first sign of infection and are vaccinated every year against flu.

[Matt Western (Warwick and Leamington) (Lab)]

I congratulate the hon. Gentleman on securing this important debate, and I commend the work of the alpha-1 patient community in pressing for it as well. Does he share my frustration that the highly specialised NHS alpha-1 service has been approved and budgeted for and was due to be put in place earlier this year, but may not actually be installed by next year?

[Mark Pawsey]

That is certainly a frustration for the many patients who suffer. I hope that the Minister will address progress towards the outcome that we would all like to see.

There are changes that patients can make to their lifestyle to help to manage the condition, including specific exercise programmes and altering their diets. It is also important for them to avoid being around second-hand smoke and other environmental pollutants, such as open fires, petrol fumes, paint, solvents and dust, and that they avoid coming into contact with anyone suffering from a cold or the flu. However, that is often not enough. There is a need for Government action. We would like the Government to look at the prescribed specialised services advisory group’s recommendations and address the specific recommendation for a national, highly specialised service for patients with severe alpha-1.

A Department of Health and Social Care paper sets it out that that service, referred to by the hon. Member for Warwick and Leamington (Matt Western), should be operational by April 2019, which is only six months away. However, I understand that the formal development of the service has not yet commenced, and that it is highly unlikely that it will be operational by the original deadline.

The need for progress on the service forms one of the two principal objectives of the alpha-1 patient community, and I look forward to the Minister’s commenting on that. The second particular ask is to ensure that alpha-1 antitrypsin augmentation therapy—access to Respreeza, the only licensed treatment—will be available. I hope that the Minister responds positively to that.

It is the view of the alpha-1 patient community that the Government should focus on five key areas. The first is that that highly specialised service should become operational in a timely fashion. Secondly, patients should be involved at all stages in the development and implementation of the service to ensure that the patient voice is fully heard and taken into consideration. Thirdly, we are calling for a review of the impact of the NICE highly specialised technologies guidelines on patient access to rare disease treatments.

Fourthly, we are looking to apply a broader decision framework to the NICE process of evaluating the value of rare disease treatments, looking particularly at the social and societal benefits that impact patients and carers. Finally, we ask the Government to consider the appropriateness of introducing a more formalised process of conditional approval of rare disease treatments in England, such as alpha-1 augmentation therapy, as is being implemented in Scotland.

I shall conclude by referring to an email I received from a patient only yesterday that sets out her concerns with alpha-1 and its misdiagnosis. The sufferer emailed me to say that her mother died from antitrypsin deficiency, and that she now has the lung version of the disease. She is 48-years-old, and two years ago was a runner, but can now barely run for a bus or climb stairs. Her lung function has dropped dramatically in just one year. She is an ex-smoker and acknowledges the harm that smoking caused with respect to the condition. Had she been diagnosed earlier, she would have been able to make better lifestyle choices. The bit that got me was when she said that the deficiency for those who are symptomatic progresses at a very fast rate, and that, for many, it will end in gasping for breath for a long, drawn-out period, until such time as their lungs stop functioning completely. She says it feels like being eaten alive.

If the Government can work towards the two principal objectives and five key recommendations of the alpha-1 patient community, there will be a huge benefit to a significant group of people. It is our hope that the present and future needs of patients suffering this rare condition may finally be met.

[Mr Philip Hollobone (in the Chair)]

The debate can last until 4.30 pm.

[The Lord Commissioner of Her Majesty's Treasury (Nigel Adams)]

It is always a pleasure to serve under your chairmanship, Mr Hollobone. I start by congratulating my hon. Friend the Member for Rugby (Mark Pawsey) on securing this important debate on the need to raise awareness of alpha-1 antitrypsin deficiency disease. I was unaware of the condition until I heard about the debate, and it has been enlightening to learn about it and the number of people it affects in this country. He set out, with great clarity and passion, the concerns of alpha-1 patients across the country.

With up to 8,000 rare diseases identified so far—a number that steadily grows as our diagnostic tools improve—the Government remain dedicated to improving the lives of all those living with a rare condition and to implementing the 51 commitments of the UK strategy for rare diseases, which was reinforced in the Prime Minister’s speech in June, in which she set out her future vision. That vision will be underpinned by increased funding for the NHS, so that the UK can lead the world in the use of data and technology to prevent, and not just treat, illness; to diagnose conditions before symptoms occur; and, importantly, to deliver personalised treatment informed not only by a general understanding of disease but by our own data, including our own genetic make-ups.

As we have heard from hon. Members, people with alpha-1 have low levels of the protective enzyme alpha1-proteinase inhibitor. That means that they are more vulnerable to body tissue damage from infections and environmental toxins—tobacco smoke, in particular. As my hon. Friend the Member for Rugby said, there is no cure for alpha-1, and treatment is focused on alleviating the symptoms.

My hon. Friend referred to the ongoing highly specialised technology evaluation by NICE of the drug Respreeza. That is a type of therapy called replacement therapy. It aims to boost the levels of alpha-1 antitrypsin in the blood. As those in the Chamber will know, NICE is an independent body and its highly specialised technologies evaluation committee makes recommendations on the use of new and existing highly specialised medicines and treatments within the NHS in England.

I am confident that NICE has in place a robust framework for evaluating technologies for rare diseases. As was said, it has not yet published its final guidance on the use of Respreeza for treating emphysema in patients with alpha-1, but it recently consulted on its draft guidance. As we heard, NICE’s evaluation committee is due to meet again to consider its recommendations in March 2019. That is to enable the company that makes Respreeza to prepare and submit additional information for the committee to consider. I am assured that, in developing its final recommendations, NICE will take fully into account all the comments that it received in response to the consultation, along with any additional information provided by the company. We look forward to hearing NICE’s recommendations after consideration has concluded.

As my hon. Friend and the hon. Member for Warwick and Leamington (Matt Western) mentioned, Ministers agreed with the advice of the prescribed specialised services advisory group that services for people diagnosed with alpha-1 should be nationally commissioned by NHS England and not by clinical commissioning groups. May I reassure my hon. Friend and the hon. Gentleman that NHS England is engaging with NICE on the HST evaluation of Respreeza? Once final guidance is received, following the evaluation committee’s meeting scheduled for March next year, NHS England will consider the commissioning implications in consultation with the specialised respiratory clinical reference group.

Should Respreeza be recommended by NICE, it would be for NHS England to make funding available within 90 calendar days of the positive evaluation. Should that be the case, NHS England would want to be assured that the centres initiating the treatment had the appropriate expertise and resources in place. NHS England is committed to involving patients in the development of new services, and routinely does so in line with the specialised commissioning framework, and with dedicated working groups that inform service specification and have patient representation.

As my hon. Friend said, alpha-1 is often undiagnosed or misdiagnosed. It is sometimes diagnosed late, as in the case of his constituent, Mr Leadbetter. More can be done to diagnose rare conditions earlier. Whole genome sequencing is increasingly utilised as a diagnostic tool for rare diseases in individuals with unrecognised signs and symptoms. I am pleased to report that about 25% of rare disease patients who have their genome sequenced through the 100,000 Genomes Project now receive a diagnosis for the first time.

The genomic medicine service was launched by my right hon. Friend the Secretary of State for Health and Social Care on 2 October 2018, making the UK the first in the world to integrate genomic technologies, including whole genome sequencing, into routine clinical care. The first national genomic test directory also became operational from October this year. It specifies which genomic tests are commissioned by the NHS in England, the technology by which they are available and the patients who will be eligible to access them. Alpha-1 is included in the new directory, which will be kept up to date on an annual basis to keep pace with scientific and technological advances.

Let me refer to one or two of the comments from hon. Members. The hon. Member for Strangford (Jim Shannon) talked about the prevention of disease and clinical trials having taken place. Improving the lives of people with alpha-1 through research is critical. We support continued research into rare diseases through the National Institute for Health Research. That has established 20 biomedical research centres that develop new treatments for patients with a range of rare diseases.

The hon. Member for Gower (Tonia Antoniazzi) referred to a UK-wide campaign to raise awareness of this condition. I fully agree with her and support the notion that we should always be working together to raise awareness of alpha-1. Many of our initiatives are aimed at raising awareness of rare diseases among healthcare professionals and the general public; it must be extremely difficult for a GP to have knowledge of, spot the symptoms of, and recognise up to 8,000 rare diseases. Health Education England and Genomics England have produced a range of educational materials about rare diseases aimed at those very people—healthcare professionals, including GPs, as the first point of contact in the NHS. Information about rare diseases is also provided for patients and their families.

Let me refer to some of the remarks made by my hon. Friend the Member for Rugby. He talked about allowing patients to be closely involved at all stages of the development and implementation of the service that we are discussing. NHS England routinely involves patients in the development of new services, in line with the specialised commissioning framework, and there are dedicated working groups that inform service specification development. My hon. Friend talked about a review to reflect the impact that the changes to the NICE HST guidelines have had on patient access. NICE’s methods and processes for assessing drugs have been carefully developed over time and are internationally respected. It continues to keep its procedures under review. That includes extensive engagement with patient groups.

[Mark Pawsey]

I want to press the Minister on the availability of the specialised service, on the assumption that use of Respreeza will be approved by NICE. We are running a little behind. Does he think that the service, which was intended to be available by 2019, might be available by 2020? Is there hope for sufferers that that service might be available to them?

[Nigel Adams]

It is absolutely a matter for NICE to make its recommendations, but I think that, if this was approved, we could have a situation in which it could be available by at least April 2020. I hope that that is some encouraging news for my hon. Friend.

I probably need to wrap up the debate, but my hon. Friend also talked about the Government considering the appropriateness of introducing a more formal process of conditional approval for rare disease treatments such as alpha-1 augmentation therapy. The Department has no plans currently to establish a new assessment process for the evaluation of rare disease treatments. NICE’s methods and processes for developing its recommendations have been developed over the past 20 years through extensive engagement with interested parties.

Finally, let me assure my hon. Friend and all other hon. Members who have taken part in the debate that the Government are dedicated to improving the lives of all patients with rare diseases such as alpha-1. The publication of the UK strategy for rare diseases in 2013 was a significant milestone in that respect, and the strategy is now being implemented across the UK. The strategy set out our strategic vision and contains 51 commitments concentrating on raising awareness, providing better diagnosis and patient care, and ensuring a strong emphasis on the importance of research in our quest better to understand and treat rare diseases. Research is at the heart of better treatment and, we hope, prevention. That is why in 2017 the NIHR BioResource for Translational Research in Common and Rare Diseases was launched, supported by £36.5 million of NIHR funding.

I thank those who have come to listen to the debate, and I thank my hon. Friend the Member for Rugby and everyone present for contributing to it and for highlighting and discussing these issues. For their constituents and for all those who suffer from alpha-1 or any rare disease, I hope that I have helped in some way to assure them that the Government and the NHS are working hard to tackle these conditions and to help improve the lives of, and treatment pathways for, all patients.

Question put and agreed to.

Spring Statement

Mark Pawsey Excerpts

Tuesday 13th March 2018 Commons Chamber

[Mr Hammond]

The public sector pay freeze has been lifted: we have removed the 1% cap, so it is up to departmental Secretaries of State to make appropriate recommendations and provide appropriate evidence to pay review bodies. But we do expect them, where they recommend settlements above the level they are already funded for, to use workforce management measures and efficiency improvement measures negotiated with the workforce, to ensure that over time increases are self-funded through higher efficiency and productivity.

[Mark Pawsey (Rugby) (Con)]

The Chancellor is right to focus on how the tax system might be used to encourage improvements in the environment, and I know that the packaging industry recognises the need to reduce waste and will respond positively to his call for evidence. I ask for it to include two things: first, that it is people who cause litter, and the Chancellor spoke about the need for behaviour change; and, secondly, will it recognise the important role packaging has in reducing food waste by keeping food fresh for longer?

[Mr Hammond]

Yes, of course, and the point of having a call for evidence is to make sure that the decisions we make are based on full knowledge and full information. My hon. Friend makes a very important point: it would be massively shooting ourselves in the foot to make a change in relation to packaging that then massively increased food waste and the energy cost of food that was wasted.

Finance (No. 2) Bill

Mark Pawsey Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Wednesday 21st February 2018 Commons Chamber

[Mel Stride]

Thank you, Mr Deputy Speaker. In response to my hon. Friend—

[Mark Pawsey (Rugby) (Con)]

Will my right hon. Friend give way?

[Mel Stride]

I will give way very quickly to my hon. Friend.

[Mark Pawsey]

On behalf of 1,000 skilled workers at the London Electric Vehicle plant in my constituency, will my right hon. Friend look very carefully at the proposals to bring forward the exemption on electric vehicles?

[Mel Stride]

If we look at bringing forward this exemption, the important thing is that we should look solely at that element that relates to low-emission vehicles, rather than applying it to all taxis, as indeed amendments 10, 11 and 12 do, as tabled by the hon. Member for Ilford North (Wes Streeting). However, having listened to the representations from my hon. Friends the Members for Hornchurch and Upminster (Julia Lopez) and for Rugby (Mark Pawsey) and indeed from the hon. Gentleman who has tabled the amendments, we are minded to look sympathetically at bringing forward the exemption by a year for those taxis that have low emissions, albeit that they cost £40,000 or more. I know that my hon. Friend the Exchequer Secretary will shortly be meeting representatives from the London Taxi Company and that he will be furthering those discussions with them.

In the one minute remaining, perhaps I could turn to new clause 10, which calls for a review of the consequences of not backdating the refund of VAT in respect of the Scottish Fire and Rescue Service. The Chancellor made it clear in the Budget that, after lobbying from our Conservative colleagues in particular, we would allow such refunds going forward. In 2012, when the Scottish Government entered into those arrangements, they did so knowing what the VAT consequences would be, but we are taking action going forward.

Finally, I understand the desire of the right hon. Member for Twickenham (Sir Vince Cable) to have information on the effects of increases of income tax by 1%. However, there is no need for that now, as information is available on that. Time does not allow me to explain what that is, but I will speak to him after this debate, and on that basis, I hope that he will not press his amendment. I also take on board his comments about dormant companies and pension fund arrangements, but we do have to look to HMRC to make those judgments so that we ensure that these scams are prevented.

Autumn Adjournment

Mark Pawsey Excerpts

Tuesday 7th November 2017 Commons Chamber

[Mark Pawsey (Rugby) (Con)]

It is a pleasure to follow the hon. Member for Glasgow South West (Chris Stephens), who has demonstrated both his effective use of early-day motions and raised some constituency issues, although he did say he would not use the debate as a moanfest.

I am not going to use this debate as a moanfest, but as a celebration. I want to use it to recognise the very powerful and important contributions made by three exceptional sets of constituents in my constituency, whom I have met over the past few years in my role as Rugby’s MP. The common factor among them is that they have all faced massive adversity in their lives, but have turned it into something positive for others. I hope to be able to give a brief account of their achievements.

The first, and the one I met most recently, is a gentleman called Andy Martin. He has always considered himself an active and healthy person, but about five years ago he was diagnosed with Parkinson’s disease. He has always been a keen rugby player—we josh each other about the fact that I used to be an Old Laurentian, while he used to play for Newbold rugby club—and he continues to play for AEI and Coventry Welsh. Once he was diagnosed, he decided that he wanted to do something to show that a diagnosis of Parkinson’s disease was not a barrier to going out and achieving great things. He asked himself what he might do to raise the profile of the disease. He said that he could have curled up in a corner and hidden, but he chose instead to fight and to do something absolutely extraordinary. He told me that he had heard about Ian Botham walking from John O’Groats to Land’s End, and became determined to do that himself. He did, on his own, throughout the month of September 2017.

The journey entailed walking, on average, 35 miles a day, booking himself into a hotel or guest house, getting up early in the morning, and cracking on and walking another 35 miles. On occasion, because of the gaps between guest houses, he covered distances of between 40 and 45 miles. He achieved his goal in just 30 days. He needed a police escort as he went over Dartmoor because it was pouring with rain. He also had to travel on A roads entirely on his own, but he achieved his objective. It was a huge endeavour and an absolutely major achievement. He has shown that, despite suffering from Parkinson’s, he can still get on with his life and achieve a great deal. He has already raised £4,000 for Parkinson’s through a JustGiving page. He is planning to go one better next year and walk from his home town of Rugby to Amsterdam. I take my hat off to him. His achievement is magnificent, and something of which I am exceptionally proud.

Another constituent who came to see me very shortly after I became an MP was Peter Realf, who, with his daughter Maria Lester, has devoted his time to raising awareness of brain tumours. Peter himself endured his own battle with leukaemia from 2002 to 2012, but his condition has stabilised. I first met Peter in 2007 when he came to see me with his son, Stephen, who, at 19, had been diagnosed with a brain tumour while training to qualify as an RAF pilot. Very, very sadly, Stephen passed away in 2014 aged just 26.

In August 2015, Stephen’s sister, Maria Lester, started a parliamentary petition to commemorate the anniversary of her brother’s death and to promote awareness of brain tumours. On 9 January 2016, the petition secured 100,000 signatures, which meant that it could be considered for a debate in Parliament. The debate took place in Westminster Hall where in excess of 30 Members took part; the Chamber was as full as I have ever seen it. That led to a parliamentary inquiry, which was attended by Peter, Maria and Peter’s wife Liz. As a consequence, there is now a much greater awareness of brain tumours. The shortage of funds, particularly in respect of young people, was also highlighted. A parliamentary task and finish group was established. The final report of the House of Commons Petitions Committee found that

“successive Governments have failed brain tumour patients and their families for decades.”

Peter has now become very involved with the all-party group on brain tumours here in Parliament, and there is a real move towards positive change.

We know that brain tumours are the biggest cancer killer of children and adults under 40; fewer than 20% of those diagnosed with a brain tumour survive beyond five years, compared with an average of 50% across all cancers. Thanks to the work that Peter and his family have done, Cancer Research UK has recently announced a new multi-million-pound investment in brain tumour research at the University of Wolverhampton and Queen Elizabeth Hospital in Birmingham. That has been labelled a “game-changer” by Sue Farrington Smith, who is the chief executive of Brain Tumour Research.

It is extraordinary how Peter, having suffered a huge loss—the loss of his son—has been motivated to put his time and effort into improving awareness of this disease so that others may benefit. I take my hat off to him. He has done a tremendous job.

I also want to draw attention to my constituents George and Giulietta Galli-Atkinson. I first met them in April 2012, when they came to tell me that they had moved from London to Rugby and I was now their MP. They asked me to get involved in their campaign to improve road safety and develop a series of awards in memory of their daughter, who was tragically killed in 1998 when a car mounted the pavement as she was walking to a ballet lesson. They founded the Livia awards, which began in 1999 and are being given this evening in the Attlee Suite in the company of the Metropolitan Police Commissioner. The hard work of Metropolitan police officers in investigating road traffic accidents is being recognised there.

George and Giulietta Galli-Atkinson did not just initiate the awards, but fought tirelessly for more appropriate punishment of those found guilty of causing death by dangerous driving. On both fronts, they have been incredibly successful. I was invited to join the judging panel of those who had been put forward for awards, and I read and heard accounts of police officers who had to attend the most harrowing incidents. It was interesting for me, as a provincial MP, to understand some of the challenges of policing in a capital as large and sophisticated as London. Often the people who have to pick up the pieces and bring families together are police officers, and we heard a great deal from family liaison officers. It gave me a window into a world that I would not otherwise have seen.

The Galli-Atkinsons have campaigned to make the penalties for causing death by driving more severe, and they have succeeded. There has been a long overdue change in the law as a consequence of their campaigning. They were assisted by the former MP for Enfield, Southgate—where they lived—David Burrowes.

George and Giulietta continue to campaign on road safety, and they have set up the Safe Drive Stay Alive initiative, which works with young people to make them aware of the dangers on the roads. It celebrates its 12th year this year. Although it runs predominantly in London, it is working its way through the country more widely, and I am delighted that it will come to Warwickshire next year. Again, they are two people whom I have met in my role as an MP, but perhaps would not have got to know in another walk of life. I have been incredibly moved by the amount of effort they put into raising standards in memory of their daughter. They turned great adversity into something for others.

I have mentioned three sets of constituents, whom I am immensely proud to have as my constituents. I am immensely proud that they are all in Rugby and making an impact on different sectors. They put their loss and grief to one side and their energy into making improvements for others. I am pleased to have had the opportunity this evening to recognise the work of Andy, Peter and Maria, and George and Giulietta. I hope that they all continue with their very good work.

Economy and Jobs

Mark Pawsey Excerpts

Thursday 29th June 2017 Commons Chamber

[Mr Hammond]

Let me make a little more progress.

All that is before we even get to the £500 billion borrowing splurge that Labour has promised us over the next 10 years—£250 billion over the course of a Parliament.

[Mark Pawsey (Rugby) (Con)]

Will my right hon. Friend give way?

[Mr Hammond]

I will in just a moment.

Then there is the nationalisation programme. Let me explain these plans, Madam Deputy Speaker, because they are important. The Labour party wants to nationalise gas and electricity, water and Royal Mail. They would borrow a fortune to do it, and it would deliver no economic benefit whatsoever.

First, a Labour Government would have to buy up the shares of publicly listed companies on the stock exchange. Taking over just the single largest company in each sector would cost close to £44 billion, and the Government would have to pay a market premium on top, because a programme to buy the shares would drive up the price. Moreover, the taxpayer would take on those companies’ debts; that is another £26 billion. So that is £70 billion of public debt. When the Labour Government were done with the publicly listed companies, they would have to strike deals with scores of private investors and funds to buy the rest. All told, we are looking at more than £120 billion. [Interruption.]

The right hon. Member for Hayes and Harlington says from a sedentary position, “You do not understand. It is a financial transaction, so it does not need any money, and it does not require us to go out and borrow any.” He is simply wrong. Financial transactions add to public debt—[Interruption]—and that is before we even get to the railways, which he has been chuntering about. I have deliberately left the railways out of my equation, because his proposals for those are more complex.

--- Later in debate ---

[Mr Hammond]

I want to make a little progress, but I will give way in a moment.

I have set out our record, but the British people did not get where they are today by admiring their achievements. We have work to do: we have to negotiate our future relationship with the EU; we have to enhance our global competitiveness through raising our productivity; we have to rise to the challenge of sustaining our public services in the face of demographic pressure; we have to address the needs of our population for affordable routes into home ownership; and we have to show the courage and vision to grasp the opportunities ahead. We will meet those challenges head on, as we have always done, with a plan that builds on the strengths of our economy, not one that denigrates them.

Let me say something about our public services and their funding. We all value our public services and the people who provide them to us. Health and social care, education, roads, local authority services, police, fire and rescue, defence and the many, many other services we enjoy all form part of the vital fabric of our society and contribute to the vibrancy of our communities. The challenge of funding those public services is accentuated by the changing age profile of the population, which necessitates a proper debate about how to make the funding of public services sustainable not just next year, but over the decades of demographic change to come. We have to be clear about the choices and what they mean because there are no free lunches or money trees in the real world, and all decisions have consequences.

There are three ways for the Government to increase spending on public services: higher taxes, higher borrowing or higher growth. Higher taxes have a cost in terms of business investment, economic growth and take-home pay. Conservatives are instinctively in favour of keeping taxes as low as possible so that business can continue to create high-quality jobs and hard-working people can keep more of the money that they earn. That is why we reject Labour’s manifesto plan, which would, according to the IFS, take taxation to its highest ever peacetime level. The right hon. Member for Hayes and Harlington is not listening, but—[Interruption.] Pay attention. If he wants to make the case for higher taxation to fund public services, will he at least make this a grown-up debate? Will he at least ask voters whether they want to pay higher taxes to fund public services, not whether they would like someone else to pay higher taxes? As Ed Balls reminds us, in the real world, it is ordinary people who pay.

When we already have an eye-watering amount of debt, higher borrowing makes our economy vulnerable to future shocks. With £1.7 trillion of national debt outstanding and an annual interest bill of £50 billion, even at the current low rates, we should be reducing debt, not increasing it. However, borrowing means something else, too. It means that we are asking the next generations—our children and our grandchildren—to consume less in their lifetimes to pay for our consumption today. That is simply not fair; it is the opposite of sustainable.

[Mark Pawsey]

The Chancellor rightly mentions the interest bill. Will he tell us what would happen to interest rates if the Opposition’s policies were introduced? What would be the impact on the average family’s income?

[Mr Hammond]

As I have already said, if it were ever to look like the shadow Chancellor was anywhere near having his hand on the lever of power, I suspect that his programme, given what we know about his values and principles around the management of the economy, would lead to a pretty sharp rise in interest rates.

We must continue the job of getting our public finances back in order, over a sensible period of time, so that we are living within our means. The shadow Chancellor referred to the decision in my first autumn statement to push back the date on which we will reach fiscal balance. I made that decision to protect our economy during a period of uncertainty due to our exit negotiations from the European Union, therefore giving ourselves a little more headroom to respond should the economy need support. I would have thought that the right hon. Gentleman welcomed that measure.

The only fair and sustainable way to fund better public services, higher real wages, and increased living standards—[Interruption.] I say to the Opposition Front-Bench team that that is absolutely not the way to do it. The only fair and sustainable approach is to increase economic growth through higher productivity. Our plan will support our public services and living standards.

Double Taxation Treaties (Developing Countries) Bill

Mark Pawsey Excerpts

2nd reading: House of Commons
Friday 16th December 2016 Commons Chamber

[Jane Ellison]

It was only this week that the Prime Minister responded directly on that subject, so the hon. Gentleman does not need my assurance because he has had it from much higher up the governmental food chain.

As the hon. Gentleman intervened earlier on the subject of Malawi, I want to get this point on the record. I have done a lot digging into this issue. It is true that we are negotiating an updated treaty with Malawi, which we hope to conclude soon, but the Malawian Government have stated that there is no evidence of any UK companies using the UK-Malawi treaty to deprive them of their revenues. An official statement from the Malawian Government said that

“both the Malawi Government and the British Government, as well as the nationals of the two countries, have evidently acted in good faith to ensure that neither party is exploited on the basis of the current agreement.”

I wanted to give the hon. Gentleman and the House that assurance on the Malawi treaty.

[Mark Pawsey (Rugby) (Con)]

Does my hon. Friend agree that the hon. Member for Kirkcaldy and Cowdenbeath (Roger Mullin) has some laudable aims, but that he is pushing at an open door because the Government have already taken substantial action and agreed to implement two of the base erosion and profit sharing outputs? They are therefore travelling in the direction he is asking for.

[Jane Ellison]

My hon. Friend is right. The OECD’s BEPS project is really important in addressing some of the issues the hon. Member for Kirkcaldy and Cowdenbeath talked about. The UK has played a leading role in that project and will continue to do so. A large number of countries have come on board with those principles and we will continue to move forward on them.

It is worth restating that the UK became the first G7 country to meet the UN target of spending 0.7% of gross national income on international development. The way in which we tackle the challenges in developing countries is very much in the spirit of what has been discussed in this debate. We understand the idea of helping people to develop capacity and independence so that they are not dependent on aid. At the heart of what DFID and the Government are doing is the idea of strengthening people so that countries can move forward and develop.

We help people to strengthen their economies and reduce their reliance on aid in a range of ways. Last year—I am particularly proud of this because it involves HMRC working closely with DFID—we committed to doubling the funding for tax projects in developing countries through the Addis tax initiative. HMRC has set up a specialist tax capacity-building unit, which deploys staff to developing countries to provide technical tax expertise. It is working closely with DFID on that.

Bilateral tax treaties can play a part. Treaties are important in encouraging private sector activity in a partner country. We know how powerful a force that can be in driving up employment, providing quality goods and services, and raising crucial tax revenues, which finance public services in those countries. We have about 130 treaties with countries across the globe, including several with developing countries, to support and sustain cross-border trade and investment by tackling double taxation and clamping down on cross-border avoidance and evasion.

The treaties are reached through negotiation by experienced officials from HMRC and are highly technical documents. Let me provide assurance on the specific points the hon. Member for Kirkcaldy and Cowdenbeath made about who is involved and the process that goes into those documents. They follow consultation exercises that help to establish appropriate priorities. That process includes the consideration of representations made by UK businesses, NGOs, other Departments including DFID and the UK’s missions based in developing countries. The approach to these treaties is very collaborative and open so that we reach the right priorities that work for both parties. Decisions on the negotiation or renegotiation of a tax treaty are taken on the basis of a range of factors, including the results of HMRC’s periodic review of the tax treaty network and the role of treaties in promoting development. The Government already strive to take wider issues, including development, into account and align our tax treaties with our wider development policies.

I know there are some concerns about the treaties, and some have been alluded to today. Let me be very clear that the UK never ties our wider assistance or investment to such treaties. We cannot impose tax treaties on other states, including developing countries, and we never try to do so. Every tax treaty we negotiate is necessarily a reflection of the interests and priorities of both states as equal partners. That of course will mean some trade-offs. Sometimes developing countries face a trade-off between reducing their tax rates and rights to encourage investment and maintaining those rates and rights and so risking losing investment. That is their judgment to make. Before engaging in a treaty negotiation any country would think about what its priorities are.

Autumn Statement

Mark Pawsey Excerpts

Wednesday 23rd November 2016 Commons Chamber

[Mr Hammond]

Our intention will be to try to ensure the fairest distribution possible. I welcome the debate that the hon. Gentleman and others have stimulated on the appropriate way to present distributional analysis—the issue is not completely cut and dried or straightforward—but I say this to him: we were elected on a manifesto commitment to get welfare under control. Working-age welfare had spun out of control between 1980 and 2010. We have now got it back under control, which implies that we have had to take some tough decisions. We have taken them. I will accept and explain the consequences of those.

[Mark Pawsey (Rugby) (Con)]

To support those who are just about managing, there need to be more affordable houses. Is the Chancellor pleased to see the welcome from the chief executive of the National Housing Federation for today’s measures that will enable an additional 40,000 such houses to be provided? With planning consents running at the highest level for years, does my right hon. Friend look forward to the sector getting spades into the ground very quickly?

[Mr Hammond]

Yes. One of the attractions of funding affordable housing is that it is a tried and tested and generally pretty efficient delivery method. I am afraid that while I stand at the Dispatch Box, I am not digitally enabled, as they say: I was not aware of the welcome that my hon. Friend refers to. However, I am delighted that this has gone down as I hoped it would with the relevant people.

Outsourcing and Tax Credits

Mark Pawsey Excerpts

Friday 4th November 2016 Commons Chamber

[Simon Kirby]

I have had the pleasure of responding to debates on this in Westminster Hall and in this Chamber, and this is now the third occasion I have had such an opportunity to respond. There are clearly lessons to be learned. The Financial Secretary has made the Government’s position very clear: Concentrix will not be providing the service in the future. However, there is no change to Government policy on outsourcing, which can be an appropriate way to deliver both quality public services and, importantly, to make savings for the taxpayer. We will have to wait to see what the independent National Audit Office review shows, but I am sure we are all looking forward to it. As I have said, there are many lessons to be learned.

[Mark Pawsey (Rugby) (Con)]

Our constituents expect the Government to spend taxes wisely and efficiently. Is it not entirely right that the Government should seek to minimise error and fraud? Is this not a case of the Government having taken some action, discovered that it has not worked in the way they sought and then taken effective action to deal with that?

[Simon Kirby]

That is a fair point. It is worth saying that most of these problems are errors—there is always, sadly, some fraud as well—but this is about getting the balance right between, on the one hand, the taxpayer and, on the other hand, making sure that people receive the service they rightly expect. We have cut fraud and error in benefits to some of the lowest levels ever, making savings to the taxpayer. As I have said, there are lessons to be learned and there is a balance to be struck.