Child Support (Enforcement) Bill

Mark Tami Excerpts

3rd reading
Friday 17th March 2023 Commons Chamber

[Ms Karen Buck (Westminster North) (Lab)]

We all know that being a single parent increases the risk of falling into poverty, and that is even more the case when an absent parent does not fulfil their maintenance obligations. We all wish it were not so, but it is, as we know; we have heard examples in contributions this morning and I am sure all of us know from our casework that there are occasions when the absent parent, usually, but not always, the father, will act abominably in seeking to avoid their obligations. I have certainly had such instances in my constituency—and not always, it has to be said, involving those on the lowest incomes.

Labour completely supports the principle that non-resident parents should meet their responsibilities for child maintenance and that where they fail to do so the state needs to step in to enforce payment. As has been reinforced this morning, timely meeting of responsibilities is crucial, because when payments fall behind and the parent with care has to take action and wait for payments, that can cause financial distress and massive psychological distress. So I, too, congratulate the hon. Member for Stroud (Siobhan Baillie) on introducing the Bill and the hon. Member for South Ribble (Katherine Fletcher) on stepping up this morning and taking it through the final stages.

As my hon. Friend the Member for Reading East (Matt Rodda), the shadow Pensions Minister, said on Second Reading, not only do we support the principle, but we recognise that enforcement of child maintenance obligations needs to be improved. This Bill will improve enforcement. It is a largely technical set of measures, but we hope it will make a significant contribution to speeding up the process by which the absent parent can be made to pay. However, we do not think it will resolve all problems with the CMS. Nor, it is fair to say, is it intended to, as I am sure Conservative Members would agree. I think everyone recognises that we are a very long way from having a Child Maintenance Service that ensures that all absent parents meet their responsibilities and that all families receive the financial support to which they are entitled.

As my hon. Friend the shadow Treasury Minister pointed out in the Committee that considered the Bill, last year’s report by the Public Accounts Committee concluded that, in the 10 years since the Child Support Agency was replaced by the Child Maintenance Service, there has been effectively no improvement in the system for parents, children and families. Around half of children in separated families—1.8 million children—receive no support at all from their non-resident parent.

[Mark Tami (Alyn and Deeside) (Lab)]

We have heard a lot of stories today, and they are always about the very difficult cases, where people work cash in hand, or try to avoid things, and it is important that we pursue those people. We also have people coming to us who say, “I play by rules, but I am pursued all the time, because I am an easy person to get hold of, whereas some of the others are not.”

[Ms Buck]

I agree with my right hon. Friend. It is really distressing when we see these cases. After separation, often, families will find themselves in financial stress. Even so, many parents will do absolutely everything that they can to put their children first and to meet their obligations. They are of course very angry about the behaviour of those parents who simply do not play by the rules and who, as we have heard, do everything that they can to avoid those commitments—they drop in and out of work, create shadow companies, and conceal their incomes in every way that they can. They do so because, sadly, money is so tied up with emotions after a relationship breakdown that it is often used as a tool to continue to cause emotional damage to those families.

It is concerning that Child Maintenance Service performance seems to have declined over recent years. Of course, enforcement action was negatively affected by the pandemic, as staff had to be redeployed to manage universal credit claims, and the courts were closed. However, performance was already showing a worrying trend before the pandemic, with the number of liability orders in process falling from 6,900 in the first quarter of 2019 to 3,700 in the last quarter of 2019. Things have improved on the most recent data, for the third quarter of 2020, but, at 5,300, numbers remain far below the earlier level. Meanwhile, the number of enforcement agency referrals in process is less than half what it was in 2019. It would therefore be helpful if, in replying, the Minister could update the House on how the Government intend to address these apparent shortfalls in Child Maintenance Service performance since 2018, and reassure the House that this legislation will not lead to any relaxation of efforts to improve performance in the round.

Having said that, I again congratulate the hon. Member for Stroud. I have no doubt that this is important and useful legislation and we on the Labour Benches give it our wholehearted support.

Social Security

Mark Tami Excerpts

Tuesday 9th February 2021 Commons Chamber

[Wendy Chamberlain (North East Fife) (LD)]

It is hard to believe that more than four months have passed since we considered the Social Security (Up-rating of Benefits) Bill last autumn, and I welcome the annual process used to ensure that social security benefits and pensions are uprated. However, like others who have spoken in the debate, I must put on record my disappointment at the decisions taken. We are just weeks away from the new financial year, and it might seem hard to believe for some Members, but for millions of people across the country, that represents a terrifying reality.

There is still total uncertainty about what will happen to the universal credit uplift of £20 a week. Under the statutory instrument, the Government plan to take away £1,000 a year from the least well-off families in Britain. This is not scaremongering. The uplift may have been for one year, but people’s situations are arguably more precarious than they were a year ago, so this is quite simply the wrong thing to do. It is the wrong thing to do morally, and it is the wrong thing to do economically, because this money will not be stored away; it will be spent and reinvested back into the economy.

The support that the uplift represents is vital, yet the Government have spurned opportunity after opportunity to make it permanent or to at least extend it. They could have done it during the Secretary of State’s publication of uprating totals back in November, and they could have done it when the latest national lockdown was announced at the beginning of the year, but they did not. Then the Government abstained on the Opposition day motion in the name of the Leader of the Opposition, which puts us in a bizarre situation where Parliament has approved a motion calling for the uplift to be made permanent, yet the Government plan to do nothing about it. The idea of non-binding motions may be familiar to those of us who occupy this place, but in terms of communicating the will of the House to our constituents, I find that an abdication of responsibility from those on the Government Benches. During all that time, millions of families have had to live with the uncertainty of not knowing what their income will be come April. The Government need to provide support, but they also need to provide certainty.

I welcome the report published last week by the all-party parliamentary group on poverty, chaired by the hon. Member for Thirsk and Malton (Kevin Hollinrake), calling for the uplift to be made permanent. As the hon. Member for Feltham and Heston (Seema Malhotra) said, support for that exists across the House. That is what the Government have to do. Otherwise, they will be letting people down at exactly the time when our safety net is meant to support them.

The report also calls for an uplift in legacy benefits, which I wholeheartedly echo and which has been recommended by the Work and Pensions Committee, the Joseph Rowntree Foundation and many others. I do not think we in this place have given enough attention to the issue of people in receipt of legacy benefits. Many of my constituents who receive these benefits were very disappointed to see that they had been excluded from any uplift. It is not right. If we accept that universal credit claimants should receive an uplift, there is no reason why that should not have been extended. Instead, the only uplifts offered for legacy benefits are the inflationary ones detailed in the statutory instrument today. That means, for example, that someone who receives ESA and is in a work-related activity group will receive 35p per week extra, and someone who receives carer’s allowance will see a 30p per week increase. Many of my constituents regard these increases, at a time of such hardship for many of them, to be derisory. I urge the Government to consider uplifting legacy benefits. It is a question of fairness. The Minister, in his opening remarks, suggested that Opposition scaremongering is responsible for those on legacy benefits being deterred from making UC claims, but surely at such an uncertain time it is understandable that people choose to stick with what they know and what they have.

[Mark Tami (Alyn and Deeside) (Lab)]

Does the hon. Lady agree that people are also exposed to loan sharks and others who know how vulnerable people are at this time and prey on them?

[Wendy Chamberlain]

I thank the right hon. Gentleman for his intervention and agree absolutely: when people are desperate, they turn to whatever options are available to them and that stores up more difficulties for the future.

I turn now to the uplifting of pensions. It is right that the Government have taken steps, such as in the Social Security (Up-rating of Benefits) Act 2020, to ensure that the commitment to the triple lock is maintained. As I said during the passage of that Act, not only does the triple lock provide an important means to ensure that pensioners are properly supported in retirement, but it is a matter of intergenerational fairness. Small increases year on year now ensure that the generation who are currently just entering the workplace will also receive that support when it is time for them to retire.

This is a timely opportunity to discuss pensions, for important research was published today by the charity Independent Age—this was referred to by the Chair of the Select Committee, the right hon. Member for East Ham (Stephen Timms)—detailing that older people miss out on £88 million a year from the warm home discount because they do not claim pension credit. Some 650,000 pensioners who are eligible for pension credit do not claim it. I hope the Minister in his winding-up speech will address what the Department for Work and Pensions is doing to promote engagement and increase uptake of this important benefit.

The final area I want to refer to where there is an inherent sense of unfairness is the frozen pensions of overseas pensioners in certain countries. I have recently met people affected by this issue. They have found it hard to survive on a frozen pension and this is especially the case during the coronavirus pandemic. There is a moral case to expand the pensions uplift to overseas pensioners during the pandemic.

I welcome the recent report of the all-party group on frozen British pensions, which is chaired by the right hon. Member for North Thanet (Sir Roger Gale), who spoke earlier in the debate. The report tells of a British citizen, a 96-year-old veteran called Anne Puckridge, who served in all three branches of the armed forces. She moved to Canada in 2001 so that she could be close to her family. Despite all that, and despite her national insurance contributions, she finds herself receiving a state pension of £72.50 a week. Of course, because of the 15-year rule, she is denied proper representation in this place, and I look forward to the Government bringing forward legislation, as they committed to do in their manifesto, to scrap the 15-year rule. She is in a strange and arbitrary situation where, had she moved a bit further south, over the border, into the United States, she would be eligible for a fully uprated state pension, because we have an agreement with the US. Does the Minister see the unfairness in that?

The all-party group has found that the Canadian Government are willing to engage on this issue and have made a formal request to the UK Government about the potential for reciprocal arrangements. I hope the Minister will be in a position to update us on what discussions he and the Pensions Minister, the Under-Secretary of State for Work and Pensions, the hon. Member for Hexham (Guy Opperman), have had about this. I hope the Minister will address three key questions on this issue. When do the UK Government plan to respond to the Canadian Government? What is the process moving forward on coming to an agreement? What is that response likely to be? I urge them to reach an agreement. It would clearly be transformative for very many. I look forward to hearing from the Minister on this issue during his winding-up speech.

Oral Answers to Questions

Mark Tami Excerpts

Monday 9th March 2020 Commons Chamber

[Mark Tami (Alyn and Deeside) (Lab)]

3. What steps she is taking to reduce the length of time between a claimant’s last universal credit payment and first state pension payment.

[The Parliamentary Under-Secretary of State for Work and Pensions (Will Quince)]

The Government recently announced that anyone reaching state pension age while claiming universal credit can receive a run-on until the end of the assessment period in which they reach state pension age. This removes any potential gap in provision, with such pensioners receiving, on average, an additional £350.

[Mark Tami]

The announcement in the written statement on Thursday was extremely welcome and a great victory for hundreds of thousands of pensioners throughout the country. I thank all Members from all parties who signed early-day motion 129, which highlighted the issue. As it was clearly a bad policy in the first place, what redress will the Government offer to those pensioners who have already suffered loss?

[Will Quince]

First, I thank the right hon. Gentleman for all his work in this policy area. As he rightly pointed out, the change does remove any potential gap in provision, with people reaching state pension age and leaving universal credit receiving an additional £350 on average. I stress that the process is already in operation on an extra-statutory basis, ensuring that nobody loses out on reaching state pension age. Legislation will be amended accordingly later this year.

Cancer Treatment: Psychological Support

Mark Tami Excerpts

Thursday 22nd November 2018 Commons Chamber

[Mark Tami (Alyn and Deeside) (Lab)]

I am grateful to be granted this debate on psychological support after cancer treatment. I recognise that there will probably be fewer Members here than there have been in the last few hours, but I thank anyone who stays to hear what I have to say.

When we talk about cancer, the conversation often starts with survival. Overall, survival has doubled in the last 40 years in the UK, but we lag behind the best in Europe, and survival rates for certain cancers—such as lung, brain and pancreatic cancer—continue to be extremely low. That means there is, rightly, a drive towards earlier diagnosis and access to new and innovative treatments. However, for most patients, just living is not enough. They want to live well, and that is why we must do more to ensure that patients receive the best possible psychological support after cancer treatment.

It goes without saying that cancer can take a huge emotional toll on patients and those close to them, right from the moment of diagnosis. Less well understood are the consequences of cancer treatment, which can affect patients’ lives on a daily basis and leave them needing support for many years afterwards. No group illustrates that better than stem cell transplant patients.

Every year in the UK, around 2,000 blood cancer patients need a stem cell transplant from a donor to save their life. It is usually their last hope. One third of patients will be lucky to find a matching donor in their families, but the remaining two thirds of patients will require an unrelated donor. The search for a donor can be extremely stressful. Despite the fact that there are more than 1.4 million incredible individuals on the UK stem cell donor register, there are still patients who miss out on the life-saving transplant they need because either no donor is available or a donor cannot be found early enough.

My experience with my son was that we were very fortunate to find a donor. That donor then failed his medical, which was a traumatic experience for the family. Not only were we concerned about what the problem was for the donor, but we did not know whether the donor would return to fulfil that pledge. We will be eternally grateful that he did.

Even when a patient does find a match, this is not the end of their journey. Tellingly, the day of the stem cell transplant is commonly referred to as day zero. First, the patient must spend a number of weeks in hospital isolation to protect them from infection. This alone can be a very difficult experience, with patients often feeling very cut off from the outside world. Things such as patchy wi-fi, poor facilities and rooms without windows do not exactly help with this experience. Hopefully, the patient then begins their recovery, which brings with it entirely new physical, emotional and practical challenges. In fact, of all cancer treatments, stem cell transplant patients experience some of the most severe long-term effects, and it is for that reason that they are often described as patients for life.

To give hon. Members some idea of what it can be like for those living with the long-term effects, approximately half will suffer from graft versus host disease, which is when their new immune system attacks their own body. I can certainly say that this is not a particularly pleasant experience, and in the worst cases it can actually kill the patient as well. Patients can also experience infertility, premature menopause, sexual dysfunction, fatigue and problems with their eyes, bones, teeth, joints and muscles, and they are at higher risk of infections and secondary cancers. In addition, it is not unusual for patients to be left with a range of psychological effects, including depression and post-traumatic stress disorder. All of this can have an impact on patients’ ability to study and work, and with that can come financial issues and even a loss of their identity. It can be completely and utterly overwhelming.

With all this in mind, it is perhaps not surprising that in response to a survey of more than 300 stem cell transplant patients conducted by Anthony Nolan, the UK’s stem cell transplant charity, nearly half—47%—said that they needed emotional and psychological support, such as counselling or group therapy. It is surprising and even shocking that only half—54%—actually received it.

Let us take some individual cases. Joanna received a stem cell transplant in 2016 to treat acute myeloid leukaemia. It saved her life, but when she got home to her family, she could not get off the sofa or out of bed. It was the worst she had felt since the actual diagnosis. Her daughter was only a teenager at the time, and the caring role of mother to child had to be reversed. In Joanna’s own words:

“I think my lowest emotional time was after transplant. I questioned why I’d gone through this experience and just couldn’t see an end in those first three to four months… I wish there had been more psychological support for me and my family—even though staff tried their best, when I really needed help, it just wasn’t there.”

Joanna’s story is not unique.

Ruth, a teacher from Yorkshire, also received a stem cell transplant in 2016. In the two years since, she has experienced many ups and downs, and she is still dealing with chronic graft versus host disease. For her, this means her eyes are constantly dry, she cannot perform fine motor skills too well and her feet are in constant pain because of nerve damage. Ruth says:

“The biggest downside of my whole transplant experience has been the complete lack of support since leaving hospital. It felt like I was on my own—my GP has offered me nothing. I’m on the waiting list for a counsellor, but it’s very long… I’m surprised you’re not referred to a counsellor as soon as you’re diagnosed.”

As well as those patients who have received transplant, the charity Macmillan has provided me with some other brief personal stories. Let us take Frances, who finished treatment for Hodgkin’s lymphoma five years ago. She says:

“Emotionally, in the first year after treatment I think I was shell-shocked because you’re trying to catch up with everything that has happened to your body. You feel like you’re a failure and you’ve failed to bounce back in the way you think you should have done.”

Ciara, who finished treatment in 2016, says:

“The fear of cancer never leaves you but I’m trying now to think, if it comes back, it comes back. I can’t live under that shadow. But it is so difficult to mentally recover.”

Finally, Chris, who finished his treatment for head and neck cancer in 2016 stated:

“People say to me, ‘I bet you wake up every morning feeling glad to be alive.’ You know, it can’t be further from the truth.”

The stories from Joanna, Ruth, Frances, Ciara and Chris affect all cancer patients—they cover everybody.

So what do we need to do? First, psychological support is for everyone, not just those with diagnosed mental health conditions. Secondly, the families of patients should also be offered psychological support, and thirdly, it seems that patients and their families are not getting the psychological support they need. Let me address those points in turn.

First, psychological support is for everyone, not just those with diagnosed mental health conditions such as depression or post-traumatic stress disorder. That includes patients who are feeling anxious, worried or frightened, and those who are having trouble adjusting to their “new normal”. The fear of cancer returning can be particularly difficult to manage. For example, some blood cancers relapse, which can be a common occurrence. Even if someone is doing physically well, that sense of dread never goes away for them or their family members.

Because of patients’ varied needs, psychological support can take many forms. Clinical psychologists and others working in improving access to psychological therapies services are able to help those with the most complex needs. Clinical nurse specialists, who we know are hugely valued by patients, can enhance overall wellbeing by providing general emotional support based on skilled communication and effective provision of information. The third sector, meanwhile, provides a wide range of services, including helplines, online forums and peer support. There is no silver bullet, however, and many different actors have a role to play.

Secondly, patients’ families should be offered psychological support because they too feel the consequences of cancer treatment. If someone is acting as their loved one’s carer, that can affect their relationship and ability to go about their daily life. They might have suddenly become the family’s main breadwinner, which could be a source of enormous stress. Family members will often feel as if they have to put a brave face on things and somehow do not deserve help because they are not the ones who are ill. In reality, however, patients regularly say that they worry more about their family than themselves and that in turn can affect their recovery. I know from personal experience that the CLIC Sargent nurse who came to us on a weekly basis to give my son chemotherapy was somebody to talk to who understood, and that side of the process was just as important to us as the medicine being given.

Thirdly, patients and those close to them are not getting the psychological support they need. According to the most recent results from the national cancer patient experience survey, only two thirds of patients felt that they were able to discuss their fears or worries, and I hope the Minister will respond to that.

In many cases, this comes down to workforce—either not enough specialists are available who properly understand the consequences of cancer treatment, or the demands on staff time are so great that it is impossible to provide patients with adequate psychological support.

In response to a 2017 survey of GPs and nurses, 31% of respondents said that workforce pressures mean patients are not being supported to regain a good quality of life after treatment. In other cases, the right support existed but patients are not being appropriately signposted. I have heard of many patients having to be proactive and find help for themselves. Patients should certainly be empowered to take control of their own care, but I think we all agree that this should be a choice and not a necessity. They should not be let down by poor communication and co-ordination, but in many cases they are.

The Minister may refer to the recovery package in her response. It consists of four main interventions: a holistic needs assessment and care plan; a treatment summary; a cancer care review; and access to a health and wellbeing event. This can certainly help to identify patients’ psychological needs and I welcome the fact that NHS England has committed to rolling out the recovery package nationally by 2020. However, does the Minister agree that identifying patients’ needs is only one piece of the puzzle and that more needs to be done to ensure they actually receive the right psychological support?

[Thangam Debbonaire (Bristol West) (Lab)]

My hon. Friend is making an extremely moving speech. Does he agree that getting the right psychological support from the start also helps the medical treatment? For many cancer patients and their families—as he said, it is very painful for them to watch the treatment—getting psychological support helps them to be able to face going through the treatment, which can be so devastating, as I know he knows.

[Mark Tami]

That is very important. What we tend to do throughout the whole process is address the disease itself and its physical aspects, but we do not address the psychological damage and problems that can occur. My hon. Friend is absolutely right that we need to do that.

Before I close, I would just like to take a moment to talk about the specific needs of children, teenagers and young adults who have had cancer. They experience many of the same physical and psychological problems as adults, but they also face some unique challenges, such as the impact on their growth and development, education and future prospects. Earlier this year I was very pleased to be part of the inquiry into patient experience by the all-party parliamentary group on children, teenagers and young adults with cancer. I would like to put on record my thanks to my hon. Friend the Member for Bristol West (Thangam Debbonaire), who set up the group and chairs it. She is doing sterling work and I thank her for that.

When parents and young people were surveyed, 73% felt that not enough was being done to ensure access to post-treatment support. Some 26% of parents and young people identified mental and emotional help as the biggest improvement needed. As Kate Collins, chief executive of Teenage Cancer Trust, summarised:

“Young people have told us that actually the experience of being spat out at the end of treatment can be as traumatic as diagnosis, because all of a sudden you’ve been radically changed, you’ve been through this remarkable transformation experience in lots of ways, you’ve faced problems that lots of adults have not had to face…you may be clear of cancer but often young people are living with long-term effects, be they psychological or physical.”

The all-party group therefore recommended that the Department of Health and Social Care makes mental health support for children, young people and parents a key part of diagnosis, treatment, follow-up and recovery. Furthermore, NHS England should engage with children and young people with cancer to ensure that the recovery package meets that specific need. The all-party group also recommended that the Department of Health and Social Care and the Department for Education should re-examine their proposals in the mental health Green Paper and take account of the impact of a long-term physical condition on young people’s mental health.

When the Under-Secretary of State for Health and Social Care, the hon. Member for Winchester (Steve Brine) gave evidence to the all-party group, he said:

“For the 80% of children who survive, they’ve got it all ahead of them, so we have to make sure that we tool them up to live their lives.”

Can the Minster tell us what she and the Department are doing to give children, teenagers and young adults the tools they need to deal with the psychological consequences of their treatment?

CLIC Sargent’s 2017 report, “Hidden Costs”, found that 79% of young people felt that cancer had a serious impact on their emotional wellbeing, 70% experienced depression, 83% experienced loneliness, 90% experienced anxiety and 42% experienced panic attacks during their treatment. For parents, the figures are similar: more than half of parents—63%—said that they experienced depression, more than one third experienced panic attacks, and 84% experienced loneliness.

It goes without saying that surviving cancer is brilliant news. However, I urge the Minister and everyone here today to remember that although survival rates are improving, people are living with the effects, including the long-term effects, that cancer has dealt them. We must do more to ensure that patients such as Joanna, Ruth, Frances, Ciara and Chris not only live, but live well. That means taking action to improve the provision of gold-standard psychological support. Finally, I thank Anthony Nolan, CLIC Sargent, Macmillan and the Teenage Cancer Trust for their help.

[The Minister for Disabled People, Health and Work (Sarah Newton)]

I am sure that I speak for everyone here in congratulating the hon. Member for Alyn and Deeside (Mark Tami) not just on securing such an important debate, but on the bravery he showed in his speech by sharing with the House his family’s experience. It is very important that we bring the voices of the people we all seek to serve in this place into the Chamber, as well as the experiences that were shared from CLIC Sargent and Macmillan, so I thank him for that. I know that he is doing extremely good work through a number of organisations in the House to ensure that cancer patients are getting the very best treatment and support. He has also given a huge amount of support to setting up the all-party group on children, teenagers, and young adults with cancer. Although the hon. Member for Bristol West (Thangam Debbonaire) has left the Chamber, I praise her work on the really good report that she and the hon. Gentleman produced. I read it last night and thoroughly recommend it to other Members.

I am standing in for the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine), who has ministerial responsibility for cancer. He is very sorry that he cannot be here this evening and he was very pleased to be able to contribute to the APPG’s report. He asked me to remind the House that he has agreed to respond to everything—all the recommendations—in the report, so the hon. Member for Alyn and Deeside will get a full written response from him.

I am pleased to respond on the Government’s behalf to this debate, because it brings together two vital issues, which are crucial to the health of the nation and are at the top of the Government’s priority list. Approximately one in four people in the UK experience a mental health problem every year. In England, one in six people report experiencing a common mental health problem, such as anxiety and depression, in any given week. Cancer affects one in two of us—there will not be anyone here this evening who has not been dreadfully affected by this disease—so it is absolutely important that the Government are focusing on these priorities.

Since 2010, cancer survival rates have been improving year on year. We estimate that some 7,000 people are alive today who would not have been here just 18 years ago, but we are not at all complacent. We know that there is more to do to make sure that our results are the best in the world. That is why last month the Prime Minister announced a package of measures, which will be rolled out across the country and which aim to see three quarters of all cancers detected in the earliest stages by 2028. The plan, backed by a record level of investment in the NHS—an extra £20 billion a year by 2023—will radically overhaul screening programmes and provide new investment in state-of-the-art technology to transform the process of diagnosis and boost research and innovation.

However, what I really want to talk about in the few moments available to me is the support that we must give to people who are living with and beyond cancer. The recovery package, which is a key component of that priority, consists of a set of four interventions that are designed to help patients and clinicians to assess patients’ holistic needs and plan appropriately for their care and support. They include a holistic needs assessment and a care plan, which guide conversations about patient’s holistic needs—not just physical and psychosocial needs, but financial, social and mental health needs. An HNA should take place within 31 days of diagnosis and at the end of each acute phase of treatment, and the care plan should be updated on each occasion. Both interventions enable patients to be referred to appropriate psychological support when necessary.

That personalised follow-up and support to help people to live well with and beyond cancer is a crucial element of the cancer strategy, and helps us to create the world-class cancer services to which we aspire. NHS England will roll out recovery packages nationwide by 2020, so that the support that they provide is available to all cancer patients in England regardless of where they live. All Cancer Alliances are receiving the necessary funding this year to support full implementation of the recovery package.

As the hon. Gentleman has said, some cancers, such as chronic blood cancers, can sadly never be cured. Blood cancer patients are frequently on a regime of “watch and wait”, often over many years, to establish whether their cancer has progressed to a point at which treatment needs to begin. Understandably, that can take a huge psychological toll on not only patients but their families, which is why the recovery package takes a holistic approach and fully considers the patient’s mental health needs. The package is already being commissioned and delivered, in full or in part, by many clinical commissioning groups across England, but NHS England’s aim is to accelerate the process to ensure full implementation by 2020 so that every cancer patient is given that full package of care.

Of course we need to ensure that cancer patients, and their families and carers, can access appropriate mental health services if and when they need such support, which is why the Prime Minister has made improving access to mental health services an absolute priority for her Government. There has been a fivefold increase in the number of people accessing Talking Therapies since 2009-10, and that is excellent progress, but we are not complacent; we know that much work needs to be done. In July last year, the Government announced an additional £1.3 billion to expand the mental health workforce and allow the NHS to treat an extra 1 million patients by 2020-21. That will help to ensure that cancer patients can be referred promptly to any psychological support that they need as part of their recovery package. We know that clinical nurse specialists can provide not just clinical but crucial emotional support for cancer patients as they go through cancer treatment, and—often more important—in the follow-up after their treatment.

[Mark Tami]

Does the Minister agree that we use the word “cured” far too often, as though there were a cut-off point when people are cured and therefore exactly the same as everyone else, and exactly the same as they were before? The problem with that is that it is not true: it does not take full account of the reality.

[Sarah Newton]

The hon. Gentleman has made a very important point. That is why the tailor-made, holistic approach to treating every person as an individual is so important: no two people will respond in the same way. No two people have the same family or community support networks around them, so it must be tailored to the individual. There must also be a recognition that some people might need a lot more help over a longer period of time than others. That is why it is so important that NHS England has committed to more people having access to clinical nurse specialists, and why last year’s cancer workforce plan produced by Health Education England committed to greater investment to make sure that everybody has access to that support. There is also a great opportunity here to signpost people to be supported by the wonderful voluntary sector organisations that the hon. Gentleman mentioned this evening.

In conclusion, I want to reaffirm the Government’s utter commitment both to improving people’s survival rates from cancer and to making sure they have tailor-made, supported arrangements, including psychological services, so that people can, not just survive cancer, but live well with cancer and continue to play their full part in society.

Question put and agreed to.

Disabled People and Economic Growth

Mark Tami Excerpts

Thursday 22nd February 2018 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I beg to move,

That this House recognises the potential talent pool within the disabled community; notes that there will be an employment gap after the UK leaves the EU and that there is ample opportunity to include disabled workers in economic growth; calls on the Government to act immediately on its commitment to get one million more disabled people into employment by 2027; and further calls on the Government to increase awareness within the business community of the benefits of employing an inclusive workforce.

I pay tribute to the Backbench Business Committee for enabling the debate to take place. I also pay tribute to the many organisations that continuously champion the rights of people with disabilities throughout the United Kingdom. Without their enduring commitment, we would not be debating his important issue today. I pay special tribute to Leonard Cheshire Disability, to Disability Rights UK—which acts as secretariat to the all-party parliamentary group for disability, which I chair—and to the Disability@Work group. That group consists of dedicated academics from Cardiff University, Warwick business school and Cass business school, and it contributed to the APPG’s inquiry report “Ahead of the Arc”. Since commissioning the report, the all-party group for disability has been pressing the Government urgently to address the disability employment gap, and I know the Minister is open and willing to listen to the report’s suggestions.

This Backbench Business Committee debate is a significant step forward in the fight for equal rights for disabled people. To my knowledge, this is the first time that people with disabilities will be debated in the main Chamber with a focus on their abilities and as contributors to our economy, and not just as employees but as entrepreneurs and as business leaders.

[Mark Tami (Alyn and Deeside) (Lab)]

Does the hon. Lady agree that many employers need education, particularly about those who suffer from mental health difficulties, as many employers are scared or reluctant to take on somebody as they do not understand some of the issues such people face?

[Dr Cameron]

The hon. Gentleman makes an important point, and only yesterday I was contacted by a number of people and organisations reminding me to highlight that very point. People with mental health difficulties, and often people with hidden disabilities or disabilities that are not always apparent, can find it a struggle to explain and raise awareness about their difficulties and the adjustments they require. We need heightened awareness among employers—and in Parliament, too, I would suggest. We must continue along that path to raise awareness, to make sure we can harness the skills and potential of everyone for our economy.

All too often, people with disabilities are portrayed as passive and unwilling to work, but that could not be further from the truth. I want to use this debate to change the narrative. I want to see meaningful action, rather than research and rhetoric. I want to see a welfare system that treats people with disabilities as a willing and able workforce. I want to see improvements to current access routes and the development of new workplace cultures that reflect a genuine appreciation on the part of employers of the positive contributions that people with disabilities make, and I want to see accredited business schemes that go further than ticking boxes. While I might not be able to cover all these points in my speech, I know that colleagues across the parties will be passionately advocating similar policy and attitudinal change, which is much needed. I hope the Minister will take on board all Members’ suggestions here today and that we will make progress moving forward.

I want to start on a positive, uplifting note. I have been greatly heartened over the past few weeks by hearing accounts of disabled entrepreneurs, employees and businesses that are champions of their fields. I would like to share but a few examples.

Hannah Chamberlain is a successful tech entrepreneur who recently won the £30,000 Stelios award for disabled entrepreneurs, which is run in conjunction with Leonard Cheshire Disability, after creating a video diary app that supports people to manage their mental health, called MentalSnapp. The app allows users to record short video diaries, rate their mood and name their feelings. It is an example of innovation at its finest, and I applaud Hannah for creating an app that will help so many.

John Cronin is an entrepreneur and now business leader who owns and runs his own sock company, which has made £1.4 million in its first year. John has Down’s syndrome. He runs the company in conjunction with his father and is the face of the brand. John is a business leader and manager, and nearly a third of his staff have a disability. John says his social and retail missions go hand in hand. He is a businessman and therefore is looking for good, reliable workers, and he believes the disabled community has a vast, untapped pool of great workers.

A number of larger corporations also understand the benefits of a diverse workforce. Corporations such as Channel 4 and Sainsbury’s are good examples of inclusive employers. Sainsbury’s and Channel 4’s workplace adjustment guides are second to none; both companies choose to focus on positive aspects of making adjustments, rather than their legal duty and minimal requirements to do so. Most importantly, these policies are distributed to all line managers, so everyone is aware of the adjustments they are entitled to, creating an open and inclusive environment and workforce in which both employees and company outputs can thrive. Channel 4 goes a step further by issuing “passports” for employees after receiving a workplace adjustment, so when the employee moves into a new role, or their line manager changes, the “passport” can be referred to and used in all future discussions with new line managers.

There are many other great examples of disabled business owners and entrepreneurs, and of inclusive employers, but I wanted to highlight those three, because each shows that in every corner of our economy, and in every type and size of business, inclusivity should be championed not just for ethical reasons, but because it makes good business and economic sense.

Pension Equality for Women

Mark Tami Excerpts

Thursday 14th December 2017 Commons Chamber

[Grahame Morris]

I agree with the hon. Gentleman, and I welcome the contribution that he has made to the campaign.

[Mark Tami (Alyn and Deeside) (Lab)]

I thank my hon. Friend for all the hard work that he has put in. I am sure that he, like me, has come across many women who have based all their retirement plans—their partners may have already retired—on what they were told, and assumed, would be their retirement age. They all say to me, “It is just not fair.”

[Grahame Morris]

I entirely agree with my hon. Friend. Many of these women have worked since they were 16. They signed up to a deal that they considered to be an agreement with the Government, but that deal has been cast aside with little or no regard for their financial circumstances.

Budget Resolutions and Economic Situation

Mark Tami Excerpts

Thursday 9th July 2015 Commons Chamber

[Mark Tami (Alyn and Deeside) (Lab)]

Is my hon. Friend as worried as I am about the amount of ex-local authority housing bought by buy-to-let landlords that, unlike properties that remain in council ownership, is in a very bad state of repair?

[Siobhain McDonagh]

I totally agree, but may I make it clear that I am a big supporter of the right to buy? I believe it has liberated a lot people, but it is the opportunity for all, or all who can, that I want to save today.

Correcting the flaws in the tax system would stop the housing market being distorted to disadvantage first-time buyers.

Mental Health and Unemployment

Mark Tami Excerpts

Tuesday 24th February 2015 Commons Chamber

[Paul Burstow]

The hon. Gentleman has underlined a point that I intend to make later, and I hope that others will do so as well. Good mental health is everyone’s business, and it is certainly part of the work of business to look after the mental health and well-being of staff. It is key to reducing sickness absence, and to improving productivity. It has so many benefits for the individual. So the hon. Gentleman is absolutely right. Leadership and culture are critical, whether in a business organisation or a public service or whatever.

The vast majority of people do want to work, and this is no small issue. Among the under-65s, nearly half of all illness is mental illness, and the cost to the UK economy exceeds £100 billion a year. The good news is that over the past five years public attitudes towards mental health have begun to change. Indeed, they have changed quite rapidly.

[Mark Tami (Alyn and Deeside) (Lab)]

I hope the right hon. Gentleman is right that there has been a change, but many Members still have people coming to see us who have admitted they have a mental health issue when they have applied for jobs and who are sure that is one of the reasons why they did not get to the next stage of the job interview.

[Paul Burstow]

That is undoubtedly true and indeed some people do not go through the recruitment process in the first instance because they believe they will be discriminated against or they are fearful of disclosure. Those are serious issues to do with lack of parity and lack of equality, and the discrimination people both impose upon themselves but that also exists within our society. It is why tackling the issue of stigma is so important and why we should celebrate the progress that has been made but also be challenging the Government to continue to support campaigns like Time To Change because they are clearly demonstrating progress.

The stigma has not gone, but it is going. Time To Change, the anti-stigma campaign set up by Mind and Rethink Mental Illness and funded as part of the Government’s mental health strategy, recorded the biggest annual improvement so far in public attitudes to mental health. It found a 7% rise in people’s willingness to work with someone with a mental health problem—from 69% to 76%. We still have to go further, but that is a mark of the progress that has been made, and I hope we can see more.

The Government have made parity of esteem between physical and mental health the clear goal of their mental health strategy, and progress is being made. However, when it comes to employment and the way people with mental health problems are supported, we still have a long way to go. Four different sets of data lead me to that conclusion. First, according to the OECD, unemployment rates for people with severe mental health problems in the UK are five times higher than for people without a mental health problem. Secondly, a clinical commissioning group outcome indicator on employment and severe mental illness was included in the 2014-15 indicator set. It published its first set of results last December, and it shows a worrying decline in the number of people in paid employment with a severe mental health diagnosis, from 43,000 to 35,000, a significant 20% drop. Thirdly, the CQC’s community mental health survey for 2014 showed that 34% of respondents on the care programme approach, and over half of respondents not on the approach, said they did not receive support from someone in NHS mental health services in getting help with finding or keeping work, but they would have liked that and would like to have been told how to access that support. Fourthly, of the 150,000 people with mental health problems on employment and support allowance who have been placed on the Work programme, just 6.7% have been helped into work. That is compared with a 25% success rate for those without a health condition.

For me, what this shows is that there is a huge amount still to do. It is worth saying that while the national average employment rate for people with severe mental health problems has dropped to 5.7%, a number of areas are achieving high levels of employment for people with severe mental illness, such as Wokingham, mid-Essex and Aylesbury, all of which are achieving employment rates of 20%.

Housing Benefit (Abolition of Social Sector Size Criteria)

Mark Tami Excerpts

Wednesday 17th December 2014 Commons Chamber

[Rachel Reeves]

I shall make a little progress before taking interventions.

We have discussed the needs of carers, but we must also consider people who need safe or sanctuary rooms to protect themselves against the threat of domestic violence. There is the woman whose case is now being heard by the High Court, and whose situation my hon. Friend the Member for Plymouth, Moor View (Alison Seabeck) tried to address with her ten-minute rule Bill. Others have kept a room for sons and daughters serving in the armed forces when they are home on leave. In The Daily Mirror this morning we read about the shocking case of Maureen Bland who was forced to move out of her home to avoid the bedroom tax after her son lost his life serving our country in Afghanistan. Quite frankly, people like that should not be forced to pay the bedroom tax because of such grief and tragedy.

The bedroom tax has been cited by the Trussell Trust and others as a key driver behind the shocking growth in food bank use under this Government. A recent in-depth study published by the Trussell Trust, along with Oxfam, the Church of England and the Child Poverty Action Group, found that at one food bank, 19% of users had been hit by the bedroom tax, many of them having applied unsuccessfully for DHP. We will have an opportunity to vote on a motion on food banks later this afternoon, but Members can make a start in this debate by voting to repeal the cruel bedroom tax, which is one of the key causes of the food poverty crisis we see in our country today.

[Mark Tami (Alyn and Deeside) (Lab)]

My hon. Friend is making a powerful case. Perhaps the cruellest element of the bedroom tax is the fact that the stress and anguish it causes is making ill people even more ill.

[Rachel Reeves]

People affected by the bedroom tax are facing impossible decisions that, frankly, no one should have to make: whether to pay the bills or put food on the table; or whether to pay the rent, at the risk of getting into debt, or risk losing their home. We have seen the evidence from the Trussell Trust and the Child Poverty Action Group, but we do not have to turn to that report to see the devastating impact of this vicious policy; we need only look at the evaluation commissioned by the Government themselves. It was conducted by the centre for housing and planning research at Cambridge university and slipped out this summer, when the Government no doubt hoped no one would notice. Its findings are clear and damning.

Independent Living Fund Recipients

Mark Tami Excerpts

Wednesday 18th June 2014 Westminster Hall

[Nic Dakin (Scunthorpe) (Lab)]

The independent living fund has transformed people’s lives. The ILF does exactly what it says on the tin: it liberates people who would otherwise not be able to live independently. It lets them make choices about how they live, things we often take for granted—when to get up or go to bed, what and when to eat. It allows them to work, to be active in the community and to live in their own homes. I challenge the Minister to guarantee to those in receipt of ILF that they will not become less independent as a result of his Government’s decision to close the fund in June 2015. That is what people fear; that is what they are frightened of—they fear losing their jobs, the staff whom they employ to support them and their independence. They fear being forced out of their homes and into institutions.

[Mark Tami (Alyn and Deeside) (Lab)]

As my hon. Friend might be aware, in Wales the responsibility will go to the Assembly and then to local authorities. I have approached my authority, and it is uncertain what exactly is happening. There is a lot of fear out there among people who are totally reliant on the ILF payment to lead as normal a life as possible. They are being hurt now.

[Nic Dakin]

My hon. Friend makes a good point. The Minister might well say that he is passing the moneys and the responsibility to local authorities—through the Welsh Assembly in Wales’s case—but that will not ease people’s fears.