Universal Credit (Children)

Debate between Nick Thomas-Symonds and Carolyn Harris

Tuesday 10th May 2016 Commons Chamber

[Nick Thomas-Symonds (Torfaen) (Lab)]

I am grateful to the Backbench Business Committee for agreeing to hold this debate in the main Chamber. I pay tribute to my right hon. Friend the Member for East Ham (Stephen Timms), whose erudite and considered opening speech was a great contribution to the debate. The hon. Member for North Devon (Peter Heaton-Jones) talked about the broader context, and I will be only too pleased to do the same in a moment. My hon. Friend the Member for Edmonton (Kate Osamor) spoke powerfully about the plight of lone working parents, who are particularly affected by cuts to the work allowance. I certainly agreed with the hon. Member for Gloucester (Richard Graham), who is no longer in his place, on the idea of ensuring that we visit Jobcentre Plus offices to see universal credit in action, something which I did recently with my right hon. Friend the Member for East Ham, but it is equally important to be in contact with local citizens advice bureaux and to visit food banks to see what is happening on the ground.

We heard a useful contribution from the hon. Member for Airdrie and Shotts (Neil Gray), who pointed out very well the new approach promised by the new Secretary of State of looking at people, not statistics. I look forward to the Minister telling us how she has changed her approach under her new boss, as I am sure everybody does. We also heard useful contributions from the hon. Members for Lanark and Hamilton East (Angela Crawley) and for Banff and Buchan (Dr Whiteford); my hon. Friend the Member for Neath (Christina Rees); the hon. Member for Horsham (Jeremy Quin); my hon. Friends the Members for Salford and Eccles (Rebecca Long Bailey) and for Cardiff South and Penarth (Stephen Doughty); the hon. Members for Foyle (Mark Durkan) and for Rutherglen and Hamilton West (Margaret Ferrier); and my hon. Friend the Member for Westminster North (Ms Buck).

This debate comes at a key time—a key moment of test for the new Secretary of State—because the outlook is bleak. The Institute for Fiscal Studies expects absolute child poverty to increase from 15.1% in 2015-16 to 18.3% in 2020-21. The Resolution Foundation believes that 200,000 more children, predominantly from working households, will fall into poverty this year. Gingerbread powerfully makes the point that my hon. Friend the Member for Edmonton made about cuts to the work allowance hitting single parents particularly hard. There is a set of damning statistics on this, which the Children’s Society has set out. A working single parent can lose up to £2,628 a year. What was the Government’s response to that? What did they say could be done about that? They told the Social Security Advisory Committee that parents could work three to four additional hours a week on the national living wage.

[Carolyn Harris (Swansea East) (Lab)]

Does my hon. Friend agree that to expect hard-working families to work an extra 200 hours a year just to make up for the cruel cuts in universal credit is an outright insult?

[Nick Thomas-Symonds]

My hon. Friend is absolutely right about that. The hon. Member for North Devon wanted the broader context to be taken into account, so let us take into account the national living wage as well. A single parent who is already working full time on the national living wage of £7.20 an hour will have to work 46 extra days a year, which is more than two additional working months. How on earth can that be put forward as a reasonable proposition by anybody? It obviously is not reasonable.

The Government were warned about the problems they face today as a result of cuts to universal credit. The Social Mobility and Child Poverty Commission report released just before Christmas, on 17 December, said that the “immediate priority” had to be ensuring that the cuts to the work allowance planned for this April did not go ahead, but the Government simply did not listen. The problem that they are getting to is that their approach is starting to deny the very purposes that universal credit was set up for. The Resolution Foundation states:

“But it is also much changed as a result of the increasingly tight financial restraints placed on it over recent years. These have involved more than just a reduction in the money available under UC, they have also altered the very structure of the policy—changing the composition of winners and losers and fundamentally damaging its ability to deliver against its purported aims.”

Perhaps that explains why the Government are so terrified of publishing an up-to-date impact assessment. Perhaps it explains why they are so terrified of telling us the figures as to what they expect will happen to child poverty over this Parliament.

Access To Medical Treatments (Innovation) Bill

Debate between Nick Thomas-Symonds and Carolyn Harris

Friday 29th January 2016 Commons Chamber

[Nick Thomas-Symonds]

These new clauses and amendments, which I support, relate to off-patent drugs. I think it would be useful for me briefly to set out the context in which they arise. The Off-patent Drugs Bill, a private Member’s Bill that I introduced—it was debated on Second Reading on 6 November—is a UK-wide Bill that would create a duty on the Government to make cheap drugs available when pharmaceutical companies had no incentive to do so. The problem, put simply, is that if a drug is shown to be useful for a new purpose after its original patent has expired, a pharmaceutical company has no financial incentive to sponsor that off-patent treatment through the processes normally used to license it and ensure its adoption on the NHS. Those off-patent or off-label treatments are certainly available at low cost. The issue is simply that although clinicians can of course prescribe them, they tend not to be prescribed consistently across the medical sector, or indeed geographically.

The Off-patent Drugs Bill ran out of time that day, but I think it is accurate to say that the Government supported its aims but not the mechanism it proposed. None the less, in recognising that there is a problem, and with a shared position on both sides of the House on the need to encourage greater consistency in off-label prescribing, a lot of work has since been done, and on a cross-party basis. I am proud that new clause 1 stands in the name of Members from no fewer than eight political parties. The concept of encouraging greater use of off-patent drugs, and indeed my Bill, have significant support across the House and outside. I pay tribute to Jonathan Evans, the former Member for Cardiff North, who first introduced such a Bill in 2014. His successor, the current Member for Cardiff North (Craig Williams), has also supported my Bill.

[Carolyn Harris (Swansea East) (Lab)]

I congratulate my hon. Friend on the excellent work he has done on the Off-patent Drugs Bill. Given the consensus across the House, does he agree that now is the time for a firm commitment from the Government on that Bill?

[Nick Thomas-Symonds]

I am grateful to my hon. Friend for that intervention. I hope to hear such a commitment today, so I look forward to what the Minister for Life Sciences has to say in that regard.

That wide support for my Bill was shared by medical research charities, NHS clinical commissioners in England, the British Medical Association, thousands of members of the public who wrote in, and four medical royal colleges. Indeed, 40 eminent clinicians wrote to The Daily Telegraph in support of my Bill.

Since then, I am pleased to say that there have been good attempts on both sides of the House to build on that good will in relation to off-patent drugs. I want to thank the hon. Member for Daventry (Chris Heaton-Harris) for the highly constructive and pragmatic way in which he has been willing to take the off-patent agenda forward when speaking about his private Member’s Bill. I thank the hon. Member for Bury St Edmunds (Jo Churchill), who brings a strong personal perspective to the debate. Her sense of what is good for patients has been highly constructive in the debates we have had over the winter months. The hon. Member for Central Ayrshire (Dr Whitford), who used to be a breast cancer surgeon—in fact, she still practises—has brought a great level of expertise and experience in recent months, for which we are extraordinarily grateful. I also pay tribute to the Minister, who has been extraordinarily generous with his time and that of his officials in order to try and take this agenda forward, and for that I am extremely grateful.

I want first to make a point about clauses 3 and 4. While there is something of a consensus around responsible innovation, I had strong concerns about those clauses, as did many across the medical profession who thought that they might encourage a more dangerous type of experimentation, if I may put it that way. Looking at the amendments tabled by the hon. Member for Daventry, I can see that his intention is to remove clauses 3 and 4 altogether, which would be a very welcome step. That would mean that the principal remaining part of the Bill relates to the database of innovative medical treatments. The hon. Gentleman’s amendments 10 and 13 would bring the off-patent concept firmly into the purpose of this Bill, and therefore into the database. A lack of data was one of the barriers identified to more consistent prescribing of off-label treatments. The amendments would be an extremely welcome step forward, because they would not only enshrine in law the off-label aspect, but bring the data into the database so that it became more widely and readily available, assisting clinicians on the frontline. I sincerely hope that the amendments will be positively received by the Minister.

New clause 1 sets out an action plan for developing a pathway for off-patent repurposed drugs where strong evidence of their effectiveness in a new indication exists, with the aim of securing routine use. Put simply, this is an action plan with clear timeframes for progress. Again, this would be a welcome step forward.

New clause 2 would require the National Institute for Health Research to develop a mechanism for gathering and recording evidence on off-patent repurposed drugs, including clinical trials evidence, and passing it to the relevant bodies. The NIHR already has a dedicated horizon-scanning centre, but this would set up a dedicated stream for off-patent repurposed drugs to speed up getting them to the frontline and into routine use.

New clause 3 proposes that where there is strong evidence of effectiveness in a new indication, the National Institute for Health and Care Excellence should be directed to conduct a technology appraisal, including a cost-effectiveness analysis. While these drugs are extraordinarily cheap, some level of cost-effectiveness analysis would none the less be desirable, since to achieve routine commissioning, in England for a start, a persuasive business case clearly needs to be put to local hospitals and clinical commissioning groups.

New clause 4 is about having a national commissioning policy for off-patent drugs. It also requests that the Minister work with the devolved nations to produce something that is genuinely UK-wide. This has already happened in the case of NHS England working with Prostate Cancer UK to produce a commissioning policy for an off-patent repurposed drug called Docetaxel.

New clause 5 would make the licensing process more accessible. What would that mean in a practical sense? For example, an initial meeting where there is a discussion of the case and the likelihood of successful treatment could be free, a representative of patient organisations could be designated within the Medicines and Healthcare Products Regulatory Agency for patient organisations, and there could be a guidance document for non-pharmaceutical applicants.

In-work Poverty

Debate between Nick Thomas-Symonds and Carolyn Harris

Thursday 28th January 2016 Westminster Hall

[Carolyn Harris]

That is a shocking indictment of the low consideration the Government have for people in need. For example, a lone parent working full time on the minimum wage who receives no support for their housing costs will experience a reduction of £2,600 a year—that is £50 a week. Nobody can afford to lose £50 a week.

The combined effect of income tax, national insurance and the universal credit taper will mean that universal credit claimants who pay income tax will keep only 24% of any increase in their earnings. They will have to increase their earnings by £210 a week—or, to put it in percentage terms, 72%—to make up the income loss they will face as a result of the reduction in support.

[Nick Thomas-Symonds (Torfaen) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Turner, and I congratulate my hon. Friend on securing the debate. She has given some figures about single parents, and this shows the full extent of the policy: for a single parent—say, a mother with one or more children—the work allowance of universal credit will be halved from this April, going from £8,808 to £4,764. In cash terms, that is a loss of £2,628 a year. Does that not show the stark reality of this policy?

[Carolyn Harris]

I thank my hon. Friend for his intervention, and I agree. That is a reality people face every day, and it can only get worse.

The short-term effect for current claimants of universal credit is that they face huge losses to income come April 2016. There are currently 155,000 recipients of universal credit, and the number is increasing every week, with an aim of there being 500,000 recipients by April this year.

During Work and Pensions questions recently, the Secretary of State claimed that the flexible support fund will act as transitional protection for current claimants and said that

“those who are on universal credit at present will be fully supported through the flexible support fund, which will provide all the resources necessary to ensure that their situation remains exactly the same as it is today.”—[Official Report, 7 December 2015; Vol. 603, c. 688.]

However, that existing fund is used for a different purpose. Its budget last year was £69 million, but the Office for Budget Responsibility estimates cuts to working families of £100 million next year, rising every year until they reach £3.2 billion in 2020.

Barnett Floor (Wales)

Debate between Nick Thomas-Symonds and Carolyn Harris

Tuesday 10th November 2015 Westminster Hall

[Nick Thomas-Symonds]

I am grateful to my hon. Friend for that intervention. The Neath Port Talbot example further illustrates and reinforces the point that I made about Torfaen.

The debate deals with an aspect of Westminster funding, the so-called Barnett floor. As Members are aware, Joel—later Lord—Barnett introduced the Barnett formula in 1978, when he was Chief Secretary to the Treasury, in the context of the devolution debate of that era. He did not originally intend that it should become a permanent feature, yet here, some 37 years later, it still governs the Wales-Westminster fiscal relationship.

More recently, in 2009, the interim report of the Holtham commission, “Funding devolved government in Wales: Barnett and beyond”, was published. It suggested that Wales was underfunded.

[Carolyn Harris (Swansea East) (Lab)]

Does my hon. Friend agree that, despite the 2009 Holtham report suggesting the implementation of a floor, it is frustrating that six years later we have still not seen it happen?

[Nick Thomas-Symonds]

My hon. Friend is entirely right. I will come to that in a moment.

The report suggested that Wales was underfunded by £300 million a year compared with how much English regions would receive were the Barnett formula applied to them. In 2010, when the final Holtham report, “Fairness and accountability: a new funding settlement for Wales”, was published, the underfunding gap was even wider, at about £400 million a year, using a needs-based formula.

As my hon. Friend has just pointed out, to prevent a further decline in relative funding per head for Wales, the Holtham interim report had called for a Barnett floor as a temporary solution until a new needs-based formula could be agreed.

Off-patent Drugs Bill

Debate between Nick Thomas-Symonds and Carolyn Harris

Friday 6th November 2015 Commons Chamber

[Nick Thomas-Symonds (Torfaen) (Lab)]

I beg to move, That the Bill be now read a Second time.

It is an honour to be drawn in the ballot and to bring forward a private Member’s Bill on such a key issue. My grandmother, who inspired me to go into politics, died of breast cancer, and it is poignant for me that this Second Reading debate takes place in the week that would have been her birthday.

I am grateful to those who have sponsored this Bill, and to Members from across the House who have supported it. I thank the former hon. Member for Cardiff North, Jonathan Evans, whose Off-patent Drugs Bill was debated last year, and his successor, the hon. Member for Cardiff North (Craig Williams), for his support for this slightly refined version of the Bill. I thank my constituents for all their support, and I also thank Jenny Goodare from Breast Cancer Now for her help in preparing the Bill.

The Bill is a UK-wide Bill that creates a duty on the Government to make cheap drugs available when pharmaceutical companies have no incentive to do so. There is a problem: if a drug is shown to be useful for a new purpose after its original patent has expired, there is no financial incentive for a pharmaceutical company to sponsor that off-patent treatment through the processes that are normally used to licence it, and to ensure its adoption on the NHS.

Such off-patent treatments are usually available at low cost, but the current system is not set up to make them routinely available when they have been repurposed. Put simply, without a licence to act as a kitemark of safety, and a cost-effectiveness appraisal to give the NHS a mandate to provide it, there are multiple disincentives to treatments being prescribed, meaning that they are not routinely made available.

I have a letter from a clinician dated 15 October 2015 that I have permission to read out—the personal details have been redacted. He says he was contacted by a lady because she was advised that she had a high risk of breast cancer, and that raloxifene, which is an example of a drug that would benefit from the Bill, could be prescribed to help to prevent it. The key passage in the letter states:

“Unfortunately, I am unable to prescribe this as it is not licensed with this indication.”

[Interruption.] The Minister shakes his head, but I am quoting directly from a letter written by a clinician only in the past few weeks. That affects real people and has had a great impact on somebody’s life.

The Bill proposes a Government responsibility to step in and address that market failure in the public interest. Part 1 of the Bill introduces the duty of the Secretary of State to seek licences for off-patent drugs in new indications. The idea is to make those cheap, off-patent drugs routinely available. The president of the Royal College of Surgeons of Edinburgh recently said that, at the moment, there is significant variation, leading to variation of access across the UK.

There are barriers to the drugs being regularly available. Lack of awareness is a problem, but it is not all about that. General Medical Council guidance states that licensed treatment should be considered before an off-label or unlicensed treatment. In addition, GMC guidance is clear that a doctor takes on an extra level of personal liability when prescribing off-label.

[Carolyn Harris (Swansea East) (Lab)]

A Government spokesman was quoted in The Independent this week saying that the only thing general practitioners need is more information. Does my hon. Friend agree that that was both unhelpful and ill-informed? Deluging GPs with yet more information is certainly not productive.

[Nick Thomas-Symonds]

My point is precisely that it is about more than information.

A licence for off-patent drugs would make a big difference. The all-party parliamentary group on off-patent drugs, which I chair, met on 15 October and took evidence from experts across the board. Pan Pantziarka, a repurposing specialist, said that granting a new licence triggers a “whole cascade of things”: the British National Formulary gets updated, clinical commissioning groups and specialist bodies take note, and guidance is updated. He said that, without that, we are dependent on doctors reading the literature and prescribing off-label, and that that is not the solution we want.

Sir John Burn, professor of clinical genetics and a non-executive director of NHS England told our inquiry:

“The other problem is making decisions in a short time scale—we haven’t got time to look at the bundle of evidence presented. The whole point of the licensing process is to distil that for the physician”