NHS Pensions
Nusrat Ghani Excerpts(2 days, 2 hours ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Karin Smyth
It is important that people have confidence in the pension system. That is why we took action in July on coming into office to understand the depth of the problems that occurred under the previous Government. This is a complicated issue, which is why we want to be clear with people that there will be no financial detriment to them. We will continue to work with employers and trade unions to ensure that the issue is resolved as quickly as possible, in line with the timelines I have outlined.
Helen Morgan (North Shropshire) (LD)
The delays will be deeply worrying and will make financial planning very difficult for those affected, all of whom are people who have dedicated their working lives to supporting the NHS and tirelessly saving lives. NHS workers and their families are being left in the dark by Government delays and may as a result miss out on using their full allowances, which is unacceptable—they deserve better.
The revised delivery plan prioritises members based on their likelihood of facing financial detriment, so clearly some financial detriment is expected for those who are impacted. Can the Minister estimate what the likely financial detriment is of missing the statutory deadline, or how much compensation, as she just mentioned, is likely to be paid? Can she tell us why the NHS Business Services Authority has failed to meet the deadlines? In response to a written question from my hon. Friend the Member for St Albans (Daisy Cooper), the Minister said that there are 112 people working on it. Will she confirm whether that is likely to be sufficient to ensure that future deadlines are met?
Tobacco and Vapes Bill
Nusrat Ghani ExcerptsWednesday 26th March 2025
(1 week, 1 day ago)
Commons ChamberRead Full debate Tobacco and Vapes Bill 2024-26 View all Tobacco and Vapes Bill 2024-26 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Consideration of Bill Amendments as at 26 March 2025 - large print - (26 Mar 2025)
Tristan Osborne (Chatham and Aylesford) (Lab)
The right hon. Member might be forgiven for thinking that we are starting from a zero-sum game, but we already have restrictions, as people must be 18 to purchase cigarettes and vapes. Shop workers are already challenging customers on their age, so the regulations do not come from nowhere. Secondly, if you read the Bill, you would know that there is a date specified that would be very clear on identification—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. Interventions should be short and the term “you” refers to me in the Chair.
Sammy Wilson
It is easier to distinguish between a 16-year-old and a 24-year-old. Usually, the younger the age, the easier it is to make that determination, but it is much more difficult when people are older, yet that distinction will have to be made.
The idea may be that the cost of the licence will be so expensive that many small retailers will be squeezed out of the market, and the only outlets will be bigger stores where there are security guards. However, the sale of tobacco provides an important part of the income of many small retailers. Whether we like it or not, we are putting a burden on people who will find that they are exposed to dangers and difficulties, and will be subject to the law if they make the wrong decision.
The second issue, which has been touched on today, is what happens when people cannot get the tobacco that they want. Where do they go? They go to people who are prepared to sell it to them illegally. We cannot run away from the fact that the sale of illegal tobacco is already lucrative, especially because of the tax increases that we have introduced. It is lucrative for criminal gangs and it funds many of their activities. We have heard statistics that 7% of cigarettes and 33% of rolling tobacco are already sold by criminal gangs. In Northern Ireland, it is probably far higher because paramilitaries were involved in the trade and used it to fund their activities for so long. If anybody thinks, “Oh well, we’ll deal with that problem when it comes,” look at the history of Northern Ireland, where hundreds of millions of pounds found its way into the coffers of terror gangs and action was not taken, because it was sometimes too hard or too difficult to trace the things. Yes, action has now been taken, but do not think that we are going to have an all-out assault on the booming industry that this legislation will produce.
My last point about the Bill being impractical is that it cannot apply in Northern Ireland because, as part of the EU single market, we are under the tobacco products directive. The Irish Republic tried to introduce similar legislation and found that it could not because of that directive. That is why we have tabled new clause 3, challenging the Government to amend the Windsor framework so that the legislation will apply across the United Kingdom. This is not a counsel of despair because I believe that there is an alternative, as set out in the amendment. Indeed, the Government’s own modelling suggests that a much more practical way is to set the age limit at 21.
If the figures and the modelling are correct—although there are questions about the tobacco modelling on doing away with smoking in a generation—and if we impose the age limit of 21, which avoids some of the problems we have talked about with the sale of tobacco, we reach zero consumption by 2050, just as we do with the generational model. That avoids many of the problems and difficulties I have outlined and the consequences for retailers, rather than rushing into this. It is a headline-grabbing measure, but it has not worked elsewhere. Why did New Zealand drop it? Because of the booming market in illegal tobacco. I believe that in a number of years, we will find that we made the same mistake.
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. “I tell you”? Sir John Hayes, you should know better than that.
Sir John Hayes
I said “two”. I said that there were two things about this legislation.
Sir John Hayes
Well, let me rephrase it. I tell you, Madam Deputy Speaker, that there are two things about this legislation—I have got it right now—and the first is its core objective and the second is the means by which that objective is met. I am, at the moment, talking about the means by which it is met, and I will say a little more about that when I address some of the amendments in my name and those of other Members. When we pass measures in this House—when we make laws—we should concentrate on both their purpose and their effect. If we do not do that, we are not doing our job as lawmakers. My concern about the Bill is that the effect will be compromised by the means, regardless of its purpose.
I entirely endorse what was said by my hon. Friend the Member for Gosport (Dame Caroline Dinenage) about plastic filters. I think that her new clause 2 would be a helpful addition to the Bill, and I should be amazed if the Minister did not embrace and adopt it. Perhaps it could be tabled as a Government amendment, but we may vote on it later. I am sure that the Government Whips will want to whip their Members to support it, because it is environmentally right, terribly sensible and entirely deliverable. It would oblige the industry to do the right thing and create filters that are biodegradable and which, as we heard earlier, are produced in immense numbers.
I have mentioned amendment 4, in the name of the right hon. Member for East Antrim, which deals with this nonsense of the rolling age of consent. It is a straightforward amendment that proposes that the age of consent should be 21—a considerable increase on where we are now—and that retailers must observe that. The hon. Member for Falkirk (Euan Stainbank) said that the matter was already being dealt with because there was already an age of consent. Yes, there is one age of consent, but not a series of ages of consent, with the need to assess people’s age presumably by some formal means. Perhaps they will have to take their passports with them every time they go to the newsagent to buy their papers and their ounce of Golden Virginia, or whatever else.
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. I apologise to all Members, but we will now have a speaking limit of five minutes.
Tristan Osborne
I appreciate that you want to guillotine speeches to five minutes, Madam Deputy Speaker.
It is a pleasure to speak on the Bill and, as a member of the Public Bill Committee, to see it come before the House. I welcome the contributions of Members across the House, and the quality of the scrutiny we saw in the Public Bill Committee. I also want to reflect on the years of campaigning and service undertaken by Ministers and shadow Ministers that have brought us to this place, and on the advocacy in broadcasts and on the news of people who were smokers but who say that they never should have started. I also welcome the views of young people in my constituency who, when speaking to me at schools and colleges, have told me how vapes are becoming more pernicious and more commonplace in their lives.
I will speak to Government new clause 11 and new clause 6 on age verification and the rising escalator, and I will challenge some of the points made about enforcement. I will also talk to new clause 13 on education and a road map to a smokefree generation, and to new clause 19, which sets annualised reporting on nicotine-based products. I will also challenge some of the Opposition’s misconceptions about trading standards and the regulatory landscape.
The Bill is forward thinking and responds to an issue, but it builds on previous legislation over many years and best practice in other places and other countries to regulate and reduce smoking. We know that noble crusaders on public health have in the past taken action to clean our air, clean our water, and introduce seatbelt restrictions and food standards. We know that public health measures work. Smoking is the largest preventable cause of illness and premature death in the United Kingdom, killing about 80,000 people a year. It is estimated to cost £2.4 billion to the NHS and a further £1.2 billion in costs every year, with smokers five times more likely to need social care support at home. The annual economic productivity loss adds up to £27 billion. Not only is there an ethical and social motivation behind the Bill; there is an economic one as well.
Age verification was a topic of debate in Committee. I welcome Government new clause 11 and new clause 6 on age verification. Government new clause 11 introduces digital identification, and links in with Government legislation to introduce digital ID over the next five years. This is absolutely enforceable. In many off-licences and supermarkets today, age challenge happens at bespoke counters. Individuals under the age of 18 who try to purchase vapes or tobacco-based products are challenged on their age. All the Bill will do is introduce a fixed date, which can then be assessed using any form of digital ID. It is no more onerous than what is currently happening, but it will require training and a transition period. I challenge the comments made by some opposing the measure that it is somehow unenforceable. We already enforce age restrictions on the sales of products—it already happens.
Male Suicide in Rotherham
Nusrat Ghani Excerpts(1 week, 3 days ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Madam Deputy Speaker (Ms Nusrat Ghani)
I believe the hon. Lady has permission from the hon. Member for Rother Valley (Jake Richards) to make a brief contribution.
Rare Cancers Bill
Nusrat Ghani ExcerptsFriday 14th March 2025
(2 weeks, 6 days ago)
Commons ChamberRead Full debate Rare Cancers Bill 2024-26 View all Rare Cancers Bill 2024-26 Debates Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Patricia Ferguson (Glasgow West) (Lab)
I thank my hon. Friend the Member for Edinburgh South West (Dr Arthur) for bringing forward this Bill. If, as we always say, politics is the language of priorities, then my hon. Friend has got his absolutely correct. I thank all Members who have shared their experiences and their stories, some incredibly moving. They should be what inspires us to take forward all the action we are proposing today.
I was struck by the fact that the hon. Member for Wokingham (Clive Jones) and I have something in common, which we probably would not want to have in common, in that we were both diagnosed with breast cancer in 2008. I have to say, my breast cancer was a strange breast cancer, and it always feels slightly strange talking about it, because no one’s ever heard of it. It is not a rare cancer as such, because it is a breast cancer, although there are some who argue it is actually a soft tissue sarcoma—whatever, it was treated as a breast cancer. It is called a phyllodes tumour.
Unlike other breast tumours, phyllodes tumours do not go into the ducts, but into the connective tissue. It presents differently from other cancers of the breast, and the treatment is also different, in that the only treatment that works is excision. Excision can be anything from a lumpectomy to a mastectomy. The hope is that there are clear margins, which mean the patient will be okay, but—and it is a big “but”—when a malignant phyllodes tumour is present, it can spread, and it can be difficult or impossible to treat. That is when it becomes a very different outcome.
I mention it today not because it is a rare cancer, but because it can be difficult to diagnose. It does not show up in a mammogram, for example, and there is no definitive explanation why such tumours occur. Some research is going on just now, but it is not conclusive as yet. A lot more work needs to happen, and because incidence is so low, it is difficult to research. The things we know about it for certain seem random to me. They tend to occur more often in the left breast. Why? I have no idea. They usually occur when a patient is in their 40s. As I have said, they do not seem to respond to chemo or radiotherapy, and they are not thought to be genetic or hormonal.
The reason I mention my case is that it can be a lonely thing to have an unusual cancer. When trying to explain it to family and friends, you say, “No, it did not show up in a mammogram. No, I am not getting chemotherapy or radiotherapy. No, I do not know why it happened. No, I had not heard of it either.” You begin to doubt yourself a little, and you begin to question what is actually going on. For someone with a very rare cancer, it must be incredibly difficult when there is not a background of research, not anything that they can read, and no one can give them a pamphlet about it and tell them what is happening.
It seems to me that we should know more about cancer full stop. We have got to 2025, and we know some things about cancer. We know how to treat some cancers, but there are so many others that we do not have the answer for. We need people to be diagnosed more quickly, which means that we have to have the research. We need people to have the best possible treatment, which means we have to look at the drugs and find out what works and what does not work, and where a drug can be transferred from one thing to another successfully. Crucially, we have to know why it is that some people get cancer and others do not.
This Bill will make a huge difference to the lives of some of the people we have heard about today. For some, as we know, it will not be soon enough. It is the responsibility of every single one of us to make change happen, and we have an opportunity today to take that step forward. My hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) spoke about her sister, Margaret, who I worked with for a time in the Labour party. While I was listening to the other speeches, I was reflecting on what my hon. Friend said. I think we all need to be angry. We need to say—to shout it from the rooftops—that change begins today.
Johanna Baxter (Paisley and Renfrewshire South) (Lab)
I will be brief, because I understand that we are at the end of the debate, but I rise to support the Bill and pay tribute to my hon. Friend the Member for Edinburgh South West (Dr Arthur) for bringing it forward, and for the dignified, collegiate manner in which he has gone about things. Up to 95 people in Paisley and Renfrewshire South will be facing a less survivable cancer. That is 95 people who will wait longer for a diagnosis, will face a postcode lottery to access specialist treatment, and will be left asking why there are so few treatment options available.
The truth is that rare cancers do not receive the research attention or funding that they need. The Bill would take decisive action to change that. It would introduce measures to break down systemic barriers preventing research and innovation in rare cancers. These are not abstract policy changes but lifesaving reforms that would give patients with rare cancers greater access to clinical trials. Researchers would have better tools to study the diseases, and pharmaceutical companies would be given stronger incentives to invest in treatments that could transform lives.
Behind every rare cancer diagnosis is a person fighting for their future, a family searching for answers and healthcare professionals looking for better treatment options. We cannot allow those individuals to be left behind simply because their condition is considered rare. We have the opportunity to change that. By supporting the Bill, we send a clear message that no cancer is too rare to matter, and that no patient should be forgotten. I am proud to support the Bill and thank my hon. Friend for bringing it forward.
Dr Arthur
With the leave of the House, I would like to thank a few people. First and foremost, I thank the Minister for her speech. I met her yesterday, and she was filled with genuine passion, energy and excitement for this subject. It is great to see her come here today and use her power to support this Bill, and let us hope that it passes.
I thank the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar). Before this debate, people told me that he was respected across the House, and he has shown why. I must also thank my hon. Friend the Member for Crawley (Peter Lamb). People in the Gallery will not know this, but he has worked really effectively, right throughout the debate, to ensure that all the people who wanted to speak could do so. I thank him for that.
I thank the Whips and the Speaker’s Office for managing the debate sensitively, because this is quite a difficult subject, and I thank you, Madam Deputy Speaker, because it was you who pulled my ping-pong ball from the goldfish bowl. It was very skilfully done.
I wish I had time to thank everybody who spoke in the debate. Sadly, I do not, but they have my thanks and respect. They have done a great job of thanking each other as the debate has proceeded, so I thank them all. I will watch the debate again over the weekend, because it has been quite incredible and quite moving.
I thank our colleagues from the Department of Health and Social Care, who are in the officials’ box. They have been fantastic. Without them, this Bill would not have happened. Privately, there have been a few Sir Humphrey moments, but those from the Department have been absolutely fantastic, and that was very clear yesterday when I met the Minister.
I thank the charities that backed the Bill. They did not just back it; they helped get it to where it is. They were not just backing a finished product; they influenced and shaped it. I think that is why so many people are here to support it.
I thank the staff in the Public Bill Office for their patience and so much more, and I thank the staff in my office. I think Noel and Solomon are here today, but it is a team effort. Back in Edinburgh are Lucie, Salim, Xavier, Evie and Hannah. [Hon. Members: “Hear, hear.”] They deserve that.
In all the contributions today, we have heard evidence that people with a rare cancer diagnosis face great injustice, because their chances are so much slimmer and they face so much uncertainty. We have shown that we want change. We are not just being angry; we are using that anger to get even, which is really important. We talk in this Chamber, but often there is no action. Today we have talked and agreed, and hopefully there is going to be action.
Madam Deputy Speaker (Ms Nusrat Ghani)
That was most definitely Parliament at its best.
Question put and agreed to.
Bill accordingly read a Second time; to stand committed to a Public Bill Committee (Standing Order No. 63).
National Cancer Plan
Nusrat Ghani Excerpts(1 month, 4 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. I know that some of these contributions are quite emotional, and if people need to leave the Chamber after they have spoken, that is okay by me.
Peter Swallow (Bracknell) (Lab)
Ethan was just 15 and studying for his GCSEs when he was diagnosed with a brain tumour. Sadly, he passed away two years later. I had the privilege of meeting his mum, Nikki, this weekend at two events organised to raise money for brain tumour research. In Ethan’s memory, will the Minister commit himself to improving outcomes for people with brain tumours through the national cancer plan?
Women’s Health Strategy
Nusrat Ghani Excerpts(2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Victoria Atkins (Louth and Horncastle) (Con)
On a point of order, Madam Deputy Speaker. On this incredibly important issue of the women’s health strategy, and the fact that the word “woman” has been excluded from the updated planning guidance, could you help me understand this? As a common courtesy to both you and the House, when a Minister is unable to organise herself such that she can get to the Chamber on time, is it not courteous to apologise to those of us she has kept waiting before we were able to discuss this important subject?
Madam Deputy Speaker (Ms Nusrat Ghani)
I thank the right hon. Lady for her point of order. She is, of course, correct that it is courteous to the House for an apology to be made. Five minutes of time was wasted this morning. I think the Minister would like to make a further point of order.
The Minister for Secondary Care (Karin Smyth)
Further to that point of order, Madam Deputy Speaker. I absolutely, unequivocally apologise.
Terminally Ill Adults (End of Life) Bill (Money)
Nusrat Ghani ExcerptsWednesday 22nd January 2025
(2 months, 1 week ago)
Commons ChamberRead Full debate Terminally Ill Adults (End of Life) Bill 2024-26 View all Terminally Ill Adults (End of Life) Bill 2024-26 Debates Read Hansard Text Watch Debate Read Debate Ministerial Extracts Amendment Paper: Notices of Amendments as at 22 January 2025 - (22 Jan 2025)
The Minister for Care (Stephen Kinnock)
I beg to move,
That, for the purposes of any Act resulting from the Terminally Ill Adults (End of Life) Bill, it is expedient to authorise the payment out of money provided by Parliament of:
(1) any expenditure incurred under or by virtue of the Act by the Secretary of State, and
(2) any increase attributable to the Act in the sums payable under or by virtue of any other Act out of money so provided.
The Government are of the view that the Bill is a matter for Parliament rather than the Government to decide. In order for the Public Bill Committee that is now scrutinising the Bill to consider the clause that would have spending implications, the Government must first table this money resolution. This is purely to allow the Bill to be debated in Committee, and the Government have taken the view that tabling this motion does not act against our commitment to remain neutral. Only the Government can table such motions, so tabling it allows further debate to happen. To assist that debate, the Government will also assess the impacts of the Bill, and we expect to publish the impact assessment before MPs consider the Bill on Report.
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. Members should keep their contributions within scope. This is about the financial implications of the Bill if it is passed, so let us keep contributions within scope.
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
To ensure that as many colleagues as possible can get in during the time allowed, there will be a speaking limit of four minutes.
Brian Mathew (Melksham and Devizes) (LD)
Let me start by saying that I am in in favour of the motion, so I will vote for it, if it comes to that. However, would the hon. Member for Spen Valley (Kim Leadbeater) and the Minister consider the inclusion of two social workers on the group, made up of two GPs and a High Court judge, that assesses requests for assisted dying?
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. Your contribution has to be within the scope of what we are discussing, which is the financial organisation of the Bill.
Brian Mathew
There would be added expense. Social workers are trained in understanding family dynamics, and need desperately to be involved in these situations.
Liz Saville Roberts
Let us imagine what the public would make of our role in this place if this legislation were to fall at this point.
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. We are going to drop the speech limit to three minutes.
Jim Allister
I would be happy to do so in a moment.
It is quite clear that the measures will impose huge costs on the health and justice budgets. Given the provisions in the Bill, is it impossible for that not to be the consequence, so when the Treasury Minister produces the financial information, will he include current Government expenditure on palliative care and suicide prevention, so that we can look at and balance what we are spending? The Bill invites the Government to move from funding charities to prevent suicide to becoming facilitators and providers of suicide.
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. Mr Allister, we must confine our remarks to the money resolution for the Bill.
Jim Allister
Madam Deputy Speaker, I was seeking to do that by asking the Treasury Minister to give us a comparison. What is this Bill going to cost our health service and justice system? How does that compare with what we are already spending on palliative care and suicide prevention? Those are pertinent questions and we need the answers.
Jim Allister
I agree. We all have our views on the merits of the Bill, but fundamentally we have a duty to our constituents to handle public money properly. In handling that money, we must know how much the Bill will cost. When it comes to that financial statement, it must not be fudged or opaque; it must be absolutely clear and it must—
Jim Shannon (Strangford) (DUP)
On a point of order, Madam Deputy Speaker. The right hon. Member for North West Hampshire (Kit Malthouse) made a comment that I feel impinged upon my integrity. I have spoken to the right hon. Gentleman and he knows what I am referring to. I underlined and highlighted that the Terminally Ill Adults (End of Life) Bill Committee went into private session; some 15 Members, who support the Bill, voted for the private session and nine Members, who oppose the Bill, voted against the private session. The record must be corrected about what the right hon. Gentleman said about the comments I made about that. Facts are facts; they matter to me, as does my integrity.
Madam Deputy Speaker (Ms Nusrat Ghani)
Thank you, Mr Shannon, for letting me know you would be making a point of order. The Chair is not responsible for the content of Member’s speeches, but I remind the House of the advice in Erskine May on the importance of good temper and moderation in parliamentary language.
Kit Malthouse
Further to that point of order, Madam Deputy Speaker. There was no intent in my remarks to undermine the integrity of the hon. Member for Strangford (Jim Shannon). I may have misunderstood his remarks, but he implied that the Committee was adopting some kind of veil of secrecy over our affairs and I was pointing out to him that, in my view, that was a misunderstanding of what we were attempting to do yesterday. I am sorry if the hon. Gentleman was offended, as he knows I hold him in great affection and I had no intention to do so.
Madam Deputy Speaker
Thank you, Mr Malthouse. I can see Mr Shannon nodding, so hopefully your apology has been accepted.
Obesity: Food and Diet
Nusrat Ghani Excerpts(2 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. As Members can see from the annunciator, the debate on financial education has been postponed, so the current debate can go on until 10 pm.
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. When the hon. Member for Chelsea and Fulham (Ben Coleman) takes an intervention, he must be seated.
John Glen
The hon. Gentleman is making a thought-provoking observation, but does he acknowledge that in times past, the proportion of income that any individual, from whichever class, spent on food was considerably higher than it is today? If we are to get to the heart of the matter, we have to address the wider challenge of our society’s expectations of how much money we should spend on food. Does he not agree that we are addicted to cheap food?
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. To ensure that everybody gets in, I am setting a time limit of eight minutes.
Medicines and Healthcare Products Regulatory Agency
Nusrat Ghani Excerpts(2 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Graham Stringer (Blackley and Middleton South) (Lab)
It is a pleasure to follow the right hon. Member for Tatton (Esther McVey). I agree with every word she said. It is late in the day for a Thursday, so I will try not to repeat many of the pieces of evidence and arguments that she proposed, but they are all valuable contributions to this debate.
I will start by talking about the attitude of Members of Parliament and politicians to regulation in general. A long time ago, I had responsibility in the Cabinet Office for dealing with better regulations. I travelled around the country to look at businesses that complained about regulations and see how those regulations could be made better—that was 18 months of my life that I will never get back. I came to a number of conclusions after that. Politicians have a knee-jerk reaction when it comes to regulation. If a child dies, if there is a fire, or if there is another disaster of some sort, there is a cry from both sides of the House for more regulation— not necessarily better regulation and enforcement, but more regulation—when, in many cases, regulations are already there but inspections and enforcement have not taken place.
The other knee-jerk response, which my Government are giving at the moment, is to say, “Regulations are burdensome so we will try to get rid of some of them.” I do not think that either of those responses deals with the issue. We set up regulators—this afternoon we are talking about the MHRA—but, by and large, once they are set up, MPs and Ministers abdicate responsibility and do not consider them until there is a crisis.
When I had that responsibility, I went to see the European Medicines Agency—this was some time before we left the EU. One of the surprising things I found—or maybe it was not so surprising—was that I was the only Minister who had been anywhere near the place. It was the major European agency that this country got after the Maastricht treaty. It had wide-ranging and important powers, to deal both with the market and with regulation, but nobody bothered with it. If there had been a crisis, however, Ministers and shadow Ministers would have been queuing up to go there.
If there is a lesson, particularly in relation to the MHRA, it is that we should look at regulators—be they water, medicine or other regulators—all the time. We cannot as a Government and MPs abdicate our responsibility, because we then come to a crisis, and the electorate say, “Well, what are you doing?” and the answer is, “Not a lot; we have passed that on.” Those water regulators or medical regulators might be, as the right hon. Lady showed, pretty useless. We should be looking at them all the time.
I was a member of the Science and Technology Committee in 2012. Partly because of that experience, and partly because there was a lot of press discussion and debate about metal hips that were squeaking and not working very well when they had been implanted and about breast implants that were falling apart, potentially damaging and poisoning the recipients, we had an inquiry that reported in October of that year. I will read out some of the comments from the witnesses we heard from about the MHRA, because they are being repeated now. They are very similar to what the right hon. Member for Tatton said about the MHRA’s responses—secretive and slow. For instance, there was evidence that there were problems with metal hips for four years before the MHRA took any action whatsoever. Nearly 14 years later, it still has the same problems.
I asked Dr Heneghan from the Centre for Evidence-Based Medicine at the University of Oxford who had authorised those metal hips. His answer was extraordinary: “Nobody knows. I don’t know—nobody knows.” It was a different regulatory regime then, because we were part of the European Union. Anybody who had the competence—or at least the authority—in any country in the EU could give authorisation, but nobody knew which body had done it, and whether that body was composed of competent people and what evidence they had used to do so.
However, when the MHRA found out, it did nothing for four years. That is disgraceful, and there were all sorts of comments that I can give the House. One was from Dr Stephen O’Connor at the Institute of Physics and Engineering, who said that the MHRA was overly bureaucratic relative to other competent bodies, inefficient, and difficult to deal with. As the right hon. Member for Tatton showed, the MHRA does not answer FOI requests, and it does not tell us what is going on.
The Lancet said about the breast implants, which I will talk about next, that the MHRA was in paralysis and in need of reform. Again, that was a long time ago. It was a different issue with the breast implants, because the MHRA was dealing with a fraudulent product—the products that had been authorised were not the products that were being sold to surgeons to be implanted in women. However, the Committee asked for there to be random and regular testing of the bodies that were responsible for manufacturing those implants. I do not expect the Minister to know at this time, but will she check whether the authorities have done any of those randomised tests on those bodies?
That is the history. The right hon. Member for Tatton has basically analysed what is going on now, but I will just talk about what we learned during the covid period. We learned that many of the NHS’s constituent parts—although not the clinicians—were secretive. Earlier today in the Chamber, we talked about the Government’s response to the first part of the covid inquiry. At the present time, that inquiry is not getting to part of what went wrong during covid, which was the fact that the NHS did not tell us what was going on, and there was also a restriction on political debate. If we are to get the best policies in any crisis, and in the regular turn of events outside crises, we need transparency so that we know how things can be improved and what we can criticise.
The right hon. Lady made the excellent point that keeping things secret encourages people who do not trust vaccines and have odd theories about how societies is controlled not to take the protection from vaccines. We know that no medicine is 100% safe, and there is no point in pretending they are safe, but vaccines have saved many lives over decades—more than decades; over a century—and it is good for society and for individuals that people understand that, and they will be less trusting if we do not tell them what is going on.
As recently as a few minutes ago, I got an email telling me that the UK Health Security Agency is still refusing to release the cost of the bird flu vaccines it has purchased. What possible reason can there be for not saying how much public money has been spent on a good cause? Having vaccines ready for any flu epidemic is a good thing because it saves people’s lives, as we have been discussing. Why should it be kept secret? Could the Minister to respond to that?
Is there any Member in the House who thinks that turning the MHRA, in the right hon. Lady’s phrase, from a watchdog to an enabler is a good idea, or even knows what it means and what is being enabled? I certainly do not know what is being enabled, but one of the things we should remember is that the MHRA and the whole of the health industry are swimming in a sea of pharmaceutical sharks. Pharmaceutical companies produce some extraordinarily wonderful products that keep us safe, but they also produce huge profits, and sometimes they get their products on to the markets by telling lies, or certainly by sins of omission. Everybody knows about the thalidomide case, and how long it took to prove it and to get compensation for the victims.
Almost at random, I have picked two other cases. With Paroxetine—I think that is how to pronounce it—GSK held back information because it did not release the tests that did not show a positive benefit. It also kept back tests that showed that Paroxetine increased the chances of children committing suicide, and it took a lot of investigation to get that—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. Mr Stringer, I assume you are coming to a conclusion soon.
Graham Stringer
I am. I have one sentence. I am sorry; I did not realise I had speaking for so long.
Lastly, Reboxetine is another example of where the information given out to doctors was inadequate because it did not show the negative tests. I use those two examples basically to show that the MHRA should not be enabling these things. It should be much more vigilant, and it should be asking for powers to demand the right to know all the information that drugs companies have before it says those drugs are as safe as they can be.
Several hon. Members rose—
Madam Deputy Speaker
Order. To enable us to get everyone in, I hope all Members will be mindful of those who are to speak after them.
Sir Christopher Chope (Christchurch) (Con)
I shall try to be brief, Madam Deputy Speaker. I follow the hon. Member for Blackley and Middleton South (Graham Stringer) by referring to a quote from Hayek’s book, “The Road to Serfdom”. I do not claim credit for identifying it myself; it was quoted in the other place by Lord Hannan of Kingsclere on 15 January in the context of the Football Governance Bill. He was talking about the growth of the administrative state, about which the hon. Gentleman was speaking at the beginning of his speech. Hayek said:
“The delegation of particular tasks to separate bodies, while a regular feature, is yet only the first step in the process by which a democracy…relinquishes its powers”.
That is in chapter 5 of “The Road to Serfdom” from 1944, so not much has changed. The MHRA is an example of what happens if we in this House transfer responsibility to unelected and unaccountable organisations.
It so happens that on the Order Paper for tomorrow is my Covid-19 Vaccine Damage Bill, which is sponsored by a former Attorney General. That Bill calls for an independent review of covid-19 vaccine damage. It calls on the Secretary of State to
“appoint a current or former High Court judge to lead an independent review of disablement caused by Covid-19 vaccinations administered in the United Kingdom and the adequacy of the compensation offered to persons so disabled.”
We know that more than 600 people have already been told by the agency responsible at the Department of Health and Social Care that they have suffered disabilities as a result of covid-19 vaccines. A large number of them, where the disability is in excess of 60%, have been awarded wholly derisory payments of £120,000 each.
My Bill goes on:
“The review must consider…the rates and extent of disablement caused by each type of Covid-19 vaccination offered in the United Kingdom”.
Relevant to this debate, the review must also consider
“the effectiveness of Medicines and Healthcare products Regulatory Agency monitoring of such side effects, and National Health Service and Government responses to such monitoring”,
as well as
“the adequacy of compensation offered to persons so disabled”.
There has always been an agreement, basically, that if something goes wrong for people who undertake vaccination voluntarily or are in receipt of other medical products—if they are doing the right thing by the country at large—and they have an adverse reaction, they will be able to look to the Government or the taxpayer to pay them some recompense under the scheme to which I have referred, if causation is established. The trust built by that scheme has been undermined by the long denial of the previous Government—and, to an extent, the current one—that any adverse reactions had been caused by the covid-19 vaccines, other than the most minor disablement. It has also been undermined by the fact that so many people have applied for a review of their cases. Some people—I think more than a thousand—have been waiting more than 18 months for a decision. That shows that this is a low priority for the Government.
I hope that when the Minister responds to the debate, she will be able to explain why the Government will block my Bill again tomorrow. If they were taking this issue seriously, as they should be, they would be open to and supportive of the establishment of an independent review of disablement.
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
We are going to have to drop the time limit to four minutes. I call Dr Simon Opher.
Yasmin Qureshi (Bolton South and Walkden) (Lab)
My interest in this matter arises as I chair the APPG on Primodos, and it is a campaign that I and many other MPs have been working on for the past 12 years. On one occasion, after a big debate, the Minister ordered an expert working group to be set up. The MHRA was supposed to examine the evidence. We the campaigners and Members of Parliament thought that all the documents we had would be looked at by the MHRA, but clearly it did not look at them. The MHRA was supposed to engage with the victims and their families, but they were not spoken to or dealt with properly, and there was no thorough examination.
In fact, some of the members of the expert working group, which was set up by the Commission on Human Medicines, had connections with pharmaceutical companies. We wanted the MHRA to look at the documents, which showed very clearly that in the 1970s it was accepted by the then Committee on Safety of Medicines that this drug was causing deformities. However, the chief medical officer at the time colluded with the manufacturer, destroyed the evidence and refused to help.
We have documents that show that the manufacturer knew there was a cover-up, and yet the MHRA refused to look at them. Subsequently, Professor Carl Heneghan from Oxford University looked at the same material the EWG had looked at and came to a completely different conclusion: he said the evidence showed that there was a connection. The EWG was asked to look at whether there was a causal connection, and it changed its recommendation again. The former Prime Minister, Mrs May, was also not convinced by the expert working group. We persuaded her to set up a review chaired by Baroness Cumberlege, who said there was avoidable harm and that the victims should be compensated.
Throughout all those years, the Government of the day did not want to communicate with us, and they have not been dealing with this issue properly. They have always relied on the expert working group’s report, which has held the victims back and held us back from pursuing a possible legal claim. We say to the Government now that the EWG report needs to be relooked at, and Professor Carl Heneghan’s study of it should also be looked at. Scientific evidence has been produced using an experiment on zebrafish which shows that there is a link with this drug, and we have sent this to the Commission on Human Medicines for the Department to look at.
We must remember that this drug is 40 times the strength of the morning after pill. Women were given this pill and told it had no effect other than to see whether they were pregnant, and it then caused this damage. I ask the Minister today, with the new Government now in place, to please relook at this; the report by the EWG, which was set up by the MHRA, has been discredited, so please stop listening to it.
Alison Bennett
In the interests of time, I will not.
Brexit caused significant confusion for companies looking to sell products from Great Britain to Northern Ireland. It has also slowed down the time in which novel medicines and treatments can be approved for use, as pharmaceutical companies have understandably prioritised obtaining a single approval, allowing access to 27 markets via the EMA.
Meanwhile, strict affordability models imposed by the National Institute for Health and Care Excellence mean that companies face a further hurdle before their products can reach patients. Again, that diminishes the attractiveness of the UK market post Brexit. To help address this issue, the MHRA introduced the international recognition procedure a year ago to streamline the authorisation process by incorporating assessments from trusted regulatory partners worldwide, including the EMA. However, that relies on those partners having already approved the products, so UK patients will inevitably still have access to medicines later than people in other countries, including EU member states. When I met representatives of Roche Diagnostics, based in Burgess Hill in my constituency, they told me about the industry’s serious concerns that the additional GB-specific conformity checks required could be prohibitively expensive and lead to significant delays.
As things stand, the forecast is looking gloomy. My Liberal Democrat colleagues and I are committed to addressing these issues head-on, and to helping the MHRA become world leading. First, we are pushing to expand the MHRA’s capacity by halving the time for treatments to reach patients suffering from illnesses such as cancer. Secondly, we encourage the Government to fully implement the recommendations of the Cumberlege review, including on compensation, corrective surgery and psychological support for those who were failed and who suffered from faulty devices and drugs. Thirdly—this is vital—the Government should actively seek a comprehensive mutual recognition agreement with the EMA to promote faster access to new and novel medicines and medical devices. That would reduce red tape, cost and friction, providing hope for those who need access to these lifesaving and life-enhancing medicines and devices.
Hospice and Palliative Care
Nusrat Ghani Excerpts(2 months, 3 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. I will now be imposing a hard stop at four minutes, and that may reduce even further. I call Sorcha Eastwood.
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. We have 60 minutes left, and 19 Members still wish to speak, so I will have to drop the time limit to three minutes.
Vikki Slade
I completely agree, but what is really ridiculous is that, according to the Department of Health and Social Care, over 10 million hospital days followed an emergency admission in the last year of life, and 10% of people who died of cancer had three or more emergency admissions in the last three months of their life. The anticipatory care model can prevent some of those admissions and reduce the trauma. Further to my letter, sent in November, I urge the Minister to meet me and Clare Gallie to talk about a transformative approach.
I was deeply concerned when Marie Curie emailed me to say that Dorset integrated care board will stop commissioning specialist end of life care from March. The rationale is that personal care commissioning will go via council frameworks, but they do not require expertise in the provision of end of life care. I urge the Minister to insist that the specialists are listened to in the framework and to ensure that Lewis-Manning and Marie Curie are heard. Those organisations are looking to make redundancies and close services at a time when hospital beds are at a premium—
Brian Mathew (Melksham and Devizes) (LD)
I thank my hon. Friend the Member for Wimbledon (Mr Kohler) for bringing forward this important debate, and all hon. Members for speaking with such compassion.
Although the £100 million for hospice capital projects is to be welcomed, it is cash that is most needed. Julia’s House, a children’s hospice in my constituency that has already been mentioned, will find itself out of pocket by £242,000 per year because of the rise in national insurance. Dorothy House hospice, which is also in my constituency, will lose even more. That is a lot of sponsored walks and parachute jumps—perhaps too many—if the hospices are to avoid cutting their services. I urge the Minister to think again, and to provide the funds that our hospices need.
Jess Brown-Fuller (Chichester) (LD)
I thank my hon. Friend the Member for Wimbledon (Mr Kohler) for securing today’s important debate, and all hon. Members for approaching the conversation with the compassion and thoughtfulness that this topic deserves.
Examples shared across the House show that hospices are a vital part of our healthcare system. They provide outstanding care for patients approaching the end of their lives, offering dignity, comfort and support to families, and they are often driven by hundreds of volunteers, alongside the paid staff. Hospices will play a key role in meeting this Government’s objective to move care from hospitals to the community. This debate is very timely, given that the front pages of the newspapers are reporting today that half a million people were left languishing on trolleys in A&E and in corridors in 2024 because there were not enough beds to admit them.
Hospices, such as the extraordinary St Wilfrid’s in my constituency of Chichester, are the cornerstone of community care. I was blown away during my recent visit to St Wilfrid’s, and I am not ashamed to admit that I was brought to tears by the accounts of the family members, patients and staff I met that day. I applaud the hon. Member for Stoke-on-Trent South (Dr Gardner) for her show of emotion, because it is an emotive topic. St Wilfrid’s provides comfort and compassion to patients and their families during life’s most challenging moments—both directly in the calm and idyllic surroundings of the hospice and out in the community, providing palliative care for 300 people in the comfort of their own homes. It is St Wilfrid’s belief that everybody should be afforded a good death, and it strives to ensure that there is beauty in every day for patients and their loved ones, yet its service is being crippled by rising costs and a lack of sufficient Government support.
Hospices are in the process of setting their upcoming budgets, and many are having to make difficult long-term decisions to cut palliative care because they lack a long-term solution to address the growing financial strain. As the hon. Member for North Herefordshire (Ellie Chowns) mentioned, it is all well and good being able to say you have a lovely car park when you do not have any nurses to park in it. Only 17% of the overall cost of St Wilfrid’s hospice is currently covered by NHS grant funding—well below the minimum requirement across the country.
One of the biggest components of hospice costs is the salary of their expert clinical and other staff. Hospices are trying to match NHS salary increases to ensure that staff can afford to stay with them, and to remain competitive. In addition, they are now burdened with paying increased national insurance contributions, whereas direct NHS providers are exempt. For St Wilfrid’s, the rise in national insurance contributions will cost an additional £210,000, which is a significant financial burden. Although we Liberal Democrats and hospices alike welcomed the capital investment announcement in December 2024, that funding does not address the challenges of day-to-day spend, so there is still a vast gulf between rising expenses and available income. As the hon. Member for Birmingham Erdington (Paulette Hamilton) said, the funding must be the start, not the end.
Hospice UK has warned that around 300 hospice in-patient beds—14% of the total—are currently closed or out of use due to a lack of funding and chronic staff shortages, meaning that fewer patients are able to access the end of life care that they need at one of the most vulnerable times in their lives.
My hon. Friend the Member for Twickenham (Munira Wilson) mentioned the Marie Curie report, as did other Members across the House, which stated that one in four people who need hospice care cannot currently get it. The term “bed blocking” is not one I am particularly comfortable with, but if adequate palliative care is unavailable in the community or in a hospice, those people will remain stuck in hospital, and those hospitals cannot provide the expert care that a hospice can. Our hospices are ready and willing to take on those patients, but they need the support of this Government to do so.
As my hon. Friend the Member for Wimbledon (Mr Kohler), who brought forward this debate, said, people do not want to die in hospital. They want to die at home or in a specialised setting such as a hospice. That is why the Liberal Democrats are calling for hospices to be exempted from the rise in national insurance contributions. This targeted measure would provide immediate relief for a sector that is struggling under the weight of rising costs, and prevent further reductions in capacity or even closures.
We must think long term. Hospices need a sustainable funding model that guarantees they can continue their vital work of providing care for patients, supporting families and easing the pressure on the NHS. Hospices must also be a part of the conversation in the Government’s upcoming 10-year plan for the NHS, and that must include sustainable hospice funding reform. Examples from across the House today showed a shared recognition of the importance of hospice care. Now we need the Government to match that recognition with action for the patients, for the families and for a health service that depends on hospices.