(7 months, 3 weeks ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My right hon. Friend has huge expertise over the entire health field and therefore in this area as well. He is completely right, and I will come on to savings, particularly potential savings in the social care budget as well as the health budget, in a couple of minutes. It is one of the points I want to emphasise to the Minister.
To return to the treatments, the Medicines and Healthcare products Regulatory Agency has already started consideration of lecanemab and donanemab—I wish treatments had more pronounceable names—two very important breakthrough drugs, and I believe a final decision is expected by the middle of this year. Inevitably, at this early stage of the development of drugs in any particular field, there are many more out there. Another 140 drugs are undergoing clinical trials around the world at the moment. They will not all work, but some of them will, so in scientific and research terms, this is genuinely an exciting period in this field.
Perhaps the most significant point I want to make to the Minister is to express the hope that the way in which the system decides whether to approve a drug is fit for purpose for this type of drug. That is genuinely in question and gives rise to the point my right hon. Friend the Member for West Suffolk (Matt Hancock) made about costs. There are inevitable gaps in our knowledge about the efficacy of new treatments in an area where, up to now, there have been no treatments. Much of the usual comparative work one would expect to be done in clinical trials cannot be done in these circumstances, so there is a task for Ministers to make sure that NHS bodies and the industry develop a joint plan to allow these new treatments to be available to the NHS at a reasonable price.
There is also an important specific point that could affect whether the National Institute for Health and Care Excellence gives financial approval to these treatments in the first place. The bulk of the current costs of dementia falls on the social care system, particularly on unpaid carers. Estimates suggest that around £22 billion a year of costs fall on informal or formal social care. The direct costs to the NHS are only £1.7 billion a year—a small fraction of the cost to the social care system. The current NICE assessment process will take into account only the NHS costs, and clearly that could adversely affect a decision about whether drugs are affordable.
Whether the current NICE system provides the proper result for this type of drug and disease would be questionable at any time, but it is particularly questionable when other arms of government are concentrating on getting more working-age people back to work. More than 1 million people between the ages of 25 and 49 are out of work because of caring responsibilities, and some of those will be caring responsibilities for people suffering from dementia, perhaps in its early stages, when we are not using technology well enough to allow people to lead more or less normal lives.
My right hon. Friend is making an excellent speech and a particularly pertinent point about NICE considering only the cost to the NHS. Is that not even more surprising given that NICE stands for “National Institute for Health and Care Excellence”? Clearly, the guidelines need urgent revision.
I am delighted to have my hon. Friend’s support. Since the old Department of Health was renamed the Department of Health and Social Care, it has been particularly important that, in all its manifestations, and indeed in all the manifestations of the bodies that report to it, the Department should reflect the treatment of health and social care as equals. That is a wider point that my hon. Friend should not tempt me to; I can go on at great length about it, and do not wish to in this debate.
As I said, caring responsibilities are a significant reason why so many people of working age are not working. I cited the figure for those between 25 and 49, but if we extend the age range up and down, less than a fifth of people who care for someone with dementia are in paid work. If someone is caring for someone with dementia, it is very likely that they will not be in paid work. I am grateful that others support my point that NICE should be instructed to consider the full cost of dementia to social care, as well as the NHS, to arrive at a proper evaluation of the economic case for the new treatments.
The prospect of these drugs becoming available also throws a spotlight on the need for better and, in particular, earlier diagnosis. At the moment, the drugs are effective only in the early stages of Alzheimer’s, and there is nothing like enough capacity for timely diagnosis. The latest NHS figures suggest that more than a third of the over-65s estimated to have dementia do not have a recorded diagnosis at all. There are significant regional variations within that figure. Some areas of the country are much worse: for example, diagnosis rates in Herefordshire and Worcestershire are as low as 53%. There is also evidence that minority groups, including black people and those of south Asian heritage, have higher rates of under-diagnosis. Without an increase in the effectiveness and timeliness of diagnosis, the beneficial effects of the new treatments will therefore be massively reduced.
For the new hopes I am discussing to be realised, we therefore need a revolution in our diagnostic capacity. At the moment, the most effective ways of diagnosing dementia—namely, PET scans or lumbar punctures—are accessible only to 2% of those seeking a diagnosis. The best short-term solution is to increase access to lumbar puncture, which is much cheaper and more scalable than expanding the expensive scanning equipment. Alzheimer’s Research UK suggests that the annual capacity for lumbar punctures should be increased from 2,000 to 20,000 a year. I am conscious that the Government are analysing the responses to the consultation on the major conditions strategy and that dementia is one of the six conditions covered by the strategy. My appeal to the Minister on that front is that, as we do in many cases in health and social care, we think at least as much about prevention as we do about cure.
Given the demographic pressures, it seems unarguable that, if we carry on as we have done since the NHS was created, concentrating almost entirely on treatments while relatively neglecting public health and preventive measures, we are heading for even more difficulties in the long run. But that is a much wider debate. In the specific area of preventing dementia, a number of factors, including hearing loss and high blood pressure, can and should be part of a preventive approach, which would reduce demand for expensive treatments in the long run and, even more importantly, allow people to continue to lead more or less normal lives.
One other point about the new era that we are hopefully entering with these treatments is that, as a country, we are well placed to contribute to the vital research that is needed. We have the scientists and the companies, but too few people are currently aware of the possibilities. Only 2% of people with a dementia diagnosis are currently registered to hear about clinical trials. The total UK share of the current clinical trials for dementia around the world is 7%. I hope that the Government will look at that aspect as part of the overall plan for dealing with dementia, which we are looking forward to.
Before I sit down, I should emphasise that I do not want to be ungenerous or over-critical about the Government’s action in this area. I am conscious that the Government have committed to doubling the funding for dementia research to £160 million by the next financial year, and I also very much welcomed the launch, last summer, of the Dame Barbara Windsor dementia mission; I am glad that the Government have put £95 million behind that. I know, of course, that the Minister and the Government widely recognise the horror of this disease, the fact that it is becoming more widespread and affecting more and more families and the fact that not just more money, but more creative thinking, will be needed to turn the tide.
I want to end on a hopeful note. This generation has the chance to see the end of the terrible situation whereby a diagnosis of dementia is a life sentence of an inevitably long degeneration. This absolutely needs to be a turning point for the millions of people who are touched by this dreadful disease. I hope that the Government and the medical authorities recognise the scale of the opportunity that scientific advance has given to them and all of us. This year could be key to setting the UK on a path to a more hopeful future. I am very confident that the Minister will be determined to lead us on that journey.
(6 years, 10 months ago)
Commons ChamberThe Government are, as the hon. Gentleman and the House would expect, preparing for all eventualities. That is the only responsible thing for a Government to do and that is what we are doing. The House will have a considerable amount of time during the Committee stage, which is coming up shortly, to debate the EU (Withdrawal) Bill. I hope, partly through the re-institution of the Joint Ministerial Committee, to make sure that the legislative consent motion will be agreed.
Given that there is no devolved Executive in Northern Ireland at present, how are views from Northern Ireland being fed into this process?
As I said in reply to the original question from my hon. Friend the Member for Brecon and Radnorshire (Chris Davies), at the moment views from Northern Ireland are being fed in through the Northern Ireland civil service, which is currently doing administrative tasks. I am sure my hon. Friend will join me in hoping that we will soon have a Northern Ireland Executive back doing their job.
(7 years, 5 months ago)
Commons ChamberUrgent 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
They are not. I can only repeat what I have said before, and if necessary, I will quote the facts again, or the detailed case that I gave to the right hon. Member for East Ham (Stephen Timms). I could go into the details, but I suspect that your patience would be tested by that, Mr Speaker. Do you want me to read the descriptors out again? [Interruption.] But seriously, the point is that it is perfectly possible to qualify for the standard rate or the enhanced rate purely with a mental health condition, so it is not the case that people with mental health conditions are discriminated against.
You have just indicated, Mr Speaker, that your patience would not be tested were the Secretary of State to give a detailed example that might clarify the situation for the House. May I invite him so to do?
Let me read it out again. A person
“with a cognitive impairment who cannot, due to their impairment, work out where to go, follow directions or deal with unexpected changes in their journey”,
even when the journey is familiar, would score 12 points under descriptor F on mobility activity 1, which covers planning and following journeys, and hence be entitled to the enhanced rate of the mobility component. Examples of such conditions could include dementia or a learning disability such as Down’s syndrome. I hope that that reassures you, Mr Speaker, and the whole House.
(7 years, 6 months ago)
Commons ChamberUrgent 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
The hon. Gentleman makes a point about people who appeal, but only 6% of PIP judgments are appealed—a very low number. We are seeking to improve the system by making sure that more health information is available earlier in the assessment process, which I am sure will help the hon. Gentleman’s constituents.
I have been following exchanges closely, and my constituents will want to know that their MP has understood things correctly. Can the Secretary of State confirm my understanding from what has been said that 25% of PIP claimants now get the highest rate compared with 15% under DLA, and that more people with mental health conditions qualify for PIP than ever did before under the old DLA system?
Yes, my hon. Friend is right in both those assumptions, and I am happy for him to share them with his constituents. Let me add a more specific assurance—that more PIP claimants with mental health conditions claim the mobility component, which stands at 27% as compared with 9% of those on DLA, which is another improvement.
(7 years, 9 months ago)
Commons ChamberIndeed. Carer’s allowance applies to people other than older workers, as you will be aware, Mr Speaker. The hon. Lady will also be aware that carer’s allowance was increased significantly at the most recent announcement. We keep all benefits under review.
Older employees bring many benefits to employers, including turning up on time, taking pride in their appearance and passing on a wealth of life experience to their younger colleagues. We have national recognition schemes for innovation, technology and exports. Has the Secretary of State thought of introducing a national recognition scheme for those employers who employ a large number of older workers?
(7 years, 9 months ago)
Commons ChamberUrgent 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
I do not think that the scheme has the effect that the hon. Lady fears. I can stand here and recite figures to her if she likes, but it is patently the case that more people are in work than before. We have more women in work than ever before in our history and unemployment is at its lowest level for more than 10 years. Our welfare policy has had a huge success in getting people into work. If we accept that work is the best route out of poverty, then that is the best measure that any Government can take to alleviate poverty in the long term.
I declare my interest as a member of Kettering borough Council. Can my right hon. Friend the Secretary of State confirm to the House that disability spending will be higher in each year of this Parliament than was the case in 2010?
I can, and my hon. Friend makes his point using his particular expertise in dealing with these cases not just as a Member of this House, but as a local councillor as well. I mentioned the figure for disability spending earlier, and it is indeed rising.
(7 years, 10 months ago)
Commons ChamberThe hon. Gentleman is slightly confusing apples and pears. This is a support programme to get people with a disability back into work. The best route out of poverty for people with a disability, as it is generally, is to have a job. As a society, we have been much less good at allowing and encouraging people with a disability back into work than we have for the general population. The Green Paper is intended to address that problem.
My constituents in Kettering want to know whether the Secretary of State thinks that the film “I, Daniel Blake” is an accurate portrayal of the benefits system. If it is, do the changes he has announced in the Green Paper address the problems raised? If it is not, what are the inaccuracies?
I have not seen the film yet but have seen quite a lot of trailers. [Interruption.] I would point out to my hon. Friend and the hon. Lady on the Opposition Bench who is chuntering from a sedentary position that it is a work of fiction and not a documentary. It bears no relation to the modern benefits system. As I understand it, it is monstrously unfair to jobcentre staff, who are hugely conscientious people doing a job, sometimes in difficult conditions, and doing it very well indeed.
(10 years, 7 months ago)
Commons ChamberI assure the hon. Lady that both I and the Home Secretary have many meetings with police and crime commissioners, both from urban and rural areas; indeed, I met all the Welsh PCCs in one group in recent months. If the hon. Lady and her police and crime commissioner are worried about fuel duties, I remind her that it is this Government who have frozen fuel duties and ended the fuel duty escalator that the Government she supported kept throughout their time in office.
Will the Home Secretary join me in congratulating Northamptonshire police, the police and crime commissioner, Adam Simmonds, and Chief Constable Adrian Lee on overseeing a 23% cut in violent crime—over halfway to their target of a 40% cut by 2016— that makes it the second most improving force in the country in this area of crime?
(10 years, 9 months ago)
Commons ChamberI am happy to tell the hon. Lady what is fair. What is fair is that recorded crime in the Slough community safety partnership is down by 26% in the 12 months to June 2013, which is greater than the overall figure for England and Wales. That was between 2012 and 2013, so I am sure the hon. Lady will welcome this improved service to her constituents.
T5. After the wave of mass immigration under the previous Labour Government, my constituents believe that this country is full, and do not want to see unrestricted immigration from Romania, Bulgaria and, as it now turns out, up to one third of Moldova. At this late stage with a month to go, I urge the Home Secretary to think again and not to waive the transitional controls.
(10 years, 10 months ago)
Commons ChamberMy hon. Friend raises a serious issue. As he knows, Wolverhampton is one of the 33 priority areas to which the Home Office is giving particular help on this issue. We are working with Wolverhampton and other areas to tackle gang-related drug dealing as part of the ending gang and youth violence programme, and we will continue to do so and also use the new National Crime Agency and the serious organised crime strategy to ensure that we continue to attack the organised crime routes of drug dealing in too many of our cities.
The good news from Northamptonshire is that overall crime is down 14% in the last three years, but the bad news is that for every 1,000 people in the county, there are 11 crimes of violence, compared with eight per 1,000 in Merseyside and 10 per 1,000 in Greater Manchester. Surprising though these figures may be, will my right hon. Friend ensure that when the Home Office allocates funds to regional police forces, it takes such statistics into account?
My hon. Friend is a doughty campaigner for the local interests of his constituents, as he should be, and we hear all the recommendations he makes to us. His county is lucky to have a particularly good police and crime commissioner, who will, I know, bear down hard on crimes of violence.
(11 years, 2 months ago)
Commons ChamberI am sorry that the hon. Gentleman did not hear my answer. There is genuine discontent about the way in which the perfectly reasonable articles in the convention have been misused in this country’s legal system, such that in many cases people who should not be able to use them misuse them in order to abuse this country’s hospitality by staying here when they have no right to do so and generally bring the whole concept of human rights into disrepute. The hon. Gentleman and I would agree that human rights ought to be the bedrock of a democratic society, but the problem with the current system is that that is in danger of no longer being the case. I would have hoped that he would welcome our attempts to reform it.
T5. If it is true that there are still almost 11,000 foreign national offenders in our prisons, what steps are being taken to negotiate compulsory prisoner transfer agreements with other nations so that these people can be sent back to secure detention in their own countries?
(11 years, 6 months ago)
Commons ChamberKettering is fortunate to have an excellent bench of magistrates and the whole nation should be grateful for the tremendous unpaid work carried out by 24,000 magistrates up and down the country. Is the Minister aware that £40 million could be saved in the criminal justice system were he to undertake this simple revision of magistrates’ powers? Justice would be better, cheaper, quicker and more local as a result.
I absolutely share my hon. Friend’s high regard for magistrates both in Kettering and around the country. They are indeed volunteers who do a very good job. I am aware of the Magistrates Association’s proposals and the costings and savings that have been suggested. Those proposals bear scrutiny, because there will be second-order effects such as potentially more people in prison and more defendants electing to have a Crown court trial. As I said, the main thing to do is to ensure that people do not reoffend, which is why we have concentrated on extending supervision to short-sentence offenders.
(11 years, 7 months ago)
Commons ChamberI can only give the hon. Lady the facts. In the Greater Manchester police area, crime went down by 10% over the past year. Her constituents’ streets are safer than they were a year ago, two years ago and three years ago, and 84% of the public say that they are satisfied with Greater Manchester police. On the specific point that she raises, the HMIC report states that the force will save money through collaboration, but that
“the public will not notice any difference in the service they receive in their community.”
Will the Minister join me in commending Adam Simmonds, the new police and crime commissioner for Northamptonshire, who, in his draft crime plan, commits himself to retaining at 1,220 the number of police officers that he inherited, while at the same time creating a new large-scale reservist police force of up to 200 officers, each of whom will be required to give 20 days a year?
(11 years, 8 months ago)
Commons ChamberI agree, and that is why I made the point to the hon. Member for Huddersfield (Mr Sheerman) that it is for the courts to decide the appropriate punishment. That might well be the use of restorative justice, which is particularly effective with young offenders.
I declare my interest as a special constable with the British Transport police. Although the age of criminal responsibility is 10, effectively many police officers will not do anything in the case of a miscreant under the age of 16. May we have a change to the law, whereby if a police officer were to issue a fixed penalty notice for somebody under 16 who committed antisocial behaviour or a crime, it would be served on their parents or guardians so that they would ensure that their children behaved properly?
I am always interested by the expertise my hon. Friend brings to this issue, given his welcome work as a special constable. I shall certainly consider his suggestion seriously.
(12 years, 8 months ago)
Commons ChamberUrgent 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
I speak to the Justice Secretary in the Scottish Government on a regular basis about various issues, because of the devolved powers in this area. I am afraid I do not have the exact figure that the hon. Lady asks for to hand, but I will write to her with it.
Will the Minister name and shame the three countries from which most of the foreign nationals in question come and that are being the most awkward in facilitating their return to secure detention in their own countries?
Two were named in the weekend press, but they were not, in fact, the most awkward. Awkwardness is difficult to define. The two countries named were Jamaica and Nigeria, whose nationals account for most such prisoners. However, I should pay tribute to both countries’ Governments, who are considerably more co-operative now than they were. I visited Nigeria recently, where I visited a prison, part of which had been built by the British taxpayer specifically to make it easier for us to return Nigerian national prisoners to Nigeria. That is the kind of practical action we are taking.
(12 years, 9 months ago)
Commons ChamberUrgent 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
For the fourth time, I will tell Opposition Members—I wish their Whips could have thought of more than one question for them to read out—that every private flight is checked against the warnings index before it arrives. That is what makes it safe.
My constituents want to know the definition of private flights, which of the main airports they fly to, and what proportion of total passenger numbers is made up of such flights.
The definition is a flight that is not a scheduled flight. The number of airports that they fly into is in the hundreds, because frankly anyone who puts up a windsock in a field can have a private airport, but the number regularly used for private flights is between 100 and 150. The biggest usage of private flights is into our biggest airports, because most of them tend to be business flights.
(12 years, 9 months ago)
Commons ChamberThe hon. Lady will know that later this afternoon my right hon. Friend the Home Secretary will make a statement covering the issues that she is interested in. The reductions in staffing are not affecting the front line because we are improving the front line by, for instance, having airline liaison officers overseas. Over the past few years, that has prevented 60,000 people whom we did not want to travel from travelling in the first place. The use of facial recognition technology and e-gates also makes our borders more secure.
Will the Minister assure the House that the effectiveness of our front-line border controls will not be undermined by pressure to reduce queues at airports?
As I have just explained to the hon. Member for Edinburgh East (Sheila Gilmore), it is important to have intelligent border controls, to use technology and to put the right people in the right places so that we can keep our borders secure. Those are elements of this Government’s transformation of the UKBA to sort out the shambles that we inherited.
(13 years, 5 months ago)
Commons ChamberWe are indeed speaking to many universities and listening to their representations, and my right hon. Friend the Home Secretary has met the vice-chancellor of Exeter university. I am sure that when our proposals are put forward, universities will discover that they defend the rights of legitimate students to come here to study legitimately at legitimate institutions. At the same time, we will also crack down on the huge and widespread abuse of the student visa.
Which three countries are responsible for the largest number of illegal immigrants into Britain and what specific steps are being taken with those countries to take those people back when they are caught?
By definition, illegal immigrants do not go through the system, so it is quite difficult to give accurate figures about where they come from, but we know the main routes by which people come into the country, one of which is from Asia, through Turkey into Greece. We are working very hard with both the Greek and Turkish Governments to stop that route and minimise the problem. One of the most effective things we are doing is improving our border controls at Calais, which mean that the number of people who are identified as coming across illegally into Britain is now running at about a third of the level it was 18 months ago. That is a significant strengthening of our border defences.
(13 years, 7 months ago)
Commons ChamberUrgent 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
It would be inappropriate for me to comment on any individual cases on the Floor of the House. I am sure that my hon. Friend understands that this is not a venue where one should discuss individual police activity.
Although I support the reduction to 14 days, Her Majesty’s Government are not treating Parliament properly on this issue. The Home Secretary will be in the House on Monday to take Home Office questions, so presumably it would be perfectly possible for her to make a statement then. The Order Paper does not list any statement on the issue for Wednesday.
The Order Paper for Wednesday is yet to be produced, so I am not entirely sure about the force of my hon. Friend’s statement. As he says, those who are eager to question the Home Secretary will have the chance to do so on Monday anyway, so I am sure that we can return to the issue.
(13 years, 8 months ago)
Commons ChamberT3. What steps are being taken with the help of the French authorities to stop the steady flow of illegal immigration from the northern French coast into our channel ports?
Very effective steps. I am grateful to the French Government for the changes that they have made, not just the closure of Sangatte some years ago but, more recently, the clearing of “the jungle”, the unofficial camp that was set up. We also have our own juxtaposed controls. British customs and immigration officers are standing on the French side of the border, not just in Calais but at the Gare du Nord and other rail points at which people can gain direct entry to Britain. That has had measurable results. The number of illegal immigrants caught in Kent in the area of the channel ports is now running at about a fifth of the previous level, so the extra controls are visibly working.
(14 years, 2 months ago)
Commons ChamberThe rationale, as with all our proposals on language, is that those who wish to come to this country need to be able to play a full role in its life. If as many people as possible who live and settle in this country are able to speak English, they will lead more fulfilled lives and be able to integrate better in our communities. That would be extremely helpful.
11. How many asylum applications were made by individuals who had passed through another safe country to get to the UK in the most recent year for which figures are available.
In 2009, 2,665 cases were positively identified as having travelled through another EU member state that is considered safe under schedule 3 to the Asylum and Immigration (Treatment of Claimants, etc.) Act 2004.
What do we do with those people? Surely we should not be giving asylum to people who come to this country via another safe country. Yes, let us give asylum to people who are genuinely fleeing persecution, but not to tourists.
I rather agree with my hon. Friend, who will know that, under the previous Government, one of the many shambles in the immigration and asylum system was the problem of being able to remove people to safe countries. We will try to do better. The Dublin regulation, which is the system under which we do this, is working—in 2009, the UK removed 625 more cases than we accepted—but it is not working well enough. [Interruption.] If former Ministers on the Opposition Front Bench can contain themselves, I shall give the reason: we must do better at returning cases to specific EU countries. We are doing better with Italy. The next case that we really need to get to grips with is Greece, but the Government are determined to do this.