Hongkongers in the UK: Visas, Security and Services

Debate between Seema Malhotra and Jim Shannon

Thursday 17th October 2024 Westminster Hall

[The Parliamentary Under-Secretary of State for the Home Department (Seema Malhotra)]

It is a pleasure to serve under your chairship, Mr Vickers. I congratulate my hon. Friend the Member for Altrincham and Sale West (Mr Rand) on securing the debate, which has given rise to powerful speeches by hon. Members from all parties.

Members have spoken up for their constituents and about their experiences and I will try to address as many of the points made as possible. Many issues were covered, whether that was the BNO visa route, security issues at home and in Hong Kong, pensions, home university fees, democratic freedoms, police stations and more.

I also thank the Front-Bench speakers, the hon. Members for Sutton and Cheam (Luke Taylor) and for Hamble Valley (Paul Holmes), for their contributions. The issue has had cross-party support in the past, and I am sure we will continue to work in that spirit in support of Hongkongers in the UK and those who may come here in the future.

I am sure that my hon. Friend the Member for Altrincham and Sale West will recognise that I may not be able to address all the issues raised today. Some of these complex matters need cross-departmental work, whether that is with the Foreign, Commonwealth and Development Office, the Ministry of Housing, Communities and Local Government or the DFE. I hope that I will cover most of the issues in my comments today, but I assure all hon. and right hon. Members that we will look at all the issues raised. I also pay tribute to the work of Hong Kong Watch and others in sharing their experience and research.

As my hon. Friend the Member for Altrincham and Sale West will be aware, the Government are deeply committed to supporting members of the Hong Kong community who have relocated to the UK. I think I speak for all of us when I say that Hongkongers have become an integral part of our economy and local communities, and make fantastic contributions to our national life.

I will speak first about the Hong Kong BNO visa route. The route was established in 2021 in response to the imposition of the national security law in Hong Kong, which significantly impacts the rights and freedoms of people in Hong Kong. The BNO route reflects the UK’s historic and moral responsibility for and commitment to the people of Hong Kong. Since its launch, more than 209,000 people have been granted a BNO visa, of whom more than 150,000 have arrived in the UK. Those Hongkongers are free to live, work and study in virtually any capacity on a pathway to British citizenship. I am sure we will welcome many more Hongkongers to the UK in future so that they can also build a new life for themselves here.

[Jim Shannon]

In my contribution, I asked about students across Scotland, Wales, Northern Ireland and here in England, as well—the Minister may be coming to it, but if she is not, I hope she will. I underlined that there is a clear issue relating to students from Hong Kong having the same opportunities as those who are born here. I urge the Minister to give us an answer on that.

--- Later in debate ---

[Seema Malhotra]

I thank the hon. Gentleman, and will come on to that point.

I will deal first with questions around the expansion of the BNO route, in particular to people born between 1979 and 1997. A number of Members have suggested that the BNO route should be expanded to include those who were children at the point of Hong Kong’s handover to China in 1997 but whose parents did not register them for BNO status. The BNO route reflects the UK’s historic commitment to those who chose to retain their ties to the UK by taking up BNO status, and we continue to uphold those commitments. Those not eligible for the BNO route need to consider other available UK immigration routes, for example as a student, graduate or skilled worker. I am sure that Members will understand that I am unable to make any policy commitments in this forum, but I want to give assurances that I will take their comments away and consider the points that have been raised today.

I will also address the point about criminality. The standard immigration rules on criminality and other adverse behaviours apply to applications through the BNO route. However, all applications are carefully assessed against the latest country information, and guidance for caseworkers provides flexibility to ensure that overseas convictions for offences—particularly those not recognised in the UK—do not result in the automatic refusal of an application. I am aware of the concerns of those applying through the BNO route, and of the risk of their being refused on suitability grounds because of a conviction for what I think we can describe as politically motivated or trumped-up criminal charges in Hong Kong. I assure hon. Members that I am keeping the issue under review.

On the question of access to services, I thank hon. Members for their comments about the Government’s welcome programme, which we have remained committed to and which is now entering its fourth year of funding. That very important programme enables Hongkongers to access support on a range of issues, including employment, education, housing and the English language. It helps them seek employment, build skills and learn more about life in the UK so they can play a bigger part in their local communities.

As the shadow Minister said, there is currently £1 million of funding for voluntary and community-sector organisations to deliver projects focused on employability and mental health and wellbeing. The Growth Company has been funded to deliver the Jobs for Hongkongers initiative, which will help BNOs in England find employment. I am aware of other good examples. The hon. Member for Carshalton and Wallington (Bobby Dean) talked about a scheme, and I would be interested to hear more about how those local initiatives are working.

International fees are a concern for those on the BNO route, who can study and work in virtually any capacity. Generally, to be eligible for student support, home fee status and fee caps, a student must have settled status in the UK, and ordinarily they must have been resident in the UK for three years prior to the start of their course. The majority of BNO status holders will be able to qualify for home fee status and student finance once they have obtained settlement in the UK, subject to meeting the normal eligibility requirements. The eligibility criteria apply to all students, except persons granted international protection by the Home Office, but I have heard what hon. Members have said today.

On the Mandatory Provident Fund, hon. Members raised the very serious matter of the estimated £3 billion of funds alleged to have been frozen. We know that individuals who have chosen to take up the BNO visa route have difficulty drawing down early their pensions held in the Hong Kong Mandatory Provident Fund. Although documentary requirements for withdrawing funds early are a matter for the Hong Kong authorities, the Foreign, Commonwealth and Development Office has raised the issue directly with the Hong Kong Government and the Mandatory Provident Fund Schemes Authority. We have urged them to facilitate the early drawdown of funds, as is the case for other Hong Kong residents who move overseas permanently, and we have made it clear that such discrimination against BNOs is unacceptable. I will certainly keep that under review.

On security, we take the protection of Hongkongers’ rights, freedoms and safety in the UK very seriously, and we continue to assess potential threats in the UK. We work closely across Government, as well as with the relevant agencies and law enforcement bodies, to protect persons identified as being at risk and ensure the UK is a safe and welcoming place for those who choose to settle here. I want to be clear that attempts by foreign Governments to coerce, intimidate or harm critics overseas are unacceptable. Freedom of speech and the other fundamental rights of all people in the UK are protected under domestic law, regardless of nationality. We will challenge where we must to protect our national security and values. We are also working to improve the UK’s capability to understand and respond to the challenges and opportunities that China poses through an audit of the UK’s relationship with China as a bilateral and global actor.

It is also worth saying in response to the cyber-security issues that have been raised that the National Security Act 2023 gives the police new powers to protect the public from these malign threats, including those actions that amount to transnational repression—I take the point about the need for a clear definition. The Act brings together vital new measures to protect the UK’s national security, creating a whole suite of measures to enable our law enforcement, security and intelligence agencies to deter, detect and disrupt the full range of modern state threats.

[Jim Shannon]

Will the Minister give way?

[Seema Malhotra]

I am conscious of time and I want to make a couple of final points before wrapping up.

A concern was raised about whether there were plans to shut down the Hong Kong Economic and Trade Office, but its status is enshrined in primary legislation and there are no plans to change that framework.

On Jimmy Lai, we continue to call on Hong Kong authorities to immediately release British national Jimmy Lai. Mr Lai’s case, as has been mentioned by the Prime Minister this week, is a priority for the Government. The Foreign Secretary raised Jimmy Lai’s case in his first meeting with China’s Foreign Minister at the Association of Southeast Asian Nations summit in July. We continue to raise his case. UK diplomats from our consulate general in Hong Kong continue to attend his court proceedings on a regular basis and will continue to do so when the trial resumes in November. We are deeply concerned about the allegations about his treatment in prison and have sought reassurances on appropriate medical treatment.

I again thank my hon. Friend the Member for Altrincham and Sale West for securing the debate, and all hon. Members for their contributions. It has been an incredibly important, thoughtful and well-informed debate. It is important that we take this opportunity to reaffirm this Government’s commitment to the people of Hong Kong and to the BNO route, which provides long-term safety and stability for Hongkongers in the UK.

Rural Depopulation

Debate between Seema Malhotra and Jim Shannon

Wednesday 11th September 2024 Westminster Hall

[Seema Malhotra]

I have to make my remarks, and the right hon. Member has spoken. I will come back if I have time.

On the vision of developing more sustainable alternatives to labour market issues, I am sure that we are all keen to work together. There is no other way. That is why I have asked my officials to work closely with Seafish, the Department for Environment, Food and Rural Affairs and across Government to address the issues facing the sector and our rural communities, and to make sure we are building together a more sustainable workforce and community.

[Jim Shannon]

I welcome the Minister to her position. I apologise for not doing so earlier; I wish her well in her job. The right hon. Member for Orkney and Shetland (Mr Carmichael) and I have pursued the issue of visas for fishermen across the sea—in Northern Ireland, my villages of Portavogie, Kilkeel and Ardglass are examples —as has the hon. Member for Perth and Kinross-shire (Pete Wishart). Along the line, we have always had verbal commitments, but we have never seen action to make visas more acceptable for skilled workers so that small fishing villages such as Portavogie, Ardglass and Kilkeel can survive. The Minister might wish to continue pursuing that, if it is agreeable.

[Seema Malhotra]

I am happy to meet the hon. Gentleman, who is a long-standing campaigner on these issues. I make the point that it is important that we work closely across Westminster and with our devolved Administrations. This is part of an important reset, and it is important that we look at how we tackle these challenges together. Many of the issues that have been raised are matters for the Scottish Government and for local authorities in Scotland, but it is important that we look at how we work together across Westminster and with the Scottish Government to ensure that we have shared projects that are a success.

Gurkha Pensions

Debate between Seema Malhotra and Jim Shannon

Monday 22nd November 2021 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate, Dr Huq. I was keen to participate. I thank the Backbench Committee for allowing the petition to be debated and the hon. Member for Stoke-on-Trent North (Jonathan Gullis) for introducing it in such a well-rehearsed fashion.

No Member of this House, as others have said, is under any illusion as to the debt owed to the Gurkhas. The pension is an issue that I have raised in the House since 2011, as have others on many occasions. To put it simply, the historic treatment that the Gurkhas have received during the 200 years for which they have proudly served this nation has been disgraceful and must come to an end.

Gurkhas have served in the British Army around the world since 1947, and even before then 43,000 Gurkhas gave their lives fighting in the first and second world wars. Their bravery is the stuff of legend. Every one of us will have had some contact with the Gurkhas over the years. When I did the armed forces parliamentary scheme, I had the opportunity to meet some of the guys. We were introduced to them. I will never forget it; I was greatly humbled to be in their presence. I say that honestly, because I was. The Gurkhas might be men of small stature, but they have tremendous courage and bravery that surpasses and equals that of many others across this great nation.

Many years ago I also had the opportunity to see the Gurkhas at Mount Stewart in my constituency of Strangford, where they were the special attraction for the beating of the retreat. It was idyllic and will remain in my memory for all my life. My wife and I were both invited. It was a few years ago, on it was a lovely sunny summer’s evening. At the Mount Stewart house, which is run by the National Trust, the beating of the retreat was done by the Gurkhas and it was unforgettable. To the day I die I will always remember it.

It has been more than three years since the joint technical report on the British Gurkha case was exchanged between two Governments on 22 March 2018 at Whitehall in London, which was the basis for a dialogue to address the main concerns of the British Gurkhas—the very thing that every person in the Chamber has said today. To date the silence has been deafening and it is time we stepped up and stepped in, just as the Gurkhas have done for us. In his intervention, the hon. Member for Greenwich and Woolwich (Matthew Pennycook) referred to the bravery of the Gurkhas and how they deserved equal treatment simply because they fought in the same theatres of war alongside those who have got the full pension, which the hon. Member for Glasgow North West (Carol Monaghan) referred to, that the Gurkhas do not have.

People have made clear their opinion in signing the petition—as clear as a bell and as clear as it can be. There can be no doubt whatsoever that they do not believe we are doing the right thing, so the issue for us and the Minister, for whom I have the utmost respect, is that we are not doing the right thing, as the hon. Member for Stoke-on-Trent North said. I am sure that those who have already spoken and the shadow spokespersons who will speak afterwards do not believe that we are doing the right thing.

At what stage will we decide to do the right thing by those brave men and their families? It is not just about the soldiers; it is about their families as well. They deserve the pension. They have honoured us. They have delivered and they deserve to have it. How many petitions will it take? How many protests? How many demonstrations? How many hunger strikes? There have already been too many.

The Minister must help us with a response that outlines the steps that will be taken to ensure that parity is restored with the other arms of our armed forces. I read in an article in The Daily Express that one of the Gurkhas who took part in the hunger strike said that he received just £47 a month after he retired, while his British counterparts got £600—a sixteenfold difference.

[Seema Malhotra]

Normally, it is the hon. Member who intervenes on me, so it is a great honour to intervene on him. He makes an important point about the huge difference in payments received. Does he agree that one of the reasons behind that inequality was the assumption that many would go back to Nepal who did not do so, and that we need to understand and address the reality of their lives, not the assumption that was made many decades ago?

[Jim Shannon]

The hon. Lady is right: it is not about the assumption. The debate is about the reality for the Gurkha soldiers and where they are. The hon. Member for Glasgow North West referred to the fact that today such a soldier receives £350 a month compared with £1,200 for former British soldiers—an £850 difference. Is that parity? Is that equality? Is that right? No, it is not, and therefore it is clear to me that we have to try to do something.

When the Gurkhas fight, no one can accuse them of being second-class warriors. Their courage is equal, if not better, on some occasions. They are in a class of their own, yet they demand only parity, equity and fairness. They fought alongside other regiments, more often than not at the forefront in battle, and deserve the same benefits, pensions and welfare as their colleagues have received. How many right-thinking persons could argue that this is not a debt that is owed, and that we have a role to play in ensuring the payment of that debt? I certainly cannot, and therefore I am proud to stand, along with others, with the Gurkhas, as they have stood for freedom and democracy under the banner of our monarchy, and of our Queen, and before that our King.

I understand, of course, that talks are set to begin between the UK and Nepal in the form of a bilateral committee to discuss all Gurkha veteran welfare issues. However, I put on the record that there is a concern, which appears valid to me, that that talking shop will deliver the same results as previous attempts: nothing of consequence. I ask the veterans Minister whether he can tell us, and state for the record in Hansard, what he expects the bilateral talks to deliver for the Gurkhas. That is what we want: delivery for the Gurkhas.

Aviation Sector

Debate between Seema Malhotra and Jim Shannon

Thursday 10th September 2020 Commons Chamber

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I congratulate my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) on securing this debate and the Chair of the Transport Committee on his work, his support and his Committee’s excellent report.

My remarks today reflect the situation around Heathrow, but are not limited to it. I thank and commend the local authorities around west London, and also west London business, Brunel University and others, for their remarkable efforts to come together for local rescue and recovery plans. I also welcome the call for an aviation communities fund from local authorities, particularly to support re-skilling, business growth and infrastructure.

This is a national emergency and the impact of not acting now to secure an aviation deal and to support businesses and aviation communities in the next few weeks will be devastating. The cost to the state will be far greater than the cost of measures to get us through even to the spring, when many companies expect to see demand grow. The message from employers is clear: aviation is much more than airports and airlines. It is the aviation fuel companies, retail, baggage handling, hospitality, security, logistics, facilities management, engineering, airline catering and much, much more. Their needs are different—some are paid for each flight, some are paid per passenger, and some are paid for services such as meals on flights—but their sustained success depends on each other. It is urgent to act now, because section 188 notices are being issued as companies plan for what they expect to be the end of furlough at the end of October.

[Jim Shannon]

One of the suggestions that the unions and others have put forward is that Her Majesty’s Government could mitigate the level of redundancies to recognise that those the hon. Lady has referred to, who could be made redundant, will have been paying national insurance of some 14% and their pensions as employees, while also saving the UK benefits and redundancy payments. Her Majesty’s Government could provide some funding—perhaps 25% funding—for each employee’s wages to retain the skills and, at the same time, ensure that the business can get to January and November next year where it needs to get to.

[Seema Malhotra]

The hon. Member makes a very important point. Indeed, may I put on record my thanks to Unite, GMB and the other unions that I have been working with for all that they have done, day in, day out, to support workers and their businesses? He also makes a very important point about the retention of skills. Airport businesses have said to me that it takes six to nine months to train somebody to work in such a complex environment. Even cleaning an aircraft is as much about understanding security and counter-terrorism as it is about being able to serve all those passengers and the company. I thank him for making that point, because it links to the issue that this is about not just individual employees, but our readiness to recover when the time comes and keeping our businesses in place.

It is important to act now. Tens of thousands of jobs could be saved by a flexible extension to furlough, allowing employers to have employees on reduced hours perhaps, which will mean that families are supported to pay their bills and to stay in work. If the Chancellor and the Transport Secretary do not do this, they are simply passing a preventable problem over to an already stretched Department for Work and Pensions. In Feltham and Heston alone, there has been a 74% increase—to more than 19,000 people— in the number of people on universal credit. The local citizens advice bureau has talked about the level of inquiries it has had on debt. People are now being forced to borrow from loan sharks to pay one bill as another red letter looms.

Prevention and Suppression of Terrorism

Debate between Seema Malhotra and Jim Shannon

Wednesday 26th February 2020 Commons Chamber

[Jim Shannon]

I thank the Minister for that, which is very positive. I always expect positivity from the Minister whenever the opportunity arises, and it very clearly has tonight.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I thank the hon. Member for his very important contribution. Does he agree with me that it may be useful to hear from the Minister about updates in relation to other police forces, and whether there could be a more systematic way in which police forces, perhaps like the Met, update Members of Parliament about where there may be growing threats in our regions or local areas?

[Jim Shannon]

Yes, I wholeheartedly agree. I think there probably is a method in place for doing that already. I believe there is—I know it is done in different ways in this House and outside this House—and I know that the Minister’s role as a former Secretary of State for Northern Ireland gives him a real insight into what happens in Northern Ireland.

I wanted to ask that question because my understanding is that there is a growth in right-wing extremism in the Province, probably masquerading under the proscribed organisations already there. I know it is very important, so could I, for the record, gently refer to the IRA dissident threat? It is still very clearly there for police officers and prison officers, with booby-traps under their cars. A large bomb, destined for the Larne ferry, was found and thwarted by the police and intelligence officers—and a real biggie that would have been for the IRA. Again, however, it shows that police forces are on top of that. It is very clear to me that this is a salient reminder that IRA terrorists and IRA dissidents in particular are just as dangerous in the United Kingdom, as indeed are ISIS terrorists.

The Minister referred to going for the assets. I welcome his comment, but could we have a bit more detail, if possible, for the record? It is so important that the assets of such organisations are targeted and focused on in order to take away the money and the opportunity that they quite clearly have. In Northern Ireland, paramilitary groups are involved in drug dealing, trafficking, protection rackets and all of those things. Again, I understand that the close contacts between paramilitary and right-wing organisations in Northern Ireland and those on the mainland involve all the spheres of fundraising that they are trying to use.

Maraviroc and Progressive Multifocal Leukoencephalopathy

Debate between Seema Malhotra and Jim Shannon

Monday 30th September 2019 Commons Chamber

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I am glad to be able to discuss an issue that I have been working on closely with my constituent, Ms Amarjit Rai. This is an urgent matter and I believe it is important to put this issue on public record and to seek greater flexibility in NHS policy on the commissioning of the drug Maraviroc to treat Natalizumab-induced progressive multifocal leukoencephalopathy, and in NHS England’s approach to individual funding requests. I thank Amarjit, her advocate, Kartik, her consultants and Mary Jo Bishop and Neha Soni in my office, as well as the House of Commons Library, for their assistance with this debate.

In my work on this case, I have been struck by parallels with the campaigns by the late Dame Tessa Jowell on the more experimental use of drugs for very rare conditions, for which there will never be the sample sizes in one country, or potentially across the world, for a full clinical trial, but for which the anecdotal evidence is positive and the patient voice should be heard. Some of my contribution today will be slightly technical, but I hope it will be clear.

Ms Rai was sadly diagnosed with multiple sclerosis in 2013 aged 34. She was prescribed Natalizumab, but sadly as a consequence she contracted PML, a highly rare and often fatal viral disease that affects only a handful of people across the UK. She has since been rendered disabled with no functional use of her right arm. She has other debilitating effects. PML affects the brain by damaging the nerves. The symptoms include muscle weakness, visual disturbance, impaired speech and cognitive difficulty.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for bringing this matter to the House. Does she agree that the treatment of this often fatal viral infection of the brain must be focused on survival rates and that, given that survival rates are better with Maraviroc, it must be available where clinically determined? If it is key to making lives better and halting this disease, we must do everything we can to make it available.

[Seema Malhotra]

The hon. Gentleman makes a point that I will come on to about how the decisions need to be made on the medical evidence and with the voice of the consultants being clearly heard by those making the decisions.

There is no cure for this condition, but two years ago my consultant’s neurologist advised that Maraviroc had had a positive effect on patients suffering from PML in relation to her condition, immune reconstitution inflammatory syndrome in multiple sclerosis. An individual funding request was submitted by my constituent’s consultant, national expert Professor Ciccarelli at the National Hospital for Neurology and Neurosurgery. The application was refused and a subsequent appeal was also unsuccessful—this process went on through 2017 and 2018—seemingly on the same basis as was given to me in writing in October by NHS England, which was that the

“use of Maraviroc for this condition is currently seen as experimental as the current evidence is limited to very small observational studies. NHS England has concluded that there is not sufficient evidence to support the routine commissioning of this treatment for the indications listed.”

The effect on Amarjit was heartbreaking. I met Amarjit and her friend and advocate Kartik. She had a wheelchair and a walking stick, and even the most basic activities were a struggle. She had decided to fund the drug privately from her savings. Maraviroc had remarkable results for her—importantly, that was also the opinion of her consultants—without any side effects. Other treatments that the NHS had sought to prescribe, such as MRIs and monthly steroids, were not just neutral but net negative. Amarjit and Kartik explained the impact that Maraviroc had had on Amarjit’s health and quality of life. I was just staggered when she told me:

“I can talk. I can walk. I can go to the bathroom on my own”—

things that we take for granted. Clinically, the PML lesion appeared inactive and there was a reduction in the inflammation around her brain.

The drug costs around £480 a month, but by the end of June this year Ms Rai could no longer afford to pay for it herself, so she has since been without it. Although her health has been stable so far, such is the condition that it could dramatically change at any time.

Aside from the issue of funding, I have been surprised over the past year by inconsistencies in NHS policy and advice. We all believe in an NHS that is free at the point of need. This is a situation where the patient, leading neurologists and all involved in her care agree that she should have the drug. In November 2018, consultant neurologist Dr Michael Gross, who was also supporting Amarjit’s care as an expert advocate, wrote to Kartik:

“Thank you for confirming further information about Amarjit Rai... Professors Johnson and Ciccarelli agree that this is the appropriate treatment for Amarjit. Long term steroids have already generated severe osteoporosis in 2016 and are not her choice.

You will have already proved in what is an N=1 trial that her treatment would appear to be effective. There will almost certainly never be the size of trials in this rare disorder that would allow a definitive statement by a funding organisation.

I think we have to ask who is making the decision, given that there are now three senior consultants confirming this is the right decision… Quite frankly I am appalled by the lack of humanity that is being demonstrated here.”

In November 2018 I wrote again to the Minister. I received a response from Lord O’Shaughnessy in the other place, who helpfully said the following:

“Maraviroc is not licenced for the treatment of symptoms of PML. There are clinical situations when the use of unlicensed medicines or use of medicines outside the terms of the licence, known as off-label, may be judged by the prescriber to be in the best interest of the patient on the basis of available evidence. The responsibility for that falls on healthcare professionals.”

Sadly, this made no difference.

Following the lack of progress, I wrote again to the Secretary of State in March 2019. I quoted the helpful response that I had received from Lord O’Shaughnessy. The Health Minister in the other place, Baroness Blackwood, responded in May and referred again to the individual funding request process. She stated that the IFR can be considered only if the patient can be demonstrated to be clinically exceptional. She said that

“an IFR can only be considered if the patient can be demonstrated to be clinically exceptional compared to the wider group of patients and is likely to derive greater benefit from the treatment.”

At face value, all of this would appear to be true for my constituent, but the use of Maraviroc is an area where policy appears to be in some confusion.

In response to a parliamentary question I asked in July about the assessment that NHS England has made of the availability of Maraviroc to patients with PML, a third Health Minister, the hon. Member for South Ribble (Seema Kennedy), wrote:

“We are informed by NHS England and NHS Improvement that it does not commission Maraviroc for progressive multifocal leukoencephalopathy… NHS England and NHS Improvement have published a do not commission policy for ‘Natalizumab-induced progressive multifocal leukoencephalopathy in relation to immune reconstitution inflammatory syndrome in multiple sclerosis.’”

That response seems to contradict earlier responses and advice. First, “does not routinely commission” is different from “does not commission”. Secondly, it made no reference to the IFR process, which two Ministers had previously mentioned.

I tabled a further parliamentary question last week to ask what assessment the Secretary of State had made of the effectiveness of Maraviroc in patients with PML. A fourth Health Minister, the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries), responded to my question. The response I received today was mind-boggling:

“Maraviroc is currently authorised for the treatment of patients who are infected with HIV type 1. The Medicines and Healthcare Products Regulatory Agency which is responsible for the regulation of medicines in the UK is not aware of any application for use in patients with PML and therefore cannot comment on the efficacy of this drug in patients with PML.”

It might be helpful if I highlight for the Minister findings from wider medical journals that the House of Commons Library has helped me to compile. In December 2016, the American Academy of Neurology published an article entitled “Severe early natalizumab-associated PML in MS: Effective control of PML-IRIS with maraviroc”. A summary of a case involving a 55-year-old Caucasian HIV-negative man diagnosed with relapsing, remitting MS in 2013 shows that that led to a subsequent diagnosis of PML. Clinically, the patient deteriorated rapidly, according to the article. Oral Maraviroc was initiated six days after his admission. Eight days after Maraviroc initiation, MRI follow-up revealed stable PML lesion size. Over the following weeks, the patient improved continuously. After 25 weeks of Maraviroc treatment, the John Cunningham virus DNA was no longer detectable. Maraviroc was continued and well tolerated at a stable dose. The patient survived both PML and IRIS.

A subsequent article was published by the American Academy of Neurology entitled “Maraviroc as possible treatment for PML-IRIS in natalizumab-treated patients with MS” in December 2016. It cited a 34-year-old man treated with Natalizumab for three years without previous immuno-suppression. After a period of time, the patient was admitted with seizures, headaches, and impaired memory, and an MRI scan subsequently confirmed PML. Twelve months after diagnosis with PML and six months after the start of Mariviroc, PML-IRIS lesions were resolved, and no new MS disease activity was detectable.

An article in 2017 by Steiner and Benninger published by the American Academy of Neurology built the medical explanation for why Maraviroc had been effective in cases of PML in MS sufferers. In summary, the condition for which the cause is believed to be the John Cunningham virus, which infects the central nervous system in patients with low immune conditions, became more prevalent and was observed in around 5% of patients with HIV prior to the availability of highly active antiretroviral therapy, or HAART. The article goes on to describe how the era of

“monoclonal antibodies for immune-mediated conditions such as Natalizumab for MS and Crohn disease heralded another context for PML. As of November 2016, there have been 698 reported cases of PML under natalizumab.”

The research goes on, and it is true that some research such as that published in The Journal of the Neurological Sciences in July 2017 confirms that it does not work in all circumstances, and steroids may be more effective in some patients. However, an article in Neurology Times in January 2018 states that in PML treatment options are limited. Maraviroc has been used successfully in some PML patients to avoid IRIS, although not all patients respond to Maraviroc. It recommends further research and testing in identifying patients at risk of IRIS and tailoring treatments accordingly.

In that context, let me make reference to the urgent clinical commissioning policy statement on Natalizumab-induced PML, which was published by NHS England in March 2018. It said:

“It has been assessed that the development of a full policy is not needed at this time as there is currently little evidence into its effectiveness for this indication”.

I do not believe that that policy statement takes account of all the research available or indeed that which has appeared subsequent to its publication. The research is more nuanced, the medical benefits for my constituent are undeniably clear, and the denial of funding is inexplicable to her and renowned experts in the country.

Maraviroc, or Celsentri, as defined by the European Medicines Agency—formerly in London, it is now based elsewhere in the European Union—is a medicine that is routinely prescribed for HIV. Although it does not cure HIV infection or AIDS, it may hold off the damage to the immune system and the development of other infections and diseases.

Medical research has identified that the JCV most associated with HIV patients with low immunity has found another context in patients with PML. My constituent’s condition is incredibly rare, affecting, potentially, 10 or fewer people in the country. Given that very few options are available, she is not the only patient for whom, in anecdotal studies, the drug Maraviroc has shown remarkable results. With no other options available, my very ill constituent has been paying £500 a month privately for the past year to fund Maraviroc herself, but she can no longer afford to do so. Amarjit’s consultant neurologist and other specialists support her receiving the treatment. There is an irony in the fact that more is potentially being spent by the NHS in a month on treatment and tests that do not benefit her as much, and have damaging side-effects. The IFR system in the NHS should be able to review and respond to that situation on the basis of medical need, and I cannot see how that has been done in this case.

Will the Minister tell me how her Department liaises with and challenges NHS England on cases such as this, and how well-researched the Department’s responses to me have been? Will she tell me with what medical advice the treatment has been refused, although three of the leading experts in the country support it in this rare case, and whether their advice can be shared with my constituent and her consultant, Professor Ciccarelli? Will she also agree to a meeting with me, my constituent and her consultant, and a senior member from NHS England to discuss the IFR process?

This is a matter of £500 a month, and of demonstrable medical benefits to my constituent. I should be grateful for the Minister’s response, and her advice on how we can move forward.

Finance (No. 2) Bill

Debate between Seema Malhotra and Jim Shannon

Monday 11th April 2016 Commons Chamber

[Seema Malhotra]

I will just continue on steel, because it is important also to talk about what is missing from the Bill. This is a serious missed opportunity to provide greater support for manufacturing and steel. The collapse of the steel industry could cost the Government £4.6 billion over the next 10 years. Some 40,000 jobs could be lost, devastating steel-making communities and industries that depend on British steel.

We welcome today’s news that a buyer has been found for Tata’s Scunthorpe steel plant, and we congratulate Unite, Community, the GMB and others who played an important role in the negotiations leading to that deal. However, against that background comes the revelation of a U-turn on business rates by the Chancellor. Before the Budget, the Engineering Employers Federation made a strong case for giving companies an allowance on business rates for plant and machinery, which could have applied to assets such as the blast furnaces in the steel sector. However, we learned from The Times that although the Chancellor was planning to act, he then pulled plans to give Britain’s struggling factories tax relief on business rates.

Why did he do that? The answer, analysts suggest, is that British manufacturing has been sacrificed on the altar of the Chancellor’s obsession with getting a £10 billion Budget surplus in the final year of this Parliament. We wait to see what actually materialises from today’s statement and what actual support comes forward from the Government, particularly for Port Talbot.

The Office for Budget Responsibility revealed that the decision was taken so late that there was no time to change the calculations in its economic and fiscal forecast. That means that its forecast for the level of business investment in this Parliament could well be an overestimate.

Families in Britain are to suffer as a result of another missed opportunity—on housing. By 2025, nine out of 10 Britons under 35 on modest incomes will not be able to afford a home. Rents in the private sector are soaring. So much, again, for a Budget for the next generation.

[Jim Shannon (Strangford) (DUP)]

On that subject, the hon. Lady will be aware that the Residential Landlords Association put forward to the Government some ideas for changes, but those have not happened. One was to give people the chance to buy their houses, and the association was happy to do that, but we have not got that in the Bill. Does the hon. Lady feel that something could be done on that to help?

[Seema Malhotra]

The hon. Gentleman makes an important point, and there are many measures we should explore, particularly as we go into Committee, to support house building and home ownership.

We know from the English housing survey that 201,000 fewer households own a home now than did at the start of the Chancellor’s tenure. That compares with an increase of 1 million under Labour. As of last year, the housing benefit bill is forecast to be £350 million more than the Chancellor intended. It is clear that this country needs a massive programme of capital investment in new affordable homes to rent and buy—nothing less will do if we are to tackle the growing housing crisis. That is why Labour has far more coherent plans to build homes and to make sure we tackle spiralling housing costs. That is the way to control the housing benefit bill.

Today’s report from the Women’s Budget Group shows that female lone parents and single female pensioners will, on average, have seen their living standards fall by 20% by 2020. Women are now set to bear a staggering 86% of the cost of changes and cuts to taxes, tax credits and benefits by 2020. That is worse than the figure of 81% identified last year.

The tax cuts in the Bill are likely to benefit men more than women. It is surely time that the Government conducted a full gender impact analysis of their proposals. That would give the opportunity for greater parliamentary scrutiny.

When it comes to measures on capital gains tax and corporation tax, the Bill must pass two tests: are they fair and are they effective? The Bill confirms that the main rate of corporation tax will be cut further to 17% from 1 April 2020, which will be worth £945 million. If corporation tax, which is already the lowest in the G7, can be reduced yet further, perhaps money can be found and the Government can think again about cuts to working age benefits and public services.

More importantly, a cut to corporation tax will not address the underlying weaknesses of our economy, such as the challenges in productivity, skills and the investment required in infrastructure. Businesses that talk to the Minister as well as to us say that these are the biggest issues affecting their future growth. Connectivity and new technology also require investment.

--- Later in debate ---

[Seema Malhotra]

The hon. Gentleman makes a very important point. That is one of the concerns. It is assumed that the proceeds from those tax cuts will go directly into investment, but the evidence for that does not necessarily stack up. In fact, an estimated £500 billion is not invested in this country at the moment. That is an important point, which is why greater analysis and scrutiny are required, as well as conversations with businesses about what will actually make a difference for them in the long term.

The basic rate of capital gains tax is to be reduced from 18% to 10%, and the higher rate from 28% to 20%. That is set to cost £735 million in 2020 and £2.7 billion over the forecast period. Capital gains tax was paid by only 200,000 taxpayers in 2013, which means that about 0.3% of the population will benefit from a giveaway of more than £600 million in total from the first year. That was not called for or expected. In fact, the Financial Times described it as an “unexpected gift” for wealthy investors. In 2010, the Chancellor told the House that raising capital gains tax was necessary to

“create a fairer tax system.”—[Official Report, 22 June 2010; Vol. 512, c. 178.]

It would be interesting to hear perhaps during the Exchequer Secretary’s wind-up speech what has changed.

[Jim Shannon]

The Residential Landlords Association was keen to see the extension of the capital gains tax relief so that landlords could sell property to their tenants. That is a small thing that could incentivise the whole housing market if it was done in the right way.

[Seema Malhotra]

I thank the hon. Gentleman for his comments, but I think he will agree that the key issue in addressing the housing crisis is the rapid building of new homes and the strategy to deliver that effectively.

I want to make a few comments about entrepreneurs relief and the Government’s new investor relief. We welcome the endeavours to encourage investment, particularly long-term investment. The question will be whether the measures pass the test of what business is looking for: simplicity, stability and a strategic approach to fiscal policy. Our concern is that tinkering is no substitute for a clear, long-term strategy to support investment. That is why we are undertaking a review of tax reliefs to see what the evidence is for what incentivises business investment and provides real value for money. Our aim is to ensure that there is a strategic approach to supporting investment and the transparency around it. Those are questions we will pursue as we go forward into Committee.

We also welcome clauses on the reduction in oil and gas corporation tax and petroleum revenue tax. The Chancellor announced that he would reduce petroleum revenue tax from 35% to zero, and that he would reduce the corporation tax supplementary charge from 20% to 10%. There is no doubt that the struggling North sea oil and gas industry needs support. In fact, we think that the Chancellor could have gone further and announced the measures that Labour has called for. Our bold new proposal to invest in the industry is based on the creation of a new public body, which would be called UK Offshore Investment Ltd, to identify areas for temporary public investment. The purpose of that new body was spelled out last month by the Scottish Labour leader, Kezia Dugdale. It would conduct an open-book review with the Oil and Gas Authority to identify assets that have long-term viability and profitability. That, in turn, would provide the evidence to allow UK OIL to commit to public investment in strategic infrastructure and potentially profitable assets.

Clause 115 gives the Government power, through a statutory instrument, to reduce the VAT rate on women’s sanitary products from 5% to zero. That is welcome, as are the Minister’s comments. I am glad that the Chancellor has finally recognised that women’s sanitary products are not a luxury. However, it is crucial that the clause should set a firm deadline for the VAT reduction, and although the Minister’s comments signalled moves in that direction, they did not go quite far enough. I am sure that we will continue to address the point as we move forward in Committee and beyond. I congratulate Labour Members, particularly my hon. Friend the Member for Dewsbury (Paula Sherriff), and campaigners inside and outside Parliament on their hard work in forcing the Government’s hand on the issue. It is a sad indictment of the Government that it took a Labour amendment and an embarrassing Government defeat to achieve that result.

Where in the Finance Bill is a clause to reflect the Government’s other U-turn, which was on VAT on energy-saving materials? The Government accepted our amendment to the Budget resolution, which allowed the Government to legislate on the matter in the Finance Bill. The lack of legislation and the contradictory and noncommittal answers from Ministers are causing uncertainty in the industry. We simply call on the Government to make a commitment that they will not include a VAT rise for solar or other green energy measures in this or future Finance Bills.

On tax avoidance, the two key issues we face are structural reforms and public confidence. The rhetoric today, as in the past, has sought to be impressive—in the past, the Chancellor has said that aggressive tax avoidance is “morally repugnant”—but the reality has yet to match the rhetoric. Indeed, the tax gap has grown under this Government to £34 billion. Serious measures to tackle tax avoidance, which is estimated to account for £7 billion of the tax gap, will be even more critical.

It is two years since the Prime Minister wrote to UK overseas territories and Crown dependencies calling on them to publish a public register of firms and individuals sheltering money there, yet virtually no progress has been made so far. Today’s statement did nothing to move us forward on such a public register of firms and individuals. Fundamentally, this issue is about a rotten system that undermines the faith of ordinary families in the fairness of our tax system. Indeed, a definitive analysis by the Financial Times shows that the corporate tax avoidance measures that the Labour Government brought in will still raise 10 times as much as those introduced during the last Parliament.

While we broadly welcome the measures in the Bill, we think that they simply do not go far enough. We believe there must be far greater transparency and enforcement in relation to those who try to hide their wealth and profits in tax havens. As ever, the Chancellor and the Prime Minister give the impression of acting tough, while in reality they are proposing half-measures. Instead, as Labour have set out in our tax transparency enforcement programme, we require the introduction of a general anti-avoidance principle that proactively looks at intent and does not need the consent of the tax profession before it can be used.

Our programme includes an immediate public inquiry into the Panama papers, and more resources for HMRC. Staff numbers having been cut by 6,000 and then added to by 670, we can see that there has been a return of about 10% of those whose jobs were cut, and real concerns have been raised about the impact on tax collection as a result. We have called for a specialised enforcement unit and for greater co-operation with European partners on country-by-country reporting and protection for whistleblowers.

Women Entrepreneurs

Debate between Seema Malhotra and Jim Shannon

Wednesday 18th March 2015 Westminster Hall

[Seema Malhotra]

The hon. Gentleman is making a powerful point about older women coming into entrepreneurship. There is no age barrier and someone can start a business when younger or when circumstances are different, but then need to accelerate later. Does he support my call for a more integrated approach to supporting women’s entrepreneurship, which has the backing and support of a range of different Departments where they may have different ways of interfacing with women’s lives?

[Jim Shannon]

I could not have said it better myself. I thank the hon. Lady for that intervention. Clearly, we need all Government bodies to work together to encourage people at whatever age they decide to start a business, whatever the reasons for starting at the time they started, and whether they are caring for a disabled relative or have family responsibilities. Whatever time they start a business, let us encourage them.

The opportunities are endless and it is clear that help and support should be given by the Government to allow people to understand how best they can begin a new business. In Northern Ireland, Invest Northern Ireland, in partnership with the Department of Enterprise, Trade and Investment, has help available. Indeed, it has a mentor programme. Perhaps the Minister and shadow Minister will say whether there is a mentor programme here in the UK mainland. If not, may I suggest they look at what Invest NI and DETI are doing in Northern Ireland? New starts are helped. There is a Training for Women website that has useful courses and guidance, and a lot of other help available.

Women into Business is Northern Ireland’s premier business women’s programme aimed at encouraging and supporting the progression of women hoping to enter or re-enter the workplace through employment or self-employment. Women in Business NI—WIBNI—is Northern Ireland’s largest and fastest-growing network for business women and entrepreneurs. WIBNI has more than 1,000 members and offers events aimed at helping women develop both personally and professionally, and to make connections and ultimately grow their business. WIBNI also offers a variety of free marketing benefits to all members, including publication of their news articles in a quarterly and a monthly magazine.

DETI and Invest Northern Ireland have worked out a strategy to encourage women in business and entrepreneurs in Northern Ireland. My hon. Friend the Member for Upper Bann (David Simpson) mentioned the importance of further education colleges. We see lots of good students coming through and taking up courses. The South Eastern Regional College does tremendous work in Newtownards and in my constituency, Strangford. It encourages young people when it comes to business start-ups and ideas, and helps to move them along the way. There are as many young girls and young women as there are young men involved in that college and those courses, and it is good to underline that as well.

There is an onus on the Government to offer help; more help can and should be offered. Again, I congratulate the hon. Member for Feltham and Heston on raising this issue today and on highlighting the great work that has been done, and the fact that there is the potential for so much more to be done, if only more support were offered.

It must be remembered that the greater the success of new businesses, the greater the benefit to the local economy and to the country as a whole. So, whether a woman wishes to create her own business at home, or open a shop, or indeed five shops or 10 shops—whatever their potential dream or wish may be—the advice and support must exist to help them do so. And the onus is on those of us in this place and in Northern Ireland, where this matter is a devolved one, to ensure that that advice and support are provided.