Access to Radiotherapy

Tim Farron Excerpts

Wednesday 12th January 2022 Westminster Hall

[Tim Farron (Westmorland and Lonsdale) (LD)]

It is a huge pleasure to serve under your chairmanship, Mr Davies. I pay tribute to my friend, the hon. Member for Easington (Grahame Morris), for securing this debate and for an excellent speech, which contained some points that I make no apology for repeating because this issue matters hugely.

I lost my mum at the age of just 54. Eighteen years on, of course I still miss her massively; I miss especially the grandmother she would have been. Few issues that we deal with in this place are more personal than cancer. Half of us will have the disease at some point in our lives. Cancer touches absolutely every family.

The good news is that, increasingly, cancer is a disease that need not be a death sentence, partly because of the advances in radiotherapy. Radiotherapy kills cancer cells through radiation targeted at a tumour. It is becoming more and more precise, and is able to cure cancers that would otherwise be untreatable, with fewer side effects, as the hon. Member for Easington set out.

Just over 50% of people with cancer should expect to receive radiotherapy, yet, as has been said, Cancer Research UK estimates that only 27% of cancer patients in the UK actually receive it. The clue to why that is is that the UK spends only about 5% of the cancer budget on radiotherapy. The equivalent average spend of similar countries in Europe, Australia and so on is about 11%. The total budget for radiotherapy each year is £383 million; compare that to the £2 billion spent on cancer drugs every year, even though radiotherapy is eight times more likely to be curative than chemotherapy.

That historic underinvestment—the responsibility of lots of Governments of all colours—is undoubtedly a reason why the UK has some of the worst cancer survival rates in Europe. Lives are being lost needlessly because the UK is so painfully slow at keeping up with and grasping the opportunities that radiotherapy provides. That is why we set up the all-party parliamentary group for radiotherapy, which I am privileged to chair. I send huge thanks to Members from all parties, especially the hon. Member for Easington, to leading clinicians across the country and to the charity Radiotherapy UK, which is led by the rightly much esteemed Professor Pat Price, who has already been mentioned.

We set up the APPG in spring 2018. We booked a room in 1 Parliament Street. A handful of MPs turned up, but 50 or 60 of the leading oncologists in the country turned up and crammed into the room—they would not be allowed in today because of covid restrictions. Why had those people left their massively important jobs for the day, just to come to London for that meeting? It struck me then that it was because there is no radiotherapy lobby. I am not in any way going to criticise pharmaceutical companies, but we know that they are large and they have large coffers. We all get letters most weeks from constituents asking for this drug or that drug to be commissioned, and very often that is right. There is no such lobby for radiotherapy.

Lobbying, in its purest and most fair form, is about being in the room with the people who make the decisions. Radiotherapy has not had someone in the room with the people who make decisions. That is the best I can come up with as an excuse for why this Government and previous Governments, including the one I was part of, have not taken radiotherapy anything like as seriously as it should be taken, why we are investing such a paltry amount in radiotherapy, and why we are so far behind comparable countries.

At the local level, a bad situation is made worse because access to radiotherapy is simply not fair or equal. In south Cumbria, cancer patients have to travel each day all the way to Preston to our nearest radiotherapy centre. The Rosemere unit at Preston is excellent, but dangerously distant. The National Radiotherapy Advisory Group stated that it is bad practice for patients to have to travel for more than 45 minutes for treatment, yet not a single person in my huge constituency reliably lives within 45 minutes of radiotherapy.

Over the years, I have had the privilege of driving constituents to Preston for their treatment. I have seen how people from Kendal, Windermere, Grasmere, Grange, Coniston, Sedbergh and other communities have to make round trips of between two and four hours every day for weeks on end. I have seen their exhaustion and the impact on their health. I have seen people whose lives would have been longer if they had had radiotherapy turn it down, because they physically could not cope with the travelling. I have seen clinicians who have chosen not to refer people for radiotherapy, understandably but sadly, because they knew that their patient’s condition would be made worse by those long, gruelling journeys. In Cumbria, because NHS England and the Department of Health and Social Care will not act, those longer journeys mean shorter lives.

For 13 years, we have run a campaign collectively in Westmorland, calling relentlessly for a radiotherapy satellite unit to be placed at Westmorland General Hospital. We also campaigned to bring chemotherapy to Kendal and were successful in that fight. I am proud of everyone who supported our radiotherapy campaign, but we have submitted petitions with more than 10,000 signatures; I have had numerous Westminster Hall debates; I have met countless Ministers from all three parties that have been in government during my time in Parliament; we have marched for the hospital in our thousands; a team walked from Preston to Kendal just to make the point; 1,000 people wrote detailed, personal, heartbreaking stories to explain why we need the unit in Kendal; and we have demonstrated that there is clearly enough demand for at least one linear accelerator at Kendal, drawing patients from the south lakes, Furness and the western dales. With an ageing population in our community, there is also clearly a growing need.

We have the space at the hospital, designs have been done, the bid has been written and rewritten, and the inaction of managers in NHS England and Ministers in the Department of Health is inexcusable. It is a reminder of why rural communities feel so taken for granted and ignored by the Government and by NHS bosses nationally and regionally. Talk of levelling up the north is meaningless when Ministers appear not to realise that there is 100 miles of England north of Preston until the next nearest cancer centre.

Networked satellite radiotherapy units have been a huge success elsewhere in the country and, once they open, have been shown to increase the number of people able to take up that life-saving treatment. Satellites save more lives. Today, I ask the Minister to instruct NHS England to work with our local trusts in Cumbria and Lancashire finally to deliver our long-awaited satellite radiotherapy unit at Kendal. Our community will listen carefully to her response.

Radiotherapy, as the hon. Member for Easington said, provides the Government and the NHS with their best way through the cancer backlog. Owing to the pandemic, 740,000 cancer referrals have been missed. Therefore, at least 60,000 people are out there with cancer, but undiagnosed. That is terrifying. There is also an enormous backlog for treatment, with people dying as a result. In the Morecambe bay area, about half of cancer patients are having to wait for more than the scheduled 62-day limit to get their first treatment. As the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt), rightly said, it would take the NHS working at 120% of its existing capacity for two solid years just to get back to where we were in March 2020. The need for an urgent and ambitious boost to cancer care is therefore obvious, but we see next to nothing specific from the Government.

Money was pledged for diagnostic hubs, but just on Monday this week, I discovered that in South Lakeland we will not see ours until next year. Where is the urgency? The Government and the NHS have done so well—commendably—on the vaccine roll-out. Why will they not treat cancer and the cancer backlog in the same way, with a ring-fenced and targeted programme to catch up with cancer?

Radiotherapy is covid-secure and non-invasive, carries no infection risk, does not need intensive therapy unit beds or precious operating theatre time, does not compromise one’s immunity, is curative, palliative and, per capita, incredibly inexpensive. We could massively increase capacity very quickly. It has been the stand-out treatment in covid, often substituting for surgery, and it is the obvious first choice for getting through the backlog of cancer cases.

As an all-party group, we first wrote to the Secretary of State on 1 April 2020 to highlight the key role that radiotherapy needed to play to tackle the covid-induced cancer backlog. Since then, multiple spending reviews and Budgets have been passed with no significant investment in radiotherapy. The oft-repeated £130 million announced in 2016 as part of the long-term plan was spent long, long ago, so I hope that the Minister will not trot that out again. Yet a relatively modest investment of £850 million over three years could have a guaranteed and dramatic impact on cancer survival. I hope the Minister will take up the hon. Member for Easington’s request that she meet us as an all-party group and, more importantly, the clinicians, so that we may talk her through this all-party plan backed by the clinicians, which will help her out and help her deal with the backlog.

The Minister should tackle perverse tariffs that do active harm to cancer treatment, and she could do so at no cost whatsoever to the taxpayer—it is about spending the money differently and less foolishly. Staff are restricted from using centres with more modern, precise kit that can treat patients in fewer sessions; instead, they must treat less effectively and over more sessions because, stupidly, the tariff rewards the number of visits, not the precision or effectiveness of treatment. The Government must be pragmatic and accept the offer from the private sector to centrally commission its capacity—at cost and not for profit—to deliver treatment on the NHS to clear the backlog and to save lives.

We must especially care for, value and boost the work- force. Radiotherapy oncologists, radiographers, engineers and physicists—dedicated, passionate professionals —are close to breaking point. The survey by Radiotherapy UK and the Institute of Physics and Engineering in Medicine, to which the hon. Member for Easington referred, showed that 75% of those professionals believe that their unit could not meet pre-covid capacity with the kit they have. Some 80% reported seeing more advanced tumours than ever before in their careers and, as has been said, nearly 80% had thought about leaving the profession.

In Cumbria and right across the UK, radiotherapy treatment and the outstanding workforce have so much more to offer in the fight to save lives than successive Governments have seen fit to acknowledge. All parties bear responsibility for that. I ask the Minister to be a laser trailblazer and to deploy radiotherapy at its full capacity, so we can end needless deaths and catch up with cancer.

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[Maria Caulfield]

I absolutely take that point on board. There are clinical reasons, if a patient has presented later, why radiotherapy may or may not be suitable. Again, they are clinical decisions that a patient needs to be discussing with their oncologist.

The hon. Member for Westmorland and Lonsdale (Tim Farron) raised the issue of satellite units. Again, I would just be slightly careful. Cancer alliances are mapping out cancer services in their areas, and I am very happy to meet colleagues who would like better provision in their local area, but they also need to meet their cancer alliances, which are looking at service provision locally.

I would just caution Members on the issue of having multiple sites for radiotherapy. These are specialist treatments, needing specialist equipment and specialist staff. I went into oncology more than 20 years ago, when surgery was done by general surgeons. They were doing mastectomies on women and colostomies on bowel cancer patients. Moving surgery into being a specialist field, with specialist provision, has transformed the way that we are able to look after women who are going through mastectomies, and bowel cancer patients, who may not necessarily need a colostomy now, because surgical treatments have advanced so much. There is sometimes a rationale for those services to be offered by specialist units, rather than multiple satellite sites.

[Tim Farron]

I want to answer a point that the Minister made earlier. Obviously, during the pandemic, radiotherapy has been used as substitutionary treatment for people who would otherwise have had chemotherapy or surgery, because it is a covid-secure treatment. But my main point is with regard to what the Minister just said about satellites. Has she looked at the data and evidence from those satellite centres that have been opened in the last few years?

For instance, at Hereford, we saw a doubling of the number of patients being treated at that new satellite centre. Why? Well, there was an assumption that the parent centre people, from that postcode, were simply transferred to Hereford. No, it turned out that a lot more people, who would not travel or who were not referred because of the travelling distance for treatment at the original place, were then referred for treatment and therefore had a longer life expectancy because of the satellite centre. With more networking capability, it is of course possible now to treat in specialist ways, with the best people, remotely and through these satellite centres. The Christie has just opened its third satellite, so surely, for more rural communities such as mine, and also in east Lancashire, the time has come to ensure that no one is left behind.

[Maria Caulfield]

There are satellite services—absolutely. We have seen them not just for radiotherapy, but for chemotherapy and even surgery. But it has to be a local decision, because local oncologists have to feel that they are able to support the multidisciplinary team who support the radiotherapy process, ranging from diagnostics through to the treatment itself. That has to be in place, so it does absolutely need to be done on a local basis, but I am happy to meet colleagues if they feel that the case is not being heard locally.

I want to emphasise this point, because a number of hon. Members talked about the commitment to cancer services. Our elective recovery programme has committed £2 billion this year and £8 billion over the next three years to step up activity and tackle backlogs. That will have a knock-on effect in improving radiotherapy access, because some patients cannot have radiotherapy until they have had surgery. Ensuring that we are tackling some of the backlogs to treatment resulting from covid is absolutely important.

There have been huge improvements in radiotherapy over recent years, not just in provision but in technique. We are able to deliver more targeted treatment, resulting in fewer hospital visits, because we can now give radio- therapy to a more targeted area of the body, resulting in fewer side effects from the treatment, and also give fewer fractions of radiotherapy, so that patients can get their total dose much more quickly. That maximises service capacity and minimises patient time in hospital.

Furthermore, we have invested £250 million into two proton beam therapy facilities, one based at the Christie in Manchester and the other at University College London. In addition, all radiotherapy centres in England are now able to deliver stereotactic ablative body radiotherapy. Both these treatments are able to target radiation at cancer cells more accurately, improving patient outcomes. I am really pleased to say that, as part of this year’s spending review, £32 million was made available to support the replacement of 17 linear accelerators aged over 10 years, all of which are on order and will be delivered by the end of March 2022.

NHS England is committed to improving the facilities for cancer patients, and has also offered NHS radiotherapy providers the opportunity to participate in a cloud-based technology called ProKnow. To date, 43 of the 49 radio- therapy providers have joined up. This technology, which will help satellite units, enables clinicians to collaborate virtually within and across organisations, to plan treatments, undertake peer-review assessments and participate in large-scale audits and quality improvement processes, ultimately benefiting patients.

A number of Members talked about the cancer workforce, because it is great to have state-of-the-art technology and multiple units providing radiotherapy, but if we do not have the staff to manage them and provide treatment we shall not make progress. Health Education England is continuing to take forward the cancer priorities identified in the NHS’s long-term plan. It is prioritising the training of 250 nurses to become cancer nurse specialists, 100 chemotherapy nurses and 58 biomedical scientists, and it is updating the advanced clinical practice qualification in oncology.

Further than that, particularly around radiotherapy, Health Education England is investing £52 million in the cancer and diagnostic workforce, increasing the number of clinical endoscopists and training more radiographers in image interpretation. That is all part of the radiotherapy process. As of August there have been an additional 4% of doctors working in clinical oncology, which is the field that manages radiotherapy, and there have been a further 5% working in radiology since August 2020.

We are making progress, but it is not just about the numbers of staff; it is about the skill mix and ongoing staff training. Very often, not being able to expand a role or take on exciting and innovative developments can make staff feel frustrated, but the cancer workforce is growing. Between 2016-17 and 2019-20, the cancer workforce grew by 3,342 full-time equivalents, compared with the ambition of 2,943. We are ensuring that there are more staff coming through into the workforce to deliver radiotherapy.

The shadow Minister touched on the importance of not only recruiting staff but retaining and developing them. I fully take on board colleagues’ comments and concerns. We are committed to investing in radiotherapy equipment, the staff that deliver radiotherapy and the innovation in radiotherapy. We are also committed to making it more accessible to patients, and to reducing the side effects—there are side effects from radiotherapy as well—and to making sure it is a fundamental part of cancer treatment, whether that is in the neoadjuvant setting, adjuvant or for those with metastatic cancer as part of the palliative treatment service.

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[Maria Caulfield]

My understanding is that it is available for stage 3 melanoma, as the hon. Gentleman has highlighted, and that it is still in clinical trials for stage 2. It is available within clinical trials. We expect the data to come forward shortly and then a decision will be made. That is where we are with melanoma.

[Tim Farron]

Will the Minister give way?

[Maria Caulfield]

I will give way one more time.

[Tim Farron]

The Minister is being very kind and I really appreciate it. I have two quick points that I do not think she has mentioned. First, will she take up the request from myself and the hon. Member for Easington for a meeting with the APPG for radiotherapy? We would love to meet her.

Secondly, I do not think she referred to the tariff situation. A lot of the issue is that we need more money. We want the Minister to accept—it is not just her fault; it is the fault of every party in this place, over decades—that we are behind comparable countries and we need to strengthen radiotherapy. The reality is that there are lots of state-of-the-art machines out there, in trusts up and down the country, that are not being used because the tariff is stupid. It incentivises trusts to do second-division radiotherapy, if I can put it that way, because more visits equal more cash, rather than targeted and specific radiotherapy—stereotactic, as she mentioned, for many cancers—because the tariff rewards number of visits, not precision or effectiveness of treatment. Would she look at that? It is free.

[Maria Caulfield]

I am very happy to look at the tariff situation, but my experience is that when a clinical oncologist is referring someone for radiotherapy, that decision is not based on whether they have smaller numbers of fractions as opposed to traditional courses. I am very happy to meet the all-party parliamentary group to discuss that further. I reassure patients that clinical decisions are what decide the type and the number of fractions that a patient needs for their treatment.

Radiotherapy is a priority cancer treatment and this Government are absolutely committed to investing not just in the equipment, but in the workforce that provides it. I say a huge thank you to all the staff across the NHS, particularly in cancer services, who kept going through all the pandemic lockdowns, made sure that cancer patients got their treatment, and helped to support them and their families through what is a very difficult time.

Covid-19 Update

Tim Farron Excerpts

Wednesday 8th December 2021 Commons Chamber

[Sajid Javid]

My right hon. Friend will not be surprised to hear that we will be taking measures to increase substantially capacity in the NHS. He will know that it is not just about beds, whether Nightingale or elsewhere, but having the right amount and type of workforce to help with those beds.

[Tim Farron (Westmorland and Lonsdale) (LD)]

We have a range of measures put in front of us, some of which will perhaps help a little bit, but will not actively control the virus very much, coupled with a colossal attack on civil liberties, which is a strange juxtaposition. Can I ask the Secretary of State to pay special attention to something that the Government have overlooked too much over the past two years, which is to invest in catching up with cancer? What the Government have done through this period is do a great job on vaccine roll-out, but I would love to see them show the same ringfenced dedication and commitment to catching up with cancer, given that we know that at least 50,000 additional people will lose their lives as a consequence of the covid situation.

[Sajid Javid]

The hon. Gentleman is right to talk about the importance of cancer and he will know that it remains a priority for the NHS. That is one reason why recently, when the Government set out the extra catch-up funding for the NHS over the next three years to pay for a lot more elective operations and diagnosis, cancer was a priority in that.

Covid-19 Update

Tim Farron Excerpts

Tuesday 9th November 2021 Commons Chamber

[Sajid Javid]

I can tell the hon. Gentleman that the antiviral drug that he refers to has been approved by the Medicines and Healthcare Products Regulatory Agency. We do have that drug, and since the point of approval last week we have already started deploying it in certain settings across the United Kingdom. We have put an order in for another antiviral, which has had very successful trial outcomes, but it has not received any final approval. If the MHRA independently decides to approve it—of course, that is a decision for the MHRA—the country will be in the fortunate position of having procured that drug, too.

[Tim Farron (Westmorland and Lonsdale) (LD)]

One of the major objectives behind the successful vaccination programme is obviously to reduce infections, reduce hospitalisations and allow health professionals to focus on other, even more dangerous conditions, including cancer. The Secretary of State will be aware that in 2020, there were 35,000 missed cancer diagnoses. The London School of Economics study shows some 60,000 potential years of life being lost to cancer as a consequence of covid, and it is estimated that the NHS’s diagnostic and treatment services will have to work at 120% capacity for two solid years just to get back to March 2020 levels.

I suspect that the Secretary of State was as disappointed as I was that there was nothing in the Budget to help us to catch up with cancer. Will he follow the Government’s good example on the vaccine roll-out and adopt the same relentless focus on catching up with cancer, with targeted resources and leadership? Will he agree to meet clinicians and those involved in the cross-party Catch Up With Cancer campaign so we can work together to save those tens of thousands of lives, which will otherwise be unnecessarily lost?

[Sajid Javid]

The hon. Gentleman is absolutely right to raise the importance of cancer. For all the reasons he set out and more, it has remained an absolute priority of the Government and the NHS throughout the pandemic, despite the huge pressure that the NHS was under. Sadly, he is also right—I have spoken about this, just as he has—that many thousands of people went undiagnosed because they were asked to stay away from the NHS to protect it. We all understand why that happened, but sadly it had an unintended consequence. He is not right, though, to suggest that there was nothing in the Budget or the accompanying spending round to help with that problem. I draw his attention, for example, to the billions of investment in the new community diagnostic centres. There will be more than 100 across England, which will mean it will be much easier and quicker for GPs or others to refer people with suspected cancer for diagnosis. There are other examples, but I hope he is reassured that this remains an absolute priority.

Covid-19 Update

Tim Farron Excerpts

Monday 6th September 2021 Commons Chamber

[Nadhim Zahawi]

I can give my hon. Friend that reassurance. We have a pretty substantial outreach programme, including webinars with midwives so that they are given all the available tools to ensure that pregnant women are given the protection that they so vitally require.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The effective cut-off for care home staff to get their first jab in order to comply with the Government’s deadline is just 10 days away, and those who are not double-jabbed in time will not be able to work in care homes. However, there has yet to be any unequivocal guidance on who will be exempt from this, and care home managers in my constituency are desperately concerned, especially in the light of the most unprecedented care home staffing crisis in a generation. They are desperate for that guidance. Will the Minister provide it today?

[Nadhim Zahawi]

The hon. Gentleman is absolutely right: 11 November is the date by which care homes and care home providers will have to comply with the legislation on the vaccination programme. I would be happy to share with him the guidance and the communication that we have sent out to the sector, and I will write to him after this statement.

Health and Care Bill

Tim Farron Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Tim Farron (Westmorland and Lonsdale) (LD)]

Will the Secretary of State give way?

[Sajid Javid]

If it is on this issue, yes I will.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Just a reminder that interventions need to be short and to the point, because there is a lot of pressure on time in this debate.

[Tim Farron]

My point is about boundaries. Lancashire and south Cumbria have a perfectly reasonable boundary, but does the Secretary of State agree that there is concern that, because most rural communities are attached to bigger, more populated urban ones, that can lead to an imbalance in decisions? One of the proposals that our community faces is that the Preston and Lancaster hospitals could be replaced by a single super-hospital somewhere in the middle. HIP2—the health infrastructure plan 2—is a good thing, but that would be very bad thing, because it would mean that people in south Cumbria could have a two-hour round trip just to get to A&E. Will he intervene and ensure that any proposals under HIP2 that undermine access to healthcare in rural communities are taken off the table?

[Sajid Javid]

I listened carefully to what the hon. Gentleman said. As I have said, no final decisions have been made, but if he would like a meeting with a Health Minister, we can arrange that so that the matter can be discussed further.

I am also very grateful to another of my predecessors, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), first for his leadership of the Health Committee, whose valuable report and recommendations we have taken on board, and secondly for his tireless dedication to the cause of patient safety, which sees its culmination in the Bill’s creation of the Health Services Safety Investigations Body. We must continue, in his words, that quiet revolution in patient safety. I have asked my officials to consider whether the Care Quality Commission could look broadly across the integrated care systems in reviewing the way in which local authorities and providers of health, public health and social care services are working together to deliver safe, high-quality integrated care to the public.

Social Care Reform

Tim Farron Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

My hon. Friend is absolutely right. The proposals in the health and care Bill are just a step on the road to reform, but they are an important step. That step includes the joining up of health and social care in integrated care systems and putting those on a statutory footing, and the oversight arrangements for social care provided and commissioned by local authorities. We will be building on those plans in our long-term plan for social care reform.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I am sure the Minister will agree that the two conditions that people most fear getting at some point in their lives are probably cancer and dementia. Yet, if someone gets cancer, the NHS will take care of them and the taxpayer will fund their treatment; if they get dementia, broadly speaking that is not the case. As has been said already, surely the only way through this is a significant injection of money. That means being honest with the British people that, collectively, we will have to pay for it. Does she agree that we would be right to say to the British people that they should pay an extra penny on income tax for social care, so that people do not have to lose their home and their dignity if they lose their health?

[Helen Whately]

I would not want to upset the Chancellor by talking about tax policy at the Dispatch Box, but, as I have said to colleagues—and, in fact, as the Prime Minister has said—one of the things that we are committed to as part of our social care reforms is ensuring that nobody should have to sell their home to pay for their care.

Covid-19 Update

Tim Farron Excerpts

Monday 14th June 2021 Commons Chamber

[Matt Hancock]

This change is emphatically not for the purpose of protecting those who have chosen not to get vaccinated. It is emphatically to ensure that we have the time to offer the jab—both first jabs to all adults and second jabs for those who have had their first. To go through the data on that, currently, 93% of over-40s have had their first jab, but there are still 4.5 million who have not yet had the second jab. We can get through the majority of those over the next four weeks. Then, of course, we have been able to bring forward the date by which we will have offered a first jab to everybody. This is about the ability of the people who want to come forward to get jabbed to do so, and that is what we will achieve by 19 July to that degree. I hope that we end up with an uptake of almost 100% by the end of this; the uptake figures have been absolutely astonishing, so we will keep offering, we will keep encouraging people to come forward and we will keep trying to make the system and the vaccines as accessible as possible, but the thing that is in the direct control of the Government—subject to supply, of course—is the offering of the jab, and that is the commitment that we have made by 19 July.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The Secretary of State will know that the hospitality and tourism industry has probably been hit more than any other part of our economy throughout this period. One of the challenges at the moment is that the ongoing restrictions mean that hospitality and tourism businesses need more staff than normal in order to cater for fewer customers than normal. Is he aware that the biggest single issue raised with me by hospitality and tourism industry bosses in the lakes and the dales is a lack of staff? This lack of staff is largely caused by the Government’s new visa rules. Would he agree to get his Immigration Minister friend to sit down with me and, more importantly, hospitality and tourism leaders from Cumbria and other rural areas—and other parts of the country involved in tourism—to discuss an emergency way of getting that vital boost to our hospitality and tourism industry just now?

Coronavirus

Tim Farron Excerpts

Thursday 25th March 2021 Commons Chamber

[Tim Farron (Westmorland and Lonsdale) (LD) [V]]

As my hon. Friend the Member for Twickenham (Munira Wilson) said a moment ago, Liberal Democrats will not support the proposals on the table today. We consider the request for extended powers for the period of time to be an overreach—these are powers the Government do not need, and certainly do not need for a period of six months, taking us right into the autumn.

My great concern is that the Government’s default, knee-jerk attempt to seek these draconian powers for a lengthier period is beginning to fit into a pattern. We saw the Police, Crime, Sentencing and Courts Bill in this place just a week or so ago, under which the Government are seeking powers to incarcerate people for up to 10 years if they protest against the Government. We are also seeing reports of the Government wanting to force carers to be vaccinated, when they have done so by choice already. That shows a complete lack of respect and tenderness towards people who have put their lives on the line for this past 12 months and longer to support others in their deepest moment of need. Of course we now have pub landlords being asked to be, in effect, border guards in their own pubs and to check a vaccine passport.

All this seems to indicate that we have a Conservative party in government that loves talking about liberty until it has to do something about it in practice, and when it comes to dealing with these issues in practice, its instincts are authoritarian. As always, if you care about liberty, you need your Liberals—and so the Liberals are guaranteed to be voting against this draconian set of powers on the table today. It is also worth bearing in mind that I do not think the police are crying out for additional extensions to their powers. What they want is two things: resources and clarity in the guidelines and laws that they do seek to enforce.

Throughout this pandemic the strictness of the laws has not been the issue; it has been the clarity of the guidance. The Government have very often been contradicting themselves, mixing messages and sending out the wrong messages, as well as not keeping the guidance themselves as individuals and therefore setting a terrifyingly awful lead.

I want to make just one suggestion. On the road map out of this difficult time that clearly we are all experiencing as a national community, outdoor education has no place whatever. We know when nightclubs are going to open, but outdoor education facilities in my constituency in the lakes and dales, and across the rest of the country, have no date for reopening. The Government are killing off a vital industry that is there to support our young people. Its skills are especially needed at a time like this, when we want to reconnect young people with a love of learning.

The lack of a date and of bespoke funding is killing off outdoor education. My friend Kirsty Williams, the Minister for Education in Wales, announced just the other day a particular package for outdoor education centres in Wales. There is a package in Scotland and Northern Ireland. Why is there not a bespoke package for outdoor education centres in England today? Today is surely the day for them to do just that.

It is also worth bearing in mind that as people become able to move in significant numbers, as of next Monday, to beautiful places such as the Lake District, we need—and have needed for some months now—investment in popularising the countryside code. That is so that people know how to behave in beautiful places, how to treat the local residents with respect and how to look after the environment that they have come to enjoy. I am pleased that the Government are, as of the Easter weekend, putting resources into the countryside code. They should have done it nine months ago when we asked them to.

My final point is about hospitality and tourism businesses beginning to reopen. They will not all be able to open at capacity when they are allowed to. That is why financial support for them must continue until the autumn.

Health and Social Care Update

Tim Farron Excerpts

Thursday 18th March 2021 Commons Chamber

[Matt Hancock]

I am currently working with the NHS to answer that question, which is a characteristically acute one from my hon. Friend. We are not yet able to answer it simply because the pace at which we can return activity to full, normal levels is not yet clear because the main barrier to that recovery is a combination of infection, prevention and control and the need for staff to get some R and R. We will know more in the coming weeks and months.

[Tim Farron (Westmorland and Lonsdale) (LD) [V]]

There was no mention of cancer in the Secretary of State’s statement, nor a single penny in the Budget to boost cancer services, despite the fact that Macmillan Cancer Support’s figures show the need to increase all cancer services by 10% for a solid 15 months, starting now, to clear the cancer backlog.

Macmillan also says that there are 37,000 people with cancer who are not even in the system yet. Given the scale of this crisis, will the Secretary of State agree to set out an urgent, ambitious and funded plan to catch up with cancer, so that tens of thousands of people do not unnecessarily lose their lives?

[Matt Hancock]

The need to catch up on the backlog is there across all elective operations and of course that includes those for cancer. The good news is that the NHS has worked incredibly hard, especially in this second peak, to make sure that cancer services have remained working and effective as much as possible. Some cancer services have in fact delivered more than their normal pre-pandemic levels of care. The hon. Gentleman is absolutely right that we have to make sure that any backlog is reduced—that is a critical part of what I have been talking about today.

Covid-19

Tim Farron Excerpts

Monday 22nd February 2021 Commons Chamber

[Tim Farron (Westmorland and Lonsdale) (LD) [V]]

My constituency has the highest proportion of its workforce on furlough of any constituency in the entire United Kingdom. There has been a sixfold increase in unemployment, and it is obvious why. It is because hospitality and tourism is comfortably our biggest employer. We have the Lake district, the Yorkshire dales and vast swathes of Cumbria so beautiful that they could not find a national park to put them in. For the people working in those sectors, the reality is that many businesses have gone to the wall already. Many, many more have survived, and they have done so because of the support that they have received. That was a wise decision that the Government took 10 months or so ago as we entered the first lockdown.

I encourage the Government not to throw away that investment now by penny-pinching towards the end of this pandemic crisis. The simple reality is that, yes, furlough is of vast importance for so many businesses to be able to keep their heads above water, but perhaps a quarter to a third or even more of their outgoings is nothing to do with staff; it is other overheads that they simply have no income or savings left to fund. Those are the businesses that are going to the wall by the week now in Cumbria and other tourist hotspots around the country.

I urge the Government to do four things: first, to extend the business rates holiday; secondly, to extend the VAT cut; thirdly, to extend furlough and to say they are going to do it right now, not delaying it until the Budget next week, because that confidence is what businesses lack, and that is what is pushing so many of them to the wall; and fourthly and finally, a specific grant package to deal with the simple fact that without any income or any savings now many businesses, though they can see the light at the end of the tunnel, might not make it to the end of the tunnel.

I must also make a further plea. After 11 months, what is preventing the Chancellor of the Exchequer from investing something to support the 4,000 people in my constituency—and perhaps 3 million people around the country—who have been excluded from any kind of support whatever, and who now face destitution as they seek to pay the rent or the mortgage and to feed their kids? I am talking about those people who are self-employed, but have been so for less than two years, those who are directors of small limited companies, taxi drivers, hairdressers, personal trainers and the like. Why will the Government not support the excluded? It is not too late for them to do so.

Let me make a final, very local point. As we pay tribute to all those people doing everything they can to serve our communities at times like this, I think about people working in social care and public health as well as the wider NHS, people working in schools, and people dealing with those who face housing need or who are looked after by our local authorities. Today Cumbria’s local government has announced a plunge into a top-down restructuring; what a witless waste of everybody’s time.