5,731 spoken contributions under 12 words (interjections such as “Will the hon. Member give way?”) are hidden. Show them
Recognising the answers that the right hon. Lady gave earlier, may I ask her to ensure that before the charter review comes out, she absolutely emphasises the need for radio news? Many people do not get to watch television news—I am sure she will be travelling later today and will not be able to watch the TV. May I ask her at this early stage to ensure that the BBC recognises just how important these radio news programmes are?
My constituents and I are deeply concerned about proposals to develop what would be one of England’s largest onshore wind farms right next to the Yorkshire Dales national park. With turbines as tall as the Gherkin, it would have a huge impact on the visual landscape in one of the most beautiful parts of our country and could damage our precious peatland in the moors, which, as the right hon. Gentleman will know, is a natural resource that we are lucky to have. Will he join me in praising the work of Councillor Thompson and the Hope Moor wind farm action group for organising our community? Will he support both their and my efforts to ensure that our local voices are heard loudly during the process?
Last year the BBC lost another 300,000 licence fee payers. The BBC’s current scale and financial model is clearly unsustainable. Yesterday the BBC announced controversial cuts, including “The World Tonight” and “Money Box Live”, without anyone in Parliament expressing a view. That is not right. The Government appear to be restricting parliamentary debate about the future of the BBC. They announced the BBC charter via written statement, not a debate. They have already ruled out some alternative funding models and consideration of the size, scope and scale of the BBC’s operations, leaving the BBC to take action unilaterally. Will the Secretary of State reconsider the scope of the charter review, and ensure that Parliament has a proper say on the future of the BBC?
I echo the Secretary of State’s introductory comments and congratulate England and Scotland on a great start to the world cup. Since coming to power, this Government have cut funding for school sport, listed places of worship, tourism marketing and so much more, yet they have found billions for welfare, Chagos and inflation-busting pay rises for their union mates. Last Sunday, the Secretary of State went on telly to say that she was in discussions about cutting DCMS spending even further. Well, where and when? And who is to blame: is it the Prime Minister, for his weakness and failure to tackle welfare spending, or is it the Chancellor, for her utter economic incompetence?
We have saved the best till last. I call Dr Peter Prinsley.
Dr Prinsley, you have done yourself proud with that contribution. I call the Liberal Democrat spokesperson.
I thank the hon. Member for giving notice of her point of order. I have received no notice from Ministers that they intend to make a statement on this matter. The House knows that I have no power to compel a Minister to make a statement, but Mr Speaker has repeatedly stated how important it is that significant announcements are made here in this House first. Ministers on the Front Bench will have heard the hon. Member and I, and no doubt they will respond in due course. The hon. Member for Thornbury and Yate (Claire Young) has also informed Mr Speaker that she will not proceed today with her debate on the potential merits of a full ban on fracking.
It is a pleasure to serve with you in the Chair, Mr Dowd, especially on what I think is your birthday—thank you for choosing to spend your special day talking about public toilets with us. I also thank the hon. Member for Strangford (Jim Shannon) for calling this important debate. Not only is he the most industrious contributor to debates and question times across this House, but he champions matters that really cut to the heart of why we are here and that really matter to people in their everyday lives. Anyone who has supported a loved one, family member or friend who has gone through the process of requiring a stoma will realise that you often do two things together: laugh and cry. If you do not do the laughing, you will just spend all your time crying. As hon. Members can probably already tell, this is quite a personal subject for me. A little irreverence and humour is a good way of dealing with the issue of stoma care and inflammatory bowel disease. In fact, I would say it is essential. It also helps to break down the barriers and the embarrassment of talking about the subject in the first place. We have had a good explanation of what a stoma is, namely a surgical opening to allow waste to leave the body. It usually comes at the cost of having significant amounts of intestine, or in many cases the entire colon, removed, which is as painful, damaging and difficult to recover from as you would imagine. However, the conditions that often lead to someone requiring a stoma involve—let us be honest—talking about poo, and the British public are not particularly comfortable talking about. So although the hon. Member for Strangford has outlined what a stoma is, most people are embarrassed about them. As I said, one way people get around that is by having a sense of humour. I have met many people with stomas; a very close loved one has a stoma, and I have met many of the friends she has made over the years during her many hospital stays. Among the things I have picked up on is what you call a stoma once you have one. The names are quite creative, and the naming process is, first, quite humorous and, secondly, about a degree of taking ownership of it. I will run hon. Members through some of the names that people come up with for stomas, so that we get beyond just a “surgical opening”. Some are ones that I have seen in research, and some are from people I know who have a stoma. Most of the names are a play on words, such as a rhyme with stoma, or references to poo or pumping—apologies to Members in advance, but hopefully there will find something in this for one of you. As an opening gambit, there is Paloma Faith, which is a good name for a stoma. Winnie the Poo is another one. Another favourite of mine is Vladimir Poopin, just because it takes the mick out of a dictator. To take something straightforward and simple, there is Windbag, which is pretty much what we are talking about. Captain Craptastic is another good one. Others include Donald Trumps and Bilbo Baggins. Finally, my favourite is Louis Shitton, which I think is excellent—I am delighted to have got that into Hansard. I hope that that gives a bit of insight. People who have had to have a stoma because of their suffering have been through difficult times, but they are remarkably resilient people, many of them with a great sense of humour. Every Member in this House will have a constituent who has inflammatory bowel disease, colonic cancer or another of the conditions that leads to a stoma, and we will all have constituents with stomas—that is beyond doubt. Many conditions can lead to people requiring a stoma, although that will depend on how controllable a condition is in any individual person—whether they get Crohn’s or colitis flare-ups or whether the cancer is caught and treated early enough. Given all those things with a similarity of issues, Members will have hundreds, if not thousands, of constituents who have a stoma or who know someone directly affected. The conditions themselves are embarrassing. It is not just about having a stoma, when you have got to that point; by the time you get to having one, you have usually been through years of having to deal with a condition and having to suffer it in silence, because you do not want to talk about it. There is also a lot of misunderstanding; a lot of people think that Crohn’s and colitis, for example, are some form of irritable bowel syndrome. Even well-meaning people suggest eating less spicy food or not eating brown bread, because they do not realise that the condition generates internal ulcers in the most painful place they could possibly be, and that those bleed internally, creating internal blood clots that need to pass through your system urgently, in an incredibly painful way—whether you had a Madras on Friday night makes absolutely no difference to that condition. Toilet provision is so important for people with stomas as well as those with the conditions mentioned. That is important to remember, because we can look at the number of people with stomas—Colostomy UK has provided a helpful briefing ahead of this debate—but that would give you a very distorted view about the total number who require access to toilets due to health conditions. As other hon. Members pointed out, when someone who has a stoma goes to the toilet, they are either going to empty it or change it. Changing it is not a quick thing and if there is a leak, which is something anybody with a stoma lives in absolute fear of, that needs to be urgently dealt with. Visualise where that would be on your body. Even if just emptying it, the proximity to the toilet means also getting very close to the floor and the toilet itself. People suddenly become experts in the cleanliness of toilets and which companies keep clean toilets and which do not. It goes back to remembering the human in all of this, and not just taking it from a purely clinical and public health perspective. Imagine going through years of dealing with a health condition that leads to needing major surgery that is life changing and life threatening in its own right and results in a stoma. Regardless of your age, but especially for younger people in this hyper body conscious world, that is not something that you want—it is not something that you are proud of—and it is something that you are often embarrassed about and will try and conceal and hide. Imagine having been through all of that and having recovered and just about psychologically coming to terms with having a stoma—and you want to go out. You want to pick up the courage to go out. You find some clothes that for the first time you think cover it so you do not feel self-conscious about it. You go out, you feel sexy, you feel confident. It is a big boost. Then you either need to empty the bag or have the dreaded leak, and there is nowhere to do anything about it. As one of my friends—I apologise in advance, Chair, but I am quoting—said: “Imagine getting dressed up for date night and then having to go and crawl around on a piss covered floor simply to change your bag.” Would that do anything other than knock your confidence, dignity and self-respect? It is not fair. There seems to be a general consensus among forums and things I have read that we men need to have a little more care and attention in toilets than women do and that the standard in male toilets is often significantly lower. However, it is a point none the less. That is what I want to get across in this debate; I do not want to talk about the stats, figures and percentages. Every one of those numbers has a human being behind it who is trying to get on and rebuild their life under immense physical, psychological and emotional damage. That is what makes this so important. There are also other issues including access to private toilets. All of this cannot fall to local councils. I have been working and campaigning on this since I was elected as a county councillor in 2017. I moved a motion in full council—those were the days—around access and the card that people can carry that says they need access to the private toilets in a commercial facility. We have our own experiences of that in our family. These are pre-stoma but they highlight the conditions as well. When shopping you suddenly feel the urge to go, and, as we have already established, you are not having a poo or a pump but are passing blood clots in an incredibly painful way and your body is trying to get them out of your system and you cannot contain it, and poo will come out with them. You are shopping and have decided to go out—even though, as hon. Members have already highlighted, a lot of people plan their journeys around that—you show your card to a member of staff and they point-blank refuse to let you use the private toilets. You soil yourself in the middle of the shop, and then you do not go out for a long time afterwards because of the embarrassment. I do not want to name or shame any individual companies that may have been involved in that example, but if I say that their slogan is “You can do it if you…it”, Members can draw their own conclusions. That chain was horrific. From my lobbying, I believe it has got an awful lot better of late. It is about raising understanding in organisations of what the cards are and why people carry them. That goes back to stigma and the “Not every disability is visible” campaign, which I pushed to be rolled out across Lancashire all those years ago. These conditions are not visible. Someone may look physically well but experience that urgency. We must make sure that people with stomas, advanced Crohn’s, colitis and so on know that they can get a RADAR key. People need to know where the toilets are. Lots of different people have tried this in lots of different ways. We already accept that councils cannot be responsible for providing a toilet in all places at all times. If someone is going to go out and they are dependent on toilets being nearby, they need to know that there is a network of companies and commercial organisations that will let them use their toilets, even if there are not a lot. It is just about pubs and hotels knowing that sometimes, someone may need to come in. I know it is really annoying when non-paying customers come in and use the toilets, but having those apps is important so that people can plan their days out and their journeys with confidence. There are knock-on benefits to the NHS and public health of helping people to have and maintain normal lives post traumatic bowel surgery and helping them with the psychological recovery. If they had to quit work, that could help them to get back into work. Stomas can be noisy. They rumble and pump. They are bowels, just on the outside of the body, or moving to the outside of the body. Dealing with that is hard enough. Therefore, people may not wish to empty or change a bag at work. They may wish to go somewhere near work to do it. They may work on the tools, in an outdoors job where they do not have routine access to toilets. There are knock-on benefits to the Government and to the Treasury of helping people back into work, stopping people becoming ill with mental health issues from lack of confidence and emotional damage, and helping people to manage their condition better so that they are not continuously spiralling and going back into the NHS. It is not just about doing the right thing and the moral obligation to those people. The hon. Member for Strangford has already outlined Colostomy UK’s requests for things that could be advanced through building regulations to make toilets more stoma-friendly and the general need for more public toilet provision. I am sure it will continue to lobby effectively on that. A lot of the time, this is about the role the Government can play in creating awareness among public bodies and organisations about why this is important—the human element that I have tried to outline. This is about people’s lives and the quality of life of some of people who deserve our support the most. It is about simple things, such as making sure that councils have nice, clean toilets, that toilets are open and that people can access information about where public and IBD-friendly toilets are. I am about to start repeating myself, so I shall end my speech, which is probably a personal best for inappropriate Hansard contributions—I look forward to reading them back. Once again, I thank the hon. Member for Strangford for securing this debate. This really is an important topic, and I know the debate will mean a lot to people. As I said, a lot of people with these conditions do not want to talk about it. They want to hide it. They suffer in silence. Their voice will not be heard. They will not contact their MP to ask if they can have better public toilets as they have a stoma or IBD, because they do not want people to know. It is therefore really important that we, as their elected representatives, are their voice. I hope that we can be their voice today, and I look forward to what the Minister and shadow Minister, my hon. Friend the Member for Mid Bedfordshire (Blake Stephenson), have to say.
The hon. Member touches on a point that I started but never finished in my walkthrough of life with a stoma, and it relates to children. I have a four-year-old. I have read the stories of parents trying to deal with children who are months old, not years old, and require stomas. As parents, we know what it is like managing a day out, but imagine trying to manage it for a child with a stoma. Imagine trying to give that child as normal an upbringing as possible. Unfortunately, the reality for that child is that they could face bullying and self-confidence issues from everything that goes with having a stoma. Those parents should be able to plan normal days out and provide normal lives for their children, so ensuring that schools and councils manage public toilets in a way that is friendly to people with stomas is important. I cannot feel anything other than real heartache for families who have to deal with that as they try to do their best by their child.
Having been a councillor and served on the front bench of a council, I know about delivering these facilities, and I feel for councils when it comes to doing so. As has been said, the reality is that even if councils want to do their best, and they know what is best for their local areas, funding is tight. We all know that ever-increasing adult social care bills and so on are creating bigger burdens on local government finances, and statutory requirements will always take priority over other things. I do not want to create a system that ends up costing more than opening the toilets themselves through its complexity and bureaucracy, but it is really important to place some greater requirement on councils to understand the provision and fill the gaps. If the Minister is looking for a commissioner for the crappers in the future, it may be a role for me!
The Minister is being incredibly generous with her time. She probably entered this room and, having seen only one Back-Bench Member, thought this debate would not get close to 4.30 pm—but here we are. I have two points. First, is there a greater role for section 106 moneys, potentially through planning processes, in supporting public toilets? The Minister gave a really good example of creative thinking around ownership of toilets in parks and cafés. My sister will kill me for saying this, but when she was growing up she had a phobia of metal toilets. I think it was actually just a phobia of unclean spaces. A lot of people would rather use a well-kept toilet in a private business, where they will not be judged for using it—provided it is not at the far end and they do not have to walk past all the tables with everyone looking at them—than use a public toilet that, by its nature and because it is not in a manned location, cannot always be guaranteed to be as clean. I think that is a great example. Will the Minister work with colleagues in local government to see whether that can be rolled out more, and consider how section 106 moneys might help to create more of an incentive for commercial operators who might not otherwise be able to afford it, or for whom it might not be viable?
(Urgent Question): To ask the Secretary of State for the Home Department if she will make a statement on the progress made since the publication of Dame Louise Casey’s review into group-based child sexual exploitation, and the impact of recent developments on confidence in the Government’s statutory inquiry.
I thank the Minister for her answer. It has been one year since Dame Louise Casey’s stark and deeply troubling review of group-based child sexual exploitation, known rightly as the rape gangs. She exposed what we now know was a culture of institutional blindness, weak data and fragmented accountability and a reluctance to confront uncomfortable truths and ultimately to stand up for women and girls who have been systematically abused, or a culture where people simply chose not to act for the bigger fear of being labelled racist. It is disgraceful. Deep concerns remain that progress on justice has been too slow, and in some areas is simply superficial. The Minister has rightly warned of a box-ticking culture. This Government talk a good game, but recent ministerial Home Office resignations have raised serious questions about what they are delivering in practice. How does the Minister respond to the deeply distressing but bold testimony of Fiona Goddard, who has bravely highlighted that some of the men convicted of abusing her have been released early, with others potentially due for release soon? These are Labour’s choices, and we warned about them. What action is being taken to rebuild the confidence of the victims in this process? Does the Minister deeply regret opposing measures to prevent early release in such heartbreaking and horrific cases? Finally, how are the Government ensuring that sentencing and post-release supervision reflect the severity of these crimes? I remind the House that we warned them about the consequences of their dire choices for the safety of women and girls. What are they going to do about it? Will anything change before the next election, or is this issue simply in the long grass? Survivors’ voices and community concerns need to be heard. This is a matter of justice, accountability and trust. This Government need to step up and protect our women and our girls.
It is a pleasure to follow the hon. Member for Blyth and Ashington (Ian Lavery). Where to start? Thank you, Madam Deputy Speaker, for the opportunity to contribute on behalf of my constituents. I congratulate the hon. Member for Eltham and Chislehurst (Clive Efford) on securing and opening this debate and on all his sterling work. Like you, Madam Deputy Speaker, I have constituents who stick in my mind and who I want to stand up for. My constituent Robert Ellinor has given me a huge understanding of the terrible injustice in this particular area, just as the Webster family has done in your own constituency. I thank Robert, who is from East Grinstead and who I have known for some time. He has done sterling activity and parliamentary engagement on this subject, which affects him, and with the all-party parliamentary group on haemophilia and contaminated blood. I am keen to raise points on behalf of Josie, from Turners Hill, and her father, Andrew Quin. Much of what I will say today will be her words, on behalf of her father. It reflects much of what my right hon. Friend the Member for New Forest East (Sir Julian Lewis) has said, and it also reflects engagement that I have had with the Cabinet Office on behalf of Josie and her father. Josie writes: “I am writing to you as my family is one of the first 15 families to be asked to begin our compensation claim for the estate of an infected blood victim, this being my dad, Andrew Quin who passed away in May 2020. We are now a few weeks into the claim process and frustratingly and sadly I feel my dad is being completely failed by the core route and I’m doubtful at this point that the proposed supplementary route is going to be any different, for the following reasons: CORE ROUTE: My father was infected with Hepatitis C and developed cirrhosis of the liver, we believe around 2017, which puts him in the severity level 3 of the core route. However, in 2018 my father underwent a 12 week course of Harvoni Hep C treatment… after completion of the 12 week course, it not only failed but at the very same time, my father was also told he had developed Mantle Cell Lymphoma, which could have been a side effect of the Harvoni treatment or could have simply been caused by the Hep C. My father was told he was too ill to undergo full chemo, due to his liver cirrhosis and other ailments caused by the Hep C, and so he did not have the required 2 rounds of chemo needed to qualify for severity level 4. My father died on 16th May 2020 from Hep C liver cirrhosis and lymphoma. What could possibly be more severe than the above? To summarise, my father died because he was infected with Hep C, which caused liver cirrhosis and gave him lymphoma, ‘for which he was too ill to receive the required 2 rounds of chemo’ and consequently he died! Yet my father does not qualify for the highest severity level 4?” That is the highest severity level. Josie continues: “Ironically, had my father’s health not been as severely impacted by the Hep C, he would have been well enough to have had the required 2 rounds of chemo, in order for him to qualify for severity level 4 of the compensation scheme, and may have even still been with us today! I believe my father has been discriminated against for being ‘too ill to receive 2 rounds of chemo’, which I find utterly disgraceful! SUPPLEMENTARY ROUTE: The supplementary route, requires victims to have had at least 12 weeks’ treatment of Interferon, in order for them to be considered for the next severity level, this being a level 3 or a new level between 2 and 3. I strongly object to this as some victims, including my father, had such severe side effects, such as chronic depression and a mild heart attack, etc, that they were un-able to sustain 12 weeks of Interferon. Not that this would even benefit my father’s claim as he is already in severity level 3 due to him developing cirrhosis—i.e. the supplementary route is no help to my father either. To summarise, once again, I believe victims who were too ill to sustain 12 weeks of interferon treatment are being discriminated against. I do not believe anything could be more severe than the death of an infected blood victim—‘a death which was caused by their infection!’ At present neither the core route nor the supplementary route addresses this injustice. I would sincerely appreciate your help and support in this matter—help to identify and rectify this injustice—in order to bring about the rightful justice the infected blood victims deserve. As the family of an infected blood victim, we desperately want to put all the hurt and pain behind us, but we cannot do that if we are still discriminated against and unfairly treated.” This week, Josie wrote to me again. She was very keen that I speak in this debate, and I am very grateful to her. She wrote: “The letter you forwarded me from the Minister for the cabinet office stated that infected blood victims would not be discriminated against for not being well enough to receive treatment, however, IBCA will not recognise this despite my making them aware of what the Minister for the cabinet office stated in their letter. IBCA have stated that in order for them to recognise this statement and not discriminate against victims who were not well enough to have treatment, this statement made by the Minister for the cabinet office would have to be made law.” Josie urged me to raise this issue today in Parliament, on behalf of “all the victims who were not well enough to receive treatment, because as it stands, victims who were not well enough to receive treatment and have died as a result of their infections will receive less compensation than those victims who were well enough to receive treatment and survived. I’m sure you will agree that this is an injustice and needs to be addressed” today. Those are Josie’s words. She and families like hers must get justice and proper compensation, and must feel that the process works for them and reflects the impact on them and their loved ones. We know that all of this is so wrong; we must make it right. I hope that the Paymaster General can give Josie and many families like hers the comfort they deserve.
I thank right hon. and hon. Members from across the House for their thoughtful, measured and often heartbreaking contributions. I would particularly mention the hon. Member for Eltham and Chislehurst (Clive Efford) for securing and leading this debate, and my right hon. Friends the Members for New Forest East (Sir Julian Lewis) and for East Hampshire (Damian Hinds) and my hon. Friend the Member for East Grinstead and Uckfield (Mims Davies), who spoke movingly about cases involving their constituents and the heartbreaking effects this scandal has had on them. The infected blood scandal remains the most devastating treatment disaster in the history of our national health service. The scale of the tragedy—the lives cut short, the families shattered, the trust destroyed—is something this House and indeed the entire country must never forget. The victims of this scandal, those infected and those affected, have spent decades fighting the establishment for truth and justice. Now that the truth has been laid bare by Sir Brian Langstaff’s inquiry, it is the duty of the state—and that means all of us in this House—to deliver that justice without further delay. It is entirely right that we begin by recognising the significant progress that has been made, because the establishment of the Infected Blood Compensation Authority, with the commencement of actual payments, represents a monumental milestone in this decades-long journey. In doing so, I again place on record my profound gratitude for the foundational work done by my right hon. Friend the Member for Salisbury (John Glen) when he was the Paymaster General. It was under his determined stewardship that the Government accepted the moral case for compensation and passed the legislation needed to establish the delivery body to administer this scheme. He faced an incredibly complex technical challenge, but his deep personal commitment to the infected and the affected communities ensured that the crucial groundwork, including the initial framework for multibillion-pound interim payments, was laid. I know that the Paymaster General and the dedicated civil servants at IBCA are building on that foundation and working intensely to stand up a complex compensation scheme from scratch. We welcome the fact that more than £2.1 billion has been paid out to more than 3,200 victims. For those living infected victims who are already registered with existing support schemes, these payments offer a long-overdue measure of financial security and tangible recognition of the horrific wrongs that they have endured. Getting billions of pounds out of the door to those who need it is no small administrative feat, and we support the progress that the Minister and the Government have made on that front. However, it is exactly because we share the Government’s desire to see the scheme succeed that we must urgently raise the profound frustration being voiced by those who are still waiting. Progress for living infected victims on existing schemes has accelerated, but the reality for the thousands of affected victims and the estates of infected victims who have tragically passed away is still one of agonising delay. Since the registration of intent opened, more than 18,500 registrations have been made, yet we know from IBCA’s own figures that the number of payments made to affected individuals—the widows, the widowers, the parents and the children of those who died—remains painfully low. The same is true for the number of payments to those claiming on behalf of deceased infected individuals. There have been thousands of registrations, but only a tiny fraction of claims from estates and affected people have been fully processed and paid. We hear from families across the country who feel that they are stuck in an unbearable limbo. They have watched the inquiry conclude; they have heard the apologies from the Dispatch Box; and they have seen the compensation scheme launched, yet they still wake up every day wondering when their claim will even be assessed. For the families who have lost loved ones, time is a cruel companion. Of course, many of those waiting are now very elderly. Tragically, victims and affected family members are dying before they receive the compensation that they are owed. We must ask ourselves: what comfort is a compensation scheme if it arrives too late? IBCA has stated that it expects to bring in all currently registered claims from living infected people and estates by March 2027. We must push to see if that timeline can be safely accelerated, because for some, even next year is simply too far away. Of course, as more time passes, the real value of the offers reduces. Will the Minister look again at uprating payments in line with the consumer prices index, so that victims and their families are not financially disadvantaged because their claims take longer to process? That brings me to a specific, acute concern that has been raised repeatedly by victims and their families, as well as by hon. Members today. It is one that I urge the Minister to address. It is the issue of the burden of proof, and the requirement to provide evidence that is, in many cases, practically impossible to access. Let me give the House a harrowing example. There are parents who suffered the unimaginable trauma of watching their children die as a result of infected blood products decades ago. Under the current requirements, some of those mothers and fathers are being told that for the claim to be processed, they must provide documentary evidence that they lived with their child at the time. Think about what is being asked here. We are asking grieving parents to source official paperwork from 40 or 50 years ago to prove that their own child lived under their roof. How many of us in this House could easily produce a four-decade-old document proving our living arrangements with our own families? It is not just an administrative burden; it is deeply distressing and re-traumatising. It makes victims feel as though they are not believed. We see similar issues for estates; they are trying to track down decades-old medical records, or navigating complex probate rules relating to relatives who died in the 1980s or 1990s. We understand that the authority has a duty to protect public funds and to ensure that claims are valid. However, we cannot allow the pursuit of administrative perfection to become the enemy of compassion. When the state has been responsible for the systemic cover-up and destruction of medical records, as the inquiry so damningly revealed, it cannot turn around and demand that victims produce those same missing records. The burden of proof must be relaxed. We must always be mindful that we are talking about huge sums of taxpayers’ money, but we need a system that operates on the balance of probabilities, applying flexibility, common sense, and, above all, humanity. We must allow caseworkers at IBCA to display the compassion that Members have spoken about this afternoon. I urge the Government to work with IBCA to review the evidence requirements immediately. We must empower caseworkers to make compassionate judgments, rather than forcing them to stick to rigid bureaucratic checklists that punish the victims of state failures. I know that the Minister shares my desire to see this issue resolved, and the tone of our debate reflects the shared resolve of this House, but good intentions must translate into urgent operational improvements. We need to rapidly scale up the processing of claims for the affected and the estates. We need to ensure that the legal and administrative support that is provided to claimants is truly adequate to help them navigate the hurdles without adding to their distress. The Opposition stand ready to support the Government on any measures needed to expedite the process. We will vote for the necessary resources, support the necessary regulations, and work collaboratively to remove any legislative hurdles. For more than 50 years, the victims of the infected blood scandal were ignored, gaslit and denied justice. This Parliament promised to do everything that we could to right that wrong. Significant progress has been made; we praise those who have worked hard to deliver it and, above all, the incredible work of the many victims and their families over many years, but our promise is not kept until the final payments are made, until the grieving mother is recognised, and until the families who lost everything finally see the tangible justice that they have fought their entire lives to achieve. Let us work together, across the political divide, to tear down the remaining bureaucratic barriers. Let us push IBCA to move faster, to act with maximum compassion, and to finally close this darkest of chapters with the dignity and urgency that the victims so deeply deserve.
It is a pleasure to be responding again to the Leader of the House. It is the day after England started their world cup campaign, and it is fair to say that they already have our hopes up; I am a bit cheered out. Today, many of our colleagues are pounding the pavement for the by-elections. I am sure that the Leader of the House is waiting with bated breath to see if the self-anointed king of the north is shortly to begin his long march south to save the Labour party from the Greens. Or maybe the Leader of the House is waiting more keenly for the next intervention from the former Health Secretary, the right hon. Member for Ilford North (Wes Streeting), bemoaning the Prime Minister’s “poor leadership, poor judgment and bad politics”. While the comedy of errors of this Labour Government is playing out, the serious issues facing our country go unaddressed: grooming gangs, the murder of Henry Nowak, the two-tier justice system, benefits Britain and, in particular, the irresponsible failure of the Prime Minister and this Labour Government to support our armed forces with a defence investment plan fit for the dangerous world we face. The Prime Minister and the Labour Government are prepared to see our veterans subjected to continuing persecution and relentless lawfare. It is a failure of leadership. It is a failure to put our country before party. It is a failure to put our brave servicemen and women before personal political survival. It is a failure to protect those who have fought to keep us safe and free. It is easy to say that the first duty of Government is to protect the country; it is much harder to make the choices needed to deliver on that duty. We know that the root cause of that failure is that Labour MPs put “Benefits Street” before anything or anyone else. The Secretary of State for Work and Pensions kindly confirmed that when he told Peter Mandelson that the only question Labour MPs ask him is: who can they tax, in order to pay more benefits? The Prime Minister did not have the backbone to confront his Back Benchers and tackle the out-of-control welfare bill. There will be £333 billion of welfare spending this year—£18 billion higher than last year. As the Centre for Social Justice pointed out recently, that £18 billion could have been invested in our armed forces. It could have bought 200 fighter jets or 12 warships, or funded 250,000 extra soldiers. Labour is taking the wealth created by hard-working families, small businesses and millions of Britons, and making it clear that in Labour’s Britain, working just does not pay. In Labour’s Britain, “Benefits Street” comes first. That brings me back to Andy Burnham, a twice-failed Labour leadership candidate who has shown that he has exactly the same flexibility of principle as the current Labour leader. This is a twice-failed Labour leadership candidate who thinks that governing will be as simple as out-Greening the Greens—spend more, tax more, repeat. This Labour party can never and will never change. Our armed forces, hard-working families and the small business across Britain deserve better. It is time for this Government to keep their promise, or go.
It is a pleasure to serve on the Committee with you in the Chair, Sir Jeremy. I echo and endorse all the comments made by the shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham, who was comprehensive in setting out our position. I therefore speak from a broad consensus surrounding the Committee that the final days of NHS England as a body are here, and so be it, because there are advantages to be gained from its abolition. The Minister set out some of the leading reasons why she and the Government are abolishing NHS England. She referred to the growing bureaucracy, the unnecessary complexity, and the overlap of roles and responsibilities between the organisation and DHSC. She also spoke about being able to better focus on delivering care rather than navigating bureaucratic hurdles.
The shadow Minister points to a much wider issue entirely relevant to the Government’s plans here: the more reorganisation we do, the more we shrink the bandwidth to deal with smaller and more operational problems because so much of the resource has been pulled in. In my area, although it is probably true everywhere, reorganisation of Department or Government responsibilities causes endless frustration that while Governments and politicians—I take some responsibility for my own side’s actions at times in the past in very limited ways—talk about reorganisation when so much can be done on what might be termed low-hanging fruit. I worry that the Government are missing out on opportunities here to make a much more meaningful difference day to day and much more quickly than this huge reorganisation will achieve. Everything is about priorities. Plainly, no Government can do everything they want to do all at one time. It slightly surprises me that reorganisation of the NHS and doing away with NHS England has become such a major priority, considering it did not feature in the Labour party manifesto just two years ago. I do not seek to put words in the Minister’s mouth, but the gist of her evidence to this Committee was that within eight months of this Labour Government coming into power, they realised that NHS England had to go. Eight months is eight months, but it seems a short timeframe in which to decide to do away with a fundamental way that health is organised and delivered in this country. Going back to priorities, I recall that before the election, the former Secretary of State for Health and Social Care—then the shadow Secretary of State—the right hon. Member for Ilford North, talked about introducing a national care service. That was the Labour party’s big priority. Although Conservative Members and, frankly, the majority of the public were slightly sceptical of his intentions, we all agree that social care needs reform and that ultimately, the success of the NHS will be delivered only if we deal with the long-standing crisis in social care, which extends back three decades or more, as it is entirely dependent on that. Before the election, the priority was the national care service, but since the not-so-random date of 5 July 2024, when the right hon. Gentleman became the Secretary of State, he ceased to refer to reform of social care, and it seems once again to have been put on the back burner. I wonder whether the Government’s plan to abolish NHS England has gotten in the way of equally large, and perhaps even more substantial, reforms, which might ultimately have made a much more meaningful difference to the delivery of not only healthcare but health and social care, as well as to the overall wellbeing, including financial wellbeing, of so many people in this country. Social care refers to people living with frailty or dementia, and the family carers, and families more widely, on whom that has an impact. Every decision made is a decision not made, given the resource and bandwidth of those whom any Government ask to implement change, such as the civil service, advisers and the hundreds or thousands of people who are relied on to deliver in their day-to-day job. I and, it seems, all the other Committee members do not disagree with the fundamentals of what Government are trying to do; their reasons for doing this are broadly sensible, so who could disagree? However, because of the manner in which it is being done, I urge caution and a check on being too optimistic—just doing it and expecting all the good things to flow. It will take an awful lot more than simply passing the Bill to make the NHS the success that, to take the Minister at her word, she intends, wants and will do her best to achieve. Ordered, That the debate be now adjourned.—(Emma Foody.)
Soaring taxes are putting visitors off coming to the UK—that is what the boss of British Airways says. Does the Minister agree?
Oh dear, that is not an answer to the question I asked. My question was about the tax burden on the tourism sector in this country. National insurance is up, and we have new taxes on part-time work. An overnight visitor levy is in the pipeline, and there are extra taxes on air passengers and ferry passengers. This Government’s assault on the Great British holiday has been brutal. It is no wonder young people are struggling to find their first job. Will the Minister recommit to the Government’s target to have 50 million international visitors to the UK by 2030, and will she tell the Chancellor to cut the brutal tax regime in order to get us there?
I approach this with a sense of déjà vu—standing in a Committee Room in the Palace to debate a Health Bill opposite the Minister for Secondary Care, the only difference being that our sides and places have swapped over in the interim. It is a pleasure to be on this Committee opposite the now Minister. I will focus my remarks largely on clause 1. My hon. Friend the Member for Sleaford and North Hykeham raised a number of questions about clauses 2 and 3 and their breadth, but I consider them to be necessary and consequential on clause 1, so I will focus on the points made in that clause, which sits behind them. One thing I want to address is the Minister’s question about why, in the Health and Care Act 2022, the Conservatives did not abolish NHS England. I have to say that arguments were made on both the pros and the cons, but the simplest answer is the context of that legislation. At the time, we were just emerging from a pandemic, and I wanted that legislation to retain a clear focus on my vision for the NHS: a linking of ICBs at the local level with the upper-tier local authorities, so that we could deliver social care through a permissive model, rather than a prescriptive one, allowing that local co-operation. I was also conscious that, emerging from the pandemic, there was only so much that the system could realistically bear while it was still grappling with its immediate aftermath, hence the approach we took. In reality, it cannot be disputed that, inevitably, this is a top-down, centralising reorganisation, and it was not in the manifesto. As Sarah Woolnough said in her evidence on Tuesday: “These arguments were very well rehearsed by the previous Secretary of State. He undertook personally that he would not follow this course of action, exactly because these things take longer and cost more, and because the benefit realisation case is not always clear.”––[Official Report, Health Public Bill Committee, 16 June 2026; c. 10, Q23.] On that point about centralisation, Jon Restell in his evidence said: “Obviously, some functions of NHS England moving into the Department, with powers going to the Secretary of State, feels like a centralising measure… On the whole, it is probably more of a centralising measure.”––[Official Report, Health Public Bill Committee, 16 June 2026; c. 79, Q122.] We have to recognise that this is a centralising measure, rather than any sort of devolution that provides local areas with greater autonomy. For me, there is a worrying lack of clarity at this stage in the process—around 15 months later—on the actual plan and approach. The hon. Member for Lichfield gave a very good speech that not only highlighted the local issues but drew a national read-through from those local examples, and he rightly highlighted that he did not want a protracted reorganisation. However, 15 months on—with the hare having been set running by the Prime Minister’s announcement back in March 2025— we still have protracted uncertainty on what will happen. That is having a very real impact on not only staff but the opportunity cost, through its impact on how services are actually being delivered and what the NHS is focused on. On that lack of clarity, when asked how this measure will work and whether it can save money, Sarah Woolnough of the King’s Fund said: “I think, on the basis of the question, we do not know. Our worry has been about the opportunity cost. The Government, when in opposition, said that they would not launch wholescale reorganisation, because they understood the potential opportunity cost on time and other resources. As this has played out, taking longer than anticipated, we have had multiple examples of teams left in limbo about where they will end up in the target operating model.”––[Official Report, Health Public Bill Committee, 16 June 2026; c. 10, Q12.] Jon Restell also highlighted the impact on staff when he said, “this is becoming psychologically very difficult. You have a change programme that started in March last year with the announcement by the Prime Minister of the abolition of NHS England and the halving of the staff of NHS England and ICBs. For 18 months, that process has dragged on, with lots of design decisions still to be taken about how the organisation will look, what functions it will have, what will be going to the Department and what might be going elsewhere”.––[Official Report, Health Public Bill Committee, 16 June 2026; c. 80, Q125.]
The hon. Gentleman makes his point very clearly and he is absolutely right. Not only is there a lack of clarity in the legislation and in the plans for how the NHS will look, but, as was alluded to during evidence, the missing bit from the Bill, which is highly relevant, is social care. It will be deeply concerning if, when the implications of local government reorganisation emerge from the Ministry of Housing, Communities and Local Government in a few weeks’ time, the two are not properly meshed together, because we will risk, yet again, a widening disconnect between the two vital parts of our health and social care system, both of which have to work well in tandem for the whole system to function. The hon. Gentleman makes a pertinent point. He also highlights ICB budgets. I suspect hon. and right hon. Members around the country are already seeing the genuine impact of those changes to the budgets, which are actually pulling through into the frontline services that our constituents receive. I know that the Minister cares deeply about our health and social care services, and has a wealth of experience from in this place and outside it. Given the comments from our witnesses and the impact assessment, which has page after page listing the risks associated with this approach, I ask her how she will mitigate that loss of focus and that distraction, which is an inevitable human reaction when there is uncertainty. When she comes forward with the plan to merge NHS England into the Department, how will she ensure that she retains the best, most experienced staff? In any organisation where there is a change, it is often the most able and experienced who find it easiest to go to another role, by virtue of their skillset. How will she ensure that there is not a loss or drain of that expertise and knowledge? I turn to a deeply concerning element that links to the lack of clarity. The impact assessment on the abolition of NHS England is pretty much silent on the monetised costs and benefits and specific figures. The first two pages with the boxes and the summary just say “N/A” in pretty much every box on assessing the costs. If I flick through to the section headed “Monetised and non-monetised costs and benefits of each option”, I see page after page. There are lots of words but virtually no figures, and where there are figures, there is no breakdown of how they were reached, and no explanation of the degree or range of confidence in the few figures that are there. I ask the Minister whether a detailed spreadsheet of all the statistics, costs and benefits, risks, confidence levels associated with the numbers, and the phasing over years of savings and costs will be published during the Commons passage of the Bill so that Members of the House can consider it. If not in Committee, could it be published at least before Report so that we can have an informed debate? More broadly, once the Bill in whatever form is passed—I expect, given the Government’s majority, that it will be—what mechanisms will the Government put in place to ensure that when a target operating model and all the other details are available, Parliament will have an opportunity to not only debate them, but have a meaningful say, potentially with a vote, be it through delegated legislation or in the House?
It is a pleasure to serve under your chairmanship, Sir Jeremy. First, I declare a number of interests. I am a consultant paediatrician working in the NHS, a member of the British Medical Association and a member of the Royal College of Paediatrics and Child Health. Like the Minister for Secondary Care, I got into politics after working in the health service. I am sure she agrees that what you see when working in the health service stays with you when working in the House, and that it benefits the House to have people who have done all different jobs working here. The NHS constitution says that health services should “improve, prevent, diagnose and treat both physical and mental health problems with equal regard”, yet in my work as a doctor—and I worked across several hospitals during my training—the gap between the vision of what should be delivered and the reality of what is being delivered has become apparent to me. The answer frequently given seems to be top-down reorganisation. As I will talk about in a minute, such top-down reorganisation has been done so many times but does not seem necessarily to have delivered in practice what it promised. Indeed, to an extent, we seem to be changing things from how they were to how they are to how they were, backwards and forwards. This Government have decided, in pursuit of better outcomes and cost savings, once again to reorganise the health service, and they seek to do so with this Bill and particularly clause 1. Clause 1 formally abolishes NHS England. The clause may have very few words, but they represent one of the biggest changes to our health service in decades. Abolishing NHS England is not just a decision about organisational structure or trimming bureaucracy, but a break with the direction of travel the health service has been on since its inception. Prior to the creation of the NHS in 1948, health services were fragmented: some people used contributory workplace schemes, people who could afford it paid out of pocket, and everyone else relied on very limited state and voluntary provision or went without. In the aftermath of the second world war, the national health service created a state monopoly provider. The Minister of Health had a duty to provide a comprehensive health service free for all at the point of use and a bureaucracy was created to manage it. There was a tripartite split between hospital services, local authority services and independent practitioner services. The hospitals provided secondary care for those with serious disease and those requiring emergency response. The NHS also took over many cottage hospitals in rural areas that had previously been run by GPs, and larger hospitals that used to be run by local authorities and the voluntary sector. At that time, hospital staff were managed by hospital management committees appointed by regional hospital boards. Those boards implemented Government policies and oversaw the budget. Meanwhile, teaching hospitals kept more independence, directed by their own boards of governors. Councils, operating as local health authorities, had a duty to provide several personal health services including health centres, maternity care, home nursing, immunisation and ambulance services—some of those are now provided by NHS England. They also had substantial powers to prevent illness and to care for the disabled. Independent practitioners—GPs, dentists, pharmacists and opticians— delivered services to local communities under contract from the health service. Now they deliver under contract from NHS England and the ICBs. The health service underwent significant reorganisation in 1974, not long before I was born. The main objective at that time was to create a unified, integrated system. Community health services previously operated by councils moved into NHS control. These functions were put under the control of new area health authorities, which took control of most NHS hospitals. Some larger area health authorities had their own distinct management teams, which managed services on the ground—we can look at the current process and ask how it is similar and how it is different. The majority of teaching hospitals lost independent governance, in the way that we, too, are seeing that go back and forth. Above the new area health authorities sat regional health authorities, which were responsible for planning and allocating financial resources. Their members were appointed by the Secretary of State. In the 1980s, Ministers recognised that the system had become very bureaucratic—perhaps similarly to today—and in 1982, area health authorities and district management committees were scrapped in favour of new district health authorities, with the aim of reducing what was in effect a three-layer structure to two layers. The thinking was that the new district health authorities would be closer to local populations, but primary care was left mostly unchanged. Once again, there are parallels with what is happening now. From its inception to the end of the 1980s, the NHS had gone through several waves of rationalisation, but the model remained that of a centrally planned public service. However, during that time, there was an intellectual change—the concept of choice. Previously, people had been happy just to get a health service, which they had not had access to before, but that changed and people wanted choice. We now see the benefits of giving patients choice, and we will hear about how the Government’s changes through the Bill will apparently improve patient choice. Of course, individuals have different values and preferences and live their lives in different ways, which makes it impossible for there to be a single public interest for the Government to pursue. Against that backdrop, the new public management approach to Government administration emerged, advocating for the introduction of market mechanisms and performance metrics—we have heard about the targets that NHS England follows—in public institutions. In theory, if elements of the state could operate more like the private sector, perhaps Ministers could achieve both cost savings and better outcomes. In 1991 the Government introduced market logic into the health service. They created an internal market by splitting the purchasers—mainly, at that time, the district health authorities—from the providers, which were the hospitals. The Secretary of State gained the power to create NHS trusts—hospitals with the freedom to acquire, hold and dispose of assets; make bids for capital directly to the NHS management executive, in the way they might for NHS England; borrow money within limits; develop their own management structure; and employ their own staff with their own terms of employment. Within three years, almost all providers had become trusts. GP fundholding was established, enabling larger practices to receive budgets to buy secondary care on behalf of their patients, but that was short lived and was shelved in 1999. When new Labour came to power in the late ’90s, one might have thought that things might swing back the other way, but in some respects the trajectory was similar. Initially, the Labour Government talked critically about the internal market. In 1998 the then Health Secretary told Members that the Government were “sweeping away the internal market”—[Official Report, 1 July 1998; Vol. 315, c. 314.] and the NHS plan published in 2000 claimed that “the internal market introduced competition but failed to bring improvements.” However, the policy choices of that Government furthered, rather than dismantled, the marketised aspects of the health service. They were saying one thing but, to some extent, doing another. There are similarities with this Bill: we have talked about decentralising power but, as we heard in evidence on Tuesday, many people feel it is more of a centralising Bill than a decentralising Bill. It was clear that the new public management approach had been adopted across the political divide. The NHS plan promised patients more choice about how to access the NHS—a good thing. It promised a system of inspection, accountability and far greater local autonomy. It said: “For the first time the NHS and the private sector will work more closely together not just to build new hospitals but to provide NHS patients with the operations they need.” When GP fundholding went, the Government introduced primary care groups, which meant that GPs, nurses and other staff came together to commission for local populations. Those groups then evolved into primary care trusts, which by 2002 were responsible for spending 80% of the annual NHS budget—a budget that is now distributed by NHS England.
Thank you, Sir Jeremy. I will be grateful if the Minister clarifies at the end, because she seems to be suggesting that Lord Darzi’s report was wrong in some way. He was assessing the NHS at the same time that she was, with the experience of having been a Minister, and made the counter-suggestion. It is not just about what one does; it is about how one goes about it. As we heard on Tuesday, there is in general a plan of what is going to happen, but so many decisions have not been made yet in relation to this. In particular, one of the witnesses from the union talked about how unsettling that was for staff and how difficult it is for staff to be asked to go from the current location to a destination unknown. It is very difficult to make transformation in a direction when it is not clear where one wants to be. In March 2025, the Government announced that NHSE would be abolished. The largest healthcare union described the handling of the announcement as “shambolic”, coming only days after the announcement of a 50% cut to staffing levels at the centre. In the days and months since, Ministers have provided only some clarity about what they are trying to achieve. According to the Government, the restructure will cut red tape, save money, devolve power and improve accountability, all with a view to improving patient outcomes. Those are not new objectives; they are the same objectives that underpinned the creation of NHS England. How is it that the same objectives require dismantling the institution created to deliver them? Again, I just do not understand what has changed the Government’s mind. Let us look at cutting red tape. As a Conservative, I welcome the ambition to make the health service more efficient. My constituents do not want to pay for staff in the Minister’s Department duplicating the work of those in NHS England, particularly when thousands every day are subjected to care that could certainly be improved. On Tuesday, we heard from the former Health Secretary, my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt), that “the bureaucracy has got completely out of hand.”––[Official Report, Health Public Bill Committee, 16 June 2026; c. 33, Q58.] However, that bureaucracy is not confined to NHS England and any medical practitioner will explain that bureaucracy exists across the entire health system. Can the Minister explain how the changes will improve that? Lord Darzi’s independent investigation said that, taken together, there are nearly 80 people employed in regulatory and headquarters functions for each NHS provider trust. Can the Minister say how many people will be in such roles once the abolition of NHS England is complete? Can she talk about how abolishing NHS England will review the volume of paperwork on patient safety, some of which is helpful for patient safety and some of which is not. That was identified by Dr Dash in her report. I remind Members that abolishing NHS England is not a prerequisite of undertaking a robust cost-benefit analysis before introducing changes. We have had difficulty in getting answers on numbers. We have been told that this will save money—£1 billion a year, I believe—but no sums have been produced for us to scrutinise to explain where that will come from. Indeed, when asking questions about where it might come from, it has been quite difficult to establish that. We have heard that the redundancy package will be worth £1.1 billion to £1.3 billion. It does not seem clear exactly where that will come from or how it will benefit patients. It is also not clear how many of those staff will end up re-employed by the new organisation, having received redundancy from the first, and what effect that will have on the country’s finances. More than a year on from the Government’s announcement that they will abolish NHS England, how much progress have Ministers made? In March 2025, Lord Scriven tabled a question about the legislation required to abolish NHS England. In her response, the Health Minister in the other place, Baroness Merron, wrote: “Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements needed to support the creation of a new centre for health and care.” One year later, in March 2026, the Liberal Democrat health spokeswoman, the hon. Member for North Shropshire, tabled a question asking what functions had been transferred over since the announcement was made. In response, the Minister for Secondary Care wrote: “Work is progressing at pace to develop the design and operating model for the new integrated organisation, and to plan for the smooth transfer of people, functions, and responsibilities.” One does not need to enlist the services of Hercule Poirot to see that, one year later, that work has not been done. The Government have no comprehensive plan for how they will abolish NHS England. They can write a line in the Bill to abolish it, but how that will happen, to which clauses 2 and 3 relate, is, as yet, really uncertain.
My hon. Friend talked about how the ICBs have merged. There are lots of different types of reorganisation going on at once: the abolition of NHS England, the changes to local authorities, the introduction of mayors in some areas, and the changes and cuts to ICBs. What effect is that having in his part of the country?
As the hon. Member for Eltham and Chislehurst (Clive Efford) did, I thank the Backbench Business Committee for granting this debate. I pay tribute to him for securing it and for all his work with the all-party parliamentary group on haemophilia and contaminated blood. He puts an awful lot of work into it—it is not like a normal APPG—and we are all very grateful. This scandal is of such a scale that probably every MP has at least one constituent who has been infected or affected, but in my constituency it has a particular weight attached to it because East Hampshire is home to Treloar’s school and college. Treloar’s is an internationally recognised centre of excellence in which incredibly committed people provide the most remarkable level of support, care, nurture and education for children and young people with some of the most profound disabilities imaginable, but it was also the place where, in the 1970s and 1980s, there was the single biggest concentration of people who were victims of these terrible practices. The reason was that at any one time there were 40 to 50 haemophiliac patients there. It was seen as an opportunity to study the disease; the NHS haemophilia centre was established nearby, and it later moved into the school grounds. Treloar’s looms large in Sir Brian Langstaff’s report: an entire section is given over to it. It describes how research objectives were put ahead of the interests of children and how those children were subjected to unethical research techniques, without them or their parents being informed or consulted about the risks attached. As the hon. Gentleman mentioned, of the 122 children with haemophilia who attended the school between 1970 and 1987, only about 30 are alive now. There have been much wider effects, too: the stigma that could be attached, the interrupted education, the long-term mental scarring for the people and their families, and the trauma through families that has lasted for decades. This is a story of lost childhoods and lost futures. It has been my privilege to meet a number of the Treloar’s boys over time. There is one gentleman in particular, Adrian Goodyear, with whom I have been in contact since I was first elected in 2010; he had previously been in contact with my predecessor Michael Mates for many years. In our 2010 debate, I read out a line from one of Ade’s emails to me that haunted me then and haunts me now: “We’ve now lost so many of our friends from the Treloar days—in fact, we stopped counting at 40”. I pay tribute to Ade, to all the Treloar’s boys and to everybody in this community who has kept up the fight, for their remarkable tenacity in seeking justice in the name and memory of their friends lost. I thank the Paymaster General for his continued and consistent positive engagement on the subject. He always comes to these events in person, which I think the House really appreciates. I have a few questions that I hope he will address later in the debate. First, I have been asked specifically to raise the lack of parity between bereaved parents whose child was over 18 and those whose child was younger. I hope that the Minister can comment on that point and on whether a change may be possible. On further elements of the award, I thank the Minister for his letter in response to our exchange at Cabinet Office questions about the special category mechanism and the psychological harm payments, but I continue to receive questions from my constituents about the unethical research awards. The increase in the amount is very welcome, but in our November 2024 debate I asked how the figures had been reached, and even with the higher number I am still being asked that question. Clearly one cannot put a value on this tragic loss or say that any amount of money could compensate it, but even if the answer is that there is no way of calculating such a number, it would be helpful to have that set out. I think IBCA has tried to engage well with MPs, which is welcome, but clearly the administration of the scheme needs to accelerate. Inevitably with these processes, things move relatively well at first with the more straightforward cases, but it becomes harder when we get on to the more complex cases. As the hon. Member for Eltham and Chislehurst says, we are talking about victims who are increasingly elderly and who, tragically, may die before they receive the compensation they have been promised.
My word! My hon. Friend puts it in very striking terms. [Interruption.] I see the Minister indicating that he has heard her question, so I think it is right that I defer to him to say a word about the matter when he makes his speech. As the hon. Member for Eltham and Chislehurst and other colleagues have said, this is not the first compensation scheme that has been set up. Obviously every case is somewhat different and involves different categories of harm, but it seems that every time this happens, processes and systems have to be set up and time is thereby lost. We want lessons to be learned from this scheme, but they should also have been learned from previous schemes. I welcome the fact that the Public Accounts Committee is conducting its inquiry; I hope to hear a commitment from the Minister that lessons will be learned, particularly from that inquiry. The last thing I want to mention is the possibility of a criminal investigation. I know that you and your constituent have been involved in discussions about that, Madam Deputy Speaker, and that you and I have both had discussions with the police and crime commissioner for Hampshire, Donna Jones. This is clearly not a question for this Minister or any Minister—not for the Cabinet Office or the Home Office; it is about the criminal justice system, the police and whether a threshold has been met. But I want to take this opportunity through the debate, without expecting the Minister to respond directly, to say that with all the passage of time, there is a premium on knowing what will happen and if we will move in this regard. Nothing will ever or could ever make up for the multiple failings of the state in this case—from successive Governments, the civil service, the national health service and many more—but we can and must ensure that at this point, we have a compensation scheme that now does pay out in a timely way, and is as effective and humane as possible for all the victims and their families. We must face up clearly to our failings as a state and —let’s be honest—as a political system over those many years, and give truth to that phrase, “Never again”.
The Secretary of State will know that the music and dance scheme supports so many talented young performers from lower-income backgrounds to access an arts education. She will also know that such specialist schools and conservatoires are now subject to VAT, because of changes brought in by her Government. In many cases, the bursaries do not even begin to cover the extreme costs, which are made up by family members, parents and everybody clubbing together to try to find the money. The VAT is still there, and it still makes a difference to whether they can afford it. What assessment has the Department made of the number of families paying VAT on the remaining fees, and how many talented young artists are now unable to attend as a result? I think I heard her right in saying that the bursaries will continue in the 2026-27 academic year, but could she please confirm that?
We now come to the Select Committee statement on behalf of the Science, Innovation and Technology Committee. Dame Chi Onwurah will speak for up to 10 minutes, during which no interventions will be taken. At the conclusion of her statement, I will call Members to ask questions on the subject of the statement. These should be brief questions, not speeches. I emphasise that questions should be directed to the Select Committee Chair and not the relevant Government Minister. However, Front Benchers may take part in questioning.
We now come to the Select Committee statement on behalf of the Justice Committee. Andy Slaughter will speak for up to 10 minutes, during which there will be no interventions. At the conclusion of his statement, I will call Members to ask questions on the subject of the statement, which should be brief questions directed to the Select Committee Chair, not the Minister. Front Benchers may, of course, take part should they wish.
Will the Secretary of State rule out extending the BBC licence fee to streaming services such as Netflix?
Across my constituency, from Hagley to Wythall, from Cofton Hackett to Belbroughton and in the villages in between, it feels as if there is a barrage of speculative planning applications from developers who have been emboldened by this Government. There are around 1 million long-term empty homes in England alone, which would go a long way towards helping the Government alleviate the pressure on the green belt as they seek to deliver their housing target. Can we please have a statement from the Housing Minister on the Government’s long-term empty homes strategy as soon as possible?
Thank you, Mr Speaker, and apologies for not being in the Chamber earlier. The sad reality is that many Christians in the west bank and Gaza face direct challenges for forced conversion to Islam, and in the Holy Lands now there is not an attempt to increase the number of Christians and bear witness. Will the Church reach out to encourage and promote Christianity in the Holy Lands, so that we can see more Christians there, rather than fewer?
I sat on the Housing, Communities and Local Government Committee for 14 years. We saw the first exposé of the scandals of the grooming gangs, particularly in Rochdale and other places in the north of England. Dame Louise Casey came in front of us and made recommendations that have still not been carried out, so full power to the Minister to actually make this happen. The sad reality, as I understand it, is that police forces are resisting the collection of ethnicity data, and indeed resisting investigations into those who turned a blind eye to what was going on with the grooming gangs. Will the Minister ensure that police forces carry out their duties properly and that those who turned a blind eye to what was going on are brought to justice and suffer the consequences of not protecting vulnerable girls?
In addition to the business that the Leader of the House has announced, next Thursday, in the Chamber, there will be a statement from the Work and Pensions Committee on its recent report. The Backbench Business Committee received eight high-quality bids for estimates day debates, and we had to disappoint two. As the Leader of the House announced, we have allocated three debates on each day. I make a plea to him to avoid Government statements on those two days, because the debates are well subscribed and Back Benchers will want to have their say about the estimates. The Backbench business in Westminster Hall on Tuesday 23 June will be a debate on fly-tipping in residential areas and the associated impacts. On Thursday 25 June there will be a statement from the Select Committee on Housing, Communities and Local Government, followed by a debate on the national lung cancer screening programme, followed by a debate on ports and port connectivity. On Tuesday 30 June there will be a debate on Government support for removing unlawful storefronts from, and regenerating, local high streets. On Thursday 2 July there will be a debate on reducing premature deaths from heart disease and stroke, followed by a debate on Government plans to tackle air pollution. Given my experience this morning, I was tempted to ask the Leader of the House for a statement on the performance of London Underground, but as that is a devolved responsibility to the failed Mayor of London, I have something much more joyous to relate: Sunday will be the International Day of Yoga, which has been celebrated across the world since 2015 and will be celebrated next week in Parliament. Personally, I do my yoga stretches first thing in the morning when I wake up. Yoga is now recognised by the national health service as extremely valuable to individual health, and I recommend it to everyone. May we have a statement next week, presumably from a Health Minister, on the benefits of yoga for personal health?
It is a pleasure to serve under your chairmanship, Mr Dowd—I wish you a happy birthday. I welcome the Minister to her place. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate on the provision of public toilets for people living with stomas, which is too often overlooked and too rarely spoken about. He began by saying that although this is not a fashionable debate, the issue needs to be aired, and he was absolutely right about that. He was also right to say that this issue is about dignity and independence, as Members from across the House have said. This debate is important for many people throughout the UK—that is evident from the personal stories that have been shared by hon. Members. My hon. Friend the Member for Fylde (Mr Snowden) described the importance of humour to deal emotionally with this difficult and embarrassing condition, including by naming stomas, which is new to me—I did not know that was a thing; every day is a school day. I have to say that my favourite from his catalogue was also Vladimir Poopin, but maybe that reflects our politics more than anything else. I thank all hon. Members for their thoughtful contributions throughout the debate, particularly in highlighting the human reality of living with a stoma. Around 200,000 people in the UK live with a stoma following surgery for bowel cancer, Crohn’s disease, ulcerative colitis, diverticulitis and many other conditions. I do hope that I have pronounced those correctly—there is a reason I am not a medic. On average, in a constituency such as Mid Bedfordshire, around 200 to 250 people are likely to be living with a stoma. With an ageing population and increasing diagnoses of bowel conditions, this need will grow, not diminish, over time. For those people, a toilet is not a convenience but a necessity, as the Liberal Democrat spokesperson, the hon. Member for Mid Dorset and North Poole (Vikki Slade), said. A stoma bag must be emptied or changed at the moment it is needed. There is quite literally no waiting when it is required. Yet the facilities that most people with a stoma rely on—standard accessible toilets—are frequently not fit for purpose, as my hon. Friend the Member for Fylde eloquently described. Too often, there is no shelf on which to lay out medical supplies, no hook for clothing or a bag, no mirror to help someone change safely, no basin within reach and nowhere hygienic to dispose of used products. I thank the Liberal Democrat spokesperson for highlighting the “Boys Need Bins” campaign, which is an absolutely fantastic campaign that we should all get behind. At present, provision depends on good will rather than on standards, which leaves a postcode lottery for something as basic as using a toilet. The result is people changing stoma bags balanced on their knees or on dirty floors. Someone with a stoma often must plan their entire day around whether a usable toilet exists. I come from a rural constituency and acknowledge what a challenge that must be on days out in the countryside. There is a second barrier, which is one of attitude. A stoma is, in the main, an invisible disability, as hon. Members have said. Many people with a stoma or inflammatory bowel disease report being challenged or even abused for using an accessible toilet, or accused of being “not disabled enough” because they do not use a wheelchair. Simple signage and staff awareness can prevent the confrontations that many people with invisible conditions face. Those attitudes are a stain on us, and it is precisely why Crohn’s & Colitis UK’s “Not every disability is visible” campaign and Colostomy UK’s Stoma Aware work matter so much. I am proud that the last Conservative Government understood that dignity in this area is a duty of the state, not an optional extra. When he was Local Government Minister, the former Prime Minister, my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak), led the drive to expand Changing Places toilets, with larger facilities with benches, hoists and space for carers, which the most severely disabled people need. He set in motion the change to building regulations that, from 2021, made Changing Places mandatory in large new public buildings in England, including shopping centres, stadiums and arts venues. That was backed by a £2 million fund to install them in more than 100 NHS hospitals, further investment in motorway service stations and funding for a national online map so that families could find them more easily. The public sector could lead by example across councils, hospitals and transport networks. The number of Changing Places has risen from 140 in 2007 to around 1,200. That is a record of practical, compassionate action and I pay tribute to the programme, but—I say this candidly—Changing Places, vital as they are, are designed for the most profoundly disabled. Most people with a stoma are fully mobile. The solutions that they need are cheaper: the simple stoma-friendly standard of a shelf, a hook, a mirror and a bin in ordinary accessible toilets. Some retailers—B&Q was mentioned, but I am sure there are others—have shown that it can be done across an entire estate at a modest cost. The additions required often cost less than a few hundred pounds per facility. This is not major capital infrastructure work; it is a small retrofit that has a huge impact on people’s dignity. The building blocks exist; what is missing is national leadership to join them up. When people cannot rely on basic facilities, they withdraw —from work, from shopping and from social life. That is not just a personal loss; there are wider economic impacts, too. Constituents in Mid Bedfordshire have told me that living with these life-changing conditions can be exhausting, isolating and unpredictable. The hidden nature of their symptoms means that they are often invisible to other people, but they deeply impact the daily lives of the people who have them. It is an honour to represent those people at the Opposition Dispatch Box in such a good debate, in which there is cross-party consensus. I would be grateful if the Minister could address three points. First, what are the Government considering doing to make places more stoma-friendly? Secondly, what meetings have Ministers had with Colostomy UK and Crohn’s & Colitis UK to discuss options? Thirdly, what consideration are the Government giving to local government facilities, recognising the interesting proposal from the Lib Dem spokesperson, the hon. Member for Mid Dorset and North Poole, for a statutory duty? This is not a party political issue; it is about whether someone can leave their home with confidence. The previous Government opened the door with Changing Places. I urge this Government to walk through it, finish the job and support people with stomas.
8. What steps her Department is taking to help support the tourism and leisure sectors.
Tourism is vital to Chester South and Eddisbury’s economy. From Snugburys and the Ice Cream Farm to BeWILDerwood and Beeston castle, we are fortunate to have fantastic attractions, and I encourage the Minister to visit them. But as one business told me following the Government’s summer savings announcement: “It feels a bit like having £100 taken off you, then being given £30 back and being expected to be grateful”. The scheme is a drop in the ocean compared with the costs imposed by this Government’s damaging policies. Will the Minister tell those businesses what more she is doing to support the sector, not just for the summer but for the long term?
It is a pleasure to serve under your chairmanship, Mr Dowd, and I join other Members in thanking you for chairing this debate. Also, if your Wikipedia page is correct, may I be the first to wish you a very happy birthday for Saturday? I am grateful to the hon. Member for Southgate and Wood Green (Bambos Charalambous) for securing this debate and to Members from across the House for the thoughtful and serious way they have approached it. The hon. Gentleman really brought to life the way that globally sourced products are infiltrating every part of our daily lives, and I thank him for that. I also thank my right hon. Friend the Member for Chingford and Woodford Green (Sir Iain Duncan Smith) for sharing the benefit of his many years working on this issue. I thank the hon. Member for North Herefordshire (Dr Chowns), the right hon. Member for Hayes and Harlington (John McDonnell), and the hon. Members for Poplar and Limehouse (Apsana Begum) and for Hornsey and Friern Barnet (Catherine West); they all brought different perspectives, for which I am grateful. There have been differences in opinion this afternoon about the causes of the problem, the strength of the enforcement required and the precise tools the Government should use, but there should be no disagreement on one central point: goods produced through forced labour, modern slavery or serious human rights abuses have no place in UK supply chains. The question is whether the Government are prepared to deliver serious enforcement, potentially with the support of new technologies and businesses such as Oritain; or whether they will simply pile fresh cost and complexity on to responsible British businesses while the worst offenders continue to evade accountability. The Joint Committee on Human Rights was right to highlight the fact that goods produced wholly or partly through forced labour are being sold in this country. It is also correct that the current framework has not been enforced strongly or consistently enough to stop that happening. The overwhelming majority of firms—responsible retailers, manufacturers, importers and investors—want to do the right thing. They invest time, money and effort into understanding their supply chains and meeting their responsibilities. They should not find themselves being undercut and placed at a competitive disadvantage by organisations willing to look the other way, nor should they be buried under layers of poorly designed and duplicative new obligations, which create cost and complexity without improving outcomes or catching the individuals who break the law. The Modern Slavery Act, which was introduced by Baroness May of Maidenhead when she was Home Secretary, was a landmark piece of legislation and placed the issue of modern slavery firmly on the national agenda. It was also Conservative Governments that imposed sanctions on those responsible for the persecution of Uyghurs, strengthened export controls, and introduced tougher penalties for businesses that fail to meet their obligations. Those achievements should not be diminished, but equally we should not pretend that enforcement cannot be strengthened. We support enforcing the laws that we already have. The first test for the Minister is whether she is prepared to make the existing framework bite on the bad actors. The task for the Government is to strike the right balance between being strong where enforcement is needed, being clear where expectations must be met, being proportionate where businesses are already acting responsibly, and being practical enough to work in the real world. Public procurement—I include in that Great British Energy, which was raised by my right hon. Friend the Member for Chingford and Woodford Green—has an important role to play in this effort. Government must lead the way. Taxpayers rightly expect that public money is not rewarding forced labour, serious exploitation or suppliers whose conduct falls far below the legally prescribed standards. The challenge is making that principle work in practice, with rules that are clear, usable and targeted at those who break them. The risks exist across apparel, food and manufacturing, and they exist in sectors that are becoming increasingly important to our future economic and national security. Global supply chains were once viewed mainly through the lens of cost and efficiency; the assumption was that they would deliver cheaper goods and greater prosperity. We now understand that they can also create strategic vulnerabilities when too much control is concentrated in too few hands. My right hon. Friend the Member for Chingford and Woodford Green has been particularly persistent in drawing attention to concerns around Xinjiang, polysilicon and critical minerals. He is right to do so. Growth and trade must never come at the price of our values, and pursuit of warmer relations with Beijing must not mean going soft on human rights or turning a blind eye to slave-made goods entering our market. If our standards apply only when the politics are convenient for them to apply, then they are not really standards at all. The framework must address risk wherever it appears, it must apply consistently, it must be based on evidence, and it must be enforced fairly. The Minister has heard the points raised in this debate and no doubt she will address them directly. After the Government’s jobs tax, the Employment Rights Act and a surge of new regulation, businesses are entitled to ask whether labour supply chain plans will be properly thought through and will address their actual needs. I have some straightforward questions for the Minister. When will the Government’s review of responsible business conduct conclude? What steps does she intend to take to strengthen enforcement? How will she improve traceability in high-risk and newly emerging sectors? How will she protect legitimate businesses from unnecessary burdens while ensuring that bad actors and the worst offenders face meaningful consequences? What lessons has she drawn from allies, including the United States, the European Union and others, about what works in practice? How will she ensure that the United Kingdom remains a leader, rather than a follower, in confronting modern slavery and forced labour? Warm words, statements and reviews on their own will not solve this problem. The Modern Slavery Act was a significant Conservative achievement, and we are rightly proud of it. The challenge now is to ensure it is enforced as seriously, practically and effectively as possible. That is the standard that Parliament should expect, and it is the standard against which we will judge the Government’s response.
This week, we have been discussing civility in public life, yet almost a year ago, I formally reported Rutland Councillor Mark Chatfield to the Liberal Democrats for a year’s worth of offensive social media posts, including, I am sorry to say, a racist post against my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak), comparing him to different shades of toast. He has also attacked local journalists, calling for them to be named and shamed, and uses phrases such as “beet-faced Tory expletive” on his social media. What do we do when we go through the formal processes that political parties have put in place but they refuse to do anything at all when their councillors are clearly bringing their parties into such disrepute?