Tuesday 16 June 2015
[Mr Philip Hollobone in the Chair]
Iran (Proposed Nuclear Agreement)
I beg to move,
That this House has considered Iran and the proposed nuclear agreement.
It is a pleasure to serve under your chairmanship, Mr Hollobone. This is an opportune moment to consider once again the proposed nuclear agreement regarding Iran. It is opportune because an outline agreement was presented on 2 April 2015, and it is expected that a full agreement might be reached by the end of this month. It is therefore right and proper that Parliament should once again consider the issue.
This debate follows the good and positive Back-Bench business debate held in November 2014, during the last Parliament. Since then, a number of parliamentary questions have been asked of the Government, and several statements have been made. On top of that, by way of context, it is important and relevant to consider the report published by the Select Committee on Foreign Affairs during the last Parliament. The context extends beyond this place to the outside world, and we need to be aware of it. The debate is opportune. I shall ask the Minister a significant number of questions, to which I hope he can respond. It is relevant to ask those questions before an agreement is finalised, as there are genuine concerns across the House about the details of the proposed agreement.
To start, we must ask what the intention is of any proposed agreement. That is crucial. My understanding was that initially, the aim of any nuclear agreement with Iran was to deal with non-proliferation and ensure no further development of nuclear weapons in that country, yet given the developments that we read about, it appears that the discussion has moved from being about a non-proliferation treaty to being about something more closely related to an arms control treaty. That is an important, but not necessarily positive, development. The original talks between the P5+1 and Iran definitely commenced on the basis of a non-proliferation treaty.
I congratulate my hon. Friend on securing this debate. Does he agree that the proposed deal seeks to legitimise Iran’s nuclear activities, such as enriching and stockpiling low-grade uranium, for which there is no civilian use whatever? We are talking about a country that is one of the world’s largest—if not the largest—state sponsors of terrorism.
Order. That intervention was perfectly legitimate and in order, but I say to all Members present that there are a lot of Members here and we have only 90 minutes, so it is not my intention to call anybody to make a speech who makes an intervention beforehand. I want to ensure that everybody has a chance to have their say.
Thank you, Mr Hollobone. There is some merit to my hon. Friend’s points, but I called this debate to see what the Foreign and Commonwealth Office’s view is of the potential context and contents of any proposed agreement.
A bilateral arms control treaty is not what our partners in the region are looking for. In preparing for this debate, I was fortunate enough to be briefed by representatives of the Bahraini Government on behalf of the Gulf Co-operation Council, and it is fair to say that our partner states in the Gulf have specific concerns about how significantly the proposed treaty has moved from what was originally intended. One of the most striking comments made by the representatives of the Bahraini Government was that they felt increasingly as if they were being treated by the P5+1 similarly to how eastern European countries were treated when there were arms control treaties between the US and the Soviet Union. If that development is concerning our allies in the GCC, the Government should take that seriously.
I congratulate my hon. Friend on securing this important debate. He mentioned the GCC and Bahrain, but another linked point is Iran harbouring and sponsoring terrorism in Yemen by supporting the Houthi rebels to destabilise the region, as well as in Syria, Iraq and Lebanon, in addition to supporting Hamas in Israel. We cannot have a nuclear agreement with a state that is sponsoring and harbouring terrorism. It is a short-term fix for a long-term problem for the international community.
My hon. Friend makes a pertinent point, which was certainly reflected in my discussions with the representatives of the Bahraini Government last week. The fact that good intentions are being taken for granted in relation to the treaty is being questioned by some of the Gulf states, which have concerns about Iran’s foreign policy objectives, to put it mildly, in that part of the world. It is important when we consider the potential treaty that we take into account the views of not just the P5+1 but partner states in that part of the world.
Does my hon. Friend not feel that what he has described as the thoughts of the Gulf states are increased by the attitude to the detail, including about centrifuges? If Iran is allowed to retain 6,000-plus centrifuges against the original estimate of 1,000, that is clearly a bad sign.
I fully endorse those comments. I will address the issue of the centrifuges in due course. It is reasonable to say that the figure of 6,000 now assumed to be part of a proposed treaty is significantly in excess of the 1,000 originally discussed by the P5+1 when the negotiations started. The question whether that is actually in the treaty must be addressed.
I do not want to be described as a cynic, but it is fair to question whether the agreement is actually an effort to resolve the issue, or whether it is effectively an effort to ensure a foreign policy legacy for the current American Administration. I am making this contribution in the spirit of the Back-Bench business debate held in November 2014. I think that there is a genuine realisation that we need an agreement, but must that agreement be rushed to achieve a foreign policy goal for a US Administration who might not be in place for very long? We need some certainty on that.
Many of the Gulf states—my hon. Friend mentioned Bahrain, but obviously this includes the United Arab Emirates and others—are nervous about Iran’s intentions. Iran knows that we want a deal, but it clearly understands the timetabling, and that it will be much easier to leverage something advantageous to Iran if we are working to a timeline that is affected by legacies in the United States of America or anything else.
My hon. Friend makes a fair point. The key thing is that the proposed treaty stands or falls on its own merits. It should not be subject to a timetable pushed on the basis of others’ priorities. That certainly came across in my meeting with GCC representatives prior to this debate.
We must ensure that the agreement satisfies the concerns of our allies in the middle east. In addition, it is important to clarify whether major concessions have been made by the P5+1, as current rumours about the agreement’s content would indicate. It is important for the Government to say what concessions have been offered in return for the ones that have been made, for example, in relation to the number of centrifuges. We need an outline of the concessions made.
To return to the Back-Bench business debate held in November 2014, I am glad to see my hon. Friend the Member for South Norfolk (Mr Bacon), who was one of the Members who secured it. It was a positive debate, in which a range of opinions were expressed about the intentions, or otherwise, of Iran, and about the historical context of any proposed deal. There were fine speeches that highlighted the missed opportunities in the past for an agreement with Iran. It would certainly benefit any Member who is interested in this subject to reread the debate, as I did prior to coming to Westminster Hall today.
I was struck by the very fair summary of that debate provided by the Under-Secretary of State for Foreign and Commonwealth Affairs, the hon. Member for Bournemouth East (Mr Ellwood), who is also here today; I welcome him back to his position in government. He concluded that debate in an excellent manner by saying clearly:
“It is right that we should leave no stone unturned in the quest to”
reach an agreement,
“but we must not, and will not, do a bad deal. The stakes are too high.”—[Official Report, 6 November 2014; Vol. 587, c. 1034WH.]
Those comments can probably be endorsed by everybody here today. However, we need certainty that a proposed deal or compromise, which is rumoured to include significant concessions, is the right deal; we need reassurance on that.
What are the main concerns? My hon. Friend the Member for Henley (John Howell) mentioned centrifuges, and I have to mention one of the biggest challenges in this debate: how do I pronounce “centrifuges”? Initially, the aim of the P5+1 was to reach an agreement that would allow Iran to maintain 1,000, or possibly 1,500, centrifuges. In the Back-Bench business debate in November 2014, the then Chair of the Foreign Affairs Committee stated that the evidence that the Committee had heard as part of its inquiry was that the maximum number of centrifuges that Iran should be allowed was between 2,000 and 4,000. It is said that 4,500 centrifuges will allow the production of 25 kg of highly enriched uranium within a six-month period, yet we hear a rumour that an agreement will allow Iran to have 6,000 centrifuges. We can do the maths. We would be looking at 25 kg of enriched uranium within not six months, but four. There is a real question as to why the demands of the P5+1 have changed so dramatically and what concessions have been offered in return. We need a response to that question.
Secondly on centrifuges, perhaps 13,000 or 14,000 centrifuges would be made redundant as a result of an agreement that would leave Iran with 6,000. How many of those 13,000 or 14,000 extra centrifuges would be dismantled? If they are not dismantled, what is to stop them being recommissioned, and how long would it take to recommission them? Again, there are significant questions about the possible allowance of 6,000 centrifuges and what happens to the 13,000 or 14,000 other centrifuges that would remain in Iranian hands.
It is important to state that 30 countries have a civilian nuclear programme. In the November debate, Jack Straw, the former Member for Blackburn, forcefully made the point that any sovereign country has the right to pursue an energy policy. I agree. However, of those 30 countries, only 11 have the capacity to enrich their own fuel. On what basis do the P5+1 conclude that Iran should become the 12th, given its Government’s track record on allowing monitoring and allowing third parties to examine its military capacity in relation to the enrichment of uranium?
I certainly accept that the good will and good intentions of Iran should be considered in the context of its continued support for terrorism in many parts of the middle east, which, as I have said, is a key concern of many of our partner nations in the region.
I will be very quick. We sometimes get stuck on the number of centrifuges. However, since the negotiations began, the technology around centrifuges —I declare an interest: my background is in chemical engineering—has advanced so far that a single centrifuge now is much more productive than when the negotiations started.
Indeed. My hon. Friend makes an important point that I was going to come on to. The research and development allowed as part of any agreement is very important. What guarantees can we be offered about the development of more advanced centrifuges? If there are no such guarantees in the agreement, real questions must be asked. If we are trying to reach an agreement to curtail the breakout time for Iran to develop nuclear capacity, the sophistication and possible development of centrifuges is crucial, yet there is no detail, as far as I can see, about what kind of monitoring of research and development will be undertaken.
I congratulate my hon. Friend on securing this debate. He asked a broader question about research and development, and about the importance of the agreement being not only retrospective but prospective. It should be future-proofed, so that improvements in technology, productivity and capacity are taken into account, and sufficient protections are put in place against the future capacity to develop uranium—and, indeed, other harmful technologies.
Again, I accept my hon. Friend’s comments. To a large extent, one of my concerns is monitoring, and the access that monitors will be allowed, so that that type of review can be conducted. There are real concerns as to whether that monitoring will be of an acceptable nature.
We also need to address the issue of the nuclear sites. If my understanding of the proposed deal is correct, two sites—Natanz and Fordow—will be retained. I must ask the Government and the Minister a question about that. If such a concession has been made, what concessions have been offered in return by the Iranians to facilitate the agreement?
I congratulate my hon. Friend on not only securing this debate, but approaching it in a very balanced way. He was good enough to accept that, in the past, mistakes were made by both sides, and we in the west would now gladly take up some of the concessions that we once refused, because things have been moved on.
I say to the Minister that although it is terribly important that we have the proper safeguards in place in any agreement, particularly to protect our friends in the region—I accept that point 100%, and we must focus on it like a laser—we must not lose sight of the benefits that would arise from our reaching some sort of agreement with Iran. There could be many such benefits across the region, which is becoming increasingly unstable, and we cannot ignore the fact that Iran is a major regional power that we created with our misguided invasion of Iraq.
I agree with many of my hon. Friend’s points, and I agree that the benefits arising from a good deal are worth fighting for. However, I suspect that many Members have concerns about the nature of the proposed deal and about the certainty that any such deal offers Iran’s neighbours, who also have real concerns, as he acknowledged. I accept the point about mistakes made in the past, and the importance of having a proper deal in place. However, the key point is that the deal must be acceptable to all and must give other countries in that part of the world confidence in the long term.
There is also a concern about the proposed length of the deal; we are looking at a deal that will possibly be limited to 10 years. Again, in the context of considering the development of nuclear capacity, we must ask ourselves whether 10 years is reasonable or sufficient. Given that the deal does nothing, as far as I can see, to deal with Iran’s ballistic missile capabilities, there is a real question as to whether 10 years is insufficient.
If the aim is to secure the right deal, can we justify the type of concessions that we have been reading about? Hon. Members touched on verification in their interventions, but we need certainty from the Foreign Office and the Government that there is confidence that the degree of verification allowed under any agreement will be acceptable. Once again, the track record of the Iranian regime does not allow us to be confident in that regard. I understand from those who comment and speculate on what happens in Iran that only last month the International Atomic Energy Agency was refused access, and Ayatollah Khamenei said:
“No inspection of any military site or interview with nuclear scientists will be allowed.”
The question whether we will have a proper verification process in any agreement gives rise to real concern. If we have an agreement with a proper verification process, it must be maintained and foolproof, but once again Iran’s track record does not give us much confidence.
The other question that we need to address is whether an agreement that is as compromising as the proposed agreement appears to be actually contributes to an escalation of the arms race in the region, rather than a reduction of tensions. The agreement appears to state clearly that putting Iran in a position in which it is within six months of a breakout for the next 10 years is acceptable. My concern, which I think is shared by hon. Members, is that other countries in the region would end up in an arms race—not to produce a nuclear weapon, but to be within six months of a breakout. It is worth mentioning that Prince Turki al-Faisal from Saudi Arabia stated clearly that
“Whatever the Iranians have, we will have, too”.
That comment should be taken seriously by the Government when they assess the merits or otherwise of the deal.
Any proposed deal has to satisfy the needs of the P5+1, a very unstable region and our allies in the region. However, the real test is whether it satisfies the original intention, which was to ensure that Iran did not develop a nuclear capacity. Dr Bruno Tertrais stated that we must not
“ignore the lessons of history: nuclear-capable countries never stay at the threshold for very long.”
Looking at the bare bones of the proposed agreement, it would appear that the P5+1 are now willing to accept Iran’s being at the threshold of a nuclear breakout and that that threshold will be maintained for the next 10 years. Dr Tertrais’s words are important in that context. Countries with the capacity to develop a nuclear weapon will almost invariably end up developing it.
That is an interesting point, but I suspect that the significant political changes in South Africa made a real difference to how it viewed its position in the world. I suspect that the changes that happened in South Africa are not going to happen any time soon in Iran, so my comments are still worth bearing in mind.
To what extent is the Foreign Office confident that the proposed deal, the outlines of which have been given, will be made in the long-term interest of not only Iran, but neighbouring states in the middle east? If assurances about that cannot be given, there are real questions to be asked about whether we can support any proposed deal.
I will call Guto Bebb at the end of the debate for two minutes to sum up what has been debated. Seven Members wish to contribute. I do not want to call the Front-Bench spokesmen any later than 10.40 am, with the debate closing at 11 am, so I am introducing a six-minute limit. If there are lots of interventions, I am afraid I will have to cut that to five minutes.
The election of Hassan Rouhani as Iranian President in June 2013 was heralded by certain sections of the western commentariat as a landmark moment: here was a Government with whom we would be able to do business and who would bring Iran in from the cold. Calls for caution from seasoned Iran observers were lost in the now all too familiar triumph of wishful thinking over critical analysis and the superficial obsession with media-friendly projection. Fast forward to 2015 and it has become clear that the country’s direction has not changed. It was never going to, and those who expected change fundamentally misunderstand the structure of Iranian power.
President Rouhani was destined only ever to have a limited influence in a state dominated by the Supreme Leader and the revolutionary guard. Khamenei has shown an amazing ability for consistency that western politicians can only dream of. He has never wavered in his belief about the purity of the Islamic revolution, his detestation of the United States or his contempt for the existence of the state of Israel. Nor has President Rouhani’s Administration brought any respite for the Iranian people. In 2014, Iran was the world’s leader in executions per capita. Freedoms that we in the west take for granted continue to be aggressively curtailed. Persecution of those who supported the green movement, and their families, continues relentlessly, and the western media seem curiously detached from, or even indifferent to, the plight of their savagely repressed Iranian colleagues. Iran remains a sponsor of state terrorism, providing financial, logistical and material support to Islamist terror groups across the region, including those targeting British forces when they were in Afghanistan and Iraq.
Iran persists in its refusal to respond adequately to the international community’s fears about its nuclear programme. Iran’s nuclear intentions cannot be seen outside the context of its support for terror proxies, arguably the defining feature of its foreign policy. The risks are clear.
Anxieties over Iran's nuclear intentions are well placed. Iran’s extensive nuclear programme features many of the key components required to facilitate the domestic production of a nuclear weapon: possession of large quantities of enriched materials; knowledge to convert enriched materials into weaponised form; and the development and possession of a delivery mechanism in the form of ballistic missiles. The country has a long history of clandestine nuclear work. Two of the nuclear-related facilities, at Natanz and Arak, which are at the centre of the international community’s concerns, were constructed secretly in a clear breach of the spirit, if not the letter, of Iran’s obligations under the NPT. For years, Iran used these facilities to enrich uranium to levels and quantities beyond those required for a legitimate and peaceful civil nuclear programme. Iran routinely neglects its obligations to co-operate with the IAEA, including repeatedly denying IAEA inspectors access to contentious nuclear-related facilities, such as the one in Parchin at which it is suspected of having previously undertaken tests related to triggers for nuclear weapons. It is logical to assume that Iran’s intentions are to develop a nuclear weapons capability and any claims that its intentions are exclusively peaceful should not be regarded as credible.
We may have seen a less confrontational diplomatic posture over the nuclear issue than under the former President, but the real position has not changed. Iran must not be allowed to dictate the terms of any final, permanent nuclear agreement; it has not earned the benefit of the doubt. A permanent deal must cover, in meticulous detail, all elements of Iran’s nuclear-related activity, including its ballistic missile programme. Ballistic missiles are, after all, the final critical-stage component of the weaponisation process and prohibited under United Nations Security Council resolution 1929. Omitting such sensitive technology from a final agreement would be inexcusable, and the Iranians are masters are manipulating the detail of any agreement to their advantage. Likewise, to be wrong-footed over this long-term issue due to short-term considerations of potential Iranian help with ISIS would be a colossal error.
We have a number of clear concerns. The time limitation of the agreement is merely to put off the dreadful day that we have all been dreading. As my hon. Friend the Member for Aberconwy (Guto Bebb) said, allowing the number of centrifuges to remain at 6,000 or above is an utterly unacceptable risk and allows breakout at almost any time. On verification, anything less than unfettered access is unacceptable, because we know, in the light of the Iranians’ behaviour in the past, how they will manipulate any weakness in the terms of the IAEA’s access.
Khamenei has already talked about how sanctions must be lifted immediately that any agreement is made, tearing up the terms of the proposed agreement before it is finally put down on paper. It is a sign of things to come and we should not be giving the benefit of the doubt to such a leader.
A nuclear-armed Iran would make an absolute mockery of the NPT, not least because it would be likely to be followed into the nuclear club in short order by its regional neighbours, including Saudi Arabia, Egypt and Turkey. The prospect of a nuclear arms race in one of the world’s most unstable regions, where the likelihood of the use of such weapons is probably greatest, should be of concern to us all. The stakes are enormous. It is no exaggeration to state that the fate of international security rests on the P5+1’s ability to secure the right deal. Anything less would reshape our whole understanding of international security with dire consequences. The P5+1 must not blink. A bad deal is worse than no deal. Appeasement has a very bad track record.
It is a great pleasure to serve under your chairmanship, Mr Hollobone, and to participate in this debate. I have listened to it with interest. I was tempted to intervene on a number of occasions, but did not because I observed your earlier injunction.
I will start with a couple of facts. Iran is a signatory to the non-proliferation treaty. The same cannot be said of Israel, Pakistan or India. Iran is surrounded by countries that have nuclear weapons: to the north, Russia; to the west, Israel; to the east, Pakistan; and, to the south, the United States through its navy. The desire to defend oneself in a tough neighbourhood is normal. Indeed, a moment ago my right hon. Friend the Member for North Somerset (Dr Fox) said that, if Iran were to get nuclear weapons, it would be rapidly followed by Saudi Arabia, Egypt and Turkey. That is probably correct, but when one listens to the debate, one might think that the Iranians are not sentient or thinking people. One might think that it had not occurred to them that, if they got nuclear weapons, it would be rapidly followed by Saudi Arabia, Egypt and Turkey. One might think that only we heard Prince Faisal when he said:
“Whatever the Iranians have, we will have”.
In fact, in the region, the Iranians are more directly affected by any of this than we are. I think we can take it as read, actually, that Iran will have a rather precise understanding and calibration of the consequences of its actions. I very much welcome the fact that the Iranians and the Saudi Foreign Ministers met in Oman recently.
I will quote from Seyed Hossein Mousavian’s book, “The Iranian Nuclear Crisis”. In a section at the end, under the heading, “An End to Double Standards”, he said:
“The fact that the P5+1 countries maintain strategic and aid relations with Israel, India and Pakistan, which have nuclear weapons and are not parties to the NPT, while at the same time they pressure Iran, which has not acquired nuclear weapons, sends a message to other countries that once they get the bomb they are immune.”
In one of the concluding paragraphs of the entire book, he states:
“I believe that P5+1 handling of the nuclear issue has been bedeviled by U.S. reluctance to give sufficient weight to accumulating evidence that since 2003 Iran has decided to respect its NPT obligation to refrain from manufacturing or otherwise acquiring nuclear weapons. This misjudgment freezes the P5+1 into positions which preclude any movement towards the areas of mutual interest with Iran that, I am convinced, exist.”
As my hon. Friend the Member for Aberconwy (Guto Bebb) said, we alluded to some of those areas of mutual interest in the debate on 6 November. I hope that there is a degree of flexibility in the negotiations to suggest that misjudgment has been suspended and that, while we need to keep our eyes open, there is a possibility of finding a mutually satisfactory deal.
In that debate on 6 November, Jack Straw, who sadly is no longer in the House of Commons, pointed out something that Foreign Minister Zarif had said to him in January last year:
“in 2005, Iran had fewer than 200 centrifuges. After eight years of sanctions, it now has 18,800.”—[Official Report, 6 November 2014; Vol. 587, c. 997WH.]
My right hon. Friend the Member for North Somerset will say, “Why on earth would they do that if they were not interested in getting nuclear weapons?” The short answer is that it is the same reason why Vladimir Putin plays silly buggers on the international stage: because he can.
Iran has been treated like a pariah state for many years. Several people, including my hon. Friend the Member for Norwich North (Chloe Smith), have referred to terrorism. Iran was described earlier in the debate as “the premier sponsor of terrorism.” It is true that Iran maintains relations with Hamas in Gaza and retains relations with Hezbollah in southern Lebanon. We know that they are groups engaged in terrorism, but no one would suggest that they are the premier threat to world peace through terrorism at the moment.
It is also true that Iran has relations with the Houthis, who, depending on the definition, are Shi’a. One can meet Iranians, as I did in Tehran in December, who will say that the Houthis are not necessarily Shi’a. When Iranian Members of Parliament visited Westminster in March this year, they made that point in the Foreign Office. Iranians are engaged with the Houthis in Yemen because they rightly think that Yemen is being used by al-Qaeda and Islamic State as an extended training base. Whoever thinks—forgive me, but I cannot remember who said it—that Iran is “the premier sponsor of terrorism” should look around. No one actually said this, but one might be forgiven for thinking that the present firestorm in the middle east, and the fact that we have the most brutal war going on, where people are being beheaded and crucified, is a direct consequence of Iran—it is not.
My intervention is extremely short, Mr Hollobone, and it is to point out that I believe I referred to Iran as “a premier sponsor”. I hope that that casts some illumination on the notion that there are various sources of threat in this world and that my hon. Friend considers all of them in his following remarks.
I will. My final point—I will observe your injunction, Mr Hollobone—is that Iran was in the frontline against the Taliban and al-Qaeda and is now in the frontline against IS, which is one of the most brutal, stone-age regimes that we have seen in modern history and which exists as a direct consequence of our having invaded Iraq in 2003 with President Bush and smashed the country into small pieces.
It is a pleasure to take part in this debate, and I congratulate my hon. Friend the Member for Aberconwy (Guto Bebb) on securing it. I certainly agreed with the first two speeches, but I did not agree with a great deal that my hon. Friend the Member for South Norfolk (Mr Bacon) said. In fact, I would describe his speech as complacent in parts, particularly what appeared to be his defence of the Iranian regime’s actions compared with other countries. I think it is very complacent to dismiss the Iranian regime’s behaviour in sponsoring terrorism and supporting the murder of individuals around the region and the world on the basis that Iran is on the frontline against ISIS, which is, as he said, a cruel and vicious organisation.
I was certainly not accusing my hon. Friend; I accused the Iranian regime, which I said he seemed to be defending, of being engaged in the support of mass murder. If he looks at the record, I am sure he will see that.
I pretty much agreed with everything that my hon. Friend the Member for Aberconwy had to say. It is not the first debate on Iran that he and I have taken part in, but as the United Kingdom is one of the members of the P5+1, it is slightly frustrating that we have had few opportunities in the House to debate the detail of what is emerging, or even to express our concerns during the negotiation process. It should greatly worry us all that, in the lead-up to the 30 June deadline, many issues remain outstanding. Not only are there clear discrepancies between the expectations and demands of the various parties to the negotiating process, but many of the proposed parameters are worthy of criticism.
At this very late stage, increasingly concerning reports have been emerging. An IAEA report—I apologise; with my flat vowels, it is hard to get all those letters out together—this month has revealed that Tehran’s stockpile of nuclear fuel has increased by 20% in the 18 months since negotiations began. That point has been made by other speakers. Worryingly, the news completely contradicts President Obama’s contention that the nuclear programme had been frozen in that period. In previous debates, I and colleagues across the House said that that was exactly what we expected to happen.
Of particular concern are the many reports of Iran’s intransigence towards the verification of the so-called possible military dimensions and its continued blocking of access to the country’s military sites to allow the IAEA to carry out crucial investigations. In a previous debate, I quoted a report saying exactly the same thing. Will the Minister tell us how we can possibly ensure that Iran’s nuclear programme is what it says it is when the IAEA is unable to determine the true extent of Iran’s historical research into nuclear weaponry or properly calculate the breakout time?
I am reminded of the words of the sadly now former Canadian Foreign Affairs Minister. His assessment of the process was that past actions predict future actions and that Iran had not earned the right—I have forgotten the quote, Mr Hollobone; I am still very tired from a recent long journey. I will come back to that point in a moment. I do apologise.
Since the announcement of the proposed parameters in April, Iranian officials have avowedly rejected any co-operation with the IAEA’s crucial investigations. That justifies the IAEA’s long-held concerns about the Iranian regime’s true intentions. Only on Sunday, the deputy chief of staff of the Iranian armed forces, Brigadier General Masoud Jazayeri—excuse my pronunciation; being from Yorkshire I am not particularly good with anything that is not English—reiterated the regime’s position that permission to visit Iran’s military centres
“will definitely never be issued for any kind of access…even if it runs counter to the acceptance of the Additional Protocol”.
That leads to the question: what do the Iranians have to hide?
As the international community makes numerous concessions to Iran, which is, as my hon. Friend the Member for Aberconwy and others pointed out, a country in the grip of a fundamentalist regime that has sponsored terrorism around the world and particularly in the region, Iran continues to hang its political prisoners and fund terror groups across the middle east. Given everything that the P5+1 and the west are seemingly expected to concede, will the Minister tell us what concessions the Iranians are expected to make in return? I will return to the words of the former Canadian Foreign Affairs Minister, who urged extreme caution in our approach to this situation. I hope that the Minister will have those words and warnings in mind when he responds to the debate.
It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate my hon. Friend the Member for Aberconwy (Guto Bebb) on securing this debate.
This is not the first time we have discussed this issue in Westminster Hall. On 26 February 2014, I initiated a debate on the interim agreement with Iran, so it is hard not to repeat oneself; indeed, many hon. Members have already outlined many of the issues of concern. I have therefore decided to approach the matter from a completely different point of view: the environmental implications of a nuclear Iran. The Iranian regime has announced that it is interested in the construction of nuclear technology only for energy consumption and that a civilian nuclear Iran seeks such capability only for peaceful uses but, in this age of environmental sustainability and renewables, it strikes me as perverse that such a claim is being made to justify a nuclear programme in the middle east.
Iran is rich in its natural supply of minerals, oil and gas, and there is an abundance of possibilities in the country to produce renewable energy from the wind and sun. The opportunities are infinite, as the production of energy from such natural resources is not only cheaper but much safer for the environment. Iran can secure not only its domestic but possibly the regional energy supply, without resorting to nuclear technology.
We have only to look at the country’s existing nuclear facilities to consider how safe such an expanded nuclear industry would be. A good example is the Bushehr nuclear plant, which lies on the coast of the Persian gulf, south of Tehran. There have been huge safety concerns about the plant, associated with its construction, its ageing equipment and under-staffing. The Centre for Energy and Security Studies, an independent Russian think tank, explained the construction delays at the plant as due partly to a
“shortage of skilled Russian engineering and construction specialists with suitable experience”.
In 2010, the International Atomic Energy Agency noted that the facility was under-staffed. It is clear that Iran does not have the human capacity for a nuclear industry.
Leaders from Gulf Co-operation Council countries have expressed fears that a serious nuclear accident at the Bushehr plant would spread radiation throughout the region. Bushehr is closer to the six Arab capitals of Kuwait City, Riyadh, Manama, Doha, Abu Dhabi and Muscat than it is to Tehran. The United States Geological Survey and NASA say the plant is near the boundary of the Arabian and Eurasian tectonic plates. The Bushehr plant could be the next Chernobyl or Fukushima, with the potential to contaminate vast swathes of the middle east in the event of an explosion.
Iran’s wants to acquire nuclear technology not so that it can match the technological achievements of the west; we all know that it is an overt attempt to challenge the military capabilities of other countries and to establish itself as a presence in the geopolitics of the middle east.
Given that, apart from Egypt, Iran is probably the most populous country in the middle east and given its strategic position occupying one entire side of the Gulf, does it surprise my hon. Friend that it might want to have an important role in the strategic geopolitics of the region?
It does not surprise me, but I worry about Iran’s intentions in such a role. I will come on to that shortly.
The nuclear programme has many attractions for the Iranian president and the supreme leader. Internally, it increases self-confidence in elements of the regime’s core supporters, such as the revolutionary guards and the Quds and Popular Mobilisation forces. Externally, it boosts the regime’s prestige in the eyes of fundamentalist militant sympathisers such as Hezbollah in Lebanon and Hamas in Gaza—so yes, I agree with my hon. Friend that Iran wants prestige and influence. The nuclear programme can also be used for the blackmail of regional countries by raising the threat of a localised nuclear attack. It allows Iran to become a dominant voice in the Persian gulf and could ensure its ascendancy in the global community as it seeks to cajole and influence. Most of all, it can be used as a tool to sabotage the middle east peace process and give advantage to Iran to dictate the terms and destabilise order in the region, especially in countries such as Israel.
The proposed deal makes no reference to Iran’s role as leading sponsor of state terrorism, which was mentioned by my hon. Friends the Members for Filton and Bradley Stoke (Jack Lopresti) and for Gillingham and Rainham (Rehman Chishti). While negotiations were ongoing in Switzerland, Iranian-backed Houthi rebels were seizing control of the Yemeni capital, and Iran was extending its presence in Iraq and attempting to establish a new front in the Golan Heights in co-ordination with the terror group Hezbollah. Again, I agree with my hon. Friend the Member for South Norfolk (Mr Bacon): Iran is seeking to exert influence.
The Iranian regime is known to provide financial and material support to extremist Islamist terrorist organisations in the middle east, including Hamas, Hezbollah and the insurgencies in Afghanistan and Iraq. It reportedly provides Hezbollah with up to $200 million a year and spends up to $35 billion to prop up the Assad regime. Between 2006 and 2011, it financed Hamas with up to $300 million annually. Iran actively sponsors international terrorist groups that are committed to the destruction of Israel and act as Iran’s proxies.
It is not just me who has concerns about the Iranian regime and its attempt to attain a nuclear weapon. The IAEA, the UN Security Council and many western countries have long-standing concerns. In November 2014, the IAEA director general called on Iran to
“increase its co-operation with the agency and to provide timely access to all relevant information, documentation, sites, material and personnel”.
Iran does not act in any way to allay the fear of us sceptics. It has repeatedly denied IAEA inspectors access to key nuclear sites, including at Parchin, where it is believed to have conducted tests involving triggers for nuclear weapons. Our concerns are legitimate. Iran needs to demonstrate the exclusively peaceful, civilian nature of its nuclear programme and intentions before it can possibly be considered a normal, non-nuclear-weapons state. It will not do that though, so I remain highly concerned about the deal, like other Members present.
The verification programme is not enough, and Iran’s failure to address the potential military dimensions to its nuclear programme undermines the IAEA’s ability to verify the programme and accurately calculate its breakout time. Iran needs to make concrete progress on the disclosure of its weaponisation activities prior to receiving sanctions relief, because an agreement that ignores Iran’s past weaponisation work would risk being unverifiable. Until such issues are resolved, I appeal to the Minister, as I did to the Prime Minister in the House, not to enable Iran to become a nuclear power. We should be wary of its intentions. As I said to the Prime Minister, the road between a civilian nuclear Iran and a military nuclear Iran is a short one. I repeat the words of my right hon. Friend the Member for North Somerset (Dr Fox), who said that it would be better to have no deal than a bad deal.
It is good to serve under your chairmanship, Mr Hollobone, and I thank my hon. Friend the Member for Aberconwy (Guto Bebb) for securing this debate.
I want to discuss the principles behind the forthcoming agreement. American Presidents in their second term are—dare I say it?—dangerous, because they are looking to leave legacies, and those who might struggle to leave a legacy look even harder. We must be careful that that is not what the agreement is about. I have much respect for my hon. Friend the Member for South Norfolk (Mr Bacon), who is a great friend of mine, but I entirely disagree with him. Will there be a pecking order for terrorism as to which groups are the worst? I think not. In our desire, which is quite right, to have Iranian help to deal with ISIS, I worry that we are blind to what is actually happening in Iran. We must be careful if we take that line.
The point has been made that Iran is supporting the international community to defeat Daesh or Faesh. I think that that is completely wrong. The G7 statement says that we must first defeat the Assad regime to defeat Daesh, but as long as Iran is supporting the Assad regime, we cannot defeat Daesh or Faesh. That point must be clear.
My hon. Friend makes a good point. The middle east is complex and contains states such as Iran that will sponsor terrorism. It is something that none of us wants to foresee, but the idea of Iran, with its attitudes towards its neighbours, especially towards Israel, having a nuclear weapon and being capable of using it is abominable.
Why does Iran need so much enriched uranium? We could go through the figures all day, but I do not intend to go into them again. I do not believe that Iran needs uranium just to create nuclear power stations; it wants to enrich it. Why does Iran not allow proper access for us to see what is going on? If we were allowed better access, we could stand up in this Chamber and say what a delight it is that we are able to go all over Iran and see exactly what it is enriching and what it is not, but we have no real idea, because we are not allowed access. We have a fairly good estimate of what might be going on, which in itself is far too much.
I am from the west of England and have the same trouble as my hon. Friend from the north of England, the hon. Member for Brigg and Goole (Andrew Percy) in pronouncing such words, but consider the Bushehr nuclear power station. It uses Russian technology— I first upset the Americans and now the Russians, so I will perhaps upset everyone this morning—and I am not always delighted with Russian technology or with Russian nuclear power stations. The idea of such a combination does not bode well. It is no good our sitting here, putting our rose-tinted glasses on and saying, “Let’s do a deal with Iran”—dare I say it?—“at all costs.” I have great faith in the Minister here today and Britain must stand up and be sensible about this matter. If we are actually to reduce terrorism in the middle east and to make the region more secure, we cannot possibly have an Iran with the capability to make a nuclear bomb.
The agreement mentions 10 to 15 years of control, but that is just not enough. Ten to 15 years passes almost in the blink of an eye. I would love to think that we could talk of a wonderfully peaceful middle east in 10 to 15 years. Call me cynical, but I do not believe that that will be the case—although I hope that it is. We must stand up to such states. It is no good sitting here saying, “It’s okay. Let’s have an agreement and brush all the problems under the carpet because they don’t really exist.” Oh yes they do. They exist and Iran will have that capability.
We have debated the matter thoroughly this morning. We need to have our eyes open. I want to hear from the Minister about the British position and not about some nice, cosy and lovely agreement that makes everyone feel warm. What is actually happening in Iran? What are we doing about getting inspectors in? I cannot see how we can sign any agreement until we know exactly what is going on.
Thank you, Mr Hollobone, for allowing me to speak in this debate, in which I will pick up on the theme of the 10-year timeline that my hon. Friend the Member for Tiverton and Honiton (Neil Parish) highlighted. Ten years ago, I had been in Kabul for a few months to set up the Afghan National Security Council, helping the Afghan Government to stand on their own two feet in security matters. It will not surprise many of my hon. Friends to hear that one of the biggest threats then was the penetration of Iranian agents and activists within the Afghan system. I do not have recent experience but have no reason to believe that that has changed.
We are not dealing with a country that is behaving in the ways of the post-Westphalian system in western Europe; we are dealing with a country that has ideas of itself that go back way beyond what anyone in Europe is discussing. We are talking about Cyrus the Great and the Sasanian empire. As you will no doubt remember, Mr Hollobone, the Sasanian empire had its first major expansion into Yemen in the 570s in the year of the Elephant, which is often celebrated as the birth year of the Prophet Mohammed. That expansionism is not something that the present Iranian regime has forgotten. Quite the reverse—it is echoed in every word that it says and in every speech that is made. When I hear that it is not interested in expansionism, I merely look at the maps of the Sasanian empire and of later Iranian empires and I see where its interests lie: all the way from Delhi to Turkey.
Such impacts are serious for us, because our world has also changed. Our friends now lie around the Persian gulf, on all parts of the Arabian peninsula and on the other side in Afghanistan, Pakistan and India. For us, the Iranian question is no longer a foreign question about which we know little. It is a personal, immediate and local question, because the nuclearisation of Iran—were it to happen—would trigger, as my right hon. Friend the Member for North Somerset (Dr Fox) said, the nuclearisation of Saudi Arabia and Egypt, both of which would probably get what they have already paid for: a Pakistani nuclear bomb. That is an extremely threatening situation not only for us, but for many other friends in the region.
In fact, the situation is not, as many people think, about Israel; it is much more fundamentally about Arab sovereignty and Arab states in the region. Those who think that the rights of an Iranian theocratic regime should become supreme also seem to overlook that the situation is also about the rights of the Iranian people. People have now forgotten that the first of the so-called Arab spring revolutions was the Iranian green movement, which was crushed with extreme brutality by the Iranian Government. They were able to do so because, since the revolution, they have constantly played—certainly under Ahmadinejad—the cities against the countryside. They have recruited the Basij, the revolutionary militias, from the countryside and have used them time and again to crush movements not even of liberalism, but of gentle reform in the cities, in particular Tehran. The proposed treaty endorses a theocratic regime that is anathema to peace in the region and anathema to civil rights in its own country. It is not only incumbent on our Government to stand up for ourselves—
When my hon. Friend says “anathema to peace in the region”, I immediately think of Gulf and Saudi financing for IS. When he says “anathema to civil rights”, I immediately think of the civil rights that do not exist in Saudi Arabia. Why does he think that Iran, uniquely, gets picked out?
My hon. Friend is right that the rest of the Gulf and the Arabian peninsula is far from being an island of perfection in an otherwise dark world. Other states have serious issues and I would not in any way seek to relieve pressure on the Salafi funding of various regimes around the area. I completely agree that such things are inimical to our interests. The pressure that Islamic State, as it has been laughably called—it should be called Daesh—is putting on our interests in the region is abhorrent. The idea, however, that somehow my enemy’s enemy is my friend is also for the birds—it is completely wrong. We are watching the continuation of a period of violence that started with the battle of Karbala and the deaths of Hassan and Hussain. We do not want to get involved, saying, “No, everyone can nuclearise themselves.” Indeed, my hon. Friend makes my point for me, that to nuclearise one would be to encourage further problems for the whole area.
I repeat that to allow Iran to get nuclear weapons would be anathema to peace for the region, anathema to the civil rights of the society and anathema to our interests. I therefore urge the Minister, who I am glad to see in his place, because he understands the region extremely well, to look hard at what Her Majesty’s Government can do. We need to reinforce our position as a voice for peace in the region, reassure our friends in the Gulf and across north Africa that we will not abandon them and be only fair-weather friends. What will we do to stand up for them if Iran insists on pushing things, because we will be standing up not only for them, but for ourselves?
My hon. Friend says that we should support our international allies in the region and around the world, but does he agree that we should learn lessons from what happened previously? For example, the international community stood by when Iran backed the Maliki Government in Iraq, which led to the crushing of the Sunnis and then to the rise of Daesh or Faesh and the massive problem we now have. Therefore, we have an international duty to support our friends and colleagues where oppression is going on and to deal with such policies and issues at an earlier stage.
I am grateful to my hon. Friend for making an excellent point. All I can add is to urge hon. Members to read “The Unravelling” by Emma Sky—a plug for a book by a friend of mine that is absolutely outstanding. It explores not only the failure of the American governance system in Iraq, but the rise of Iran’s influence. The point my hon. Friend made most eloquently is just that—Iran did not wait for us to push, but has been constantly pushing out from its borders, because its view of itself is not the same as what we say when we see the borders. It is not a post-Westphalian state; it is a pre-Islamic state that is still exploring its areas of influence.
It is a pleasure, Mr Hollobone, to serve under the chairmanship of a fellow alumnus of Bromley Borough Council. I congratulate the hon. Member for Aberconwy (Guto Bebb) on securing the debate, although I will highlight one or two differences from his approach. I make apologies for my hon. Friend the Member for Harrow West (Mr Thomas), who previously dealt with the subject; he has departed from the Front Bench to spend more time with the London mayoral election. Interestingly enough, this will also be my last debate from the Front Bench on foreign affairs, because I will be spending more time on politics, which I look forward to.
Given how the hon. Member for Aberconwy introduced the debate, I think that we may find more common ground between Front Benchers than between Front Benchers and Government Back Benchers—probably not the last time that will occur in this Parliament, particularly on foreign affairs. We have to define what we see as the objective of our relations with Iran, particularly in terms of the nuclear talks. Is any agreement a nuclear freeze or, as some have described it, weapons control? Is it to influence Iran’s foreign policy, and particularly its actions in respect of its neighbours, or is it to achieve regime change? All those things might be desirable, but they are not necessarily the prime objective of the talks. An analogy was made with eastern Europe and arms control, but that was immensely successful, as indeed were the Helsinki accords that helped to bring about perestroika and glasnost.
To clarify, the analogy with eastern Europe was made in the context of an agreement that was possibly successful as regards arms control, but was not especially good for the people of eastern Europe. An agreement now might be successful in controlling arms, but not be good for the people of the Gulf states, or indeed of Iran.
That may be true, but such an agreement is preferable to achieving none of those objectives. Not everything has to be agreed, particularly if we view the possession of nuclear weapons as a qualitative rather than simply quantitative change—it is not only another step. Throughout the history of arms control agreements, it has been recognised that the nuclear threshold is a particular and qualitatively different threshold in international relations. We could therefore have arms control agreements with the Soviet Union, even though it was repressing its own citizens and the citizens of eastern Europe and sponsoring terrorism abroad.
I take the right hon. Gentleman’s exact point. In fact, he is reinforcing my argument. The fact that there are other undesirable aspects of the Iranian regime does not necessarily mean that we cannot seek a proper, verifiable and effective nuclear agreement. We may argue about how that is achieved, but the other aspects, desirable as they may be—we should certainly press them with the Iranian regime—should not prevent us from reaching an agreement. The former Defence Secretary is right: we need to focus on the arms control agreement.
I wish that I had some of the confidence of the hon. Member for South Norfolk (Mr Bacon) about the internal dynamics of the Iranian regime. The same goes for his comments about the sponsorship of terrorism. He referred to relations with Hamas and Hezbollah, but Iran acts as the armourers of those organisations. Furthermore, it is reasonably argued that in many cases Iran is pressing and supporting elements within Hamas and Hezbollah who want to take things further, as against those who want a more moderate position.
Forgive me, but I am the hon. Member for Tonbridge and Malling; the Secretary of State for Communities and Local Government, my right hon. Friend the Member for Tunbridge Wells (Greg Clark), is not present.
Does the right hon. Member for Warley (Mr Spellar) agree that Iran’s actions in support of terrorism have not been limited to the region? We have heard a lot of talk about IS, but the reality is that actions in Argentina and Bulgaria, and the murder of Israeli and European citizens in Germany over many years, demonstrate that Iran’s involvement in terrorism is not a foreign matter, but very much a domestic one.
Of course, the right hon. Gentleman is right: the Iranians have been sponsoring groups of what we call terrorists in Gaza and Lebanon. I did not deny that at all; in fact, I think I said it. I was simply making the point that the world is on fire, and that is not because of Iran, but because George Bush, who did not know the difference between Shi’a and Sunni six weeks before the invasion of Iraq, smashed the region. We are still suffering the consequences, and Iran is trying to help clear up the mess.
That is a very simplistic reading of history. The idea that Islamist terrorism was dependent on the invasion of Iraq does not bear any scrutiny. It is interesting that, yet again, the hon. Gentleman referred to “what we call terrorism”. No, it is what the world calls terrorism—and that, indeed, is what it is.
We need to move on to the core questions: what is Iran’s capability, and what is its intention? Those are undoubtedly complex issues. We certainly did not create Iran; it is of very long standing. As the hon. Member for Tonbridge and Malling (Tom Tugendhat) rightly said, it is a great historic and continuing nation, and was a great empire and civilisation. The hon. Member for Basildon and Billericay (Mr Baron) said that we made it a regional power. History, resources and population made it a regional power.
Interestingly, unlike some other Islamist groups, the Iranian regime has not discouraged education, but very much encouraged it. There is a substantial educated—indeed, sophisticated—section of society. Unfortunately, a considerable number of its members now live in exile, and they would be a huge benefit to a liberal country. There is clearly strong internal opposition to the regime, as we saw with the green revolution after the previous elections, which, as the hon. Member for Tonbridge and Malling said, was ruthlessly and shockingly repressed, with too little reaction from the rest of the world—probably not just a moral, but a strategic mistake. There are also widespread executions, and there is imprisonment in absolutely appalling conditions.
It is also rightly said that Iran has drastically worsening relations with its neighbours, who rightly accuse it of not only external threats, but fostering internal subversion. Although there are clearly legitimate, well expressed concerns at some of those neighbouring states’ internal reactions, there is, equally, an understanding of the problems they face. Those problems are a concern to the outside world, just as they are to countries to which Iran—or the Iranian regime, to be more correct—poses an existential threat.
I hope that the Minister will address the broader contextual issues, but my concern is that we see little evidence of strategic vision as Britain retreats from the world stage—something that has been widely commented on in the United States and that is being increasingly understood here. That vision does not mean simplistically dividing the world into friends and foes.
A strong reaffirmation of article 5 of the NATO treaty would be especially welcome to our allies on NATO’s eastern front, who face increasing Russian assertiveness and pressure, but that does not mean that we do not have similar concerns to the Russians in some other parts of the world. Over the years, Ministers will have clearly heard about the Russians’ focus on Islamist fundamentalism and what they refer to as the arc of instability to their south. I agree that that is hard to reconcile with the support given by the Russian nuclear industry to the emerging Iranian nuclear programme. I have heard the justification from Russian Ministers that that support is good business. The argument has also been put to me that one driver of the Russian approach—this was rather echoed by the hon. Member for Hendon (Dr Offord)—is the Iranians’ lack of capability to run the system. That runs against the evidence that there is an educated workforce in Iran. It is perhaps a slightly dismissive, almost colonial, position, and a serious miscalculation on the part of the Russians. Will the Minister tell us what efforts have been made to engage with Russia on this issue? Is there a unified Russian view, or are there diverse views in the Russian hierarchy?
Similarly, there is inconsistency in the Russian support for the Assad regime, which is, most significantly, being propped up by the Iranian Hezbollah and the revolutionary guard. We do not need to have any illusions about President Putin’s actions in Ukraine—and, indeed, right the way along Russia’s western flank up into Scandinavia—to see that we may have common interests and concerns in the middle east and north Africa. Ministers will recall that during the last Parliament I regularly made similar arguments about the need to engage Afghanistan’s neighbours in the post-drawdown settlement to ensure stability, stressing that not only Russia and the “stans”, but Iran, should be involved. We therefore need a broader policy on this issue.
I recognise that the Minister needs to time to reply, so, in conclusion, I thank him for his courtesy and for the assistance he has provided during his time in the Foreign Office, which has been most welcome and most appreciated.
Thank you, Mr Hollobone, for the opportunity to reply to this interesting, informative and important debate, which is taking place before the negotiations.
Let me begin by responding to the kind words from the right hon. Member for Warley (Mr Spellar). I am sorry that we have heard his valedictory foreign affairs speech. We will certainly miss him. I have worked with him for more than a year, and it has been a real pleasure. There has been huge cross-party support on this and other issues, and that is very welcome. I am sorry that the energy and enthusiasm he has shown in the debate has not been reflected by Labour Back Benchers, who have not taken part in the debate. It was perhaps also too early for Scottish National party Members to make the debate. I would have thought that they would want to engage in a debate on nuclear issues. None the less, I am grateful for the debate.
Like others, I congratulate my hon. Friend the Member for Aberconwy (Guto Bebb) on securing the debate and on his continued interest in this matter. We had a good debate last November, and I hope there will be further opportunities to discuss the issue. Through you, Mr Hollobone, I would certainly ask the Backbench Business Committee to make time for it to be debated on the Floor of the House as well as in Westminster Hall.
For more than a decade, the Iranian nuclear issue has posed one of the most intractable and persistent threats to international security and stability. The prospect of a nuclear weapons-capable Iran carries severe consequences for the security of the UK, the region and, indeed, the world. The Government have always been clear that the best solution lies in finding a peaceful, diplomatic and negotiated settlement. The process has been long and challenging, and we are grateful to both sides of the House for their support.
Our discussion today comes at a crucial moment. The joint plan of action agreed by the E3 plus 3 and Iran in November 2013, and extended in July and November 2014, froze the most concerning elements of Iran’s nuclear programme in return for limited sanctions relief. When the interim deal was extended in November, we, our E3 plus 3 partners—China, France, Germany, Russia and the United States—and Iran set ourselves a deadline of 30 June to reach a final comprehensive deal.
The UK played a leading role in diplomatic efforts that secured agreement on the key parameters of a deal in Lausanne on 2 April. That marked an important milestone in the ongoing negotiations, but as has been made clear today, those negotiations are not complete. Since April, UK diplomats and experts, and E3 plus 3 colleagues, have been working intensely to secure a comprehensive agreement by the 30 June deadline. That agreement, which has been questioned in the debate, must satisfy the Government’s objectives, which have remained consistent throughout this process: preventing Iran from developing a nuclear weapons capability, while recognising its right to access nuclear energy for peaceful purposes. We have always been clear that we will not agree to a deal that fails to address our proliferation concerns.
My right hon. Friend the Foreign Secretary will be present for the talks in Vienna in the coming weeks, where he will maintain a laser-sharp focus on our key UK objectives. As the deadline draws ever nearer, it is crucial that Iran should appreciate what is at stake. Significant economic advantages and political benefits await if Iran agrees to a robust nuclear deal. Right hon. and hon. Members must forgive me for not going into the detail of the deal, but I will try to outline answers to some of the questions.
My hon. Friend is right to raise that question: what assurances do we have that Iran would maintain the deal? I shall certainly try to answer the questions that have been asked. I am, to the horror of my team, going to abandon the speech that they have carefully prepared for me, and do my best to answer the questions from the debate. I offer my apologies if I do not manage to answer all the detailed questions. I shall read Hansard—not because I like reading what I have said, but because it is important that I read what Members have said and reply in writing, if I may, to keep dialogue going.
My hon. Friend the Member for Aberconwy asked whether the agreement was intended to be a non-proliferation or arms control treaty. It is a mixture, as I have made clear. It important for us to be able to maintain that, because there are breakout weapons systems that we are concerned about in addition to what Iran is doing on the nuclear side. He mentioned Iran’s foreign policy objectives, for itself and the wider region, which I want to touch on in relation to other concerns. Iran’s role, and where it sees itself in the region, is a major issue. It has a responsibility not just to itself but in the wider region and we look to it to act responsibly.
My hon. Friend mentioned the United States foreign policy aspects of the matter, and my hon. Friend the Member for Tiverton and Honiton (Neil Parish) raised the question whether there was a legacy issue. I have never heard the line before that a President is most dangerous in his second term. It could be argued both ways; a President in that case is not tied by anything and therefore can be more robust in some of the measures that he or she is willing to pursue.
I want to go through the eight major headings of the deal, which may help the House to understand where the conversation and agreement are going, leading up to 30 June. First there is the question of a durable and verifiable deal. The first heading is enrichment, which covers Iran’s capacity and its enriched stockpile. The number of centrifuges is obviously part of that. Many figures have been given in the debate, but the number is less significant than the breakout time—how quickly a weapon could be procured if it was decided to close the doors and prevent IAEA from carrying out inspections. We have set that as a year. Whatever the experts are saying, that leads to the number of centrifuges that we would consider acceptable. We are less focused on the actual numbers at the moment, and more on the breakout time.
The second area heading is research and development, covering types of centrifuges, and leading to a mutually agreed scope and schedule. Thirdly, the Arak plutonium reactor has been mentioned. There will be a redesign to cut off the plutonium route to a nuclear device. Fourthly, Fordow, which has also been mentioned, will no longer be a site for the enrichment of uranium. The fifth area is duration. There are programme restrictions in a number of areas. A period of 10 years for the agreement has been mentioned. It could well be that parts of it will last longer, and parts might even be shorter. That is some of the detail being worked out.
The sixth heading is the possible military dimensions, which I have touched on. That covers the measures that Iran must address: the IAEA’s concerns about the possible military dimensions of its nuclear programme. If there is one area that is of concern in the discussions at the moment, that is probably the most difficult. The seventh area is sanctions: relief from the comprehensive EU and US economic and financial sanctions in return for IAEA-verified actions on Iran’s programme; an agreement on the termination of UN sanctions, with limiting transfers of sensitive technologies and activities; and other issues relating to conventional arms and ballistic missiles. The eighth and final area is transparency and verification, which many hon. Members have mentioned. That covers the ability to make sure that nothing is being done behind our backs, and a robust and credible monitoring programme including the implementation of various protocols to give the IAEA greater oversight of Iran’s activities.
My right hon. Friend is right; we must have such access. I am pleased that the IAEA has confirmed that it currently has the access it needs. Were that to be closed down, those would be the consequences—it would be about whether sanctions would be brought back. I acknowledge my right hon. Friend’s understanding of and interest in the matter. He spoke about the Iranians as a proxy power elsewhere in the area. If Iran is looking for a more responsible role, as he mentioned and encouraged, it must be seen to take greater responsibility in events in places such as Syria. It is propping up Assad, so no space is being given to moderate Sunnis. They are then pushed, or encouraged, to join ISIS. Iran could easily assist the international community in progressing with a political solution for Syria, and could help immensely with what is happening in Anbar and Nineveh province in Iraq. General Soleimani is pushing across with the Hashed militias and causing sectarian friction in Iraq; that is unhelpful in the long term. Likewise in Yemen, weapons systems coming by boat and the provision of weapons for the Houthis, further complicate an already difficult and complex issue.
There are ways for Iran to show its initiative and greater responsibility in the region, and I think that many hon. Members would like to see that. It is not happening now and we are concerned about that. I am conscious of the time; I will write to hon. Members with more details. The debate has been extremely good. I simply want to make it clear that we are working hard for the deal, but, as has been explained, we need to make sure we reach the correct one. Without the correct deal, we have no deal.
The reason we needed this debate in Westminster Hall was timing. The issue is live and is reaching a conclusion. I am grateful for the Minister’s comments and for his generous offer to write to right hon. and hon. Members on points raised in the debate. I fully understand that the complexity and extent of questions made it a challenge for him to respond in full in the 12 minutes allocated. I pay tribute to the shadow Minister, the right hon. Member for Warley (Mr Spellar), for his final Front-Bench speech. He said he disagreed with my viewpoint, but few disagreements came to light from his comments. I wish him well on the Back Benches.
The debate has made it clear that there is interest, certainly on the Conservative side, in this important issue. The Backbench Business Committee has not yet been convened, so Westminster Hall was our only option for getting this debated in the House. Given that the Foreign Secretary will go to Vienna, and in view of the interest shown in the Chamber, a statement should perhaps be made after the visit—and there should certainly be one if an agreement is reached.
A statement will absolutely be made, and there will be an opportunity for Members to comment. Perhaps I may suggest that when the Backbench Business Committee is formed, if an opportunity is not provided by the Government, a full debate should be held in the House in the aftermath of 30 June.
I thank the Minister, and I am sure that there will be a delegation to the Committee.
Despite the fact that most of the Members who spoke were Conservatives, we were pleased to have some opposition, and I thank my hon. Friend the Member for South Norfolk (Mr Bacon) for his comments, which showed that this was a debate, not a one-sided discussion.
Question put and agreed to.
That this House has considered Iran and the proposed nuclear agreement.
Isle of Sheppey (Prisons)
I beg to move,
That this House has considered prisons on the Isle of Sheppey.
It is good to see you in the Chair for my first Westminster Hall debate of this Parliament, Mr Hollobone.
My constituency has three prisons: Elmley, which is a category C prison; Standford Hill, which is a category D prison; and Swaleside, which is a category B prison. Combined, those three prisons house almost 3,000 inmates —one of the largest concentrations of prisoners in the country. I would like to pay tribute to the fantastic men and women who work on the island’s prisons. They are dedicated and hard-working professionals of whom I am immensely proud. They work in an extremely challenging environment, facing the threat of violence on an almost daily basis with few complaints and a great deal of courage.
The threat of violence is growing. I have been associated with Sheppey’s prisons for almost 30 years and I now live in the village of Eastchurch, where all three prisons are located. Over those years, I have visited the prisons on a number of occasions—first, as the Swale borough councillor for the area, and then as Kent county councillor. Since becoming the Member of Parliament for Sittingbourne and Sheppey in 2010, I have visited the prisons every three months to meet local representatives of the Prison Officers Association. In addition to those meetings, I have been privileged to tour the prisons on a regular basis and have been able to chat with the staff and with the inmates, occasionally in their cells.
Last year, I was taken on a tour of Elmley, which is a regional prison, by the local POA representative, Mike Rolfe. For the first time in all my years of visiting, I felt a tangible air of intimidation on the wings, which was emanating from some of the inmates who were noticeably hostile. I have to admit that I was happy and pleased to have Mike Rolfe looking after me that day.
In Swaleside over the past three months, the special accommodation cells have been used for a total of 340 hours as a result of violent behaviour by prisoners towards staff, other prisoners and, on one occasion, self-harm. The latter incident is an example of the increase in mental health problems among inmates. In the same period, violent incidents have accounted for 23 planned control and restraint interventions and 42 spontaneous control and restraint interventions.
There are several reasons for the increase in intimidation and violence in Sheppey’s prisons. One is the increased use of drugs and so-called legal highs that have been smuggled into prisons—the latter are an increasing problem. There is consumption of illicit alcohol, which is often distilled from fruit stolen from the kitchens. Indeed, that was the alleged cause of a disturbance at Swaleside last year, which led to a prison officer being stabbed in the head.
There is an increased gang culture in prisons. Not only are there gangs from south London and Liverpool competing in Sheppey’s prisons, but foreign prisoners—particularly in Swaleside, which has a high percentage of foreign prisoners—who are forming their own national gangs. That is causing huge problems in our prisons.
Violence is caused by retribution for the non-payment of debts owed by prisoners for the supply of things such as mobile phones. These days, people can buy a mobile phone from Tesco for a tenner. Smuggled into a prison, that phone can be worth £300 to £400, causing a lot of illicit trade. Violence is also generated by the recovery of stolen contraband, such as mobile phones. Increasingly, frustration is caused by a reduction in recreation time because of a shortage of prison officers. I am particularly concerned about that problem because, unless something is done soon to increase staffing in Sheppey’s prisons, all the other problems I mentioned will simply get worse.
Let me again use Swaleside as an example. The target staffing level for the prison is 178 officers. However, 153 officers are currently in post. The lack of staff puts pressure on those officers who remain in post. Recruitment and retention are immensely challenging and are influenced by a number of factors. Morale is low, which is hardly surprising considering the environment in which prison officers have to work. The police are dealing with people all day, every day, but many of those people are either victims of crime or people suspected of a crime who turn out to be innocent. The people with whom prison officers have to deal, day in, day out, have all been found guilty of a crime—many of them violent crimes.
Prison officers feel undervalued compared with the police. If a police officer is attacked and injured, the perpetrators are tracked down, prosecuted and, if found guilty, sent to prison for a lengthy sentence. If a prison officer is attacked by a prisoner, too often the only punishment meted out is a withdrawal of privileges.
Let me give an example of the type of violence that prison officers face. Last year a prison officer, whom I know well and who works in Swaleside, was attacked by an inmate. The prisoner threw a kettle of boiling water at the officer. Such casual violence is not an isolated case; it happens on a daily basis. Thankfully, my prison officer friend’s reactions were quick—he ducked out of the way and the boiling water missed him—but he could have been severely burned. The police took no action against that prisoner. That cannot be right. If a prisoner attacks a prison officer or, indeed, another prisoner, that person should be tried and, if found guilty, given as harsh a sentence as if the crime had been committed outside prison. That sentence should then be added to the sentence that that prisoner is already serving.
Another factor in the difficulty of retaining and recruiting prison officers on Sheppey is the relatively low unemployment in our area, as in the rest of the south-east. Last year, UK Border Force ran a successful recruitment campaign that led to a number of my local prison officers leaving to join it. I acknowledge that the Ministry of Justice has done its best to get more staff into Sheppey’s prisons, including the temporary attachment of staff from as far away as North Yorkshire. I welcome those initiatives, but a long-term solution is needed. The canteen at Swaleside is operated by the private company, DHL, which pays its staff a better salary than a new entrant prison officer. That is the nub of the problem.
I congratulate my hon. Friend on securing this debate. I know that he feels passionately about the three prisons in his constituency. I have had the fortune of spending some time—I hasten to add in a professional capacity—at one of those prisons, Elmley. Impressive and constructive work was available for prisoners at Elmley prison, ensuring that their time was spent fruitfully. Does my hon. Friend agree that it is essential that the prison does not use its unique circumstances to undercut local businesses in any way and, thereby, increase unemployment in his constituency and in the surrounding areas?
Yes. It is delightful that among the small number of MPs present for the debate are three Kent MPs. That is probably unique. I do agree with my hon. Friend, but there is another factor. That employment in Elmley and Swaleside is good for the prisoners and their rehabilitation, but it cannot take place unless there are sufficient staff to manage it, and that is one of the problems that we face. I believe that we need a proper review of the working conditions and pay structure for prison officers, including, perhaps, consideration again of regionalised pay that recognises the higher cost of living in the south-east of England and the difficulty of attracting people into a job with so many challenges when there are better employment opportunities elsewhere.
I also believe that the Government need to re-examine their policy on the retirement age of prison officers. It is simply unfair that police officers and firefighters can retire at 60, whereas prison officers are expected to work until they are 68, despite their work being just as physically demanding.
What goes on in our prisons is rarely something that resonates with the public, so the Prison Service never receives from the Government the priority that it deserves. It is the Cinderella service and prison officers are the forgotten public servants. In many ways, they are as much a captive of their penal environment as the inmates whose incarceration they are charged with supervising. I believe that the Prison Service needs both financial help and moral support. In the climate of austerity in which the public sector currently operates, it is perhaps naive of me to ask for help and support for the prison officers in my constituency. However, I am very concerned that, without action, we are building up a penal powder keg on Sheppey that could explode with very serious consequences. For that reason, I believe that the Prison Service in general, and my prison officers in particular, should be made a special case.
It is always a pleasure to serve under your chairmanship, Mr Hollobone. I warmly congratulate my hon. Friend the Member for Sittingbourne and Sheppey (Gordon Henderson) on securing the debate. He has rightly raised very important issues. He started by talking about the fantastic men and women of our Prison Service. I echo those comments completely. It gives me enormous pleasure to take every opportunity that I have in the House to say how much the work of our prison officers up and down the country is valued. As he said, it is often unseen, but it is incredibly important. Our prison officers are the last stop in our justice system. They are essential, and we must protect and support them.
Let me say how important the Government believe that the issues that my hon. Friend has raised are. Staffing and safety are central to everything that we are seeking to achieve in prisons. The challenges facing managers at the three prisons on the Isle of Sheppey are particularly acute, which shows the need for managers and local trade unions to work closely together to secure positive outcomes in the future. I welcome this debate to discuss the steps that the Government are taking to maintain safe, decent and secure prisons, to tackle violence and serious incidents and to reduce staff vacancies.
For those not familiar with the region, let me explain that on Sheppey there are three prisons, collectively referred to as the Sheppey cluster. HMP Elmley is a category B local prison serving all courts in Kent. That establishment opened in 1992 and includes a category C unit of up to 240 prisoners added in 1997. With an operational capacity of 1,252, Elmley is the largest of the three prisons in the group. HMP Swaleside opened in 1988 and holds 1,112 prisoners. That establishment is a category B training prison holding long-term prisoners, including those serving life and other indeterminate sentences. HMP Standford Hill is a category D open prison with an operational capacity of 464.
My hon. Friend rightly referred to staffing levels in the Sheppey cluster. I acknowledge that last year a significant number of prisons across England and Wales experienced acute staffing vacancies. With an unexpected rise in the prison population, economic recovery in a number of regions made recruitment more competitive and challenging for prisons in some areas. Those dynamics, combined with short-term retention and sickness issues, increased pressure on the prison system. I have not sought to underplay those difficulties and I am grateful for the resilience and professionalism that staff have shown in maintaining delivery in challenging circumstances.
In the past few years, there has been significant change across our prisons and the wider offender management system. The National Offender Management Service has delivered savings of almost £900 million for the taxpayer, while fundamentally reforming the way it works both in the community and in prisons.
A significant contribution to the savings was made by the benchmarking programme in public sector prisons. The benchmark applies consistent staffing models and routines to prisons of the same type, removing historical and unjustified variations in the running costs of similar establishments. It also provided a refreshed approach to the prison regime, increasing the time for which prisoners can undertake appropriate and meaningful work, training and education to enable them to obtain employment on release to their home areas, which is particularly important.
I thank my hon. Friend for his intervention. I do accept that. The benchmarking was worked out with the help of the Prison Officers Association and, as he will hear in a second, has had some benefit for two of the prisons in his constituency.
The impact of benchmarking on the number of staff posts has varied from prison to prison, depending on their starting points, but overall it has reduced the number of staff posts and been a driver of financial savings across the system as a whole. For example, the benchmark reduced officer posts at Elmley while it will increase officer posts at Standford Hill and Swaleside. In the past five years, overall numbers of uniformed prison officers have reduced. However, the benchmark also changes the way people are deployed and work, by setting the resource according to the work required.
Nationally, the staffing picture has improved significantly following 12 months of accelerated recruitment. National recruitment delivered 1,700 new prison officer recruits into the service between January 2014 and March 2015. In the coming year, the National Offender Management Service will focus activity on recruiting greater numbers to priority regions—those geographical areas, such as London and the south-east, including the Sheppey cluster, where recruitment under the accelerated scheme has not yet matched demand.
Recruitment and retention of staff is one of the most significant challenges facing the three prisons on the Isle of Sheppey. The pressure has been felt most acutely in the number of prison officers available, but increasingly also in relation to other front-line staff. Staff numbers fell significantly despite recruitment during 2014. By the end of March 2015, the number of officer vacancies had fallen to 550 across the whole estate. At the same point, the three prisons on Sheppey cumulatively had 70 officer vacancies.
In the shorter term, the Prison Service has a number of other ways by which it can support prisons with shortfalls in staffing levels on Sheppey. Those include the ability to offer staff additional working hours, some at premium rates under a scheme known as payment plus. The service has also deployed prison officers from other parts of the country to work at sites with more acute staffing issues on a detached duty arrangement.
My hon. Friend raised concerns about officer pay and pension age. Pay rates are set at comparable levels for similarly weighted jobs in the same area. The National Offender Management Service reassesses that every year to ensure that rates remain competitive and to see whether any change is needed. Since April 2015, starting pay has increased significantly, and we will assess what impact that has on recruitment of staff. However, we are aware that certain establishments are having difficulties in recruiting and retaining staff, and a review is now being undertaken of the pay offered in the relevant areas. That includes the Sheppey cluster, and the review will conclude shortly. I point out, however, that ultimately rates of pay and local allowances are determined by the independent Prison Service Pay Review Body after receiving evidence from both the National Offender Management Service and the trade unions.
The Prison Officers Association is discussing retirement age with the Government and the Cabinet Office. We will consider any information submitted to us. Regardless of age, it is important that prison officers are fit, healthy and able to perform their role, to safeguard their colleagues and those within their care.
We are under no illusion about the scale of the problem of assaults in prison. The number of assaults increased by 10%, from 14,664 in 2013 to 16,196 in 2014. Although the increase is partly due to improvements in reporting of assaults following changes in data assurance processes, those improvements do not account for the whole increase. Serious assaults, including on staff rather than on other prisoners, have risen even more, to 2,145 in 2014 from 1,588 in 2013—an increase of 35%.
Deaths in prison custody have risen over time, alongside an overall ageing of the population, which includes an increasing number of elderly prisoners. Around two thirds of deaths in prison custody are from natural causes. Self-inflicted deaths are a serious cause for concern. In 2014-15, there were 76; although lower than the 88 in 2013-14, that figure is higher than the level over the previous five years.
Some incident categories in the Sheppey cluster have also increased, although not all. Assaults on staff have increased significantly, and we have also seen an increase in self-inflicted deaths at Elmley prison, although not at the other sites. However, assaults on prisoners have reduced year on year since 2011 and self-harm decreased between 2013 and 2014.
Although we do not downplay the significance of each and every incident—and I wish to make clear again my commitment to reducing violence further—the statistics show that violence is a complex issue that is influenced by a number of behavioural and situational factors. There is strong evidence that an increase in the illicit trade and misuse of synthetic drugs and new psychoactive substances is linked to the recent increase in violence across the prison estate. The problem is increasingly prominent in the community at large, and my hon. Friend will be aware of the Government’s intention to legislate to control such substances. We are also developing a range of responses to the challenge within our prisons, including training of drug detection dogs and the deployment of urine testing capability.
In addition, the Serious Crime Act 2015 introduced two new offences that will help combat violence in prisons. One is being in possession of a knife or other offensive weapon within a prison—I think my hon. Friend will agree that it is amazing that that was not an offence before the 2015 Act—the other is throwing items over a prison wall, which is a common way of introducing contraband, including new psychoactive substances and other drugs, into a prison. Both offences carry a penalty on conviction of imprisonment, a fine or both, depending on the circumstances of the offence.
The National Offender Management Service has established a violence reduction project to gain a better understanding of the causes of the current levels of violence in prisons and to ensure that both prevention of and response to violence are strengthened. A range of action is being taken across the prison estate as part of that programme, including issuing new guidance to governors to support the development of local violence reduction strategies. We are also piloting the use of body-worn cameras across 24 establishments, including 42 cameras at Elmley and 34 at Swaleside.
We have introduced a joint protocol between the National Offender Management Service, the police service and the Crown Prosecution Service on the handling of crimes in prison, to address precisely the issue that my hon. Friend raised. I assure him and the prison officers he represents that I take that issue extremely seriously. Where there should be a prosecution I absolutely want to see one, with a due penalty. We have also introduced the development of more rigorous case management of individuals with a greater propensity to violence. HMP Swaleside is delivering a case management pilot as part of its work with personality-disordered offenders. Although distinct from the main programme at this stage, it will ultimately contribute towards learning to inform our future violence reduction work. We are also investing £2 million in increasing closed circuit television coverage during 2015-16.
A programme of work to address the rise in self-inflicted deaths is being taken forward. Last summer, new regional leads were put in place in each public sector prison’s region, as well as in Wales, to support staff in prisons and share best practice. Additional staff were provided to certain high-risk establishments, and national learning days on deaths in custody were held last year. Regular communications have been sent to governors and staff to share learning from deaths in custody and promote learning from independent bodies such as the prison and probation ombudsman.
I acknowledge my hon. Friend’s concerns about the prisons in his constituency. I do not underestimate for a moment the challenges faced by staff at those three prisons, and the significant challenges we face serve only to emphasise the achievements of those staff. I hope that I have reassured him that I take the issues seriously and that we will continue to do everything we can to address them.
Question put and agreed to.
Drugs: Ultra-rare Diseases
[Mr David Crausby in the Chair]
The Speaker’s Commission on Digital Democracy recently recommended the use of regular digital public discussion forums to inform debates held in Westminster Hall. A digital debate has taken place on Twitter ahead of today’s debate on access to drugs for ultra-rare diseases. For this reason, Mr Speaker has agreed that for this debate members of the public can use hand-held electronic devices in the Public Gallery. Photos, however, must not be taken. I encourage Members who wish to refer to the Twitter debate to call it the rare diseases Twitter debate, rather than using people’s individual Twitter names.
I beg to move,
That this House has considered access to drugs for ultra-rare diseases.
I am delighted to have the chance to speak on this important topic today. I was also delighted to lead and take part in the historic Twitter debate yesterday, which was a great success. On top of the very strong show of support from Members of all parties, the fact that nearly 1 million people took part in the debate yesterday shows how important the issue is.
I got involved in the issue because Katy and Simon, the parents of Sam Brown, a six-year-old boy in my constituency, came to see me. In 2009, when Sam was 16 months old, he was diagnosed with Morquio syndrome, an ultra-rare disease that 88 people in the United Kingdom have. It is a degenerative life-limiting condition with a typical life expectancy of around 25 years. It limits considerably what those suffering from it can do. All of us here can only imagine what it must feel like as a parent to receive the devastating news that your child will deteriorate before your eyes, not live to an old age, and may not even see much, if any, of their adulthood. Imagine how it feels when a nurse rings up and says, “There might be a treatment, but it is only a trial.” Of course, on hearing such news, what parent would not want to sign up for a trial for the drug Vimizim, supplied by the drug company BioMarin? That is exactly what Katy and Simon did: they signed up Sam to the trial without hesitating.
For the past three years, Sam has been doing a 100-mile trip from Otley to Manchester every Thursday to get Vimizim, his enzyme replacement therapy. Without it, Sam would see his growth stunted more than it already is, with further skeletal deformities and possible heart and vision problems. With Vimizim, Sam’s parents, and, even more importantly, Sam’s medical team, say that he is clearly physically more capable and stronger, with more stamina than ever before. To quote Katy, his mother:
“The drug has given him the freedom to be a child again.”
I ask right hon. and hon. Members to take the opportunity to share the single, “There is a Boy”, produced by the Keep Sam Smiling campaign and produced at his primary school, the Whartons in Otley, where they have shown huge support to an ordinary little lad who wants to be an ordinary boy and an ordinary man. The video for the single shows Sam being a fireman, a doctor and an astronaut, the kinds of things that he has the right to hope one day to be, but he can have that hope only if he gets treatment and is able to continue to take Vimizim.
We are here today because, after three and a half years, in just nine days’ time, Sam’s access to Vimizim looks set to be cut off.
The hon. Gentleman knows that I represent the grandmother of Sam Brown. This debate is important. As the hon. Gentleman has said, the mother has already testified to how Sam is stronger and fitter as a result of taking the medication. NICE has said that it is
“likely to provide valuable clinical benefits for certain aspects of the condition”.
Even if it does not provide a full cure, how can the treatment for that wonderful young boy be axed?
The recommendation from NICE is strange—I will come on to that—given that, clearly, the drug is effective.
Sam and other children and adults with Morquio disease are not the only people being let down. There are other conditions. I have been working with Members and organisations on the mutation of Duchenne muscular dystrophy and tuberous sclerosis. We have come together to campaign as one to say that we need a better way of approving drugs for ultra-rare conditions. At the moment we have a system in this country where people with ultra-rare diseases are discriminated against, and that must stop.
I pay tribute to the hon. Gentleman for the work that he has done and for securing this debate. On other rare conditions, I have a very sick two-year-old in my constituency who suffers from neuroblastoma, a rare form of cancer that only 100 children suffer from each year. It is difficult to accept that my constituent has to raise money and travel to the United States to get treatment. We should ensure that children or anyone suffering from rare conditions, such as Ruby Young and those in the hon. Gentleman’s constituency, get the treatment they need at the first port of call in their own country.
The hon. Gentleman is right to say there are other such conditions. I will not be able to mention them all today, but other Members may wish to do so. I will concentrate on the three conditions that I have been working on: Morquio, Duchenne and tuberous sclerosis. Some 180 people suffer from those conditions. I am sorry to say that all those people and their families have been hugely let down by the repeated failure of process by NHS England and by the thick wall of bureaucracy and utter lack of accountability.
Like the hon. Gentleman, I have been involved in the issue of Morquio. The correspondence that we have had seems to want to blame the company; the company says it has not had the information; and patients suffer. This matter has been drawn out, and we now have the news from NICE.
I thank the hon. Gentleman for his intervention. It has been a pleasure working with him and others. We must continue to do so. That leads me on to the fiasco of the decision-making process. The leadership of NHS England should hang their heads in shame over the way they have handled this. There is also a responsibility on the shoulders of the Minister, who I know cares about this, but he needs to get a grip of NHS England and the way that it has failed families. Part of the problem goes back to the passing of the Health and Social Care Act 2012, which led to the disbanding of the advisory group for national specialised services in April 2013. That advisory group was the expert body that advised on specialist treatments and services, and it was respected by many rare disease charities.
I congratulate the hon. Gentleman on securing this debate. There are muscular dystrophy treatments in Europe that have suddenly been halted in this country. I hope the Minister can give us a good answer on that because people are suffering while there are delays. In some instances, it could shorten their lives.
I pay tribute to the hon. Gentleman’s work on this issue. I joined this campaign because of Archie Hill, a constituent of mine aged 10 who has Duchenne muscular dystrophy. No matter what the Minister says about drugs such as Translarna and the process that the hon. Gentleman is about to outline, which has been disgraceful, that drug is available in other European countries and we have still not cleared it for patients in the UK.
Indeed. It was a pleasure to meet the right hon. Lady’s constituent, Archie, and his parents. These young people are inspiring us to campaign. She is absolutely right. We are debating the European Union Referendum Bill today in the Chamber. Other EU countries, and some non-EU countries, regard these treatments as effective and affordable, yet we do not.
I will fast-forward from the scrapping of the previous body to October 2014, when NHS England came out with the scorecard system. That is despite one of the clinicians involved, Dr Chris Hendriksz, saying on 22 October in an email:
“I would suggest the scoring is not used at all for decision making this round and I would rather have people acknowledging that they are making random decisions than to try and give some credibility to a process that was deeply flawed.”
That is from one of the senior clinicians.
NHS England none the less went ahead with the scorecard system to decide which funding should be prioritised. Suzanne Mallah and her 10-year-old boy Kamal, who has Morquio and is another inspiring young person whom I have been delighted to meet, saw that that was not only haphazard but discriminatory. With the help of the MPS Society, they threatened legal action on 28 November against NHS England on the basis that the scorecard was clearly discriminatory, that there was no policy explaining it and that there had been no public consultation on its use. Just one week after that, on 2 December, NHS England announced that it was suspending use of the scorecard because the MPS Society and Kamal were right and it was wrong.
The hon. Gentleman makes a good case. Is it not also the case that clinicians have not been listened to all the way through this, in the same way that they were not listened to when the Health and Social Care Act went through? That is what has led us to where we are. I have been the chairman of the all-party group on muscular dystrophy for 10 years. We had a very good working relationship with the specialised commissioning groups, which were effective in getting medication of this type to people, but the bureaucracy created by the Act was against clinicians’ wishes, which is why we are here today. NHS England has a lot to answer for. The Government’s decision to ignore the voice of professionals has put us in this position.
It has been a pleasure to work with the hon. Gentleman and the APPG on muscular dystrophy on the Translarna part of the campaign. He is absolutely right. We want not only an acknowledgment from the Minister that the current processes are not fit for purpose and not fair on those with ultra-rare diseases, but a drive to overhaul them.
I congratulate the hon. Gentleman on securing the debate. Does he agree that one of the best ways to help people suffering from ultra-rare diseases is Muscular Dystrophy UK’s suggestion of a fund to ring-fence money for these rare diseases?
We are all extremely grateful that the hon. Gentleman has been so generous in giving way. Like him, I was at Downing Street last week, supporting my constituent Harry Barnley, who suffers from Duchenne muscular dystrophy. The headquarters of the Batten Disease Family Association are in Farnborough in my constituency. The hon. Member for North Tyneside (Mary Glindon) referred to ring fencing. Part of the problem is that there is a very small number of these cases and they are very expensive to treat. I wonder whether we should either ring-fence some funding or introduce a surcharge on prescription charges generally paid by the public, so that the funding issue is taken out of it. There are two issues: the clinical issue and the funding. If we remove the funding issue, we can concentrate on the clinical issue.
I thank the hon. Gentleman for his contribution. I am sure the Minister will want to consider that in his drive for an appropriate system.
After NHS England suspended the use of the scorecard on 2 December, a meeting of the NHS England clinical priorities advisory group on 15 December was called off. That is when we started campaigning for an interim process while NHS England went back to the drawing board. NHS England refused to do that, which I am sorry to say left all these families in the dark, with no idea what would happen next or in what timescale. NHS England then launched a consultation on 27 January, with a new process for deciding which drugs to fund that closed on 27 April. We still have not heard the decision. We have been told that there may be a decision on 25 June, although that has not been confirmed in writing. I hope that the Minister will give confirmation today.
Linked to that are the recent NICE recommendations, and particularly those on Vimizim. Even though we were clearly told by NHS England that its decision on 25 June would not be dependent on NICE, it now says that it will not approve Vimizim because NICE will not do so in the short term. The whole thing is a fiasco and an embarrassment. I understand the Minister’s argument that we cannot have political interference. However, the Secretary of State for Health made clear when he appeared before the Public Administration Committee in the previous Parliament that he accepts that the buck stops with him. When things are wrong and when bureaucrats are failing, it comes to his desk and to the Life Sciences Minister’s desk. I urge the Minister to take that up.
I pay tribute to the MPS Society for its amazing campaigning, and particularly to the chief executive Christine Lavery, whose son Simon had Morquio and died in 1982 aged just seven. Her passion and her colleagues’ passion have inspired me and others, and we will continue to work with them. The enzyme replacement therapy produced by BioMarin, Vimizim, is currently supplied on a free trial by BioMarin to 34 patients around the country out of a total of 88 patients, so more people with Morquio are not getting Vimizim than are.
The list price for Vimizim is £395,000 per person per year. In October, BioMarin proposed a fixed-term arrangement with NHS England to supply the drug at a lower price for a number of years. After BioMarin’s offer in October, NHS England did not even reply, despite repeated follow-ups, forcing BioMarin to announce in February that it would cease to supply the drug after 11 May; that date was then extended to 25 June. Having heard nothing, BioMarin said that it would have to withdraw the drug.
Gracie Mellalieu in my constituency, fortunately being in Wales, will get the drug until October, but there is still that cut-off point. Is the hon. Gentleman amazed, as I was, at the total lack of engagement from NHS England, even when that offer was made?
It is absolutely disgraceful and I urge the Minister to properly take that up. We have not had answers or justifications, although there can be no justification for NHS England behaving in that way. NICE’s decision not to recommend approving Vimizim in the short term has already been deemed to be flawed by those involved, including the MPS Society and clinicians, because it fails to consider BioMarin’s offer and has assumed that the cost of the drug will be the original £395,000. How has that happened? NICE also took months to put together the interim guidance, but has given only until next Tuesday to receive the extra evidence that it has asked for. Surely that is an unfair timeline for response.
As of 28 April 2015—which, incidentally, is a year after Vimizim was approved by the European Medicines Agency, meaning that it is approved in 20 European countries, including France, Germany and the Czech Republic—the drug was still not available in the UK, because NHS England has failed to put in place arrangements for funding it. Does the Minister not share the sense of frustration, anger and disbelief that the NHS refuses to fund the drug when so many of our neighbours do? More fundamentally, Earl Howe gave patients an assurance that their access to the drugs that they need would not depend on the cost per quality-adjusted life year measure. Can the Minister tell us why his Department has gone back on that assurance? That is exactly what it appears to have done.
I appreciate that the Minister has taken the time to meet us, but I remind him of the 11-page letter that he asked the organisations to send him some 11 weeks ago. We expected him to respond to that, as it was a complaint about NHS England’s handling of the matter, yet he simply passed it on for NHS England to respond to. That is not what we asked him to do, and the response does not address the points that we made to him, at his request, about how NHS England has failed people. I ask him again to reply directly and properly, and to investigate the mishandling of the situation by NHS England.
Duchenne muscular dystrophy has been mentioned. Again, I highlight the campaigning of organisations such as Muscular Dystrophy UK, Joining Jack, Action Duchenne, the Duchenne Family Support Group, the Duchenne Children’s Trust, Alex’s Wish and the Harrisons Fund. Those groups share the MPS Society’s frustration at the process. As many hon. Members know, Duchenne muscular dystrophy is a condition affecting only boys, and numerous potential treatments are in late clinical trial. Translarna, in particular, received conditional approval funding in the EU in August 2014. This clearly effective drug is being funded in a number of countries, including Greece, even given its economic situation, yet we are still no closer to hearing whether it will be funded here. I hope to hear positive news on that drug today.
I pay tribute to the Tuberous Sclerosis Association and the work of Jayne Spink and her colleagues. For those who do not know, tuberous sclerosis is a condition that causes the growth of tumours in organs, including the brain, eyes, heart, kidneys, skin and lungs, and a range of associated health problems, including epilepsy, learning difficulties and behavioural problems. The drug everolimus has been found to be effective in shrinking the tumours, extending life and improving quality of life, but although it was licensed for use in patients with tuberous sclerosis in February 2013, NHS England has failed to draw up a prescribing policy. At least two people have already died since the drug was licensed; Chris Kingswood, a consultant nephrologist, said that Julie Brooker’s death in January 2013 was “absolutely preventable” if she had been given access to everolimus.
My constituent William needs that drug. The issue for his family is the timeline, which the hon. Gentleman mentioned. They have waited two years and been told that it may be another year, but they have said to me that William might not have that much time and that, like the woman the hon. Gentleman just mentioned, he might no longer be with them by then. Those parents are fighting for their son.
The hon. Lady is right: none of these children or families has time. All those conditions deteriorate irreversibly. She is right that it has been 28 months since the drug was approved, yet patients are no closer to accessing it. What will the Minister do to speed up a commissioning policy for everolimus?
I turn to Batten disease, another condition already mentioned. I pay tribute to the Batten Disease Family Association. Batten disease is another condition that I had not heard of until I was approached by my constituents Duncan and Lynsey Brownnutt. I have been pleased to join Duncan to support some of his amazing fundraising efforts. This summer, he is off on a wonderful cycling trip to the Arctic Circle with his friend Rod to raise money, but the day after the general election, his six-year-old daughter Ellie Mae passed away from Batten disease.
Batten disease is another condition currently without any cure. It includes increasing visual impairment, complex epilepsy with severe seizures, decline of speech, language and swallowing skills, deterioration of motor skills resulting in loss of mobility and ultimately death. Potential treatment for Batten disease is not even being considered for 25 June. If the situation of the other conditions is still unclear and their drugs have been turned down, when will action be taken on treatment for Batten disease?
The Batten Disease Family Association explained that to me when I met with representatives, but unfortunately that is not even in the consideration for 25 June. That is why we need an overhaul.
We have a five-year Parliament. I hope that the Minister will serve as the Life Sciences Minister for a considerable time, if not for the whole Parliament. His challenge as the Life Sciences Minister, as well as dealing with the accountability deficit that clearly exists in NHS England’s decision making, must now be to initiate a proper process for the approval of drugs for rare conditions. Of course there are cost implications, and of course drugs must be effective, but the situation is that there are effective drugs that this country is not funding, while other countries with less strong economies are finding the money in their health services to fund them.
The hon. Gentleman talks about funding, but one aspect that precedes funding is awareness of such diseases. For example, the Government’s “Be Clear on Cancer” campaign does not take into account rare conditions and cancers such as neuroblastoma, from which my constituent, who is near death, is suffering. The Government must ensure that rare conditions are part of the bigger campaign, so that the people suffering from them get the help that they need as well.
The hon. Gentleman is right. I am afraid to say that politically, particularly at election time, there is not enough focus on rare conditions and too much focus on more common conditions in order to appeal to a broader group of people. We cannot allow that to lead to discrimination against people with ultra-rare conditions.
I will finish with two quotes. The first is from the framework agreement with NHS England, which clearly lays out that the Minister and the Secretary of State can and should intervene. Paragraph 4.11.3 says:
“If the Secretary of State considers that NHS England is significantly failing in its duties and functions, he is able to intervene and issue directions to NHS England. This also applies where he or she considers NHS England has failed to act in the interests of the health service.”
Clearly, that is what NHS England has done, and he must now act and get a grip of this process.
I will leave the final word today to Katy Brown, the amazingly courageous mother of six-year-old Sam, because we can imagine the devastation that she felt after the flawed NICE decision not to recommend approving the drug for the time being, knowing full well that NHS England will just use that decision as its cue to say no on or before 25 June. Katy has said that, if that is the case,
“Sam is being handed a death sentence…He is being denied his freedom, his independence and his future.”
That is not something that any of us should allow when we have a drug that is affordable if we have a system such as that in other European nations and that is clearly clinically effective. We need major change and, Minister, we need it quickly.
It is a pleasure to serve under your chairmanship, Mr Crausby.
I am pleased to be the first to congratulate the hon. Member for Leeds North West (Greg Mulholland) on securing this important debate. I also pay tribute to him for the enormous amount of work he has done on Morquio syndrome, which he has raised many times in the House and in Westminster Hall. He has also held numerous meetings and led delegations to Downing Street. He has worked assiduously on behalf of his constituent, Sam Brown, and, as we have heard this afternoon, he has worked on not only Morquio syndrome, but a range of ultra-rare diseases. He has done an excellent job today of highlighting the problems, the delays in funding and the amount of time it has taken simply to get these drugs through the approval process.
Rather than focusing on those aspects, I will talk about the human cost of these diseases, highlighting the case of my constituent, Jagger Curtis, who is just seven years old—he will be eight in August—and a pupil at Romsey Abbey primary school in my constituency.
Last Wednesday, Jagger was one of the brave boys who walked up Downing Street to hand-deliver his letter to the Prime Minister, which was an incredible experience for him and his parents. It was a really important part of their campaign to highlight the need for funding and approval of Translarna, because Jagger suffers from Duchenne muscular dystrophy.
Of course, Translarna is a relatively new drug. I say “relatively”, because it has been used in European countries since last year; it received conditional approval from the European Commission in August 2014. Yet here in the UK, as the hon. Gentleman has said, we are still waiting.
Duchenne muscular dystrophy is a very serious condition that affects about 2,500 people in the UK, almost all of them boys. It causes muscle weakness, leading to a dramatic loss of muscle function. Typically, patients will lose the ability to walk in their early teens; they will require respiratory support by their mid teens, and they are likely to die either of heart failure or respiratory failure before they reach 30. I cannot emphasise enough what a devastating condition it is and how brave families are when they have to face up to and deal with the reality of a Duchenne diagnosis.
Currently, the only treatments available address the symptoms, rather than the cause of Duchenne. They include the prescription of steroids, which of course have some very severe side effects, including sudden and dramatic weight gain, mood swings, which can be particularly difficult to contend with in teenage boys, and thinning bones.
As has been said this afternoon, Duchenne is a rare condition, with very few sufferers in the UK, and only about 10% to 15% of them have what is referred to as “the nonsense mutation”, which makes them eligible for treatment with Translarna. In some respects, Jagger is very lucky, because he is one of the boys with the nonsense mutation and is therefore eligible for Translarna. Currently, he is still mobile, which is absolutely critical when the use of Translarna is being considered, because it cannot be prescribed after a patient has lost their mobility. Translarna has the best chance of having a beneficial effect while the boys can still move around. Once they have lost their ambulation, it is too late and the opportunity has been missed.
Jagger’s parents, Julie and James, were told late last year that he was a suitable candidate for Translarna, and they genuinely believed that they were within a few weeks of going to the hospital and picking up a prescription for the one drug that they had been told could make a difference to their son. In November 2014, they had no idea that they would still be waiting for the drug now and that it still would not have finished going through the administrative process by the end of June. We are now seven months on from the day that they had expected to go and collect a prescription, but there has still not been a decision and they simply do not know what the outcome of this process will be.
During that time, of course, Julie and James have watched their son lose some of his mobility; his muscles have wasted away further. More than anything else, they desperately want an extension of the time in which Jagger is able to move around by himself, without the need for a wheelchair.
In his letter to the Prime Minister last week, Jagger wrote that he wanted to keep on playing football forever, just like his friends. He is an enormous Saints fan, and one of his proudest moments was going on to the pitch at St Mary’s to lead the team out. There is a fantastic photograph that he included in his letter to the Prime Minister, showing him shaking hands with the Saints manager, Ronald Koeman. In every other way, Jagger is a lively, lovely, normal little boy, who has a massive love for football, but, and it is a huge but, unlike most seven-year-olds Jagger has already been fitted for a wheelchair. His parents have had to make the necessary preparations—it was difficult, even heartbreaking, but they had to do it—to ensure that when Jagger’s mobility is more restricted a wheelchair will be ready and waiting for him so that he can still get around.
For Jagger and every other boy with Duchenne muscular dystrophy who has the nonsense mutation, the clock is ticking. In fact, it has been ticking since last August, when Jagger’s parents and others had their hopes raised that there was a treatment that was about to become available on the market. That treatment could give boys such as Jagger the chance to see out their time at primary school without needing a wheelchair, so that, as Jagger himself puts it, he can run around with his friends and be like any other normal little boy.
My hon. Friend the Member for Leeds North West—I should refer to him as the hon. Gentleman now, but old habits die hard, and on this subject he has been a great friend and a great campaigner; I pay tribute to him for that—along with Muscular Dystropy UK and Action Duchenne, has done great work to highlight the problems that people have faced in getting approval for Translarna in the UK. We expect a decision on Translarna at the end of June, and the company that manufactures it, PTC Therapeutics, indicated last week that it was ready to go, had stocks available and could supply it as and when it was needed.
If that drug is given the green light at the end of June, it will be distributed here, but the boys I have mentioned today have already waited for far too long, and this drug is the only one that is giving them any hope. I know the Minister has been most diligent for some months; he has listened to all we have had to say in this Chamber, in the House, on Twitter and indeed in the media. However, as we have heard, there are real concerns about how long the approval process has taken and about how complicated it has been, as well as about some of the inconsistencies and contradictions about when the drug might be made available. I hope that the Minister will make some comment on that.
I am conscious that there are many Members here in Westminster Hall this afternoon who want to contribute, so I have deliberately kept my remarks short. I will conclude with the words of Jules Geary, because I do not think anyone else could better summarise how her family feels:
“It is hard enough watching your child have to go through losing their muscles. For the drug to work, Jagger still needs to be mobile, so we simply don’t have time to wait. We have been given hope through this drug. We just can’t let it be taken away again.”
First, I congratulate the hon. Member for Leeds North West (Greg Mulholland) on bringing this matter to Westminster Hall for consideration. Westminster Hall is well filled today because we all have constituents who are suffering and do not have access to the drugs needed to combat these rare diseases. I also congratulate the hon. Gentleman on his hard work on this issue, for which he is well renowned; we have all said that, but it is the truth, and we all want him to know that we know it.
I am glad this debate has occurred, because it is on a subject that affects many people in my constituency. We have heard some stories and we will hear more before this debate is over.
The diseases we are considering may be rare, but collectively they affect the lives of 3 million people across the United Kingdom. That emphasises that everything must be done to create a comprehensive initiative for providing care to those affected by these difficult and challenging diseases.
Rare diseases tend to be life-threatening or chronically debilitating. There are between 6,000 and 8,000 rare diseases. Each one affects less than 0.1% of the UK’s population, but Rare Disease UK calculates that 75% of these illnesses affect children.
We are here today on behalf of our constituents, but we are also focusing very much on young people across the United Kingdom of Great Britain and Northern Ireland who have these problems.
The ultra-rare diseases that have been mentioned include Morquio disease, Duchenne muscular dystrophy and tuberous sclerosis. I would also add Prader-Willi syndrome, which some of my constituents suffer from.
The chance of improving people’s quality of life depends very much on a narrow timescale. It requires quick diagnosis, treatment and drug provision, so that drugs can be accessed when they are proven to be most effective. In other words, as every Member who has spoken has said, time is of the essence—the people who are suffering need help now, not in six or 12 months. It is our duty to make that timeline as transparent and effective as possible within the finite resources we have, and I understand the problems the Minister has. There must be adequate assistance for practitioners, to allow for timely diagnosis and the timely provision of drugs and treatment.
The hon. Gentleman has been very consistent on this issue, and he is right: as those of us in the all-party group on muscular dystrophy have found, one of the main reasons for delays is that clinicians—particularly GPs—do not see these diseases very often, and when they do, they are sometimes lost as to where to go. Once a disease is diagnosed, the people suffering from it should have no worse access to treatment than people with much more common diseases—surely that is the issue that has to be addressed. Once a disease is identified, we have to get to grips with it, and people have to get the medication and the support they need, so that they can get on and live the best life they can.
I agree wholeheartedly. I am sure the Minister has heard us all say that time is of the essence and that we should strike right away. That is what we are about.
The health and social care professionals involved in the diagnosis, treatment and care of these patients face difficult tasks. As I was saying, there must be adequate assistance for them, to allow for timely diagnosis and the timely provision of drugs and treatment. There also needs to be sufficient funding UK-wide.
In Adjournment debates and other debates about these issues, I have always referred to Queen’s University in Belfast and to the importance of research and development. Queen’s University is one of the universities that do research, and it works in conjunction with the Health Department. Perhaps the Minister could therefore give us some idea what the Government are doing on research and development to ensure that new drugs are found.
My hon. Friend mentions research. As he will know, I am involved in a campaign in Northern Ireland and across the United Kingdom on complex regional pain syndrome. The condition affects children, but it mostly affects adults from the age of 50 onwards, and people can lose limbs to it. One in every 3,000 people is affected, and many lives have been destroyed. We need more research to find a drug to cure this condition, and research funding needs to be put in place so that that research can be done.
I thank my hon. Friend for his intervention. That is a message that I, too, believe in, and I am sure the Minister will respond positively.
Leaving aside all the statistics we have heard today, we need to imagine the emotional strain these things put on people and their families, and we have had examples of that. Only 35% of patients are aware of a licensed treatment for their condition. There is something wrong when that is the case. How come only 35% of people know there is something there for them? How are the Government addressing that? I am not attacking the Minister—that is not how I work—but how do we move things forward in a positive fashion? Of that 35%, 89% are able to access the treatment, but 11% are not. Therefore, 65% of people are not aware of the drugs, and of the 35% who are, a proportion are not able to get them.
Like others, I want now to touch on Duchenne muscular dystrophy. If Translarna is given at the correct time, we can prolong the sufferer’s mobility. My constituents deserve to have access to that drug as soon as possible, and that is what I would like to see happen. The effects of long waiting times and uncertainty are widespread, and although ultra-rare diseases affect the few, their effects for those who suffer from them are an inescapable reality and should be treated with the utmost seriousness.
Families deserve a solution to the continual failure to establish a lawful, robust and transparent commissioning service that enables the rare disease community to access new drugs in an equitable and timely manner and to avoid situations such as those we have spoken about, where crucial windows of opportunity pass by. This is a crisis—it cannot be described as anything else. People are in trouble, and they need our help now.
Let me quickly pay tribute to the lady who looks after the Northern Ireland Rare Disease Partnership, Christine Collins. Last year, we met the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), to discuss these matters. We were clearly moving forward, and the Minister was very responsive. The background information for the debate says that, in November 2013, the UK Department of Health and the devolved Governments published the UK strategy for rare diseases. In June 2014, the Northern Ireland Assembly endorsed it and gave a commitment to publish an implementation plan, and last year’s meeting provided an opportunity to underline the need for that to happen. Perhaps the Minister can give us some idea today of what discussions he has had with his fellow Minister to move things forward so that we can deliver on that commitment.
The debate has dealt with access to drugs. It has also given us an opportunity to bring out the gaps in the patient experience. Let us remember the patients, the families, the children and all those who suffer. They require a co-ordinated response from not only the health service and the social services, but research bodies and the relevant charities. I hope that the common experiences we have described signal the urgent need for access to these vital treatments. I remind all those in a position to have a tangible impact on drug access that while we are debating these issues, somebody else is falling into the trap and will, unfortunately, be unable to access the necessary drugs. I urge the Minister to respond positively, and I thank the hon. Member for Leeds North West again for giving us all a chance to speak about this issue.
I pay tribute to the hon. Member for Leeds North West (Greg Mulholland) for raising this issue and for his untiring work. I agree with my hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) and the hon. Member for Strangford (Jim Shannon), who made many of the points I hoped to make.
I am grateful to have a short time to raise the case of my constituent Archie Hill and his parents’ tireless campaigning to get access to Translarna for him. It is inspirational to see how this family, and many others, have campaigned for their children. I can imagine nothing worse than watching one’s child slowly lose their mobility, knowing that their life expectancy will not be as great as ours might be.
Translarna is available in other European countries. As we have heard, it is available in Greece, which is not in the best economic health. Only recently, in Germany, the Federal Joint Committee determined that it provides a benefit for ambulatory patients aged five years and above with the nonsense mutation. The rise in the PTC Therapeutics share price on the back of that announcement shows that the company is well placed, and its drug is being recognised right around the world.
There is an irony here. If the decision coming down the track goes against making Translarna available to the patients who deserve it so much, the question arises as to whether this is about cost. The decision will almost definitely be made on a cost basis. Day by day, I see millions being spent in my constituency on High Speed 2 when we cannot spend £150,000 to keep a 10-year-old boy ambulatory and enjoying his life. We must question where a Government’s priorities are, when there are such people in front of us and we see the pie-in-the-sky projects that Governments of all complexions sometimes choose to pursue.
The point I really want to make is that if the decision is against providing the drug—bear in mind the failed processes that it has gone through—the Government have a golden opportunity to rescue the dish from the fire. I do not think it will necessarily fall out of the frying pan. On 8 July the Chancellor of the Exchequer will deliver his emergency Budget. We have previously created a cancer drugs fund, so that expensive drugs could be available to save lives. Will the Minister have conversations with the Treasury to see whether the Chancellor will on 8 July announce an access fund for drugs for rare conditions? If Translarna was one of the drugs on the list, it would be available in time for Archie Hill and the other children we have heard about today. To me, the awful thing is that time is running out. I do not think that letting time run out for those children would be the mark of a civilised Government, when the cost involved is small compared with some other expenditures that Governments make.
I add my congratulations to those that have been offered to the hon. Member for Leeds North West (Greg Mulholland) on tabling the debate. His passion and commitment on the subject are second to few.
Last week in Bath I met an incredibly impressive constituent of mine named Sarah Long. Many hon. Members will already know of her from the Twitter debate yesterday. She met me to discuss the benefits that she has received from Vimizim, the enzyme replacement therapy to address the cause of Morquio A. She is estimated to be one of just 88 people in the UK who need the drug. While she has been on Vimizim she has experienced dramatic changes, which have become gradually more apparent. She told me that since being on the drug her ability to use her lungs has been transformed. Before she started treatment she needed almost constant access to oxygen, and today she needs just four hours of nebulising. Pre-Vimizim, Sarah found it difficult to talk, but Vimizim has given her voice back to her. The idea of a return to the former days obviously fills her with dread.
Following recent conversations with the MPS Society, the National Institute for Health and Care Excellence announced on 4 June that it is leaning towards not recommending Vimizim for treating people with MPS IVA, or Morquio. That is only a preliminary recommendation and is not its final guidance; the decision may change after consultation. I hope in the interests of my constituent that it will change. I request my hon. Friend the Minister to lean heavily on NHS England before 25 June as it decides about reimbursement with respect to Vimizim on an interim basis, while NICE completes its decision making.
The date of 25 June is critical, as hon. Members have said. If NHS England announces a positive decision, all those who want treatment and who meet the criteria will be allowed access to treatment, regardless of whether they were on the clinical trial. If NHS England follows NICE’s current position and the decision is negative, BioMarin will immediately withdraw compassionate use from those in England who are receiving treatment.
As hon. Members will know, MPS can lead to reduced life expectancy. However, Sarah is in her forties. We have heard an awful lot in the debate about treatments that support young people, but Vimizim also supports adults, if they manage to get to such an age. If NICE gathered more evidence from people such as Sarah, the Minister would see that Vimizim has worked for her and for and others. The real injustice is that her quality of life has dramatically improved, but it appears that NICE is unable to conduct a peer review because of the lack of cases. I hope that the Minister will be able to look into that Catch-22 case.
Being on the drug has dramatically reduced the cost of my constituent’s care, because the amount of time on oxygen has fallen. That is also an obvious cost reduction to the taxpayer. NICE clearly needs to acknowledge the significance of clinical expertise in its processes, and to address its current expertise shortfalls to prevent other constituents with a rare disease from having to suffer the same problems. However, if a further extension to Vimizim is granted, it must be available to all ages and not just children.
I am delighted that the Government have published a strategy for rare diseases, but a strategy is only as good as its implementation. The strategy highlights a commitment to protecting patients with rare diseases and emphasises the need to improve and deliver effective interventions quickly, equitably and sustainably. I hope the strategy will put my constituent in a good place. I am pleased that the Government are leading the way on scientific and pharmaceutical research, but what good are those things if they do not reach those who most need them? The rare diseases strategy is excellent, but will the Minister provide the House with an update on an ultra-rare disease strategy? I would be most grateful if he were to have the time to meet my constituent in the coming days, given the urgency of the matter.
I thank and commend the hon. Member for Leeds North West (Greg Mulholland) for his work.
I find it heartbreaking that we have today heard about many constituents who have had access to drugs that have given them hope and improved their lives but which have then been taken away. Like the hon. Member for Leeds North West, I have a constituent who suffers from Morquio, Angela Paton. She is 35 years old; it has taken 35 years to find a drug that works, and it is now being taken away from her. Matthew Firth is another constituent, a young man with special needs who can no longer get a basic cream that he needs.
The case of Abi Longfellow is much in the news at the moment. She is a 12-year-old girl with a rare form of dense deposit disease. She needs a kidney transplant to live. Her father has been prepared in the past 12 months to give her his kidney. He should have had the operation on Friday, but for that to go ahead she needs the drug eculizumab. NHS England and NICE say that the drug will not work in Abi’s case—she has a very rare form of DDD—but there is research from the US, Canada and Italy indicating that the drug does work.
I thank the Prime Minister for intervening and asking NHS England to examine the case, and I ask my hon. Friend the Minister to ensure that that happens. There is research available; I find it difficult to understand whether, when the likes of NHS England and NICE say the drug will not work, that is just a tick-box exercise, or whether they look at research from outside this country. It is important to consider that. I would like a joined-up approach between NICE, NHS England and the Department of Health. I ask the Minister to consider the matter comprehensively, and to ensure that NHS England and NICE look into it.
I will now call the Front-Bench Members; there may be a vote, in which case I shall suspend the sitting for 15 minutes. The new rules allow Mr Mulholland to wind up the debate briefly, if there is time, but for that to happen, the Minister must be allowed enough time.
I was a breast cancer surgeon for more than 30 years, and I often experienced the situation that has been described in the debate with my patients and new cancer drugs. We were turned down for Kadcyla earlier this year. With cancer, it is often end-of-life research that later translates to early treatment research. People read things in the paper and say, “Oh, £90,000 for six months of life—that doesn’t make sense.” Inevitably, however, those drugs move forward. We have a different system in Scotland, and while listening to the debate I have been struck by how what is required is a system that is open and can be approached, and which looks from all angles.
In Scotland, the Scottish Medicines Consortium considers drugs as NICE does, and it considers worldwide evidence. It will work up a drug in detail. The balance for us seems to be slightly more on effectiveness than cost, although obviously cost is part of it. Our impression is that, for NICE, cost would sometimes be a bigger component. They are both looking at cost-effectiveness, and we all know there is not an infinite pot of money.
What has changed in our system over the last year is that we have combined our cancer drugs fund with our rare diseases drug fund and simply called it the new drugs fund. The amount in the fund has been quadrupled from £20 million to £80 million, which means that in any year it is a little more flexible in responding to demand, whether that is for drugs for rare diseases or for a new cancer drug. NICE only assesses three drugs a year, so rare drugs are never going to get that work-up. They need a separate system. In Scotland, we have pathways to follow for rare diseases and ultra-diseases.
The biggest change in Scotland in the last year is patient and clinician evaluation. If the evidence for a drug is so strong that it will go through on the nod and there is not an issue, that is fine and PACE is not engendered; but if things look more finely balanced or the drug will not go through, patient groups or drug companies can request a PACE assessment. That will involve expert clinicians, patients and patient groups, and allows people to get slightly outside the numbers and talk about life change, quality of life and money saved in respect of other aspects of the NHS—things that perhaps do not appear in a research paper. That is what is required: a system.
At the end of the day, the system will not produce a favourable result for every single person and every single new drug in the world, but it has to be fair. We cannot have things not being looked at properly, or individual requests being used as the main way of accessing a drug. The system I am talking about is meant to be a transition—supporting young people, for example, who have been on a trial, by giving them access on a compassionate basis, while we get through the paperwork prior to a drug being accepted. It cannot be left as the main method.
That system sounds excellent. I commend the Scottish Government on their work. That could be a great help to my constituent, Mr Trystan James, who suffers from tuberous sclerosis complex and is reliant on a clinical trial drug to deal with a life-threatening tumour. Of course, his drug prescription is therefore completely at the discretion of the drugs company and his family are going from one prescription to the next. That relates to what the hon. Member for Strangford (Jim Shannon) said about emotional pressure on families. I commend the Scottish Government on their work.
The important thing to remember is that if this is all done by individual requests, the NHS does not go to the companies. We need to realise that companies have often made investment over decades and that nine out of 10 drugs they research will go nowhere, but it is important to have a wider debate with companies to get the best price. Hon. Members mentioned that some companies are willing and able to reduce the price to get a drug in.
Drugs are licensed. We must not mix up licensing with funding. Licensing is about asking, “Is this drug safe and proven at a basic level?”, not anyone coming in and saying, “Rare plant juice will cure everything.” These are licensed drugs that we could prescribe—a doctor has the right to prescribe them—but the NHS has to make the decision about whether to fund them; those are funding decisions, not licensing decisions.
It is important that families know what the pathway is and how they move on when their clinician takes a case forward. It is important that they know they can respect decisions and how to lobby at the next step, and that they feel their voice is being listened to. We feel that PACE has, over more than a year, allowed us to do that. Clinicians in Scotland got frustrated about decisions going through without us informing that decision.
There could be a system that sits on the side of NICE, or a sub-group. One of NICE’s three assessments will never be given over to a drug intended for 88 patients when it is also assessing drugs that might be taken by 500,000 people. Rare diseases would always fall behind, and that is why those must have their own system and why the patient voice must be heard in these ways. Obviously, things have changed with the Health and Social Care Act 2012, but I commend such a structure to the Minister.
The hon. Lady is making a thoughtful contribution. Does she agree that it would be worth all Administrations in these islands, who together form the British-Irish Council, collaborating on these issues, particularly borrowing from the good example being developed in Scotland, and seeing whether there can be common achievement and common advances, and perhaps even creating some common funding stream, as well as the discrete funds that she has talked about?
Obviously, devolution gave us the power to do things differently, but I do not think that we should re-invent the wheel. Often, we will accept work done by NICE or re-evaluate it quickly, to see whether things should be applied differently, but we do not just go back to the beginning. However, I am sure that ideas can be shared in both directions.
It seems that certain drugs were left as orphans when the system changed. We know that patients with the brain tumour form of tuberous sclerosis, which the hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards) mentioned, can access the drug through the cancer drugs fund, but if they have a kidney tumour and are treated by urologists they are not part of that system and simply will not be aware of it. Such random unfairness exists.
There is a forum and association, driven by the Health Minister, that discusses matters together with the three regions. A UK-wide strategy is already in place. The process is allowing that to happen already. However, it is delayed and has not happened yet; that is why we are concerned.
I think it is a matter of what ideas go on the table and what is being discussed in the meetings. Good ideas are going ahead. I commend the idea of including patients and clinicians in evaluations, because the numerical data from trials will often be small due to the nature of the diseases in question, and we will have to look wider. The problem for children is that if these drugs are to prevent deformity, they have to be got in early. People with Morquio already have the changes. We do not know yet how much change could be prevented, or how much saving there could be on a person’s disability in the long term if metastatic breast cancer treatments, which eventually become adjuvant treatments, are given earlier.
I commend the system I have talked about. I know it is difficult and challenging, but it is clearly fair, with an interim period for compassionate reasons, and people know where their voice should be heard.
It is, as ever, a pleasure to speak under your chairmanship, Mr Crausby. I, too, commend the hon. Member for Leeds North West (Greg Mulholland) on securing this important debate on access to medicines for ultra-rare diseases and on his contribution to this debate. He has pursued the issue doggedly through debates and questions, and it is right that he has been allotted time to bring these matters to the attention of the Government today.
I commend the UK parliamentary outreach team for hosting the online debate on this issue yesterday on Twitter, using #RDdebate. The public have had an opportunity to contribute to and inform this debate, and that is valuable. I am aware that many are watching us this afternoon. I also welcome the Minister.
When viewed collectively, it is more than apparent that rare diseases are simply not that rare. One in 17 people will be affected by a rare disease at some point in their life, which means that some 3.5 million people in the UK have a rare disease. About 75% of rare diseases affect children and almost one in three rare disease patients will die before their fifth birthday. These are sobering statistics and it is clear that more must be done.
In June 2009, the previous Labour Government adopted the Council of the European Union’s recommendation on action in the field of rare diseases, which recommended that member states should establish and implement plans or strategies for rare diseases. Following the work set out under the Labour Government, the coalition published the UK strategy in November 2013, and NHS England published its statement of intent with regard to the UK strategy in February last year. Since then, we have had the five-year forward view, which reaffirms NHS England’s commitment to achieving better outcomes for people with rare diseases. While each of the publications is a step in the right direction, so much more needs to be done, as many have said this afternoon. The health reforms of the Health and Social Care Act 2012, which was introduced by the coalition, have seen patients and professionals left to navigate a labyrinth to access particular medicines that in many cases have already been approved and received licences.
We have heard already about tuberous sclerosis complex. It is a rare genetic condition that is estimated to affect 1 million people worldwide. Those with the condition develop non-cancerous tumours, often in the brain, eyes, heart, kidney, skin and lungs. Often, TSC patients are at risk of complications, and surgical removal of the tumours is not always an option. It can have a massive and often severe impact on a person’s quality of life. We have heard about a drug called Everolimus that has been developed to treat some tumours associated with TSC; it has been granted market authorisation by the European Medicines Agency. However, despite being licensed in the UK 28 months ago, it has not been appraised by NICE. It is only available through the NHS on an individual basis or through the cancer drugs fund, resulting in significant inequalities in patient access.
Another example we have heard about throughout this debate, and on other occasions in recent weeks in the House, is Duchenne muscular dystrophy, which leaves many patients wheelchair-dependent by the age of 12. The drug Translarna received conditional approval in the EU in August 2014 for the treatment of DMD. However, almost a year on, too many boys who could benefit are still awaiting a decision on funding from NHS England. I commend my hon. Friend the Member for North Tyneside (Mary Glindon), who has done so much to raise awareness of the issue on behalf of her constituents. As we have heard, many Members from all parts of the House also have constituents who are affected, and the hon. Member for Romsey and Southampton North (Caroline Nokes) made a passionate contribution. Each day of delay sees the boys come closer to losing the ability to walk, by which point they would no longer be eligible for the drug.
Countries across Europe have already approved the drug. The UK has taken a leading role in clinical trials for Translarna, but we are lagging behind other European countries in the delivery of the drug to patients. Will the Minister tell us why we have fallen so far behind? I understand that NHS England is set to take a decision on funding shortly. We often hear the word “shortly”, so will he provide a further update and clarify and qualify what “shortly” actually means?
The system to approve prescription is confusing and frankly chaotic. There are seven pathways through which drugs for rare diseases can be evaluated and made available to patients. I will not go through every one of them, but it is clear that there is no clarity in the process to decide on which pathway a particular drug will be put. In particular, owing to a lack of clarity and transparency in the process, information on how or why one medicine evaluation approach or access route is selected over another is simply not available. Will the Minister outline the steps the Government will take to clarify the process, to speed up decisions and to make those decisions more open, so that patients can better understand the process?
I have specific questions for the Minister on two of the pathways: the highly specialised technology evaluation programme, which is administered by NICE, and Evaluation through Commissioning, which is administered by NHS England. There is significant concern that they could limit access to medicines for people with rare diseases. There are widely held concerns that the process in the highly specialised technology evaluation programme, introduced following the 2012 Act to appraise medicines for rare diseases, is too opaque and that the topic selection process is out of date. Does he have any plans to work with NICE to update the selection criteria for the pathway, as they do not take into account conditions defined by genetics, biomarkers or differences in clinical presentations?
Do the Government have any plans to increase the resources available to NICE to evaluate drugs through the highly specialised technology evaluation programme route, given that it is only resourced for three drugs appraisals a year, despite the European Medicines Agency licensing more than four times that amount? Finally, it is essential that patient groups have input on the process by which the drugs upon which patients rely are appraised, but a consultation on the programme has not yet been announced. When does the Minister expect that to take place?
Evaluation through Commissioning is a specialised commissioning pathway to conduct pilots to collect data to inform the decision-making process on funding for specialised commissioning proposals. It is more than a year since Commissioning through Evaluation was expanded, and a few months since it was rebranded as Evaluation through Commissioning. Will the Minister update members on the progress the process has made in expanding patient access to drugs? As I understand it, no medicine has been selected for the programme. When does he expect that to change? Will he update the House on the effectiveness of the early access to medicines scheme to date?
There are more than 6,000 rare conditions. A disease can be described as rare, but having a rare disease is clearly anything but. Improving access to medicines and treatments for the 3.5 million people affected by rare diseases is crucial in improving their quality of life. We have heard moving personal stories from Members from all parts of the House in this debate. I was looking on Twitter at some of the contributions made by members of the public in the past 24 hours. One tweeter said:
“If I could go on the #vimizim I could start to work and pay taxes for others to get hold of the drugs they need”.
That is just one contribution among many, and I ask the Minister to reflect on them after the debate. Many issues need addressing to improve the system of medicine appraisals, and we have touched on just a few today. I hope the Minister will take on board what Members have said, and I look forward to his reply.
I start by thanking Mr Speaker and the Speaker’s Office for granting this debate and for allowing the Twitter debate, which has been a big step forward for public engagement. I thank the hon. Member for Leeds North West (Greg Mulholland) for bringing the debate to this forum this afternoon. I suspect that in the 14 minutes I have available, I will not be able to answer every question, but I have made a detailed log and, with permission, perhaps I can write all those present with answers if I run out of time.
I pay tribute to the parents and the patients, some of whom are here today, whom I have got to know over the past few months, particularly Sam Brown and his mother, Katy, Jagger Curtis and Archie Hill. Others have mentioned the MPS Society and Christine, and the many people in Action Duchenne and the Muscular Dystrophy UK group. This campaign raises some of the hardest issues at the heart of public health and the NHS, and is being driven hard by the parents and patients with active representation from all parties in the House. It is my job to respond as best as I can and to try to put in place a policy landscape, but I pay tribute to them for their work in raising difficult issues that need to be dealt with. I do not think anyone can fail to be moved by the situation that the parents and children find themselves in. I assure them, as I do everyone else in the Chamber, that I wish there were an easy solution.
It is absolutely right that every child and patient in this country should ask for and expect the very best from our NHS, but it is equally true that, as a taxpayer-funded, universal, free-at-the-point-of-use, comprehensive health service, we simply cannot afford to provide every single treatment. I will say some more about the pressures on the system, particularly in the field of rare diseases.
As several Members have been kind enough to point out, this is one of the issues on which I have worked most tirelessly since taking office as the first Minister for Life Sciences last year. I have had several meetings with the hon. Member for Leeds North West and campaigners. Indeed, the Prime Minister and I spent more time talking about this subject than any other in my first nine months in office. I continue to work with NHS England to help it develop a more appropriate mechanism for the transparency and timeliness of its processes in all the specialist services. I have met MPs from all parties, patient groups, drug companies, campaigners and children, and I will continue to be happy to do so.
These are some of the most complex, difficult and life-changing decisions that any Department has to deal with. It is in everyone’s interest that such decisions are taken not by politicians but by clinicians and healthcare professionals, whose job it is to make those decisions—indeed, they do it for us every day of every week of every year. I thank them for that.
I want to discuss the context in which the challenge of rare diseases is developing, and what the Government are doing about it. I also want to discuss the timetable for the specific drugs that have been mentioned. I will then deal with some of the questions that were asked. We are at the forefront of an extraordinary revolution in biomedicine that is increasing pressure on all healthcare systems throughout the developed world, and will continue to do so. There are currently more than 6,000 rare diseases, and it is estimated that one in 17 people will suffer from a rare disease at some point in their lives. Therefore, more than 3 million people have a rare disease in the UK. The NHS is attempting to put in place a fair mechanism for dealing with their needs as best as it can.
The term “ultra-orphan” has no formal or legal definition, but it is taken to mean a disease
“affecting fewer than 500 people in England”,
which means a prevalence of around one in 100,000 patients. Having come to the House after a career in biomedical research, I know well that rare-disease pressure is going to grow exponentially as the extraordinary advances in genomics and biomedical research mean that we discover that more and more diseases that we used to think of as a one-size-fits-all blockbuster are rarer diseases that require stratified, targeted and, ultimately, personalised therapies. I can assure the House that the Prime Minister, who has experienced first hand the huge pain of rare disease in a family, feels that personally. We have devoted time to trying to tackle it, and will continue to do so. Indeed, that is part of the reason why the Prime Minister created my role: part of my remit in government is to tackle some of these issues.
We are doing a number of important things on rare diseases. We have put £20 million into funding the National Institute for Health Research’s rare diseases translational research collaboration and £900,000 into funding to support the work led by Public Health England to establish the first UK rare diseases register. We are leading the work with other EU countries and key colleagues to develop a European reference network to support research. We have also launched the precision medicine initiative and the rare disease consortium, but we are going further.
Central to the mission of the new ministry of life sciences is dramatically accelerating UK leadership in the field, which is why we have established Genomics England. We are the first nation on earth to seek to sequence the full genome of 100,000 NHS patients and combine that with clinical data to form the world’s reference database for targeted and stratified diagnostics and treatments. That is why we have launched the stratified medicines initiative, and why I have launched the early access to medicines scheme.
A number of colleagues challenged me about whether we were getting a grip on this: I have launched a review of the accelerated access to innovative medicines and technologies for that reason. I can assure Members that the scope of the review has struck a chord around the world. We are looking at NICE and at the regulator, and the vision of the review—I have asked for first recommendations this autumn—is to look at how we can dramatically accelerate the timeline for innovative medicines to come into the NHS, dramatically shorten the timeline for patients, and unlock what is essentially the great win-win at the heart of the NHS. We can use its research potential—its genomic and clinical informatics potential—as the world’s only integrated healthcare system to drive research into new drugs and bring down the time and cost of developing them. That way we can get drugs tested and developed here, to the benefit of our patients, while putting this country at the forefront of the revolution again.
We need to remember that it typically costs a billion to a billion and a half pounds and takes 10 to 15 years to develop a new medicine. That is unsustainable for the industry and for us. We cannot afford to pay the premium price at the end of patent life that the industry requires. We are leading the global race to put in place a new landscape. I fear that the solution will not come in time to solve the particular funding issue that has been mentioned, either this month or this quarter, or even this year. Nevertheless, we are making rapid progress. We will look back with pride on the UK’s leadership in this field.
NHS England has in place very carefully worked out decision-making processes for making drugs for rare diseases available to patients, and I want briefly to outline how they work. Because of their rarity and the low patient populations, services for rare conditions are commissioned nationally by NHS England, as opposed to locally by clinical commissioning groups. These specialised services include 146 prescribed medical services set out in legislation and account for approximately 14% of the total NHS budget—£14 billion a year. It is worth remembering the price of the system. For just this one class—the Translarna drugs alone—we are talking about hundreds of millions of pounds over a lifetime. We have to reduce the cost. We simply will not be able to afford the price required by the companies for every single new class that comes on stream.
The NHS England specialised commissioning process has been set out very carefully. It starts with one of the 68 clinical reference groups in NHS England creating a commissioning policy, which is produced by clinicians and other medical professionals. The commissioning policy is referred to one of the care boards and then to a clinical panel, which assesses the draft policy against the known evidence, with particular regard to clinical effectiveness and cost-effectiveness. The supported policies are passed on to the clinical priorities advisory group, which ensures that due process has been followed and makes a recommendation to the specialised commissioning oversight group. It considers the appropriateness and relative priority of new and existing treatments. The final sign-off is by the specialised commissioning committee, an NHS board sub-committee. NHS England’s clinical priorities advisory group formulates recommendations on the basis of clinical advice. I stress to colleagues across the House that it is not in anyone’s interest for Ministers ever to attempt to intervene in clinical decisions.
I want to touch on the timetables for the drugs mentioned by a number of colleagues: Translarna and Vimizim. On Translarna, the clinical priorities advisory group developed the clinical commissioning policy for the treatment of the mutation, and the policy was out for consultation between 24 March and 23 April. The group is considering the draft commissioning policy today and tomorrow and will make a recommendation to the specialised commissioning oversight group very shortly. The oversight group will consider the recommendations on 24 June and make recommendations to the specialised commissioning committee. The committee will make recommendations on 30 June and then make a decision on whether to commission Translarna nationally until NICE releases final guidance.
Before purdah, I was delighted to refer Translarna as a topic for evaluation by NICE’s highly specialised technologies programme. It is unfortunate that the general election fell right in the middle of the consultation process; that explains some of the difficulty we had dealing with the correspondence, as the hon. Member for Leeds North West mentioned. Final guidance on Translarna is expected in February 2016; draft guidance will be complete by the end of this year.
Similarly, Vimizim is being considered by the clinical priorities advisory group today and tomorrow and a recommendation will go to the oversight group. That recommendation will be considered on 24 June, and the final recommendations will be made on 30 June for subsequent consideration. NICE’s highly specialised technologies programme will release final guidance on Vimizim in October 2015. It is important to point out that NICE has not yet issued its final guidance on Vimizim to the NHS. I encourage patients, the public, professionals and the manufacturer, BioMarin, to engage with the ongoing consultation.
I have several questions to answer with just under 120 seconds remaining. It would not be appropriate for me to try to spin through every one, so with colleagues’ permission, I will write with detailed answers to them all. Several Members from across the House asked whether we could do something to raise money more quickly to purchase these drugs. I am discussing with the Chancellor the whole issue of how we purchase specialist drugs and put in place a landscape so that we are not only bringing drugs more quickly into the NHS and unlocking its power as a research engine, but updating our commissioning structures.
The accelerated access review that I am leading does not just address how we light the runway in terms of regulations and NICE and the Medicines and Healthcare Products Regulatory Agency’s processes to bring drugs to proof of concept in the system more quickly; it specifically looks at how we can commission better. It also deals with the cancer drugs fund. I hear the comments from north of the border—I used to advise Scottish Enterprise on this whole field. We will look at whether we might put in place some kind of innovative medicines fund for rare diseases and specialist drugs to support testing medicines within the system in a research medicine setting, particularly for rare diseases.
In the next few years, Genomics England and our leadership of genomic insights into diagnostics and new drugs will bring on a range of potential new therapies. We need to ensure that England has a landscape for testing those drugs that is compatible with Scotland. That may well mean that we will not pay premium retail prices to manufacturers at the end of a traditional phase III or phase IV development process, but build a new model of commissioning based genuinely on evaluation, thus unlocking the power of the NHS as the world’s greatest research engine.
Motion lapsed (Standing Order No. 10(6)).
Worcester’s Southern Link and the Carrington Bridge
[Mr Andrew Turner in the Chair]
I beg to move,
That this House has considered dualling of Worcester’s southern link and the Carrington Bridge.
It is a pleasure to move this motion under your chairmanship, Mr Turner, and to do so before a Minister whom I am truly delighted to welcome to his place and his new role. I discussed the strong case for improving Worcester’s transport links with the previous Roads Minister, the Under-Secretary of State for Transport, my hon. Friend the Member for Scarborough and Whitby (Mr Goodwill), when he hosted me, my hon. Friend the Member for West Worcestershire (Harriett Baldwin) and the former Member for Mid Worcestershire, as well as representatives from Worcestershire County Council and the Worcestershire local enterprise partnership, at his office in the Department for Transport. Since then, the Secretary of State for Transport has been to Worcester to see for himself both the ongoing work to dual the southern link and the bottleneck currently formed by the Carrington bridge. The new Minister is always welcome to make that journey himself, and I would be delighted to show him the long queues of traffic.
The Minister will know that traffic is one of my constituents’ top concerns—it is one of the few things keeping Worcester from the very top of the list of cities in the country in which to live; it is in the top 10—and that the southern link road is not only a vital road but a key strategic link for our county and its neighbours. In addition to its crucial role as a transport link, it provides essential flood resilience for a city that is unfortunately all too well known for its propensity to flood. Beyond the single carriageway Carrington bridge, there is a long area of causeway on which the A4440 crosses the flood plain to the south of Worcester, and I was pleased to learn from the Environment Agency only this morning that it is already advising on how best the widening of that causeway could be achieved without a negative impact on flooding elsewhere.
I am delighted that after years of support from Sir Peter Luff I am joined for today’s debate by his successor, my hon. Friend the Member for Mid Worcestershire (Nigel Huddleston), whom I congratulate again on his election to this place. My hon. Friend the Member for West Worcestershire, newly elevated to high Government office, would also be here were it not for the demands of that office. The A4440 southern link road around Worcester is not only a vital part of the city and county’s infrastructure, but the key link between the M5 and her constituents in Malvern and many other points west of Worcester. In addition to the strong support we have won for its improvement from Worcester City Council and Wychavon and Malvern Hills District Councils, we have now submitted letters of support from Herefordshire County Council and The Marches local enterprise partnership. It is one of only two crossings of the mighty River Severn between Holt Fleet and Upton-upon-Severn, and the only one with the potential to carry more than a single lane of traffic. It is the key bottleneck for a population of hundreds of thousands and an increasing amount of business traffic.
As my hon. Friend the Member for Mid Worcestershire pointed out at last week’s Prime Minister’s questions, Worcestershire has been the third-fastest growing county economy in the UK over the past few years after only London and Oxfordshire. That growth has seen unemployment more than halve and youth unemployment decline even further. It has seen huge numbers of new businesses starting up, existing businesses, such as Joy Mining Machinery and COMPCO in the west of Worcester, growing and taking on more staff and the development of new clusters of excellence, such as Malvern’s thriving cyber-security cluster. The rise of rural broadband notwithstanding, such commerce naturally increases the weight of traffic and the demand for infrastructure.
At the same time, our county has committed to building tens of thousands more homes. There are already smart new estates to the west of Worcester and where once Dines Green marked the western edge of the city, there are now new houses, doctor’s surgeries and care homes at Earl’s Court Farm and along the Bromyard Road. Under the south Worcestershire development plan, tens of thousands more homes will be built to the south and west of the city. Not all those people living to the west of the city will be able to work, shop and get to schools on the west side of the river and not all those on the east will be able to stay on the east. We want the new residents of the south Worcestershire urban extension to be able to enjoy the beautiful Malvern hills and the Elgar trail, and we want those on the west to be able to venture across to the constituency of my hon. Friend the Member for Mid Worcestershire and experience the delights of Evesham, Droitwich and Broadway.
In addition to the rising demand, there are some wonderful transport improvements in prospect for which I should thank the Minister and his Department. The previous Government committed to upgrading both of Worcester’s motorway junctions and resurfacing much of the M5, as well as making it a smart motorway. That will improve our access to Birmingham, to the M5 corridor with its high-tech jobs and aerospace and, indirectly, to London and the rest of the country.
That improved access will only fully benefit my constituents, and those of my neighbouring Worcestershire MPs, when the southern link allows them to reach the M5 with greater ease. We also have the exciting prospect of a project for which the county has been calling for over 30 years being delivered in the next two: Worcestershire Parkway Station. That crucial addition to our rail links will improve our rail connections with London, Bristol and Birmingham and serve the entire south of the county. For my constituents in Worcester, it will mean that thousands more have access to our railways, as neither of our existing stations has sufficient parking for people to be able to leave their cars. For people living in Warndon Villages, St Peter the Great or anywhere on the western side of the city, Worcestershire Parkway will make rail travel an option, but only if they can reach the station. The southern link provides crucial connectivity for all those people.
Today, however, and for most of the past decade, the southern link has been running at capacity. As a regular listener to BBC Hereford and Worcester, I am far too often regaled with the news that traffic is at a standstill on the Carrington bridge. Far too often in the morning, I am sat in long queues on the bridge or the approach road. Every morning and every evening, that crucial transport link is simply overwhelmed by the amount of traffic with which it must cope. As a result, more traffic is diverted through the centre of Worcester city.
When the floods hit Worcester last February and closed our city centre bridge, the queues could take hours. Getting up at 6 am to make a 9 am appointment in Worcester was not an ideal commute. That happened before the new developments in the south Worcestershire development plan, which the county council estimates could generate an additional 342,000 trips a day by 2019 and 588,000 a day by 2031. The road that has skirted the south of Worcester for decades has needed dualling for most of that time and the bridge that joins the west of the Severn with the east might have admirably met the challenges of 1985, but it desperately needs upgrading for the 21st century.
One of the pleasant surprises of the visit of the Secretary of State for Transport on a sunny April day this year was taking him down the hill from the viewing platform that overlooks the Carrington bridge and coming across the plaque that commemorated my father, as MP for Worcester and Energy Secretary, opening it on almost precisely the same day in 1985. A great deal has changed since 1985 when I was seven years old, but I hope we share with that period the fact that we have a Conservative Government prepared to invest in our country’s infrastructure and inject new energy into the challenge.
It is worth noting that the coalition Government invested in improving the southern link and, along with Worcestershire County Council and the LEP, delivered the substantial upgrades that the Transport Secretary was able to see under way during his recent visit. Through a combination of pooling the new homes bonus, local funds and a Government contribution to the Worcestershire LEP’s strategic economic plan through the local growth fund, the dualling of the southern part of the road and upgrades to its major roundabouts have already been set in motion. After decades in which Worcester’s infrastructure seemed to be set in stone, this is a huge step forward and the first major new roads investment since the 1980s in this part of the county. However, the full benefits of all that work—the dualling of the A4440 between the M5 junction and the Ketch roundabout—will not be seen until full dualling of the road is achieved, including the bridge and the causeway beyond it.
Many constituents have complained to me that it could be a waste of money to have doubled the road only as far as the Carrington bridge. Many more have pointed out that traffic from the west will still head through the city, rather than around it, as long as there is no dual carriageway between the west and the south. Put simply, the wise investments made by our county, our districts and our country in upgrading the road could be made to look like a white elephant if the job is left incomplete, but a golden opportunity if it is finished. A well-supported online petition put together by my constituent Brian Gladman also made that point. Mr Gladman also campaigned for many years to improve the broadband infrastructure in the west of Worcester, which ensured that all my constituents are well served. It is great that he is bringing his leadership to improving our roads infrastructure, the importance of which was hammered home to me on the doorsteps of Worcester during the recent election campaign.
Any reader of the Worcester News will know about the concerns regarding the layout of the new roundabouts and that they are a consequence of the design of the scheme being for a proper dual carriageway but the work at this stage only being funded sufficiently to deliver that dualling as far as the River Severn. Once the dualling is taken across the river and over the Carrington bridge, the bottlenecks will be removed, the traffic will flow more freely and the roundabouts will work as they were intended.
To date, dualling has achieved significant improvements in traffic flow, but what can be achieved in taking it further would be much greater. The work has been proceeding on a phased basis and we are seeking help with phase 4, estimated to cost a total of about £74 million. The first three phases, which cost about £40 million, will be completed by 2018. At that point, crucially, whether through local funds, further LEP bids or Government funding, we must have the finance in place to secure the fourth phase. Worcestershire County Council has estimated that the Government contribution required would be in the region of £60 million, but that the benefit-cost ratio is more than 2:1.
My point today is to make it clear that that would be money well invested. As the chairman of our LEP, Mark Stansfield, said,
“The southern link road is a key initiative focussed on keeping businesses moving and connected in Worcestershire and to neighbouring counties. The dualling”—
of the Carrington bridge—
“is fundamental to achieving the goals set out in the ten year Strategic Economic Plan.”
Simon Geraghty, leader of Worcester City Council and deputy leader of the county council said:
“The Worcester Southern Link Road is one of the most important strategic routes in the County, used by over 30,000 motorists a day, to connect communities and businesses west of Worcester to the M5 Motorway network as well as providing an alternative route for local traffic to bypass the busy…City Centre. However, heavy congestion on this road is now holding the Worcestershire economy back and hampering efforts to improve the environment in the historic City Centre. Everyone agrees this road needs to be dual tracked from the motorway to the west of Worcester to enable strong economic growth to continue and allow the much needed new homes and employment sites to go ahead. Working together, clear plans and funding packages are now in place to complete significant sections of the route but the narrow single lane Carrington Bridge is proving to be a real bottleneck. Securing funding to tackle this issue is now the County’s number one transport and infrastructure priority.
It is vital to deliver the growth targets set out in the County’s 10 year Economic Plan and working together funding must be secured if we are to unlock the economic potential of this part of Britain whilst preserving the great quality of life and environment that Worcestershire already offers.”
As Councillor Linda Robinson, the newly elected leader of Wychavon District Council, put it,
“The Carrington bridge is an essential piece of infrastructure, being part of a main arterial route connecting much of South Worcestershire and the M5. It is a notorious bottleneck and currently causes considerable delays and frustration to residents, visitors and commercial users alike. Its deficiencies represent a very real negative impact on business investment. Improving accessibility reinforces the message that Worcestershire is open for business by addressing such key issues.”
My favourite quote of the lot, however, comes from the president of our chamber of commerce, Jim McBride—never knowingly underspoken—who said:
“We must proceed with the Southern Link Bridge as the current situation is intolerable. We have a dynamic growing industry, mainly in the high tech sector, being held back by our inability to build ONE bridge. It’s like having a fibre optic cable with an old fashioned copper section in the middle making the whole thing unworkable!”
You just need to come off the motorway and down to the bridge to see how ridiculous it is. We need to help our industry not hinder it.”
Amen to that.
Carrington bridge overlooks the battlefield of Worcester where, in 1651, Cromwell won the day for Parliament and stormed the River Severn with his bridge of boats. The same barrier that he overcame that day in a few hours remains a challenge centuries later for my constituents and many others beyond, but securing the investment will turn it from a barrier to growth into a pathway to prosperity. I commend the project to the Minister and I hope that he can support it for funding, whether as a pinch point, a local road or a vital strategic road. Most of all, it is a project that is essential to local growth.
It is a pleasure to serve under your chairmanship, Mr Turner, for the first time.
I congratulate my hon. Friend the Member for Worcester (Mr Walker) on securing this afternoon’s debate on the dualling of Worcester’s southern link and the Carrington bridge. I also thank him for the invitation to come and see things for myself. I have some knowledge of the area and have driven the roads that we are discussing, but my main reason to visit my hon. Friend’s constituency has often been related to New Road and watching the cricket. Nevertheless, at some point I hope to take him up on his offer.
My hon. Friend mentioned that people want to travel around the area and to experience the delights of the Malvern hills and western Worcestershire. I, too, want them to experience that, because the area is truly special. I liked the lovely link across the years with the story of his father opening the bridge in 1985 and my hon. Friend now working to make it even better.
I am aware that the topic has been the subject of previous parliamentary questions and ministerial correspondence. I praise my hon. Friend for continuing to highlight the importance of good transport infrastructure in building a strong economy and sustainable communities. I am aware of his excellent work over recent years to represent and promote Worcestershire as a whole. I hope to address some of his points.
Worcestershire is a marvellous county with a population of more than 500,000. It is served by a number of key transport connections, and today’s debate should be placed in that broader context, which I will highlight. The nationally important M5, M42, M50 and A46 all run through the county, as do the major local roads, the A449 and the A4440—our focus today. Rail also plays an important role in the county, with lines offering connections to Birmingham, Hereford, Bristol and London, via Oxford.
My hon. Friend emphasised the success of the Worcestershire economy, which has an entrepreneurial work force—that is certainly my experience—and the county is an attractive place in which to live and do business. As he said, the Worcestershire transport network is critical to the performance of its local economy. Reliable connectivity enables the residents of Worcestershire to have good access to jobs and local businesses to have good access to their markets.
The area, however, has a propensity to flood—it is famous for that—and I have been there during occasions of intense floods, seeing for myself the impact on local roads. My hon. Friend highlighted the floods of the winter of 2013-14, which was the wettest winter on record. We had flooding not only in Worcestershire, but in parts of the south-west, the south-east, and Yorkshire and the Humber—throughout the country. I remember the Prime Minister visiting my hon. Friend’s county one weekend in February during the flooding. I checked before the debate, and the River Severn had peaked at 5.3 metres, its highest level since summer ’07, and 100 or so properties in Worcestershire were flooded, with more than 40 of them in his constituency.
Resilience is an important issue for the local transport network. The floods caused a number of road closures and impacted on business. The Worcestershire County Council emergency response team did an impressive job, which was highlighted at the time by my hon. Friend. The Secretary of State for Transport has announced additional funding for highways authorities throughout the country—some extra support to tackle their resilience issues—and that saw more than £2 million allocated to Worcestershire County Council. My hon. Friend made the point about the importance of the reliability and resilience of the transport infrastructure.
One of the key things that I have to tackle and one of the key priorities of the Department for Transport is our road investment strategy. Basically, the Government are committed to a long-term economic plan, as we have detailed previously, and part of that is to deliver infrastructure investment—such investment in transport is key to continuing economic growth. As we all know, roads play an important part in our economy—a central role. Nearly every area of that economy would grind to a standstill if our road network did so. We require a high-performing road network to deliver the economy that we need. Our commitment in delivering that is the road investment strategy, which is a significant, £15 billion commitment that will see investment in 127 schemes across the road network between now and 2021.
This is a positive time for road investment, and that has implications for my hon. Friend’s constituency, because our strategy includes significant investment in Worcestershire, such as the introduction of smart motorways between junctions 4a and 6 on the M5. The work on that scheme is due to start later this year. When it is complete, we will see additional capacity through the use of the hard shoulder as an extra lane. We will also see the deployment of world-leading technology to make journey times more reliable and to reduce congestion on the network.
I am grateful for the investment that has been announced, which I welcomed earlier in my speech, in particular the fact that new surfaces are included, because that will help to make the motorway quieter for nearby residents. Over the years that has been a major concern for my constituents in Warndon Villages and for those of my hon. Friend the Member for Mid Worcestershire in Droitwich. Does the Minister accept that linking the extra capacity on the M5 to the west of the county will have significant economic benefits for the wider county economy?
I certainly accept that. Improving the strategic road network will have a knock-on effect on all the other arterial roads surrounding it. That is the point. A network does not just stop; it runs and flows—or at least it is meant to. I agree entirely with my hon. Friend.
Investment in local transport infrastructure such as the southern link road is vital to communities in the area, as recognised not just by my hon. Friend but by all local MPs. The strong economic benefits that the southern link road and Carrington bridge would bring are recognised by the LEP in its strategic economic plan. The A4440 Worcester southern link road is seen as an essential part of Worcester’s main road network, providing that important link between the M5 south and west to Worcester, Great Malvern and the wider Malvern Hills district, and on into Herefordshire and beyond. It is also an important bypass of the city centre and provides one of the two crossings of the Severn—the next crossing, at Upton, is a long way south. The road’s importance—its impact on the immediate area and on the remainder of the county—is entirely understood.
That is why, as my hon. Friend has highlighted, there has already been some investment in the road: the improvements to the Ketch roundabout and dualling of the A4440 towards Norton roundabout received funding as a major local transport scheme through the Worcester transport strategy. That strategy received a funding package of £14.2 million from the DFT and aims to improve the role of Worcester as the county’s principal economic hub through the delivery of a package of measures designed to improve sustainable transport and maximise access to economic activity in the city.
The elements of the southern link road package have already been detailed, and have made quite a difference. My hon. Friend highlighted how phases 1 to 3 have already brought improvement, but the image he gave of high-level fibre optics suddenly coming to an old copper connection brought home the importance of completing the scheme. I understand, however, that the work on that fibre-optic section—phases 1 and 2—has been progressing well and is due to finish this summer.
The Government recognise the need for improvement. That is not the issue here at all. The improvements on the A4440 south of Worcester have helped to support growth. The Government have put investment funding in place for those improvements. The importance of further investment was recognised in the expansion of the Worcestershire growth deal in January this year. We have confirmed that we will work with the county council, as the local highways authority, to determine how further stages of the work on the A4440 can be taken forward.
The A4440 is a key local road, and as such is the responsibility of the local highways authority, the county council. Any proposal for further improvements to the road is therefore a matter for the council. I know that the council recognises the complexity of the situation. The road is in a beautiful area of historic significance, as my hon. Friend highlighted, and crosses the Severn at its floodplain. The situation is sensitive, and I understand that feasibility work would need to be undertaken on the scheme. That is already under consideration.
I turn now to the point about clarity on funding streams. The Government have made a commitment to growth deals and to providing ongoing support to local enterprise partnerships to deliver jobs and growth. Funding for proposals such as the further development of the southern link road and the Carrington bridge is provided through the Government’s local growth fund and the growth deals agreed with LEPs. Any future growth deals would allow Worcestershire to put forward schemes that would make the biggest difference in the area, as has happened with previous deals, including the one for this road. It is therefore important that local MPs continue to work with the county council and the local enterprise partnership to maintain the scheme’s visibility as funding becomes available.
The Government recognise the power of transport to change lives and economies. It brings opportunity, tackles congestion, and improves connectivity and quality of life in an area. I have mentioned some of the ways in which the Government are already working to support transport infrastructure in Worcestershire. There are others. The local enterprise partnership was awarded £47 million in its growth deal last year, and a further £7.2 million in January. The local enterprise partnership has made a good start in delivering its growth deal and should be congratulated on both its strong governance and its excellent work in delivery. My hon. Friend gave a pithy quote from his LEP leader.
My hon. Friend has made a compelling case. He has clearly won local support. The quotes from the LEP and the council demonstrate that phases 1 to 3 have made a difference. I cannot say today, “I am bringing you a cheque from the Treasury”—I wish I could—but I can say that I think the scheme is a good one and that phase 4 would indeed complete the package. The Government will continue to invest in transport, in local growth deals and through LEPs. It is therefore important to make sure that this scheme is at the front of the funding queue—he has made a compelling case but it is a big queue. Historically, there has been under-investment in infrastructure, and the Government are trying hard to catch up. The infrastructure deficit almost matches the financial deficit that we are also tackling. The Government remain committed to investing in infrastructure and to excellent projects waiting for funding. I know that, with his customary tenacity as a champion for Worcester, he will keep working with neighbouring MPs to maintain the profile of the scheme. I will keep working to make sure that the Government deliver the best we can for the people of the city of Worcester and the rest of the fine county of Worcestershire.
Transport infrastructure is necessary, and the scheme is a good one. It is a question not of lack of will but of making sure that we have the cash. As the Government get and keep the economy moving, more and more cash is being invested in infrastructure. The issue is making sure that this scheme is at the top of the list locally, and my hon. Friend has done a fantastic job of making a compelling case for that today.
Question put and agreed to.
Sustainable Development Goals
I beg to move,
That this House has considered negotiation and implementation of the Sustainable Development Goals.
It is a pleasure to serve under your chairmanship, Mr Turner. I begin with the words of Nelson Mandela 10 years ago at the Make Poverty History rally:
“Like slavery and apartheid, poverty is not natural. It is man-made and it can be overcome and eradicated by the actions of human beings.”
It is useful to reflect on those words as we discuss the negotiation and implementation of the sustainable development goals. I am pleased to see that Members from across the House are present. I hope there will be time for everyone who wants to speak to do so, and I look forward to the response from the Minister. I am grateful to the many organisations that have provided briefings in advance of the debate.
I refer Members to my entry in the Register of Members’ Financial Interests: until the election I worked for the Scottish Catholic International Aid Fund, so I had a professional as well as a personal interest in international development issues. I was also the vice- chair of the Network of International Development Organisations in Scotland and I sat on the Scottish working group on sustainable development goals, which I will refer to later.
The Make Poverty History rally that Nelson Mandela spoke at came five years after the United Nations agreed the millennium development goals—at that time, the most ambitious agenda for tackling world poverty in history. For 15 years, the MDGs have provided a framework on which national Governments, multilateral agencies, and even small local charities can base their international development efforts. Progress has been significant, if not complete.
The headline goal of halving the proportion of people living on less than $1.25 a day has been met, but not uniformly around the world. In some parts, notably sub-Saharan Africa, progress towards many of the goals has remained static or even gone into reverse. The framework was established with a 15-year timeframe, which is why global attention is now turning to what comes next.
Negotiations on the successor framework—the sustainable development goals—were notable for their inclusive and participatory nature, and particularly for the role played by global civil society and social movements, especially in the global south and the worldwide Beyond 2015 network. The SDGs will therefore begin life with considerably greater legitimacy than the MDG framework, but it is important in the final months of negotiation that civil society’s voice continues to be heard and respected. The last thing that should happen is diplomats and ministerial delegations locking themselves in a basement room at the UN to thrash out last-minute concessions.
The zero draft outcome document for the SDG summit in September was published on 1 June, and is the culmination of several years of work by a whole range of stakeholders, including the high-level panel that the Prime Minister co-chaired in 2013. The zero draft outcome is a highly ambitious document. In its own words, it is
“a plan of action for people, planet and prosperity that also seeks to strengthen universal peace in larger freedom.”
The zero draft sets out 17 goals and 169 targets, encompassing a broad range of economic, social and environmental objectives, including on issues traditionally associated with tackling poverty, such as health, education and nutrition; but it also tackles questions of equality, including gender equality, and climate change, and recognises the importance of infrastructure and sustainable consumption.
Most important is the universal aspect of the framework, and the concept of leaving no one behind. The goals and targets are to be met by all social and economic groupings. These concepts have been warmly welcomed by civil society and many other stakeholders, but the draft is not perfect; it is the basis for further negotiations by UN member states. I hope that in the months that remain, more can be done to reinforce the aims and objectives that it outlines.
Save the Children and others have suggested that the language on leaving no one behind could be strengthened, and others, such as Age International, have called for a stronger commitment to data monitoring and disaggregation. There are some broader concerns about the model of development implied by the language of the zero draft. Both the Catholic Agency for Overseas Development and SCIAF call for the promotion of human dignity, rather than ideas of prosperity and economic growth, to be the driver of the development agenda. Indeed, the UN Secretary-General’s synthesis report on the post-2015 agenda earlier this year specifically talked of a
“Road to Dignity by 2030”.
I would be particularly interested to hear the Minister’s views on including that concept in the framework.
As the final negotiations proceed, I hope that Scotland’s voice will be heard at the top table. I referred earlier to the Scottish post-2015 working group on the SDGs, which has brought together civil society as well as officials from both the UK and Scottish Governments to share knowledge and information about the negotiation process and begin to look towards implementation. I hope that the Minister and Secretary of State will seriously consider inviting one of their Scottish Government counterparts—the Cabinet Secretary for Culture, Europe and External Affairs or the Minister for Europe and International Development—to join the UK delegation to the SDG summit in New York in September.
I congratulate the hon. Gentleman on securing this important debate, and on securing a debate this early in his parliamentary career. I agree with him with regards to the Scottish Government, and I ask the Minister to consider the other devolved Administrations, where there is expertise in bilateral agreements between their nations and nations in Africa and other parts of the world.
That is a helpful point. I spoke briefly in my maiden speech about the ties between Scotland and Malawi; such reciprocal agreements and community links are to be found across the United Kingdom. The respect agenda, which we heard so much about during the independence referendum, means that this is a good opportunity for the voices of Scotland and the constituent parts of the UK to be heard on a world stage.
Once those negotiations are complete—indeed, before they are complete—we must consider how the new framework will be implemented. The universal nature of the goals is markedly different from the MDG framework. It places an obligation on all Governments—north and south, rich and poor—to work towards a world free of poverty. The Financing for Development conference in Addis Ababa in a few weeks’ time will be an important opportunity for world Governments and civil society to agree ways of making funds available to deliver the goals. I hope that the Prime Minister and the Chancellor will give the summit the same priority that many of their global counterparts plan to.
Traditional aid flows are important, and I congratulate the UK Government on meeting the 0.7% target, but I question the measure of gross national income that they are using to calculate their 0.7% contribution. The Scottish National party will continue to ask hard questions about how that money is spent. Our official development assistance spend should not undermine public services in developing countries, nor should it be used for defence or securitisation purposes.
We must also move beyond aid. Many campaign groups, including Oxfam and Christian Aid, are rightly calling for a radical overhaul of international taxation. Corporate tax dodging is costing developing economies billions each year—money that could be spent on education, healthcare and other vital services. Initiatives such as the Robin Hood tax could generate further funds for tackling poverty and climate change, and we must remain alive to the question of unjust and unsustainable historical debt, which still burdens too many developing countries.
Implementing the SDGs will require a whole-of-Government response. Every decision made by the Government has some kind of impact overseas—not just tax and trade decisions, but decisions around procurement, energy, education and more all have a global footprint. Indeed, our own individual energy use and consumption habits have been, for too long, at the expense of the poorest and most vulnerable people in other parts of the world who are now being hit first and hardest by the impacts of climate change.
The other major summit this year, December’s United Nations framework convention on climate change in Paris, must also be part of the process of implementing the SDGs. The same is true of the World Humanitarian Summit in Istanbul next year. Once again, I draw attention to the work of the Scottish Government, and their pioneering work in the areas of climate justice and policy coherence for development.
The universal nature of the SDGs means that implementation is an individual, national and global responsibility. It means that each of us should question our lifestyle choices and consumption habits. It also means that Governments of so-called rich or developed countries must look to their own backyards. What steps will Governments take finally to eradicate poverty here at home, to bring about gender equality and to tackle the causes and effects of climate change? Perhaps we should also ask under what reading of the SDG framework a decision to spend £100 billion on the renewal of Trident can be justified.
In concluding, I would like to thank again the many organisations that took time to provide briefings. I have not been able to refer to all their points but, in addition to those I mentioned, I encourage the Minister to look at the points raised by UNICEF, the Royal Society, Health Poverty Action, Leonard Cheshire Disability, the World Wide Fund for Nature and World Vision UK.
During the 2005 Make Poverty History campaign, it was often said that we were the first generation with the knowledge, tools and resources finally to end poverty. Ten years on, the SDGs have the potential to provide a robust framework to put that knowledge, those tools and those resources into action. With the right political will, they can capture the imagination of not just Governments and civil society, but the wider public and communities around the world, because—to finish as I started—in the words of Nelson Mandela:
“Overcoming poverty is not a gesture of charity. It is an act of justice. It is the protection of a fundamental human right, the right to dignity and a decent life. While poverty persists, there is no true freedom.”
It is a pleasure to serve under your chairmanship, Mr Turner. I congratulate the hon. Member for Glasgow North (Patrick Grady) on securing this very important and timely debate, providing an opportunity for Members of all parties to explore these issues and for the Minister to respond. The hon. Member for Glasgow North brings a wealth of experience from prior to his election. I refer people to my relevant entries in the Register of Members’ Financial Interests. I worked for five years, between 2005 and 2010, at the Foreign Policy Centre and for the Aegis Trust charity, which works in Rwanda.
As the hon. Member for Glasgow North said, Make Poverty History has been one of the most powerful social movements of this century so far. The impact that it had in mobilising a wide section of public opinion and its influence on our Government at the time was profound. It is good to have the opportunity to reflect on that and on the progress made since the millennium development goals were adopted. I do not want to repeat everything that the hon. Gentleman said, but he referred to various statistics. There is still a very big challenge on some of the basic issues that the millennium development goals were designed to address. About 1 billion people across the globe still live on less than $1.25 a day. That is the World Bank’s measure of poverty. The levels of hunger around the world are still far too high. Yes, things have got better, but more than 800 million people live without enough food to eat. Women are still fighting hard for their rights, and millions of women across the globe still die in childbirth. A great deal more needs to be done.
Like the hon. Gentleman, I welcome the progress that has been made in moving towards the summit in New York this September. The level of engagement and consultation with stakeholders, Governments and, most importantly, civil society offers the potential for a more holistic approach to development policy, which is welcome. It includes, for example, a renewed focus on climate change, the oceans, sustainable industrialisation and a strategy for modern and sustainable energy.
Focusing on the root causes of poverty is absolutely the right thing to do. The universal goals, about which the hon. Gentleman spoke, are most welcome. In particular, the aim of the focus on equality—one of the 17 proposed goals—is to reduce inequality both within and among countries. That, too, will secure a welcome. There is concern that with, as he said, 17 goals and 169 targets, this could all become somewhat unwieldy. It is right that the process is ambitious, but it must also be achievable. I echo what he said about the importance of listening to the voices of civil society as the process moves forward.
Taking an holistic approach domestically is also critical. I would be interested to hear the Minister’s response to this point. The Select Committee on International Development in the previous Parliament said that the Department for International Development
“must do more to influence policy across all Government departments”.
Concern has been expressed that DFID is now not represented on some key committees—ministerial committees and, crucially, the National Security Council, which covers very important issues such as climate change, economic stability, counter-terrorism and money laundering. It is surely vital that the Secretary of State for International Development be represented on the National Security Council, as well as on key committees such as the economic affairs committee, which deals with the crucial question of international taxation, to which the hon. Member for Glasgow North referred in opening the debate.
Let me finish by echoing what was said by both my hon. Friend the Member for Ynys Môn (Albert Owen) and the hon. Gentleman about the importance of our taking a UK-wide approach, engaging the devolved Administrations, welcoming the work that the Scottish Government and the Scottish Parliament have done with Malawi and listening to the voices from Wales and Northern Ireland as well as from Scotland and, indeed, to those at local government level in all parts of our country. The more that these issues engage not just central Government and Parliament, important as they are, but civil society, trade unions and business organisations, the more impact the sustainable development goals will surely have.
Parliament itself has a very important role to play. Opportunities such as today are, of course, welcome. There is also the role of the Select Committees—the International Development Committee and others—and groups such as the Commonwealth Parliamentary Association and the Inter-Parliamentary Union, which often provide a vehicle for focusing on some of these issues, country by country and region by region. Let us also use the opportunity of today’s debate—I hope that the Minister might have something to say about this—to emphasise what Government can do, because that is vital, and what civil society can do, which the hon. Gentleman rightly emphasised, but also the very important role that this Parliament can play in ensuring that we get the decisions right in September in New York. It is important not just that we have a good summit in New York in September, but that those decisions are built on beyond that, so that in 15 years’ time we can celebrate real achievements from the key goals that will be discussed in New York.
It is a pleasure to serve under your chairmanship, Mr Turner, and to follow such an excellent speech from the hon. Member for Liverpool, West Derby (Stephen Twigg). We do not agree about very much, but I suspect that on this issue we are largely in agreement. I also congratulate the hon. Member for Glasgow North (Patrick Grady) not only on securing the debate, but on securing his election. He is very welcome in the House, not least for the expertise that he brings in this area. Out of an abundance of caution, I will say, although this is not in my entry in the Register of Members’ Financial Interests and, I think, is one of the things that do not have to be, that my partner is currently employed by the Government of Sierra Leone, but that is not something that touches much on this debate.
The debate is incredibly welcome, in part because of the importance of the sustainable development goals but also because all of us in the House who are interested in these issues have, to some extent, had our eye taken off the ball, in what has been a long process, by our own electoral cycle. I think that this is the first opportunity that the House has had to consider this matter, which is extraordinarily important not just for the developing world but for the security of this country, since we returned to this place. That makes the debate very welcome. I hope that we will have the opportunity again, before the House rises for the summer recess, to discuss all the matters that arise and to inform the process through which DFID is passing as we move towards the important adoption of the goals in September of this year.
As the hon. Member for Glasgow North said, the millennium development goals have been extraordinarily successful in tackling the root causes of poverty in much of the developing world. Some of the statistics that he mentioned are extremely telling and important. I do not know where the hon. Gentleman gets his figures from, but as I understand it, the number of people living in extreme poverty—on below $1.25 a day—has reduced by some 700 million since the previous Government adopted the goals as part of British policy. Efforts against disease and particularly against malaria and tuberculosis made great strides between 2000 and 2012. An estimated 3.3 million deaths from malaria were averted because of the interventions resulting from the millennium development goals.
There has been access to improved drinking water across the developing world, and disparities in primary school enrolment between boys and girls have almost disappeared, although there is more work to be done in that area. The role of women—the political participation of women—has increased throughout the developing world. That is very much to be welcomed. I know that that agenda is important to all Members of this House.
None the less, there are major respects in which we have not achieved what the world community set out to achieve. Major threats to sustainability, particularly in the developing world, continue. I am thinking of the way in which resources are exploited by companies that are interested only in the bottom line and by countries that regard it as in their national interest to rape the natural resources of the poorest in the world, who have no means by which they can defend themselves against those companies and countries. That is something on which the world will have to concentrate.
Hunger continues to decline, but further efforts are needed. The proportion of undernourished people in developing regions has decreased, but progress on that has slowed considerably since the advent of the financial crisis. That issue is particularly important. We take it for granted in this country that we have enough food. If people travel in west Africa or east Africa, they will see that that is not the case there. People genuinely do not have enough food on which to live, and chronic undernutrition of children remains a very considerable problem, as does child mortality.
I want to speak briefly about HIV therapy. There has been progress since the millennium development goals were introduced, but there remains a pervasive culture, particularly in much of Africa, in which HIV is regarded as something that cannot or ought not to be treated, and which is certainly not spoken about. The world needs to tackle that. We will tackle it when we adopt the goals in September, but there is a considerable problem to which Members have already drawn attention.
One of the great successes of the millennium development goals was that they were brief. They were an organising framework for donors and developing country governance. They provided a consensus around which the world community could coalesce, but here we have 17 goals: an amorphous set of principles that we all want to see achieved, but there are so many of them that, as the Prime Minister has said, there are simply too many to communicate effectively and there is a real danger that they will simply end up on a bookshelf gathering dust. I know that that is also the view of the Secretary of State for International Development.
In the remaining stages of the negotiation, it would be good if the message could go out clearly from this House, through the Government, that what needs to be done is to focus efforts so that the goals themselves are clear. In one sense, the SDG is a visionary document—how we all want to see the world in 2030—but the targets that have to be met must be measurable. We must have a set of aims and values that we can communicate to those who provide the funds that we rightly, although we often have to persuade people that it is right, deploy in the international aid budget. There are areas that are simply not tackled in the sustainable development goals, to which the hon. Member for Glasgow North alluded, such as climate change, because the attitude of the UN is that it is dealing with them by other means. Although the goals are welcome, more progress could be made as we move towards the meeting in September.
There are two areas on which I want the Minister to concentrate when he responds to my remarks. The first relates to health. The Ebola outbreak in west Africa showed that health systems in the developing world are not adequate to deal with large, widespread outbreaks of significant problems. When we get to the end of the outbreak—pray God that we now are; it seems as though we are—more people will have died of malaria in west Africa than will have died of Ebola for the simple reason that the healthcare systems in Sierra Leone, Liberia, Guinea and other affected countries such as Mali have not been able to cope with the appalling epidemic that the world has had to face and at the same time treat endemic diseases such as malaria. Such a discussion needs to be ongoing. What is the Minister going to do to make healthcare systems in the developing world more robust, and what is DFID’s view about the reform of the World Health Organisation, which, as everybody here knows, dropped the ball in relation to Ebola?
The Minister needs to concentrate on another issue that is not really mentioned in the sustainable development goals or the targets that surround it: corruption. Corruption in the developing world is endemic and takes money from the poorest people. The money being used to fund corruption, particularly in the civil services of developing countries, is money that would otherwise be used for public services and for the alleviation of poverty. That really needs to be tackled; it has not been tackled by the United Nations convention against corruption, because there are so many respects in which states are not monitored for compliance with it and so many respects in which, even if they are monitored, they fall down in relation to the common standards that ought to have been accepted. This has not been a priority for DFID and it ought to be, because economic growth is the one thing that we can probably all agree assists in the prevention of poverty.
The prevention of poverty in the developing world is important not only because it is the right thing to do, which is why we stand behind the 0.7% target, but because it secures the national security of this country and its citizens. Will the Minister say a little more about how DFID will influence the sustainable development goals and how it will drive them and ensure there is a robust healthcare system in the developing world? Will he also say more about the corruption that takes money from the poorest people in the world? If the Minister can reassure us on that, we will all know that the Government are moving in the right direction and that the world is moving in the right direction with regard to the goals.
I also would like to make a declaration. I am still a Scottish Catholic International Aid Fund ambassador for south-west Scotland, although I am not sure how long I will manage to do that along with this role. Through SCIAF, I had the opportunity to visit AIDS projects in Kenya and Tanzania in 2006. Others have referred to Make Poverty History, and I remember traipsing off to Edinburgh with my 11-year-old son, who is now a big 21-year-old man. Although some things have improved, they definitely have not improved enough. I commend the reference to the devolved Governments, where there is expertise. The issue is reserved, but certainly in Scotland we have been active and I would like to see Humza Yousaf, our Minister for Europe and International Development, included in the summit, because devolved Administrations have things to say.
How we deal with other people matters, as well as our understanding of aid for trade and aid for defence. We have been talking about TTIP, the Transatlantic Trade and Investment Partnership, for the past couple of years, but we now have a TiSA, a trade in services agreement, that tries to ensure that developing countries, and indeed developed countries, are forced to have a more private basis of service provision, so they could not emulate the health provision that we have here. In developing countries it needs to be done in the simplest, cheapest way. Setting up private systems means the wealthy getting healthcare and illness lying at the bottom levels, so that we never eradicate polio, never control malaria and certainly never control Ebola.
I am sorry; I did not mean to imply that that was coming from the hon. and learned Gentleman’s comments. I was respecting his comment that such countries need help to have a robust health system. But TiSA is out there. It is not very much on our horizon, but within Europe people are already beginning to see it coming and seeing the impact it would have in Europe and developed countries and also in developing countries. We should look at the unsustainable debt and at the terms that are often laid down when a country has to borrow: we need to ensure that we are not, as it were, shackling both its ankles and one arm together and then sending it off to do things.
One important thing not within the sustainable goals is climate change. We must recognise the absolute disaster that is coming. We are currently dealing with refugees coming from north Africa and the near east because of conflict, but the Sahara is expanding. Current wars have been about oil; future wars will be about water. As the Sahara expands in both directions, populations will be driven into other territories. What we see in the Mediterranean at the moment will pale into insignificance compared with what we will see in future. That needs to come into our policies. It needs to come into everything we do; it must not just be the international development group, which is not included in anything else.
We absolutely need to look at our own behaviour, how we generate power, how we produce things and what we use. We take some weird approaches in looking at how we produce energy. We make the world price of food go up so that we can put it in cars and go on driving bigger cars. We say that nuclear is the solution to the carbon dioxide problem, despite the massive CO2 released in the production, building and commissioning of a nuclear power station. We must look at these things in the round. Individuals, and the Government who lead individuals, need to look at our obsession with consumerism. We think sticking in a low-energy light bulb lets us off the hook, yet we are obsessed with stuff. Do we really need more gadgets? Do we really need up-to-the-minute fashion? Unless we look at every level, led by and promoted by the Government, we will not change quickly enough. It is poorer people who pay the price, through climate injustice, for our behaviour.
It is a pleasure to serve under your chairmanship for the first time, Mr Turner. I welcome the Minister to his new appointment, and I congratulate the hon. Member for Glasgow North (Patrick Grady) on securing the debate. A lot of what I wanted to say was said by the first few speakers and by the hon. Member for Central Ayrshire (Dr Whitford), but I will concentrate with a lot of optimism on some of the goals outlined on climate change, energy and sustainability.
We need joined-up thinking between the Department of Energy and Climate Change and the Department for International Development. We need to work together. In the past, Departments have tended to work in silos. That is why I mentioned in my intervention the need to co-operate with the devolved Administrations. I have seen some very good practice in Wales, such as the bilateral agreement between Wales and Lesotho, with links between the schools. They are going out to educate young people there. Link-ups through modern technology are also easy to do. Many primary schools in my constituency of Ynys Môn have live link-ups to see exactly what life is like there.
I must make a declaration: I have never done anything in the conventional way. I left school at 15 and went into the merchant navy. I saw with my own eyes some of the extreme poverty and extreme wealth across the world, and it shaped my life and my politics in many ways. It is important in this modern 21st century that young people have those links with the developing world.
I congratulate the Government on some of their work, particularly on Ebola. There has been a great coming together of the world’s health organisations and this country’s national health service to provide essential skills to help eradicate that disease. Good work is being done. I am proud that the United Kingdom has a Department for International Development, and I was proud when it was set up. I am also proud of the Climate Change Act 2008. The theme of my speech is that we need to link those two together. We need to understand, as the hon. Member for Central Ayrshire said, the importance of weaning countries that have developed on fossil fuels off them.
This is a golden opportunity for countries that do not have the infrastructure or the legacy from oil and gas and that can adapt many of the new technologies being developed across the world. Solar energy, for example, can go into villages in isolated locations around the world. We can have new schools and clean water because we will have the electricity to provide the pumps in those areas. That is a great opportunity.
Goal 7 talks about ensuring
“access to affordable, reliable, sustainable, and modern energy”.
One problem in industrialised countries such as the United Kingdom is that our energy facilities are ancient and need to be rebuilt and retrofitted in many ways. Newer, underdeveloped countries have the opportunity to start from day one, but we have to learn and do it by example. We are doing well with our goals on renewable energy. The hon. Lady and I will not agree on nuclear power, but I believe that it will help us to reduce our carbon emissions. We in the United Kingdom have 1% of the world’s population but produce 2% of carbon emissions. We need to reduce that. Nuclear technology can help us to do that, but we have to lead on it.
With these two big conferences coming up in New York and Paris, I hope that the Minister will assure me that he, the Secretary of State for International Development and his Department are talking with the Secretary of State for Energy and Climate Change so that we have joined-up thinking. We can then go on to the world stage, lead by example and use our expertise in a positive way to combat climate change and its impact on lesser developed countries.
I have a few final things to say about Scotland, Wales and Northern Ireland before the hon. Member for Glasgow North replies—is that how it works? The Department for International Development needs to get out more, to be absolutely frank. It needs to go to East Kilbride, where the Department has an office. It needs to go to the Welsh Assembly and Belfast to see the good practice in the devolved Administrations, as well as to the regions of England. Rather than talking to ourselves here in the UK Parliament, we need to go out and learn from the best examples. We can then hopefully go to these summits, speaking and working with the devolved Administrations, to put the case for all parts of the United Kingdom and show leadership across the world. These are important summits. We want to be present and we want to make a difference.
Finally, I will talk about the Make Poverty History campaign. Although I indicated that I did not do things in the conventional way and went to sea at 16, the Make Poverty History movement really excited me because it brought together the Churches, non-governmental organisations and real people across this country. That was the important thing about that movement, and it left us with these development goals. We are now going into round 2, and we must ensure that the goals are meaningful and that they work.
It is a pleasure to serve under your chairmanship, Mr Turner, and to be back in Parliament for this important debate. I congratulate the hon. Member for Glasgow North (Patrick Grady) on an excellent opening speech that set the tone for the rest of the debate. I offer my extended congratulations for the first time to the Minister and welcome him to his role. He will already know from the short time he has been there that the Department for International Development is a fantastic Department to work in and alongside. It works on tackling many of these issues. We already share something in common, which is a very similar name. I have learned that over my five years in Parliament, because the postman here does not always deliver with 100% accuracy. I have noticed that the Minister’s invites are often printed on considerably thicker card than mine. Now that I am shadowing him in this position, I hope that we will tackle that inequality as well.
We live in a global society, yet every 10 seconds a child dies from hunger and malnutrition. Even after the millennium development goals come to an end this year, nearly 1 billion people will still be living in extreme poverty. Hundreds of thousands of women die each year during pregnancy and childbirth, and a population of more than three times the size of Birmingham dies each year purely from water-related diseases. To stand aside and allow that to continue when we may take action is to perpetuate a great injustice. Ours is the generation that could see the end to extreme poverty, reduce inequality and tackle climate change. It would be easy in the current climate to turn away from tackling some of the world’s most intractable problems.
The thread that connects the key issues we face of climate change, economic crises, disease and conflict is their global and interdependent nature. This year is a unique opportunity for the world to see a realignment and a new settlement of institutions and shared action that can tackle those threats. The agreement to be secured in September on the replacement of the millennium development goals will take place at one of the two crucial summits this year. As Members have said, we will also hopefully agree a framework in Paris in December to tackle climate change into the next generation. The Labour party stood on a manifesto that promised to prioritise those global accords, as well as twin and related ones. We are determined to hold the Government to account throughout this Parliament to ensure that Britain’s reputation as a leader in international development —a reputation hard-fought and hard-won by the previous Labour Government—endures.
There have been valuable contributions in today’s debate. My hon. Friend the Member for Liverpool, West Derby (Stephen Twigg) went right to the heart of what our focus needs to be in the coming months in his comments about inequality. The hon. and learned Member for Sleaford and North Hykeham (Stephen Phillips) made a powerful contribution. Some of his most interesting comments were about the disconnect between the 17 goals and 169-odd targets currently in the zero draft, as well as the desire that I am sure we all share for those goals to be clearly explained. That probably means having fewer of them. The hon. Member for Central Ayrshire (Dr Whitford), in speaking about her own experiences, brought home how powerful it can be to confront the reality of extreme poverty and inequality, as well as the hope that many people hold not just for their own lives but for their whole community. My hon. Friend the Member for Ynys Môn (Albert Owen) spoke not just about co-operation at UK level, in which I believe passionately, but about the experiences that we can garner from devolved Administrations, such as the Government in Wales, which I know from my own experience has been hugely inspiring in tackling these issues at community level as well.
Some specific concerns were also raised, and I will go through them one after the other. We have discussed the fact that the sustainable development goals are there not just to eradicate extreme poverty but to tackle growing inequality. We put particular emphasis on that in our manifesto. Gender, caste, race, community, disability, religion, age and ethnicity all too often determine people’s life chances. Health, education, jobs and participation are increasingly determined at birth, so we promised to prioritise human rights, climate change and universal healthcare in a bid to tackle that growing concern.
Health inequality is one of the most debilitating inequalities that someone can experience. As the party of the NHS, we want everyone to enjoy the protections that we in this country take for granted, and we are committed to providing the global partnerships, support and encouragement needed to countries that want to provide healthcare for their own citizens. Therefore, it was welcome to hear the Secretary of State say two weeks ago at the Dispatch Box that the Government
“have advocated very strongly for universal health coverage that truly makes a difference to people and puts them in a position to be able to play a role in helping to develop their country.” —[Official Report, 3 June 2015; Vol. 596, c. 575.]
That is particularly welcome because it stands in stark contrast to the previous Secretary of State—who also happens to be the current Secretary of State—who failed to provide before the election for universal health coverage in the post-2015 agenda and refused to support a stand-alone goal on universal health coverage. Most devastatingly, she cut her Department’s direct support to health systems year by year, creating the conditions in which Ebola went unchecked for too long. Can the Minister outline what steps the UK Government will take in the light of their new position on the crucial agenda of universal healthcare? Will they push for universal healthcare, in the language of the goal on healthcare, in the room in September?
Last week in the Chamber, I spoke about how climate change will be seen as development in reverse. The world’s poorest face rising sea levels, droughts and storms. When one’s very survival is under threat from natural disasters, thriving diseases and conflict over resources, economic development can often become a romantic ideal. We remain concerned that, despite those clear links, the zero draft of the outcome document is still unambitious on that agenda, allowing goal 13 to remain essentially a holding text for an agreement that has not yet happened and whose start date and implementation is five years from now.
That is why I urge the Secretary of State and the Minister to ensure in September that climate change remains a stand-alone goal in the post-2015 SDGs, with a 2º global temperature rise embedded in the language of the goal. That may seem dry, but the lesson of the millennium development goals was that their language was hugely important for focusing minds and measuring progress. Will the Minister say a few words on that issue as well?
This debate is about more than just negotiating the language of the sustainable development goals; it also needs to be about their implementation. We particularly welcome the opportunity to hear what the new Government see as their priorities within that expansive agenda. As the hon. and learned Member for Sleaford and North Hykeham said, it might be difficult to galvanise political will around 17 goals and 169 targets. Is it the UK Government’s position to have fewer goals and greater focus on each of them? If so, what will those goals be?
There are questions about this Government’s global leadership. When the Prime Minister was appointed co-chair of the high-level panel, we were disappointed to see that he attended only half the meetings. In that context, how does the Prime Minister mean to go about negotiating the SDGs, especially given that key issues such as climate change have fallen off the agenda in meetings that he has chaired in the past? It took Germany’s Chancellor to put climate back on the agenda in the most recent G7 discussions.
The all-embracing nature of the zero draft risks prevarication and duplicity, potentially enabling Governments to address selectively those goals and targets most aligned to their existing agenda, while failing to challenge the more complex and formidable issues that we face.
Does the hon. Gentleman agree that there is also the difficulty that unless there is effective monitoring, there may be differences within regions and indeed countries? The sustainable development goals might be properly implemented in some areas, or efforts might be made to do so, but rural areas in particular in the developing world might simply be left behind because everybody is concentrating on the capital cities.
I agree completely with that well-put point. I add that one challenge that everyone in our generation must face following the negotiation of the first millennium development goals is increasing urbanisation, which could leave some people even more disconnected. On issues such as universal healthcare, the problem becomes obvious: how can a healthcare system reach out across all communities? Monitoring will be key, which is why we have called for the disaggregation of data in the results produced through the process.
We believe that we have been clear about our priorities, and we ask the Government to be equally clear in their negotiating position, to tackle inequality, ensure the attainment of the human rights—including the fundamental rights of women and girls—that remain at the heart of the agreements and combat climate change. Not just now but in Paris in December, I hope that the Minister is willing to match our ambitions in the field.
It is fantastic to see you back in the Chair, Mr Turner, and a pleasure to serve under your chairmanship. I congratulate the hon. Member for Glasgow North (Patrick Grady) on securing this debate, right up front at the beginning of this Parliament, on an issue about which I know he is passionate and has a great deal of knowledge and expertise through the Scottish Catholic International Aid Fund and through the incredible Scotland-Malawi partnership, which runs incredibly deep. As the hon. Member for Central Ayrshire (Dr Whitford) also mentioned, it is threaded through everything that goes on in international development in Scotland.
I was in East Kilbride only last week and, as the hon. Member for Ynys Môn (Albert Owen) will be pleased to hear, I will no doubt be going to the Welsh Assembly soon. One thing that I discovered there was that—I think I have these numbers right—some 157 primary schools in Scotland have direct links with Malawi, as do more than 900 different non-governmental and similar organisations and 47% of Scots. That is absolutely extraordinary, impressive and commendable, and we will seek to replicate it in other important areas of development during this Parliament.
This is a fantastic debate to have, and it has been good-natured, with some extremely important points raised. I will pick up on some of them. The hon. Member for Glasgow North mentioned the principle of dignity on behalf of some NGOs. The UK Government support the concept of dignity in development; it is absolutely right, and we welcome the Secretary-General’s report on dignity. He makes the intelligent point that prosperity and dignity, while allied, are not exactly the same thing.
As the new guy to this subject, I know this is the most fascinating topic that the Government have to deal with—perhaps only we in this Chamber know that. As the hon. Member for Liverpool, West Derby (Stephen Twigg) said, the number of people living on $1.25 a day, although falling, is not yet down where we need it. However, it is interesting that people are now living for a decade longer than they were in the 1960s, even though their income is not necessarily higher. Also, more children are going to school now. Whereas in the 1960s, only half the kids of primary age went to school, now 90% of children in the world go to school. The world is somehow getting better without prosperity necessarily rising, although we want to see that, too. However, dignity is absolutely key to this process and the hon. Member for Glasgow North is right to raise it as an issue.
The hon. Gentleman asked a direct question about the representation at the summit on sustainable development goals; the hon. Member for Central Ayrshire also referred to that. I assure both hon. Members that although the summit is in September—so still a little way away—and the exact composition of the delegations is still being worked through, I heard what they said and I will reflect on it.
There was a rather transient comment, which is none the less important to respond to, about what on earth having Trident does for supporting development goals. The answer is, quite simply, that it has prevented the world from getting into all sorts of trouble in the last 60 or so years. I will say no more about that now, but I believe that being on the Earth is an important objective in itself, rather than our being entirely wiped out.
The hon. Member for Liverpool, West Derby made some excellent points, including about the cross-governmental nature of the Department for International Development’s position. I can reassure him by saying that I absolutely know for certain that the Secretary of State for International Development regularly attends the National Security Council; I can put his mind at rest on that. Indeed, one or two people touched on cross-Government working. The level of cross-Government working at DFID is the most impressive of any Department that I have been involved or been a Minister in, or have seen operating.
I think the hon. Member for Ynys Môn asked about DFID working with the Department of Energy and Climate Change on the climate change agenda for international development. Again, the Secretaries of State for both those Departments, and the Ministers in them, including me, all work incredibly closely across government on that agenda.
DFID is different from other Departments. It does not have a role in writing to the Home Affairs Committee to seek collective agreement on policy in the same way that the Home Office, or another domestic Department, has. However, I assure the hon. Gentleman that that absolute tie-in with other Departments, many of which have a strong role in and relationship with international development—indeed, they spend some of their budget on international development—is not missing. They include DECC, the Ministry of Defence, the Foreign and Commonwealth Office, and so on. There is a very close tie-in between Departments and international development.
My hon. and learned Friend the Member for Sleaford and North Hykeham (Stephen Phillips) made an excellent speech, which included the absolutely correct observation about the extraordinary fact that there are 17 goals and 169 targets. Those numbers are rather unwieldy, but the zero base document starts to get to grips with them. I think the document comes up with nine principles, which will be easier for people to understand. However, we are where we are with this whole process, and I do not think that anyone believes that we should go back to square one and start again; it is important that we push forward. However, our goals need to have a sense of clarity, and some of the suggestions made in this debate can play an important role in achieving that.
My hon. and learned Friend was particularly exercised by the healthcare systems in countries such as Sierra Leone and by their inability to respond to the Ebola outbreak and its consequences. I want to reassure him by saying that the UK’s chief medical officer will now work with the World Health Organisation—as my hon. and learned Friend said, WHO’s difficulties, given the tools that it had available to it, were rightly pointed out by all who saw its performance—to develop a new and more advanced system to share data on disease spread on the ground. The CMO will also work with health agencies, doctors and nurses on the front line. We, as a Government, absolutely intend to make certain that the lessons are learned from what happened in Sierra Leone and elsewhere, so that we do not allow the shortcomings that existed to become problems in any future outbreak of a different disease.
My hon. and learned Friend also zeroed in on corruption and he was absolutely right to do so. Anyone who has listened to the Prime Minister talking passionately about what he calls the “golden threads” will know that having secure institutions that work on behalf of a population, rather than against it, is absolutely critical to any sense of international development. We will simply make no progress without those institutions. Anyone who has read the book, “Why Nations Fail”, will know that it is one of the inspirations for the golden threads. I think that those “golden threads” are absolutely embedded in target 3.8—no, sorry that is on universal health care, so I will have to find the exact target for my hon. and learned Friend. It is actually goal 16, which is to
“Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels”.
I hope that will reassure him.
The Independent Commission for Aid Impact produced a report in November 2014 that stressed that this area of corruption was one that DFID was not concentrating on and needed to; the report raised a number of red flags. Will my right hon. Friend give an undertaking to the House that he will go and look at that report, to see whether those issues are now being dealt with?
Yes, I am pleased to give my hon. and learned Friend that undertaking.
I will quickly move on to the energy questions that were put by the hon. Member for Central Ayrshire. She made very sensible points. I am absolutely amazed that 1.2 billion people in the world do not have any energy in their own homes. In a world where the price of solar is tumbling, batteries are becoming more available and micropayments are available in developing countries— for example, through the British-inspired M-Pesa system— there is no reason to allow that situation to continue. I intend to spend my time in DFID particularly focusing on bringing energy to domestic housing situations, and I hope that hon. Members from all parties will join me in that work.
In Tanzania, I met a woman called Elizabeth who can now power three light-bulbs and charge her mobile phone from a tiny solar panel on her roof that is no bigger than a sheet of A4. That has changed her life; it saves her money on kerosene, and we should spread that practice to all the 1.2 billion people in the world who do not have such energy.
I disagreed with the hon. Lady when she said that somehow consumerism in the west is to blame for the situation. I do not think that is the case, but I fear that, because time is running out, I will not be able to have a longer and more interesting debate about that point.
The hon. Member for Ynys Môn talked about joined-up thinking, which I think I have covered, in addition to the visits that I have made to East Kilbride.
The hon. Gentleman and the hon. Members for Glasgow North and for Central Ayrshire will be interested to hear that I am going to Malawi next week, where I will do everything I can to push our relationship with Malawi and indeed learn from it.
Finally, I thank the hon. Member for Luton South (Mr Shuker) for welcoming me to my position. I can tell him that we have very strong plans. On inequality, for example, the UK is committed to an agenda that will end extreme poverty and build on prosperity for all. I can reassure him on that, as indeed I can on the language about climate change, where the goal is to take urgent action to combat climate change and its impacts, as a crucial part of our framework.
I would like to spend more time satisfying the hon. Gentleman about the issues he raised, but I know that there are only a couple of minutes left for the hon. Member for Glasgow North to respond to the debate.
Thank you, Mr Turner, for giving me the opportunity to respond to the debate, and I also thank the Minister for his comments. I, too, welcome him to his post and I look forward to many exchanges with him in the coming years. He touched on a number of areas that we will probably revisit in the Chamber in the weeks and months to come.
I will respond briefly to three main points that were made during the debate. First, I chose the original title—“Negotiation and Implementation of the Sustainable Development Goals”—quite deliberately, because the window for negotiation is closing, and the time has passed for getting into a debate about the number of goals and so on. The opportunity now is to make the language as robust as possible, and the negotiations need to focus on collecting data and monitoring the impact of the SDGs.
The link with climate change, which was touched on, is also vital. It is mentioned; there needs to be a synthesis, and we have to respect the United Nations framework convention on climate change process. However, the language about climate change needs to be as robust as possible in the SDGs.
I am grateful to the Minister for his comments about the role of the Scottish Government. I look forward to hearing the outcome of his reflection on the question of Scottish representation at the summit on SDGs. No doubt we will continue to press him to find out when that reflection has been completed.
The contributions today recognise the importance of this issue. I am aware that in another place this evening there is a debate on exactly the same topic, which will be led by the former First Minister of Scotland, Lord McConnell, who is a champion of Scotland’s links with Malawi. Perhaps when the Minister comes back from Malawi we will have an opportunity to discuss his experiences there in detail, either formally or informally. Indeed, if he wants to speak to me—
Motion lapsed, and sitting adjourned without Question put (Standing Order No. 10(14)).