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Westminster Hall

Volume 603: debated on Tuesday 8 December 2015

Westminster Hall

Tuesday 8 December 2015

[Sir Edward Leigh in the Chair]

Backbench Business

Cystic Fibrosis

I beg to move,

That this House has considered access to medicines for people with cystic fibrosis and other rare diseases.

As always, it is a pleasure to see you in the Chair, Sir Edward. I thank Carly Jeavons from Dudley for contacting me to suggest that we hold this debate and for what she has taught me about cystic fibrosis; Ed Owen, the chief executive of the Cystic Fibrosis Trust, and all his staff for their help and advice in organising this debate; and all the right hon. and hon. Members who are here to take part and to speak up for their constituents with cystic fibrosis and other long-term conditions.

Three years ago, Carly Jeavons was at a crossroads. She did not know whether to leave work and face financial turmoil or to continue working while risking her physical wellbeing and mental health. She struggled to breathe and had a lung function of around 44%. Every day she was taking around 90 tablets and undertaking around two hours of physiotherapy, and she spent two weeks in hospital every three months. In September 2014, Carly was offered the opportunity to participate in a clinical trial for a new type of treatment. Initially on a blind clinical trial, she was unsure what treatment she was taking, but later found out that it was a new treatment called Orkambi. The treatment has enabled her to spend more time with her family, and she has been able to go on holiday. She now attends a cystic fibrosis clinic every eight to 12 weeks, rather than every four.

Personalised medicines can have a transformational impact, not only for people with cystic fibrosis, but for a range of other illnesses. Without a more effective process for appraising such medicines, however, patients are unable to access new and innovative treatments. That is why I called for this debate. Cystic fibrosis is a life-shortening inherited disease that affects more than 10,000 people in the UK. It causes the lungs and digestive system to become clogged with mucus, making it hard to breathe and digest food. The damage to the lungs caused by cystic fibrosis means that many people come to rely on a lung transplant to stay alive. There is no cure, but many treatments are available to manage it, including physiotherapy, exercise, medicine and nutrition. Tragically, the median survival age is just 28.

Cystic fibrosis care has long been limited to managing symptoms and decline, but now, after 25 years of research, the Cystic Fibrosis Trust says that there is a pipeline of precision medicines that target particular cystic fibrosis mutations and seek to correct the basic underlying genetic defect. This new type of personalised medicine, which targets the defective gene, is a testament to modern science, and provides an opportunity to tackle this life-shortening inherited disease. As a contributor to the human genome project, British science has played a leading role in creating this new era of genomic medicines, and the UK is a global centre for clinical trials such as the one that my constituent Carly participated in. That work continues through the NHS’s 100,000 Genomes Project.

The first precision medicine for cystic fibrosis, Kalydeco, targets a mutation that only a little more than 4% of people with cystic fibrosis in the UK have. On that medicine, patients have shown increased lung function and slower progression of lung disease, and the number of hospital admissions has fallen by more than half. There are predictions that some people on the drug could expect a near-normal life expectancy. Orkambi is the next precision medicine for cystic fibrosis. It is being developed by Vertex, based here in London. It targets a mutation that around 50% of people with cystic fibrosis have, and, like Kalydeco, it has the potential to offer significant health benefits. Orkambi is now licensed for use in the EU and will soon begin its separate appraisals for clinical and cost-effectiveness across the NHS, covering England, Scotland, Wales and Northern Ireland. Work in this area is also important for people affected by muscular dystrophy and related conditions, with a number of drugs in late-stage clinical trials and one, Translarna, which is used to treat Duchenne muscular dystrophy, undergoing appraisal by the National Institute for Health and Care Excellence.

Muscular dystrophy is a progressive condition, often rapidly so, meaning that delays at the regulatory, approvals and funding stages can make all the difference to whether someone can access a treatment. Genomics England is currently delivering the 100,000 Genomes Project, the aim of which is to create a new genomic medicine service for the NHS. The project is focused on rare diseases and cancer. The developments in cystic fibrosis treatment and the impact of the new medicines have already demonstrated the human benefit from work in this area, but the current single technology appraisal system may not enable access to personalised medicines.

The existing NICE appraisal system makes decisions on the efficacy of a drug based on 24 weeks of clinical trials data. It fails to take into account the long-term benefits to sufferers’ quality and length of life. The focus on measuring the benefits of a treatment in terms of quality-adjusted life years does not work for genetic diseases such as cystic fibrosis, because it massively underestimates the impact that the drugs have on quality of life over the long term. It also fails to take account of the wider societal benefits of these medicines, such as the way they can help sufferers or their carers to get into work. In short, the existing system cannot provide an accurate assessment of new treatments, such as Orkambi, which offer long-term, preventive stabilisation of cystic fibrosis. It may say no too soon to treatments that require time for their value to be realised.

This debate is not about spending more money on drugs. In fact, it is the opposite: it is about making sure that we are helping people with conditions such as cystic fibrosis in the most cost-effective way, which could actually reduce hospital admissions and enable them to work more easily. According to the Cystic Fibrosis Trust, new genomic treatments could be available to 90% of people with cystic fibrosis within five years, but under the way in which NICE currently appraises medicines, none of those drugs is likely to be approved for use in the NHS. The system simply is not set up to assess personalised medicines where the patient target audience is, by definition, increasingly small. The situation affects many other rare diseases beyond cystic fibrosis, but without reform, research into precision medicines of this kind could dry up and a once-in-a-lifetime opportunity to beat cystic fibrosis and other rare diseases could be missed.

The Government recognise that change is needed. The creation of the Office for Life Sciences and the accelerated access review are among various initiatives to investigate reform. We need a system that gives new treatments the chance to prove their full effectiveness with long-term, real-world data. We have started to see that in other disease areas, with the development of the first managed-access agreement between a manufacturer and NHS England, which will allow unapproved treatments to undergo long-term testing before requiring full approval. That new model has the potential to be applied across the entire system.

I welcome the establishment of the accelerated access review to find ways of speeding up access to innovative new drugs and treatments. The interim report on the review emphasised the importance of flexibility and anticipating potentially transformative technologies, both those on the horizon and those already available. Such innovative transformative medicines should be seen as part of the solution. We need the NHS to give clinicians and patients time to assess how new precision medicines might slow the decline of diseases, and we need a system that gives medicines the chance to prove their true effectiveness with long-term, real-world data.

Cystic fibrosis is a test bed for reform because the Cystic Fibrosis Trust hosts the UK cystic fibrosis registry, an anonymised database that lists the 10,583 people in the UK with cystic fibrosis. The registry already provides real-world data to health commissioners and pharmaceutical companies so that they can monitor the efficacy of treatments. That makes cystic fibrosis a unique testing ground to pilot a new appraisal system for innovative medicines that could be applied to treatments for a wide range of conditions beyond cystic fibrosis. Orkambi could be the first treatment piloted. This is a once-in-a-generation opportunity to beat cystic fibrosis. Like Carly Jeavons, the 4,000 people in the UK eligible for Orkambi do not have time to wait for the system to catch up.

Last night, hundreds of people with cystic fibrosis, along with their families and carers, took part in an online digital discussion on social media that enabled them to share their experience and opinions directly with Members of Parliament ahead of this debate. Simon, who took part in that debate, said that it is

“hard to state the significance on quality of life”

that new drugs had given him. He said that he

“now had a stable job”

and is

“in the middle of getting a mortgage”.

Lorraine, who cares for two children with cystic fibrosis, told us that these new treatments mean that she can go back to work and worry less about outliving her children. Michael said they will enable him to focus on his career without fear that he will have to give it up as he gets more unwell. Kelly pointed out that having healthier people who need less hospitalisation could save the NHS in the long run. Last night’s discussion and this debate are supported by Parliamentary Outreach, which aims to enable people with cystic fibrosis to come together and express their views.

Cystic fibrosis is a uniquely cruel condition. The people who suffer from it are unable to come together because they are vulnerable to the different bacteria that grow in their lungs. Although those bugs are usually harmless to people who do not have cystic fibrosis, they can settle in the lungs of those who do and harm them. Our discussion last night and this debate are important because they enable people with cystic fibrosis, who do not normally get the chance to speak up, to be heard. They show that if we embrace new technology and think of new ways of opening up democracy beyond the walls of Westminster, people such as Carly, Lorraine, Michael and Kelly can be heard.

The system needs to change. We need NICE reform and an appraisal system fit for a future that includes personalised medicines, which cannot be approved too soon. In the current system, decisions about a drug’s efficacy are based on 24 weeks of clinical trials data, but for new medicines such data are not available. The system needs to account for the development of data over time, and for cystic fibrosis it needs to account for the fact that the value of the new medicines will be realised over time.

Cystic fibrosis is a test bed for reform. The Government must agree to explore ways of collaborating with the trust. I know that the Minister is meeting the Cystic Fibrosis Trust later today to discuss some of these issues. There has been major investment in the life sciences in the UK, but we cannot continue to invest in developing innovative new medicines if patients cannot access such treatments.

I have several questions for the Minister. Can he update the House on the timings for developing proposals for a new system for appraising new medicines? Will he consider meeting the CFT to discuss working with it to develop a system for managed access to medicines that includes a CF registry? Can he comment on the safeguards that will be in place to ensure equality of access to medicines under any new scheme? Will he consider amending the appraisal process for the new drugs to give more weight to the societal benefits for sufferers and their carers? What is the Government’s latest thinking on following Scotland and Northern Ireland by introducing a ring-fenced fund for rare disease drugs in England? Will he write to the chief executive of the National Institute for Health Research to ask how his organisation plans to work with specialist muscle centres to address concerns about the lack of clinical trial capacity for Duchenne muscular dystrophy? Finally, how can NICE and NHS England be given greater powers to negotiate the best price with pharmaceutical companies to ensure that new treatments are not held up or rejected on the grounds of cost?

It is a pleasure to serve under your chairmanship, Sir Edward. I warmly welcome the Minister, who, I am afraid, is very familiar with what I am speaking about today; I hope he gives me an A for effort and persistence. Given that we have spent so much time discussing access to Translarna, perhaps in his winding-up speech he will have some good news for me and my constituent.

I congratulate the hon. Member for Dudley North (Ian Austin). I am absolutely delighted that he secured this debate on access to medicines for people with cystic fibrosis and other rare diseases. Like me, he knows how important this issue is for families up and down England. I have been looking at the issues surrounding Duchenne muscular dystrophy for what seems like many years—in truth, it has been for just over a year. Only 90 boys affected by the disease in England are eligible for this drug, and the number is slightly larger across the whole of the United Kingdom.

Duchenne muscular dystrophy is a devastating condition that leads to full-time wheelchair use between the ages of eight and 11. It is a progressive, muscle-wasting disease that eventually affects the muscles involved in the respiratory and cardiac functions. Sadly, few with the condition live to see their 30th birthday. I have been working with Muscular Dystrophy UK, which fights causes to do with muscle-wasting conditions. I pay tribute to that organisation for all the support and help it gives. It not only informs Members of Parliament, but helps people affected by those diseases. My constituent, young Archie Hill, is an inspiration to everybody in this area. He has been campaigning for many years, and he and his family are indefatigable in their efforts to get the right medicine at the right time to these boys.

I congratulate my hon. Friend the Member for Dudley North (Ian Austin) on securing this timely debate. As the right hon. Member for Chesham and Amersham (Mrs Gillan) will recall, some months ago we all went to Downing Street to petition to get something done about muscular dystrophy. I am sure she would agree that one of the big problems is that even if the new treatments are okay, there is always a long run-in, in which negotiations take place between the Government and the pharmaceutical companies.

The hon. Gentleman is absolutely right. I pay tribute to the other colleagues in the House who took part in that petition. That truly cross-party effort aimed to draw attention to the drugs that are not readily and fully available to our constituents. I was grateful that it was a cross-party delegation, because such things are much stronger when they take place in an atmosphere of good co-operation across the board rather than a political atmosphere. We saw parliamentarians at their best, so I thank the hon. Gentleman for attending that lobby at No. 10 Downing Street, which was inspired partly by Muscular Dystrophy UK and partly by the families it supports.

The issue for me is the drug that the hon. Member for Dudley North referred to. Translarna is its trademark name; it is called ataluren. It is produced by a company called PTC Therapeutics, which calls it its “lead product candidate” for these disorders. I know that the Minister is familiar with PTC Therapeutics, and I hope that in his winding-up speech he will refer to any contact he has had with the company. One of the issues surrounding the efficacy and licensing of the drug is the cost, so I hope the Minister will update us on that situation.

PTC Therapeutics states that the drug is a

“novel, orally administered small-molecule compound for the treatment of patients with genetic disorders due to a nonsense mutation. Ataluren is in clinical development for the treatment of Duchenne muscular dystrophy caused by a nonsense mutation…and cystic fibrosis caused by a nonsense mutation…Ataluren was granted conditional marketing authorization in the European Union under the trade name Translarna”.

I believe that it is already available in France, Germany, Italy and Spain. It is the first treatment approved for the underlying cause of Duchenne muscular dystrophy, which is a complicated condition.

Nonsense mutations are implicated in a variety of genetic disorders. They create a premature stop signal in the translation of the genetic code contained in the mRNA. That prevents the production of full-length, functional proteins. The company says that

“ataluren interacts with the ribosome, which is the component of the cell that decodes the mRNA molecule and manufactures proteins, to enable the ribosome to read through premature nonsense stop signals on mRNA and allow the cell to produce a full-length, functional protein. As a result…ataluren has the potential to be an important therapy for muscular dystrophy, cystic fibrosis and other genetic disorders for which a nonsense mutation is the cause of the disease.”

The importance of access to Translarna cannot be overstated. Boys such as my constituent Archie Hill have been waiting since August 2014 for a decision on whether Translarna will be approved in England. As I said, it is the first licensed drug to tackle an underlying genetic cause of Duchenne’s. It would help to keep Archie and these other boys walking for longer and potentially delay the onset of the devastating symptoms affecting the heart and lungs that I referred to earlier.

NICE’s appraisal of the drug is ongoing, but the families have not yet been made aware of when guidance will be issued, leaving them facing an anxious wait over the Christmas period. Over the time I have known Archie and his family, I have seen his mobility decrease; it is depressing to see such an active, energetic, lively, intelligent young man, who has his life before him, being denied a drug that could well keep him active for longer and improve his quality of life.

My right hon. Friend is making a powerful argument. She is right to say that we must improve access to new medicines, which can transform the lives of people such as her constituent Archie. Does she agree that new medicines may also reduce hospital admissions, which would have a huge impact on the NHS?

I thank my hon. Friend for that intervention. He is absolutely right. There is no doubt that increasing the length of time that these young people can be kept active and mobile will inevitably reduce the amount of time that they spend requiring treatment in other health settings.

I also want to describe the emotional journey. Seeing anybody suffering with a muscle-wasting condition is terribly draining, because they fade before one’s eyes. That is why the drug is so important, particularly for young people suffering from Duchenne’s. I turn now to my constituent’s mother, Louisa Hill, for a quotation. She said:

“Decision makers need to understand the impact on children of even a small change. It gives them more time to run and play football with their friends. It’s really buying precious time. Archie will have to deal with very difficult mental and physical challenges as his condition progresses. Translarna is buying time for Archie just to be a kid.”

If you are not touched by that statement from a mother, I do not know what you would be touched by.

Translarna is not the only potential therapy that could benefit Archie. For example, others, such as utrophin upregulation, which involves injecting a protein called utrophin into the muscles to compensate for the loss of dystrophin in boys and young men with Duchenne’s, are in a later stage of clinical trial. It is vital that the process of moving such drugs from the laboratory to the clinic is expedited, including ensuring that appraisal processes are as swift as possible; that secure funding is available to help meet the costs of new drugs; and that NHS England and NICE have effective mechanisms to negotiate an appropriate price with drug companies.

On 14 October, I had the temerity to question the Prime Minister on Translarna at PMQs. He referred to the cancer drugs fund and its role in reducing the costs of drugs for rare types of cancer. A similar model would help for rare disease drugs for conditions such as Duchenne muscular dystrophy. The Prime Minister said:

“The cancer drugs fund has helped to reduce the costs that the companies charge. We need to see that in other areas, too.”—[Official Report, 14 October 2015; Vol. 600, c. 313.]

The Government’s accelerated access review provides an important route through which such issues could be addressed. I hope that the Minister will have his feet held to the fire by the Prime Minister’s answer.

Research into treatments for Duchenne’s is at a promising stage, with a range of potential therapies in late stage clinical trials. As I said, Translarna is already licensed in Europe, but the UK muscle centres where trials are conducted are reporting that given the growth in clinical trials they lack the resources, such as staffing levels and equipment, to keep pace. As a result, centres report that they are turning away new trials—not because of bad science, but because of a lack of capacity. [Interruption.] I see the Minister shaking his head. He knows that the situation is serious and I hope he will comment on it.

That lack of capacity risks causing a bottleneck in drug development and gives boys such as Archie Hill less chance to enrol on a trial that could allow them access to a new therapy. A clinical trial capacity audit, conducted by Muscular Dystrophy UK as part of the “Newcastle Plan” of joint working with UK Duchenne charities to address clinical trial capacity, corroborated the reports and also found that:

“Work on clinical trials is not counting towards specialist training at many centres for medical doctors, physiotherapists and nurses”

which is affecting trainee participation. In addition, it was found that a

“lack of acknowledgment of research in clinical job planning means that already overstretched clinical staff are having to carry out research activities in their own time. This is consequently severely limiting centres’ abilities to take part in research.”

It also found that the process of setting up a clinical trial can be excessively bureaucratic. Perhaps the Minister, with his experience in this area, will be able to comment on that.

I am disappointed that Archie Hill and the other boys suffering from Duchenne’s do not have access to Translarna. The process has seemed to take an incredible length of time, and I hope that the Minister will be able to do something about it. Like the hon. Member for Dudley North, I have a series of questions that I want to put to the Minister, which may help him when he sums up.

First, will the Minister commit to meet representatives of Muscular Dystrophy UK? I would be grateful for that, and it would be helpful for him to discuss the accelerated access review, particularly in the context of the emerging treatments for Duchenne’s. Secondly, I do not suppose that he can say this, but when can families such as Archie’s expect to be notified of NICE’s guidance on access to Translarna on the NHS? It is the obvious question and one that I hope he can answer.

Thirdly, will the Minister ask the chief executive of the National Institute for Health Research’s clinical research network how his organisation plans to work with specialist muscle centres to address concerns over the lack of clinical trial capacity, particularly for Duchenne’s? The hon. Member for Dudley North referred to the latest thinking in Scotland and Northern Ireland, such as introducing a ring-fenced fund for rare diseases. I hope that that might be a recommendation of the accelerated access review.

I do hope that the Minister will be able to give us some optimism. Boys such as Archie Hill are an inspiration to us all. For one so young, he is very mature in his attitude towards not only his Duchenne muscular dystrophy, but other children suffering from rare diseases. He has great capacity for humanity and for tireless campaigning. This will be the second Christmas since I met him that he will be waiting for an outcome on Translarna. Will the Minister talk to PTC Therapeutics, to NICE and to anyone else to whom he can reach out, to ensure that this year the Christmas present for Archie Hill and other boys in England is to have access to ataluren or Translarna?

It is a pleasure to serve under your chairmanship, Sir Edward.

I thank my hon. Friend the Member for Dudley North (Ian Austin) for proposing today’s debate on cystic fibrosis and on the future of the drug therapy. I thank the cystic fibrosis team at York hospital. I have met with them and discussed at length their innovative service, which is at the cutting edge of provision for those with cystic fibrosis and takes on board the need for clinical excellence and the sterile conditions that we have heard about—they work the service around the patient, not the patients around the service. I also thank the people at the Cystic Fibrosis Trust for their time.

I emphasise the points made by the right hon. Member for Chesham and Amersham (Mrs Gillan). Her tireless campaigning was triggered by the inspiration of Archie Hill from her constituency and presses for the need to make progress on the right therapeutic responses for those with Duchenne muscular dystrophy. We would all like to see progress with Translarna.

I want to take a wider view of the therapeutic measures for those who experience cystic fibrosis. I am a physiotherapist by training and have worked for 20 years in the NHS with respiratory and neurological conditions, so I have a real understanding of the people who experience cystic fibrosis. There has been massive change in the management of that condition in my time in practice, in particular in physical therapy. Treatment is now more dynamic in support of individuals—physical treatment, rather than a more static treatment, especially when dealing with mucus clearance and building up lung capacity. That is all about the treatment and management of symptoms, however, similar to the drug regime that accompanies the physical therapy.

We have seen progress, therefore, but today we are debating a step change in our approach to cystic fibrosis. We are trying to provide hope to the 10,000 people who happen to have cystic fibrosis. Looking at a new generation of drugs might provide that hope. Orkambi is a drug that targets abnormal proteins, which will deal with the symptoms. When we look at drug therapy for cystic fibrosis, we should be looking not only at the immediate impact, which so many drugs do, but at the long-term effect. Every instance of a chest infection brings about damage to the lungs, as people have to expectorate continually, and that has long-term implications that can be fatal for some.

It is vital that we look at early intervention, which is what Orkambi is all about—about bringing a step change in the treatment process for those with cystic fibrosis. By targeting the proteins we have the opportunity to ensure that the cells in the lungs are healthy, which will produce longevity among patients. It is hoped that the new drug will bring improvement to about 50% of people with cystic fibrosis, which in itself will be a seismic change in the outcomes for them. It will have a profound impact.

I encourage the Government not to be nervous about cost, because costs for someone with cystic fibrosis are already high and cannot be underestimated. I will focus on existing costs, such as the cost of frequent visits to hospital, including the frequent use of intravenous drugs. A large proportion of people are on IV drugs for approximately one month a year, which is costly. People also have to be in sterile conditions, because the risk of further infection is incredibly high. Ongoing therapeutic intervention with drugs or physiotherapy has significant bearing on costs. There are also costs to do with managing a high-calorie but healthy diet.

Another expense is the drugs. Cystic fibrosis is not on the list of diseases for which people get free medication. Will the Minister look at that? When the list was drawn up, people with cystic fibrosis were not living into adulthood, so we should re-examine it. There are the costs of having lung transplants, if people require one, and any drugs that prevent future lung transplants have to be a positive, despite the risks, because people will be brought long-term hope.

There is the cost to an individual of education, which for many will have a disturbed pattern—in and out of school—and the impact on long-term employment opportunities. Even if in work, many people find it difficult to hold down a job, because the nature of the disease often takes them out of the workplace and they have to organise and balance their day with fitting in physio and the demands of drug therapy and diet.

Finally, there is the cost of care. Rarely is only one person involved in care for any of the diseases that we are talking about—a network of care is put around an individual with such a disease. Moving to a precision, early-intervention drug, therefore, is a way to bring in resource management, which can be positive not only for the individual, but for the NHS as a whole.

The result of what is being called for today would be positive economically and for people’s lives. In my short contribution, I want to ask the Minister to address the timeline for progress. There is obviously discussion in Europe, such as on the European regulations for Orkambi, and we want to see the timeline tightened up, so that people can have real hope in the new year that they will get access to the drug, because each time someone has a chest infection it has an impact on their long-term future. Time is not something that so many have, so my plea is for progress on securing access to the drug for those with cystic fibrosis.

It is a pleasure to serve under your chairmanship, Sir Edward. It is also nice to see the Minister in his place again—whatever the debate might be, there are few for which the Minister and I are not in the same room at the same time.

I thank the hon. Member for Dudley North (Ian Austin) for bringing this important issue to Westminster Hall. It affects my constituents and I am here to speak on their behalf—this is the place for us to do that as elected representatives. As he mentioned in his introduction, in Northern Ireland we have had some good news, with money set aside for rare diseases. Any approach to such diseases needs to be innovative and to take into account all those who contribute, be they academics, researchers or hard-working charities who provide support for those suffering from cystic fibrosis and their families.

I also commend the right hon. Member for Chesham and Amersham (Mrs Gillan) and the hon. Member for York Central (Rachael Maskell) who have spoken. They are doughty campaigners on behalf of those who have Duchenne and on many other issues. It is good to see them in their places and making valuable contributions.

We are surely duty-bound to support and fund those who fight for the sufferers and those developing new treatments. The debate is very much about how we develop new treatments and move forward.

I also congratulate the hon. Member for Dudley North (Ian Austin) on bringing the debate. Does my hon. Friend agree that pharmaceutical companies need to be sent a message that their work in research is not about large profits; it is about curing rare diseases? We saw that difficulty whenever we approached pharmaceutical companies on meningitis B: some companies held out for large profits at the expense of people who were suffering.

I thank my hon. Friend for focusing on the pharmaceutical companies. They can do a great deal and there is also a role for Government and the NICE guidelines, which direct the direction in which pharmaceutical companies will proceed. The companies are driven not always by profit or margins; criteria also indicate to them what to do.

We should be ever mindful that people are suffering through no fault of their own, so we need to help them move forward. It is good to see facts and figures that show that, on average, a child born in the 21st century with cystic fibrosis will live for more than 50 years. There have been tremendous advances. The innovation and hard work done by charities and researchers is too often forgotten, but it has brought about real results, with new precision medicines treating not just the symptoms, but the underlying cause of the condition. We must go further in that direction. To be fair, cystic fibrosis is one condition that we are probably treating rather than solving at the moment, but we need to see a future where everyone with cystic fibrosis can live a life unlimited, which the facts show is more achievable today than ever before.

Unfortunately, precision medicines are expensive and, as my hon. Friend the Member for Upper Bann (David Simpson) said, it is difficult to predict the cost-effectiveness of new treatments. However, we need to get those treatments and try them out to move forwards. I understand that the Government are considering how we can speed up access to innovative treatments, which I think comes under the NICE guidelines. Will the Minister respond to that in his speech? There are proposals to approve new drugs provisionally while using real-world data to assess their benefits. I welcome that and look forward to seeing more of it.

May I put on record my thanks to the Northern Ireland Rare Disease Partnership under the chairmanship of Christine Collins, who happens to be one of my constituents? We have worked together over the years on this matter. Indeed, in the previous Parliament we spoke to the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), in a private meeting. She was supportive and allowed us to make positive progress. As everyone knows, health in Northern Ireland is a devolved matter. The Minister there, my colleague, Simon Hamilton, has set aside about £3 million for the partnership, which shows there are positive approaches in Northern Ireland and a positive way forward. Perhaps that could be emulated across the whole of the United Kingdom of Great Britain and Northern Ireland.

It is estimated that one in 2,500 babies in the UK will be born with cystic fibrosis and there are more than 9,000 living with the condition. The facts are stark. It most commonly affects white people of northern European descent—it is much less common in other ethnic groups. Those are the facts, which in my constituency means that we are looking at virtually the whole populace. Other constituencies will have similar demographics, so it is concerning to hear that, but it is encouraging that research has advanced so much that we can pinpoint such factors so that we know where problems could arise.

Babies are screened for cystic fibrosis at birth using a heel-prick test as part of the NHS’s newborn screening programme. The NHS and Ministers responsible are taking correct steps to diagnose such conditions at an early stage. Treatment for cystic fibrosis is not curative, but it seeks to manage symptoms. Medications including steroids, antibiotics, insulin and bronchodilator inhalers are often used. Nutritional advice and physiotherapy for airway clearance are commonly part of management.

Cystic fibrosis patients may also be suitable for lung transplants. NICE provides a number of guidelines on specific treatments for cystic fibrosis, which it is currently updating. They are due to be published in 2017. On organ transplants, I believe that we should all be considered to be donors unless we say otherwise. The Welsh Assembly has taken steps to bring in that in Wales and such legislation is pending in other regions of the United Kingdom as well, but whenever we see stories about those who are managing but no more and for whom a lung transplant would be the beginning of a new life, perhaps we should emphasise the organ transplant system and find a method to make progress on that.

The hon. Member for York Central rightly referred to families. We focus on those who have cystic fibrosis, but let us also focus on those who support their loved ones at times of hardship and difficult health symptoms. I will also plead the case for Prader-Willi syndrome. I have a number of constituents who have it, but that is not unique by any means to my consistency; it is seen across Northern Ireland. We do not hear much about this, which is another muscular wasting disease and also an eating disease—it is an obsessive disease.

The right hon. Member for Chesham and Amersham talked about Duchenne muscular dystrophy. I have constituents who suffer from that and I have attended events just across the way with people from across the UK with it. It comes in different levels and types, but, as she said, there have been advances in medication. The Minister may refer to those in his reply, but we also need to focus on how we can help those families.

Recent developments show that innovation is working in advancing treatment of cystic fibrosis. I commend the Department for its work. I will also mention the hard work done by universities in partnership with private business and enterprise to come up with innovative ideas for new drugs. We can never underestimate the importance of what they do. Just as others speak highly of their universities, I do so of Queen’s University Belfast and Ulster University which are bringing forward innovative ideas for advances in medicine and other things. We could work well together with them on this.

I spoke earlier of the hidden or forgotten sector: the voluntary charities, of which there are many. Where would we be without them and their dedicated researchers? Such people often dedicate their lives to helping humanity overcome disease. The Cystic Fibrosis Trust is just one example. It is the largest charity funder of cystic fibrosis research in the UK. Last year it invested more than £3 million in groundbreaking research and it plans to invest a further £3.5 million by the end of this financial year. By adding our support and funding where possible, we can add to the great work being done and make a real life-changing difference for those with cystic fibrosis and their families.

It is a pleasure to serve under your chairmanship, Sir Edward. I applaud the hon. Member for Dudley North (Ian Austin) for bringing this timely debate. If any fact highlights the importance of this, it is that the median survival age is just 28. That really highlights the issue. If that does not focus minds on the need to do something, nothing will. He also touched on quality of life. We must remember that it is not just about statistics and medical reports. It is about the life of not just the sufferer, but the families involved. I am grateful to be able to take part in the debate.

The hon. Gentleman also mentioned issues relating to NICE, its assessments and medicines. I am obviously a Scottish Member, and things are slightly different in Scotland, so I was grateful that Members mentioned the differences. One thing we have is the Scottish Medicines Consortium, which assesses medicines a bit quicker, putting them through the peer-approved clinical system. That is a good practice, which the Minister should perhaps look at. Having said that, we are also still waiting for the assessment of Orkambi, and we hope to have it around April, so there is still a delay in getting things through for everyone.

The right hon. Member for Chesham and Amersham (Mrs Gillan) made some good points. I was interested to hear about muscular dystrophy, which is not an issue I know much about, although the situations people face are obviously very similar. She highlighted the impact on families and the importance for children and young people. When we hear people’s life expectancy, that really highlights just how devastating this issue is.

The hon. Member for York Central (Rachael Maskell) made interesting points about therapeutic measures. Her key message was about providing hope, and I share her view on that. I hope that this Government and all the Governments in the devolved Assemblies take on board the message that we should not be nervous about costs. That message needs to go out from here very strongly.

The hon. Member for Strangford (Jim Shannon) highlighted the different and positive practices in Northern Ireland, which, again, I find interesting. I am sure there are things we can learn from each other’s areas. One positive in Scotland is that the Scottish Government have the UK-leading new medicines fund, which, in May, more than doubled the support it provides, from £40 million to £90 million. That will affect all rare diseases, including cystic fibrosis. There are therefore things we can do, and there is good practice we can demonstrate and lead the way on.

Another thing we did in Scotland was to abolish prescription charges. Before we did that, two thirds of all paid-for prescriptions were for long-term conditions. That was another financial impact on the families we are talking about, who already have enough difficulties.

With those comments, I look forward to hearing the Minister’s view. I hope we have sent a strong message to not only the Government here, but the Governments in our devolved Assemblies.

It is a pleasure to be back, having spent four and a half weeks in cold, wet Oldham, running the Labour party by-election campaign. I pay tribute to my fellow shadow Ministers for standing in for me in numerous Westminster Hall debates. It is good to be back, and it is good to see you in the Chair, Sir Edward.

I pay tribute to my hon. Friend the Member for Dudley North (Ian Austin) for making sure that this important debate could take place. He is right that we need to make sure that access to pharmaceuticals is one of the most important policy areas. With the results of the accelerated access review coming out in the new year, the effectiveness of NICE is very much on the agenda.

I also pay tribute to the right hon. Member for Chesham and Amersham (Mrs Gillan), who spoke powerfully about not only Archie, but Duchenne muscular dystrophy, which is a terrible disease, and she is right that we need to do much more to make sure drugs are available to treat it. I hope the case she made for Translarna will not fall on deaf ears with Ministers, because such drugs can make a big difference to the quality of life of children such as Archie. The right hon. Lady has put that case very powerfully in her question to the Prime Minister, and in her contribution today.

In June 2009, the previous Labour Government adopted the European Council recommendation on action in the field of rare diseases, which recommended that member states should establish and implement plans and strategies for rare diseases. Following on from work set out before the 2010 election, the coalition Government published the UK strategy in November 2013. 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, and when the Minister concludes the debate, I am sure he will give us more detail about how he sees the points made by my hon. Friends the Members for Dudley North and for York Central (Rachael Maskell), the hon. Member for Strangford (Jim Shannon) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who leads for the SNP on these matters, and the right hon. Member for Chesham and Amersham. Rare diseases are a crucial part of the five-year forward view, and given that the UK leads in life sciences, there is no reason why we cannot start to push the boundaries on what is achievable in respect of the drugs available for rare diseases.

The problem is that, although each of the publications I mentioned set out some laudable intentions, the actions arising from those publications have been baby steps in comparison with what we actually need. Changes resulting from the Health and Social Care Act 2012 have left patients and professionals to navigate a labyrinth when accessing medicines that, in many cases, have already been approved or have received licences. That really should not be happening.

Before the last election, the Opposition said unambiguously that we would reform NICE from top to bottom to remove the requirement to enforce competition rules and to ensure that access to medicine was decided on the basis of a medical justification, balanced with consideration of how much money we had available. I think we all now agree that NICE needs some reform. The current appraisal system makes decisions based on 24 weeks of clinical trials data, but that understates the efficacy of drugs that provide long-term stabilisation of a condition.

Other Members have spoken of the frustration cystic fibrosis patients have felt at not being able to access new treatments because those will not be approved given the way NICE appraises them. As my hon. Friend the Member for York Central said, the NICE system is not set up to assess precision medicines, and the issue extends well beyond cystic fibrosis to other rare diseases. Members have spoken powerfully about cystic fibrosis, and what we have heard about could be an excellent platform for testing new ways of doing things, and that could, indeed, also be the case with muscular dystrophy. The appraisal system for innovative medicines needs to be overhauled and to be adapted to include personalised medicines. Until the system is prepared to look at the value of new medicines over time, instead of looking for more rapid effects, it will not be suitable for its purpose.

I have some specific questions for the Minister. I am concerned that the highly specialised technologies evaluation programme could limit access to medicines for people with rare diseases. There are widely held concerns that the process, which was introduced after the 2012 Act to appraise medicines for rare diseases, is opaque and that the topic selection process is out of date. Does the Minister have plans to work with NICE to update the selection criteria for the pathway? Am I right that the process does not take into account conditions defined by genetics, biomarkers or differences in clinical presentation? Will he look again at that? Will he, as other hon. Members have asked, meet representatives of Muscular Dystrophy UK and the Cystic Fibrosis Trust to discuss those matters?

I accept that there has been huge investment in life sciences in the UK, but the current system, which encourages investment in technology and does not facilitate patient access to it, is unsustainable and wrong. Without such reform as we have discussed, funding for research on the relevant medicines could dry up and we could lose crucial shots at tackling a lot of rare diseases once and for all. The accelerated access review is a timely opportunity to take a careful look at how people get access to the kinds of medicines that might change their lives. It would be a tragedy if we threw that opportunity away.

I do not doubt for a moment that the Minister is fully behind every Member taking part in the debate in wanting to expedite the availability of the drugs in question, and I am keen to hear more about how the Government plan to do that. I commend Members for speaking so powerfully in a consensual cross-party manner in today’s debate and at other times when we work in Parliament to promote such causes. I hope that the Minister will answer all the questions that have been asked, and offer a glimmer of hope for those people who seek access to such drugs.

It is a pleasure to serve under your chairmanship, Sir Edward. I congratulate the hon. Member for Dudley North (Ian Austin) and other hon. Members from across the House who have spoken. This timely debate has been incredibly powerful—not that there has been much disagreement in it. It has been an opportunity to raise important issues that I am dealing with, and I am grateful to colleagues for acknowledging that.

The debate is particularly timely because I am convenor of a major summit today on accelerated access for faster cures. There is a precision medicine summit in London and the Association of Medical Research Charities has just held its annual conference, at which I exhorted members to come to my table with ideas about how to accelerate novel treatments and give the charities more of a voice. A powerful and helpful debate is going on.

I pay tribute to the work of the Cystic Fibrosis Trust, which is among a number of charities that lead the debate on innovative treatments and medicines. Its leader Ed Owen in particular plays an important role in that; but so do Carly, Lorraine, Michael, Kelly and the other people who have been mentioned. Many of the charities do extraordinary work to articulate the experience of patients who suffer from disease and bring it to the policy table in a powerful way. It is a change in policy making that I am keen to accelerate.

The debate goes to the heart of the challenge and opportunity that precision medicines represent for our system and the landscape of assessment, testing, approvals and reimbursement, as well as the growing role of charities and the patient voice. Those things are passions of mine and I want to discuss why, in the next few months and the years ahead, there will be dramatic progress.

The Government and I wholeheartedly support the cystic fibrosis campaign’s central aim of ensuring that as many people with CF as possible will have access to personalised medicines by 2020. That sets an inspiring and clear goal and I relish the attempt to deliver it. I want to make some remarks about the condition, about what NHS England and the NHS in Scotland and Northern Ireland are doing about treatment today, about the rare diseases and precision medicine landscape, and about the reforms that I am pushing to try to deal with the issues that have been raised.

I have had a career in biomedical research, so it is an extraordinary privilege to have been given my role by the Prime Minister, who has personal experience of the tragic consequences of genetic disorders affecting children. I am delighted to share with the House the fact that my passion to lead in this field, and unleash the power of the NHS and our research expertise in a new landscape for accelerated access, is exceeded only by the Prime Minister’s.

As hon. Members know, cystic fibrosis is the most common life-limiting inherited condition in the UK. It affects about 10,500 people in England—and more, of course, in Scotland, Northern Ireland and Wales—more than half of whom are adults. Cystic fibrosis is one of the UK’s commonest life-threatening inherited diseases. It is caused by a single defective gene. As a result, the internal organs and especially the lungs and digestive system become clogged. That results in chronic infections, inflammation in the lungs and difficulty digesting food.

The number of adults living with CF is gradually increasing over time, because of improvements in diagnosis from newborn screening and new treatments. The condition affects everyone differently—that is an important point—but for many it involves a rigorous daily treatment regime including physiotherapy, oral, nebulised and occasionally intravenous antibiotics, and taking enzyme tablets with food. For those who are very ill with cystic fibrosis and who have very poor lung function, daily life can be a struggle as basic tasks can leave them breathless. Some patients use a wheelchair to get around, and use oxygen to help them breathe.

For patients and their families, managing the condition is extremely challenging. That is made worse by the absence of an effective treatment or cure—or, as several colleagues have explained today, by the tantalising presence of a possible treatment or cure that cannot yet be administered to them or their suffering loved ones. I pay tribute to patients who grapple with the disease day in, day out, and who have done so for years, for their patience as we try to bring new solutions to the table. Current treatments generally target the complications rather than the cause of the condition. Treatments can be broadly classified as nutritional support, relief of airway obstruction, treatment of airway infection and, ultimately, lung transplantation.

What are the Government doing? I want first to talk about what the NHS is doing in England and in Scotland and the other devolved areas, and then to say something about what we are doing more strategically to tackle the new landscape.

Since April 2013 NHS England has been responsible for securing high-quality outcomes for patients with cystic fibrosis as part of its remit to deliver specialised services. Its service specifications for cystic fibrosis—one for adults and one for children—set out what providers must have in place to offer high-quality care and support equity of access to services for patients with cystic fibrosis, wherever they live. The NHS England cystic fibrosis clinical reference group has developed a number of clinical policies for the treatment of patients with cystic fibrosis and it reviews outcomes with the Cystic Fibrosis Trust and with patients and charities.

As we have heard, Scotland, leading within the United Kingdom—and it is not the first time—has launched a dedicated fund worth £40 million this year to give patients greater access to new medicines, as the Scottish Health Secretary, Alex Neil, has announced today. The £40 million new medicines fund expands and replaces the rare conditions medicines fund established in March 2013, giving health boards access to greater resources. In 2013-14 the rare conditions medicines fund supported the cost of 45 different medicines, benefiting more than 200 patients, including ivacaftor for cystic fibrosis as well as other treatments for related rare diseases.

NHS England is investing significant resources into the provision of new medications that work directly on the genes causing cystic fibrosis. Since 2013, it has routinely commissioned ivacaftor or Kalydeco for the treatment of cystic fibrosis in those with a certain gene mutation affecting only 5% of the CF population. Earlier in 2015, that indication was extended to an additional eight mutations for patients aged six years and above. NHS England is considering a policy proposition for extending the use of ivacaftor for the same gene mutations to children aged two to five years. It will consider the evidence base and be included with other therapies requiring investment as part of NHS England’s prioritisation process for specialised services for 2016-17.

Several colleagues raised the matter of Orkambi. Some drugs for cystic fibrosis will be considered by NICE through its technology appraisal process, including Orkambi, which, as many will know, is lumacaftor in combination with ivacaftor. NICE is currently developing technology appraisal guidance on the use of Orkambi for the treatment of patients with cystic fibrosis. It currently expects to issue final guidance in July 2016. NHS England will commission drugs where there is a positive NICE technology appraisal, and I will say something about the changes that we envisage in the landscape in that respect.

NHS England operates a horizon-scanning process to identify new treatments and the cystic fibrosis clinical reference group advises on the development of services for patients and keeps relevant published literature under review. Where NICE is not considering a therapy, NHS England can consider the evidence base and may propose commissioning treatments through its policy development process. I shall say something shortly about changes that we are considering in the way NHS specialist commissioning might embrace the new freedoms in the accelerated access review to accelerate the commissioning of rare disease treatments.

In fact, ivacaftor is something of a mild success story. NHS England commissioned it earlier than might otherwise have been expected, having agreed, in discussion with the company that makes it, a flexible pricing model. We want to see more of that sort of innovation.

I am grateful to the hon. Member for Denton and Reddish (Andrew Gwynne) for giving me some time to answer the various questions asked, which I will try to do in some detail. First, I want to set the scene in terms of why this debate is happening and why this landscape is under such pressure. The truth is that breakthroughs in genomics and informatics—our ability to understand patients’ genetic predisposition to different diseases and to respond to different drugs, as well as the availability of large-scale data sets, including individualised patient treatment histories and anonymised cohort studies—are transforming the traditional pathway for drug R and D, which normally takes years. It now takes roughly 15 years and $2 billion to bring the average drug to patients.

Genomics and informatics, particularly for some of the rare genetic diseases, allow us to take time, cost and risk out of the development pathway in a profound way. That is driving opportunity and challenge in our system; the Prime Minister created this post and put me in it to ensure we respond to that challenge with ambition.

My hon. Friend the Minister is absolutely right to say that the medical landscape is changing hugely at the moment, but does he feel that the wider implications of new medicines are being fully explored by NHS England and NICE? We have heard about the huge consequences of cystic fibrosis for not only the sufferer but their wider family and the NHS. Does he feel that those wider consequences are being fully explored?

My hon. Friend raises an important point. Over the past few decades, the NHS across the UK has played an inspiring role in leading a lot of the breakthroughs in new treatments, but we have become latterly a slower adopter of the very treatments we often helped to discover. That is partly because the pressure of an ageing society and the rising cost for the health system today of just treating existing conditions are extremely challenging. In some areas, that has made innovations appear a cost to the system, when in fact good innovations may come with a cost spike on day one but generally lead to downstream savings in years 2, 3 and 4.

My hon. Friend puts his finger on a profound challenge at the heart of this landscape: in order really to assess the impact of innovative treatments, we need a much better handle on the existing costs, many of which are hidden, that come with a diagnosis. For that reason, I am spearheading work in the Department of Health to drive through a system of per-patient costing, so that we can begin to get a much clearer handle on what a CF diagnosis means on day one for both the patient and the health economy. That will allow NICE and NHS England to develop much more intelligent systems for assessing whether an innovation really represents good value.

Genomics and informatics are changing the landscape; for that reason the Prime Minister has created my post and we have launched a series of initiatives. On genomics, we have launched a groundbreaking £300 million initiative to sequence the genomes from 100,000 NHS patients of cancer and rare diseases. We have also launched 11 genomic medicine centres across the NHS, so that genomics is fundamentally embedded in our health system. On informatics, we have released huge amounts of cohort data to drive research, and we just announced in the comprehensive spending review a major £3.5 billion programme to invest in NHS digital infrastructure to support that.

We have launched precision medicine and cell therapy catapult centres with the Medical Research Council and industry partners to lead in both understanding causal mechanisms of rare diseases and developing and accelerating new treatments. We continue to fund the excellent National Institute for Health Research, for which it is my privilege to be responsible, to the tune of £1 billion a year, and we committed this year in the CSR to fund it throughout this Parliament, at a cost of £5 billion. We have funded the £700 million Francis Crick Institute, and roughly £2 billion of the drugs budget is allocated to new medicines and new treatments in this Parliament.

There is a major commitment, in terms of science and funding, to trying to tackle this issue, but crucially we need policy reforms to ensure that breakthroughs in science can be harnessed for much quicker benefits for patients. That is what the accelerated access review and a number of other initiatives, such as the test bed programme and the vanguards I am running with NHS England, are about—trying to ensure we can change the pathways for getting innovation into our health system for much quicker patient benefit.

I want to say something about the accelerated access review and the specialist commissioning reforms that NHS England is putting in place. I know all Members here take an interest in this subject, so I hope they will be aware that I have launched the independent AAR to ask and answer one big question: what can we better do to harness the extraordinary infrastructure here in the UK in terms of our deep science research base, our NHS-NIHR research base and our NHS daily treatment platform?

The NHS is the fifth biggest organisation in the world, making millions of diagnoses and carrying out millions of treatments every day. Its original founding mission was to be a research organisation, but unless we better capture the data on those interventions, we are still practising, in many cases, blind medicine; we are not harnessing that intelligence enough to inform treatment.

I have asked that the AAR tackles three big questions. First, what can we do to allow the innovators—the developers of new drugs and innovations—quicker access to patients, to reach the all-important moment of proving an innovation works in patients? Secondly, what can we do to harness our leadership in genomics and informatics in order to create a more intelligent system for NICE and NHS England, with more flexibilities, so that they can assess, adopt, approve and reimburse innovations using real-time data about real patients? That will allow us to develop a more flexible set of pathways and adaptive tools with which to embrace this revolution.

When a drug comes to us with a genomic biomarker and we know that it will work for a certain sub-cohort of patients, that profoundly changes the risk dynamic of a traditional pharmaceutical clinical trials programme and should allow us to accelerate adoption for particular patient groups.

Within those considerations, will the Minister also look at international evidence, so that we are looking at not only our own clinical trials but those on a global scale? Clearly, developments are global rather than just national.

The hon. Lady makes an important point. I have been to Washington three times and to Berlin, Paris and Brussels to highlight that while the UK is leading in this field, we need a transatlantic—European and American—agreement on how we move things forward. That is why I am convening and chairing a summit this afternoon with the Washington-based FasterCures campaign, which is a cross-party group on the Hill pushing for innovations in this space. I have been talking to the Commission about the European framework. I want the UK to be the best entry point into the European market, but I also want the European regulatory framework to be consistent and coherent; that is an important point.

The second question I have asked the AAR to look at is: what freedoms, flexibilities and new pathways can we envisage giving NICE and NHS England, particularly in the field of specialist commissioning? For CF, the decision to purchase ivacaftor is a national one, made by an NHS England specialist commissioning unit. I would like that unit to work much more closely with the Department of Health pricing team, so that where we can offer a company faster access to a key patient cohort, data and genomic information, we are able to do a much better deal with the company.

At the moment, we are operating the Translarna and Vimizim programme in the existing landscape. I share colleagues’ frustration, but it is important we go through due process. I do not think anyone wants a world in which Ministers decide what drugs come through on the basis of political pressure, tempting though it may be. I have done everything I can this year to expedite the existing process.

Following the positive news on Vimizim, I am hopeful about Translarna—a similar drug. NICE has been consulting on the process, and I believe the company has been engaging with NICE on pricing. I am hopeful that there will be a decision in the next few months to parallel the one on Vimizim, but that decision is not in my gift: it is up to NICE, which is rightly working on the basis of the very best clinical evidence.

I had better crack on; I will come to the questions that my right hon. Friend the Member for Chesham and Amersham (Mrs Gillan) asked later, if I may.

Hon. Members have raised a number of questions and I want to deal with them all. The hon. Member for Dudley North asked about timings for the accelerated access review. We have had an interim report. I have asked for final recommendations in the spring—in March or April—and also that the review considers whether the process should go on. I want recommendations that we can implement quickly, but equally these discussions are complex and we may well need to go on to look at other bits of the landscape. I would be delighted to meet the Cystic Fibrosis Trust—in fact, that is already arranged; we are meeting this afternoon at the summit that I have organised.

The hon. Gentleman also asked about safeguards, which is a very important point. Although all of us share a recognition of the need to accelerate access, nothing in what is happening must in any way undermine patient trust and confidence in safety and protections. That is an important balance to strike. Nothing in what we are doing in any way looks at changing the legal basis in terms of negligence, consent or the clinical trials framework. The issue is about ensuring that our systems have the flexibilities to embrace the very latest science, and particularly, in this case, genomic biomarkers.

The hon. Gentleman asked about amending the NICE appraisal process to weight wider societal costs. At this point, the review is not specifically looking at the internal mechanics of NICE’s current high-technology appraisal process, but we are looking at giving it, with its new flexibilities and freedoms, a suite of different types of innovation that might come through. We are particularly looking at where that can be ring-fenced and targeted at particular patient groups.

The hon. Gentleman asked about a ring-fenced fund. As I said, we are looking at the allocation that we have had from the Treasury, which is about £4 billion extra on drugs in this Parliament, £2 billion of which is more or less the existing demand driven by demographic change. There is about a £2 billion allocation in there for new medicines. The difficulty is that the drugs that we might consider now to be most worthy of ring-fencing and accelerating may not be the ones that in five years’ time, on the basis of the clinical evidence, we look back on and say, “Why did we not accelerate that?”

We want to make sure, through the AAR, that we are putting in place a system that gives us the flexibilities to pull through those drugs that have the most transformational effect. But let me be clear: we are looking at wanting to build in, over the next few years, a wider understanding of the real costs to our health economies—local and national—of different forms of disease. That is why the Secretary of State and I are leading on per-patient costing so that, in due course, we can develop a more intelligent system to reflect that.

The hon. Gentleman asked about the NIHR and specialist muscle centres. This debate covers a number of different disease areas, and it is a tribute to the NIHR’s research network that more and more charities are now wanting to build centres of excellence. In the forthcoming NIHR five-year funding cycle, looking at the biomedical research centres and the biomedical research units, I am keen to make sure we consider where we can bring funding in from charities to complement that core research network.

Finally, the hon. Gentleman asked about the accelerated access review and the powers that we are looking at for NICE and NHS England. I do not want to pre-empt the findings of that independent review, but I have asked that the review looks precisely at how we can make it easier for NICE and NHS England to work more closely together. Specialist commissioning would be an obvious place to start to share those data and look at how we can get a better deal for everybody—for patients, the system and the economy.

My right hon. Friend the Member for Chesham and Amersham asked about Translarna and Vimizim and how quickly we may be able to get good news for Archie. I pay tribute to my right hon. Friend; she has been a very doughty campaigner on this matter during the last year. I share her frustration that in the existing system, due process has to be gone through and that, although we have expedited this as much as we can, it has taken a long time. I pay tribute, as she has, to Archie. He, like so many of these patients, is an inspiring example of the very best of this sector and of this country. They are people who have the most reason to complain, but tend to be the least likely to and the most inspiring, given their generosity about the system and their demand that we take their suffering and use it to make sure that others do not have to suffer.

I have touched on the timetable. I am very hopeful that we should get a decision from NICE on the basis of the secondary consultation early in the new year.

I thank the Minister for the way in which he is still pursuing this matter on behalf of my constituent and the other boys. However, does he share my frustration? I know we have to go through due process, but why does due process have to take so long? Every day matters to these children and to their quality of life. I cannot impress enough on the Minister, NICE and anybody else watching this debate, that due process must be executed in a more timely fashion. This is nothing short of torture for these boys and these families. I know that the Minister has tried very hard, but I just hope that the people at NICE will be listening to this. I appeal to them directly through him to make a positive decision on this before Christmas; it would be the best Christmas present that these boys and their families could have.

My right hon. Friend makes her point as powerfully as ever. I shall not add to it; it has been put on the record very clearly.

My right hon. Friend asked about contact with the company. It is not for Ministers to get actively involved—much as, at times, I would like to—in negotiating these deals, but I have made contact with the company, both on Vimizim and Translarna, to urge it to be as flexible as it can in discussions. I can only say that I am hopeful that it will have been able to reach a point where NICE feels able to make a recommendation.

Part of the reason why due process is important is that when NICE makes a recommendation, NHS England is bound in law to provide the drug in perpetuity, so it is a major cost undertaking. In some cases, these drugs cost £200,000 or £300,000 a year, so it is a commitment of several hundred million pounds from NHS England. Other patients would say, “We must make sure that when you make a decision like that, it is done properly.” However, I share my right hon. Friend’s frustration that a lot of these breakthroughs scientifically mean that we ought to be able to speed things up.

My right hon. Friend asked whether the Prime Minister is holding my feet to the fire. She need not worry; I am as passionate about this as ever and very impatient to make sure that the AAR is landed with some good recommendations.

My right hon. Friend made an excellent point about NIHR staffing. I am working with the chief medical officer and the NIHR on that at the moment. A number of our clinical research facilities could, with a few more staff, turn over more and do more trials work. There is an opportunity for us to get more people internationally to enrol in NIHR training—in clinical trials and translational research training—which would give us more capacity and allow us to move things along faster.

The hon. Member for York Central (Rachael Maskell) raised an important point about cost. I have touched on the work that we are doing on per-patient costing to try and make sure that we develop a system that more intelligently captures the real cost of disease.

I am grateful to the hon. Member for Denton and Reddish, the Opposition spokesman, for his comments. I congratulate him on the by-election victory. He asked about NICE reform, which I have touched on, through the AAR. We do not want to interfere with or undermine NICE’s independence and their “gold standard” reputation, but we want to create a place in which the accelerated access review gives them the freedoms that they are, indeed, helping to shape.

In conclusion, this debate has highlighted not only the challenges from the rising costs of new drug discovery—£200,000 to £400,000 a year for patients in the rare disease space—and the pressure on the one-size-fits-all model of assessment, but the opportunities for us to unleash our leadership in genomics and informatics to create a new landscape. That is why this week, the Association of Medical Research Charities conference and my summit this afternoon, and the accelerated access review work is creating momentum for a new landscape for accelerated pathways for patient-led innovation.

I think we will look back in two or three years at this as a crucial turning point at which the system that was set up to assess a very one-size-fits-all, 20th-century model was rapidly adapted, creating new opportunities for patient-led innovations and charities such as the CF Trust to bring through innovations that benefit their patients more quickly.

If I may, Sir Edward. I thank you for chairing this debate. I thank the Minister and the Opposition spokesman for what they have said. It was really interesting to listen to the Minister and my hon. Friend the Member for York Central (Rachael Maskell) bringing to bear the deep expertise that they have gained from their careers before coming into Parliament. The right hon. Member for Chesham and Amersham (Mrs Gillan) spoke really movingly, and incredibly passionately and powerfully, about Archie Hill.

Most of all, I want to thank the people at the CF Trust and my constituent, Carly Jeavons, for raising this issue with me. I think this debate shows exactly how Parliament and politics should be working—with our constituents raising issues with us, us coming here to speak up on their behalf, and the Minister responding to their concerns—so I am very grateful indeed for that.

Question put and agreed to.


That this House has considered access to medicines for people with cystic fibrosis and other rare diseases.

Shakespeare Theatre (Knowsley)

I beg to move,

That this House has considered the proposal for a Shakespeare theatre in Knowsley.

Let me begin with a few acknowledgments of those who helped me to prepare what I am about to say: Professor Kathy Dacre, a Shakespearian scholar who is heavily involved in this project; Dr Stephen Lloyd, the archivist at Knowsley Hall, who made some helpful suggestions; Mr Mike Harden, chief executive of Knowsley Council; and, last but by no means least, Professor Elspeth Graham of Liverpool John Moores University.

Prescot, my home town in Knowsley—which I also share with my hon. Friend the Member for St Helens South and Whiston (Marie Rimmer)—has a unique place in theatre history. It is a market town and one of the oldest settlements in Merseyside. In the later Elizabethan period, Prescot was a lively town providing lodgings, hospitality and entertainment for visitors, including gambling and cockfighting. In 1592, it supported 19 alehouses and by 1622 it had an astonishing 43 such premises—far more than were needed for the town’s modest population of a few hundred. That reflects the fact that it was an entertainment centre to which people would travel for the market or the theatre, which I am about to describe. It also explains why there were very few people in each of the alehouses.

Prescot was the site of the Playhouse, the only free-standing, purpose-built theatre outside London in the Elizabethan period. It was built in the 1590s by Richard Harrington, who was closely connected to the Stanley family, the Earls of Derby, who were one of the most influential families in England. Ferdinando, Lord Strange, fifth Earl of Derby, and his brother William, the sixth Earl, were directly involved in the theatre, maintaining a talented group of professional players. Several important companies performed in Knowsley, and it was home to the Earl of Derby’s Men and Lord Strange’s Men, the troupes of actors which later formed the core of the Lord Chamberlain’s Men, who performed Shakespeare at the Globe in London.

The original Playhouse in Prescot was a relatively small theatre that held public performances and rehearsals prior to more prestigious performances at Knowsley hall and the further estates of the Stanleys, such as Lathom house near Ormskirk, as well as those belonging to leading families in Lancashire. William Shakespeare attracted audiences from all social backgrounds and his actors had played at the Globe, where performances were effectively public rehearsals for more intimate and prestigious evening performances at the court.

There is evidence that some of Shakespeare’s earliest plays, which contain tributes to the Stanleys, were first staged at Prescot or Knowsley hall. If so, William Shakespeare would almost certainly have supervised the performances and may even have acted in them. They included “Richard III” and “Titus Andronicus” by Strange’s Men, and “The Taming of the Shrew” and “Love’s Labour’s Lost”, which were written to flatter his patron. Later, he would write “A Midsummer Night’s Dream”, which was first performed at the wedding of the sixth Earl of Derby to Elizabeth de Vere in front of Queen Elizabeth. Last summer, there was a professional and accomplished performance of “A Midsummer Night’s Dream” in Prescot, partly in the parish church of St Mary’s and partly in the churchyard. It was given by a local company of performers and I had the privilege of attending.

In “Love’s Labour’s Lost”, which is set in a deer park, King Ferdinand’s ambition to make his court

“the wonder of the world”

is likely to have been based on the real plans of Ferdinando Stanley. It was said that, had he lived longer, he would have been the leading English contender for the throne. Shakespeare almost certainly wrote his early plays while under the powerful patronage of these powerful Lancastrian families. Evidence from archival records is supported by references in the plays.

Let me turn to the proposal for a Shakespeare theatre of the north. The aim is to create a unique, internationally renowned educational facility to encompass a commemorative theatre, to provide a key link between national, regional and local cultural and educational policy, and to contribute to the economic regeneration of an area that has deep connections with one of the nation’s greatest cultural icons. The Shakespeare North trust plans to commemorate the significance of Prescot’s history by creating a playhouse built to designs drawn in 1629 by Inigo Jones for the Cockpit theatre. Inigo Jones was one of the greatest English architects and theatre designers of his day and designed the perfect stage on which to present the plays of his time, the most celebrated of which were Shakespeare’s.

The project has the capacity to create a Shakespearian triangle with Stratford and London. As such, the Playhouse in Prescot will be unique as the only replica of this indoor Jacobean court theatre in the world, and the site of the only actor training programme in Shakespearean performance in the UK. It will be a leading public theatre with a student programme at its core and a purpose to realise one of the UK’s premier cultural assets. It will be home to Shakespeare’s language, lyrics and performance potential.

At this point, it is worth summarising what we are trying to do with some words from, appropriately, “A Midsummer Night’s Dream”:

“The forms of things unknown, the poet’s pen

Turns them to shapes and gives to airy nothing

A local habitation and a name.”

I contend that that name is the new Playhouse in Prescot.

An overall programme of education and community engagement would be integrated with the work of the Playhouse so that all aspects cohere around the philosophy and aims of Shakespeare North. That will allow individuals to participate at many levels linked to college work either through discrete courses, workshops and activities, or in a developmental series of activities through the stages of people’s lives. In particular, the activities involving early years and school-aged children are designed to provide a strong platform for the years of compulsory education and beyond.

There are a number of strands to the project’s work and themes, including the seven ages of man. In particular, there will be postgraduate education in the form of a master’s degree programme in Shakespearean performance and practice; an exploration of language and lyrics linked with formal education providers; informal education and community engagement; priority for groups in collaboration with existing local government and voluntary sector initiatives for special focused-needs groups in which applied drama work will offer a range of relevant and productive frameworks; a music and memory programme of work for elderly members; a plan to increase the skills base and employment prospects of local residents through a range of skills training and volunteering opportunities; a base for the Shakespeare schools festival performances in the north-west; and finally, the Knowsley international Shakespeare festival, which we propose in conjunction with the project.

The trust’s fundraising strategy to secure the cost of the scheme, which is likely to be in the region of £19 million—this is not special pleading—is likely to be the basis of a lottery bid. However, if the Chancellor happens to find a spare £19 million in his budget, we would be grateful to receive it towards the capital costs. The business plan indicates that the development would achieve sustainability in a relatively short period and would not need to rely on regular revenue funding.

Shakespeare North has been established to work in partnership and improve the attainment of education and skills needed for long-term local and regional resilience and to help to create a place where people aspire to live, visit, work and do business. I am not asking the Minister for anything in particular, but I would be grateful for some indication of the Government’s general support for the programme, without any specific, tangible support at this stage, although, as I said, that would always be gratefully received.

I conclude with a request to the Minister by way of some words from “Hamlet”:

“Speak the speech, I pray you, as I pronounced it to you, trippingly on the tongue. But if you mouth it as many of our players do, I had as lief the town crier spoke my lines. Nor do not saw the air too much with your hand, thus. But use all gently.”

We look forward to the Minister’s gentle response.

Sir Edward, to give you your appropriate title, may I say what a great honour it is to appear under your chairmanship? I thank the right hon. Member for Knowsley (Mr Howarth) for calling this important debate. To respond to his eloquence, I should of course say:

“To be, or not to be: that is the question”.

But we very much hope that it will be—that this important project does get off the ground.

It is a great pleasure to speak about the proposed Elizabethan theatre and the community hub in Prescot in Knowsley that will result from it. It has been inspired, of course, by our most famous Englishman, William Shakespeare. The Shakespeare North project in Knowsley has been proposed by the Shakespeare North trust, and it has been long in gestation. To quote from “A Midsummer Night’s Dream”,

“The course of true love never did run smooth”.

The project cannot simply be wished into existence overnight, but it is an exciting project and I hope to stay close to it now and in the future, because a lot of hard work has gone into it and it deserves to succeed. It would be fantastic if the proposals to recreate the Elizabethan theatre, about which the right hon. Gentleman spoke so eloquently, came to fruition. That would bring with it the chance for local residents and visitors to see Shakespeare’s plays performed in Knowsley 400 years on from when they were originally performed there by Lord Strange’s Men.

The project has widespread support, not only from the right hon. Gentleman and the hon. Member for St Helens South and Whiston (Marie Rimmer), who both represent Prescot, but from local cultural figures such as Phil Redmond, who is the chairman of National Museums Liverpool as well as a renowned writer, the actor Alison Steadman, Tom Baker, Willy Russell and Alan Bleasdale. The proposed theatre and hub would be an excellent opportunity for the young people of Knowsley and would play a part in inspiring the next generation of theatre makers and performers, who could see Shakespeare’s work on their very doorstep.

It is indeed a very distinguished list of patrons that the Minister has read out. He might add to that Sue Johnston, who went to school in Prescot and was brought up in the area and is of course a distinguished actress herself.

If it is the Sue Johnston I am thinking of, of “Brookside” fame as well, I am delighted to add her to the list of distinguished people who have supported the project.

Also included in the list of patrons are Dame Helen Mirren, Sir Patrick Stewart, Vanessa Redgrave and of course, as my right hon. Friend the Member for Knowsley (Mr Howarth) said, Sue Johnston. At the launch of the appeal, Knowsley Council supported a bid to the Big Lottery Fund, and the project made it on to a shortlist of nine, out of 400 bids, but unfortunately it did not receive the grant.

At a public presentation involving 200 local residents at Prescot parish church early in December, the trustees described the fifth and sixth Earls of Derby as the Simon Cowell and Cameron Mackintosh of their day. Prescot is a very old, distinguished, former industrial town. To have Shakespeare performed in that town was unique; it was the only such place outside London. The fifth earl, Ferdinando Stanley, sponsored his own theatre company, Lord Strange’s Men, who performed William Shakespeare’s plays at Knowsley Hall and at the original theatre. Many of the playwright’s characters are named for the Stanley family. In 1593, Prescot became home to the first and most important freestanding theatre outside London. Although no pictures of the Prescot playhouse remain, it is believed to have been a cockpit theatre much like those designed by the famed Tudor architect Inigo Jones. It stood at the end of Eccleston Street, a quaint shopping street in the market town, where the flat iron building stands now. The chief importance of the venue was in bringing drama to ordinary working-class people, making theatre accessible to everyone—something of which the earls could have been extremely proud.

I will leave it there, as my throat is cracking, but I urge the Minister to empty his pockets and purses, and whatever he can find should go towards this project. There are many local philanthropists, including Lord Derby, I understand, who will help to make it happen, and a little from the Government would go a long way.

I hear what the hon. Lady says and I commend her for making those remarks, given the sore throat that she clearly has. I will obviously put the names that she read out as supporters of the project alongside those of Sir Paul McCartney, Cherie Blair, David Alton, Clive Owen, Trudie Styler and many others. Of course there is also the chairmanship of the Shakespeare North board. Peter Scott is the chair, but Professor Kathy Dacre has been mentioned, and many others have given so much of their time to make this project happen. As the hon. Lady remarked, at one point the project was shortlisted for a lottery bid, but it was unsuccessful. We can put a girdle about the earth in 40 minutes, but projects such as this take some time.

What is really exciting about the project is that it speaks to my own personal passion, which is to put culture and heritage at the heart of our communities. The project combines both. It includes a heritage element. It recreates the historic link that Knowsley and Prescot have with our greatest playwright. It provides a heritage centre by recreating the Elizabethan theatre and bringing alive the plays of Shakespeare. However, it is also an extremely contemporary cultural project, which reaches out to the widest community possible—to actors themselves in terms of training, to young people and to everyone as a community resource. That is one of the other reasons why I am so supportive of the project—because education and community engagement are central to the proposals. There is a proposal for an international university college, with a strong link to Liverpool John Moores University. That is a theme that I want to bring out more. The role that universities now play in culture and heritage is too often unacknowledged, but I hope to bring it to the fore over the next few months.

Of course the project will depend to a certain extent on philanthropic support. Many people who have ties with Knowsley, not least some of the people whom we have mentioned in the debate, will provide support, and I reiterate my thanks to them.

The hope is to create a Shakespearean triangle between Knowsley in the north-west, Stratford-on-Avon in the midlands and of course Shakespeare’s Globe in London. It is an ambitious target, but it could be an incredibly important asset for the heritage and tourism industry in this country, as well as increasing employment and aspiration in the constituencies of the right hon. Gentleman and the hon. Lady. As I have already pointed out, Shakespeare is possibly England’s most famous son and his stature across the globe is unrivalled. As an example of what Shakespeare North can achieve, Shakespeare’s Globe in London still receives some 350,000 visitors every year; Stratford-on-Avon had 150,000 overseas visitors in 2014, which represents an increase; and some 400,000 people visit Shakespeare’s birthplace every year. Those visitors to places such as Stratford-on-Avon generate millions of pounds for the local area, and it is hoped that if the project is successful, Knowsley’s links to Shakespeare will be of similar benefit to the local area.

I have hinted at the fact that I am passionate about themes such as place making, education and putting culture and heritage at the heart of a place. Next year, we will publish a White Paper on arts and culture, in which we may reference the project in Knowsley, because we want to talk about place making and education. Having a new performing Elizabethan theatre and arts hub would certainly put Knowsley even more firmly on the map. I was delighted to hear that the local council is strongly behind the project, as are the people of Knowsley, who understand the opportunity that it will bring to create new jobs and growth in the area.

The proposal aims to make the project in Knowsley part of the northern powerhouse, which is, as I am sure all hon. Members are aware, a major priority for the Government. That was demonstrated in this year’s spending review, which included investment in the Factory in Manchester and the Great Exhibition of the North. If the theatre in Knowsley gets off the ground, it will be close to areas that are replete with rich cultural heritage. Liverpool is a former European capital of culture and the home of National Museums Liverpool, as well as Tate Liverpool and the Everyman theatre. I was delighted to go to Liverpool the other day to host a round table for our White Paper and to see the continued commitment and enthusiasm in Merseyside for the arts. The devolution deal is part of our work to hand back power and responsibility to the region, and it is important that Liverpool’s arts and culture form part of that deal.

It is important to have this debate now, because next year, which marks 400 years since his death, will be a year in which we celebrate Shakespeare’s life. We will commemorate his works in a variety of ways. One of those will be “Shakespeare Lives”, a major programme of events and activities to celebrate Shakespeare’s life, which has the ambition of reaching 500 million people all over the world. The programme will be an invitation to the world to join in the festivities by participating in a unique online collaboration, and experiencing the work of Shakespeare directly on stage, through film, in exhibitions and in schools. The programme will run throughout 2016, exploring Shakespeare as a living writer who still speaks for people and nations, and it will feature activities across English, education and the arts to explore the story of how a playwright from England came to be enjoyed all over the globe. The British Council is working on the project, alongside the Foreign Office, UK Trade & Investment and, of course, my Department.

Here in the UK, Shakespeare 400 is a consortium of leading cultural, creative and educational organisations co-ordinated by King’s College London that will work together to mark the 400th anniversary through a connected series of public performances, programmes, exhibitions and creative activities inside and outside the capital to celebrate Shakespeare’s legacy. The BBC will also play a major role. Its contribution will include a live broadcast from Stratford with the Royal Shakespeare Company, hosted by David Tennant, and new adaptations of Shakespeare’s plays. In addition, the BBC’s Shakespeare archive resource will provide schools, colleges and universities across the UK with access to hundreds of hours of BBC television and radio broadcasts of Shakespeare’s plays, as well as his sonnets and documentaries about him.

The RSC will mark the anniversary with a far-reaching national and international programme of productions, including “A Midsummer Night’s Dream: A Play for the Nation” which will be co-produced with 14 amateur companies across the UK. It is important to recognise the amazing work that the RSC does with children and through its live screenings. The Birmingham Royal Ballet will create a new full-length ballet of “The Tempest” under its director David Bintley, and the London Philharmonic Orchestra will also celebrate Shakespeare’s legacy.

There could not be a better time to raise the prospect of a new northern hub for Shakespeare in Knowsley and Prescot. All the organisations that I have mentioned have the support of Arts Council England, and I am sure that all hon. Members will welcome the generous settlement we secured from the Chancellor a few weeks ago. He made it clear that the arts are one of the best investments the Government can make, and that we will continue to support arts and culture across the country. I am delighted that Knowsley Council feels the same as we do. Incidentally, we will also ensure continued free access to our national galleries and museums.

I understand the continuing concerns about local authority funding, but I point out that other sources of income, such as business rates and income tax, can put local government in a strong position to support local arts and culture. That is why Knowsley Council’s strong support for the project is very welcome, and I hope that its passion for the project will be communicated to other councils across the region.

It only remains for me to thank the right hon. Member for Knowsley for calling the debate and the hon. Member for St Helens South and Whiston for speaking so eloquently. The Government are very supportive of the project, and we will continue to work with the right hon. Gentleman in any way we can to bring it to fruition.

Alas, poor Howarth, he cannot sum up, under the rules. I have asked whether he can, but—just say a quick word; go on.

I will just make two quick points. First, although the Minister’s comments about local government funding and the recent comprehensive spending review are welcome, Knowsley will find it difficult to take advantage of those opportunities, simply because the tax base is not there to allow it to do so.

Secondly, the Minister quite rightly indicated the tourist potential of the Liverpool city region and his ambitions, which I share, for our city region. I simply point out that Prescot is proud of the fact that it predates Liverpool. Although we very much associate with Liverpool and, equally, with St Helens, we feel that there is something unique and special about Prescot.

I am grateful for the general support that the Minister has offered, and I hope that we can collaborate with the Shakespeare North trust and others over the coming months to try to bring this ambitious, but exciting, opportunity into reality.

I thank the right hon. Gentleman for his intervention, and I take note of the points that he makes. Local co-operation is important, but a little local rivalry is also welcome. I hope that Prescot will continue to press its case for being the most venerable town in the area. I reiterate that next year offers a unique opportunity to raise the profile of the project, given the huge focus that will come to bear on William Shakespeare’s life.

Question put and agreed to.

Sitting suspended.

Marriage Registration Certificates

[Mr Graham Brady in the Chair]

Good afternoon. Before we begin, it might be helpful if Members know that we can continue until 4 o’clock, but we are expecting a Division in the House at 3.45 pm.

I beg to move,

That this House has considered marriage registration certificates.

It is a pleasure to serve under your chairmanship, Mr Brady. The latest intelligence that I heard is that we might have a vote at 2.45 pm, but of course we are on a running three-line Whip, so we will just have to see.

I am happy to have secured a Westminster Hall debate on this important subject. Since 1837—the beginning of Queen Victoria’s reign—marriage certificates in England and Wales have included the names of the spouses’ fathers, but not their mothers. I know that I am not alone in finding this state of affairs unacceptable in our modern society. Indeed, the Prime Minister said as much in August 2014.

The issue has attracted calls for reform from many Members: the hon. Member for Brighton, Pavilion (Caroline Lucas) has tabled two early-day motions on the subject, each of which attracted 100 signatures; a petition on was signed by more than 70,000 members of the public; and the hon. Member for Neath (Christina Rees) has introduced a private Member’s Bill in an attempt to secure the inclusion of mothers’ names on marriage certificates. I believe that the Second Reading of that Bill is scheduled for 22 January, and it underlines the point that this is clearly an issue that concerns Members from across the House and requires urgent attention and reform.

The Church of England recently held an internal consultation exercise of archdeacons and legal officials to gauge the views of the clergy about changing the way we do marriage registration. It received an overwhelmingly positive response. It cannot be that difficult to change the format of marriage certificates so that the mothers’ details can be captured, can it?

I understand that the problem lies with the practicalities of the current system of marriage registration, which has not changed since 1837. Marriages are registered in register books, which are held in churches and other religious premises as well as in register offices. There are around 84,000 open register books in more than 30,000 churches and religious buildings. Marriage certificates are simply an exact copy of the marriage register entry, so under the current registration system changing the content of the marriage certificate would mean first changing the content of the register books. In order to do that, all 84,000 books currently in circulation would need to be replaced, at a cost of around £3 million.

I am well aware that that is one of the sticking points, but as the right hon. Lady will be aware, there is a space next to where the details are recorded, which could be used to record the mother’s details without the need to replace all the books.

I quite understand the hon. Lady’s point, but as she will see in the course of my speech, there is an opportunity to step forward, right into the 21st century, in the way that we register marriages, which will secure the mother’s name on the register. If she will bear with me, I think she will see that some other benefits could flow from a practically different way of registering marriages.

If we ended up having to replace the books, few would disagree that it would not be a good use of that sum of money. There is another, more efficient way that marriages could be registered, which is to adopt a system very similar to that which already exists in England and Wales for the registration of civil partnerships and which is already in use for the registration of marriages and civil partnerships in Scotland and Northern Ireland.

Under the alternative system, known as the schedule system, marriages are registered in a single electronic register instead of in marriage register books. Changes to the form of the register entry can be made easily without the need to replace all the register books. Instead of signing a register book at the ceremony, the newlyweds sign a document that is then returned to the register office to be entered in the existing electronic register so that a marriage certificate can be issued.

Having all marriages registered online would create a central database without the need for any further administrative processes, but changing the way we register marriages requires a change to primary legislation. Depending how this debate goes, it is my intention to introduce a marriage registration Bill, which may look remarkably like the one that the hon. Member for Neath proposes to introduce. I would be very happy to make copies of that as soon as possible. There is a great desire across the House to find the best possible vehicle to make the change.

I congratulate the right hon. Lady on bringing the important subject to the House. On Friday, we debated the Riot (Damages) Act 1886, and some Members here were present. That Act has not been changed since 1886, which is quite recent compared with the legislation that the right hon. Lady mentioned. I understand that the Home Office Minister, James Brokenshire, said in October that there would be a timetable in due course. Does the right hon. Lady have any insider information as to whether there has been any progress on that?

Just before the right hon. Lady continues, may I remind Members not to use the names of other Members of the House?

Nor can I, off the top of my head. The hon. Member for Ealing Central and Acton (Dr Huq) might have been present at Prime Minister’s questions—I think it was the week before last—when her hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq), who is here today, secured a promise from the Prime Minister that if we cannot succeed in getting marriage registration certificates changed through private Members’ legislation, the Government will do so through Government legislation. Maybe like the Riot (Damages) Act, which the hon. Member for Ealing Central and Acton described—clearly I missed the action on Friday—this subject is an example of something that is really good to come from the Floor of the House of Commons. It is something that we feel strongly about and it is an example of a good opportunity for private Members’ legislation.

My draft Bill would contain powers to amend the Marriage Act 1949 by regulation, subject to the affirmative resolution procedure, to make provision concerning the registration of marriages in England and Wales. The Bill would not make mention of marriage certificates or the inclusion of mothers’ names for an important reason: the Bill would be an enabling measure. If enacted, the actual content of the marriage register, and therefore marriage certificates, which are a copy of the entry, would need to be prescribed in regulations made by the Registrar General with the approval of the Secretary of State.

Simply updating the marriage entry to include the mother’s name in addition to the father’s would not go far enough in today’s fast-changing society. Already, some families do not have a legally recognised mother and father, but instead have a mother and a second female parent, or, as in surrogacy cases, two legally recognised parents. In fact, there have always been cases that the current form of the register failed to accommodate properly, including where a child had been brought up by a guardian and might not know his or her father. As family composition continues to change, the marriage register must be capable of adapting.

I congratulate my right hon. Friend on securing this important debate. I just want to clarify something. I completely get the point about the need for electronic progress. An electronic certificate is an interesting idea and perhaps one that would allow us to take a more modern approach, reflecting current social mores. However, would it mean that when people got married and signed the register in the side antechamber, the mother’s name would still not appear in that book?

No, I can reassure my hon. Friend on that. The mothers’ names will appear. I can tell hon. Members that, personally, there is no stronger motivation for me than to ensure that the mothers’ names can appear on the marriage certificate. Unfortunately, my mother is long gone, but when it comes to the marriages—hopefully—of my children in due course, I shall take particular satisfaction if allowed, as a mother, to appear on the certificate. I expect that every other mum in the room feels exactly the same.

The right hon. Lady is making an interesting point. That, in fact, happened to me. My father died when I was a teenager and I could not put my mother’s name on the marriage certificate. I had to have a deceased parent on it, which is slightly strange. It seems that the Bill of my hon. Friend the Member for Neath (Christina Rees) is already on the table and we could be debating it, so could the points made by the right hon. Member for Meriden (Mrs Spelman) not be included as amendments when it is in Committee?

That is certainly one way of doing it. I will need to look closely at the Bill tabled by the hon. Member for Neath. I would be more than happy for us to work together. It would be good if all of us who have sought to bring about the change support it on the Floor of the House. That is our endeavour, and it is what we should seek to achieve.

I recognise and commend the right hon. Lady’s desire for the proposal to be made on the Floor of the House, but she must accept that in purely practical terms it would be far better if the Government gave a clear lead.

I am not convinced. This subject lends itself to private Members’ legislation, as do a number of private Members’ Bills that come through the House, otherwise why would we bother with the private Members’ ballot? This is a really good subject for a private Member’s Bill, and legislating with the Whip on is a fall-back position. As the Prime Minister has said, if private Members cannot secure the measure in this Session, the Government will do so in the next Session.

I do not want to burst the right hon. Lady’s bubble, because she has far more experience of this place than I do, but I have served on the Procedure Committee for six years. The Committee has conducted a thorough inquiry into private Members’ Bills and, unfortunately, my bubble was burst when I discovered that not one private Member’s Bill that was not a hand-out Bill has become law since, I think, 1962.

That is not quite true. In my 18 years here, private Members’ Bills have become law, but I agree that good private Members’ legislation is too often blocked for one reason or another. We should look to Mr Speaker, who always says that he is a champion of the Back Benchers, and ask the hard question, “Which Back Benchers?”

One purpose of today’s debate is to draw out the concerns and other things that might be barriers to legislating to make this change—I suspect that everyone in this room is broadly aligned on achieving the change. We may not have the people who might be disposed to block the measure, for whatever reason, but I have made sure that all Members of the House are aware that we are holding this debate today. Members have an opportunity to raise their objections so that we can tease them out and smooth the way for this measure to become law.

The right hon. Lady is being very patient in giving way. Again, I put it to her that an actual Bill is being drafted by specialists in the House. That Bill covers all the points and has cross-party support, and it would be a wasted opportunity not to have this debate in Committee.

I secured this debate so that I could run through my concerns in advance of thinking about what form a draft Bill should take to address those concerns. It may be that, after our debate in Westminster Hall today, we look at one made earlier and take the view that, actually, it is the best vehicle. This debate is a precursor to supporting private Members’ legislation and, in my capacity as the Second Church Estates Commissioner, I am trying to raise concerns brought out in the Church of England consultation, which is another dimension to the debate. If the hon. Lady and other Members bear with me, I will highlight some of the points raised in the consultation.

Having waited two centuries to change the register entry, it is important that we do not introduce inflexible measures that would require further primary legislative change in the relatively near future. We should not be over-specific in a Bill, but should make the changes through regulations—I made that point earlier. Will the Minister confirm that, in prescribing the marriage entry in future, consideration will be given to accommodating all family situations?

It might help if I outline some of the more detailed existing steps involved in registering a marriage and the changes I would make through regulations if I were to introduce a private Member’s Bill. The regulations, which would amend the Marriage Act 1949, would of course be made under the affirmative procedure, so they would be debated on the Floor of both Houses.

Couples wishing to marry in England and Wales may follow either civil or ecclesiastical preliminaries, which is a jargonistic word for things such as the reading of banns. Some consultees in the Church of England expressed concern that ecclesiastical preliminaries might be abolished, but in my view they should definitely not be abolished. I do not think there is any proposal that the reading of banns should be abolished. Ecclesiastical preliminaries are available to those wishing to marry in the Church of England or the Church in Wales, which would not change. Couples would still be able to have their banns called or to obtain a common or special licence in exactly the same way as they can now. Clergy would continue to certify a marriage by their signature—clergy sought particular assurance from me on that point.

The only change to marriages following the ecclesiastical preliminaries is that, before the ceremony, the member of the clergy who is to solemnise the marriage would be responsible for ensuring that a document, called a “marriage document,” is completed and contains all the details required to be entered in the marriage register. The marriage document would still be signed. After the marriage had been solemnised, the newlyweds and their two witnesses would sign the marriage document, just as they currently sign the register. Indeed, the couple may be photographed at the signing of the marriage document in what is, after all, the classic wedding photo.

The couple would be responsible for ensuring that the signed document was returned to the register office within three days to be registered, and a marriage certificate could then be issued. The couple would not have to return the document to the register office personally, as they will hopefully be on their honeymoon; they could post the document or ask someone else to return it. In Scotland, it is traditionally the duty of the best man to return the signed document on the couple’s behalf—we might say that there is no such thing as a free speech.

Civil preliminaries to marriage are available to everyone, including couples wishing to marry in the Church of England or the Church in Wales and those intending to marry in a civil ceremony according to other religious rites. At present, each party to a proposed marriage gives notice of marriage to the superintendent registrar in the district in which they have resided for at least the past seven days. After a waiting period of 28 days, and provided that there is no impediment to the marriage, the superintendent registrar to whom notice was given will issue each party with a certificate for marriage that must be taken to the marriage and authorises the marriage to proceed. The waiting period of 28 days can be extended to 70 days for certain couples subject to immigration control.

Under the proposed new system, instead of two certificates for marriage, a couple would be issued with a single document called a “marriage schedule,” which would act as the authority for the marriage to proceed and would contain all the information required to be registered. As for marriages following ecclesiastical preliminaries, the schedule would be signed by the couple after the ceremony and returned to the register office to be registered. The proposed changes would not affect the point at which a couple are married, which happens once a couple have said the appropriate marriage declarations in their marriage ceremony. As now, the validity of a marriage does not depend on the marriage being registered, although it would be a legal requirement to register it.

I am sure that any couple would want to register their marriage and obtain a certificate, and the experience in Scotland has been exactly that. The changes would mean that churches and other religious buildings registered for marriage would not hold open marriage register books and would not need to issue marriage certificates. However, the clergy of the Church of England would still be required to maintain records of marriages solemnised in church, and other religious groups may wish to maintain their own records, too. Indeed, during the consultation in the Church of England, the clergy particularly emphasised the pastoral importance of keeping a record of marriages so that relatives can visit and see the record for themselves. There is great interest in genealogy and family history, as we know from many television programmes. Marriage provides an important opportunity for the clergy to speak with family members about personal things, and keeping a record of it is important to family life.

As well as facilitating change to the register entry, the proposed changes would have other significant benefits. First, they would greatly increase the security of marriage registers—that addresses the books issue somewhat—as, at present, register books and blank certificate stocks are held in some 30,000 religious premises in England and Wales, where, sadly, they may be stolen, with obvious security implications. Under the proposed scheme, certificates would only be issued from register offices, and the register itself would be securely held electronically.

Secondly, the administrative burdens of registering marriages would be greatly reduced. Under the current regime, all those responsible for registering marriages, including members of the clergy and persons authorised on behalf of religious groups, are required to submit copies of all the marriages they register to the superintendent registrar of the district for onward transmission to the Registrar General. That is so the Registrar General can maintain a central index and register of all marriages that have taken place in England and Wales. It is an early 19th-century process and is cumbersome in the modern age. Under the proposed new system, there would simply be no need for the returns to be made.

Finally, the proposed system is expected to generate significant cost savings not only for central Government but for local authorities, which have responsibility for registrars and superintendent registrars, and for religious groups. Overall, the system is expected to generate savings of approximately £30 million over 10 years, although, as I said, that is not the principal reason for making the change.

I hope that hon. Members will agree that replacing the existing marriage register books to add the mother’s name would be an efficient way to resolve the present inequality, righting a wrong that has been allowed to continue for too long. The introduction of the new registration processes would create a modern, cost-efficient, secure and adaptable system while remedying an historic inequality. I hope that hon. Members will welcome the proposals.

I am delighted that the right hon. Member for Meriden (Mrs Spelman) has secured this debate. As has been pointed out, I presented a private Member’s Bill on 4 November to change the marriage certificate in England and Wales, and notwithstanding the now-abandoned rule against anticipation, I am pleased to have the opportunity to speak on this important matter.

I presented the Bill on 4 November, so I assume that all those here will have had ample time to read it. It is not a long Bill, and its beauty is in its simplicity; it makes necessary changes without overcomplicating the situation. The Bill would amend the Marriage Act 1949 and the Civil Partnership Act 2004 to make provision for the recording of the name and occupation of the mother of each party to a marriage or civil partnership for registration purposes, and to require such information to be displayed on marriage certificates and civil partnership certificates and for connected purposes in England and Wales. It would cement those requirements in primary legislation, which is important.

My hon. Friend is making an important point about the Bill that she introduced. Does she agree that it is a matter for the Government to discuss the details of the Bill, just as elements of my 10-minute rule Bill have been accepted into primary legislation? Points made by the Second Church Estates Commissioner, the right hon. Member for Meriden (Mrs Spelman), could also be incorporated, either in discussions with the Government or certainly after Second Reading.

I agree totally. It can be discussed and agreed in due course, because there is widespread support in this debate for the measures. The sooner we get on with it, the better. The reason why we want to put the change into primary legislation is that, as a regulation—as it is in respect of civil partnerships—it could be changed at any time. We need to cement the regulation relating to civil partnerships as well.

As the right hon. Member for Meriden said, the Bill is the result of a long campaign. A petition in January 2014 on in January 2014 collected more than 70,000 signatures. A campaign on Twitter followed with the hashtag #MothersOnMarriageCerts, which had heavy coverage from the BBC, the Telegraph’s Wonder Women journalists and the New Statesman, which is a varied segment of the press to be supporting such a change. In August 2014, campaigners pressed the Prime Minister on the issue, and he agreed that it was high time the system was updated.

I apologise for my keenness to intervene. My hon. Friend mentioned the Prime Minister. I think that he said at the time that marriage certificates do not reflect modern Britain. Given that he declared recently at Prime Minister’s questions that he is now a feminist, is that not an example of how he seems to say one thing and do another? There has been zero progress on this important subject since August 2014.

I agree with everything that my hon. Friend the Member for Ealing Central and Acton (Dr Huq) says. In January this year, the Minister for Immigration, the right hon. Member for Old Bexley and Sidcup (James Brokenshire), said in response to press inquiries that he was

“continuing to develop the options that will allow mothers’ names to be recorded on marriage certificates as soon as practicable.”

But still nothing has been done and this outdated practice continues.

In 2012 alone, 262,240 marriages took place in England and Wales, a 5.3% increase from the number of marriages in 2011. Unfortunately, we cannot calculate how many marriages have taken place since August 2014, because the Office for National Statistics stopped counting in 2012. However, it is safe to extrapolate that hundreds of thousands of marriages have taken place while the Government have failed to act. That is hundreds of thousands of instances in which women have been accorded second-class status. In a developed country in the 21st century, that beggars belief.

Does the hon. Lady appreciate that the announcement of the private Member’s Bill prompted, among other things, the Church of England consultation of the clergy, which only concluded just before the 4 November deadline? The consultation was among some of the practitioners most directly involved, and it is relevant to the discussion of what form some of the changes should take. It probably feels as though it has taken a very long time, but it is not when compared with the two centuries that we have allowed to elapse without putting the mother on the certificate. Getting it right is important. Often, when private legislation is introduced, it prompts action, which is what has happened here.

I am grateful to the right hon. Lady for acknowledging that the Bill prompted action and a consultation. Her offer to work together is encouraging. She mentioned that the practice has been changed in Scotland and Northern Ireland and for civil partnerships, so I cannot see why it cannot be done in England and Wales. Why delay further?

My daughter Angharad may one day get married—who knows? I had better wave to her—and if she does, I sincerely hope that my name will feature on her marriage certificate. My hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq), we are delighted to hear, will soon give birth to a daughter. She has raised this important issue during Prime Minister’s questions and has rightly called for women not to be written out of history.

My final appeal is for support for the Bill that I have presented, which will have Second Reading on 22 January. Its beauty is in its simplicity. We can make any changes that might need to be made to embrace further family set-ups. We might not know how families will be composed in future, but I am sure that that can be taken care of in Committee. We need to move forward without delay.

It is a pleasure to serve under your chairmanship, Mr Brady, and to speak in this debate, which we are all grateful to the Second Church Estates Commissioner, my right hon. Friend the Member for Meriden (Mrs Spelman), for securing. I should probably declare an interest, given that two members of my staff intend to get married—not to each other—in the next year, so I was under a certain amount of pressure to attend this debate. We talk of nothing but wedding dresses in the office.

It is almost 19 years since I married my husband on a cold and frosty December day. Since then, the idea of marriage has evolved considerably, but it remains important to many of us. It is noticeable that the mothers in this debate—I hesitate to call it “the audience”—go particularly shiny-eyed when we talk about our daughters getting married. As the mother of a 14-year-old and a 12-year-old, I am already thinking of those happy days that I hope will happen one day—but not too soon.

We should recognise that families today look very different to how they looked even 20 years ago, when I thought about getting married, and extremely different to how they looked two centuries ago, so I will focus on how we adapt to that change.

I did not declare my interest as a mother before; I do so now.

The hon. Lady makes an excellent point that the constitution of families has changed dramatically. Is she aware that, according to Gingerbread, there are now 2 million single parent households, which is 25% of all families with children, and 90% of those single parents are women? Given those figures, this erasing of women from history, as my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq) has called it, seems even more anomalous.

The hon. Lady makes a point that I will come on to shortly.

First, however, I will again quote the Prime Minister, from his speech to the Relationships Alliance summit, which I referred to earlier. He said:

“We all know that a strong family begins with a strong relationship between two loving people who make a deep and lasting commitment to each other…in Britain we recognise and value the commitment that people make to each other. And that’s just as vital whether the commitment is between a man and a woman, a man and a man or a woman and another woman.”

As we have heard from other Members this afternoon, it was in that same speech that the Prime Minister announced plans to address the “inequality in marriage”, to enable mothers’ names to be included on marriage certificates as well as fathers’ names.

I have discussed this issue at length with one of my constituents, who has been in a relationship for a considerable time; in fact, we are all eagerly awaiting her engagement as well. She pointed out that she is estranged from her father, who subjected her and her siblings to sexual abuse over a number of years, and has not seen him since she was 10. As a result, she would not want his name to be included on her own marriage certificate.

I looked into this matter and I understand from guidance from the General Register Office and from my own diocese in Oxford that

“If either party does not wish to put their father’s details in the Register or they do not know who their father is, you should not put ‘unknown’ or leave the column blank. You should put a horizontal line through both columns to show that no information was given.”

Although that would reflect in some ways my constituent’s wishes, it would also mean that there would be no mention of her mother, who understandably had to act as both mother and father to her during the very difficult circumstances of her upbringing. I feel strongly that a marriage certificate should recognise such a scenario.

There is a rare exception by which a mother’s details can be included; it is if she has been authorised by a court as the sole adopter. Then a couple can make a special request to have her details put on the register and in the certificate. The other way that it can be done is via a loophole, whereby the mothers’ names can be included if the mothers are witnesses, but that is the only other way I can see round this problem.

I thank the hon. Lady for that intervention. Sadly, this matter involving my constituent never came before a court, so it is not possible to resolve it in that way. It is now important that we move forward to reflect the fact that families do not look how we once thought they always would.

My hon. Friend is making a very powerful speech and I was greatly interested in her significant point about survivors of abuse and their involvement in this situation. In that regard, is it not, frankly, just a bit of a farce that we have to look for loopholes in order to recognise women on a marriage certificate? Would she like to reflect on that?

I could not agree more. Personally, however, I am not sure whether including the mother’s name on a certificate goes far enough. In the speech that I referred to earlier, the Prime Minister also set out his plans to make adoption by same-sex couples more straightforward. That is important because increasingly we are seeing same-sex couples with children who will eventually want to get married themselves. In such circumstances, they will not have a “father’s name” and a “mother’s name” to note on the certificate, but might have two fathers or two mothers.

I wonder whether this is the moment to go one step further and provide two fields on certificates for “Parent 1” and “Parent 2”, or whatever terminology we see fit to use, after consultation. It seems to me that that would cover most scenarios. I would be interested to hear from the Minister what consideration has been given to such a suggestion.

Of course, any change is a step in the right direction. It must be possible, given that the mother’s name, surname and occupation are already included on a civil partnership schedule, to include those details in wedding certificates. I simply add that, given it has taken us this long to get this far, I hope that we will not have to wait a similar length of time before we recognise different forms of parental relationship.

It is a pleasure to serve under you, Mr Brady.

The arguments for changing marriage certificates have already been well articulated by several Members today and I thank the Second Church Estates Commissioner, the right hon. Member for Meriden (Mrs Spelman), for securing such an important debate. She joins other Members who have gone before us in trying to make changes, in this place and in their own way, for gender equality.

For many of us, the reason for wanting to rectify the situation is deeply personal. I was fortunate enough to be brought up in a home with two loving parents, who had different impacts on me in different ways. Although my politics has been formed by my life in England, a lot of my cultural background and history has been shaped by my mother’s experience of being a political asylum seeker who came to this country in the 1970s and settled in the constituency that I now represent here in Westminster.

Strangely enough, I actually got married here in Parliament, with my mother next to me, and yet I could not put her name on my marriage certificate. That was a great shame: in the most democratic institution in the world, I still could not put my mother’s name on the marriage certificate.

Putting the gender issue aside, families such as mine—families with complex histories or histories that we want to be reflected on what is the most important day of our lives, other than being elected of course—want to put the mother’s name on the marriage certificate. We want to account, in official documents, for the way we travelled to this country.

This issue has a long history, but there can be absolutely no doubt about where public opinion is on it. I simply cite the example from back in 2002, when the then Labour Government issued a White Paper and there was a consultation. One of the things that came across clearly back then was the overwhelming support among ordinary members of the public for the change that we are discussing. Does my hon. Friend agree that what was true then is even truer now?

I absolutely agree.

I have also found that men and women who are interested in family history often find it very difficult to trace it through a family line and official documentation. It is about time that situation changed.

However, my main reason for raising this issue in Prime Minister’s questions is the sheer number of my constituents from Hampstead and Kilburn who have written to me about it. In particular, I will highlight the case of a single mother who wrote to me recently. She was brought up by her mother and has had no contact whatever with her father. She told me that she was devastated to learn that the outdated practice that we are discussing is still a requirement of marriage. She said:

“When I get married, I will be expected to put my absent father’s name and profession on my marriage certificate whilst my mother who brought me up will not be included.”

It puts a dampener on this important day in someone’s life—when they are getting married—if they cannot acknowledge the person who raised them.

We must remember that our discussions today reflect the deeply held anxieties of the people we represent in our various constituencies.

I want to draw my hon. Friend’s attention to The Daily Telegraph, which is not normally sympathetic to the Opposition—it has been known as the “Torygraph”. Its Wonder Women section backs a campaign on this issue, and a report in the paper in October included a quote that sounds very similar to the one my hon. Friend read out. Someone who is interviewed in the report says:

“I cannot believe it that in a developed country such a primitive reality would stare me in my face in the UK. I am deeply distressed”.

Well, if the Torygraph says it, we must agree with it. I agree with my hon. Friend, who puts a lot of hours into managing her life and her son—he is 11 years old and a delight.

I should point out that my constituent’s case is not a stand-out case. As my hon. Friend pointed out earlier, there are now 3 million lone-parent families in the UK—an increase of 500,000 over the past decade. According to the Office for National Statistics, there are now 2.5 million lone-mother families, compared with 437,000 lone-father families. The number of families with single mothers is therefore significantly higher than the number of families with single fathers. Although circumstances will differ from family to family, we need to bear those figures in mind while we fight to rectify the injustice we are talking about.

When I spoke to colleagues about marriage certificates and other issues, several of them—particularly one from London—talked about the large amount of correspondence they receive about certificates in general. Although the issue I want to raise is slightly different from the subject of the debate, I want the Minister to be aware of it.

It is virtually impossible to put fathers on birth certificates if they die before the birth of their child. Such cases are for another day, but I would like the issue to be reviewed. In one case, a father died a month before his child was born, and the mother is having to go to court to put his name on the certificate. She is having to deal not only with her grief following her bereavement, but with the fact that her child’s birth certificate will not mention her partner’s name. Will the Minister meet me and my London colleague to discuss the issue and see whether the Government will launch a comprehensive review into the various injustices that seem to occur with official documentation as a whole?

We operate in a political culture where policies do see U-turns. Earlier today, I was pleased that our Justice Secretary said that the criminal courts charges will be reversed. We also have the example of tax credits. If those polices can go through U-turns, almost on a whim, is it not possible to implement a policy that has been talked about endlessly? Early-day motions have been tabled, and questions have been asked at Prime Minister’s questions and at other times on the Floor of the House. We do not want the public to think that gender equality is not among our top issues. We must make sure that this change in policy gets through.

This is not the first injustice the Government have been slow to correct. However, there is something rather surreal about the Prime Minister demanding a change, and that change still not happening.

Of course we can make this party political, but is it worth it? We have waited two centuries for this change, during which time the Labour party has been in power and had ample opportunity to make a change, and my party has finally also got into power, after a long wait. Could we not just drop this party political approach? That is what annoys people about politics. I am just saying, “Come on. We can do this as private Members. Let’s do this. Let’s do it differently.”

I do not want to make things party political, but I do want to put pressure on the Government to change this policy. If putting pressure on them is the way to do that, that is what we need to do. The debate is not just about correcting a bureaucratic policy; it is another step in the fight against the gender discrimination that still blights Britain today. If it is possible to put pressure on the Prime Minister and the Minister sitting in front of me, I would like to take the opportunity to do that.

This is not party political. In the country we live in, there is still a deeply entrenched gender pay gap. There is still violence against women, and that is a major cause of death every year. Women are still disproportionately hit by cuts to local government budgets. That is the reality of the situation—it is not party politics.

I suppose I should declare an interest as well, as the mother of a 21-year-old daughter. However, to pick up the point about party politics, I should add that the civil service is independent. As my hon. Friend the Member for Caerphilly (Wayne David) said, there was a White Paper somewhere in the bowels of the civil service, and change was about to be made to the Regulatory Reform Act 2001. However, the Bill introduced by my hon. Friend the Member for Neath (Christina Rees) is now on the table, and it has cross-party support. Therefore, this debate did not have to happen—the machinery, the process and the legislation are already there.

I agree with my hon. Friend. As I said at the beginning, I am grateful to the right hon. Member for Meriden for calling the debate, because this is an important issue. I am pleased that men and women from different parties are here today, which reflects how passionately we feel about this issue.

Finally, I have a few points. This issue may seem simple when compared with other issues.

To be clear, there is nothing in the Bill introduced by the hon. Member for Neath (Christina Rees) about the practicalities—certainly from the clergy’s point of view—and the electronic registration process. I was just trying to put the practitioners’ view, and that is why I am not suggesting that we simply take the hon. Lady’s Bill off the shelf. There is also the wrinkle that the Bill is very specific, with its reference to the mother. If we do things by regulation, as I suggested, we can deal with all the subsequent changes in family composition. I was genuinely trying to put those points across in holding the debate.

I will not speak about the Bill introduced by my hon. Friend the Member for Neath (Christina Rees), but I am happy to let her intervene if she wants to.

The point is that regulation can be changed at any time; if these things are put in primary legislation, they cannot be. As I said, I welcome discussion, and we can change my Bill in Committee. The Bill will have its Second Reading on 22 January, and it addresses the main points. I think we should move forward with that.

I thank my hon. Friend.

I will just make a few final points. It is worth noting that countries such as Thailand, Bangladesh, Spain and France have already changed their laws so that mothers can be included on marriage certificates. Mothers’ names are already included on certificates in Scotland and Northern Ireland, which brings home the injustice for all of us. I want to make sure that changing the policy on this issue forms part of the patchwork of equality I hope all of us will champion in Parliament.

If my daughter gets married—she has the choice of whether to get married—she can have just her father on her marriage certificate if she wants, or she can have her mother on it if she wants. However, I want the option to be there, because if she cannot have her mother on her marriage certificate, she will have to write to her MP—which is me.

It is a great pleasure, as ever, to serve under your chairmanship, Mr Brady. Let me congratulate my right hon. Friend the Member for Meriden (Mrs Spelman) again on bringing forward this subject for debate and on the expertise she has shown as the Second Church Estates Commissioner.

My right hon. Friend is my neighbour, but there is another lady in my life I would like to pay tribute to: my mother. My mother brought me up as a lone parent—my father left when I was very young. She often worked two or three jobs to keep a roof over our heads and to ensure that I was clean and ready for school. Despite all the hours she worked, she always made sacrifices in that regard. My politics were formed very much by my mother’s hard work and self-reliance. She is a great example in my life.

When I was married last year—rather late in the day—I had the great pleasure of my mother being there as a witness. She had a fantastic hat, whose dimensions were such that I imagine it could be seen from space. It was a great sadness to me that her name could not appear on the marriage certificate. I was completely unaware of that. I was involved in politics, but in local campaigning and not in the minutiae of legalistic matters that I am involved in today. Until I arrived at the wedding I was completely unaware of the situation, and although obviously I did not make a fuss or a big deal out of it, I just thought it was a ridiculous anomaly that the person who had played the greatest role in my life should not, on my special day, have her name appended to the record of the event.

I had a similar experience when I got married many years ago. My father died when I was a young teenager and my mother brought me up. The father of my husband-to-be had also died many years before. The two mothers came to the ceremony but their names could not be on the certificate. That was when I realised it was a great injustice. I agree with what the hon. Gentleman says about someone being confronted with that on the happiest day of their life.

That shows the importance of the Bill that the hon. Lady has introduced. We bring a lot of our own experiences to this place, and from that negative thing she has made something very positive. I welcome the private Member’s Bill, and perhaps the hon. Lady and my right hon. Friend the Member for Meriden, in her capacity as Second Church Estates Commissioner and with her tremendous expertise, can come together to discuss and make progress with the matter. My right hon. Friend, with the Church, speaks with compassion about this matter.

We have been here before, with the 2002 White Paper. I believe that the idea was to make the change without primary legislation, and that it was decided that it could not happen by what I believe would have been a statutory instrument—I am still getting used to the terms. It was very unfortunate that that never came about. It would have been good to pass legislation then, although it would still have been happening many years later than it should have. Regardless of who is in power and of whether there is any party political aspect to the matter, I ask hon. Members to put those things behind us and focus on the issue now.

I welcome the review. My hon. Friend the Minister for Immigration has been discussing the matter and I look forward to hearing the response to the debate from the Minister who is present today. My hon. Friend the Member for Banbury (Victoria Prentis) made a significant point about survivors of abuse, and I have a constituent who is in a similar position. She is in a serious relationship and looking towards marriage, but in her background is an abusive father and there are issues about what that person’s place is in her life. We need to be sensible of that issue—and the idea that we can get rid of it with two broad strokes of the pen across the paper is ridiculous.

We must work together across the parties, with expertise. Let us have the change that would, frankly, get us into the 20th century and, with civil partnerships and the recognition of same-sex relationships and marriage, move things forward into the 21st century.

We have about 35 minutes, which should be plenty of time, I hope, for three Front-Bench winding-up speeches and a moment or two for the right hon. Member for Meriden to respond.

It was Scotland’s national bard, Robert Burns, who wrote:

“While Europe’s eye is fix’d on mighty things,

The fate of Empires and the fall of Kings”—

there is more of it, and I could give Members all of it if they want, but I will not. [Hon. Members: “Go on!”] I will just get to the good bit—or the interesting bit; it is all good:

“Amid this mighty fuss just let me mention,

The Rights of Woman merit some attention.”

I am delighted to offer my wholehearted support to those looking for gender equality on marriage certificates. I commend those in the House and outside it who have campaigned on the issue for many years now, and I congratulate the right hon. Member for Meriden (Mrs Spelman) on leading the debate.

I did not feel that the hon. Member for Hampstead and Kilburn (Tulip Siddiq) was being particularly party political. There is a general acceptance in the Chamber that the situation we are debating has existed for 178 years, in which time there have been Governments of different hues. Everyone has played a part in that, and we are all now playing a part in doing something about it.

In Scotland, as has been mentioned, there is space for both parents to sign the wedding certificate. That has been the case since registrations began in 1855. In fact, the certificates also list the occupations of both parents and allow for the possibility of same-sex parents. All of that is sensible and is a reminder that Scotland, with a distinct Church and legal system in the years after the treaty of Union, also had distinctive features with regard to marriage. It was customary in earlier times, as is becoming increasingly fashionable in the 21st century across the UK, for Scots brides to retain their original surname—I hate the term “maiden name”—instead of taking their husband’s. I am not claiming that in Scotland we are always ahead of the times—most of the time we are; I simply make the point that we would do well to remember that customs and their attendant paperwork are not set in stone. The current certificates are simply a poor reflection on our Victorian forebears.

Why, then, am I, a Scottish Member, speaking today? Clearly there is nothing to stop my constituents getting married and registering that marriage in England, and many of them do. More importantly, the issue is about equality of status for men and women, and that is of course a universal issue. It is clear to all right-thinking people that the recording of paternal names but not maternal ones on marriage certificates is an anachronism that has survived far too long. At best it speaks of the patently sexist Victorian view of the man as the head of the household, and at worst it treats women as little more than property to be transferred from one household to another. Then again, if someone who states publicly that the best place for a woman is on her back can be shortlisted for BBC sports personality of the year, perhaps we have not moved on quite as much as we should like to think since Victorian times.

I confess that when I saw the debate coming up I wondered whether it really merited a full 90 minutes—simply because it is about something that should go without saying—but I was wrong and I think it does deserve the time. The issue may seem relatively minor to some people, but it says something about attitudes to women. The fact that this practice is still going on is insulting and hurtful. It is another example of women being written out of history. We are invisible. We exist, but we are not important enough to be remembered or acknowledged. Historians and genealogists support what the right hon. Member for Meriden is calling for today. They tell us that it has historically been harder to track down female bloodlines because of this anachronism.

It is bad enough that women who achieve great things on a large scale are not as well acknowledged or remembered as men who do the same—or not, as the case may be. I was delighted to read yesterday that at long last the funding has been secured to erect a statue in memory of a hero of mine, Mary Seacole, the self-taught Jamaican-born nurse of Scots Creole descent who set up the British Hotel, where she nursed thousands of wounded soldiers in the Crimean war. That has been a long time coming and it is bad enough that it took so long, but there are thousands of women—some would call them ordinary women—whose achievements have affected fewer people but who have been the lifeline for their families or their communities. Those are the women who sacrifice everything to support their husbands’ careers, and the mothers who put aside all selfish thoughts to concentrate on building a secure life for their children. We have heard many Members referring to those things today.

On behalf of ordinary, average, not brilliant, fantastic mothers everywhere, I want to say that sometimes our children love us too and might want us on their marriage certificates, along with their fathers.

That is exactly the point I was coming on to. The idea that mothers who bring up the doctors, plumbers, teachers and joiners of the future, and the community campaigners who give hope to their neighbours by refusing to stop caring about their neighbourhoods, are treated like they never existed when it comes to their children marrying is not acceptable. Women are not less important than men; they are equally important. An anachronism it might be, but it is time to sort it out, and we have agreement across the House.

As has been mentioned, in August last year the Prime Minister said:

“it’s high time the system was updated”,

and in January of this year the Immigration Minister said:

“We are continuing to develop the options that will allow mothers’ names to be recorded on marriage certificates as soon as practicable.”

We have heard some explanation today as to why it is taking so long, but I still gently ask: how difficult can it be?

We are all aware of the emotional and financial investment that people put into their wedding days. Weddings are full of symbolism, and are a public statement of commitment, but what does the symbolism of such blatant inequality say about our society? I remember my dad talking about giving me away—incessantly talking about giving me away. My disinterest in marriage was frustrating to him, but it allowed him to regularly tell people how he would be happy to give me away to whoever wanted to take me. I laughed, obviously—I had no choice—and I always knew that, for his sake, should I ever give in and get married, I would allow him to give me away. In the back of my mind, though, I always felt uncomfortable with the suggestion that I was his—or anyone’s—property.

My sister reminded me on Sunday that as early as the 1960s Church of England ministers saw the light and began to allow a mother to give her daughter’s hand in marriage if the father was not there. There are human ways, therefore, of addressing the patriarchal tendency to see the act as a man’s privilege.

Interestingly enough, my father passed away a number of years ago and it fell to my mother to remind me that my sister had allowed her to give her away. I suppose my point is that no one is anyone else’s property, but there should be equality if someone is someone else’s property and they have to be given away. I do not feel comfortable with it at all, but it is simply a tradition and one that many are happy to go along with. Not allowing the mother’s name and occupation to appear on the marriage certificates of her children is a different matter, and I cannot understand why it has to be so complicated.

I again congratulate the right hon. Member for Meriden on securing the debate and I look forward to hearing from the Minister. I hope that he will do what I believe the hon. Member for Hampstead and Kilburn suggested, and just get on with it.

It is a pleasure to serve under your chairmanship for the first time, Mr Brady.

I, too, start by congratulating the right hon. Member for Meriden (Mrs Spelman) on securing this important debate, and I take heart at her repeated emphasis of the fact that she wants to work collaboratively. I agree with her. The debate has shown that there is cross-party agreement and support, but we need to consider how to make the legislation reflect the intention. I urge the right hon. Lady to work collaboratively with my hon. Friend the Member for Neath (Christina Rees) because we have the prime opportunity of the Second Reading of her Bill coming up on 22 January.

It was interesting that the right hon. Member for Meriden elaborated on the practitioner’s view and on some of the practical problems. I appreciate that she was looking to move the debate forward from the gender point, but as that is where we are at the moment I will stick with it as the theme.

The current system of marriage registration asks for the names and occupations of the fathers of the bride and groom, but not those of the mothers and, as my hon. Friend the Member for Caerphilly (Wayne David) stated, it has been Labour policy to end that unacceptable inequality since 2002. The then Labour Government released a White Paper proposing wide-ranging reforms to marriage registration, including the adding of mothers’ names to certificates. That is still our position today, and I want to set out why it is so important that the reform is finally implemented.

Inequality in marriage certificate details is a 19th-century anachronism, as our marriage registration is still based on the 1836 marriage registry system. That is a slightly different date to the one that the right hon. Member for Meriden gave, but I take heed. It goes without saying that marriage today is very different from what it was then—whether it was 1836 or 1837. I think we can all agree that society has changed for the better: women are no longer forced to hand over their property to their husbands; divorce is no longer the exclusive preserve of men; and women are no longer forced to surrender their right to consent, or not consent, to sex with their partners. In short, the past 200 years has seen great emancipation for married women and some of the grossest gender inequalities within marriage have been eliminated.

Ultimately, the current system of marriage certification is a symbol of another unseemly aspect of the 19th-century idea of marriage. Marriage then was considered to be a transactional, and indeed a financial, relationship between the father of the bride and the father of the groom. That is why, historically, the fathers’ names appear on the certificate. That is as outdated as the dowry. Thankfully, we no longer see marriage in transactional terms, although, as the hon. Member for Glasgow North East (Anne McLaughlin) said, the language of fathers giving their daughters away is still around. Marriage in the 21st century is a choice that both partners freely make to spend their lives together, with both partners equal in the relationship, and it is important that our marriage certificates reflect what we now think marriage is about, rather than the misogynistic morality of the 19th century.

I ask the Minister to consider a specific issue that highlights some of the problems we have. Unfortunately, the current marriage certification system can encourage the use of the divisive and judgmental language of Victorian morality. On the Government’s Passport Office website, in the section explaining the details of various legal documents, there is an annotated picture of a standard marriage certificate. The box about the father states:

“These details are vital for checking you have the right certificate. No name would suggest illegitimacy.”

It is not appropriate for a Government publication to describe a family without a father as illegitimate, and I hope that the Minister will look at that.

A person’s wedding day is one of the most important days of their life, and sharing the moment with their entire family is one of the things that makes it so special. A lot of brides and grooms are surprised, and disappointed, when they find out that the marriage certificate they sign, at what can be a really special moment in a wedding, does not include their mothers’ details. I pay tribute to my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq), the hon. Member for Solihull (Julian Knight) and my hon. Friend the Member for Neath who beautifully and powerfully spoke about how the blocking of the most important person in their life—their mum—on their big day affected them. I also pay tribute to the mums, for all they have done—and to their hats. We have to work together to get rid of the inequality.

The situation is particularly hard for brides and grooms who have primarily been brought up by single mums. Their guardians and most important loved ones are arbitrarily excluded from an important moment of the wedding, and the signing of the certificate can act as a reminder of absent fathers—some Members have spoken of the kind of father people do not want to remember on their big day—and that just cannot be right.

When I was researching my speech, I came across a moving testimony that made exactly that point. A young woman who signed a petition to Parliament on the issue wrote on the petition website:

“I have just got engaged, and having been brought up by a single mum I am devastated to learn that this outdated practice is still a requirement of marriage. When I get married, I will be expected to put my absent father’s name and profession on my marriage certificate whilst my mother who brought me up will not be included.”

The current system is letting down that young woman badly. As has been said, the issue affects millions of people, as one in four children are now brought up by single parents.

Changing marriage certificates should not be a difficult reform to achieve. As the hon. Member for Banbury (Victoria Prentis) pointed out, the mother’s name, surname and occupation are already included on civil partnership certification, and on marriage certificates in Northern Ireland and Scotland. The reform to marriage certification in England and Wales is long overdue.

In August 2014 the Prime Minister promised to address the matter about the certificates:

“At the moment, they require details of the couples’ fathers, but not their mothers. This clearly doesn’t reflect modern Britain - and it’s high time the system was updated.”

I could not agree more with what the Prime Minister said then—18 months ago—but it is now more a year later, and we are still waiting. The Immigration Minister—I googled him; he is the right hon. Member for Old Bexley and Sidcup (James Brokenshire)—stated in January that the Government are

“continuing to develop the options that will allow mothers’ names to be recorded on marriage certificates as soon as practicable.”

I hope the Minister puts me in the right place on this, but it appears that no progress has been made over the course of the year, which is disappointing to say the least.

In the absence of Government action, it has fallen on Back Benchers to take the initiative. Early-day motion 446 was tabled in September this year by the hon. Member for Brighton, Pavilion (Caroline Lucas), and it expressed many of the sentiments that we have heard today. Members from all major parties have signed the motion. I pay tribute to my hon. Friend the Member for Neath, who currently has a private Member’s Bill before Parliament that would deal with the issue legislatively. Members from across the House have supported that Bill. Second Reading is scheduled for 22 January 2016, and I hope the Bill will move forward to Committee. It will certainly have the full support of Opposition Front Benchers.

As important as Back-Bench initiatives are, we all know they need Government support and backing if they are to bring about the necessary change in the law. My hon. Friend’s Bill will need proper parliamentary time to make progress, and I urge the Minister to facilitate that. He has indicated that implementing changes to marriage registration is also likely to require a new IT system, as we rely on a paper-based model. If the Government seriously back reform, the Home Office needs to show that it is willing to provide those resources, or at least to consider whether changes can be made to the paper-based system without having to implement a new IT system. Also, the Government have access to experts in legal drafting, who should support Back Benchers with any technical issues that need to be cleared up.

If the Government do not offer serious support, it will be just another issue on which they are willing to talk about supporting equality, but are not willing to take the necessary action to bring it about. Unfortunately, thus far all we have seen is delay and warm words from the Home Office. All the people who feel excluded by the current marriage registration process deserve better than that, and I hope the Minister will give them reassurance.

It is an honour to serve under your chairmanship, Mr Brady. I may be competing with the Division bell shortly, but I leave such matters to your judgment. I congratulate my right hon. Friend the Member for Meriden (Mrs Spelman) on securing this debate, but I will get to the point. Many Members have raised good points, and everyone is right: the Prime Minister made a commitment in his speech to the Relationships Alliance summit. It is obvious to anyone that it is high time that the system was reformed, and reformed quickly. I do not think there is any dispute about that. The system was established the year that Queen Victoria came to power. It was also the year that Rowland Hill decided that we might be able to fold up paper and put letters inside and post them. It is now 2015 and it is absurd that the system has not changed.

The hon. Member for Darlington (Jenny Chapman) made a point about there being no private Members’ Bills, apart from Government ones, that had become law in her time. Respectfully, there are good exceptions to that. One of the main ones came from my hon. Friend the Member for Warwick and Leamington (Chris White), who is in his place behind me. His Public Services (Social Value) Act 2012 was enacted in the last Parliament. Putting that to one side, there is a good precedent in this field with the Marriage Act 1994, which started as a private Member’s Bill. It allowed homes and hotels to be used for marriages.

I am delighted to hear what the Minister is saying. It is news to me. Does he mean that we can assume that the Government will give a fair wind to any of the private Members’ Bills before the House on this topic? Will they give them Committee time and not use any of the techniques well known to the Minister to prevent the Bills from becoming Acts?

As the hon. Lady will know, I cannot speak for every private Member’s Bill. The 1994 Act was brought forward by Gyles Brandreth, then a very well known MP. I had better make progress.

There is no question but that the Government want to see the issue remedied. The question is whether the private Member’s Bill of the hon. Member for Neath (Christina Rees) can be, as many have suggested in this Chamber and elsewhere, the piece of legislation that is needed. I point out that many Members here seem to have children of marriageable age who are currently unmarried: I have two boys aged 24 and 21. I am pleased to say that the hon. Member for Walsall South (Valerie Vaz) is a good personal friend of mine, and I think we should discuss the matter outwith the Chamber.

Getting back to the important point, can the private Member’s Bill be adapted? I would very much like to say yes. The Bill requires the Secretary of State to consult and then to make regulations setting out the marriage register entry, including the mother’s and father’s name, but it does not reform the whole registration process. It would simply require the replacement of tens of thousands of books at a cost of £3 million. The Bill does not take account of different family circumstances, where there may not be a mother and father. Members have mentioned many particular cases relating to that. It also does not give flexibility for the future. After we have amended the law, the matter may not be again for another 100 or 200 years, so we have to get things right.

Will the Minister work with me to make the private Member’s Bill cover the things he mentions better? Can we work together to move it forward on 22 January?

I cannot pledge to work with the hon. Lady on the Bill, because I am not convinced that it is the right way to deal with the matter, although many of the points and sentiments in it are right. What we need—I assure her that this will be progressed quickly—is a vehicle that will transform the whole system of marriage registration for the digital age, so that all the points and everything that is changing in society can be taken into consideration. I assure her that that is not in any way meant to be disrespectful to what she is trying to do. I am not against any of the sentiments or saying that anything within the Bill is wrong, but we need a comprehensive solution. I assure her that this is not Government waffle. We have to deal with the matter once and for all, quickly and properly. I would like to be able to say that her Bill is the vehicle for that, but I do not believe that it could be. A combination of the hon. Lady, my right hon. Friend the Member for Meriden and some of our discussions could get to a vehicle that could deal with things quickly—I have every reason to believe that.

I would like to say that it makes sense to have a simple amendment of the current marriage register. Like so many of the things that we get involved in—I find this when speaking to constituents—we think that the matter is simple and that we know the solution, but this matter is much more complex than that. We do not want to have to change the system again and again. We want a comprehensive solution with a framework for the modern digital economy, where—we hope everything will be transformed in this way—people will get a certificate quickly with all the relevant details and where there will be no need for replacement certificate stock to be sent to thousands of different churches and other institutions.

Also, the solution should minimise the public protection risk of marriage registers being held in some 30,000 different religious buildings. Every year criminal gangs steal registers and certificate stock for all sorts of different purposes, and it is time that the system was modernised once and for all. It would cost up to £3 million simply to replace the materials. A simple solution of just filling in the empty box was suggested, but that would lead to all sorts of mistakes and inaccuracies. While the suggestion is perfectly well-intentioned, I do not think it is very practical.

As the shadow Minister mentioned, we have to make the necessary IT changes with the correct resources. It is not a question of trying to save money with the new system, although once it was set up, it would probably save a lot of money and be much more efficient over the decades. Costs would be incurred. It is not just about making the system more cost-effective, although it will be over the longer term.

I want to mention some of the contributions made by various Members. The hon. Member for Rotherham (Sarah Champion) made a point that, although not specific to the debate, surprised me. She asked me to look into the subject of illegitimacy on the Passport Office website. I will do that and I will respond as quickly as I can. I was astounded to hear what she said.

There have been so many good contributions, although I disagree with what the hon. Member for Hampstead and Kilburn (Tulip Siddiq) said about the Prime Minister’s feminism, because he is very much a feminist. However, the point that she made about the deceased father on the birth certificate is valid and I will write to her on that subject when I have had a chance to look into it.

My hon. Friend the Member for Banbury (Victoria Prentis) talked about a constituent and what form the marriage certificate should take, but it is not a simple matter. At the moment, our officials at the Home Office are working with key stakeholders to ensure that the needs of all different types of families are met. It is not simply a case of making a one-off change to include the mother. The matter affects different types of families, and the change needs to be done properly.

I smiled when the hon. Member for Glasgow North East (Anne McLaughlin) mentioned Seacole, the Scottish lady, and explained her background. A big chunk of the Home Office is named after Mary Seacole. I do not know whether the hon. Lady has visited, but she is welcome to come and look at the plaque. Of course, she is right. We are not talking about the contributions of women to society, because that is taken as read and is obvious. The concept of property in Victorian times would be laughable if it were not so serious, because it blighted women’s development for centuries. If we explain that to our kids, they simply cannot understand such concepts. I have shown children and visitors from my constituency the pictures in the Committee rooms of men—all men—in Parliament, but they cannot imagine such a situation. I can only say that what the hon. Lady said is absolutely right.

The serious point to make is that the Government are not simply playing with the issue in order to kick it into the long grass and say, “Well, it is one of those things.” It is very serious. It is absolutely absurd that the law has not been changed before. It is absurd, whether under a Conservative, coalition or Labour Government, that it has taken from the 1830s to today to even look at the matter. I know that people like the tradition of the marriage certificate. I have one, as have many people in this room, but we should keep the best bits of tradition and amend accordingly.

I ask for the brief patience of hon. Members. The issues are sometimes personal to us and our constituents, as highlighted in the debate, but I ask for brief patience because the Government are determined to get this right.

I believe we have an imminent vote, so I will be quick. The hon. Member for Glasgow North East (Anne McLaughlin) asked a poignant question: did the debate merit 90 minutes? Given that we are right up against the clock, I think the answer is a resounding yes. At the very least, most women and girls have absolutely no idea that they are discriminated against until it is too late. It is a handful who write to us, plus we have the poignant cases that we as Members of Parliament come across and the very telling personal stories of colleagues present for whom the moment has gone. Our mothers have not been able to put their names on our marriage certificates. That grieves us, but in their memory and for ever we want to change that. That is the message that comes out of this debate.

The only difference between the approach that I propose and the approach in the Bill produced by the hon. Member for Neath (Christina Rees)—I do not underestimate the amount of work that goes into producing a private Member’s Bill, having tried to do so myself three times—is that she is focused on the narrow point about putting the mother on the certificate. Sometimes that is the right approach to change legislation, because it has more chance of succeeding, but my approach has the practitioners’ thoughts standing behind it: are there other things we could do at the same time to ensure that in perpetuity we have a change that does not discriminate against anybody in society in terms of their rightful place on a marriage certificate in the future?

As the Second Church Estates Commissioner, it behoves me to point out that whatever change we make to the law must work for people of all faiths and none in our society. That is incredibly important. It has to be properly thought through. That is why I maintain we should try very hard to make sure we keep this cross-party approach and, in that spirit, I am more than happy to continue working with the hon. Member for Neath and her colleagues on this issue. Together we can put right such inequality, but we are impatient. The Minister begs a little patience of us; very little is what we are prepared to give him. The change needs to be made as soon as possible in the memory of all those we hold dear and those who in future will join our families. This matter needs to be put right. I thank all hon. Members for their contributions to this debate.

Question put and agreed to.


That this House has considered marriage registration certificates.

Sitting suspended.

Electronic Communications Code

[Philip Davies in the Chair]

I beg to move,

That this House has considered mobile phone coverage and the Electronic Communications Code.

It is a pleasure to serve under your chairmanship this afternoon, Mr Davies.

Before I start on the main content of my speech, I shall quote some of my constituents; apparently, that is a part of the kinder politics we now find ourselves in—as if no one had ever quoted a constituent before. I called for this debate because of the ongoing issues with mobile phone coverage in my constituency. Andrew from Rawcliffe said:

“I live in Rawcliffe and can use my phone only from upstairs, hanging out of the bathroom window.”

Gary from Goole said:

“As an employee of the Carphone Warehouse in Goole I’m on the front of finding many customers who struggle to get a decent signal in areas where I would expect to receive a strong signal.”

Mike from the Isle of Axholme said:

“O2 coverage in Epworth has been terrible lately, with no signal for hours on end.”

Sue, also from the Isle of Axholme, said:

“I would just like reception in Fockerby and Garthorpe without a walk in the garden!”

Another of my constituents, Jim from Wrawby, pointed out that in the absence of the roll-out of superfast broadband in his area—it has been generally very good in north Lincolnshire—he has to rely on mobile wireless broadband.

Significant issues remain. At the back end of last year, I secured a debate on this subject following a survey I conducted among 6,500 of my constituents, many of whom responded. Seventy per cent of respondents reported significant issues with access to mobile phone services. That is an ongoing problem throughout east Yorkshire and north Lincolnshire.

I do not want to be wholly negative, because some positive things have happened. We have seen big improvements in mobile phone coverage in parts of my constituency, but there is no doubt that there is a lot more to be done. I have met the providers on numerous occasions and they have all promised me that they are going to make improvements, but progress seems to be very slow indeed.

Consistent mobile phone coverage is essential in the modern world. For small businesses to succeed and for families and friends to stay connected, they must be able to rely on the mobile phone coverage to which they subscribe. The issue is very much one of people getting what they are paying for.

I am grateful to the hon. Gentleman for securing this debate, and I agree entirely on that last point. It appears that individual companies do not give sufficient information about what people will receive in their area. For example, people in Wrexham are not given specific enough information about the quality of service they will receive.

The hon. Gentleman is absolutely right, although in fairness the mobile coverage checker that has recently been introduced should help people to zone in on where they are and check their coverage. Nevertheless, a lot of constituents in my patch tell me that according to the coverage maps their coverage should be good, but they are literally having to hang out of the bathroom window with a finger in one ear trying to get a signal. That is not acceptable.

The issue is not only about the signal at home. People travel and move around, as we would all expect them to. My constituents are sick and tired of losing their signal. Instead of going to the party conference—in my view, no one should ever attend a party conference—I went to Canada. Over the November recess, I drove from Regina in Saskatchewan to Calvary in Alberta, crossing the badlands of southern Alberta, and there is nothing in between. I lost my 4G signal for all of five or 10 minutes of a six and a half to seven-hour journey. I cannot get on to the M18-M62 interchange in Goole without losing my signal, or use the east coast main line every week without the signal dropping in and out. It is unbelievable that in a country as vast as Canada I was able to get 4G access the whole length of that journey; I have little chance of that at home.

I thank my hon. Friend for securing this debate. It is great to hear about his trip to Canada, but in my constituency of Brecon and Radnorshire we unfortunately do not have those vast expanses between places—we have vast mountains instead. That means we have terrible problems with our mobile phone signals. I have a couple of ideas that I would like to put to the Minister in my next intervention, if I may.

I think that was an intervention to ask permission for another intervention, which I am sure the Minister will be happy to accept. In our area we have the opposite: most of my constituency is a fair few feet below sea level. We are as flat as a pancake—a bit lumpy in some places, but generally quite flat—yet the signal is ridiculous. The Isle of Axholme is a prime example. It is largely as flat as a pancake, but the signal in places such as Fockerby and Epworth is absolutely terrible.

In the year or so since I last secured a debate on this subject, there has been some progress, which I want to acknowledge. The £5 billion investment deal that the Government signed with the mobile operators has made some improvements. It will guarantee voice and text coverage from each operator across 90% of the geographic area of the UK by 2017, although we still need more action on notspots, of which there are two in my constituency. Full coverage from all four mobile operators should increase from about 69% to 85% by 2017.

There have, therefore, been some improvements, but although 99% of premises can receive a 2G signal, Ofcom has found that the proportion of the entire UK landmass that is able to receive a signal from all four operators has remained at 55% since last year. Nevertheless, I welcome the Government’s announcement in the comprehensive spending review of £550 million to make the 700 MHz spectrum available over the next five years.

The most recent update on coverage was in Ofcom’s “Connected Nations 2015” report, which found that almost 46% of the country now has 4G coverage from all major operators. It would be unfair of me to say that some of the improvements have not affected my constituency, because they have, but we still have significant issues with progress on this matter. I welcome some of the other moves. Voice over wi-fi is a really important way of helping people at home, although in many parts of the country the roll-out of superfast broadband has been disappointing. I exempt from that the north Lincolnshire part of my constituency, where the roll-out has been incredible, but the roll-out in the East Riding of Yorkshire part can best be described as hopeless—I think my hon. Friend the Member for Beverley and Holderness (Graham Stuart) will agree. It is all right having voice over wi-fi, but people often do not have access to that at home.

In many respects, would it not almost be better in some areas to have no coverage or complete coverage, rather than good coverage in one area and bad coverage in another? It is creating a social and economic divide that seems to be getting wider rather than narrower. The Prime Minister’s welcome comments about universal broadband really ought to have been about universal minimum standards throughout the whole of the UK and for mobile phones as well.

My hon. Friend makes a valid and important point. I completely agree: the arguments that apply to access to superfast broadband also apply to mobile phone coverage. The two are now indistinguishable. People do the same things on their mobile networks as they do over broadband. They use both for the same thing, whether that is work or keeping in contact with friends and family. Of course, many people now do not have a landline; they simply rely on their mobile.

With your permission, Mr Davies, I want to leave a couple of minutes for my hon. Friend the Member for Beverley and Holderness to comment. I have some questions about the electronic communications code, on which the Government consulted earlier in the year. The networks have expressed concerns that the code has not been meaningfully updated since it was introduced in 1984, and the Law Commission called it “complex and confusing”. According to the mobile providers, reforming the code is the single most important step that the Government can take to reduce the costs of network extension and improve mobile coverage. Before this debate, the operators told me that they can build a new site and put in new kit in about three months, but, because of the complexities of the code, it takes a year to 18 months to complete that work.

I hope that there will be a response to the consultation, but I have a couple of questions for the Minister now. On fair site payments, we need to end the practice of landowners being able to demand ransom rents because the lack of alternative sites locally means a lack of competition. That is a particular problem for rural roll-out.

I suspect that the situation changes from site to site. The problem with many of the rural masts is getting access at particular times of the year, perhaps because the harvest is on. With landowners in rural areas, it can be more complicated and difficult to get access. The average punter expects an outage in the network to be fixed within four hours. At the moment, it takes about 48 hours, and sometimes a lot longer, for the companies to negotiate access.

We want the fair site payment, and we want the sharing and upgrading of sites to be reflected in the new code. Under the current code, mobile operators have to renegotiate rental terms when they wish to make a change, such as to deploy new technology or reduce the number of masts. That is patently ridiculous.

We need quicker access to sites. It is nonsense that it takes 48 hours to gain access. There is a problem with the EE signal in Burton-upon-Stather at the moment, and the landowner has held up access for weeks. It is partly due to the harvest, so there may be legitimate reasons, but it is clearly not good enough that the companies are unable to access the sites when there is an outage. In fairness to the operators, it means that they cannot deliver the service they wish to deliver.

We want better dispute resolution in the new code. There is a disconnect between the main networks and the independent mast operators on the issue of whether they should be covered by the code. I do not plan to get involved in that dispute; it is one for the Minister. [Interruption.] He is nodding away—I can see that he already has the solution.

This is an important issue for my constituents. There have been improvements, but we want the roll-out and the improvements that the networks have promised to happen much more quickly. With your permission, Mr Davies, I will hand over to my colleague.

It is a pleasure to serve under your chairmanship, Mr Davies, and to follow my doughty colleague, my hon. Friend the Member for Brigg and Goole (Andrew Percy), who secured this important debate. He has been relentless, as he often is—not just conversationally, but in championing issues on behalf of his constituents. What may be a fault in one area of life is very much a benefit in another. It is fantastic that he has taken up this issue with such energy.

Over the summer recess, I wrote to the chief executives of all the major mobile operators to press them on what they are doing to ensure that mobile coverage for my constituents improves. The Government’s agreement on the provision of 90% coverage is fantastic, but the feeling is always that if the percentage is less than 100% it is my constituents and those in rural areas who will miss out. In subsequent replies and meetings, I was pleased to hear about the significant progress and the investment that is going in to meet the 2017 target. We want it to go ahead as quickly as possible, as my hon. Friend said, so that people who are trying to live their normal life, call their girlfriend, do a business deal, run a small business or fulfil the normal obligations of life are able to do so as easily in rural areas as elsewhere in the country. At the moment, they cannot, which is what this debate is all about; it has got a very human dimension to it.

My hon. Friend made the key points, but what can be done to ensure we get this done as quickly and cheaply as possible? Every imposition on those companies will feed through into our constituents’ bills. We want to deliver a fantastic and effective mobile phone system as cheaply as possible and without imposing unnecessary burdens and regulations on those businesses, which is why the electronic communications code needs to be reformed. The Minister, who was nodding earlier—not because he was being put to sleep by my hon. Friend, but because he agreed with him—must make sure that happens.

I represent a rural constituency, so many of my constituents own land. Like my hon. Friend the Member for York Outer (Julian Sturdy), some are farmers who want to ensure that they get a fair return for any disruptions. There are reasons why the Government might create frameworks that impinge on the exploitation of land by its owners for the maximum return—such is the importance of this utility to our constituents. There are also regulatory issues that are driven not by the landowners but by the rules.

Will the Minister comment on raising the permitted development height for mobile phone masts? Having taller masts is a cost-effective way for operators to increase their coverage without installing and maintaining new masts. There might be a visual impact, and my constituents would be sensitive to that. Vodafone told me that, because of our planning restrictions, its 3G masts in the UK are about 10 metres shorter than its masts in the rest of the EU. It is asking for the permitted development height to be increased from 15 metres to 25 metres so it does not have to go through expensive and protracted planning procedures to get what it needs. Increasing the mast height would have the big effect of increasing the coverage area of each mast by 90%, so although the masts would be taller we would have fewer of them. There is a balance to be struck, and I would be interested to hear the Minister’s thoughts about how best to strike it.

Although I fully agree with my hon. Friend about the size of masts, big is not always beautiful—that is the philosophy of my life, and the Minister’s, too, I am sure. Small cell boxes can be used in small, rural areas. I would like the Minister to pay attention to the fact that, whether someone is installing a large mast or a small cell box, they still face the same planning restrictions. Perhaps that could be looked at.

My hon. Friend is absolutely right. Under the code, mobile operators have to pay about £8,366 per year to rent a site, whereas a pylon costs £283. As well as dramatically high rents, additional payments are levied by landowners in return for access to make repairs, whether or not it impinges on them. Disputes over those charges leave some consumers experiencing network outages for an overly long time. I will not labour that point, but I am interested to hear from the Minister how to strike that balance.

As my hon. Friend the Member for Brigg and Goole said, mobile telephony is a basic utility. We have had frameworks in the past to ensure we keep the cost of delivering that basic utility as low as possible to encourage operators to deliver the service as widely and effectively as possible. That is true for other utilities, and it should be true for mobile telephony. I look forward to hearing from the Minister, who will doubtless give a brilliant response to all those points.

It is an absolute pleasure to serve under your chairmanship, Mr Davies. I hope that I live up to the billing given to me by my hon. Friend the Member for Beverley and Holderness (Graham Stuart). I thank my hon. Friend the Member for Brigg and Goole (Andrew Percy) for securing this important debate, and I welcome the contributions of my many hon. Friends on this important issue. His speech came through loud and clear. It was not dropped at any stage, it was not interrupted and the message reached me without any form of interference, electronic or otherwise.

Earlier this morning, I was reflecting with a colleague about the fact that I seem to spend my life bumping into people who tell me about their holiday experience. They appear to get 1,000 gigabits per second on their mobile phone or computer, wherever they go on holiday. My hon. Friend did not disappoint with his Canadian experience. Far be it for me to compare Canada with the UK, but we are comparing a road trip across a vast expanse of land in a country the size of America that has a population of 30 million—it is one of the least densely populated countries in the world—where land costs are low and planning is easy, with an extremely busy motorway junction in the north of England in one of the most successful economies in the world. I would say that one is perhaps comparing apples with oranges. I also sympathise with my hon. Friend’s experience on a train, but I remind him that a train is a Faraday cage and that it is difficult to get a signal. We are working with the train operating companies—which is not unlike herding cats—to get a solution for mobile on trains, because it is an important part of the mix.

I say to my hon. Friend—and, indeed, to all my hon. Friends who appear regularly in broadband debates—that I have been working on the issue for quite a long time, and I intend to work on it for many more years to come, to deliver for them the kind of connectivity that they would expect. In return, I hope that when they rise to their feet in future debates, they acknowledge some of the progress that we have made. In Brigg and Goole, for example, some 25,500 premises that would not have been able to have a broadband connection can now connect to superfast broadband should they so wish, thanks to this Government’s highly successful broadband roll-out scheme.

We had three masts in South Suffolk under the mobile infrastructure project and the experience was mixed. I am not directly blaming the Minister, and the problem was with local communities in many respects. I am interested in what will be done to encourage investment, given that the publicly subsidised project had mixed results. Does my hon. Friend see changes to the electronic communications code as one way of bringing more investment into rural areas through the private sector?

I will take that as a positive point, because it helps me to make some of the arguments that I want to make. I remind hon. Members that mobile operators are private companies making private investment. Indeed, they contributed some £2 billion to the Treasury’s coffers in the last 4G auction, and we now have the fastest roll-out and take-up of 4G in the world. They are to be applauded for their achievements. It is also true, however, that the Government can help.

A recent report by the International Telecommunication Union saw the UK rise from 10th place in 2010 to fourth place in 2015 in terms of connectivity, much of which was driven by mobile coverage. I should also point out that one thing we never take into account when considering mobile coverage is how cheap mobile contracts are in this country compared with many other places. We also do not take into account that the modern smartphone is actually not that great at receiving telephone calls, due to its short antenna, which contributes to the difficulties that people have with calls.

The key thing that the Government can do is to work with mobile operators to increase coverage. We are here celebrating the first anniversary of a landmark agreement on mobile operators’ licence obligations brokered by my right hon. Friend the Member for Bromsgrove (Sajid Javid), then Culture Secretary, now Business Secretary. One operator has a licence obligation to achieve 98% indoor coverage by the end of 2017, but that is 98% of premises, which does not equate to 98% of the landmass. We therefore changed the licence conditions so that, by the end of 2017, all four operators will achieve 90% coverage of the landmass.

That will make a massive difference to coverage, particularly in constituencies with a rural expanse, where people drive between villages in a relatively rural area, such as the constituency of my hon. Friend the Member for Brigg and Goole. This is an important, landmark agreement. About 6% of the East Riding of Yorkshire and 1.2% of Lincolnshire have been affected by notspots. As a result of the agreement, we will eliminate notspots altogether. Just 0.2% of north Lincolnshire and less than 1% of the East Riding of Yorkshire will have partial notspots, which is when just one mobile operator provides coverage. Therefore, 99% of East Yorkshire and almost 100% of north Lincolnshire should have coverage from all four operators. That will make an important difference.

I think this could be positive. I agree with the Minister that massive progress has been made on notspot coverage, but will he confirm how those notspots are being recorded and reported? There is some confusion about accuracy. The Government are making progress, but can he confirm how the reporting is done?

We work with Ofcom to record what we regard as a notspot or partial notspot. We have an agreed signal strength with the operators, and we have had a robust debate about whether it should be -83 dBm or -98 dBm, but Ofcom provides the imprimatur, as it were, of what we regard as a notspot or a partial notspot.

That brings me neatly on to the mobile infrastructure project, with which we have had some difficulties. Not enough Ministers acknowledge when projects have problems and difficulties, but I freely acknowledge such difficulties because the MIP was pioneering and we can learn from some of its failures. One thing we discovered when we announced the project was how difficult it is to measure a notspot, because the efficacy of radio waves can differ depending on climatic conditions or how many people happen to be using their mobile phone at the time. It has been a huge learning experience.

The other learning experience has been working with planning authorities. I am pleased to say that we have erected some 15 masts and hope that, by the programme’s end next March, we may have got as far as 75, but I freely acknowledge that we have not got as far as we wanted. I have also been slightly astonished that organisations such as the National Trust have point blank refused to have masts on their land and planning authorities have turned down applications for masts despite local communities wanting them. Some members of local communities have even put concrete blocks in front of the generators provided for mobile masts. We have had some astonishing examples, where one part of the local community has actively tried to stop a mobile mast when the rest of the community wants it. My message to my hon. Friend the Member for Brigg and Goole is that we can work together with landowners to provide them with better coverage as long as they are prepared to support mobile masts and not see them as cash cow or simply oppose them.

My hon. Friend the Member for Beverley and Holderness talked about changing the size of masts. I have been passed a note from my officials that says:

“Details on permitted development. However, you cannot announce them.”

So we are negotiating within Whitehall. We know exactly what we want to do, but we have to have Whitehall clearance and we have to pass secondary legislation. We want to increase the height of masts, to increase the height at which cells can go and to increase the time in which operators are allowed to take emergency measures to repair masts, because my hon. Friend is quite right to point out that the size and length of masts is important. I have a huge mast on the top of the ridge literally half a mile from my home. It is unsightly and ungainly. Would I prefer it not to be there? Of course I would. Does it provide great mobile coverage around the area? Yes, it does. I think that is a compromise worth making.

Finally, my hon. Friend the Member for Brigg and Goole quite rightly focused on the important reform of the electronic communications code. It has been like wading through treacle. It is extremely complicated. It has been in place for over 30 years, regulating the relationship between mobile masts and landowners and that between mobile operators and the wholesale operators, such as Arqiva and Wireless Infrastructure Group, which provide something like a third of masts. We want to revise the code and to change it to support the roll-out of broadband while protecting the rights of landowners. We will be bringing forward proposals next year to achieve those reforms.

I say in every debate, whether it is about mobile or fixed broadband, that we are conducting an engineering project. I sometimes compare it to Crossrail. When I am jammed on the tube with my nose against a stranger’s armpit, I do wish that Crossrail would open earlier so that the tube was emptier, but because I can physically see that tunnel, I know that it will not open until 2018. However, I am looking forward to using the new Tottenham Court Road station on Thursday, on my way to say farewell to Neil MacGregor, the brilliant head of the British Museum, who is retiring. This is an engineering project, and we will complete the roll-out of phases 1 and 2 of broadband over the next two years, achieving 95% superfast broadband coverage for the entire United Kingdom, which is an astonishing achievement.

We will also see the fulfilment of our agreement with the operators for 98% indoor premises coverage and 90% geographic coverage, and we will do that by supporting them with the electronic communications code. I also want to revisit the MIP, because we have made such astonishing progress in the past 12 months that we could have a phase 2 in which we take all the learnings from our mixed initial programme and take them forward to make meaningful progress. The electronic communications code, the licence changes, a potential further MIP and taller masts should all make the difference that my hon. Friend the Member for Brigg and Goole is looking for.

Motion lapsed (Standing Order No. 10(6)).

Lead Shot Ammunition

I beg to move,

That this House has considered lead shot ammunition.

It is a pleasure to serve under your chairmanship, Mr Davies, in my first Westminster Hall debate.

An important petition is posted on the Parliament website and thousands of people from across the country have signed it, including eight in my constituency. The language is fiery and impassioned and the argument is clear: it points to an issue that concerns the House and has done for 100 years. I refer to the petition to keep all lead ammunition. About 20,000 people have signed the call to keep using lead in their guns:

“Lead ammunition has been used for hunting and shooting since the first guns were manufactured over three centuries ago. Never has there been a recorded death through lead ingestion.”

I take the matter seriously. I have constituents who hunt and shoot, as do other Members—in particular those who represent rural areas—and I recognise that sport shooting is a tradition and part of people’s way of life. Done sustainably, it can make a real contribution to the local economy and to the countryside. It is right to consider the future of the sport.

There is also another, quieter petition on the Parliament website in support of banning the use of lead ammunition in favour of non-toxic alternatives. Fewer people have signed it—about 3,000 to date—but that is the petition I commend to the Minister and to the House.

The case for using non-toxic ammunition is clear. Non-toxic alternatives to lead are effective, affordable and safer for wildlife and people. We have known the dangers of lead poisoning for thousands of years. The phrase “crazy as a painter” was coined centuries ago to express the awful effects that lead-packed paint had on people’s minds.

I have already given you my apologies, Mr Davies, but I might have to leave early. Does my hon. Friend agree that given that the known negative health effects of lead are well established and that, to minimise risk, lead has been removed from paint and petrol, it seems a tad ironic that lead remains in the shot used for killing birds that might be for human consumption?

I wholeheartedly agree. I hope to set out in the course of my contribution why that is such an important point.

Some people have even explained the fall of the Roman empire as having been caused by the Romans’ use of lead in pipes and cosmetics. More recently, the World Health Organisation, the Food Standards Agency and the Oxford Lead Symposium have all highlighted the toxicity of lead. Its negative human health impacts are scientifically established, even at the lowest levels of exposure, and lead poisoning is also a big problem for wildlife.

Much of the lead shot misses its target and builds up on the ground. It is then eaten by birds, which gobble up grit to grind up their food. The lead shot is dissolved in the digestive system and absorbed into the birds’ bloodstream. Scientists at the Wildfowl and Wetlands Trust have estimated that 50,000 to 100,000 wildfowl die of lead poisoning every year in the UK, along with many more game birds and birds of prey. Members might ask, “Where are all these dead birds?” but lead is known as the “invisible killer” because the poisoning is slow and distributed.

I am sure my hon. Friend was as shocked as I was to discover that the existing regulations have a poor rate of compliance. In 2013 the Department for Environment, Food and Rural Affairs commissioned a study that showed that 70% of ducks sampled had been killed with lead shot. The study was repeated in 2014 and showed that compliance had not improved, with an increased number of 77% of ducks sampled being shot illegally with lead.

I thank my hon. Friend for making that point, which illustrates how the existing arrangements are unsatisfactory and in some cases ineffective, which is why they need to be updated.

Birds die gradually from lead poisoning, but die they do. The WWT found that one in four migratory swans seen at post mortem had died of lead poisoning. Other leading conservation organisations such as the Royal Society for the Protection of Birds and the Wildlife Trusts have also highlighted lead poisoning as a major issue for UK wildlife. Yet we continue to spray about 5,000 tonnes of lead out over the countryside each year.

Why have more people signed the petition to keep lead? I could argue that it is a classic case of small interest groups rallying around to defend their privileges. I could blame the shooters for looking after their own interests to the detriment of wildlife and the general public. People are rarely vocal about long-term environmental consequences, or about widespread public benefits. By contrast, it is easy to portray the proposal to ban lead as an attack on country life, prompting a rush to oppose any change—but this is no attack on the countryside. The irony is that it is surely rural communities who would benefit most from a change in the law to phase out the use of lead ammunition.

Some people will point out that most of the lead that the public consume comes from vegetables. That is true, but people who eat game meat are far more exposed. It is not only the shooters themselves; we must also consider their families and the increasing number of people who eat game. Many game birds sold for human consumption have lead concentrations far exceeding European Union maximum levels for meat from cows, sheep, pigs and poultry. No maximum levels have been set for game.

Simply removing lead shot from the meat does not solve the problem, because particles of lead too small to be seen often break off or dissolve and are left in the meat.

I am struggling to understand why the hon. Gentleman thinks that the existing regulations are not sufficient to deal with the problem. Would he back more detailed environmental studies to work out what the real effect on the community is?

During the remainder of my contribution I hope to address the point made by the hon. Gentleman.

Simply removing lead shot, as I said, does not solve the problem, because traces of lead can be left in the meat. In the UK, as many as 12,500 children under eight eat game once a week in the shooting community alone. In children, less than one meal of wild-shot game a week could result in blood lead levels associated with a decrease in IQ.

As the hon. Gentleman said, the shooting of birds with lead shot has been going on for many centuries. Where is the public health crisis to which he alludes? It would be news to many colleagues, because we have not had people coming to our surgeries or writing to us with any experience of a problem with eating lead-shot birds, whether personally or in their families.

It is not a case of the vast majority of members of the public speaking out on an issue such as this, but the studies are out there. I have outlined some in my contribution and will outline more.

The Food Standards Agency has also highlighted the risks to pregnant women. Of course, no one has died of lead poisoning from eating game, but nor would any serious scientist dispute that lead is a poisonous metal. The Secretary of State for Environment, Food and Rural Affairs has set up a new Great British Food unit and game is increasingly being sold as a healthy, local option. What better way to improve that brand than to ensure that the meat we eat is safe and lead-free?

Progressive countryside organisations such as the Sustainable Food Trust are backing the call to phase out lead as part of a modern countryside economy. Non-toxic alternatives are better for the image of the shoot, the economy of the countryside and the health of the shooters themselves.

In advance of the debate I talked to a number of clay pigeon shooting grounds in and around my constituency, and their problem with steel shot is that it ricochets. If lead shot is banned, all those shooting grounds will be put out of business—not just in and around my constituency, but across all Members’ constituencies. Has the hon. Gentleman thought about how that could be tackled?

The hon. Gentleman makes a good point, but there are alternatives that could be looked at. We are asking for this matter to be properly looked at and investigated, with a timescale to phase out lead.

As I said, there are good alternatives to lead on the market such as tungsten, bismuth and steel, which the hon. Gentleman mentioned. Many shooters in the UK will say that alternatives to lead are not as effective and argue that wounded birds are a welfare issue. Of course, that takes absolutely no account of the welfare of thousands of birds that suffer from lead poisoning. What is more, such evidence is entirely anecdotal.

Ballistics studies and blind trials have shown that alternatives such as steel are just as effective as lead. In terms of prices, steel is now competitive with lead and although other alternatives such as tungsten are more costly, they still represent a fraction of the overall cost of shooting. Some guns will need retrofitting, which is a process that can cost £50, and a few may not be compatible with lead at all, but surely those costs are small compared with the benefits of cleaning up the industry.

In Denmark, a ban on lead shot was introduced 20 years ago and the hunting and shooting sector has not been affected. What should be done here in the UK? The time for voluntary initiatives is surely over. The use of lead shot over and near wetlands is already restricted by law. Shooting groups have repeatedly encouraged members to respect the law, yet 45% of shooters admit that they have not complied with it and, as my hon. Friend the Member for Swansea East (Carolyn Harris) mentioned, three quarters of ducks sampled in 2013 had been killed with lead shot. What is more, we know that the problem is not restricted to wetlands. Many vulnerable species feed on lead all across the countryside. Quite simply, the law as it stands is insufficient and ineffective, so the Government must take sensible steps.

The UK is party to the convention on the conservation of migratory species, which last year agreed guidelines calling for the replacement of lead with non-toxic alternatives in countries where migratory species are at risk from poisoning. Back in 2010, DEFRA set up the Lead Ammunition Group to identify risks and solutions. Its chair, John Swift, submitted the group’s work and his report to DEFRA on 3 June 2015. Its results were definitive:

“regulations restricting the use of lead shot in wetlands and for shooting wildfowl are apparently not achieving their aim and are insufficient for dealing with the wider risks.”

The science and the politics are clear and the time for reflection is over. Thirty years ago, the Royal Commission on Environmental Pollution advised the Government that they should legislate to ban any further use of lead shot where it is irretrievably dispersed in the environment.

The question of lead ammunition is not a debate that could or should be decided by petition. It is a question for the House, DEFRA and the Department of Health. Back in 1983, Willie Hamilton MP summed it up in a debate on lead in petrol:

“Whatever the technical arguments may be and however much it is said that lead can be produced in the body by other means, that is no reason for saying that we should leave everything alone and not tackle the problem. We must tackle this problem and it can be solved and eliminated”.—[Official Report, 21 January 1983; Vol. 35, c. 632.]

The same is true today. We can quibble over exact numbers and fuss about the precise costs of steel shot, but the basic message is clear.

We have banned lead from pipes, petrol and paint, but it still ends up on our plates. We have tried to protect wildlife by restricting the use of lead over wetlands, but the rules are too partial and too easily ignored. The Government have evidence from the Lead Ammunition Group and power in the Environmental Protection Act 1990, so I hope that, in the public interest, the Minister will show that the Government have the sense to act on the science and commit to phase out lead shot ammunition.

Order. For those who are new to one-hour Westminster Hall debates, it might be helpful to say that the format is that the Scottish National party spokesman and the Labour spokesman get five minutes each and the Minister gets 10 minutes at the end. I will therefore be going to the Front Benchers no later than 5.10 pm. Four Members are seeking to catch my eye, which gives them about six minutes each. I will not set a formal time limit, but I hope that people will be mindful of each other’s opportunities and will look to speak for about six minutes each.

May I draw the House’s attention to my entry in the Register of Members’ Financial Interests and also to the fact that I am probably the only Member who has been shot by a lead cartridge? It was about 35 years ago and I still carry 20 lead pellets in my left knee as testimony to that—colleagues will judge whether that has affected my physical state or indeed my mental state.

This is not a new discussion. When I was chairman of the shoot summit nearly 10 years ago we discussed it and came to the view 10:1 that the evidence was lacking—to some extent it is still lacking—that the risk of lead was either significant or unmanageable, or that the alternatives, as mentioned by the hon. Member for Merthyr Tydfil and Rhymney (Gerald Jones), posed less of a risk. That was in the context of both food consumption and environmental concerns. That fell into the hands of the Lead Ammunition Group, which was set up by DEFRA.

If toxicity is not a problem, why does the Food Standards Agency advise frequent eaters of lead-shot game to reduce their consumption for health reasons?

I am grateful for that intervention. I have not yet said, and I am not sure that I will say, that there is no toxicity issue at all. Perhaps if the hon. Gentleman will hear me and other colleagues out, he may get the answer he requires.

The Lead Ammunition Group was set up to come to a unanimous view on steps forward for the Secretary of State. However, it has failed to do that. Nearly half of its members resigned, which meant that its final report was submitted without input from those valuable sources. The report, which was based on evidence that was and remains disputed, reached conclusions outside the terms of reference set by the Secretary of State in the first place. Therefore, when coming to conclusions about what all of this means, I hope that the Minister will recognise that, for whatever reason, the Lead Ammunition Group has failed in its objectives.

Food concerns were mentioned by the hon. Member for Stockton North (Alex Cunningham). The advice given so far does not need any alteration. That is key, because if we look at it in the context of other food scares and consumption habits, there is no evidence to suggest that the danger posed by lead is any greater than that of any other food substance that we might arguably eat to excess. That is the point: we can point to any number of foodstuffs and say, “If you ate this foodstuff to excess, you might come across a health problem.” The advice given is quite contextualised, which has not been the case in the debate.

The contribution I want to make to the debate is to give a word of caution about the Lead Ammunition Group’s findings. They are not definitive; they are disputed and the evidence it relied on is hotly debated. Finally, if the problem was as great as one or two Members suggest, it would have emerged as a health scare long before now. We therefore need to treat what we are hearing with caution, assuming that it is evidence. It is nothing new.

I am listening closely to my hon. Friend. Will he address my concern that steel shot ricochets, which will cause the closure of many shooting grounds, and that tungsten, bismuth and Hevi-shot cost five to seven times as much as lead? That would be a significant part of most people’s shooting budget.

My hon. Friend makes a good point. We have to consider all these things in the round. It is no doubt very easy to find reasons to argue in favour of a general phase-out of lead, but unless we have applied the same rigorous test to the alternatives—whether it is about the cost, humaneness or toxicity—there is no reason to believe we will go from a bad place to a better one, so I take his points entirely on board.

I hope the Minister will be robust in making a careful examination of this so-called report, because it does not meet the terms of reference that his own Department set.

It is a pleasure to speak about this issue, and I thank the hon. Member for Merthyr Tydfil and Rhymney (Gerald Jones) for securing the debate. Unfortunately, I do not hold the same opinion as him; I want to make that clear at the outset. I want to raise important issues that I feel need to be put on the record.

There are potential risks of lead shot ammunition—I admit that, and the hon. Member for Carmarthen West and South Pembrokeshire (Simon Hart) referred to them—but it is always possible to manage, control and reduce them to negligible levels through the enforcement of existing regulations and careful monitoring. I have shot wildfowl and wild birds and eaten them regularly since the age of 18—that is not yesterday—and it has not done me any harm that I am aware of. The bird I like most is probably the wood pigeon, and I look forward to wood pigeon meat on any occasion.

Restrictions on the use of lead shot are already in place across the UK, and I will comment on restrictions in the four regions. Some environmental groups are campaigning for further restrictions or a total ban on lead ammunition. They argue that lead shot poses such a serious and unmanageable risk to the environment and human health that new legislation is required. Scaremongering about lead has become a useful way to attack game and sport shooting for people who are fundamentally opposed to shooting in general. With great respect to the hon. Member for Merthyr Tydfil and Rhymney, some people are simply using this issue to attack shooting, so we need rationalism in the debate.

Shooting is hugely important to the rural economy and of great benefit in terms of wildlife management and conservation. Unscientific restrictions could have serious implications for the gun trade, the rural economy and the natural environment. Without lead, many shooting activities could be substantially curtailed. The vast majority of the evidence presented to decision makers in support of further restrictions on lead ammunition has failed to pass rigorous academic scrutiny. The Countryside Alliance believes that those attempts are unjust and unfair, and highlight the way in which science can be used and manipulated to suit a political agenda. I declare an interest: I have been a member of the Countryside Alliance for a great many years.

In truth, the true impact of lead ammunition has yet to be scientifically proven, and any current findings are not as significant as some opponents claim. I accept that lead is toxic, and we should take all opportunities to continue monitoring its potential impacts on the environment and human health. If it is proven that lead ammunition poses a significant and unmanageable risk, we should consider mitigation measures, further regulations and phase-outs in that order before any ban is taken forward. At present, however, there is insufficient evidence to justify changes to the existing regulations, and any attempts to do so are in no way based upon science or evidence we have at this time.

The majority of the evidence used to justify increased restrictions or a complete ban on lead shot ammunition is outdated and heavily reliant on research undertaken in other countries. No studies have been carried out in the UK on blood lead levels and the impact of lead shot ammunition, so that is something the Department might wish to do before proposing any legislation on this issue.

In England, there are already some controls. The use of lead shot has been prohibited for all wildfowl, with further restrictions below the high-water mark of ordinary spring tides and over sites of special scientific interest. In Scotland, there are similar controls on the use of lead in wetland for shooting activity, with wetlands being based on the Ramsar definition. In Wales, there are some restrictions on the use of lead shot for wildfowl, with further restrictions below the high-water mark of ordinary spring tides and specific SSSIs. The constituency that I represent—Strangford—is renowned for its wildfowl shooting across the whole of the United Kingdom of Great Britain and Northern Ireland. In Northern Ireland, we have the same prohibition of the use of lead shot in any area of wetland for any shooting activity. For the purpose of the regulations, wetlands are based on the Ramsar definition, as in Scotland.

It is clear we already have appropriate legislation to mitigate the negative impacts of lead shot use, so why are we seeking to add more laws and red tape? We cannot ignore the value of shooting activities. Some 600,000 people in the UK shoot live quarry, clay pigeons or targets every year, and shooting is worth £2 billion to the UK economy. Conservation goes hand in hand with shooting, and those who shoot spend some 3.9 million work days on conservation—the equivalent of 16,000 full-time jobs.

The impact of a ban would be enormous for shooting, conservation, the rural economy and the natural environment. A ban on lead shot ammunition would have a seriously negative impact on the shooting industry, because most of the guns made by historic British gun makers, and many guns made abroad, are unsuitable for use with economically comparable alternatives to lead.

Denmark led the way in banning toxic materials a way back. It also banned steel shot in forest areas and tungsten in 2014 because of the carcinogenic properties of some of the binding properties used. Norway banned lead ammunition in 2005 but changed its mind after nine years and repealed the ban, because it felt a ban was wrong. We must look at what is happening elsewhere.

Lead shot is preferred as ammunition because of its excellent ballistic performance. It would be unwise to pursue a lead shot ban at this time. The evidence is not conclusive, and the scientific information is not there. There is some dispute among shooting organisations and those who are involved in this field. We need this, as shooters. Securing a humane and clean kill is surely the aim of every shooter of live quarry. I am totally against a lead shot ammunition ban.

I begin by reminding Members that I am the chairman of the all-party group on shooting and conservation, which enjoys wide membership from both sides of the House. Secondly, I draw attention to my entry on the Register of Members’ Financial Interests: I participate in shooting sports.

Shooting and conservation are highly important to the UK economy, contributing £2 billion to GDP and supporting the equivalent of 74,000 full-time jobs. Members of the shooting community spend £250 million a year on conservation. Most importantly, they actively manage 2 million hectares for conservation as a result of shooting.

Lead shot ammunition has long been used due to its superior ballistic qualities, as my hon. Friend the Member for Broxbourne (Mr Walker) said, and I am disappointed by calls to ban it. The Royal Society for the Protection of Birds and the Wildfowl and Wetlands Trust’s calls for such a ban seem to derive from the Oxford Lead Symposium’s report and the Lead Ammunition Group’s submission to DEFRA, which I understand is still being considered by the Government. I will not say too much about that group—the hon. Member for Merthyr Tydfil and Rhymney (Gerald Jones) already referred to it—but it had two arguments against lead shot ammunition: in game meat, it damages human health, and it poisons birds exposed to it in the environment. I would like to deal briefly with both arguments.

With regard to the assertion that lead shot damages human health, there has been significant scaremongering without a full review of the facts. Lead is found in all food types at a variety of levels. The threat from game meat specifically is extremely small. The European Food Safety Authority has stated that lead from game meat represents 0.1% of average total dietary lead exposure—significantly less than other groups such as beer and substitutes, which expose the average European consumer to 62% more lead than game meat. When game meat is consumed in high quantities, the threat of lead poisoning naturally increases. However, only 0.1% of the British adult population consumes game meat at higher levels than the Food Standards Agency’s guidance. The FSA’s guidance on lead is the same as for other food groups such as oily fish and tuna. Indeed, further evidence shows that removing damaged tissue from lead shot game meat can reduce its overall lead content by 95%. That is the current advice in Sweden.

The group’s second argument is that lead shot ammunition damages the environment. There are claims that between 50,000 and 100,000 birds die of lead poisoning each year, although there is no evidence of any population-level impact on species. It is accepted, however, that lead has potential environmental risks—for example, due to the way certain water birds feed, some species are susceptible to ingesting lead if it is left within their feeding area. However, there are international agreements and UK legislation to protect areas where those migratory and water birds exist. I agree with the hon. Member for Merthyr Tydfil and Rhymney that our compliance levels with that legislation are not good enough and that we should all condemn those who shoot duck with lead shot in prohibited areas.

The report used by campaigners against lead shot ammunition—the one that comes up with the 50,000 to 100,000 figure for birds—was produced by the Oxford Lead Symposium. However, it uses data from research that was carried out between 1960 and 1983, before the current restrictions on lead shot were introduced, so it is clearly not a rigorous piece of academic work.

In conclusion, I see no reason to support a ban on lead shot ammunition. There is no clear alternative, as those that do exist are either more dangerous to human and environmental health or significantly more expensive. The claims that lead shot is damaging to human and environmental health are exaggerated and based on inaccurate data, and do not take into account the restrictions that already exist on shooting with lead shot in protected areas.

Finally, the impact would be significant on the current contribution that the shooting community makes to the UK economy and conservation management, which I outlined at the beginning of my speech and which is very significant in rural areas. I hope that Members across the House realise that a move to ban lead shot would be counter-productive and would not produce the significant human or environmental health benefits that the hon. Gentleman claims.

When most people think about shooting, the picture that they have in their heads is often all too clear: they imagine old-fashioned men in old-fashioned outfits, with old-fashioned accents. However, I stand in this Chamber today as the representative of a rural community for whom shooting is not a quirk of history, or something from another century; for my constituents, it is an industry that creates real businesses, real jobs, and real investment in our landscape. It is an integral part of our community.

Today, we are here specifically to consider lead shot ammunition. I would like to make three simple observations. First, to echo the comments of previous speakers, there is limited evidence of the need for further environment regulation of lead shot. Secondly, as it relates to humans, game meat is a tiny source of our exposure to lead. Lastly, in considering regulations on this industry, we should appreciate the vital contribution that shooting makes both to our economy and our countryside.

Nobody denies that there are environmental risks associated with lead ammunition.

That is why there are already restrictions on the use of lead shot in all parts of the UK, to address international obligations and proven environmental concerns. Many of the figures that we heard earlier relate to the supposed risks to water bird species, but those data were collected before the legislation was passed in 1999. That legislation made it an offence in England to shoot lead shot over wetlands or for the purpose of hunting wildfowl. Not only that, but almost all wildfowl species are migratory, so it is very hard for the studies to know exactly where the lead collected has been picked up.

Internationally, it is worth noting that earlier this year, Norway’s Parliament overwhelmingly repealed a ban on lead shot. Meanwhile, after considering the matter, Austria has stated that it will no longer be pursuing a ban on lead ammunition. My firm belief is that we need to collect evidence on the regulatory action that we have taken before we rush into yet more legislation.

I turn to the human exposure to lead. It is clear that game meat is a tiny source of our lead consumption. Lead is no doubt a toxic element, but, as we have heard, it can be found in all types of food at a variety of levels. The comprehensive study conducted by the European Food Standards Agency concluded that lead from game represents just 0.1% of the average dietary exposure to lead. In fact, as we have heard, the average consumer is exposed to 60% more lead from their consumption of beer. It may interest colleagues to learn that products contributing more lead to our diets than game meat include potatoes, coffee, and even everyday eggs. Simply put, all studies carried out to date show that eating game meat in moderate quantities has no effect on blood lead levels.

Lastly, shooting is vital to the economic and environmental well-being of our countryside. Shooting and conservation go hand in hand. We are often told about the importance of rainforests—well, heather moorland is even rarer than rainforest and, as a result of conserving and nurturing that moorland for grouse shooting, 75% of the world’s heather moorland is found right here in the UK. On walks around my north Yorkshire constituency, I have witnessed at first hand the unique biodiversity that the moorlands hold. From seeing beautiful curlews to scampering voles, I am sure you would agree, Mr Davies, that our moorlands are not only a Yorkshire treasure, but a national treasure. No less than the Royal Society for the Protection of Birds has said that “management for grouse shooting” has

“created and shaped the moors as we know them today.”

As well as helping to preserve our nation’s landscape, shooting is also a key driver of our rural economy. As we have heard, it supports hundreds of thousands of jobs and contributes over £2 billion annually to the economy. In my area, however, it is still more relevant. Everyone knows the difficult time that farmers are going through at the moment. Prices are low, so when we talk about the economic benefits of shooting, it is important to consider who we are talking about. In my constituency, it is very often the farmers’ families who go beating at weekends to top up their incomes so that they can make ends meet during what is a very difficult time. For them right now, the shooting industry is an economic lifeline.

No one in this country is more passionate about preserving rural Britain than the people who live there. It is rural communities who, day in, day out, balance the welfare of our animals, the beauty of our landscape and the security of our food supply. It is clear to me that any changes to the use of lead shot ammunition would damage that balance.

It is a pleasure to serve under your chairmanship, Mr Davies, and to be acting as picker-up for this debate.

The hon. Member for Merthyr Tydfil and Rhymney (Gerald Jones) certainly has not just walked up to the issue; he has done a lot of research. In his speech, he made the case that we should see more non-toxic ammo and said that there are indeed traces of lead in food. He talked about the risks to pregnant women, saying that alternatives are available. In his view, time is up for lead shot and he put the ball firmly in DEFRA and the Department of Health’s court.

The hon. Gentleman also flushed out a number of interventions, which went side by side, in terms of for and against. We heard that lead is banned in petrol, so why should it not also be removed from shot? However, we also heard that more detailed environmental studies are required and about the rebound problems from using alternatives such as steel shot. The hon. Member for Carmarthen West and South Pembrokeshire (Simon Hart) talked about the danger from lead and meat being no greater than any other foodstuff eaten to excess. He said that this would have emerged as a food crisis, had there been any serious issue. The hon. Member for Strangford (Jim Shannon) talked about this being scaremongering from those opposed to shooting in general and he discussed the implications for the rural environment. If it was proved that there was a problem, he believed that there should first be mitigation and then some further regulation, and that it should then be phased out.

The hon. Gentleman also mentioned the different regulations in the nations of the UK. This issue is of course devolved, and the regulations are separate in England, Wales, Northern Ireland and Scotland. In Scotland, the Environmental Protection (Restriction on Use of Lead Shot) (Scotland) (No.2) Regulations 2004—that is quite a handful to say—prohibit the use of lead shot in wetlands. The regulations are taken very seriously and seek to meet the highest standards to protect wildlife. However, it is fair to say that the Scottish Government will consider all the evidence and the conclusions of DEFRA’s Lead Ammunition Group on that matter. What is undisputed is that, as we have heard from around the Chamber today, lead is clearly a poison and more research must be carried out to get to a definitive position on the health risks.

The hon. Member for The Cotswolds (Geoffrey Clifton-Brown) talked about the importance to the economy, and he was backed up by the hon. Member for Richmond (Yorks) (Rishi Sunak), who talked about the fact that this industry is worth £2 billion to the UK. The hon. Member for The Cotswolds said that lead shot research had been exaggerated by the Oxford Lead Symposium. It is important to reflect on the fact that, according to the Oxford University research in 2015, around 100,000 birds are killed by lead poisoning and discarded lead ammunition. According to the report, consuming game with traces of lead ammunition affects human health too. Lord Krebs, emeritus professor of zoology of the University of Oxford and a former chair of the UK Food Standards Agency, said there was an overwhelming body of evidence that lead in hunting is a risk to both humans and wildlife.

Finally, the hon. Member for Richmond (Yorks) mentioned the effect of wildfowl migrating, which would cause difficulty with research. He said that the average person consumes up to 60% more lead from drinking beer and that eating game has no more effect than any other foodstuff. We have had an interesting debate on some of the challenges facing the Minister in taking this forward. We have to ensure that we have detailed research on the effects. I hope he will work closely with DEFRA to make sure that that research satisfies those who are for and those who are against the position on lead shot.

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate my hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) on securing the debate on this important matter. It not only relates to the health of wildlife and the environment, but has ongoing ramifications for humans if it is not dealt with. I am grateful to the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Drew Hendry)—it is one of my favourite parts of my homeland and I very much enjoy spending time there—for his comprehensive summary of the debate so far.

My hon. Friend the Member for Merthyr Tydfil and Rhymney was, of course, right to mention our long-standing recognition of lead’s toxicity and to highlight the plethora of bodies that have issued warnings on this matter. I look forward to hearing the Minister’s assessment of that advice in due course. Unlike other trace metals, lead plays no physiological function in the human body. Instead, it acts as a neurotoxin. Even at low levels of exposure, the damage that lead triggers can be significant: impairment of the developing brain and nervous system, increased incidence of hypertension and stroke, and weakening of the immune system. Worryingly, some of these impacts appear to be irreversible.

We have heard some emotive points this afternoon from all parts of the House. Indeed, I was fascinated to hear my hon. Friend give the etymology of “crazy as a painter”—the origin was lost on me before now—and anecdotal explanations for the fall of the Roman empire. The risks from lead poisoning must be taken seriously and the importance of a strong evidence base in assessing them cannot be overstated. The evidence is clear that there is no safe level of exposure, which is why the World Health Organisation has been clear that all forms of lead are toxic, and food safety agencies across Europe have highlighted the risk to health of eating game shot with lead ammunition.

Under food regulations, there are limits on the amount of lead in lamb, pork, beef and other products, but they do not apply to game. Is it not time to bring it into line? Lead is without doubt one of the best-studied contaminants in the world and there is overwhelming scientific evidence demonstrating its toxicity to multiple physiological systems in humans and other vertebrate animals.

The hon. Gentleman said that there is no safe level of tolerance for lead, but we have heard this afternoon that lead is present in many foods that we all consume, and in alcohol and beer, so clearly there must be some level of tolerance or we would all be dropping down in the streets.

Just because there is a level of tolerance does not mean that it is not dangerous. Somebody may smoke over a lifetime and then suffer deterioration or a specific condition, and that can apply in this case too.

The International Agency for Research on Cancer has classified inorganic lead as being “probably carcinogenic to humans”, while no safe blood lead level in children has been identified below which negative health effects cannot be detected. In March 2013, a group of 31 eminent scientists signed a consensus statement on the health risks from lead-based ammunition in the environment. Based on “overwhelming evidence” and “convincing data”, and alongside the availability and suitability of non-lead alternatives, they recommended the eventual elimination of lead-based ammunition and its replacement with non-toxic alternatives.

Just last month, the Oxford Lead Symposium published research further confirming what we already broadly knew about lead and the risks to humans, wildlife and the natural environment. The Lead Ammunition Group, which the Government set up, submitted its draft report this summer and I would welcome confirmation from the Minister of the date this evidence was received along with a timeframe for the release of its findings and recommendations.

Can the hon. Gentleman point to any evidence of any premature deaths caused by lead poisoning? Indeed, on the contrary; I have known many people who have eaten game regularly and lived to a ripe old age.

The hon. Gentleman makes a great point: I cannot provide that particular piece of evidence, but what I am told by health organisations and others is that ingestion of lead over a period can be quite dangerous. As others have said, as a responsible society that recognises the inherent dangers, we have already taken action and regulated to cut lead from petrol, paint and water pipes, so most exposure to lead in the general population now comes from diet. However, despite the evidence and our previous moves to regulate other sources of exposure, we have not yet completely banned the use of lead by shooters. Instead, we have stopped short, although in response to the UK’s obligations under the African-Eurasian migratory waterbird agreement to phase out the use of lead shot for hunting in wetlands, it has been illegal to hunt certain wildfowl over certain wetlands since 1999. The long and short of such patchy regulation is that lead continues to find its way into the food chain and on to our dinner plates. Compliance with regulations is sporadic at best, and most consumers are simply unaware of the contamination risk to themselves and wildlife.

My hon. Friends have alluded to studies showing that 76% of game bought from supermarkets, game dealers or game shoots have lead shot fragments present. Indeed, a DEFRA-commissioned study found that 70% of ducks sampled were illegally shot with lead. If that were not enough, almost half of respondents to a British Association for Shooting and Conservation survey admitted that they did not always comply with the law. To top it off, a repeat study in 2013-14 showed that compliance had not improved, revealing that 77% of sampled ducks had been shot illegally with lead. Yet, to the best of my knowledge, there have been no primary prosecutions and only one secondary prosecution for non-compliance with the regulations. That is a law that is not working in this land, so we need a change.

The hon. Gentleman is quoting evidence, but the crucial point is that if he wishes the Government to introduce new restrictions, he must surely come up with evidence indicating that people who consume game in this country have contracted some illness or died prematurely as a result—not in another country; we are talking about UK consumption habits. Unless he can come up with that evidence, he is doing nothing more than making mischief.

I am certainly not mischief making. I support the countryside and everything else. As I said to the hon. Member for The Cotswolds (Geoffrey Clifton-Brown), I cannot point to anyone who has died as a direct result of lead consumption; the point is that various organisations are saying that lead is a danger in diet. We need debates such as this. It might be that we just say, “Okay, we need to further explore the issues,” but it appears from the organisations that I have been speaking to that we need to act now.

I encourage the Minister to outline his assessment of the compliance problem over wetlands. Given the demonstrable disregard for current restrictions, I would welcome his acknowledgment that a complete phase-out is a proportionate means to secure legal compliance. Why have the ban if we are not going to do anything about it, and if there were no danger to wildlife and, ultimately, people?

I draw attention to resolution 11.15 of the convention on the conservation of migratory species of wild animals, which was adopted last year and calls for lead ammunition to be phased out by 2017 in countries where there is significant risk of poisoning to migratory birds. Let us not forget that, on top of that, the Royal Commission on Environmental Pollution concluded a little over 30 years ago that

“the Government should legislate to ban any further use of lead shot and fishing weights in circumstances where they are irretrievably dispersed in the environment”.

We have already heard this afternoon that lead-based ammunition continues to be one of the greatest sources of lead in our environment. As much as 6,000 tonnes of shot is discharged every year and at least 2,000 tonnes of shot used for game and pest shooting is irretrievable. I would therefore be pleased to hear whether the Minister agrees with me that, in the light of the evidence on the numbers of wildfowl killed each year, there is a significant risk of poisoning to migratory birds from lead ammunition in the UK. While other nations, including Denmark and the Netherlands, are actively dealing with the matter, the UK seems content to look backwards and turn a blind eye to those who flout the current regulations.

To avoid the real risks that exist, we need positive actions to close the existing regulatory gaps, rather than passivity. It is high time that we stopped ducking the problem and took a common-sense approach to regulating lead ammunition. With softer restrictions on the use of lead ammunition having been widely flouted, the time has come to embrace the growing body of evidence and for all lead shot and bullets to be replaced with non-toxic alternatives. Like so many other hon. Members taking part in the debate—

I am on my last paragraph, Mr Davies. Like so many other hon. Members taking part in the debate, I urge the Minister to join me in supporting the call for the UK to meet our international commitments and phase out lead ammunition by 2017.

Let me begin by congratulating the hon. Member for Merthyr Tydfil and Rhymney (Gerald Jones) on securing the debate. He showed the passion that he feels on this issue in his opening remarks. As we all know, lead is a noxious substance with potentially fatal impacts. This is therefore an issue that it is right for the House to address.

I pass on the apologies of the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Penrith and The Border (Rory Stewart), who has responsibility for this issue. Hon. Members will have noticed that he has been otherwise engaged in Cumbria in the past couple of days in his role as floods Minister. I am therefore responding to the debate on his behalf.

Government practice is to obtain and use the best possible evidence when taking decisions. That is why, almost six years ago, our predecessors chose to set up the Lead Ammunition Group, commonly known as the LAG—and I think one thing we can all agree on is that there was a time lag in that group’s concluding its work. The LAG began work in 2010. Although a creation of Government, it was deliberately set up as an entirely independent group, formed of experts who would approach the evidence from their various perspectives and provide clear advice on whether and what risks might be posed by lead ammunition and how they could be managed. The potential risks that it was asked to assess related both to wildlife, which is a DEFRA responsibility, and to human health, which is the responsibility of the Food Standards Agency. I hope that hon. Members will find it helpful if I set out the subsequent history.

First, the LAG was established in 2010 for an initial 12-month period, after which progress was to be reviewed. However, its final report was not presented to Ministers until June this year. The shadow Minister, the hon. Member for Stockton North (Alex Cunningham), asked when it was presented. That was on 3 June. Secondly, by the time the LAG reported, only five of its 10 members remained in place. The remainder had resigned, with four of those submitting a different set of recommendations.

We are therefore in a position in which we have no expert consensus about the impact of lead ammunition on wildlife or on human health. Nevertheless, we must start from where we are, so it is important that we look at the report that the LAG produced and the material that it contains. Even if that report has the support of only half its members, it is nevertheless a substantial document that represents several years’ worth of work. We must therefore consider it carefully, which is exactly what the Under-Secretary and my right hon. Friend the Secretary of State have been doing since DEFRA received the report in June.

Subsequently, as a number of hon. Members pointed out, there has been the minority report from those who resigned and the report arising from the Oxford Lead Symposium, which was organised by opponents of lead ammunition. I realise that hon. Members and others outside the House are anxious to have our response to the LAG report, but it is important that we take the time to get this right and weigh up all the other comments, views and evidence that have been submitted to us. The time that it has taken to review that evidence reflects the fact that it is a serious debate and that my ministerial colleagues are looking at the issue closely.

Let me remind the House of the action that Government have already taken. Lead shot has been prohibited for wildfowling since 1999 by the Environmental Protection (Restriction on Use of Lead Shot) (England) Regulations 1999. Those regulations introduced a double restriction. First, lead shot cannot be used, on any game, in certain areas—namely, over the foreshore or over a list of named sites of special scientific interest. Secondly, lead shot cannot be used anywhere for shooting certain species—namely, ducks, geese, coot and moorhen. In passing, I will mention that the general supply of lead weights for angling was ended in 1986.

The 1999 restrictions reflected the resolution made that year through the African-Eurasian waterbird agreement, to which the UK is a party. It was agreed that members would work to phase out the use of lead ammunition over wetlands, reflecting the clear evidence that waterbirds can and do scoop up spent lead when feeding and suffer health consequences from doing so. We delivered on the resolution through our regulations of the same year.

There is of course nothing to stop those who shoot from choosing, of their own volition, to use alternative forms of ammunition. Although no other material has exactly the same combination of malleability and density as lead, a number of alternatives have been available, and used in the field, for some time. Those include steel and tungsten for shotgun cartridges and, for bullets for rifles, copper and copper alloys. Use of an alternative is compulsory for wildfowling, but the alternatives can also be used more widely. I understand that some shooters have made the switch, although others have not.

I am intervening simply on the point about lack of compliance in relation to shooting wildfowl over wetlands and the use of lead shot in the killing of ducks. Will the Minister respond on the huge level of non-compliance?

I was going to come on to that. The hon. Gentleman highlighted a DEFRA study that did show—he is correct—that the level of non-compliance was up to 70% in certain areas. I will simply say this: it is the law. As my hon. Friend the Member for The Cotswolds (Geoffrey Clifton-Brown) pointed out, we can all condemn those who are using lead shot where they should not be, against the law, and it is a matter for the police to enforce those existing regulations. Where the law is being broken, it must be enforced, and we are keen to work with stakeholders and others to ensure that we raise awareness of the 1999 regulations—the regulations that already exist. The key point made by a number of hon. Members was that the starting point should be to enforce the regulations that we have, rather than jumping to introduce new regulations.

My hon. Friend the Member for Broxbourne (Mr Walker) made a very important point about the impact on clay pigeon shooting and the danger of steel ricocheting. The hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for Richmond (Yorks) (Rishi Sunak) mentioned that some countries—notably, Norway—had introduced a ban and then reversed it. I understand that in that case, it was for the somewhat surprising reason that steel bullets were getting embedded in trees and that was affecting the machinery of timber merchants. That shows that all sorts of unintended consequences can come from these things. My hon. Friends the Members for The Cotswolds and for Richmond (Yorks) highlighted their view that some of the data used in the reports were out of date, particularly in relation to the Oxford symposium, and predated the 1999 regulations. I think that is probably a fair point, although other hon. Members have made an equally strong argument that the 1999 regulations are not being enforced as effectively as they could be at the moment; that is also very valid.

In conclusion, I agree with what my hon. Friend the Member for Carmarthen West and South Pembrokeshire (Simon Hart) said: this is a very important issue. The contributions in the debate show how complex it is and how strongly felt views are on both sides. That is why the Under-Secretary and the Secretary of State are right to take their time to weigh up all the evidence carefully before submitting their response to the LAG report.

I thank hon. Members for their contributions in this important debate. I mentioned during my speech that this is not an attack on the countryside. It is not about shooting or the rural economy; for me, it is very much a health issue. Risks have been identified by health organisations, and even small risks deserve to be considered and removed, because there is a detrimental effect on birds and, as we have heard, potentially on humans through the food chain. That needs to be considered and action taken.

Question put and agreed to.


That this House has considered lead shot ammunition.

Sitting adjourned.