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House of Commons Hansard
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Westminster Hall
12 January 2016
Volume 604

Westminster Hall

Tuesday 12 January 2016

[Nadine Dorries in the Chair]

Global Fund to Fight AIDS, TB and Malaria

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I beg to move,

That this House has considered the Global fund to fight AIDS, TB and malaria.

The debate was chosen by the Backbench Business Committee after a submission by the chairs of three all-party parliamentary groups. I have the privilege to co-chair the APPG on tuberculosis; and my hon. Friend the Member for Finchley and Golders Green (Mike Freer), who chairs the APPG on HIV and AIDS, and my hon. Friend the Member for Stafford (Jeremy Lefroy), who chairs the APPG on malaria and neglected tropical diseases, are here today because we are concerned to ensure that there is a continuing fight against three diseases that between them have accounted for, and continue to account for, millions of deaths every single year.

I would like to start by talking about the continuing need to fight these diseases, focusing particularly on tuberculosis, because that is the disease in which I have a particular interest. It continues to kill 1.5 million people every year in spite of the fact that the millennium development goal to halt and reverse the spread of the disease, as well as of HIV and malaria, by 2015, was met, with the prevalence of tuberculosis having halved.

Tuberculosis continues to kill a very large number of people every year. Indeed, the latest figures published by the World Health Organisation indicate that it is now the world’s deadliest disease, surpassing the mortality caused by HIV, although there is a significant issue of co-infection in relation to HIV/AIDS. Some 400,000 people a year die of tuberculosis related to AIDS. Despite the huge progress that has been made on AIDS—progress, however, that did not meet the millennium development goal—the disease continues to kill 1.2 million people a year, and despite the great progress on malaria, it continues to kill 600,000 people a year.

The first point to make is that despite the global effort to counter these dreadful diseases, they remain very significant killers, and continuing action will be needed if they are to be eliminated. It was a fine thing that the world came together in September to agree the new sustainable development goals to replace the millennium development goals, and that objective 3.3 of those goals is to end the three diseases by 2030—in just 15 years’ time. However, the current trajectory of tuberculosis suggests that we will not end the disease in 15 years’ time. We will end it in 200 years’ time, which means that there will continue to be a large number of deaths every year, and indeed an ongoing cost, unless we take firmer action now to beat the disease.

The second reason why it is important to tackle the diseases in question, quite apart from the humanitarian cost, the loss of life and the suffering caused, is that their prevalence has an impact on economic growth. If we want to see the economic development of countries—the continuing development of middle-income countries and the acceleration of development in lower-income countries—it is essential to ensure that there is a healthy population, and it is a condition of economic growth that the population can work and has access to healthcare. These diseases place a burden on the population that impedes economic growth. The circle that needs to be squared is how we support countries in the development of their health systems to produce a healthy population that, in turn, helps to generate economic growth.

The third reason why it is important to tackle these diseases is on the grounds of what one might describe as broader security. For instance, we see the growing risk of drug resistance in the case of tuberculosis, which is a transmissible disease that is easily carried and spread—a disease that knows no borders. The growing risk of drug resistance is linked to the old-fashioned regimes used to treat tuberculosis and to the fact that there has not been a sufficient focus on drug development since the disease resurged. That poses a risk not just to the countries involved but to countries around the world.

The UK Government have taken particular interest in drug resistance. The Prime Minister has led a focus on it through the antimicrobial resistance review, which is chaired by Lord O’Neill. The threat of drug resistance poses a huge risk to the global economy, amounting to billions of pounds of potential cost. By 2050, about a quarter of that cost might be incurred due to drug-resistant tuberculosis if we do not take action.

On all three grounds—humanitarian, economic growth and security—there is an argument for continuing action to tackle these terrible diseases. The question, then, is what the right mechanism to do so is. More than a decade ago, the world came together in the belief that it was important to set up a new means of fighting them. What was then described as a “massive effort” was launched under the auspices of the United Nations, and it became the Global Fund to Fight AIDS, Tuberculosis and Malaria.

In the 10 years that followed the launch of the Global Fund in 2002, the world’s economies have committed more than $22 billion to the fund. In turn, it has developed 1,000 programmes in more than 150 countries to tackle these diseases. The Global Fund now estimates that since its inception, it has saved 17 million lives and is on course to have saved some 22 million lives by the end of the year. That is more than 2 million lives saved annually as a consequence of the effort that was put in place in 2002 under the Global Fund. It has put more than 8 million people on antiretroviral treatment for HIV and treated more than 13 million people for tuberculosis and more than half a billion people for malaria—a quite staggering effort. As a consequence, it has contributed to a decline of a third in the deaths from these three diseases in the countries where it operates.

The importance of the fund to beating these diseases is illustrated particularly in the case of tuberculosis. The Global Fund provides three quarters of the funds that are committed to beating TB globally. In the absence of the Global Fund and its continuing ability to raise resources to beat TB, how would we continue to ensure that resources were deployed to beat this terrible disease, particularly given the ambition in the sustainable development goals to eliminate it in just 15 years?

The first reason why the Global Fund is the right mechanism to continue to tackle the diseases is that it is an established organisation that has experience in marshalling the resources that are needed. The second is that it encapsulates the important principle of partnership between donor countries—western countries with sufficient resources to contribute to the fight against these diseases—the Governments of the countries affected and civil society and the private sector.

The principle upon which the Global Fund was established is that it does not implement programmes to beat these diseases itself. It provides funding for those programmes and presides over them, but the ownership of the programmes is vested in the countries affected. The fund helps to mobilise and unlock domestic resources in the high-burden countries themselves. The principle of partnership between donor countries and the affected countries, and partnership among those who have a role to play in beating these diseases, is incredibly important and underpins the whole of the Global Fund’s work.

The third reason why the Global Fund is the right mechanism to continue this work is its accountability. It is clearly immensely important to the public’s view of international development money that it is spent properly, with accountability and transparency so that we know that resources are deployed properly. It has been a key principle of the Global Fund since its inception that there should be proper accountability in what was described at the beginning as a programme of “tough love” to ensure that the affected countries themselves are contributing to beating these diseases.

Fraud has surfaced over the life of the Global Fund, and I think it is true to say that the fund revealed most of those instances itself. They are part of the problem that any international aid agency has when it operates in countries where fraud can be a problem. The fund’s accountability mechanisms, which have been strengthened, are part of how we will address such issues. Some of the ongoing media criticism of the Global Fund has been misplaced. There is a misunderstanding of the fund’s success in ensuring that resources are implemented properly.

What are the issues for the Global Fund going forward? The fund is an immensely important mechanism in the fight against these diseases, but it has always been beset by external challenges. The terrible tragedy of 9/11 diverted the world’s attention from the need to maintain support for the Global Fund, and then the world financial crisis severely affected the willingness of donor countries to contribute. Some of the most important contributors to the Global Fund—relatively wealthy western countries—have faced a challenge to their own finances and have scaled back their commitment to the fund. That is a serious mistake for the west to make, despite the great challenges that every country faces because of the downturn. It remains important to continue to invest in beating these diseases, for the reasons that I have set out.

We now enter the replenishment phase that the Global Fund goes through every three years. It estimates that the combined external funding required to beat the three diseases, in line with the sustainable development goals, will be a staggering $97 billion over the next three years, 2017 to 2019. Those resources will be provided by the affected countries themselves and the countries that will be contributing to the fund. That requires the Global Fund to raise some $13 billion over the period, which is slightly less than the $15 billion that it was proposed the fund would raise in the last replenishment period, but it should be noted that the fund did not raise sufficient resources to meet that target. The fund estimates that that additional resourcing over the three-year period will save another 8 million lives, avert up to 300 million new infections and, crucially, support $41 billion of domestic investment, which represents an increased rate of growth. It will generate economic growth of some $290 billion, which underlines my point that such investment in beating these diseases ultimately does not impose a cost on the economies that are required to find the money; it actually helps to generate economic growth.

The UK has a proud record of supporting the Global Fund. In particular, the UK contributed up to £1 billion over the last three-year replenishment period, which made it the third largest contributor among donor countries. That was made possible by the Government’s commitment to meeting the international target of spending 0.7% of gross national income on international development, at a time when other countries have scaled back their spending. However, it would be helpful if the Minister responded to some points about how the Government made their commitment.

First, some conditionality was placed on the investment, so that only if other countries raised a certain amount of money would the full UK commitment be met. There is a question about whether that really produces an incentive for countries to fulfil their contribution or whether the real effect is simply to reduce the UK’s intended commitment. I hope the Government will consider that closely when they review their commitment for the next cycle. For all the reasons that I have set out, I hope the Government will now consider making a similarly significant investment in the Global Fund going forward. We are talking about substantial sums, and they should not be committed lightly. The Government need to assure themselves that the money is being spent properly, and it is encouraging that the Department for International Development’s 2011 multilateral aid review, and its 2013 update, assessed the Global Fund as providing very good value for money. Other studies have underlined the effectiveness of how the Global Fund spends its resources.

If the world community’s support for the Global Fund were scaled back, it would raise serious questions about whether we mean what we say when we sign up to international agreements to beat diseases such as HIV/AIDS and malaria. There is no point in the world coming together and setting an ambitious target to eliminate such diseases in 15 years if those targets are not only not met but not met by a country mile. That would undermine the whole process of international agreement that brings countries together to say, “We will work together to tackle these diseases.” It would place the sustainable development goals in a different position from the millennium development goals, which, at least in part, were met in relation to the diseases in question. There would be an ongoing humanitarian cost, as lives would be lost. There would be a continuing risk of the development of drug resistance, which would not be addressed properly. In relation to diseases such as TB, it would raise the question, “If the Global Fund, the principal agent by which this disease will be tackled, does not have the resources to do so, where are those resources going to come from?”

The UK Government are doing a great deal to fight these diseases in addition to their Global Fund commitment, and I was delighted by the Chancellor’s announcement in the autumn statement of the Ross fund, which, in partnership with the Bill & Melinda Gates Foundation, will ensure that £1 billion is invested over a three-year period in a new fund to develop the new drugs and vaccines that will be needed to address the world’s deadliest diseases, including malaria and tuberculosis. That is exactly the kind of focus that we need on new tools to beat those diseases. Only if such new tools are developed will the diseases be tackled properly, particularly tuberculosis, so that is immensely welcome.

However, I want the Government to appreciate that unless they and their fellow major donors continue to contribute to the fund, the progress that we have made in beating diseases such as tuberculosis, which has already been too slow, will fall further behind target. That would be a serious matter, which is why this debate is so important, coming at the point when the new round of replenishment is being considered. It is why voices are needed to discuss the value of Britain’s international aid contribution and the importance of investing in the global fund. Of course there are issues to discuss about the fund’s effectiveness and operation, and other Members might discuss them, but the overall picture is that it has made a vital contribution to saving millions of lives. If we want to continue to do so and to beat these diseases once and for all, it is essential that Britain maintains its contribution to the Global Fund.

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Order. If I put a four-minute time limit on speeches and there are no interventions, we will still not have enough time to get everyone in. I will start the list of speakers and go in the order in which Members submitted their request to speak. If those speaking keep their contributions short, we will be able to get everybody in. I will set a time limit of three and a half minutes, and if everyone is brief and no one intervenes, we might make it. Without wasting any time, I call Pauline Latham.

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It is a pleasure to serve under your chairmanship, Ms Dorries, for the first time not just during this Parliament but since I have been here. I congratulate my right hon. Friend the Member for Arundel and South Downs (Nick Herbert) and colleagues on securing the debate, because the issue is incredibly important at this time. He talked about the generalities of the funding, but I will focus on a specific case, because although the Global Fund is fantastic, its eyes and ears cannot be on every single problem in the world.

I recently returned from northern Uganda, where I visited Gulu and Pajule in Pader, which are experiencing a huge problem with a malaria epidemic. Even the in-country director of the Malaria Consortium, the organisation I travelled with, was shocked at the level and scale of it. Women and children are dying in huge numbers, including babies aborted and stillborn during pregnancy after their mothers contracted malaria. Hospitals there are completely overwhelmed. The best hospital that I visited—the Lacor hospital, a private, non-profit Ugandan hospital whose mission is to guarantee affordable medical services, particularly to the most needy—was admitting up to 500 children into a 100-bed area, meaning that children were sleeping three or four to a bed and under the bed. Their parents were there as well. It is causing huge problems.

That is a really good hospital: it has bedsheets, which are pretty rare in many hospitals there. I saw one child of about three who was fitting badly due to cerebral malaria. I suspect that that child is no longer alive. The mother and other mothers were all attending around the bed, plus the doctors and nurses. That institution is doing the best that it can in incredibly difficult circumstances. Another hospital I visited, a state hospital, had no bed nets or sheets, and the mattresses were so decrepit that no one over here would put a dog on one, never mind lie on it themselves. Most facilities that I saw had no water. How can anybody recover when basic hygiene is not available to the doctors and nurses?

There are also huge pressures on hospitals when families go there too, because they must feed the families as well as feeding and looking after the patients. There is no patient confidentiality, because the patients’ families are there, and when patients are three to a bed, other families listen in as well, but the doctors and nurses say that they desperately need the families to come, because they do not have sufficient staff. It seems to me that the system in Uganda is failing to provide adequate healthcare.

Wherever we went and whatever health facility we visited, the statistics were the same, because spraying had stopped. Residual indoor spraying stops the epidemic, which has now gone through the roof. In one place, the number of cases had decreased to 33 a month by last April, but by May, it had rocketed to 1,500. No health facility, however well prepared, could cope with such a jump. Stock-outs of drugs are not unusual. The director-general of health told us that there was no problem, but she was discussing statistics that were a year out of date.

Hospitals treat 100% of patients with fever in malaria-type facilities, despite the fact that probably only 85% of them actually have malaria, which is not helping the issue of drug resistance. The problem is that drugs are funded, but diagnostic tests are not.

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Order. I am sorry, but I must call the next speaker.

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I am pleased to follow the speeches that we just heard, which set out clearly the need for action to ensure the delivery of sustainable development goal target 3.3 to end AIDS, tuberculosis and malaria. We need the political will to do so, and we are already beginning to see it in this Chamber.

The fund does not implement programmes but raises and invests $4 billion a year to support programmes run by local experts in communities most in need. Countries therefore take the lead in deciding where and how best to fight disease, as well as how to work with international partners. That enhances countries’ ownership and, as the right hon. Member for Arundel and South Downs (Nick Herbert) ably sketched, it increases domestic resource mobilisation through counterpart financing, which is important. I saw for myself on a visit to Cambodia with Results UK how our leadership, through the Global Fund, empowers directors in the countries by allowing them to sort things out themselves. It is a powerful model.

Using a country’s health and wealth to determine funding is indicative of the Global Fund’s model. It sees health as key to improving economies, and as a country’s wealth increases, its reliance on international support should decrease. With that in mind, the UK Government should press the Global Fund board, of which the UK is a member, to introduce a transition strategy to ensure that, when recipient countries move away from the Global Fund, they are still supported sustainably. For example, statistics show that 94% of gene expert diagnostics for TB and two thirds of second-line TB drugs within the World Health Organisation Europe region are provided through the Global Fund. It is imperative that those recipients continue to receive Global Fund support so that people who fall ill have access to diagnosis and treatment.

In short, the Global Fund should remain global, and support should be provided to middle-income countries to transition sustainably. Successive UK Governments have supported the Global Fund, and we can all be extremely proud of that, but the UK kept its contribution during the last replenishment in 2013, hoping that others would respond to the challenge of meeting the target. We have heard from the right hon. Member for Arundel and South Downs that that does not appear to have worked as a strategy, so I hope the UK Government will revisit and reconsider it.

The rationale given for the cap was that it would incentivise others to donate. Ahead of the replenishment, have the Government conducted any assessment of whether it has done so? It has been suggested that the cap has served only to limit our own contribution. The UK Government should commit to that important global initiative, on which so many people’s lives rely. That is clear and unambiguous. The Government should take steps other than a cap to ensure contributions by other donors. The UK should maintain its leadership role, continue to show strong support for the Global Fund and push for the $13 billion ask to be met by making its own substantial contribution, leveraging other donors to invest and expanding the donor base. By doing so, the Minister and his colleagues will show the word leadership that we have shown in the past and match it, which is something of which we can all be proud.

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Thank you, Ms Dorries, for chairing the debate. It is the first time, I think, that I have served under you. I congratulate my right hon. Friend the Member for Arundel and South Downs (Nick Herbert) on securing this incredibly important debate. Before I go any further, I must declare an interest. Last summer I went with Results UK down to Zambia, where we saw for ourselves some of the issues related to HIV and to TB, both of which are important. TB has a tendency to break down the immune system, which makes people much more susceptible to HIV. I am also the chairman of the all-party parliamentary group on Zambia and Malawi, and the vice-chairman of the all-party parliamentary group on Zimbabwe. After visiting Zambia, I went to Zimbabwe to see what was going on there.

To my mind, there are a number of incredibly important issues. Yes, it is vital that we continue to put investment, through the Global Fund, into sorting out some of the health issues, but we also need to concentrate more on education, so that people are in a better position to look after their own economy and sort themselves out. The issue that is about to strike in a big way, I think, is that of famine. I am interested in knowing what the Government plan to do, because we are probably looking at there being some kind of famine in southern Africa, and that matter needs attention as well.

The Global Fund is important and, as members of the all-party group, we saw for ourselves just how important it is that investment is going into hospitals and healthcare units in Zambia. The British Government have been criticised somewhat for putting money into overseas aid development, but I point out that many asylum seekers might have TB. Trying to ensure that we deal with TB at source prevents problems from coming into this country and having an impact on our national health service.

I would be grateful if the Minister could explain the Government strategy for dealing with the potential of famine in southern Africa, so that we can ensure that later this year we do not see on our television screens a mass of starving children and adults.

I am acutely aware that others want to speak, so I will now keep myself to myself.

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I appreciate being called in the debate, Ms Dorries, and I also declare an interest. I remain an ambassador for the Scottish Catholic International Aid Fund—SCIAF.

When I became an ambassador, I got the chance to visit Kenya and Tanzania—back in 2006—before the big change to cheap access to antiretrovirals. I saw people languishing and I saw women in their fifties and sixties looking after the children of their children—sometimes 10 or 11 of them. In my local work I have established a youth group, and through the charity ZamScot we are building a school in a children’s centre in Lusaka. The centre rescues young boys who have grown up on the streets as AIDS orphans and sends them to primary school. They have often been on the streets since they were toddlers, and they finally go to school at the age of 12 or 13.

Along with other hon. Members, last autumn I had the opportunity, through Results UK, to visit Ethiopia. People who might have HIV—or even AIDS—are now on antiretrovirals and are looking after their families by taking part in growing their own food. That shows the difference that the world has been able to make by taking the decision to make the drugs available. The decision has transformed sub-Saharan Africa, and it has shown what the world can do when countries get together.

The trip to Ethiopia was about polio, a disease we are close to eliminating. The last remaining area with polio is on the border of Afghanistan and Pakistan. It has taken 30 years to get to that point, but it is incredible to think that polio might disappear in the next few years. Something can be done, and we have to keep on doing it.

The two things that require consideration are, first, the 10% limit, and whether it really leveraged anything or whether diplomatic pressure and sheer embarrassment would be more powerful, and, secondly, the transition in middle-income countries. It is important that such countries get at least a three-year warning and that, in our arrangement with them, we work towards a Government institution taking over. Often, non-governmental organisations do a lot of the work, and as we see ourselves moving towards a transition with a country we need to start pushing it to have proper institutional structures. Some 75% of HIV cases are in middle-income countries, and if we pull back, we will see that change.

In 2013, the United Kingdom stepped up in an incredible way, and we must not take our foot off the gas. It was the structures that had been developed through efforts to eliminate polio that spotted Ebola in west Africa. As the hon. Member for Plymouth, Sutton and Devonport (Oliver Colvile) said, we need to protect ourselves—and not just our NHS—from multi-resistant TB coming in. There are selfish reasons for acting, but we can also develop the world economy, the African economy and the developing economy by allowing countries to have healthier populations.

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The latest figures released by UNAIDS show that nearly 16 million people now access antiretroviral therapies—ARTs—compared with fewer than 1 million just 10 years ago. In 2014, there were 2 million new HIV infections, compared with 3.4 million in 2001. That shows progress, but about 22 million people living with HIV still do not access ARTs and an incredible 19 million are simply unaware of their status.

If the aim of ending AIDS as a public health threat by 2030 is to be achieved, the bulk of the progress must be made in the next five years, to bend the curve of the epidemic towards manageable levels. The joint United Nations programme has accepted and released fast-track targets. These are that 90% of people living with HIV know their status, 90% of those people are accessing treatment and 90% of those on treatment are virally supressed. That would significantly reduce the number of onward transmissions. The challenge of achieving universal access, however, remains ahead of us.

Affordable first-line treatments are available in low-income countries in the form of generic drugs, but those drugs are denied to middle-income countries—MICs. MICs are excluded from licensing deals and are forced to buy drugs at inflated prices, making second and third-line ARTs prohibitively expensive. It is estimated that, by 2020, only 13% of those living with HIV will be found in low-income countries. We will be leaving the rest behind. If international donors, including the UK, continue to scale back bilateral overseas development aid for MICs, we will leave the bulk of people infected with HIV with reduced access to treatment, as the countries we were aiding choose not to fill the gap because the groups that are left vulnerable are either marginalised or criminalised. We are leaving those people high and dry.

Multilaterals such as the Global Fund must be allowed to provide critical bridging finance for MICs. We cannot simply pull out and leave Governments to fill the gap when we know they will not do so. As countries transition into the middle-income category, we know that we will withdraw, but we must put some form of package in place to support the transition; otherwise we will not be supporting a successful response to the HIV epidemic.

The UK has championed the inclusion of the principle of “no one left behind”, but we are leaving people behind because of our focus on middle-income countries stepping up to the plate—something they are not doing. We have the influence and the money. When we withdraw—for the perfectly legitimate reasons of trying to persuade middle income countries to bridge that gap and step up—we need to ensure that we provide support. Simply withdrawing leaves too many people vulnerable and exposed. I hope the Minister will commit to looking at providing technical support before funding is withdrawn to ensure that programmes do not collapse after withdrawal and that illegal or marginalised groups are not simply left to their own devices.

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It is a pleasure to speak in this debate, and I congratulate the right hon. Member for Arundel and South Downs (Nick Herbert) on securing it for our consideration. As the Democratic Unionist party’s parliamentary spokesperson on health, and someone who has a particular interest in the issue, I think it is always good to come along and make a contribution. The debate is about the Global Fund to Fight AIDS, Tuberculosis and Malaria, but I am ever mindful that in Northern Ireland we have rising numbers of people with HIV, so there is a problem for us at home, too.

Although much progress has been made in responding to the epidemics, the dual impact of HIV and TB continues to be devastating for millions of people and their families. I have had the opportunity to speak to people with HIV and to the HIV and TB organisations. The combination of both diseases is deadly to those who have them. Of the 1.5 million people killed by TB in 2014, 400,000 were HIV-positive. AIDS-related illnesses claimed 1.2 million lives in 2014, including the 400,000 TB deaths among HIV-positive people. Malaria causes hundreds of thousands of deaths every year, predominantly among young children. I congratulate the Government on how they have responded, because they have done many good things, and their support for the Global Fund is essential in reducing those upsetting statistics. The Global Fund can be part of the drive to eradicate the diseases, but it needs help from Governments across the world.

The Global Fund is also asking the private sector for support. That involves the pharmaceutical companies, and perhaps the Minister can give us some thoughts on the partnerships with them and what they mean. I and other Members have been made aware of the issue of out-of-date drugs being sent to the third world, where people have said, “We would not use them, but we will send them over there.” I have some concern about that, which other Members will share. Can the Minister give us some ideas on that?

We are well aware of the tightening of the purse strings and the finances at home, but we need to be able to respond in a positive fashion. Responding to the Global Fund’s call for additional resources, UNAIDS executive director Michel Sidibé said:

“We have to invest additional resources today to end these epidemics, otherwise the deadly trio will claim millions more lives, as well as costing us more in the long run”.

The Government and the country need to ensure the future success of the Global Fund, so that it can deliver. That of course will not be free, but the Global Fund plan can work to end the pandemic.

The Global Fund has been successful and is ready to continue its lifesaving work, if funded. The statistics on what has happened so far should encourage us, as should what could happen if the Global Fund had more money. Because of the work of the Global Fund partnership, 17 million lives have been saved globally and 8.1 million people living with HIV and AIDS who would not otherwise receive any treatment are receiving antiretroviral therapy. Some 13.2 million people who would not otherwise have been tested for tuberculosis have been treated and 548 million insecticide-treated nets have been distributed by the Global Fund partnership. Those are some of the things that the Global Fund has been able to do, and it could do more if the opportunity was there.

The Global Fund partnership has been working in Nigeria. The number of Nigerians dying of malaria has declined by 60% since 2000, but every year around 250,000 Nigerian children still die from the disease. If we want to do something for more people that is even better, more effective and more long term, we need to ensure that the Global Fund can continue its work. There is a serious return on investment in the Global Fund, but with more funding the partnership can make even greater strides.

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It is a pleasure to serve under your chairmanship, Mrs Dorries. I represent a Leeds constituency and we have suffered a lot with the recent floods. I have had a number of letters and emails from people suggesting that the easy solution would be to cut the funding for international development and to put that money into flood prevention instead, but frankly that is a short-term solution that would not help. I want to see all countries succeeding, and to achieve that, they need healthy populations that can then drive healthy economies. That requires long-term thinking and investment.

While I have been a Member of Parliament, I have had the opportunity to visit a number of countries, and like my hon. Friend the Member for Plymouth, Sutton and Devonport (Oliver Colvile) I declare an interest, in that I also went to Zambia in August. The trip was arranged for us to see how the country is addressing serious health challenges, such as TB and HIV. Over the past decade, Zambia has shown strong growth and during the visit we learned that the Government contribution to the health sector has doubled in the past five years, but that the health sector is dependent on other sources of funding, which account for something like 30% to 40% of health spending in that country.

Zambia has a serious AIDS epidemic. Malaria is the leading cause of illness and death. The country has a serious problem with TB, with the risk of co-infection with HIV. Zambia is working hard to tackle those things, offering support and education and raising awareness among those suffering with those illnesses. In 2014, some 64,000 Zambians developed TB, which is a rate of 406 per 100,000. In this country, the rate is 12 per 100,000. That gives us an idea of the scale of the problem they are facing, but they are making great progress.

Two visits particularly stuck in my mind. One was with a young health adviser in a village. His name was Elias. He dressed up smartly for us: he was wearing a waistcoat and tie while we all frankly looked like scruffs. He was educating villagers on the basic standards of living, so that they reduced the risks of infection. The other most notable visit was to the St Luke’s mission hospital in Chongwe district. It receives funding from the Global Fund and is set in a very rural location. We were told that a man had walked for two days with his son to get to the hospital, but sadly got there too late. That shows how far these people have to travel to get the treatments they need. There we met patients who were suffering with TB and HIV, and they were becoming advocates in their communities to address the need for people to get treatment and, more importantly, testing. That is just one example of how much the Global Fund has done.

In Zambia, the Global Fund has diagnosed and treated more than 81,000 TB cases, provided 14 million bed nets and given antiretroviral treatment to some 670,000 people. We should be very proud of what the Global Fund has achieved. It is critical to ensure that healthcare is available to everyone who needs it. It says that the £13 billion it is looking for could generate another £41 billion in additional domestic investments. We have a proud record in supporting international aid, and I hope that when these diseases are eventually eradicated, we as a country can look back and say that we helped to achieve that.

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I thank the right hon. Member for Arundel and South Downs (Nick Herbert) for bringing this debate to the Chamber. I congratulate him on his thorough and eloquent introduction. He was able to lay out all the pitfalls facing us if we have a cut in the Global Fund.

In the summer of 2015, I was also on the same delegation to Zambia as the hon. Members for Plymouth, Sutton and Devonport (Oliver Colvile) and for Pudsey (Stuart Andrew). We went with Results UK. We were able to see at first hand the impact of the Global Fund and the importance of continuing to push to address global health challenges, including infectious diseases.

According to the World Health Organisation, 64,000 Zambians developed TB in 2014. That includes a high level of TB and HIV co-infection, with an estimated 38,000 TB cases reported among people living with HIV. The Zambian Government’s contribution to the health sector doubled between 2011 and 2014. Unfortunately, they rely heavily on external resources, which account for between 30% and 40% of health expenditure in recent years.

On the delegation, I was able to see at first hand the positive impact that the Global Fund has had on healthcare in Zambia. I, too, visited St Luke’s mission hospital in the Chongwe district, which has received Global Fund grants, and was able to speak to patients who had undergone and lived through treatment for HIV and TB. They had become confident advocates, and were proud to be able to stand with us and eat with us, and to explain to us how their lives were before the hospital’s intervention. I know how important the Global Fund is in transforming people’s lives and making a difference to those people in Zambia. Overall, Global Fund-financed projects have treated more than 81,000 new cases of TB, distributed more than 14 million bed nets to protect families from the transmission of malaria, and provided antiretroviral treatment to more than 600,000 people with HIV living in Zambia.

I call on the Government and the Minister to end the cap and push for the 2017-19 proposed investment contribution of £13 billion to be met through both our contributions and those of others’. If it is not, I am concerned that all the great work that has been done in places such as Zambia will be eroded.

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I thank my right hon. Friend the Member for Arundel and South Downs (Nick Herbert) for his eloquent speech and for setting out the case so strongly. I declare an interest as a trustee of the Liverpool School of Tropical Medicine, and I have previously done work on artemisinin.

The impact of the Global Fund cannot be underestimated. Since its inauguration, we have seen for malaria alone a reduction in deaths of at least 48%, most of them among children. It is largely through the Global Fund that we have seen the possibility of the mass distribution of insecticide-treated bed nets, which cut in half the chances of children catching malaria. The fund has also supported the use of rapid diagnostic tests, which have made rapid diagnosis possible in rural areas for pretty much the first time. Malaria treatment can therefore begin quickly, before the disease has taken hold.

Five hundred and fifteen million treatments for malaria have been provided, largely of the effective artemisinin-based combination therapies, which were previously much too expensive for most people. The Global Fund has without doubt helped to transform the global malaria situation from one that was becoming out of control in sub-Saharan Africa in the 1990s, to the current situation, where we are speaking with some confidence of elimination—indeed, several countries have become malaria-free.

There have, of course, been problems. The misuse of funds and tools—such as bed nets—and poorly implemented programmes have hit the headlines. However, the Global Fund has always taken such problems seriously and taken action to remedy them. The question is whether the fund is the best way to tackle these diseases in future, and if so, what it needs to change to become even more effective. I am certain that it has a vital role to play. As my right hon. Friend the Member for Arundel and South Downs said, one of the strongest arguments is that it funds programmes developed by the affected countries themselves. Aid-funded programmes have often been criticised for being the pet projects of the donors without reference to those who are supposed to benefit. The Global Fund takes the opposite approach.

It is important that the Global Fund looks hard at how it operates. I shall mention very briefly four things that it should look at. First, it could do more to ensure that its programmes are fully integrated into the health systems of the countries that it supports and strengthens. I would have much more to say on that, but there is not enough time. I would be very happy to speak to my hon. Friend the Minister about that on another occasion.

Secondly, the global community needs to consider the case either for a separate fund for neglected tropical diseases or for including such diseases in the work of the Global Fund, with increased funding. Diseases such as lymphatic filariasis, soil-transmitted helminths, trachoma and so on—there are 17 of them in total—affect 1.4 billion people on the planet.

Thirdly, the Global Fund needs to report more regularly and more strongly on the work that it does. I was perplexed that the fund did not respond more strongly to adverse reports in the press last year of malaria bed nets being misused. They were indeed being misused, but it was in only a tiny minority of cases. It is vital that corruption and the diversion of funds are investigated and offenders caught, and the Global Fund does that, as it did in Sierra Leone in 2014. At the same time, it needs constantly to point out just how many lives continue to be saved every year as a result of its work across the three diseases. I would like to see quarterly, not annual, reporting.

Fourthly, the Global Fund needs to keep a very close eye on the fight against resistance to antimalarial drugs and the insecticide on bed nets, and allocate money accordingly. The same goes for multi-drug-resistant TB, which my right hon. Friend the Member for Arundel and South Downs mentioned. If not checked, such resistance threatens the substantial gains made over the past 15 years. The importance of the Global Fund to the battle against malaria cannot be overestimated. We were losing that battle but we are now, I hope, on the winning side.

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It is a pleasure to serve under your chairmanship, Ms Dorries. I congratulate the right hon. Member for Arundel and South Downs (Nick Herbert) on his eloquent opening speech, along with all the chairs of the all-party groups who successfully bid for this debate. Once upon a time I was involved in the campaign for the South Downs national park, and a very beautiful part of the country it is too.

A number of Members have made a lot of excellent points. The importance of the issue to the House is shown by the fact that so many Members wanted to speak. Thanks to your skilful action, Ms Dorries, they have been able to contribute to the debate. I pay tribute to Members for their contributions and for the expertise that they have shown, not least the hon. Member for Stafford (Jeremy Lefroy).

We often hear in Westminster Hall debates, and in political discourse more generally, that any given political change is possible or achievable and all that is lacking is the political will. The Global Fund to Fight AIDS, Tuberculosis and Malaria is a good demonstration of that principle. It was the determination and political will of world leaders to tackle three of the most challenging and infectious diseases of our times, which at that time were killing about 6 million people a year, that led to the establishment of the fund in 2002. As we have heard, in the years since, literally millions of lives have been saved by a massive scaling-up of proven responses and the targeting of funds and resources where they are most needed. The fund is an effective model of co-operation between Governments, the private sector, civil society and affected communities, reaching people in more than 140 countries. As we have heard, it is estimated to have saved more than 17 million lives since it was established.

We have heard about the need for the fund, about the human and societal costs of these diseases, and about the downward spiral that they can bring about for international development. Becoming infected with any of them severely limits the life chances of not only the individual affected but their wider family and community, which can be affected by the loss of income of either the individual or others who have to give up work to take on caring responsibilities. Just as on other issues, it is the poorest and most vulnerable and marginalised in society who are most at risk, with women and girls being disproportionately affected, as is sadly too often the case. The means and opportunity to rid the world of these diseases is there, which is why that ambition is reflected in sustainable development goal 3.3. Because of the challenges I have described, the replenishment of the Global Fund is incredibly important.

As we have heard, last year, for the first time, tuberculosis killed more people than HIV/AIDS. Again, it disproportionately affects the poorest in society, because crowded living conditions, poor ventilation and lack of access to clean water and sanitation all contribute to increased susceptibility. Because it affects people with weakened immune systems, it is one of the biggest killers of people with HIV and AIDS. I was particularly struck by the statistic on the progress that is currently being made on TB: it could easily take between 150 and 200 years to get rid of it, rather than the 15-year ambition that the world has set itself. The need for investment is clear.

Despite being so easily preventable, according to the World Health Organisation, malaria claims the life of a child every two minutes. I was not on the trip that many other Members went on, but in a previous life I spent some time living in Malawi, where I saw how prevalent and debilitating the disease could be. I also saw the challenge of providing relatively simple interventions, such as mosquito nets and prophylactic treatments, given what could sometimes be slightly relaxed attitudes. It seemed to me that in parts of Africa malaria was regarded in the same way that we regard the flu: as a bit of a hassle that some medicine and bed rest will sort out. But, like flu, it is a killer. It has become a catch-all term for all kinds of illnesses. Treating malaria is complex, and investment is needed not just in practical things such as the distribution of nets and treatment, but in education and awareness raising.

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Does the hon. Gentleman recognise that access to clean water through boreholes and the like is also important?

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Absolutely. I mentioned sanitation in the context of TB, but that is true across a range of health interventions. Improving access to water across the whole of sub-Saharan Africa would go a long way towards tackling not just these diseases but many other challenges. Access to water helps children pay attention in school, for example, so I agree with the hon. Gentleman.

One of the biggest barriers to progress against malaria is drug resistance. If people do not take the complete course of treatment, that helps to build resistance. We must therefore continue to invest in medicine research and development. Providing education and challenging stigma are crucial components in the fight against AIDS. Like TB and malaria, AIDS is an easily preventable disease, yet it continues to have devastating consequences in too many parts of the world. We often hear that HIV is no longer a life sentence in the west—that remarkable achievement is the result of significant investment over many years—but in developing and middle-income countries it remains a killer and, like other diseases, it is a barrier to economic and social progress across society.

The scale of the challenge is clear. I want to echo a number of the questions and points that have been put to the Minister. It would be useful to hear how the Government intend to respond to calls for resources for the fund. What amount are they considering contributing? What timetable have they set for their response? What further opportunities for scrutiny will there be? Will the replenishment be put before us as a statutory instrument? What will the process of disbursement be?

The subject of the cap has been well covered, but I want to re-emphasise some points that have been made. If the Government are prepared to say that they can commit up to £1 billion, the money must be there, so why do they not make those funds available in full? The replenishment request is based on a needs analysis. If the need is not met in full, we risk having an incomplete response, which could cost us and the world more in the long run.

We welcome the announcement of the Ross fund, but it would be useful to know how it will complement the Global Fund’s work. I heard for the first time from the right hon. Member for Arundel and South Downs that it is a three-year programme. I did not find that information elsewhere; perhaps I did not read the correct briefings. It would be useful to know what the plans are after that and how the two funds will complement each other.

A number of Members mentioned the need to tackle the spread of diseases in middle-income countries. The UK Government are free to set their own priorities for their international development programme. They announced that 50% of overseas development aid would be spent on fragile states, but they must recognise the Global Fund’s expertise and the need for it to be able to target funding effectively to prevent backsliding. My hon. Friend the Member for Central Ayrshire (Dr Whitford) made an important point about transitioning middle-income countries from aid. It would be useful if the Government would commit today not to interfere with Global Fund decisions to support programmes in middle-income countries.

Drug resistance is a challenge in tackling all of these diseases. The Minister will be aware of the World Health Organisation meeting in Geneva in March, which will look at reforming global research and development structures and ways of incentivising the production of pharmaceuticals to meet global health need, rather than simply tackling the most lucrative and profitable diseases, for which medicines can be sold. It would be useful to know whether the Government will take part in that conference.

The Global Fund estimates that meeting its next replenishment target could save up to 8 million lives and prevent 300 million new infections. That level of achievement would put us firmly on the path to meeting the SDG eradication target by 2030. However, a failure to resource the fund properly risks reversing progress, increasing drug resistance in new strains and new areas, and ultimately resulting in more unnecessary loss of life. The Government have a chance to show leadership. I look forward to hearing their response.

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It is a pleasure to serve under your chairmanship, Ms Dorries. Thank you for skilfully fitting in so many contributions into such a short time. I have to declare an interest: like the hon. Member for Glasgow North (Patrick Grady), I did not go on the Zambia trip last year. We have heard incredibly powerful testimonies from the hon. Members for Pudsey (Stuart Andrew), for Central Ayrshire (Dr Whitford) and for Mid Derbyshire (Pauline Latham), and from my hon. Friend the Member for Edmonton (Kate Osamor). The change that we can make as a developed nation helping developing nations is essential, and they have brought real quality to the debate.

I, too, congratulate the right hon. Member for Arundel and South Downs (Nick Herbert) on securing this timely debate. I thank him for his leadership on the issue of tuberculosis—he chairs the global caucus on the matter. This debate follows on from the debate on malaria that the hon. Member for Stafford (Jeremy Lefroy) secured in October, so the House has been highly focused on these issues and on the Global Fund. It is incumbent on me to welcome the new International Development Minister to his place and congratulate him on his position.

We all welcome the recently adopted agenda for sustainable development, which will guide international co-operation, including the UK’s development co-operation, over the next 15 years. We are entering a new era of efforts to eradicate poverty, foster human wellbeing and protect our planet. It is a universal programme for all people in all countries. As the hon. Member for Finchley and Golders Green (Mike Freer) said, it should leave no one behind. We now have to realise the transformational potential of the agenda.

We are talking about three diseases. In the October debate, the hon. Member for Stafford highlighted the issue of global malaria. Global malaria control is one of the great public health success stories of the past 15 years, but we face substantial challenges, such as the spread of resistance to drugs and insecticides. The prevention of infectious diseases is one of the best uses of aid, as the hon. Member for Pudsey said. It is estimated that if global malaria targets are achieved by 2030, more than 10 million lives will be saved, generating more than $4 trillion of additional economic output. We know what that kind of output can mean to developing nations.

Through sustained efforts, the tuberculosis mortality rate has nearly halved since 1980. However, as has been said, more than 1.5 million people died from TB in 2014. According to the World Health Organisation’s 2015 global tuberculosis report, most of those deaths could have been prevented. The report highlights the need to close the detection and treatment gaps. We want to get there by 2030, as the right hon. Member for Arundel and South Downs said, not in 200 years. We need to fill the funding shortfalls and develop new diagnostic tools. Through partnerships, Global Fund programmes have detected and treated more than 13.2 million cases of TB.

AIDS is the biggest killer in the world of women of reproduction age and the second biggest killer of adolescents. Some 1.2 million people died of HIV or HIV-related illnesses in 2014, and more than 36 million people live with the virus. Global Fund programmes have enabled 8.1 million people with HIV to access antiretroviral therapy.

The Opposition welcome the establishment of the £1 billion Ross fund, in co-operation with the Gates Foundation. We will hold the Government to account on how that co-operation is going in the months and years ahead. That £1 billion includes a £300 million package on malaria and £115 million to develop new drugs and insecticides for malaria and TB. We also need to support multilateral partners, such as the Global Fund, to fight HIV, AIDS, tuberculosis and malaria. It is essential that we continue to fund that work and build on what has already been done. In particular, we must invest in new vaccines, medicines, insecticides and diagnostic tools.

If we tackle AIDS, TB and malaria, there will be a number of spill-over effects, such as greater productivity and growth, reduced worker and child absenteeism, increased equity and women’s empowerment, and improved wellbeing, particularly for vulnerable and marginalised populations. Failure to act could lead to the diseases resurging, leading to increased deaths and lost opportunities for progress and development. The Ebola crisis in west Africa has painfully illustrated the importance of strong public health systems in fighting diseases. The lessons also apply to our efforts to combat AIDS, TB and malaria.

We need to scale up our efforts in combating malaria, to which the hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for Scunthorpe (Nic Dakin) alluded. We need to invest more in AIDS and TB research and development, tackling resistance to life-saving medicines and boosting health systems across the world to help bring an end to these terrible diseases.

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It is a pleasure to serve under your chairmanship for the first time, Ms Dorries. I congratulate you on getting everyone in to speak. I also congratulate all three chairs of the relevant all-party groups, especially my right hon. Friend the Member for Arundel and South Downs (Nick Herbert) who gave a powerful opening speech, on working together to secure this debate. My hon. Friend the Member for Mid Derbyshire (Pauline Latham) was cut off mid-speech because three and a half minutes was not enough for her to articulate the power of what she saw in northern Uganda. She has my commitment to sit down with her and reassure her that the Department and the Global Fund to Fight AIDS, Tuberculosis and Malaria are on that situation.

I thank my hon. Friend the Member for Plymouth, Sutton and Devonport (Oliver Colvile) for raising El Niño. As the topic is not central to this debate, I will write to him, but he is quite right to raise it, because in Ethiopia, for example, we are seeing drought conditions that are comparable with 1984. What has changed is the capacity of the domestic Government to manage the situation on behalf of their own people, which has been supported to some degree by our development work over many years.

I am glad that it became clear towards the end of the debate that I was not the only person who had not been to Zambia recently, but it was powerful to hear accounts of how the Global Fund has worked on the ground. I am extremely grateful that this debate is happening now. I am also pleased that so many Members, from both sides of the House and representing all parts of the country, have decided that this is where they want to be this morning, to hold the Government to account and to press ministerial feet to the fire on the future of the Global Fund. I am grateful for that, as it makes my job that bit easier knowing that there is that level of scrutiny and interest inside Parliament.

The debate is extremely timely for several reasons. As many colleagues know, this is an important time because some key decisions, which flow from the spending review, are being taken inside the Department relating to our review of bilateral and multilateral aid programmes, of which the Global Fund is obviously a central piece. As many have said, however, the Global Fund is on the brink of a fifth replenishment, and active discussions between donors and Governments are ongoing. It is therefore an important time to take stock of the progress made through our investments and to think about how we can match resources to need in an even more intelligent way.

What strikes me and what has come through in many of the speeches, and which I had not fully appreciated before taking on this brief, is just what incredible progress our species has made in the face of these dreadful diseases over a relatively short time. We have seen radically improved access to treatment, significantly reducing the number of people dying from HIV, which fell by over a third between 2005 and 2013. There have been dramatic increases in the diagnosis of TB in high-burden countries, saving some 37 million lives since 2000. As my hon. Friend the Member for Stafford (Jeremy Lefroy) brought home so powerfully, global death rates from malaria have almost halved since 2000, saving over 4.3 million lives. As my right hon. Friend the Member for Arundel and South Downs outlined, the Global Fund is a critical part of that success, saving the lives of at least 17 million people who would have died needlessly.

There is no doubt in my mind that the Global Fund is a success. It works. It has made a crucial contribution to the fight against all three diseases. It has been reformed over time and those reforms have strengthened its efficiency and effectiveness. It scores very highly in most independent assessments of transparency, accountability and, critically for us, value for money. It plays an important role in the crucial work of strengthening domestic health systems, although that is challenging to measure. As was shown, the fund has also been an extremely effective catalyst for unlocking domestic resources and really important partnerships that are really the only way forward in bearing down on these diseases and bending the curve, as my hon. Friend the Member for Finchley and Golders Green (Mike Freer) put it so well.

But—it is a big “but”—however amazed and satisfied we can be with the progress so far, we are not where we need to be. I find it chilling that 90 children will have died of malaria and 45 adolescent girls will have been infected with HIV during the course of this 90-minute debate, and that 4,000 people will have died of TB over the course of today. I am sure that everyone here will agree that that is absolutely unacceptable on humanitarian grounds and is undermining everything that we are doing to try to lift people out of poverty and to put economies on a more prosperous path. As was powerfully put by various Members, it also carries a risk to our stability and security, so there are absolutely no grounds for complacency or any suggestion that we should lessen our intensity in this fight.

Malaria is a preventable and treatable disease yet it continues to kill almost half a million people a year, the vast majority of whom are children and pregnant women in Africa. Progress is threatened by drug-resistant malaria and by mosquitoes adapting to the insecticides that we use to treat bed nets. As we have heard, TB is now the leading cause of death, with an estimated 1.5 million people dying and 9.6 million falling ill with TB in 2014. At least one in 10 of those people were also HIV-positive. There is no doubt that drug-resistant TB threatens global health security with only around a quarter of those with the disease diagnosed and treated, meaning that tackling it is both the right thing to do and firmly in our national interest.

HIV continues to be one of the leading causes of death and disability globally, disproportionately affecting the poorest and the most marginalised. Some 22 million people living with HIV still do not have access to treatment. It remains the leading cause of death in women of reproductive age globally and in adolescence in Africa. In 2013, an adolescent girl was infected with HIV every two minutes. In sub-Saharan Africa, she is twice as likely to get HIV as her male peers. Although incredible progress is being made, there is no doubt that this is absolutely not the time to ease up. The Global Fund is central to the global effort to bear down on the diseases. I hope that I have reassured Members that the matter and our evaluation of how effective it is are important to this Government. However, it is our responsibility—I was interested in the various comments about this—to ensure that the fund works even more efficiently and effectively in its next phase, and that the lessons of the last phase are absorbed and understood. I was particularly interested in the points made by my hon. Friend the Member for Stafford and I will be discussing them further with the head of the Global Fund when I meet him shortly.

The central challenge for all of us who are accountable for the money and who care passionately about this agenda is to ensure that resources are directed where they are most needed. There are priorities to set and difficult decisions to take in that context, but we must certainly give priority to countries with the highest burden or risk of disease and the lowest ability to pay for tackling the epidemics on their own. The point was powerfully made by my hon. Friend the Member for Finchley and Golders Green and the hon. Members for Scunthorpe (Nic Dakin) and for Central Ayrshire (Dr Whitford) about the need to ensure that any transitions—in particular for middle-income countries—or movement of resources are managed extremely responsibly. My hon. Friend has my reassurance that that is very much top of mind in our discussions with donors and other countries.

As my right hon. Friend the Prime Minister remarked at the launch of the global goals in September 2015, we

“commit to putting the last first”,

and to end extreme poverty

“we need to put the poorest, the weakest and the most marginalised first to Leave No One Behind”.

Those words are important to the Department.

How may we ensure that the Global Fund delivers? For HIV it needs to work with young women in Africa, who on average catch HIV between five and seven years earlier than their male peers. For malaria it means ensuring that the children and pregnant women who account for 80% of all malaria deaths have access to bed nets and quick diagnosis and treatment. For TB it means working with people with HIV and harder-to-reach groups, such as migrants and miners, to test and treat them. The Global Fund must use the right interventions, evidence-based tools that we know work, and diagnostics, treatments and tools for prevention.

My hon. Friend the Member for Finchley and Golders Green asked about the need for the UK to finance the most vulnerable in middle-income countries, but the numbers need to be treated with caution. The middle-income country category is very broad, ranging from countries that have just crossed the threshold, such as Zambia, where the GDP per capita is less than $2,000, to countries such as Malaysia, where the GDP per capita is more than $11,000, which primarily self-finance their own disease responses. We therefore need to match the solution to the problem. The vast majority of people living with the three diseases are in the first category of middle-income countries—countries that do not yet have the ability to pay for the response to their disease epidemics—and in that context external resources are still needed, so we encourage continued investment by the Global Fund.

In other middle-income countries the issue is willingness to pay, in particular for the marginalised and hard-to-reach groups of people. There the different parts of the health architecture must work together to encourage and enable Governments to step up and take responsibility for the rights of their citizens, which means ensuring that the World Bank works with Governments to build systems that allow them to plan and independently finance their disease responses according to need. It also means encouraging the World Health Organisation to provide technical assistance to help countries develop the most cost-effective way of delivering services as part of a broader health system. It means holding Governments to account to deliver for their most marginalised, not least by working with civil society and partners such as UNAIDS. My key point is that I absolutely understand what my hon. Friend and other colleagues were saying about the need to manage transition responsibly. I hope I have given him some reassurance that we are aware of that and take it seriously.

On intellectual property, my hon. Friend rightly pointed out that the costs of treatment are an important factor in determining a country’s ability to pay for it. The Global Fund supports countries to obtain quality-assured products at the lowest cost. I am pleased to say that in 2014 and 2015 IP restriction was only an issue for 0.5% of the total value of antiretroviral orders made by the Global Fund. We recognise, however, that intellectual property is a very important issue in some cases, which is why the UK also funds the medicines patent pool, which works to address IP blockages related to HIV, and why we are starting to explore TB and support the WHO, the United Nations Development Programme and UNAIDS in working with countries to support them to address their intellectual property issues.

A number of colleagues raised the issue of the UK’s cap in the most recent replenishment. It is important to note that the cap was intended not only to incentivise others, but to ensure that everyone plays an appropriate part in addressing global challenges. To be frank, it is difficult to assess the impact of the cap on other donors; some said—one in particular—that the cap was a factor for them, but we will have to review that in terms of our tactics in relation to the forthcoming replenishment.

I am very proud and many colleagues in the House are extremely proud of the leadership that this country has shown under successive Governments to move the development agenda, to shift gears of ambition, to meet international commitments and to encourage others to step up and meet their responsibilities. We helped to shape the latest round of sustainable development goals. We have been extremely ambitious in the commitments we have made through the new official development assistance strategy, through our manifesto commitments, and on the role that this country intends to play in supporting that ambition with action that will make a difference on the ground. The Global Fund is a key element in the delivery of that strategy.

Colleagues know that because discussions are ongoing, I am absolutely not in a position to front-run any decisions or to make any commitments. That would be something with career implications that I am not prepared to contemplate—

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Be brave!

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I will resist the call to be brave. I hope, however, that I have reassured Members that successful replenishment of the Global Fund, which is about not only the UK’s commitment, but the role we play in encouraging others to step up, is personally important to me and extremely important to the Government. I am grateful to all Members who were present today for putting a spotlight on the Global Fund and on the need for Britain to stay up and to maintain its position of leadership in the world.

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May I make two apologies? First, I apologise to my hon. Friend the Member for Mid Derbyshire (Pauline Latham) and indeed all hon. Members for foreshortening their time: my maths was insufficient and I had not realised the number of people who wished to take part in the debate, so I spoke for too long. That follows on from moving amendments on planning matters at 2 am last week, which added immensely to my popularity with colleagues. Those of us who wear Apple watches know that it is possible to receive electronic reminders when one should be taking more exercise. Perhaps a reminder to shut up when one is speaking for too long would be a useful additional app for someone to develop.

Secondly, I apologise to the Minister, because I should have welcomed him to his new position. The way in which he responded to the debate confirms the impression that many of us had that it is an ill wind that blows no one any good, and that his appointment and return to Government were immensely welcome, in particular to the Department for International Development. He has a genuine interest in international development matters and speaks with some passion about them. What the Minister said about the importance of the Global Fund and its replenishment to the Government and to him personally was encouraging.

It is important to debate such issues and we had welcome contributions from Members of many parties, in particular on the need to focus on the effectiveness of the Global Fund and the points made by my hon. Friend the Member for Stafford (Jeremy Lefroy). I hope that those points will be taken on board by the excellent director of the Global Fund, Mark Dybul, who has made great efforts to improve its effectiveness. We look forward to further discussion with him as well as with the Government.

A real issue is that of middle-income countries, which affects the Government’s international development agenda more broadly—when countries reach a certain income threshold, what is the right role for wealthier countries? We cannot simply step away. Much of the burden of those diseases falls on the middle-income countries and there is a real question about whether they would devote sufficient resources to tackling the diseases. If international bodies such as the Global Fund concentrate on other, lower-income countries, there is an imbalance in the resourcing and the focus is wrong. That is an important debate, which we will need to have.

This has been an excellent debate. I am delighted to tell the Minister that I, too, have been to Zambia, although I am sorry to say that I was not on the trip with my hon. Friends the Members for Plymouth, Sutton and Devonport (Oliver Colvile) and for Pudsey (Stuart Andrew) and the hon. Member for Edmonton (Kate Osamor). I look forward to an opportunity to follow their example in future.

Question put and agreed to.

Resolved,

That this House has considered the Global fund to fight AIDS, TB and malaria.

Redhill and Reigate Rail Users

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I beg to move,

That this House has considered Redhill and Reigate rail users.

I think this is the first time I have had the pleasure of serving under your chairmanship, Ms Dorries, and it is extremely welcome. I sought the debate on behalf of rail users in my constituency, because quite frankly they are at the end of their tether.

Many colleagues’ constituents are also adversely affected by Govia Thameslink Railway’s poor performance all along the Brighton main line, but I want to highlight the particular injustice faced by passengers using the Redhill and Reigate routes, who are not only taking the brunt of service reductions and disruptions but uniquely facing disproportionately higher fares. I seek action to rectify that double injustice faced by my constituents, which is a unique strand of the overall performance issues on the line.

When we were here six months ago to debate Southern’s performance, following last year’s catalogue of misery, I put the Minister on notice that my constituents would expect a meaningful effort to give commuters a decent level of compensation. Since then we have met and corresponded about options to provide reparations and to simplify and reduce fares, but so far we have not found a way through.

I cannot overstate the frustration and anger felt by commuters in my constituency, which is represented by the 3,300 people who signed the petition for Redhill and other stations to Gatwick to be included in Oyster zone 6. That compelling case cannot be ignored any longer.

Let me start with service reductions. The number of morning peak trains from Redhill to London Bridge has been cut from nine to four—a 55% cut. Off-peak trains to London Bridge have been cut by 50%, as have off-peak trains to Crawley and Horsham, and off-peak trains to the south coast have been axed altogether. Journey times have also increased as some trains have been moved across to the slow lines and other fast trains have been removed from the timetable or been given longer journey times, such as evening trains to Coulsdon. However, there has been no compensation or fare reduction to reflect that reduction in service levels.

Passengers recognise that service alterations are inevitable while the works to upgrade London Bridge are under way, but no one imagined that Southern, now under the Govia Thameslink Railway management contract since July, would fail so catastrophically to deliver even the reduced timetable. Indeed, reliability has deteriorated to the extent that it is barely possible to say that a functioning timetabled rail service exists. The service to and from Redhill and Reigate is a nightmare, with delays every morning and evening. Delays are being unreasonably heaped on the Redhill line. No peak evening train from London Bridge to Redhill has arrived on time since last October. Trains are on average 10 minutes late, and more than 10% of them do not run.

Overall, the Redhill route appears to get more cancellations as a proportion than any other part of the Southern network. For example, Redhill performance statistics show that just 30% of peak trains from London Bridge arrive within five minutes of schedule. By contrast, the figure is 52% for Brighton, 49% for Haywards Heath and 65% for East Grinstead.

Govia Thameslink Railway’s moving annual average public performance measure of trains “on time”—the proportion of the total number of trains planned that arrive within five minutes of the advertised arrival—stands at the lowest of all franchises, at 81.7% against a national average of 89.3%. Commuters also face the consequences of driver shortages, broken tracks and no spare rolling stock: regular cancellations, delays, short formations and last-minute station skipping, which cause untold stress for commuters. All of this—drastic cuts, chronic overcrowding and appalling reliability—has created significant discomfort and extended journey times, affecting the health and ruining the family life and quality of life of regular commuters.

There are serious questions for the Minister to answer about the specification of service delivery levels set out in the management agreement. Are they too lenient? Perhaps she can explain whether it was because of that inadequacy that the Department for Transport issued Govia Thameslink with a remedial plan notice requiring it to set out improvement measures that, once agreed with Government, will become contractually binding. Will she tell us when that will be agreed and what penalties will be able to be imposed, with a view to providing direct reparations to rail users affected by terrible service?

It is clear that, regardless of the Minister’s deep-dive examination, her performance improvement plan and her undoubted energy and engagement with colleagues, the franchise appears to be fundamentally flawed. Is she prepared to set a deadline in public for specified performance improvements in the remedial plan, which, if missed, would trigger the termination of the franchise?

There are also questions to ask about the level of services that commuters can expect once the Thameslink upgrade is completed in 2018. Are the Redhill, Reigate and other local commuters who I represent suffering all this pain now for someone else’s gain later? I invite the Minister to commit to discuss with Govia Thameslink’s management the specific timetable improvements that Redhill and Reigate rail users can look forward to. Will the future Thameslink timetable be able to improve journey times and create regular, fast services to London? Will it provide a better service than in 2011 or replace it with an inferior service, which is what my constituents fear?

We should be hearing about the improvements that are to be secured, but the Department is still considering the hare-brained idea of building a second runway at Gatwick airport, despite the Airports Commission having so decisively dismissed it, not least on the grounds of the inferiority of Gatwick’s surface transport links. There is no way that an expansion at Gatwick, involving a fourfold increase in passenger numbers, can be supported by the Brighton main line. That the proposition is still alive hardly promotes confidence in the Minister’s Department.

Commuters have lost confidence in train operating companies’ ability to deliver even a half-decent service, and the historically high and continually higher fares just rub salt into the wounds. A Redhill annual season ticket including zones 1 to 6 costs £1,100 more—47% more—than the same ticket from Coulsdon South, which is two stops up the line. Fares to and from London for stations on the Redhill route are significantly higher than those for equivalent stations in Surrey, even those outside Oyster zones, such as Oxted and Dorking. Even tickets from places further away from London, including Gatwick, Three Bridges and East Grinstead, are cheaper.

I repeat all of that to remind the Minister of the unfairness in the pricing structure, which she heard about when she met the Reigate, Redhill and District Rail Users Association in October. At that meeting, and in subsequent correspondence, we presented a reasonable proposal, supported by the borough council and London TravelWatch, to extend Transport for London zone 6 to stations to Gatwick, with a review on completion of the Thameslink works. Our case is both logical and affordable. The long overdue introduction of Oyster pay-as-you-go for trips to and from Gatwick airport and the installation of such technology at the stations on the short stretch of main line between Gatwick and the current Oyster boundary at Coulsdon South provides the opportunity for the Minister to extend zonal fares, ending the confusion that has arisen from the complicated fare structure on that stretch of railway.

Such measures to simplify and reduce fares have always shown a benefit of increased usage of about 4% to 5%. That happened when zonal fares were introduced in 2007 and when Oyster was introduced on the national rail network in 2010. Revenues have also held up following substantial fare reductions of up to 40% on some off-peak services, associated with the transfer of several London and Essex services to London Overground in May 2015. The expected increase in usage alone would recover most—or probably all, if not more, based on previous experience—of the approximately £6 million cost of introducing zone 6 to the stations at Redhill, Reigate, Merstham, Earlswood, Salfords and Horley. The total risk, if all of that is completely wrong, is less than 0.1% of the revenue stream in 2013-14.

Despite the case that was made to the Minister, she wrote to me on 16 December to turn down our proposal. It appears to the commuters I represent that she is proffering every assistance short of actual help, whether that is introducing zonal fares, direct reparations or an annual RPI minus a percentage change—something she has powers to do.

Why should my constituents be expected to pay a premium price for substandard services? Local rail users will find it incomprehensible that the Minister and her officials cannot even consider a fare reduction through zoning or otherwise. They will not understand why Dartford and Brentwood could be brought into Oyster zones last year, and why Stratford and other east London stations could be brought into financially better zones for commuters this year, when Redhill and surrounding stations cannot be considered.

Commuters using the Redhill and Reigate routes are fed up with being given excuses and the brush-off. They are suffering the double whammy of disproportionately more severe delays and disproportionately higher fares. They have asked me who is responsible, and I have so far ducked giving them a direct answer. Uncomfortably, however, it seems that the Minister and her Department are responsible for the management contract. That contract now gives her responsibility for the fare stream, which she receives directly. It has now been more than a year since the disaster following the London Bridge works last Christmas. I hope that she will not only explain who is responsible, but bring some relief on an issue that she can control directly, given her responsibility for the fare stream, while she also wrestles indirectly to improve the inadequate performance we have seen.

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It is a pleasure to serve under your chairmanship, Ms Dorries. May I wish you and the rest of the team in Westminster Hall a happy new year?

I congratulate my hon. Friend the Member for Reigate (Crispin Blunt) on securing this important debate. He tempts me to comment on issues that are rather outside my brief, such as the runway decision, and I will resist that temptation. However, I am always happy and, indeed, anxious to discuss the performance on his line, and I am committed to doing that.

My hon. Friend has raised these issues repeatedly with me in correspondence and, most recently, in our meeting on 22 October. He has eloquently made his points about the need for clarity about who does what under the management contracts and about the need to ensure that his constituents get a reliable service.

I genuinely welcome the ongoing campaigning and activity of the Reigate, Redhill and District Rail Users Association, of which my hon. Friend is president. The campaigning and the information and analysis that the group has presented to me is truly excellent. That is exactly the sort of on-the-ground, forensic analysis we need to ensure that we get things right.

My hon. Friend pointed to the fundamental problem: over many decades, successive Governments ducked carrying out the improvement works that were needed at London Bridge station—the fourth busiest station in the country—and on the Brighton main line. It was this Government who finally took the decision to make those necessary investments as part of spending an unprecedented £38 billion on upgrading vital transport infrastructure across the country.

It is difficult—it would be fair to say that it is more difficult than the project team perhaps thought—to carry out such enormous improvement works on a vital functioning railway. There is always the choice whether to blockade the whole service for a time or to keep it running and to manage the timetable so that the improvements can be carried out.

Now that we have gone through the worst of the project—I am the first to admit that it has been very difficult for all the users of London Bridge station and particularly for Brighton main line commuters—the light is quickly emerging at the end of the tunnel. Half the new station will be open this year. There will be new trains, and they will serve the main line that commuters in my hon. Friend’s area connect with. We will start to see a steady improvement in services and the benefits that were the basis for all that investment. About £800 million is being invested in and around London Bridge alone.

As my hon. Friend will know, the Brighton main line, with which his loop connects, is one of the busiest lines in the country. In the last five years, the number of passengers on Thameslink has grown by 40%, while the number on the Southern network has grown by 32%. In a way, therefore, we have had a perfect storm of enormous and long-overdue investments to sort out creaking infrastructure; continued growth in passenger numbers; and a railway system that has, in some cases, struggled to cope.

My hon. Friend was right to allude to the series of completely unacceptable engineering overruns that happened last Christmas. I am sure that he, like me, welcomed the fact that this year, all the planned engineering work done right across the country, including at London Bridge, was completed on time, and that the railway was handed back to passengers. There were then several unacceptable points of disruption in the first week of service. We are investigating those, but Network Rail has, quite rightly, learned how to do these major pieces of infrastructure work and then to hand back the railway on time so that passengers can benefit.

My hon. Friend asked what was in it for his constituents and whether we can confirm that there will be new services. He is right to point out that the timetable has been squeezed to deal with all the pinch points on the network. In 2018—this will, of course, be subject to consultation—Redhill alone will have five extra trains to and from London in the morning and evening peaks. They will be new, state-of-the-art, longer trains, and there will be more capacity. At that point, I think we will be able to say that his constituents are getting the service they deserve. What we all want from that work is once again to make that part of the network a high-performance route, with improved trains, stations and performance.

My hon. Friend asked me repeatedly to talk about compensation. I have considered the issue extremely carefully. Having done some research over the holidays, I want to point out that Britain has one of the most generous compensation systems in the world for rail users. We already have in place compensation payout triggers that we do not see on any other network. The challenge for my hon. Friend’s constituents, whose average journey time is about 43 minutes, is that the compensation triggers come in after 30 minutes, which is not much use on a 43-minute journey. We need compensation that addresses the repeated short-term delays. My hon. Friend will be pleased to know—this is something the Conservative party committed to in its manifesto—that we are looking to introduce compensation payments from a 15-minute delay trigger point. That is something I would like to introduce very quickly, because my hon. Friend is right that we have to improve the compensation. The challenge is that it is really difficult to target a compensation package specifically at passengers using a particular station on what is a very open network. We have repeatedly looked at ways of doing that, but, so far, we have not found a way of targeting the compensation specifically.

My hon. Friend’s point about fares is absolutely right. That is why I am pleased that we were able to commit to an RPI plus 0% deal on fares for the remainder of this Parliament. For too long, commuters in the south and the south-east were seen as easy pickings—as a way to subsidise the overall railway operation, particularly for other franchises in the country that received a subsidy. That is completely wrong. The RPI plus 0% deal that we have put in place means that, on average, regulated and unregulated fares will go up by only 1.1% this year. That is worth about £750 million to commuters across the life of this Parliament. The average season ticket-holder will save £425 over the life of this Parliament and for the first time in a decade wage increases are outstripping rail fare increases—quite properly. We are listening and trying to do all we can to improve the fare structure and the deal for commuters.

My hon. Friend raised the point about extending Oyster zone 6 to Reigate and Redhill. I know that he knows quite how hard we have all worked to get the Gatwick extension proposal up and running. Indeed, that extension was opened yesterday and people can now buy a pay-as-you-go Oyster card at Gatwick and use it on the intermediate stations. He also knows that that is not the same as a zonal extension. It is difficult but possible to put the technology in place and there is a very small reduction in fares if people buy a pay-as-you-go Oyster card, but it is a much more complicated structure to rezone.

My hon. Friend mentioned some stations. I need to double-check. My understanding is that the fare changes, for example at Dartford, were almost de minimis when the zoning happened—very similar fares already applied. Rather than responding on a piecemeal basis to requests for rezoning, which may be very valid, I would like to look at this issue on the round. He will know from our conversations that we are supportive of a proposal to consider further changes regarding who does what between Transport for London and those with franchise contracts let by the Department. We are committed to devolution where it makes sense, and I am hopeful that we will be able to have a consultation and a conversation on that specific issue in the very near future. I also hope that he and those he represents will continue to lend their voices to that conversation. We want to do things right and make something work for the future.

My hon. Friend again raised his concerns about the disparity in fares between Redhill and Reigate services and East Grinstead and Oxted services. Again, his user group made some very clear points when we met. However, he will know that it was dear old British Rail that changed the whole basis upon which fares were calculated. Until 1968, fares were based on mileage, which was something we could all understand. Then they were changed for all sorts of reasons—frankly, the thinking of BR management at that time was about what the market could bear. We have ended up with discrepancies such as the ones he pointed out.

Although Redhill and Oxted are both about 20 miles from London, rail fares are no longer calculated on distance alone. That is why, rather than trying to manage some of these discrepancies, we have focused on the overall cap and capping the fare increases at RPI plus 0% over the duration of this Parliament. Fundamentally, however, if we had a train service that ran on time and did not have delays, the questions about compensation and fair fares would drop off.

Delivering performance on one of the most heavily congested lines when some of the most substantial engineering works in the country are being carried out is a real problem. My hon. Friend will know that performance on that route and indeed specifically on the Brighton main line has been in decline for several years. Passengers on that part of the network have not received the high-quality service that they deserve.

As my hon. Friend knows, that is why, since the election, I have set up and chaired a south-east quadrant taskforce, which for the first time brings together Network Rail, the operators and Transport Focus to thrash through these issues and to understand what is causing the problems—it is fair to say that most of the problems are infrastructure-related, but there are challenges around driver numbers and train reliability. Both those issues are reducing in terms of the level of disruption they are causing. People should remember that, when the franchise was let, the franchise holders inherited a very substantial driver shortage.

On the Southern and Gatwick Express line, I can tell my hon. Friend that, by looking at my charts, I can see that the headcount deficit for drivers will be cleared by May. In other words, there will be enough trained drivers out there driving trains so that the number of trains cancelled because of driver shortages will drop very substantially. The same is true regarding the new train fleet. As the new fleet comes into service up to 2018, the issues caused by fleet reliability will decline.

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I have had the frustration of being on a train that was cancelled because it did not have a driver, only to move to another train that could not move because it did not have a conductor, which is an entirely typical experience for the people I represent. My hon. Friend has given that promise about improvements by May. Can she say what there is within the contract to hold Govia Thameslink’s feet to the fire? If it does not deliver, when will it lose the franchise?

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I am quoting from the plan, which is baked into both the contract and the remedial plan that was put in place last year, when we were fervently of the view that the performance on the line was unacceptable. That is what the company is now being managed to in terms of driver delivery and the train roll-out. Slightly later—I am conscious of the time—I want to discuss with my hon. Friend what happens with the contracting process.

Fundamentally, we are trying to address the challenges: what is happening with the underlying infrastructure, drivers and train performance? By the way, I hope my hon. Friend and MPs from all parties on the route will attend the meeting with the head of franchising in my Department, the management team and Network Rail next Monday, 18 January, to hear the conversation. I want all that information out in the public domain and I want the commitments to be made very public.

What has happened since we let the contract? Clearly, there has been an unacceptable period of poor performance and we have notified the franchise holder that it was effectively in breach of its contract. The first stage is to come up with a remedial plan that sets out the measures that it will take, which is what I am referring to, particularly on the driver side.

The other question is on Network Rail because, as I have mentioned, most of the delays are related to infrastructure. My hon. Friend will know that Network Rail has been put on notice and has agreed a £4 million package of remedial works for the Brighton main line to address some of the more immediate performance issues.

My hon. Friend has invited me to set out a vision of what good looks like. The answer is that we have that information and we need to ensure that it can be delivered. What we want is a performance target that can be delivered. Subject to all those works, the new trains will roll out, which is what we are all striving for. That is what good looks like and what we are contracting for in 2018. If he comes to the meeting next Monday, we can further discuss what it looks like both for his line and right across this network.

My hon. Friend will see some very specific improvements to his local station in the next couple of years. We have committed to providing a £270 million, 12-car platform at Redhill station, so that we can get longer services on that line, and so that the Great Western Railway can increase its services on the north down lines linking Redhill and Reigate to Reading, accessing all the works that are going on through Crossrail and on to Heathrow. A series of other benefits come at that point.

Fundamentally, however, my hon. Friend invites me to say at what point we would take the franchise back. I would invite him to consider that we would remove the franchise only if we felt that the management team could not deliver. Having spent far more time down in the weeds of railway management than I ever intended to on that particular line, I have to assure him that I think everything is being done to address the performance issues, the driver shortages and the roll-out of new rolling stock. For the next 18 months, there will be a difficult period of performance. It does not need to be as difficult as it has been, and we are doing all we can to ensure that the new timetable delivers the sort of reliable service people want.

My hon. Friend mentioned one thing that I want to go away and investigate. If it is true that no peak evening train has arrived on time since last October, that will give me great cause of concern. I want to go away and look specifically at that particular timetable.

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I am very grateful to the Minister and I appreciate her giving away. I will have to present the case to her behalf to my constituents. The reason that I called for the debate in isolation from the wider line performance is about the proposal to zone the line down to Gatwick. Rather than simply a no, can she give me a full costed reason if the answer remains no, which I hope it does not? I need a full explanation to take back to the rail users to say exactly why she has come to that decision. I will be very happy to help her to do that.

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What I will tell my hon. Friend’s rail users is that the proposal to rezone and effectively to change the boundary between TfL and the franchising should be quite rightly looked at in the round, so that his constituents and others who are involved—this is an around-London issue—feel that the proposals have been properly worked up. What he can take back to his constituents is that they will shortly be asked for their opinions regarding a London-wide and suburb-wide series of proposals on devolution. I would expect that he and they will make their voices heard.

In conclusion, my hon. Friend is well aware of the constant level of concern that that railway causes. It is the biggest and busiest franchise. We look at performance measures. By the way, what I want to see is performance measures that focus on the people rather than the trains.

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

Airport Expansion: East Anglia

[Mark Pritchard in the Chair]

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I beg to move,

That this House has considered the effect of airport expansion on the Anglian Region.

I welcome you to the Chair, Mr Pritchard. It is an honour to serve under you for the first time, and I am glad to see that you are enjoying being a member of the Panel of Chairs. I also welcome the Minister—if he grimaces at any stage in the course of my remarks, it may well be because he feels he has heard it all before—and I welcome colleagues from the region and others who have come to take an interest in the debate.

I will give a little history, if I may. In 1977, I became very fortuitously the successor to R.A. Butler and Sir Peter Kirk as the Member of Parliament for Saffron Walden. They had fought successfully up to that point against the proposition that Stansted should become London’s third airport. Despite their efforts, the fascination of officials in Whitehall persisted. Here was this very long runway built by the Americans for their bombers in the 1940s; surely it could be put to civilian use.

When I came to Saffron Walden, I had previous, as they say: I had been the Member of Parliament for Middleton and Prestwich in Greater Manchester between 1970 and 1974 and had very much absorbed the findings of the Roskill commission—a long-time predecessor to the Davies commission that had been asked to advise the Government on where to provide extra accommodation, specifically in terms of a third airport. The commission rejected Stansted, even on its shortlist, and by a majority recommended Cublington in Buckinghamshire. There was a dissenting view by Colin Buchanan that there should be an airport in the Thames estuary. That was adopted by the incoming Government of 1970, who proceeded to construct the airport, which was termed “Maplin”.

I had time in those days to fully read the Roskill report, and I also became familiar with all the inland sites being considered. I came to the view that a third inland airport would be a mistake, so I heartily supported the proposition that there should be a new airport altogether in the Thames estuary. Why, I asked myself, should there be a third airport when there were already two?

What was, to my mind, unfortunate was the legal agreement arrived at between West Sussex County Council and the British Airports Authority, when it was still a statutory authority, that there should be no second runway at Gatwick for 40 years, expiring in 2019. In a sense, it had cut off a limb for expansion and was seeking a third site. I did not think that that made any sense in 1979, and I do not think it makes any sense now.

After the airports inquiry of 1981 to 1983, which considered further expansion at Stansted or Heathrow, the recommendation was to allow a terminal at Stansted, limited to 15 million passengers per annum. It took about two years for the Government to reach that decision after the inquiry reported—Howard Davies, please note. The inspector also stated firmly that he would only recommend such a degree of expansion at Stansted provided it was made clear that there should never be a second runway—Howard Davies, again, please note the worth of that type of promise.

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I do not know whether my right hon. Friend remembers this, but it is my understanding that Stansted airport was then marketed to the local community as its own airport in the countryside, not at all with the sort of pretensions necessary for a major airport such as Heathrow.

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My hon. and learned Friend is quite right. There was an attempt to damp down the feelings locally about Stansted by not referring to it as London’s third airport, but the assumption in its design and construction was that it would, indeed, share an even amount of the traffic coming into London.

What followed? Well, traffic distribution rules were abolished. The effect was that 19 airlines promptly moved from Gatwick to Heathrow, leaving rather a large hole at Gatwick, which made that airport much more attractive at the time than Stansted. The next decision was to give BAA, when privatising it, a monopoly of the three London airports, which of course meant in the circumstances that it had no particular priority for Stansted. It was probably making more money at the other two airports, so there was no pressure from that direction to improve access to Stansted.

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One problem that arose from BAA being given control of the major airports was that London Luton airport was squeezed completely out of the picture. Does the right hon. Gentleman agree that that was a big mistake?

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I do not want to enter too much into the undoubted controversy that I know exists around Luton. It has its proponents and its opponents, but I accept what the hon. Gentleman says.

All we got in terms of access from London to Stansted airport—apart from the M11, which had originally been conceived as the London-Norwich motorway but was somehow stunted and ended up close to Cambridge—was a spur off the main rail line. The tunnel into the airport has a single track, so there is an obvious limitation on its capacity. A 41-minute service from Liverpool Street was inaugurated and quickly proved to be unsustainable, because there was not the rolling stock to accommodate the continuing and growing commuter needs, while half-empty trains were going out on a regular basis to the airport. In the end, the service had to slow down over the years in order to deal with the totality of traffic.

In those circumstances, it was small wonder that major carriers were not attracted to Stansted. The day was saved by the emergence of low-cost carriers such as Ryanair and easyJet, which had never been heard of at the time the terminal was built. The terminal was not designed for the kind of traffic that it eventually found itself accommodating. The day was also saved for Stansted by the break-up of BAA much later on. There is no doubt about it: Manchester Airports Group is incomparably better than BAA at looking after Stansted. London Gatwick has also become a far more welcoming airport than it ever was in the past.

Relations with the local community improved. Stansted is the largest employer in my constituency. Manchester Airports Group has been active in developing educational and apprenticeship opportunities, and in that direction has been aided and abetted by my right hon. Friend the Minister for Employment, whose ministerial duties prevent her from being here this afternoon. Passenger throughput is now growing and has reached 22 million passengers per annum. Jobs are being created on and off the airport. Its presence has had a wider regional effect, and we are now seeing world-class businesses clustering close by, notably in Cambridge but also at various points along the spine of that railway and further afield, in places that have access. The whole M11 corridor is attracting high-end business growth and, at the same time, is of course generating housing development.

Thinking about it, that might be seen as a dream scenario for anyone who wants to build and operate a railway and operate trains. The airport is growing its passenger numbers and needs to find employees. High-tech companies, large and small, need to draw in staff, and influential business visitors are coming from overseas. There is a level of housing construction along the line which, although it may be worrying to some in its concentration, is nevertheless unavoidable if we are to provide homes for aspiring owners. However, in all this time, nothing has been done to improve the West Anglia rail line.

Fast, efficient, comfortable surface transportation is essential, and not just for the railway, although I focus on that to a large extent. The volume of traffic is increasing, whether from the north or the south. If the constituencies nearest to the airport have high employment, they have to look further afield for employees for the jobs being created, and those people also need the convenience of being able to travel. Quite a number of people travel out of London to work in Hertfordshire, Cambridgeshire and so on, as well as those who come in the other direction. There is just a growing volume, which includes airport passengers.

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My right hon. Friend makes an interesting point and is giving a very interesting speech. South Suffolk is not far from Stansted, but the commuter transport is very poor. One reason why we want improvements to our local roads—there has been a long-running campaign for a Sudbury bypass—is so that young people in our constituency can get within commuting distance of Stansted.

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I am grateful to my hon. Friend for underlining my point. There have to be wider connections across the region, and notably with Norwich. Given that it is one of the major cities in the region, it is incredible that the rail link is so insubstantial.

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I congratulate my right hon. Friend on securing the debate. Does he agree that improved connectivity through rail can really enable Stansted to be a major engine of growth for the whole East Anglia region, including my constituency, which is the most easterly constituency in the region?

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I agree with my hon. Friend. Stansted would, of course, see itself as already being that engine of growth. Its presence is undoubtedly a major factor in the investment decisions being made by some very important businesses.

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To the right hon. Gentleman’s relief, I do not intend to speak about Luton airport, which is based in my constituency. I hope that my hon. Friend the Member for Luton North (Kelvin Hopkins)—my good friend—will talk about it later. To underline the point, in the analysis on east-west rail, one of the most interesting growth pairs between two different places over the next 15 years will be between Luton and Essex. East-west applies both on the eastern and western sides of the region.

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I am grateful to the hon. Gentleman. I think there is something called “the golden triangle,” and I certainly do not reject the idea of the east-west connections in any way, but we do not have the money to do everything. I concentrate on this line as a priority, simply because, at the moment, it is the main link between the city and the airport and it has had so much neglect over these past years.

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I congratulate my right hon. Friend not only on securing the debate, but on his remarkable leadership over many years in fighting this corner for his constituents, and indeed, for mine, given that we are from neighbouring constituencies. A lot of people are concerned about access, which he has mentioned. The airport is very important for the wider economy, but for many of my constituents, being unable to get into London because of the inadequacy of the rail connections is the core issue.

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I agree with that, without ignoring the points that other colleagues have made. It cannot just be seen in terms of north and south—there are other considerations—but my hon. Friend is absolutely right. He and I, in neighbouring constituencies, probably suffer the weight of the complaints from quite a lot of rail passengers.

There is also the A120 which, I was told 38 years ago, was to be a critical route across to the M11 for traffic coming from the east-coast ports. The section between Braintree and Marks Tey is still not in place, which is an absolute scandal. We then have the other minor scandal of junction 8 on the M11 motorway. My hon. Friend’s predecessor, Bowen Wells, and I appeared bravely at the public inquiry into the motorway services area. After it was decided that the airport access should be from junction 8, it was then decided that we should have the motorway services area access at another quadrant of it. The result was chaos, and yet, Bowen Wells and I were told in the inquiry—of course, we really knew nothing and were not experts—that they had got it absolutely measured. It has been a disaster. There is consideration even now that perhaps the only way of overcoming the inherent difficulties of that junction will be to shift the motorway services area. It is not beyond the realms of possibility that that might have to happen. There are also the demands from my right hon. Friend the Member for Harlow (Robert Halfon) for a junction 7A to ease the pressures from people getting to the airport.

I want to feed these points into the bigger picture of airport provision. Stansted undoubtedly has the spare capacity to soak up a lot of the pressures that are going to arise until the decision on the Davies commission has been made and, perhaps more importantly, implemented. Without a decent railway, however, Stansted will struggle to address that demand. The bigger airlines expect a high standard of connectivity and quality rolling stock to go with it, and as local MPs, our concern has to be, as much as anything else, for our long-suffering commuters, who are having to pay more to travel in not very good conditions. There is problem after problem, and they extend across the region to the Great Eastern line—not least already this week.

Even Davies concedes that the quickest increase in runway capacity can be achieved at Gatwick. It has multiple rail access. That is currently being upgraded, which is fine for them, but it is galling that there still has been no upgrading on the West Anglia line. Stansted has absolutely nothing to compare in rail access with either Gatwick or Heathrow, yet to fulfil the role of that airport in our region, four-tracking of the West Anglia line is the minimum needed now. Four-tracking between Tottenham Hale and Broxbourne is needed, not in 2025 or 2030, but now, just to sustain the existing level of demand, let alone what is in prospect from north to south of the line. Four-tracking is also the vital precursor to the Crossrail 2 project, which would naturally follow on from that.

The Anglian region needs to be plugged in better to Greater London, not just to Liverpool Street, but to Stratford and to places that Crossrail 2 will reach. I say to the Government that, if only to buy time on their airport strategy, they need to sort out the West Anglia line.

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Will my right hon. Friend give way?

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If I may, I will continue. If the Government want to underpin the growth potential of the Anglian region, they need to sort out the West Anglia line. If they want the increasing population in our constituencies to travel conveniently to work, they need to sort out that line. It is in no one’s interest to let improvement work slip into what Network Rail calls control period 6 or even control period 7. There has been a 30-year struggle to get this improvement, and if nothing is done soon, the potential of the Anglian region will be severely handicapped.

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I am pleased that you are presiding over the debate, Mr Pritchard.

Sitting suspended for Divisions in the House.

On resuming

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I was going to say that I was pleased to see the Minister in his place, but he is not there—I am sure he soon will be. I am, however, delighted that my hon. Friend the Member for Cambridge (Daniel Zeichner) is in his place to respond on behalf of the Opposition, and I congratulate him on his promotion. This is the first time he has done so in a debate I have taken part in, and that is particularly appropriate today, given that he represents a constituency in the Anglian region.

I agree with much that the right hon. Member for Saffron Walden (Sir Alan Haselhurst) said in opening the debate. I particularly want to pick up his point about rail access to Stansted from Stratford. Well over 20,000 people in the borough I represent in east London work at Stansted airport. We have a bright and youthful population in east London, with many people looking for rewarding careers. Having a good rail service from Stratford to Stansted will be important for many of those people, as well as giving the airport access to key future talent, which will be very much in its interests.

I want, however, to focus on the potential contribution of another airport on the east side of London—London City airport, which is in my constituency. It is disappointing that the major capacity increase needed at London airports has been delayed yet again, this time to avoid embarrassing the Conservative party in the London mayoral elections. However, the expansion proposals for London City airport, which will be considered on appeal in a couple of months, can help to meet rising demand while we await the decision on Heathrow versus Gatwick.

I have a long association with London City airport. I was at its opening 29 years ago, as chair of Newham Council’s planning committee. I particularly welcome the imaginative and committed way in which the airport, with its “Take Off Into Work” initiative, is ensuring that local residents have access to the expanding employment opportunities it offers. Partly on the strength of that, it won last year’s all-party group on corporate responsibility award for national responsible business champion.

London City airport catered for 4.32 million passengers in 2015. Some 52% travelled on business, but quite a large group now travel on leisure flights. Ten airlines fly to and from the airport, mainly serving European destinations, although British Airways also flies to New York from London City. Some 2,000 people work at the airport, and its development will create 1,500 additional jobs by 2023.

The proposed expansion at London City does not require any increase in the movements allowed under the existing permission or any change to the runway. However, it does require larger aircraft parking stands to accommodate quieter and more fuel-efficient aircraft, such as those in the Bombardier C series, whose wings are manufactured in Belfast. It also requires a further seven stands for aircraft, a new taxi lane parallel to the runway to increase the number of movements per hour on the runway, and expansion of the airport terminal. Altogether that represents a £200 million investment, which will deliver increased capacity for the benefit of the Anglian region and the wider UK economy by 2018.

As the local planning authority, Newham Council gave the development permission last February. However, against the advice of his officials, the Mayor of London blocked the expansion. His letter of 26 March 2015 said that the application did

“not adequately mitigate and manage its adverse noise impacts.”

I am not entirely clear what the Mayor meant by that. The airport is appealing, and the appeal will be heard in March and April. The decision will then be made jointly by the Secretary of States for Communities and Local Government and for Transport, although we do not know precisely when.

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I wonder whether the Mayor was concerned that an expansion of London City might dent his ambition for a Boris island airport.

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That is possible. I think it might be more to do with his objection to expansion at Heathrow, and a feeling that to be consistent he needed to object to expansion at London City as well, but that is speculation on my part.

London City airport is the only London airport that does not operate night flights. It shuts from 10.30 pm to 6.30 am. It also closes for a full 24 hours from 12.30 pm on Saturday to 12.30 pm on Sunday. Of course, there are people who are concerned about noise from the airport, as is the case with any airport, but quite what the Mayor meant when, against the advice of his officials, he said there was not adequate mitigation and management of noise impacts, I am not sure. The plan includes £25 million for an enhanced sound insulation scheme, and the whole purpose of the plan is to allow the use of newer aircraft that are quieter than those that use the airport at the moment. It includes the introduction of a fixed noise contour enforced by the local authority, which will limit noise impact and incentivise airport operators to use quieter aircraft. I am disappointed that development at London City airport has been delayed.

Everyone recognises that additional airport capacity serving the Anglian region, London and the south-east is needed. Development at London City can provide extra capacity quickly, with the potential for nearly an additional 2 million passengers a year by 2023, while we await the longer-term decision on Heathrow versus Gatwick—I presume that is where the decision will land.

Of course, expansion at London City is a bit of a sticking plaster for the needs of the Anglian region and the wider UK economy, but it will be an extremely valuable step. Its delivery will have substantial economic benefits for east London, which is increasingly the focus for investment from outside and inside the UK, the home to more and more people, and an economic centre. The expansion of London City airport can only help and support it.

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I congratulate my right hon. Friend the Member for Saffron Walden (Sir Alan Haselhurst) on securing this important debate. I want to speak only briefly, to reiterate the important comments that my right hon. Friend made towards the end of his remarks, that we should view the decisions we take about Stansted airport within a wider economic context, and take a wider strategic overview of the economy in the east of England. He, more than anyone, will know that the airport at Stansted is the largest single-site employer in the east of England, with 11,500 people and more than 200 individual companies working there. He will also know that the Airport Operators Association concluded in its report in November 2014 that as a whole the airline industry in the United Kingdom contributed £52 billion to our country’s gross domestic product, was responsible for employing 960,000 people, and directly contributed £8.68 billion of tax.

My right hon. Friend put the national and local debate about Stansted airport into its correct historical perspective, and it seems to me that all the issues to do with airport expansion essentially revolve around the position of an airport within the economy. The environmental issues are noise, ground access, congestion and pollution, and those things come to the fore when we consider Heathrow versus Gatwick and the so-called Boris island. The decisions of the Davies commission, and the expediting of a final solution to the issue next year or at the end of this year are, obviously, eagerly awaited. It is an issue that has dragged on for at least 10—probably nearer 15—years. It is accepted now that Heathrow is at capacity and Gatwick is not far off it, and across the whole of the wider south-east, including the eastern region, we will be at capacity by 2030.

I want to concentrate on the economic issues. You will know, Mr Pritchard, that the area loosely described as the London-Cambridge economic corridor—I make an oblique reference to Cambridgeshire’s second city, Cambridge, as opposed to Peterborough—is not just about London and Cambridge. It was the Labour Government who identified a London-Cambridge-Peterborough growth corridor, an integral part of which, for sustainable economic growth and employment, was Stansted airport. That is important. On a serious note, the success of Cambridge in particular means the success of Cambridgeshire and the wider eastern region, so we need that level of connectivity, not just on the railways but as a matter of worldwide airport connectivity and a local—if I can use that word—airport that can serve Cambridge and the wider economic area including Suffolk, north Essex and east and north Hertfordshire, as well as London, which is a world city.

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I totally accept the point about the Cambridgeshire corridor. Does my hon. Friend agree that surface access to airports is very important—particularly the upgrading of road routes such as the A120, and similar routes to give access to Stansted and the Cambridgeshire area? That is important for the potential expansion in airports and airport use.

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Absolutely. One of my bugbears, which I brought up in Transport questions not that long ago, and which I have been raising for years, is the fact that we tend to be slightly London-centric and think about the Stansted Express and the connectivity between east London and Stansted. The right hon. Member for East Ham (Stephen Timms) touched on that issue in talking about London City airport. However, we should remember that there is also a need for enhanced connectivity between the midlands and the north of England, via a key subregional transport hub such as Peterborough, bringing jobs, opportunities and tourists and other people to Stansted from the north and the midlands. It is just as important in the context of the wider infrastructure picture, which is that the east of England suffers from relatively poor road and rail infrastructure. We might think of the Liverpool Street to Norwich line and road access to places such as Suffolk—particularly Waveney, Lowestoft, Great Yarmouth and the very large county of Norfolk.

I have for years pressed for a little strategic thinking about the CrossCountry service from the midlands to Stansted. My constituents want to be kind to the environment. They do not want to get into a car at the crack of dawn to drive down the A14, on to the M11, to reach Stansted. They would much prefer to get a CrossCountry train that began its journey in Birmingham, and to get to Stansted in good time for their flight—perhaps with time for an early breakfast and some shopping there. They could support the local economy of Uttlesford and Essex. However, they cannot do that because the train does not run at the appropriate time. That is something pretty straightforward and simple that goes to the heart of the issue of connectivity.

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The east Anglian region has for a long time been the poor relation with respect to airport connectivity. Does my hon. Friend agree that we can up our game? In the Chamber today there are Members representing constituencies with Stansted, London City, Luton and Cambridge airports—and there is also Norwich. We need a strategy for connecting to those airports and making the best use of the facilities and resources that we already have.

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My hon. Friend makes an important and astute point that speaks to a lack of joined-up thinking on transport infrastructure. We get it right on the smaller, strategic projects. One only has to think of the guided bus that links St Ives in Mid Cambridgeshire to Cambridge. I used that bus to go into Cambridge over Christmas. It is a fantastic facility and, as I understand it, it is now scrubbing its face financially. My hon. Friend the Member for North East Cambridgeshire (Stephen Barclay) is campaigning for a better link between Wisbech and Cambridge, and I thank the Minister because we are having an upgrade of the east coast main line. Some £43 million has been spent on Peterborough railway station, for which we are inordinately grateful. However, do we actually join up all those individual projects across a big area? I suspect that we do not. Airport capacity and connectivity is another issue that we need to look at.

I want to talk briefly about air passenger duty. The elephant in the room is the massive generational decision that will be taken about airport capacity, which will centre on evidence for or against Heathrow. It seems that successive Governments have missed a trick by not availing themselves of the opportunity to use air passenger duty as a way of driving, or at least influencing, demand for the creation of new long-haul services at places such as Stansted, Luton and so on. The Minister will say that that lies within the bailiwick of the Treasury and I accept that, but the debate about air passenger duty needs to continue and we need to look at it again.

To conclude, my right hon. Friend the Member for Saffron Walden made an excellent case for the importance of Stansted. My contention is that we need to look at the expansion of Stansted as our regional airport. We need to move away from a London-centric, overly prescriptive focus on what is good for Greater London, which I admit is a world city of 8 million people. This needs to be about rebalancing the economy, and that does not just mean the north-west, Yorkshire and Humberside and the east midlands. It also means creating jobs, new opportunities and transport infrastructure in the east of England. Stansted can be at the heart of that but it must be in a co-ordinated, long-term, sustainable and comprehensive infrastructure plan.

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It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate the right hon. Member for Saffron Walden (Sir Alan Haselhurst) on launching this important debate. Not surprisingly, I will speak about London Luton airport, as I have been doing for a very long time. When I first came into this House 18 and a half years ago, there was a south-east airport strategy. Luton was constantly ignored and marginalised. It was not even mentioned in that report, largely because BAA dominated and had the ear of Downing Street, so Luton was just pushed out of the way. That has changed. Luton is now taken seriously as an airport. I am pleased to say that the Government are accepting that it will expand, and plans are now well advanced for Luton airport to expand.

There is a debate, of course, as to whether Luton is in east Anglia. The airport serves London and the south midlands and it could be argued that it is almost a Greater London airport, but it is in the eastern region so I will speak in those terms. Luton will never be a major hub airport because the topography means that the runway cannot be extended. It is limited in the number of passengers it can put through but it could almost double the number of passengers. There are currently just over 10 million a year and the airport could—indeed, it is planning to—go up to at least 18 million a year. It might even go beyond that with the parallel taxiway, expanded ground handling and, I hope, a fixed link to the mainline railway, which would be a tremendous advantage and something that I have argued for ever since I came to the House.

Rail connectivity has been mentioned regarding other airport areas and it is important for Luton as well. Luton Airport Parkway station has been open for a decade or so now but, unfortunately, only one East Midlands Trains service an hour stops there. East Midlands Trains runs the mainline trains—the express trains—and the airport wants four an hour to stop there. We are arguing strongly for that.

As excellent as the Thameslink local trains are when they are running well—I travel on them every day—they do not run early enough. The airport would like those trains to run earlier so that more people, particularly from London, can travel out to get business flights from London Luton airport early in the morning. They could fly out and back within a day, doing business in continental towns and cities and, of course, within the United Kingdom, but they need those earlier trains to get from London out to the airport to catch those early flights.

Oxford Economics has just produced an excellent report called, “The economic impact of London Luton Airport”, which I recommend to the Minister and his colleagues in the Department. It makes the case for Luton and says what splendid effects expansion will have. In time, London Luton airport could take more aircraft, especially with the modern, composite body aircraft coming through. Those aircraft will have shorter take-off and landing distances, higher load capacity and travel longer distances because they are lighter.

Although London Luton airport does mainly medium and short-haul flights at the moment, in time it could do some long-haul ones. I would hope that it could take some of the long-haul burden from other airports in the region, perhaps even including flights to the far east. Luton has a large population from Pakistan, for example. Why could we not fly to Karachi or Islamabad direct from Luton? I would like to think that that will happen one day. Luton is the base for easyJet and for Monarch, and Wizz Air flies a lot of people to and from eastern Europe. The airport has a good future and can make a major contribution.

I was lobbied recently by a group that argued that we do not need the third Heathrow runway, and that making maximum use of and expanding the existing airports—using them as efficiently as possible—would be sufficient for the future. I was, in part, persuaded by that argument, but I do not have the economic arguments at my fingertips and I know that the business community is keen on a new runway at Heathrow. There is possibly a case that we could just expand existing airports, including Luton, and the Government should look at that. It would be a useful way forward. I want to emphasise that Luton has a serious contribution to make to airport capacity in the east and, indeed, to London and the south midlands. I hope that the Government will continue to be supportive of the expansion of Luton.

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I advise Members that the debate is due to end at 4.25 pm due to the additional time for the votes.

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Mr Pritchard, it is a pleasure to serve under your chairmanship for, like some other Members here, the first time. I congratulate the right hon. Member for Saffron Walden (Sir Alan Haselhurst) on securing the debate.

I will outline some of the Scottish National party’s views before I sum up. On the ongoing debate between Gatwick and Heathrow, the SNP has been fairly agnostic on airport expansion and the choice of location. Our main proposal would be to secure two-way benefits and sustainable connectivity between Scotland and our global markers. We need assurance that we can enjoy sustainable access to the hub airports that serve Scotland. Clearly, some of the final decisions to be made—the costly and large infrastructure decisions—affect many billions of pounds in commercial activity. Like the right hon. Member for East Ham (Stephen Timms), we are particularly disappointed that it seems to have turned into a bit of a bunfight for political advantage. A quick decision on airport capacity is needed. There is a risk attached: if the decision is further delayed, it is to the detriment of all concerned. We cannot allow the machinations of the Landon mayoral elections to get in the way—that point was clearly made by the right hon. Gentleman.

The right hon. Member for Saffron Walden has made a good case that his local airport is successfully managed. He mentioned the number of apprenticeships and jobs that were created by the airport and the increase in passenger traffic. It is also vital to recognise that where we have a successful airport such as Stansted, we do see a clustering of high-quality businesses. Again, for the long-term sustainability of the economy, these are extremely valid and good reasons to have airport expansion across the UK. However, he made the point that if such expansion was to take place, connectivity to such airports, particularly rail links, would be vital.

I cannot comment on the scandal of the A20, as the right hon. Gentleman called it; I think he was going back 38 years. I might not be chronologically challenged on that one, but I am geographically challenged, because I am not fully aware of where the A20 either starts or goes to. I am sure that is something we can discuss at a later stage.

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The hon. Gentleman need not be too embarrassed. It is a devolved matter, so I do not expect to know all the road numbers in Scotland, either.

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I take that on board.

The right hon. Member for Saffron Walden mentioned that the rail infrastructure around his airport is not nearly as good as the rail infrastructure around Heathrow and Gatwick. As a Scottish MP, all I can say is, “Welcome to the club.” We have to deal with that daily.

I will quickly address the comments of the right hon. Member for East Ham. Obviously, there is the issue of the Stratford link and ensuring that people in his constituency can gain employment by making it an easy move for them. There is also the promotion of London City airport. The right hon. Member for Saffron Walden will already be aware that, as soon as such a debate comes up, we get people from all over the country saying, “Our airport should be the one that is favoured,” or “Our part of the country should be favoured,” and supporting various airports that are close to their heart.

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I think I am right in saying that London City airport has more flights to Edinburgh than any other London airport. Will the hon. Gentleman join me in celebrating its contribution?

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Certainly. I am a regular user of London City airport in the right hon. Gentleman’s constituency, and I am grateful for the services provided from that airport.

It is also a shame and a great pity that the hon. Member for Uxbridge and South Ruislip (Boris Johnson) is not here to support the proposal for Boris island. Perhaps he is too busy playing whiff-whaff—I do not know what he does in his spare time. The Boris island proposal is obviously another part of the discussion that maybe has to take place.

The hon. Member for Peterborough (Mr Jackson) helpfully not only highlighted the capacity issues but focused on economic growth for the eastern England corridor. He made the good point that that should also include Peterborough, which is a fine city. He also recognised that, under many parties that have been in UK government, joined-up strategic plans that support our air industry have been missing for a great number of years.

Like other Members, the hon. Member for Luton North (Kelvin Hopkins) highlighted Luton and the need for a more strategic approach—there seems to be more speed behind that. He also highlighted the weaknesses of the current report, which only considered the Heathrow-Gatwick dogfight. Many more passengers and cargo need to be moved from across the UK in a much more strategic way, rather than just focusing entirely on what he called a London-centric approach.

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It is a pleasure to serve under your chairmanship, Mr Pritchard. I also congratulate the right hon. Member for Saffron Walden (Sir Alan Haselhurst) on securing this debate. He has been passionate about this issue for many years, and in a previous debate said that,

“the word ‘Stansted’ will be found engraved on my heart.”—[Official Report, 26 November 2015; Vol. 602, c. 1562.]

His contribution today confirms how strongly he feels about this issue, and particularly about the rail infrastructure linking Stansted to our region. Everyone who has spoken in this debate is united in wanting the best possible outcome for people in our region, a region whose economic prosperity and job growth have perhaps too often been let down by poor transport infrastructure. Alongside those concerns, many of my constituents in Cambridge—I share their concerns—feel just as strongly about the environmental and community factors linked with airport expansion, which must always be weighed carefully against the economic and operational arguments for expansion.

We have had some strong contributions today. I am delighted to say that three quarters of the members of Labour’s east of England parliamentary team are here today—it is amazing what can be done with statistics. I am delighted to hear the kind words of my right hon. Friend the Member for East Ham (Stephen Timms), for which I thank him. He has always been a good friend to Cambridge, which we have always appreciated. He made a series of points about the important role of London City airport.

Obviously, my hon. Friends the Members for Luton South (Mr Shuker) and for Luton North (Kelvin Hopkins) also require commendation. My hon. Friend the Member for Luton North is always a passionate advocate for Luton—both my hon. Friends always are—but I was particularly struck by his comments on the opportunities offered by new aircraft, which brings something new to the debate.

There were also strong contributions from Government Members, including my regular sparring partner from up the road, the hon. Member for Peterborough (Mr Jackson). On this occasion, we probably find ourselves much more in agreement than on some other occasions. His points about regional connectivity were very well made. It was good to hear some kind words about Cambridgeshire’s guided bus, which has been much maligned over the years, but I agree is now doing rather well.

I think we can all agree that the aviation industry is important to Britain’s economy. As we have heard, it generates some £50 billion in GDP, 1 million jobs and £8 billion in tax revenue, servicing and connecting millions of passengers every year. On Labour’s side there is no doubt that if Britain wishes to remain a global player in the aviation market and to enjoy the subsequent economic benefits, there is a strong case for a new runway in the south-east. Heathrow is operating at full capacity while Gatwick is operating at 85%. The Airports Commission has found that, without action, the entire London airport network would be operating at the limits of capacity by 2040.

As the Opposition, it is our job to scrutinise decisions on airport expansion made by the Government whom we are opposing. That puts us in a slightly difficult position because, of course, the Government have been unable to set out that decision, breaking their own promises and leaving the country effectively on hold. The Prime Minister guaranteed a decision by the end of last year but is now dragging his heels. Meanwhile, the Secretary of State for Transport has said only that he hopes to make a decision this year. That strategic dithering is not only farcical and weak; it is completely unacceptable. It potentially means years of additional uncertainty for people living close to airports. That tactical indecision is also economically damaging. Furthermore, considering that the Government have claimed that the delay on airport expansion is for environmental reasons, it seems absurd that they are not backing the industry’s attempts to deliver cleaner fuels. Aviation is not included in the renewable transport fuels obligation, thereby damaging potential investment.

In addition to their promise to unveil a decision by the end of last year, the Conservatives also pledged in their 2010 manifesto not to add a runway to Heathrow, Gatwick or Stansted, which means there is likely to be yet another promise reneged upon by the Government. It seems that we will just have to wait and see which one it will be.

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I do not wish to take away from the hon. Gentleman’s kind words on those matters on which we are in accord, but I am slightly disappointed that he has chosen to bring party political differences into the debate. There is blood on all hands over the years as far as airports policy is concerned. I could somewhat mischievously say to him that, had a Government of his political colour not cancelled the Maplin project in 1974, we would not be in the difficulties we are in now.

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I thank the right hon. Gentleman for that point. As a historian, I always find it interesting to note which point in history people like to go back to in order to attribute blame but, as the Opposition representative in the Chamber, I fear it is my role to make these important points about the potential damage being done to our country by the Government’s lack of decision. We shall see. Probably after the London mayoral election, all will become clear.

Once the Government set out their expansion recommendation, we will be able to examine its relative merits properly based on four tests that the Labour party has set out, including commitments to meet our legal climate change obligations and mitigate local environmental impacts. Only then can we truly assess the impact that expansion will have on the south-east, the wider Anglian region and the rest of the UK.

We know now that, regardless of the decision made, its effects will not be felt quickly. A new runway will take about a decade to come into being, even without further delay in Government decision making. Thus any short-term changes should positively impact the connectivity of our country, including our region. Indeed, the fourth test that Labour set out to inform our response before the publication of the Airports Commission report was that the benefits of any expansion should not be confined to London and the south-east. The Government might be standing still, but the aviation industry will not. We must act to help connect UK businesses and people with new markets and places in the meantime.

The Airports Commission has also called for the improvement of surface access links to other airports, which has formed the basis for much of our discussion in this debate. In its response to Network Rail’s consultation on the Anglia route strategy, the Airports Commission called for a more joined-up approach to meeting the needs of Stansted airport users. Improving rail infrastructure to Stansted is a key request of both Stansted and the London-Stansted-Cambridge Consortium. It is worth noting in passing that the current Stansted Express service uses a relatively new fleet of trains introduced under a Labour Government.

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My hon. Friend is making the point that surface access is key to all airports, including Luton airport in my constituency. It sets the airport’s reputational standard. People do not judge an airport based only on the airlines, the airport itself or the journey there but on the whole experience. Certainly in Luton, surface access is letting us down at the moment.

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My hon. Friend is absolutely right. I suspect that we can all agree on that. I assure the right hon. Member for Saffron Walden that we heartily agree with his argument about improving surface access. I am absolutely sure that local commuters would benefit, including those in my constituency. We can agree that the Government should invest in a West Anglia line, making life that little bit easier for many in our region.

To conclude, the Government need to stop dawdling and decide. Until they get their policy off the ground, we will be unconvinced that they are taking environmental concerns and capacity needs seriously. While in this state of flux, the Government could still take decisive steps to improve access to our country’s airports, helping provide short-term solutions to capacity and connectivity problems. Anything less would do a disservice to people and businesses in our region and across the UK.

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Before I call the Minister, I remind him that, under the new Standing Orders for this Parliament, as I am sure he is aware, the mover of the motion is allowed two or three minutes to wind up the debate. I remind the mover of the motion that if he wants the question to be put formally, he must allow the Chair at least 30 seconds to do so.

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It is a great pleasure to serve under your chairmanship, Mr Pritchard. I congratulate my right hon. Friend the Member for Saffron Walden (Sir Alan Haselhurst) on securing this debate. I enjoyed his recap of the history of Stansted; I do not think I grimaced even once. He talked eloquently about the importance of airports not only for the Anglian region but for maintaining the UK’s air connectivity and for jobs and economic regeneration across the country. I therefore welcome the opportunity to respond to the debate on behalf of the Government.

I hope my right hon. Friend will be encouraged that we all have the same interests at heart. I acknowledge his specific points about the continued and future importance of Stansted airport. Indeed, I have visited some of the facilities with him to see them at first hand. I made a point of travelling there by train, so that I could experience that journey myself. When I visit airports, I try to travel in the same way as members of the public in order to experience the whole journey that they would cope with in some cases or enjoy in others.

As my right hon. Friend mentioned, Stansted is one of the largest employers in his constituency, employing 11,500 people on site across 200-plus companies. It provides significant economic benefits not only locally but to the wider Anglian region by supporting the globally competitive high-tech and biomedical industries, not least in the constituency of the hon. Member for Cambridge (Daniel Zeichner), who speaks for the Opposition.

This is a timely debate, given the Government’s recent announcement on airport expansion in the south-east. The Airports Commission set out a convincing case for new runway capacity in the south-east by 2030, which the Government have accepted. We also accepted the commission’s final shortlist of three schemes. It is vital that we get the decision right so that it will benefit future generations, which is why we will consider further the environmental impacts and continue to develop the best possible package of measures to mitigate the impact on local people and the environment.

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Mr Pritchard, I was remiss earlier in not saying what a delight it is to serve under your chairmanship. Does my hon. Friend agree that, in terms of sustainability, it is also important to concede that even during the 10 years that we have been in the House, aircraft have become cleaner and quieter? There have been big technological changes in the development of aviation fuel, for instance. The aircraft industry and airlines are much more sustainable than they have ever been.

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My hon. Friend is absolutely right that aircraft have become much quieter. Each generation of new aircraft is quieter than the previous one. Of course, the problem with aviation tends to be the very long life of aircraft. Cars might have a 10, 12 or 15-year turnaround, but many 25-year-old aircraft are still flying. Turnaround happens more slowly in the aviation sector, but it is good news that both Boeing and Airbus have thick order books and that companies such as easyJet, which is based in Luton, are buying new aircraft. We heard that, at London City airport, new Embraer aircraft are providing quieter and cleaner journeys.

Of course, air quality around airports is not just about aircraft. In some cases, it is mainly about other sources of pollution, particularly NOx from traffic. I need not remind Members of the problems that we experienced last year with vehicles that did not come up to the emissions standards that might have been expected from the lab tests. That is one factor that we must consider to see how we can improve air quality in areas, particularly London, where air pollution has not decreased as much as we would have expected based on the replacement of old vehicles with new vehicles that perform to Euro 6 standards.

Crucially, the timetable set out by the Airports Commission for delivering additional capacity to the south-east by 2030 will not alter. My right hon. Friend the Member for Saffron Walden will, I am sure, appreciate the importance of airports for businesses and residents in the Anglian region. This debate has shown that it is not just larger airports such as Stansted and Luton that are important to the Anglian region; some of our small airports also play a key role in supporting the economic growth of the regions that they serve. The Government have always made it clear that regional airports make a vital contribution to the growth of regional and local economies as a way to provide convenience and travel choice for air passengers.

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Has the Minister, or have the Government, been lobbied by a group that seems to make a reasonable case for expanding all the airports as a better way forward than an extra runway at Heathrow? I leave it with him; I have not definitely made up my mind one way or the other, but there seems to be a case.

[Mr Christopher Chope in the Chair]

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Virtually every airport that I have visited around the country shows increased passenger numbers and investment, both by the airports themselves and by the airlines that use them. I support the growth of regional airports. It is all about choice. We have a fantastic opportunity in this country to provide more choice, aside from the arguments that we will revisit later this year about the main decision on airport capacity at either Gatwick or Heathrow.

The smaller regional airports help to encourage investment and exports. They provide valuable local jobs and fuel opportunities for the economic rebalancing of their wider region or area. In the 2013 aviation policy framework, we emphasised the importance of regional airports for the availability of direct air services. Indeed, I prefer to call them local international airports rather than regional airports, because if someone lives in a region their local airport is their international airport.

Flights from those airports help to reduce the need for air passengers and air freight to travel long distances to reach larger UK airports. The Civil Aviation Authority’s statistics for 2014 show that the UK’s regional airports handled 92 million passengers, which was about 39% of the UK’s total. That underlines the point that the hon. Member for Luton North (Kelvin Hopkins) made about the importance of regional airports. Services from UK regional airports operated to more than 100 domestic and international destinations.

It is heartening to see that many of the airports that were impacted by the economic downturn a few years ago are now seeing real growth again, like the rest of our economy, and we want to see that growth continue. We warmly welcome the ambition of the UK’s airports. They are responding to local and regional demands by investing in their infrastructure to enable services to more destinations, better facilities and more choice for their passengers. That is particularly true for airports in the Anglian region.

At Stansted airport, passengers are seeing the benefits of a £260 million investment programme. That funding is transforming the airport and the passenger experience, with a terminal upgrade, improved security and immigration areas and investment in car parking facilities. It is not just the passengers who are benefiting from that investment. The airport has recently invested half a million pounds in a new education centre for five to 18-year olds to create an inspirational airport-themed learning environment for the local communities. That will encourage the next generation to consider jobs in the aviation industry. Indeed, I was pleased to hear about similar work being done at London City airport.

At Luton airport, a £100 million investment programme is seeing expansion of the existing terminal, investment in the latest security scanning technology and improvements to the airport’s forecourt.

Southend airport did not get much of a mention today, which I was a bit disappointed about. However, I will visit it in two weeks’ time. Substantial redevelopment of the airport has seen a new control tower, a dedicated rail station, improved terminal facilities and a runway extension. The Secretary of State for Transport had the pleasure of opening the new £10 million extended passenger terminal back in April 2014. Private sector investment at Southend airport has also meant the dedicated railway station being opened, providing direct rail links to the airport for passengers travelling on the line between Southend Victoria and London Liverpool Street.

We have heard from almost everyone who has contributed today that good surface access links to our airports are essential, because getting to and from an airport as quickly and easily as possible is vital for passengers. Also in Southend, investment by the Government is seeing improvements to routes in and around the town, including those to the airport. More than £38 million of funding has being provided through the local pinch point fund and local growth fund. In addition, funding secured by the South East local enterprise partnership will see further expansion of the Southend airport site to create a business park, commercial developments and jobs.

The Government’s plans for the first road period, from 2015 to 2020, include investments that will improve access to many of England’s major airports. For Stansted, that will include a technology upgrade on the M11 between junctions 8 and 14—incident detection improvements, automatic signalling, variable messaging signs and CCTV cameras will all benefit those travelling to Stansted airport. Further improvements are scheduled for passengers travelling to Stansted by rail.

Between 2014 and 2019, which is control period 5, Network Rail will deliver the construction of a third track between Tottenham Hale and Angel Road and power supply improvements on the line, along with a new station at Cambridge science park. Those changes will benefit passengers from the rest of the Anglian region and from London who travel by rail to Stansted.

I am well aware that my right hon. Friend the Member for Saffron Walden chairs the West Anglia taskforce, which I understand is looking at ways of improving rail connections between London Liverpool Street, north-east London, Cambridge and Stansted airport. We look forward to seeing the taskforce’s findings when they are presented later this year. During the debate today and on other occasions—often over breakfast—my right hon. Friend has made his own position on the issue more than clear.

At Luton airport, we have funded improvements connecting the M1 spur to the wider motorway network, improving access to the airport and helping to reduce congestion. The South East LEP has also secured more than £21 million of funding to improve road access for passengers and planned development around Luton airport. By the way, we will also consider the recommendations set out in the Transport Committee’s study of surface access to airports when they are published later this year. I was pleased to be able to give evidence to that Committee.

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Given the Minister’s remarks, does he recognise the potential benefit of the expansion that is proposed at London City airport? Of course, that expansion is now subject to a planning appeal procedure, but it is a potentially worthwhile and significant addition to airport capacity for London, the south-east and the Anglian region, which could be delivered quite quickly.

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I thank the right hon. Gentleman for making that point. I will be very careful about what I say in the light of the planning inquiry that is scheduled to take place in March. As he mentioned, the Secretaries of State for Transport and for Communities and Local Government will make the final determination on the application, so it would not be appropriate for me to comment. I very much enjoy using that particular airport. Indeed, I timed myself passing through security the last time I used the airport. It took just four minutes, which is just what members of the business community want. They want to arrive very late at the airport but still get on the flight, although I am not sure that the airport management would suggest that as a strategy.

Within the UK, airlines operate in a competitive and commercial environment, and we consider that they are best placed to determine which routes they operate and from which airports. We know that the commercial aviation market brings many benefits to air passengers. However, the Government also recognise that aviation plays an important role in connecting regions, so there may be occasions when aid is necessary to develop air services to airports where local economic conditions prove unattractive to airlines. However, we are conscious of the risk of competition being distorted by Government intervention in the commercial market. That is why we have been careful in balancing the commercial imperative with the need to provide support for new air routes from our smaller airports.

The Chancellor announced in November that 11 new air routes from smaller UK airports would be supported, with about £7 million of start-up aid over the next three financial years. Those routes—two of which are from Norwich airport and one from Southend airport—will begin operating from this spring, and they will provide domestic links between England, Scotland and Northern Ireland, as well as international connectivity to France, Germany, the Netherlands and Ireland.

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The Minister is being generous in giving way. Will he undertake to continue to monitor the fiscal impact of air passenger duty, including on the growth of regional airports and on potential new long-haul routes? APD is an important issue, although it does not lie within his remit.

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Yes, I almost say without thinking that that is a Treasury matter. However, as my hon. Friend outlined in his speech, we have seen massive investment in road and rail, which has been funded in part by air passenger duty and other taxes. I point out that APD raises £3.2 billion per year, and the Chancellor has responded to concerns about it in a number of Budgets, not least by simplifying the banding so that people travelling on the longest-haul flights are not penalised. Most importantly, however, he has recognised the problems that many parents face with the high cost of flights during school holidays by bringing forward exemptions to APD for children. If there is one thing that I cannot criticise the airline and airport industries for it is making clear their views on APD.

My right hon. Friend the Member for Saffron Walden raised the issue of the A120 from Braintree to Marks Tey. In the July Budget, the Chancellor announced that the Government would co-fund a study with Essex County Council into dualling the last single-carriageway section between Stansted and the A12. That puts the scheme in a strong place for the next roads investment strategy. If funding is secured for the scheme, it could be one of the first schemes at the start of construction in roads investment strategy period 2, which I think is the equivalent of a control period in the rail industry.

The hon. Member for Luton South (Mr Shuker) talked gloriously about Luton airport and its benefits. Luton Borough Council is part of the east-west rail consortium of local authorities, and the rail investment strategy has made funds available for the reinstatement of passenger and freight services between Oxford, Bedford, Milton Keynes and Aylesbury. The infrastructure is expected to be completed by 2019, although the final stage of the electrification between Bletchley and Bedford will not be completed until 2020-21, to coincide with the electrification of the midland main line.

The hon. Member for Luton North also, not surprisingly, talked about Luton airport. Luton airport will assist the Department and Network Rail in examining the opportunity to secure four fast train services an hour to London. Upon completion of the Thameslink programme, the new franchisee Govia Thameslink Railway expects to operate 16 trains an hour between London and Luton Airport Parkway at peak times.

I have received a copy of the Oxford Economics study on the benefits of Luton airport, and I will consider the points made in it. Having visited the airport, I am aware that the short journey up the hill would be much improved were there a rail link, but given that such a link would benefit mainly the airport, it is not a project for which I would expect the taxpayer to stump up most of the money.

The hon. Member for Dunfermline and West Fife (Douglas Chapman) talked about the importance of connectivity to all parts of the United Kingdom, including Scotland. Indeed, part of the assistance that we are providing to build connectivity is helping airports in Scotland. He also said that we must not be London-centric. I say “Hear, hear” to that, coming from Yorkshire as I do. He wisely did not touch on Prestwick airport, which is now run by the SNP—the Scottish nationalisation party, as it is becoming—and he did not update us on how that is turning out. He shakes his head—I am not surprised.

The hon. Member for Cambridge was kind in recognising the high level of agreement on aviation issues, and I am pleased that we will be scrutinised in that spirit. He talked about the sustainability of aviation, which is a subject close to my heart. This year will give us a once-in-a-lifetime opportunity to secure a global market-based mechanism at the International Civil Aviation Organisation meeting, so that we can bear down on aircraft CO2 emissions. I hope that that mechanism will be agreed later this year. Of course, airlines such as British Airlines and Virgin do tremendous work on alternative fuels produced from waste and from by-products of the steel industry.

I will give my right hon. Friend the Member for Saffron Walden plenty of time to sum up. The Government have established the right foundations for moving forward, gaining consensus and securing the benefits that aviation brings to the whole nation. We are clear about the economic and connectivity benefits that all our airports bring to regions and to business.

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I am grateful to colleagues for their contributions to the debate, which, as I anticipated, has covered a wide range of points. In response to the right hon. Member for East Ham (Stephen Timms), I respect the role that City airport can play and I hope that it will not be constricted in its future development. I mentioned Stratford because I believe it will become an increasingly important destination for people coming down the West Anglia line and for those going up that same line to take up job opportunities in Essex and Hertfordshire.

I say to my hon. Friend the Member for Peterborough (Mr Jackson) that I share his worries about the cross-country service. Perhaps we need to consider how we can strengthen it. I plead with him not to refer to Boris island, because when Maplin was conceived and started to be implemented our hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson) was probably still wearing short trousers.

My hon. Friend the Member for Colchester (Will Quince), in his brief intervention—he had to return to the Chamber—mentioned the A120, and the Minister’s words on that subject were helpful. It really has taken a long time.

The hon. Member for Luton North (Kelvin Hopkins) understandably spoke, as he always does, in support of Luton airport. Within its runway constrictions, I think that it has to look for point-to-point services, and there are possibilities there with the development of aircraft such as the Airbus A350 and the Boeing 787.

I say to the hon. Member for Dunfermline and West Fife (Douglas Chapman) that I sought to make a speech not wholly about benefits to my constituency but about a much wider area. One has to take a balanced approach, and in that sense I agree with the hon. Member for Cambridge (Daniel Zeichner). It is about quality of life versus economic prosperity, and we have to get the balance right. It is important to be able to draw employment and benefit from as wide a field as possible, rather than having to concentrate those things in any one particular area and give rise to a lot of popular opposition.

I am grateful for what my hon. Friend the Minister said, but we have no promises yet, and I hope that the West Anglia taskforce will deliver a message that gives the Government confidence that the project must go ahead. That project was my starting point, and I believe it is the key to a major improvement for the whole region. Although the four-track section might have a price tag of £2 billion, it is in fact cheaper than some of the other projects that we need to carry out over time, and it is key if people are to have any kind of decent transportation in their everyday lives, and key to supporting businesses and the airport. I leave that with the Minister, as the kernel of what I have been trying to say.

Question put and agreed to.

Resolved,

That this House has considered the effect of airport expansion on the Anglian Region.

Swine Flu Vaccination: Compensation

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I beg to move,

That this House has considered the compensation for people with narcolepsy and cataplexy linked to swine flu vaccination.

It is a pleasure to serve under your chairmanship, Mr Chope. I thank Mr Speaker for allowing this debate on an important issue, and I thank the Minister for being here to respond to the concerns that I will raise on behalf of my constituent, Lucas Carleton.

I begin by saying something about vaccinations in the broad sense. We are fortunate in this country to have a robust and comprehensive vaccination policy. The policy has saved countless lives since its incarnation almost 100 years ago. Through our vaccination programmes, and those of other nations, we have successfully eradicated diseases such as smallpox across the world, and have reduced the number of people affected by polio by something like 98% over the past three decades. To this day, the advice from mainstream medical professionals and the national health service is that everyone should be vaccinated, not only to protect themselves but for the wider benefit of the communities in which we all live.

Historically, we have seen the tragic consequences of terrible epidemics that vaccinations can protect us against. For example, during the ’20s and ’30s, Spanish flu killed more people than the first world war had. Vaccinations, which are often brushed off in our everyday lives as a painful exercise, save thousands of lives a year, reducing human suffering and misery on a huge scale.

There is no serious scientific debate among mainstream scientists about the benefits of vaccination to public health—medical advice is clear that vaccination is one of the most successful and cost-effective public health measures—but vaccination is not without controversy. There have been a small number of instances when vaccinations have been responsible for adverse reactions, causing sometimes long-term and sometimes irreversible problems. I stress that that is rare, but tragically it is the reason we are here today.

During 2008 and 2009 there was a global swine flu pandemic, also known as the H1N1 pandemic. The particular strain of flu originated in Mexico, but it quickly spread, leading to the World Health Organisation issuing its first ever “public health emergency of international concern” declaration. Cases were confirmed in 171 countries and more than half a million people are thought to have died as a consequence.

During the outbreak, the British Government decided to purchase enough swine flu vaccine to immunise the entire population with two doses, meaning that 120 million doses were ordered. Almost 99% of the vaccines that were given out were Pandemrix, manufactured by GlaxoSmithKline—GSK.

Vaccines, as with all pharmaceutical products, are subject to extensive clinical trials. However, it is recognised that during a pandemic the trials may not be as rigorous as they would otherwise be, because of the demand to safeguard lives. Completing mass trials can takes months or even years. For that reason, the European Union intervened and licensed Pandemrix for use within the EU, including the UK, without the completion of the normal rigorous trials. That was followed by advice from the UK’s Joint Council for Vaccination and Immunisation, which advised that the Government begin immunisation to protect against a swine flu pandemic in this country.

As a consequence of the speeding up of the licensing process by both the EU and national Governments, GSK was not prepared to supply the vaccine to Governments unless it was given indemnity from any liability. The UK Government gave GSK that indemnity. For a number of reasons, other countries were much more cautious about granting an early licence. For example, the Food and Drug Administration in the United States had a policy of not licensing adjuvant vaccines—that is where a substance is added to vaccines to increase the body’s immune response—without robust clinical trials demonstrating that they are safe. Adjuvant vaccines have additional chemicals that speed up the body’s immune reaction to the antigen, and it is considered that that sometimes increases the risk of adverse reactions. That possibility led other countries, such as Switzerland, to license Pandemrix only for adults and not for children.

Pandemic swine flu vaccinations were added to the Vaccine Damage Payment Act 1979 by the Vaccine Damage Payments (Specified Diseases) Order 2009 in September 2009. The vaccine was added to the Act for the duration of the pandemic campaign, which lasted from October 2009 to August 2010. The campaign ended when the Swedish and Finnish Governments expressed concerns about a vast increase in the number of paediatric narcolepsy cases in children under 10. The condition usually shows symptoms in those in the 15 to 30 age bracket. It was not until August 2010 that the Swedish and Finnish Governments discovered a link with Pandemrix. On 1 September 2010, Finland stopped vaccinating with Pandemrix. The UK Government discontinued the pandemic campaign from the same date, but encouraged GPs to continue vaccinating with Pandemrix where no seasonal flu vaccine was available.

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Figures indicate that one in 2,000 people have narcolepsy that is not related to vaccination. When it comes to compensation, how would the hon. Gentleman ensure that those who are vaccinated and are due compensation actually get it?

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The hon. Gentleman’s intervention is timely, because he raises the issue to which I now turn. Lucas Carleton is a young boy who lives in my constituency in Liverpool. On 17 January 2011, he was vaccinated with Pandemrix. He was seven years old at the time and was in good health. His mother, Pauline, asked her GP to vaccinate Lucas because a family friend had recently been very ill with swine flu and, perfectly understandably, she believed it was a responsible step to get her son vaccinated. A week or two after Lucas received the vaccination, he began to experience excessive daytime sleepiness, which is a common characteristic of narcolepsy. He also started falling when he laughed or got excited, made strange facial expressions and experienced a loss of control of his tongue. That is known as cataplexy and is a common symptom of narcolepsy. After two to three weeks, Pauline sought medical help from a GP and Lucas was taken to hospital on a number of occasions. In August 2011, he was diagnosed with narcolepsy.

Narcolepsy is an incurable neurological disorder that until 1999 was classified as a psychiatric condition. Its main symptoms involve excessive daytime sleeping, hallucinations, sleep paralysis, temperature control problems and cataplexy. Cataplexy is a side symptom of narcolepsy that causes involuntary muscle relaxation brought on, for example, by laughing or anger. Narcolepsy begins in the hypothalamus, the part of our brain that controls our autonomic nervous system, which involves processes such as breathing and the regulation of the heart. Narcolepsy occurs when the brain cells that produce neurotoxins in the hypothalamus are destroyed, either through a trauma or through the body’s immune system mistaking those cells as foreign bodies.

The Department for Work and Pensions has accepted that the Pandemrix vaccine is capable of causing narcolepsy in children. It has also accepted that, in many cases, Pandemrix did in fact cause narcolepsy in children. However, it disputes that narcolepsy amounts to a severe disability. That is an issue on which the DWP has been defeated in court, but I understand that it is appealing against the decision. Herein lies the issue: the 1979 Act recognises that there can be adverse reactions to vaccines that can cause severe and irreversible damage to patients. Since the Act was passed, around 900 people have been awarded compensation, which is a very small number when compared with the 650,000 children vaccinated every year. Compensation can range from £120,000 into the millions.

The pandemic swine flu vaccine was part of the 1979 Act from September 2009 until it was removed by the Vaccine Damage Payments (Specified Disease) (Revocation and Savings) Order 2010. That is preventing Lucas from claiming compensation, as he had the vaccine administered outside that period, in January 2011. If the pandemic swine flu compensation period was simply extended to April 2011, Lucas and others who had adverse reactions could claim compensation for the reaction to the vaccine.

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The hon. Gentleman is making a powerful argument, and I congratulate him on securing the debate. My constituent Ben Foy sadly suffers exactly the same symptoms as Lucas, and the DWP has acknowledged that there is a link between Ben’s swine flu vaccination and the development of narcolepsy and cataplexy. The Department appears to acknowledge that he is disabled as a result, as Ben is in receipt of disability living allowance, but it is saying that his case is not severe enough and there are no grounds for that disability compensation. As can be imagined, the family feel that that is a complete insult. Does the hon. Gentleman have any thoughts on that?

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I am grateful to the hon. Gentleman for making that point. While the focus of my remarks has been on the compensation period, there is clearly a related issue with the attitude of the DWP on the severity of disability. I concur with the important point that he raised on behalf of his constituent. A number of other families in other constituencies around the country are also affected, and I welcome the colleagues from all parties who are in the Chamber for this debate.

It is worth reiterating the point that the hon. Gentleman just made: the Government have accepted that there is a causal link between the vaccine and narcolepsy. Since 2014, the Department of Health has had responsibility for the 1979 Act, which is a welcome change. Bringing the Department of Health into the process should ensure that responsibility for the legislation is controlled by health professionals, rather than benefits officials. That shift of responsibility can be a good thing for constituents like mine who have outstanding compensation claims. I am asking the Department for Health to extend the compensation scheme to make it possible for all citizens who have life-changing conditions as a result of vaccines to claim compensation. That is not only important for the individual families suffering as a consequence of adverse reactions; it is crucial to ensuring public confidence in the vaccination system.

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Does my hon. Friend agree that the quality of life of people who have been affected or damaged by the vaccine is dreadful and quite deplorable? We should be doing something as soon as we can to sort that out.

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I thank my hon. Friend for making that point. He is absolutely right. In preparing for today, I was struck that some of the aspects of this subject are technical in character. It has been a little like going back to school and doing biology again in learning some of the terminology. What lies at the heart of the debate, however, is the lives of children and their families. I raised this issue on behalf of my constituent because I want to ensure that he and his family have the quality of life that any family should have the right to expect.

I was about to say that extending the compensation scheme is important not only as a matter of compassion and decency for the families concerned, but to ensure public confidence in the system of vaccination. There is barely a one in a million chance that people will react badly to a vaccine, so if it was certain that, were that to happen, there would be compensation, that would not only be right for the affected families but increase confidence in vaccination.

In conclusion, I am aware that the Department of Health has for some time been in discussions with the lawyer representing Lucas. I thank the Department for listening to my constituents’ concerns, but, on behalf of Lucas and his family, I urge the Minister to do everything she can to ensure that those discussions are brought to a successful conclusion.

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It is a pleasure to serve under your chairmanship, Mr Chope. I congratulate the hon. Member for Liverpool, West Derby (Stephen Twigg) on securing this debate. I am aware that he has sought to support his young constituent and his family on this difficult matter for a number of years, and we have written to each other about this case previously. I was very pleased that, despite this sad case, the hon. Gentleman emphasised his general support for vaccination programmes. We are lucky to have a world-class national immunisation programme. Such programmes are a vital way of protecting individuals and the community as a whole from serious diseases, so I am grateful for his sentiments in that regard.

The hon. Gentleman referred to the global swine flu pandemic and the arrangements for licensing drugs during a pandemic. Flu pandemics are natural phenomena. They occur when a new flu virus emerges and spreads around the world and most people do not have immunity. Each pandemic is different. The nature of the virus, the population groups most likely to be affected and the impact cannot be known in advance. It is impossible to predict the severity of a new virus strain. Large swathes of the population can become infected over a relatively short period if transmission spreads rapidly. The potential impact of pandemic flu makes effective measures to limit the spread and morbidity of virus infection a public health priority. Countermeasures are employed in combination. Vaccination, when possible and appropriate, is one such countermeasure.

Thankfully, the H1N1 strain of swine flu turned out to be relatively mild, but we should not forget that it still caused more than 450 deaths in the UK. Pandemrix, the vaccine that the hon. Gentleman’s constituent received, was developed specifically for use in a flu pandemic when the number of lives lost and people with serious illness could not be known. Once a new pandemic strain emerges, it takes several months to produce batches of a specific vaccine to protect against it. As a pandemic strain of flu generally spreads rapidly, there is of course little time to undertake large-scale clinical trials. To address such constraints, the European Medicines Agency has a mechanism for the fast-track licensing of pandemic vaccines to address the immediate public health threat. The mechanism includes accelerated clinical trials while permitting the use of the vaccine in advance of receipt of all the required clinical trial data.

It would be unfeasible to conduct very large clinical trials in the midst of a pandemic, when time is of the essence, to identify risks that are very rare. Indeed, regardless of the pandemic situation, very rare potential risks can generally be identified only after a medicine or vaccine has been licensed and used in the wider population. All Governments have a responsibility to protect public health. The decision to commence the swine flu vaccination programme, which was made by previous Ministers in 2009, would have been based on the expert advice of the Joint Committee on Vaccination and Immunisation, an independent expert committee that advises Ministers in the Department.

Pandemrix was used against H1N1 swine flu in the UK from October 2009 to March 2010. It was used again on a limited basis in the following flu season until March 2011. The hon. Gentleman has noted that his constituent received Pandemrix in January 2011, during the seasonal flu vaccination programme for winter 2010-11, rather than the specific response to the swine flu pandemic in 2009-10. As he noted, that is highly relevant. He summarised his constituent’s experience and described the impact that narcolepsy and cataplexy can have on an individual. I very much assure him that I do not underestimate how distressing narcolepsy can be, for both those with the condition and their carers. Indeed, I was talking to a constituent about that very issue only this past weekend. I fully recognise the impact that narcolepsy can have on quality of life. It is important that anyone with narcolepsy, with or without cataplexy, receives the appropriate care and attention so that they can manage their illness.

At the time Pandemrix was used in the UK, no potential association with narcolepsy was known. Following suggestions of a possible association with narcolepsy, its use was stopped in the UK in March 2011, on the advice of the EMA. The hon. Gentleman referred to the Vaccine Damage Payment Act 1979, which was designed to help to ease the burdens on those individuals to whom, on very rare occasions, vaccination has caused severe disablement. The degree of disablement is assessed on the same basis as for the industrial injuries disablement benefit scheme. It would not be appropriate to comment on the case raised by the hon. Gentleman.

Despite the title of this debate, I would like to clarify for the House that the vaccine damage payment scheme is not a compensation scheme. The hon. Gentleman referred to compensation ranging from £120,000 to millions of pounds; in fact, the VDPS provides a one-off, tax-free lump-sum payment of £120,000. The scheme does not prejudice the right of the injured person to pursue a claim against the manufacturer of the vaccine. As the hon. Gentleman alluded to, his constituent is pursuing that course of action and, again, it would not be appropriate for me to comment further on that case.

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I appreciate that the Minister cannot comment on an individual case in this forum and that the discussions are ongoing, but is she able to comment on the affected time period? It is the definition of the time period that is denying my constituent access to the scheme.

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I am aware of that and will address it shortly, although I suspect the hon. Gentleman might be disappointed by what I have to say.

A VDPS payment is for those who are severely disabled as a result of a vaccination against those diseases listed in the 1979 Act and those that have been specified by statutory instrument since then. As I have already mentioned, the hon. Gentleman noted that his constituent received Pandemrix in January 2011; however, the Act relates to diseases, not vaccines. The list of specified diseases covered by the Act includes pandemic influenza A (H1N1) swine flu, where vaccination was administered from 10 October 2009 to 31 August 2010—the period of the swine flu pandemic. That was a temporary addition considered appropriate by Ministers at the time. The hon. Gentleman’s constituent’s vaccination was administered in January 2011, so it was not given for pandemic swine flu, which is covered by the Act.

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GlaxoSmithKline was indemnified because there was an issue of risk—that is the whole point. Why are the Government not as quick to effectively indemnify the victims of this vaccine?

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Perhaps it would be easier if I wrote to the hon. Gentleman after the debate to clarify that point.

As I have said, it appears from the timing that the constituent of the hon. Member for Liverpool, West Derby received the vaccine during the 2010-11 flu season. The 1979 Act did not cover seasonal flu vaccination at that time as it was not part of the routine childhood immunisation programme. Influenza was added to the Act as a specified disease in February 2015, but the order stipulated that the vaccination against influenza must have been administered after 1 September 2013, when flu vaccination became part of the routine childhood immunisation programme. Unfortunately, that will not assist the hon. Gentleman’s constituent. I am afraid that it is not possible to accept a claim outside the conditions laid down in the Act. I recognise that that aspect of the scheme has produced an unfortunate result in this case, but we must work within the confines of the law. The Act has been in place for many years on the basis of disease rather than vaccine, and the Government currently have no plans to change how the scheme is run.

Of course, I have sympathy for the case that the hon. Gentleman has made on behalf of his constituent, and I recognise the frustration and disappointment that his constituent and his family will feel at my response. This is a complex topic, with no quick or easy answers, as successive Governments have found. I stress, though, that the VDPS is only one part of the wide range of support and help available to severely disabled people in the UK. Other examples include the disability living allowance, which provides an important non-contributory, non-means-tested and tax-free cash contribution towards the disability-related extra costs for severely disabled children. I encourage the hon. Gentleman’s constituents to consider what other entitlements might be available. I know that the hon. Gentleman will continue to offer Lucas and his family every support in that regard.

Question put and agreed to.

Access to Jobs: Disabled People

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I beg to move,

That this House has considered access to jobs for disabled people.

It is a pleasure to address the Chamber under your chairmanship, Mr Chope. It is important when assessing the impact of Government policy and judging its success to look closely at the individuals we represent. We must bring to the attention of Ministers—I know this particular Minister quite well by now, and I know that he is assiduous in his duties—individual cases that we consider representative of the failure or success of Government policy.

I want to talk about a constituent of mine, Margaret Foster, whom I have come to know quite well over a number of years. Margaret has suffered from cerebral palsy from birth. She has been directly affected by Government disability policy in recent years, because for 26 years she worked at the Remploy factory in Wrexham. During that period, she was a taxpayer who contributed to her community and all of our communities by paying taxes and working hard in her job. She did not particularly like her job; she is quite frank about that. She is a very bright woman, and she felt that it did not stretch her capabilities. Nevertheless, she held down the job for 26 years and took great pride in it.

I first met Margaret in about 2007-08, when the then Labour Government proposed to close the Remploy factory in Wrexham. I argued against that proposal at the time, and I was pleased ultimately to win the argument to the extent that the factory remained open in 2008. Unfortunately, the coalition Government revisited the issue of Remploy in 2012 and decided to close the factory in Wrexham, as they did a large number of Remploy factories across the country, affecting many disabled people.

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I congratulate my hon. Friend on bringing such an important issue to the House. Does his constituent feel as betrayed as my constituents about the Government’s broken promises about the closure of the Remploy factories? The Government guaranteed support into employment, which is not there any more, but more than two thirds of the people in my constituency who worked for Remploy have not been able to get employment since the closure of the factories.

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Part of the reason why I secured this debate is to point out the failure of Government policy and the way in which it affected Margaret, who worked for Remploy for 26 years. Since the Prime Minister and the Conservative-Liberal Democrat Government decided to close Remploy, making Margaret redundant, she has not been in employment for a single day and has not been offered a job.

Rather than being a taxpayer, Margaret now lives on benefits. She has an income from the disability living allowance, and she receives an enhanced level of mobility allowance—£57.45 per week—and the middle-rate daily care component of £55.10 per week. She has even been refused employment and support allowance. When the initial assessment was made, she received no points. Even on appeal, she was given only nine points. She needs 15 points to qualify for the allowance. How can the disability benefits system present a case such as Margaret’s? She wants help to work and has been disabled from birth, but does not qualify for the benefit put in place by the Government supposedly to support her into work. What does the fact that the taxpayer is not supporting Margaret in her attempts to find work say about the Government’s policy?

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The hon. Gentleman is telling a powerful story about his constituent, Margaret. Is he aware that in Gloucestershire we recently launched a programme called Supported Internships? Remploy was a partner, as were the local authority, the local further education college and two employers. Supported internships are an effective way for people with significant disabilities to get back into employment.

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I have no doubt that they can be, but I am afraid they are not happening.

The 2014 labour force survey recognised that,

“disabled people remain significantly less likely to be in employment than non-disabled people.”

There is a 30.1% gap between levels of employment for disabled people and non-disabled people. I welcome any efforts to find internships and support individuals into work, which is what we all want. Margaret was in work when the Government decided to close Remploy factories, and we were told at the time that they would support those disabled people into jobs in the mainstream. When Remploy in Wrexham was closed and Margaret was put out of work, we received all sorts of assurances about how disabled employees would be helped into the mainstream jobs market.

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I lost a Remploy factory in Croespenmaen in my constituency, and the Welsh Government Minister at the time offered to take on the Remploy factories on the proviso that the Westminster Government devolve the Remploy budget to the Welsh Assembly. Does my hon. Friend think it is an absolute shame that, rather than looking at that proposal properly, the Westminster Government flatly said no to those Remploy workers?

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It is a matter of profound regret that the Welsh Government’s helpful offer to take over responsibility for the Remploy factories in Wales was not taken up. Their constructive effort to address this issue was rejected out of hand. Consequently, the 35 or so people in Wrexham who would have been in work if the Welsh Government had taken on the responsibility for ensuring that the factories remained viable lost their jobs, and Margaret has remained out of work ever since.

Margaret is not alone. I am grateful to the large number of organisations that are interested in the fact that I secured this debate and forwarded me numerous briefings, all of which I have read. Time does not allow me to refer to them in detail, but Mencap said:

“Current back-to-work support for disabled people has proved ineffective. Job outcomes for disabled people on the Work Programme are low at only 8.7 percent”—

nine people out of 100—

“for new ESA claimants, and 4.3 percent for other ESA/Incapacity Benefit customers.”

Sitting suspended for a Division in the House.

On resuming

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Since all the key players are here, I call Ian Lucas.

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Thank you, Mr Chope. It is always good to be described as a key player.

I was quoting Mencap:

“Work Choice, the Government’s specialist employment support programme, is ineffectively targeted and offers support to a small number of disabled people with just 17 percent of referred customers claiming ESA. This represents only a small proportion of disabled people who are looking for work and it is unlikely that many people with a learning disability are benefiting from it.”

Incredibly, between 2011 and 2015 the number of jobcentres employing a full-time adviser to help disabled people fell by more than 60% from 226 to only 90, with reductions in every recorded year. It is only going to get worse. Under the Welfare Reform and Work Bill, which is being considered in the Lords, employment and support allowance for those in the work-related activity group will be cut by almost £30 a week for new claimants from April 2017.

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Given the context that the hon. Gentleman is describing and the shocking statistics that he is giving us, is it not not in the least surprising that 3.7 million disabled people in this country live in poverty? That number increased by 300,000 last year and will only get even worse in the light of the issue that he is raising.

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Absolutely. We want to get people into work. The irony of Margaret’s case is that she was put out of work. The responsibility must rest with the Government. I am not talking about a private sector job, but about a job taken away by a Government led by our current Prime Minister. He must take full responsibility for that, and it makes me angry.

Seventy per cent. of respondents to a recent survey carried out by the Disability Benefits Consortium said that the £30-a-week cut would affect their health and more than half said that it would mean them returning to work later. So constituents are now approaching us. Margaret is only one example, but it is important to refer to individual cases—one of the benefits of being a Member of Parliament, having constituency surgeries and getting to know our constituents, is learning from them how they are directly affected by Government policy. I want the Minister and everyone in the Chamber to be aware of how Margaret has been affected by Government policy, because if the Government really want to address the situation that they have created for someone such as her, they must give proper support to those who are unemployed.

The mentoring scheme that the hon. Member for Gloucester (Richard Graham) mentioned sounds like a good one, but we need more of them. We need to find placements for disabled people to give them experience of work and to give them the opportunity to be in a workplace. If someone who has worked somewhere for 26 years has that job taken away by their own Government, that Government have a responsibility to persuade employers to ensure that such people have an opportunity to go to a different workplace and to have proper support.

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I congratulate the hon. Gentleman on securing the debate.

My constituent worked in Remploy, as Margaret did, under a skilled seamstress. She has learning disabilities and although she has worked since, it has been in wholly unsuitable jobs. The ESA group to which she has returned is the WRAG, and the concern for people such as my constituent is the disincentive to go to work because of cuts for new claimants in the WRAG. Does the hon. Gentleman agree that that threat of having less work will not promote work for people such as my constituent and Margaret? When things go wrong and their disabilities perhaps prevent them from being able to carry out their employment—

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Order. I understood the hon. Lady to be making an intervention, rather than a speech.

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It is difficult for me to respond to a speech, Mr Chope. I might get an opportunity later, but in view of the number of people present I should move on for now.

We need support, incentives for employers and mentoring of employees. None of that has happened for Margaret in my constituency since 2012. Margaret is only one example and there are many more. Many more people who were made redundant by the Government were told that they would be able to go into mainstream employment, but have not been able to do so. Some are now not even being provided with support through the ESA. As a consequence, they remain unemployed.

I want to hear from the Minister that the Government have a real intent to address the issue. He should be providing the level of support to which I believe citizens such as Margaret are entitled. The Government failed following the closure of Remploy. They have let Margaret and others such as her down. The Government need to up their game, because people’s lives are being destroyed and they are suffering because of ill-advised and improperly implemented Government policies.

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It is a pleasure to serve under your chairmanship, Mr Chope. Given the number of people wanting to speak, I will keep this as brief as I can.

When I saw the name of the hon. Member for Wrexham (Ian C. Lucas) leading on this debate, I rather suspected that we might dwell a bit on Remploy, because he has a long track record of campaigning on the issue. He is, however, right to draw attention to the plight of his constituent. Personally, I take a much wider view of disability employment. On many occasions I have said that I regard Remploy as but one model, and a model that harks back to a different era of how we saw disabled people fitting into the workplace.

I know that people rarely read election manifestos—I make the effort to read my own at least, if not the Opposition’s—but one of the proudest moments of my life was to see in the Conservative manifesto for the 2015 election a commitment to halve the disability employment gap. Such a commitment cannot be seen in any other party’s manifesto—only in the Conservative party’s. I for one am proud of that fact. I am equally proud of the fact that, over the past two years, we have got 340,000 more disabled people into employment, although I recognise that there are individuals who have not benefited and that there are always detailed reasons for how things can be done better.

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I congratulate the hon. Member for Wrexham (Ian C. Lucas) on securing this important debate, which should be not only about what has happened over the past two years, but about what is in the spending review. As I understand it, the spending review included a real-terms increase in the Access to Work budget for disabled people. Will my hon. Friend reflect on that for a moment?

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I certainly will. I served with the shadow Minister on the Select Committee on Work and Pensions, where we looked at the Access to Work scheme in some detail. I am sure we had different interpretations of what we heard, because we normally do, but that is a really important project that the Government have at their disposal—it is often described as their best-kept secret.

We could do far more on Access to Work, which is one of the few uncapped Government benefits in the sense that no artificial cap has been placed on the overall amount spent. It is really important that we realise that and understand what else it could do. It is not just for critical adaptations any more. The number of people with mental health conditions who benefit from Access to Work has increased by 202% since 2010—it has more than doubled.

That demonstrates a really important point that I want colleagues on both sides of the House to understand. Once upon a time, disability employment was about physical access: the nuts and bolts of equipment, doorway widths, desks and chairs and so on. While that remains important, today, mental health issues are just as important, but they do not get sufficient attention.

I hope Opposition Members will join me in paying tribute to the Minister’s commitment. He is working tirelessly to pursue the goal of halving the disability employment gap. The Disability Confident campaign occupies a great amount of his time and I know that he is personally committed to it. We should welcome that. In the previous Parliament, we saw frequent changes in the identity of the Disability Minister. I sincerely hope that our current Minister stays in his post for the entire Parliament—he may not wish that, but I do, because he is doing a superb job.

To return briefly to Access to Work, while one may think that the entire picture is rosy based on what I have said, it is far from that. Certain groups in the disability community are really struggling to get on to the employment ladder, such as those with learning difficulties and autism in particular. The hon. Member for Wrexham quoted the labour force survey and, I think, the 47.6% figure in it, which I saw in the Mencap briefing, too. There are arguments about the starting point, but, while the overall employment gap is 19%, for groups such as those with autism it is significantly greater than that and much more challenging.

If I had to give one recommendation to the Government, it would be to ensure that Access to Work is available at the pre-employment stage when people are looking for work. The employer needs confidence that Access to Work will be available. It cannot be something for them to discover after they have made a leap of faith to take a person on. That would be one way in which Access to Work could benefit a new group of people.

I am fortunate enough to chair the all-party parliamentary group for young disabled people and, when a few months ago the muscular dystrophy campaign Trailblazers did a short report on the right to work, it found that much more support was needed at the job-seeking phase of engagement with employment. That cannot all occur after employers have decided to employ someone, because only then can they start solving some of the practical problems.

There is a wider reason to increase disability employment not just for the sake of human dignity and equality, but, I am afraid to say, for fiscal reasons, too. If we can halve the employment gap, the gain to the Treasury, according to Scope, is somewhere in the region of £12 billion. That is a sizeable sum of money that should not be ignored by any Chancellor of any political persuasion.

I also want to make a plea. To go back to my point about Access to Work, one of the avenues I pursued in the Select Committee’s inquiry was the similarity between the ultimate purpose of disabled students’ allowance and Access to Work, which are both about allowing people to participate in their place of work, be that a college, university or workplace. I still struggle to understand why they are managed by two different Departments on different sets of procedures and with different criteria. It would be far better to bring them together, because they both seek to equip people to function in everyday life. I urge the Minister to look at that.

I will move on to my final point, because, while there is much more I could say, I want others to be able to contribute. No one should underestimate the difficulty of halving the gap. That will not be easy. I know that policy makers like to use the cliché “low-hanging fruit.” That is a disrespectful way to talk about individuals, but some will be closer to the workplace than others and it will be easier to get them into it. The difficulty will come when those with much more complex needs that are more costly to address come into play in terms of meeting the goal.

No one should underestimate the courage, ambition and confidence that young people need to try to seek work. A young person in their teens is probably still in the family home and in the school environment that they have always been in. To a certain extent, they are in a safe environment. It is not until one gets out there and tries to find a job that one really discovers the existence of prejudice against the disabled in society. That can be quite a shock to many young people—it certainly came as a shock to me. I was not expecting to encounter it when making job applications, yet I rapidly ran into it and I do not consider myself to have a particularly severe form of cerebral palsy at all.

When we discuss disability employment overall, it is worth remembering that we need to encourage young people. They do not aspire to a lifetime of supported employment and their families do not aspire to that on their behalf, either. They want full equality in the workplace and we must do all we can to make that happen. It is not easy. I do not doubt that it is a very ambitious target. We are making progress now, but there is no guarantee that that will continue for ever. I therefore thank the Minister for what he is doing. I have offered a few helpful suggestions and I look forward to hearing what other Members have to say.

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It is a pleasure to serve under your chairmanship, Mr Chope. I start by congratulating the hon. Member for Wrexham (Ian C. Lucas) on bringing this extremely important debate. I will declare an interest: I previously worked with individuals with disabilities and I chair the all-party parliamentary group on disability.

The importance of employment to those who are disabled should not be underestimated. As for all members of society, having a job is not just about earning a living; it also contributes to psychological wellbeing. A job, and the day-to-day experiences that come with it, can provide people with a sense of belonging and purpose. It can help them to build confidence and self-esteem. It can also help to provide social opportunities for people who may otherwise be vulnerable or isolated. In addition, closing the disability employment gap and helping people to reach their full potential has benefits for society and our economy as a whole. The Conservative party committed in its manifesto to halve the disability employment gap, although at present there appears to be no comprehensive strategy on how that is to be fulfilled.

Changing Faces has highlighted ongoing issues with attitudes and stigma, which can affect the employment prospects of people with facial disfigurements. Low confidence and poor expectations can also be internal barriers for disabled people.

Yesterday, my office team met Callum Russell, who is blind from birth and the founder of disabledgapyears.org, which seeks to encourage and enable young people with disabilities to volunteer on a gap year or a shorter-term project. The key point Callum highlighted was the benefits of such opportunities being available to those with disability.

I want to speak only briefly, because I am aware that so many people wish to contribute, but in addition to securing jobs it is also extremely important that the Minister considers enabling people with disability to start their own business and supporting people to maximise their skills and abilities in that realm. I am pleased to have been able to speak in this important debate. This is an area that the APPG will focus on and inquire into in the next 12 months. It is critical to address that, which is about empowerment, enablement and, ultimately—this is one of my favourite words—independence.

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It is a pleasure to have the chance to speak on this incredibly important topic. I congratulate the hon. Member for Wrexham (Ian C. Lucas) on securing the debate.

As my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) mentioned, the Conservative party committed in its election manifesto to help open up opportunities for the disabled, which I was very pleased about. The Prime Minister’s speech yesterday repeated the theme that the Government must be the enabler of people and the destroyer of prejudice. It is not just about providing this or that service.

Many great national third sector organisations such as Mencap, Scope, the Royal National Institute of Blind People and Action on Hearing Loss do so much to help those with disabilities, and we all welcome and appreciate the work they do. We are fortunate in Portsmouth to have some great work being done to support those with disabilities by the Beneficial Foundation—I declare an interest as patron of that organisation. It is a great organisation that works with people with a variety of needs, and I had the pleasure of showing the Prime Minister the work it does in 2014 when he visited Portsmouth.

I know from discussions I have had with the Beneficial Foundation’s chief executive, Jenny Brent, that finding a job or placement is just the first step in a journey back into secure and rewarding work for anyone with a disability. It is vital that there is support for that disabled worker in terms of adaptations so that they can do their job and have equal access to facilities.

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Will my hon. Friend reflect on the Disability Confident events that are run around the country, which bring together charities, employers and potential employees and help to bring people into the workforce?

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We have had examples of that in Portsmouth too. It is extremely important, as with any job fair, that people know exactly what opportunities are out there.

It is equally important that others in the workplace understand the needs of disabled workers and what disabled workers do not need. There is a difference between treating someone with respect and perhaps unintentionally adopting patronising attitudes. Organisations such as the Beneficial Foundation offer in-role support to both the disabled employee and their colleagues, ensuring that everyone makes the most of the opportunity.

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I congratulate the hon. Member for Wrexham (Ian C. Lucas) on securing the debate. Does my hon. Friend agree that we need to encourage people to look not at a person’s disability but their ability, to ensure they can bring that out?

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Yes, and if more organisations did that, many more people with disabilities would be employed. That is a message we must put out.

Local organisations are able to develop strong links with businesses and respond both quickly and flexibly. We know that there is still a big challenge to ensure that the disabled are able to take advantage of opportunities. The Access to Work programme helps a large number of people to overcome their physical disabilities in the workplace, but given our focus on achieving parity of esteem for those with non-physical conditions, I am pleased to see that Access to Work is also helping a growing number of people—the number has doubled since 2007—with dyslexia, learning difficulties or mental health conditions.

Everyone will welcome the Prime Minister’s speech yesterday on opening up opportunities across society. I am pleased that the state is standing up for its responsibilities as an enabler and not just a provider.

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It is a pleasure to serve under your chairmanship, Mr Chope. I congratulate my hon. Friend the Member for Wrexham (Ian C. Lucas) on securing this timely debate. Like him, whenever I think of Remploy, and particularly its Croespenmaen factory in my constituency, I feel anger, because I remember standing in the factory canteen on the day when it was announced that the Remploy factories were going to be closed. Some people were in tears and many were angry, begging me to save their jobs, but there was nothing I could do. That was one of my worst days as a Member of Parliament.

When that factory was under threat in 2007, the Remploy workers and the management did not sit back and protest. They went out and found business in the market. Indeed, one of the last acts of my predecessor, Lord Touhig, in 2010 was overseeing the signing of a contract between the blue chip company BAE Systems and Remploy to provide packaging.

What made me even more angry during that period was not only all the hard work that had gone to waste, but, as I mentioned in my intervention, what happened when the Welsh Assembly asked whether the Westminster Government would consider devolving the budgets so that it could provide a future for Remploy. When my right hon. Friend the Member for Cynon Valley (Ann Clwyd) raised the issue at Prime Minister’s questions, the Prime Minister gave a commitment to look at it. Unfortunately, the question was met by the Department with a big fat “no”.

The comment by the Secretary of State for Work and Pensions at the time that Remploy workers were only good to make a cup of coffee rubbed salt into the wounds and was absolutely damning. I try to hold back my anger when I think of comments like that. There was never an apology, and I am ashamed to say that that man is still in post.

I will, however, say this: there is nothing that can be done about Remploy now. It is no good looking back to the past. Those factories are gone. The workers unfortunately do not have a job, as in the case of Margaret, who my hon. Friend the Member for Wrexham spoke of. She has no future and is parked, like many of my constituents who worked in Remploy on employment and support allowance.

The worst thing is that, according to the solicitors firm Leigh Day, one in five people who have disabilities and find themselves in work still believe they are under pressure and under duress, and are fearful of announcing that they have some sort of disability. People who have short-term disabilities, such as those who have been diagnosed with Crohn’s or colitis, find themselves in disabling situations where they cannot work and find it difficult to come back to work. They rely on understanding employers, but many of them do not have that. Many of them find themselves out of work because of that.

I always want to give the Minister some suggestions, as the hon. Member for Blackpool North and Cleveleys (Paul Maynard) did; he made a very good speech and spoke from the heart, with great knowledge as a member of the Select Committee on Work and Pensions. I think the Minister knows what I am about to say, as I have said it to him on a number of occasions until I am blue in the face: the main tool for getting people back into work—Jobcentre Plus—is not fit for purpose. I am basing that not on anecdotal evidence but on the fact that 80% of people who gain a job through Jobcentre Plus are back out of work in six months. The fact is that statistical evidence shows that the most effective systems are not provided through Jobcentre Plus but based in the community. A job club or a training scheme based in a local library or supermarket is more effective.

Anybody who has ever had to walk into a jobcentre will know that it is akin to walking through Pentonville prison. There is a security guard on the doorstep. The seats are screwed into the floor. If someone is not there on time, the adviser will sanction them. They are not good places to look for jobs. What jobcentres are essentially doing when they sanction people is reaching at the most vulnerable. Those who are stuck in the system are being pushed further into it, and they are not being provided with the help and support they need. I have said over and over again that it does not matter how many schemes we have.

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Has the hon. Gentleman had the experience I have had of a really good Access to Work programme provider—in my case, Pluss, which has had considerable success in helping people with disabilities back into work? Does he agree that one thing we might do is put together some films of agencies and businesses that have had real success, so that we can show them in Parliament and spread the word about some of the great success stories, to encourage other employers to do more?

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I have come across Pluss. As the hon. Gentleman will know, I was once the unsuccessful candidate in the constituency of Cheltenham, right next door to his constituency. The work that Pluss does is absolutely fantastic, and I agree that we need to do more inside and outside Parliament to promote such training organisations.

The point I was coming to, which ties in well with the hon. Gentleman’s intervention, is that since the 1970s we have had 43 schemes in this country, introduced by Governments of all colours, and all of them have failed. Long-term unemployment is still stubbornly high, particularly for young people and those with disabilities. We now have to think outside the box. We can rebrand all our schemes—whether it is the youth training scheme, employment training, the new deal or even the Work programme—but they are not getting the outcomes we want.

I expect the Minister to defend Jobcentre Plus, which is a Government scheme; that is his right, but I want him to give people some hope that we will start thinking outside the box more.

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Mr Chope, may I ask how much time is left, so that the hon. Member for Wythenshawe and Sale East (Mike Kane) and I can divide it between us?

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There should be ample time for you and the other hon. Gentleman who is seeking to catch my eye. The latest we can start the wind-ups is 5.47 pm, but we do not have to use all the time until then.

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You have inspired me to speak longer, Mr Chope, but I will not; I will divide the time clearly between us. I thank the hon. Member for Wrexham (Ian C. Lucas) for bringing this debate to Westminster Hall. It is a really good subject matter and one on which we are all keen to participate. In my short speech, I will mention some good things that we do in Northern Ireland—I know this is a devolved matter, but it is good to exchange ideas about what we do in Northern Ireland and what is done here in the mainland.

Despite the great services that exist and the Access to Work scheme, the proportion of people with a learning disability in paid employment has remained stubbornly low—we cannot ignore that fact—and according to Mencap UK, which represents people with learning difficulties, that proportion appears immune to economic factors. There are clearly issues to be dealt with. I know the Minister is totally committed to that and that he has done great things. We respect him greatly, but I think we need to look at what we can do better.

The proportion of learning-disabled people known to social services in paid employment fell from 7% in 2012-13 to 6.8% in 2013-14. Some hon. Members have spoken about the good things that have happened in their areas, and when that is the case, that is good—let us recognise those. We need to exchange such ideas and make others aware of them. However, that fall in numbers happened despite the fact that the majority of people with a learning disability can and want to work. There is an eagerness and a keenness to work, and we should encourage it. The figures are stark if we compare them with a national employment rate of 76% and an overall disability employment rate of just below 50%. As hon. Members have said, the Government pledged to halve the disability employment gap. Indeed, that pledge was in Conservative party’s manifesto, and we recognise and welcome it. It is good to see a commitment to it—well done.

Although welcome moves have been made to realise that commitment, the facts show that we need to do a bit more. I know the Minister will respond in a positive fashion, and I look forward to his comments. The Government need to monitor the disability employment gap, identify the factors that are still preventing it from closing and preventing disabled people from having access to work, and take action on those factors. There are things that the Government can do.

Department for Work and Pensions data show—I say this respectfully—that between 2011 and 2015, the number of jobcentres employing a full-time adviser to help disabled people fell by more than 60%, from 226 to 90, with reductions in every recorded year. We cannot ignore that issue. We all know that the Minister is a very pleasant person who is approachable and who does his job well, but that fact needs addressing. Perhaps he can tell us what steps the Government have taken to address the fall in the number of jobcentre advisers, and how we can best help people who are disabled when they come looking for assistance and help. That reduction surely contradicts the Government’s commitment to reduce the disability employment gap, and the effects of that cut in services need to be closely monitored to ensure that it is not having an adverse effect on the efforts to reduce disability unemployment.

I will give an example from Northern Ireland, because it is always good to put in the mix what we have done back home. We have an additional scheme to help reduce the disability employment gap. As well as the Access to Work scheme, there is Workable (NI), which is delivered by a range of providers contracted by the Department for Employment and Learning. Those organisations have extensive experience of meeting the vocational needs of people with disabilities, and using them is a great way of advancing social enterprise and supporting that sector.

Workable (NI) is a two-year programme that helps people out of economic gloom, gives them support and hope and prepares them for employment. It tailors support to individuals to meet their specific needs. The provision can include support such as a job coach to assist the disabled worker and their colleagues adapt to the needs of a particular job, developmental costs for the employer, and extra training, including disability awareness training. Those are all vital factors for any and all disabled people who want to work.

As I said, I am a great believer that this great country of the United Kingdom of Great Britain and Northern Ireland is better together. We know that, and many of us would subscribe to it. Let us exchange the good points and good practice that we have in every region of the United Kingdom. Lessons can clearly be learned from the approach in Northern Ireland, and we can develop additional strategies here in the mainland to help make good the Government’s comment to halve the disability employment gap.

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It is a pleasure to serve under your chairmanship, Mr Chope. I congratulate my hon. Friend the Member for Wrexham (Ian C. Lucas) on securing this important debate, and I pay tribute to him for the powerful personal testimony he gave about his constituent, who will feel very well represented tonight. I thank all Members who have contributed, including the hon. Member for Blackpool North and Cleveleys (Paul Maynard), who also gave powerful personal testimony—I would not want to pass by his contribution.

I grew up in a household in Wythenshawe where I saw a parent with progressive multiple sclerosis move from being in hard-working employment all her life to being on benefit. That was what really inspired me into public life. My recruiting sergeant was a certain Lord Alf Morris, who was my constituency Member of Parliament at the time. He introduced the absolutely groundbreaking Chronically Sick and Disabled Persons Act 1970, which revolutionised the way we looked at disabled people. It was about their rights, rather than what we gave them, and about how they could aspire to a better life. He also became the world’s first Minister for the disabled. I still get calls to my office asking if Alf is the Minister for disabled people in the Government today. I follow in the footsteps of giants, but I am prepared to do my best.

I also want to mention my predecessor, Paul Goggins. I worked with him when I was a local councillor in 2007 and the first threat to the Remploy factory in Wythenshawe came up. We lobbied the then Member for Neath, who was the Secretary of State for Work and Pensions. Paul did amazing things. He got on board with JCB and with the Authentic Food Company in my constituency. We brought together a whole host of businesses. He really turned things around—it went from having a £200,000 turnover to having a £600,000 turnover. It did not help in the end, and unfortunately the factory was shut in 2012.

I do not want to make a particularly party political point, even though 20 people lost their jobs. The hardest thing for my predecessor and for me at the time was not just those people losing their jobs—following on from what my hon. Friend the Member for Wansbeck (Ian Lavery) said, a lot of them have not gone on to find new work—but the fact that during the time we ran the campaign, 500 people got into employment through the work that we did. It was a solid way for disabled people to build skills and confidence and get into the workplace. It was measurable, attainable, smart and specific. It was a really good campaign.

I want to press the Minister by comparing and contrasting what Remploy did with what the hon. Member for Blackpool North and Cleveleys said about Disability Confident. Because of my personal passion, I am a supporter of any scheme that helps disabled people get into employment. I was therefore pleased to be asked by the DWP to get involved with a Disability Confident event in south Manchester. I worked with my next-door neighbour, my hon. Friend the Member for Stretford and Urmston (Kate Green), who is just as passionate about the subject and who held the post of shadow Minister for disabled people in the last Parliament.

We attracted 80 employers to the event, representing nearly 100,000 people around south Manchester. It included Manchester airport, Wythenshawe hospital and British Gas, which is in my neighbour’s constituency, and we had an extraordinarily good event. It was hosted by Vodafone—I asked it to host—which also sponsored the event, and I want to place on record my thanks to it for doing so. We had Cherylee Houston from “Coronation Street”—the disabled actress—who provided extraordinarily powerful testimony about her life and how she struggled to get into employment and into the acting industry. People from ITV talked about the company as an employer and about the changes and adaptations that it had made to make sure that she could play an important role in that TV series. I pay tribute to her and to ITV for providing role models of disabled people on our TV sets day in, day out.

I want to press the Minister on Disability Confident and how I think it should be improved. The event relied extraordinarily heavily on the contacts of the local MPs. That is an important point. Really it was the MPs, with their business contacts, who brought businesses to the event. That is a good thing, but the administration had to be done in the MPs’ offices, along with all the other things. It placed an inordinate strain on my extraordinarily hard-working staff and those of my hon. Friend the Member for Stretford and Urmston, but we did it. The DWP lacked co-ordination and leadership. It wanted us to lead as MPs, but things were extraordinarily difficult on the ground. I do not want to criticise DWP officials—far from it. They were well intentioned and worked hard, but there was a lack of a joined-up approach between various parts of the DWP and the agencies that it brought in to help. That needs to be looked at.

We know from our feedback surveys that the companies found the event extraordinarily informative. Many of them went away and implemented the good practices that we had showcased there. That involved companies, chief executive officers, human resources directors and the disabled people working in those companies—we had a number of disabled people there. However, as a politician and policy maker, I like to see numbers and outcomes. It was the lack of follow-up that was so difficult to understand—I am talking about getting all those companies in and understanding how they implemented the good practice. How many disabled people did we put in touch with them for pre-employment and employment opportunities? I just do not know those figures, and I find that quite frustrating as a Member of Parliament.

There is a strong narrative about getting disabled people into work, and we are trying to show leadership as local Members, but we need some resources from the DWP so that we can accurately measure the outcomes of such events—what we have achieved—and then plan further ahead by looking at the areas and expertise that we need to develop in order to go forward. I would like to run a similar event in the next year or two, but until I get substantive data about what we were able to achieve with the first events, that will be quite difficult.

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The reason I was so keen to speak in the debate is that 22% of my constituents in North Ayrshire and Arran aged 16 to 64 are recognised as disabled under the Equality Act 2010 or have work-limiting disabilities. It is therefore very important that I participate in the debate in order to represent my constituents.

We know that a compassionate and decent society dictates that halving the disability employment gap, which the Conservatives pledged to do and which is an extremely laudable aim, requires the correct amount of support to be provided, not the withdrawal of support, which is causing so much concern. The reduction of the ESA WRAG payment from April 2017 will force many sick and disabled people backwards and further away from getting the help that they need to get back to work or, indeed, to enter the workplace for the first time. That is despite the fact that the WRAG was created specifically to support the ill and disabled back into work, rather than simply placing them as jobseeker’s allowance claimants. The Chancellor of the Exchequer himself acknowledged in his recent Budget statement that ESA WRAG payment recipients are usually—very often—actively seeking a sustainable place in the workforce, but there is a credible argument in the community and voluntary sector that instead of incentivising work, the Government are actually disincentivising it. Many hon. Members have touched on that today.

Many sick and disabled people find the prospect of the demands of the workplace increasingly challenging, especially in terms of how employers will react to them. According to the Disability Benefits Consortium, one third of disabled people live below the poverty line; I also mentioned that earlier. It is the case that 3.7 million people who are disabled are living in poverty, and that figure is increasing. We know that because the figure increased by 300,000 last year. What is needed to enable those living with a disability to enter the job market is to treat disabled benefit claimants with personalised and compassionate care, instead of implementing reforms that ignore the complexities and challenges of these people’s lives. If we want to support disabled people into work, the benefits system designed to achieve that end must reflect that.

We have all heard in our constituencies anecdotal evidence of the shocking treatment of some claimants since the introduction of the work capability assessment, with “fit to work” decisions being made that seem to defy all logic and reason. Thankfully, many of those decisions have been overturned, but the stress and trauma that they cause the claimants in the first place is simply not acceptable. Far too many disabled people continue to face barriers that deny them the chance to find fulfilling work opportunities. What a tragedy that so many of those barriers have been erected and—looking into the future—appear to be continuing to be erected by the Government themselves, marginalising a group that is already excluded in so many ways. I urge the Minister to reflect on those concerns in his response.

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I pay tribute to the hon. Member for Wrexham (Ian C. Lucas) for securing the debate. He spoke powerfully about his constituent who has been personally affected by the decision taken in the last Parliament to close the Remploy factories. As many of us predicted at the time, that move has had a devastating impact on the lives of those directly involved, the vast majority of whom have been unable to move into alternative employment. That has been the case for Margaret and others we have heard about today.

Few would disagree with the aspiration of the Sayce review of supporting disabled people into mainstream employment, but that has proved much easier to hypothesise than actually to deliver. Too many disabled people who are seeking work find it difficult to enter the labour market or to access the kind of support that they need to help them to sustain employment.

Let us not forget, however, that about half of disabled people of working age are in work, most of them in mainstream jobs. Obviously, there are some disabled people whom we cannot expect to work, but there are also disabled people currently not in work who could, with the right support and workplace adjustments, overcome the disadvantages that they face in the labour market, and we have heard about many of them today.

We should also remember, though, that access to employment for disabled people takes place in a wider economic context. For instance, I do not think that the closures of the Remploy factories really took account of the economic situation at the time, or the local economies in those areas where the factories were based. In most cases, there have been scant opportunities for those people since the factories closed.

Disabled people are far more likely to be in work in times and places where jobs are plentiful. It is always easier to find a job in an area of low unemployment than in an area where many people are chasing every vacancy. The barriers facing disabled people are sometimes related less to their disability than to prospective employers’ preconceptions about what they can and cannot do. We therefore need to acknowledge that although disabled people have certain legal protections in work, getting a job in the first place is often much more difficult, especially for those who disclose invisible or fluctuating conditions, like those alluded to by the hon. Member for Strangford (Jim Shannon), or for those whose health conditions have left them with a patchy work history. We need to be honest with ourselves in this place about the extent of the disadvantage affecting disabled people in the labour market.

It is very difficult in a short debate such as this to do justice to such a broad topic, but as the hon. Member for Blackpool North and Cleveleys (Paul Maynard) reminded us, the Government had a manifesto commitment to halve the disability employment gap and now need to bring forward a credible strategy on how they intend to do so. At present, disabled people are disproportionately employed in the public and third sectors. Many are in organisations that have active equal opportunity policies in place and monitor the recruitment and retention of disabled staff. Unfortunately, parts of the private sector have not always kept pace with that, but one way for Government to make a difference, proposed by Disability Rights UK, is to ensure that businesses above a certain size monitor and publish data on the numbers of disabled people they employ. Many good employers do that already, but it would be a proportionate and effective way to improve access to work and would possibly help to tackle the direct and indirect discrimination that too many people who are disabled experience in the workplace.

The barriers to work for disabled people mean that the support that we offer through the social security system is all the more vital, but unfortunately the record of the last few years has been pretty abysmal in that regard, as we have heard, particularly in relation to the Work programme. As my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) pointed out, one third of disabled people in the UK live below the poverty line. That is about 3.7 million people. At a time of improvement in the labour market, the number of disabled people living in poverty actually increased last year. The shift from disability living allowance to personal independence payment has also meant that people with significant disabilities are losing eligibility for support. For many disabled people in low-paid jobs, such support enables them to stay in employment, so the clawback is counterproductive. Meanwhile, the Government’s plan to cut £30 a week from the support given to people in the work-related activity group—people who are not currently fit for work—is just vindictive.

This has been a timely debate, with substantial contributions on both sides. The Government are not doing enough to support disabled people’s access to employment, and I hope that Ministers will take on board the concerns raised today and bring forward the promised disability employment strategy as soon as possible.

I have a final request for the Minister. Will he reintroduce the “access to elected office” fund to enable more disabled people to enter political life? We have heard this afternoon that around one in five people in our society are disabled according to the definition in the Equality Act 2010, and it would be better if this place reflected that fact more accurately.

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It is a pleasure to serve under your chairmanship, Mr Chope. Congratulations to my hon. Friend the Member for Wrexham (Ian C. Lucas) on raising such an important issue, and on representing his constituent Margaret Foster so ably. The situation he described is, unfortunately, happening to disabled people up and down the country.

Since 2010, 3.7 million disabled people have been affected by £23.8 billion of cuts as a result of, for example, the Welfare Reform Act 2012. It does not stop there. Under the Welfare Reform and Work Bill that is passing through the House at the moment, another 500,000 disabled people will be affected by changes to ESA WRAG support—another £640 million of cuts. That does not include the cut to the universal credit work allowance, or the £3.6 billion of cuts made to social care since 2010. The hon. Member for Banff and Buchan (Dr Whiteford) was absolutely right to mention that disabled people are twice as likely as non-disabled people to live in poverty. The figure increased by 2%, or 300,000 last year; those measures will definitely impact on disabled people living in poverty.

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My hon. Friend mentioned the cut to the work allowance in universal credit. Has she seen the research by Liverpool Economics that shows that disabled people in work could lose up to £2,000 a year, making them one of the hardest-hit groups?

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I have seen that analysis. My hon. Friend makes a vital point. I know that that area is not the Minister’s responsibility, but we must try to get the Government to think again. That change will result in the same cuts as those that the Government reversed to tax credits; the process will just be slowed down slightly.

I want to get back to what happened with Remploy. The coalition Government closed 48 Remploy factories, and a total of 2,000 disabled people—including Margaret—were made redundant. Of those former workers, 691 were given the Government’s work-related activity support, 830 received jobseeker’s allowance, and we just do not know what happened to 470.

In addition to what has been said about Work Choice and the effectiveness of the Work programme, we must not forget Access to Work, which some people have mentioned. Of the 4 million disabled people in work, Access to Work is currently supporting only 36,800. If we are really serious about halving the disability employment gap, which is a noble target, that is totally inadequate. I know that the Government stated in the spending review that there will be a real-terms increase in spending on Access to Work, but what is the money? Nobody has said. Will it be a smaller chunk for more people? The Government need to be very clear on that.

The hon. Member for Strangford (Jim Shannon) has mentioned the specialist advice and support in Jobcentre Plus. There used to be only one adviser for 600 disabled people, but that has gone down further. I commend the Minister for what he is doing about the Disability Confident scheme. He is doing his very best on that, but across the country there are only 79 active members—79 employers—33 of which are disabled charities. We will not meet the target of reducing the 30% disability gap—it is 34% in my constituency—with such low take-up. To echo the language that has been used, it is absolutely vindictive to take money from disabled people who do not have the opportunities, support or resources to enable them to take up a job. It is quite perverse.

I am coming to the end of my time, but I would like to know from the Minister what is planned for Access to Work. Will he also undertake to investigate the position of the people who were made redundant when Remploy closed? Clearly, the situation is not good enough. Will he also look at the perverse position that we are in now, where we are making cuts to support for disabled people before we have work for disabled people to get into and support for employers?

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As your parliamentary neighbour, Mr Chope, it is a pleasure to serve under your chairmanship. I pay tribute to the hon. Member for Wrexham (Ian C. Lucas), who made a passionate speech on this incredibly important subject. I have already have some dealings with the hon. Gentleman in the course of his work on the all-party group on spinal cord injury. It was a real credit to him that he took time out of his busy schedule to come and engage on that.

I will cover the Remploy issue, and I would be happy to meet to discuss what more can be done in the specific case of Margaret and on the broader subject of disability employment. First, I want to answer some of the questions asked by various Members in what I thought was a constructive debate. As a Government, we are very much in listening mode. We are looking at ways in which we can make changes to improve the situation, and there are many ideas that we will look to take from today’s debate.

I thank my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) for his kind words, and I would be happy to continue in this role. He demonstrated a huge knowledge of the proactive work that needs to be done. It has been a real pleasure to work with him on a number of different areas of my role, and he is a real credit to his constituency.

It was a pleasure to attend the all-party group on disability, which the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) chairs so ably. We crossed paths on several occasions that day, when we went to a number of different meetings. She mentioned the work of Changing Faces. I met that organisation, which is doing a huge amount in a very important area. I am a big supporter of its “What Success Looks Like” campaign, which is an important part of the wider work that we need to do.

I echo the comments on self-employment. I had my own business for 10 years, and the careers advice that I always give to sixth-formers was, “If you are good at what you do, do it yourself. If you are not very good at what you do, be paid to be not very good.”

My hon. Friend the Member for Portsmouth South (Mrs Drummond) is doing a tremendous amount of work in her constituency. I was excited to hear about the work of the Beneficial Foundation, and I would be interested to visit and see that at first hand. I think that there are some lessons that we can learn.

It is always a pleasure to listen to the hon. Member for Islwyn (Chris Evans), who is easily one of the best speakers in Parliament. His suggestions about Jobcentre Plus were constructive. We are bringing forward a White Paper, which gives us an opportunity to look at how we can improve the situation. What he said about thinking outside the box was crucial. Some brilliant ideas have been put forward, and I encourage him to be very proactive, because there are some lessons that we need to learn.

It is also always a pleasure to hear from the hon. Member for Strangford (Jim Shannon). I do not think that I have responded to a single debate to which he has not contributed, and I am glad that he has not had another meeting that has clashed. It is good to exchange ideas, because if there are areas of best practice anywhere, we need to look at them. As I have said, the White Paper gives us a huge opportunity to change the support we offer, and I will discuss that further.

The personal passion of the hon. Member for Wythenshawe and Sale East (Mike Kane) shone through. I am grateful for the huge amount of work that was done in the Disability Confident event. I was disappointed to hear some of the negatives but it is important to raise them. We have addressed some of them and I will talk about that a bit more later. I would appreciate an opportunity to discuss them further because it is an important part of the work we are doing.

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I apologise for missing some parts of the debate but I was listening closely to the feedback of the hon. Member for Wythenshawe and Sale East (Mike Kane) on his Disability Confident event as I want to ensure that we have a Disability Confident event in Worcester. I ask the Minister to engage with the issue of the follow-up to the events to ensure that we make the most of the opportunity they represent.

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That is perfect timing because later in my speech I will highlight our drop-in event for parliamentarians. We are also producing a pack, which I will discuss later, and I would be delighted if my hon. Friend engaged with this because I know that he has done a huge amount of work engaging with employers, particularly with apprentices and at jobs fairs. We definitely need to recruit him to the campaign.

A comment was made about the role of the media and role models. I am doing a huge amount of work on that because it makes a big difference. The hon. Members for North Ayrshire and Arran (Patricia Gibson) and for Banff and Buchan (Dr Whiteford) covered relatively similar points regarding the ESA work-related activity group. Let us not forget that only 1% of people in the ESA work-related activity group were coming off that benefit each month. Rightly, it was highlighted that people want to get into work. Clearly that system was not doing that right. We can discuss in another debate how it will be done.

We will be spending an extra £60 million providing support this year, rising to £100 million by 2020. We should remember that no existing claimants will lose out on the cash. The proportion of people in relative poverty who live in a family in which someone is disabled has fallen since 2010. Without opening up a debate on disability living allowance and the personal independence payment, let us not forget that under DLA, 16% of claimants were on the highest level of benefit whereas, under PIP, the figure is 22.5%.

I turn to the issue of Remploy before moving to the broader issues. In March 2012, the Government confirmed that it accepted the Sayce review’s recommendations to focus support on individuals through services such as Access to Work, and away from specific workplaces or facilities such as Remploy in order to significantly increase the number of people who could be supported to access the labour market—it is that point about being in the mainstream. I understand that that is not what Margaret wishes to hear but I will come to more specific points.

The background to the case is that the 54 Remploy factories operated at a loss of £49.5 million, amounting to about £22,500 a year to support each disabled person working in a Remploy factory. That is in contrast to the average Access to Work award to support a disabled person in mainstream employment at £3,100. I understand that it is a lot more complicated than that. That debate took place in 2011 and 2012, and there was clearly a disagreement on what should happen. Following that, all disabled Remploy staff affected by the exit of Remploy factories had access to tailored support from an £8 million people help and support package for up to 18 months to help with the transition.

The final statistics of 21 August 2015 confirmed that just over 1,500 former disabled employees had received support through personal caseworkers, 867 were in work and a total of 1,182 jobs had been found. I accept that the point is what has happened since then. I do not know whether I can find that information but I will look into it.

In broader terms, ultimately we want as many people as possible to have the opportunity go into work. The Prime Minister personally committed the Government to halving the disability employment gap, and that was widely welcomed by all. In the past two years, there has been significant progress with 339,000 more people with disabilities going into work. A number of strands will help to make the aim a reality.

First, many Members have mentioned Access to Work. There is roughly a £100 million budget at the moment helping a near record 37,000 people. We have had four years of growth. Following the spending review, by the end of this Parliament we are looking to spend about £123 million and we would expect a further 25,000 people to be supported through that. We now have record numbers of people with learning disabilities, people with a mental health condition, and young people.

We have more specialist teams providing specific advice, including the visual impairments team, and other teams for hearing impairments, self-employment, large employers, and the hidden impairments specialists. Broader unique opportunities are also presented. We are looking at further ways to improve Access to Work, particularly raising awareness among small and medium-sized businesses, which would most benefit and could remove the most barriers. We are also looking into how we can simply provide more advice through that service. A number of speakers said that employers would be worried about whether they had the skillset to support somebody with a disability. Access to Work could be an opportunity to provide that.

Today we had our first Disability Confident taskforce. The hon. Member for Oldham East and Saddleworth (Debbie Abrahams) has rightly asked what more we can do to push that. We had a number of the great and the good from a huge wealth of backgrounds including recruitment agencies and groups that support people with disabilities to get into work, including the Federation of Small Businesses, Clear Company, the Business Disability Forum, the Shaw Trust and a number of others. There was a collective brilliance around that table. I told them that I am very much in listening mode and I want them to challenge us and to identify ways in which we can take advantage of the Chancellor increasing the funding.

The whole point is to make more businesses aware of the huge wealth of talent out there. That is being underpinned through our Disability Confident campaign, which is there to share best practice, bust myths and signpost businesses and potential employees to the help and support that exists. Underlying all this is ensuring that people understand that it is a positive benefit. We are not asking businesses to do something that is not right, but to take advantage, often through making small changes, having greater recognition or understanding that a huge network of support is available. We will push that, with a real emphasis on small and medium-sized businesses.

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The Minister is making a good case for Disability Confident. Does he agree that we need measurable outcomes for those events?

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Absolutely. I am coming to that, and we will be having that further meeting.

More than 300 organisations are signed up but that is not enough, which is why we will be doing a lot more promotion this year. The digital sign is now up and we are keeping more records of that. We will go back and challenge, particularly those larger businesses, to find out what more they can do with their supply chains and what further questions can be asked. That point was raised as well.

Motion lapsed, and sitting adjourned without Question put (Standing Order No. 10(14)).