House of Commons
Wednesday 2 May 2018
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
The Secretary of State was asked—
Welfare reforms in Wales are working. Since 2015, 54,000 more people have been employed; 25,000 fewer people are unemployed; and 25,000 fewer people are economically inactive. This demonstrates that welfare reforms are transforming lives across the country. As research shows, universal credit claimants spend more time looking and applying for work than those on previous benefits.
In January, the Wales Audit Office produced a report saying that the Government’s welfare reform policies were contributing to homelessness in Wales. What does the Minister think is causing homelessness in Wales?
We have been taking time to roll out universal credit and have responded to some of the needs and suggestions put forward, which is why people now get two weeks’ extra housing benefit, but I would add that not every council has used its discretionary payments for housing.
If universal credit is such a good thing, why is the Minister’s Government denying some Welsh-speaking people the right to apply for it?
I have already written to my colleagues in the Department for Work and Pensions about this because I recognise the importance of claimants being able to access the service in the Welsh language. That is exactly why the roll-out has been delayed in areas with a high proportion of people who speak Welsh. In addition, Welsh speakers can access some services via a freephone line.
Some 13% of adults in Wales received treatment for their mental health in 2015, and one in four of the wider Welsh population are thought to live with a mental health condition. Many suffering with mental illness are too ill to work. Last year, I was told by the Government in a response to a parliamentary question:
“No psychologists or psychiatrists are currently employed by Centre for Health and Disability Assessments to conduct work capability assessments.”
Will the Minister join me in requesting a meeting with the Secretary of State for Work and Pensions to discuss reviewing this policy and ensuring that those suffering from mental illness are properly assessed by professionals and not denied the welfare to which they are entitled?
We have been very careful to consult a wide range of experts—people working for disability charities and medical professionals—to make sure we get these assessments right. The hon. Gentleman is right that mental health needs to be looked at very carefully, and I will take up his invitation: I will meet my right hon. Friend the Secretary of State for Work and Pensions.
Network Rail: Electrification
Network Rail’s budget for investment in the Wales route is more than £1.3 billion—record investment in Wales’ railway infrastructure. Passengers in south Wales are also directly benefiting from our £5.7 billion of investment in the new intercity express trains operating from west Wales through Swansea to London.
The Secretary of State knows that Wales has 5% of the population and 6% of the railways yet less than 2% of the investment. Network Rail has just cut £1 billion from its projects, and £700 million has been cut from rail electrification. Will he now promise to support the Swansea bay electrified city metro scheme, alongside alignment, which would reduce the time between Cardiff and Swansea and result in faster, greener connectivity for Swansea bay?
The hon. Gentleman well knows that Wales does not operate in isolation. The hon. Member for Wrexham (Ian C. Lucas), for example, has been campaigning for the Halton curve, which is in England but of course would serve north Wales and link it better with Merseyside, demonstrating how the rail network in Wales does not operate in isolation. I have met Mark Barry, the proponent of the Swansea bay metro. He is undertaking a host of work on it, and we will happily look closely at it, but I point the hon. Gentleman to the need for a decent cost-benefit ratio.
On the subject of electrification of the line to Swansea, is my right hon. Friend aware that the South Wales chamber of commerce, in Swansea, is a darned sight more concerned about there being an old Labour Government in this country destroying industry than about shaving two minutes off a journey time?
My hon. Friend makes an important point. The political grandstanding by some Opposition Members does nothing other than undermine potential investment in Swansea. Nor will we take any lectures from a party that left Wales in the same league as Moldova and Albania in not having a single track of electrified railway line.
There is considerable disagreement about the total amount saved by the cancellation of electrification to south Wales—the figures range from £430 million to £700 million—but, irrespective of the total amount saved, does the Secretary of State not agree that there is a compelling case for reinvesting any funds saved by the cancellation in the Welsh network?
The hon. Gentleman has made an important point. There are opportunities for new railway investment in Wales. The Department for Transport’s strategic outline business case includes a range of options, one of which is improving access to west Wales; that would be transformed by a Swansea parkway railway station, for which there is a growing demand. We are well aware of the Welsh Government’s interest in linking Aberystwyth and Carmarthen, and I think that those schemes would be complementary.
Before I ask my question, Mr Speaker, I hope you will allow me to mention Tecwyn Thomas, a stalwart of Welsh Labour for many years, who has sadly passed away. He was my agent, and the agent of many Labour candidates in Wales. My colleagues and I send our condolences to Tecwyn’s widow Iris, and to his family.
According to a report from the National Audit Office, the Transport Secretary knew that bimodal trains would not provide the equivalent of electrification and that no trains exist that could deliver the timetable. Does the Secretary of State agree that the Transport Secretary acted against the advice that he was given when he cancelled electrification to Swansea, and that that has resulted in poor execution of Network Rail’s electrification work in south Wales?
Let me also pay tribute to the late member of the Labour party whom the hon. Lady mentioned.
A report from the Public Accounts Committee, to which I refer the hon. Lady, said that the plan for electrification between south Wales and Paddington should be reassessed on a stage-by-stage basis, and that is exactly what we did. Electrification would provide no practical journey time saving between Cardiff and Swansea; passengers would sit on the same train. I think we need to get over that issue. I am seeking to attract investment to Swansea, and constantly criticising the cancellation of a plan that would deliver no practical benefits to passengers does nothing to help that.
In the Transport Secretary’s statement of 20 July 2017, which cancelled the electrification of the line of Swansea, it was proposed that a new pipeline service be established for rail enhancement schemes. However, details of the process, and mechanisms for the development and delivery of the schemes, have not been forthcoming, and no Welsh scheme has yet entered the pipeline. Will the Secretary of State explain what the Transport Secretary is doing to prioritise the funds that Welsh projects so desperately need through that pipeline service?
As I have said, there are a number of options in the strategic outline business case, and it is important for us to use that to assess the merits of the study. The increase in the costs of electrification projects throughout the United Kingdom has naturally caused alarm—I mentioned the report of the Public Accounts Committee earlier—but I am excited by the proposals in the business case. I have already mentioned the potential, and the growing demand, for a Swansea parkway station, as well as a new station at St Mellons. There is a host of opportunities.
UK Administrations: Co-operation
I was always optimistic that discussions with the Welsh Government would result in agreement on the European Union (Withdrawal) Bill. The agreement that has been reached is testimony to the close intergovernmental working that has taken place and to the spirit of co-operation, and I am still hopeful that the Scottish Government will sign up to it as well.
Does my right hon. Friend agree that the agreement—announced last week—between the Welsh Government and the UK Government in respect of clause 11 of the Bill shows what can be achieved when Governments work together constructively for the benefit of the whole United Kingdom and all its peoples?
My hon. Friend has made an extremely important point. I think the agreement demonstrates the maturity of the relationship between the UK Government and the devolved Administrations. The Welsh Government recognised the merits of providing certainty and security for businesses and communities. I am still hopeful that we can underline the benefits of the scheme to Scottish businesses and communities, and that we can attract the support of the Scottish Government.
The heavy hand of the Treasury is still delaying investment in north Wales. Will the Secretary of State commit to real devolution, as we in north Wales want the freedom to invest and attract investment ourselves, to improve our infrastructure?
I draw the hon. Gentleman’s attention to the north Wales growth deal that we are currently negotiating between the authorities and businesses in north Wales. I met Ken Skates, the Economy Minister, just last week to discuss it. We are anxious to see greater devolution, but some Assembly Members do not want that, because some areas of north Wales have traditionally felt as isolated from Cardiff Bay as from Westminster.
Will my right hon. Friend extend to the Welsh Government the thanks of many hon. Members of this House for accepting the UK Government’s sensible and pragmatic proposals for resolving the issue of the repatriation of powers, thereby reflecting the fact that Wales voted to leave the European Union in 2016?
I am grateful to my right hon. Friend for that question, because he rightly focuses on the practical benefits and the outcomes. I believe that so long as we are focusing on an environment in which business can continue to invest, employ and represent communities in the way we have negotiated with the Welsh Government, that will put us in the strongest position to get the best benefits for every part of the UK.
I am sure that, in the interests of co-operation, the Government would not want to do anything that undermines the devolution settlement. Do they not recognise that the Conservatives are isolated in the Scottish Parliament, where there is a cross-party consensus that the EU withdrawal Bill is not fit for purpose? Will the Secretary of State therefore ensure that the House of Lords is not asked to consider the European Union (Withdrawal) Bill on Third Reading until all the devolved Assemblies have had a chance to pass a legislative consent motion?
As my right hon. Friend the Member for Clwyd West (Mr Jones) highlighted, so long as we focus on outcomes—and the Scottish Government focus on outcomes and delivering for Scottish businesses—I am confident we can reach an agreement. The Welsh Government clearly would not undermine the devolution settlement as far as Wales is concerned, and I hope the Scottish Government will see the merits of the certainty and security that we can offer Scottish industry and Scottish business with this agreement.
The Government understand that police demand is changing and becoming increasingly complex. That is why, after speaking to all forces in England and Wales, we have provided a comprehensive funding settlement which will increase total investment in the police system by over £460 million in 2018-19.
Cardiff hosts more than 400 major events a year—civic, political and royal—as a UK capital city, and on top of the Government’s police funding cuts, my constituents are having to find money to pay an extra £3 million for the annual cost of policing those events, which is the equivalent of 60 police officers. When are the Government going to recognise South Wales police as a capital city force, with proper funding to match?
As I said earlier, we have consulted all the police and crime commissioners and chief constables, as they are ultimately best placed to understand their local needs. Following the police funding settlement, most PCCs have set out plans either to protect or to increase frontline policing this year. I acknowledge the hon. Lady’s point on Cardiff; that is part of a national formula, but I will be happy to meet her if she wants to discuss it further.
Does the Minister agree that policing is not just about budgets and money, although they do matter, but about leadership, strategy and organisation?
My hon. Friend is absolutely right. I saw an interesting statistic recently: if we increase productivity through the better use of digital technology, we could save each police officer an hour a day, when they could be on the frontline. That would be the equivalent of 11,000 extra police officers a year on the streets of the country.
I, too, extend my condolences to the family of Tecwyn Thomas. He was well known, and was ready to work with other parties, including mine, to the benefit of his area.
Police forces in Wales pay £2 million a year towards the Government apprenticeship levy, yet get virtually no financial support towards training. Skills and education are devolved competences, but this levy was imposed by Westminster—cue entirely predictable confusion and buck-passing. Where was the consent decision to impose a 0.5% tax on major Welsh employers?
In the conversations I have had with many businesses around north Wales, they have welcomed the apprenticeship levy—
Not the CBI.
Well, I have been round a number of businesses, and they welcome the levy. The fact is that training in Wales is devolved, as the hon. Lady has said, and the amount of money that the UK Government have given to the Welsh Government exceeds the amount that the Welsh Government are spending on training.
I am sure the Minister shares my concern that the word “Orwellian” is overused in contemporary politics, but does he also share my concern that the Orwellian concept of doublespeak is epitomised in what now constitutes devolved consent agreement—namely, consent as agreeing to consent, consent as disagreeing to consent and consent as refusing to consent? How can Wales possibly say no?
There have been extensive discussions with the Welsh Government, and they have recognised that the UK Government have come a long way and that the levy is beneficial to the whole United Kingdom. I hope that other Governments will follow suit.
Order. If the hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards) wants to come in briefly on this question, he can, but he is not obliged to do so.
As the hon. Gentleman will know, the responsibility for overseeing NPAS lies with its strategic board, which is made up of police and crime commissioners and chief constables, including the Dyfed-Powys PCC. Both NPAS and the National Police Chiefs Council have already announced that they are undertaking work to address the issues that he has raised, and Mark Burns-Williamson has said that many of the areas identified in the report have already been recognised and they are doing work to address them.
Rail Links with England
The Secretary of State and I hold regular discussions with Cabinet colleagues and the Welsh Government on modernising cross-border rail connectivity. Improving connectivity drives economic growth and spreads prosperity to our communities on both sides of the border.
The western rail link to Heathrow—a 4-mile track between Slough and Heathrow—could mean a two-hour journey from Heathrow to Cardiff and Newport and a journey of around three hours to Swansea, not to mention huge economic and environmental benefits. The Welsh Government are in favour of this, the UK Government themselves committed to it in 2012, and yesterday an all-party parliamentary group on the western rail link to Heathrow—co-chaired by the right hon. Member for Newbury (Richard Benyon) and myself—was launched to remind the Government of their commitment. Will the Minister tell us when the link will finally be built, or are we to be subjected to further sluggish studies and Government procrastination?
I was about to be very complimentary and say that the hon. Gentleman had been a doughty campaigner on this issue, as have many people across the House. The western rail link to Heathrow would significantly improve rail journey times, and it is named in Network Rail’s enhancement pipeline. Network Rail is progressing the design and development of the link, and a final consultation on the proposed alignment is expected to commence this month.
Since the Secretary of State for Transport has agreed to give the power to award the next Cardiff to Manchester rail franchise to the Welsh Assembly, will my hon. Friend give the English MPs through whose constituencies—which include the beautiful towns of Church Stretton, Craven Arms and Ludlow—this line passes some indication of how we can hold the Welsh Government to account on this matter?
It is a line that I have used many times myself, and my hon. Friend is right to say that parts of his constituency are very beautiful. We have ensured that there is an agency agreement between the UK Government and the Welsh Government, so that English passengers—and Members of this House—can go to the Secretary of State for Transport and he can raise their questions directly with the Welsh Government.
There are significant opportunities for Wales from the industrial strategy, particularly in relation to innovation, where there is a commitment to raise the total research and development spend to 2.4% of the economy. This is already benefiting Wales, with almost £6 million committed to 17 Welsh partner projects.
I am grateful to the Secretary of State for that answer, but will he outline how he is ensuring that research and innovation, which is a key part of the industrial strategy in Wales, is recognised across the world?
My hon. Friend is a key campaigner for the steel industry, and I draw his attention to the Swansea bay city deal and the industrial strategy, which has established a new national Steel and Metals Institute, not only offering long-term viability to the industry in Wales, but complementing his constituency’s interests.
I thank my right hon. Friend for his answers so far. Does he agree that the combination of scrapping the Severn tolls and the cross-border commitment to the industrial strategy represents a significant boost for south Wales, mid-Wales and even south-west England?
My hon. Friend rightly draws attention to our commitment to scrap the Severn tolls by the end of this year, which will benefit south-west England and his constituency, as well as the south Wales economy. We are developing a new economic region and the industrial strategy commits to cross-border growth corridors. There is a great deal of excitement in south Wales and the south-west.
In view of the lack of news about a sector deal for steel—[Interruption]—coupled with looming trade disruption caused by US steel tariffs, what is the Secretary of State doing in Cabinet to press for action to get the UK—[Interruption.]
Order. The hon. Lady has been overwhelmed by just how popular she is. We will just have to hear the question again from start to finish.
In the light of the lack of news about a sector deal for steel, coupled with the looming trade disruption caused by US steel tariffs, what is the Secretary of State doing in Cabinet to press for action to get the UK steel sector a more sustainable future? When is the next Steel Council?
I have already referred to the national Steel and Metals Institute at Swansea University, which is important for the sustainability of the steel sector. On the US trading arrangements on steel, the UK and European exemption was extended last week, and my right hon. Friend the Secretary of State for International Trade has travelled to the US specifically to discuss the matter. I have also raised the matter with the US ambassador here, and we are optimistic.
It is not possible to be more grateful to the Secretary of State.
At the heart of the industrial strategy is a commitment to 5G connectivity for businesses in Wales. Most businesses across Wales, including in my constituency, have little or no connectivity and slow connections. The Secretary of State has been warned by the CBI that the industrial strategy must be achievable. Is all this not just pie in the sky for businesses that are not connected at the moment?
I point to the commitment to the Swansea bay city deal and to our ambition for Cardiff to be a 5G testbed, and we are excited for the opportunities that they will bring. As for connectivity, the Welsh Government have a significant responsibility and, although they have recently committed more money, I ask them to look at their planning rules. The highest that a mast can be in Wales is 15 metres, whereas masts can go to 25 metres in England.
Swansea Bay Tidal Lagoon
I have regular discussions with Ministers at the Department for Business, Energy and Industrial Strategy on energy matters pertaining to Wales, including the potential role that tidal could play in our energy mix. As I have said previously, it is an untried technology, so it is quite right that we take time to consider both the opportunities and challenges that it presents.
Will the Secretary of State now make a statement on the timetable for a decision on the Swansea Bay tidal lagoon? Has he asked his colleagues in BEIS to commit to such a timetable?
I have regular discussions with my colleagues in BEIS and with my right hon. Friend the Secretary of State for Business, Energy and Industrial Strategy about the project. We would like it to go forward, but it must provide value for money, so it is right that we take time to consider the matter. Data has been shared with the Welsh Government, demonstrating the partnership approach that we are determined to take, but no one should want the project to go ahead if it does not represent good value for money for the taxpayer.
Leaving the EU: Welsh Economy
The agreement reached between the UK Government and the Welsh Government on the European Union (Withdrawal) Bill will ensure that we exit from the EU with the certainty and continuity that businesses and communities across Wales have called for.
Will the Minister reassure the House, and businesses across Wales, by confirming that arrangements will be put in place to ensure that new trade deals negotiated after we leave the European Union do not undermine devolved policies?
I am grateful that the hon. Gentleman is looking at the opportunities that leaving the European Union provides. Obviously, exports from Wales to the rest of the world are expanding at a much quicker rate than exports to the European Union, which demonstrates that businesses are already looking to those new opportunities, and more Members are looking to those opportunities as we have them.
My constituent Damian Harris owns a cycle shop in Cardiff North but is struggling because of the uncertainty caused by Brexit. Twenty-nine of the 30 bikes he stocks come from the EU and, at the very least, he needs a customs union to have any sort of viable future. We are now hearing that 60 Tory MPs are plotting to sink their own Government to force the Prime Minister to abandon any form of customs arrangement. Will the Secretary of State guarantee that he will work with the Welsh Government and speak up against that decision? A low-skilled workforce and—
Order. We are grateful for the hon. Lady’s thoughts but, unfortunately, one has to take account of the situation in the Chamber. The question needed to be a bit shorter.
My right hon. Friend the Prime Minister is absolutely clear that we will be leaving the customs union but, of course, we are keen to negotiate to allow for the most frictionless trade possible with the European Union. We are also keen to take the new opportunities that leaving the European Union provides. We are keen to strike trade agreements right around the world, and to strike free trade agreements in due course.
My right hon. Friend will know that Labour’s economic development spokesman in the Welsh Government, Ken Skates, has spoken of the fact that Wales is receiving record amounts of inward investment. He said that Wales is “punching above its weight” at the moment. Is it not time that Labour Members started to listen to their own economic development Minister in Wales and stopped talking down the Welsh economy, which is booming under this Government?
Having met international investors from Japan, Qatar, the US and elsewhere over recent months, I am excited and optimistic about our prospects outside the European Union. Yesterday it was a privilege to be part of the inaugural flight from Qatar to Cardiff, which demonstrates that the industrial strategy, and the wider approach taken by the UK Government in seeking new markets, is already working.
Continuing the success of the “Wales reducing reoffending strategy”, the Prison Service in Wales, working with the Welsh Government, recently launched a joint framework to support those at risk of offending in Wales by focusing on early intervention to reduce the number of people entering the criminal justice system.
Does my hon. Friend agree it is vital that prison governors prepare offenders for life outside prison? For that purpose, will he therefore draw on the lessons from the Homelessness Reduction Act 2017, which has already been implemented in England?
My hon. Friend knows more about the Homelessness Reduction Act than anyone, and I congratulate him on the hard work he did to introduce the Act. He will be pleased to hear that the Ministry of Justice recently reached its target early to recruit 2,500 additional prison officers so that prisons can start to introduce a key worker model. This new model will mean prisoners have a dedicated officer to help them access services, many of which are devolved in Wales.
The Prime Minister was asked—
I know that Members across the whole House will wish to join me in offering our deepest condolences to the family and friends of Michael Martin, latterly Lord Martin of Springburn, who died earlier this week. He served as Speaker for nearly nine years, and I am sure Members will remember his sense of public service, his commitment to his constituency in Glasgow and his good humour. I particularly remember him for the courtesy he always showed me.
This morning, I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall have further such meetings later today.
Upskirting is the vile practice of taking a photo under a woman’s skirt without her consent. It is neither a specific nor a sexual offence under the current law in England and Wales. I have been working closely with Gina Martin, who has been campaigning for months to change that, and her lawyer to produce a private Member’s Bill to make upskirting a specific crime under the Sexual Offences Act 2003. They have both joined us here today.
Does the Prime Minister agree with us that the law in England and Wales should be reformed so that, in all circumstances, women like Gina and, indeed, the Prime Minister herself will be protected from upskirt images being taken without their consent?
May I first say to the hon. Lady that I share the outrage at this intrusive behaviour that she has referred to and the distress it can cause to victims? We are determined to ensure that victims do have confidence that their complaints will be taken seriously. It is possible currently to bring prosecutions, but my right hon. Friend the Justice Secretary is examining the state of the law at the moment to make sure it is fit for purpose and, as part of that work, he is considering her Bill in detail.
We absolutely share my hon. Friend’s concern about ensuring that we are supporting local communities, and that we are delivering better infrastructure in those communities and maximising the potential of our country. The housing infrastructure fund is an important part of that. We need to build more homes across this country, but we also need to ensure that the infrastructure is there to support those homes and help those local communities. That is exactly what we are doing.
I join the Prime Minister in paying tribute to Michael Martin, the former Labour MP for Glasgow, Springburn and later Speaker of the House. He worked in the engineering industry in Glasgow and was active in the then Amalgamated Union of Engineering Workers. He and I first met when we were fellow organisers in the National Union of Public Employees in the 1970s, campaigning for decent public sector pay and a national minimum wage. Michael loved the community he represented and loved his family, and our deepest thoughts and sympathies go to his family at this time.
Did the Prime Minister feel the slightest pang of guilt when the Home Secretary was forced to resign due to the failures of her predecessor?
I think it might be helpful if I first update the House on the actions the Government have taken and are continuing to take in relation to the Windrush generation. My right hon. Friend the Home Secretary will be addressing the House on this later today. We all share the ambition to make sure we do right by members of the Windrush generation, which is why he will be announcing a package of measures to bring transparency on the issue, to make sure that the House is informed, and to reassure Members of this House but, more importantly, to reassure those people who have been directly affected. Speed is of the essence and my right hon. Friend will be commissioning a full review of lessons learned, independent oversight and external challenge, with the intention of reporting back to this House before we rise for the summer. The review will have full access to all relevant information in the Home Office, including policy papers and casework decisions.
This was a crisis made in the Home Office by successive Home Secretaries. Only a week ago today, the right hon. Member for Hastings and Rye (Amber Rudd), then Home Secretary, was denying there were any targets, in front of the Home Affairs Committee. On Monday, the Prime Minister told the media:
“When I was Home Secretary, yes, there were targets”.
One wonders why the Prime Minister didn’t tell her Home Secretary about that. The pain that has been caused to the Windrush generation needs to be resolved very rapidly, with full compensation paid as quickly as it can possibly be done and an understanding of the hurt that they feel. But this is not the only failure of this Government or of their policies. The Government used to talk about a “long-term economic plan”, but now we have the slowest growing economy in the G7. The Chancellor, sitting two places along from the Prime Minister, told the House that he had a “positively Tiggerish” view of the British economy, yet it has the worst economic growth figures for five years. What plans do the Government have to change course to ensure we do get economic growth?
First, may I say to the right hon. Gentleman, on the Windrush generation, I was Home Secretary when some of these decisions were taken and mistakes were made about individual cases, and I have apologised for that. The former Home Secretary also apologised for that. The right hon. Gentleman is right in saying that these are decisions that have been taken under successive Home Secretaries, including under the last Labour Government, and if he wants to talk about the economy, let’s just look at what we have seen in our economy in recent weeks: day-to-day spending in surplus for the first time in 16 years; the lowest net borrowing in over a decade; exports of goods and services at a record high; employment at a record high; and real wages up. That is a Conservative Government delivering an economy fit for the future.
Four facts about the economy: more people in debt, more people using food banks, more people sleeping on our streets, and more children in poverty. The consequences of decisions made by the Chancellor of the Exchequer are that the NHS is suffering the longest funding squeeze in history. It has sent our health service into an all-year-round crisis. Will the Prime Minister apologise to NHS patients waiting longer than ever for the worst A&E waiting times on record?
I gave the right hon. Gentleman some facts about the economy; I can give him some others: more people in work, and actually fewer children in absolute poverty under this Government. When it comes to the national health service, since November my right hon. Friend the Chancellor of the Exchequer has announced £10 billion extra for the national health service. I have also said that we want to ensure that the national health service is able to operate on a long-term plan. That is why we are conducting a review to produce that long-term plan, with sustainable multi-year funding. That is the sensible approach to take—not just to say that this is all about money, but to say, “How can we ensure that the NHS is the NHS that will deliver for people in the future?” That is about funding. It is also about reforming the NHS to make sure that patients get the right treatment.
Not only was March the worst month on record in A&E departments; it was also the worst month for cancelled operations. There are 100,000 vacancies for NHS staff—and the Prime Minister personally intervened to overrule the Health Secretary and the previous Home Secretary when they asked for a relaxation of visa rules in order to recruit staff to work in our NHS.
But it is not just the NHS where the Government are damaging our public services. In January, the Education Secretary promised that no school would see a cut in its funding. Last week, he was invited to repeat that pledge, and refused. I wonder why. Will the Prime Minister now tell parents, teachers and students the truth—that the schools budget is in fact being cut in real terms all over the country?
The right hon. Gentleman is wrong. What we are doing is ensuring that there is more money available to schools. We are ensuring that we are protecting that core budget, because we want to ensure that every child, regardless of their background, gets the education that they need and the education that fulfils their potential. That is why, once again, it is not just a question of the money you put in; it is about how you spend the money you are spending. That is why I am pleased to say that 1.9 million more children are in good or outstanding schools under this Government and education standards are going up under this Government. That means more opportunities for our young people.
It is quite astonishing that the Education Secretary has been corrected by the UK Statistics Authority. The Institute for Fiscal Studies says that schools budgets are being cut, and the Prime Minister still appears to be in denial. It is not just in the NHS and education that this Government are damaging our public services; it is also about police budgets. The previous Home Secretary claimed there was no link between police numbers and serious violent crime; yet Home Office civil servants said there is a link. Who does the Prime Minister think is right?
First, on crime and police budgets, we are of course this year making available £450 million more for police forces across the country. We have been protecting police budgets, which is in direct contrast to what it was suggested to me I should do by the former shadow Home Secretary and Labour Member who is now Mayor of Manchester. He suggested 5% to 10% cuts could be made in police budgets.
The right hon. Gentleman talks about the relationship between police numbers and crime. His own shadow Police Minister has said in terms that there is not that relationship between police funding and the number of crimes that take place. Once again, it is about how we ensure we are dealing with these issues. It is about ensuring about that the police are able to deal with the challenges and crimes of today, and that is what we are doing with our serious violence strategy and our National Crime Agency—taking action across the board to ensure that our police are able to keep people safe.
Our shadow Police Minister was pointing out that there has been a £2.3 billion cut in police budgets in the last Parliament, and it is the Prime Minister’s Government who are underfunding our police force: 21,000 police officers have lost their jobs since 2010, and 6,700 police community support officers lost their jobs. Meantime, violent crime is rising and, sadly, there are deaths from knife crime on the streets of most cities, particularly in London.
The economy is slowing, homelessness is rising, more children are living in poverty, the Home Office is in chaos and the Government are making a complete shambles of the Brexit negotiations. They are damaging our NHS, damaging our children’s schools and cutting police as crime soars, and they claim to be “strong and stable”! With council tax rising by more than 5% all over the country, is not the truth facing voters tomorrow that with the Tories you pay more and you get less?
More funding going into the NHS, more funding going into our schools, more funding going into social care, but if the right hon. Gentleman wants to talk about council tax and its impact on local residents, I suggest he go to Hazelbourne Road in Clapham. On one side of the road in a typical home someone will pay nearly £1,400 in council tax. Now that, of course, is in Labour-run Lambeth. On the other side of the road, someone in a typical home will pay just over £700 in council tax. That is in Conservative-run Wandsworth. No clearer example can there be that Conservative councils cost you less.
I am tempted—[Interruption.]
Order. I do not think we are in any danger of not hearing the question, but we must hear the answer.
My hon. Friend is absolutely right; we will be leaving the European Union. I am tempted to say to his request, how can I refuse?
A young mother in Coatbridge; a grandmother who has lived here for 50 years; a former cook in this Parliament—just three examples of people who have been wrongly told to leave the United Kingdom. Then there are numerous people wrongly detained or deported, lives turned upside down and irreparable damage to families. The Prime Minister said in this Chamber on 22 October 2013,
“deport first and hear appeals later.”—[Official Report, 22 October 2013; Vol. 569, c. 158.]
Will she now withdraw those remarks?
The right hon. Gentleman is referring to changes to the legislation that later became the Immigration Act 2014. He is right; and I have apologised not just for the anxiety that has been caused to people in the Windrush generation, but to those who have found that the wrong decisions have been taken about their situation. The Windrush generation are British and they are part of us, which is why my right hon. Friend the Home Secretary is making sure that the taskforce that has been put in place is dealing with cases expeditiously and is giving people reassurance about their status here. We need to ensure that we are a welcoming country for people who want to come here and contribute, but that we take action against those who are here illegally, who break the rules and try to play the system.
Interestingly, the Prime Minister failed to remove these insulting remarks. It is easy for her to change her Secretary of State—she does it frequently —but she needs to change her policies. An estimated 120,000 undocumented children are currently entitled to UK citizenship by law, but only if they register at the cost of £1,000. This is a new Windrush generation, who will be unable to secure jobs and rent properties. These children, who are entitled to citizenship, should not be charged to exercise their rights. How can she possibly justify these policies?
Members of the public want to ensure that we have a fair immigration system and that we have rules that people abide by, and that is why we make a very clear distinction. I want people who come here legally, who do the right thing and contribute to our society, to feel that this is one of the most welcoming countries in the world. On the other side, we need to ensure that we have a system that deals with those who break the rules, play the system and try to jump ahead of others. That is what people expect from us. They want us to have a system that is fair and sets out rules, and for us to ensure that people are abiding by those rules.
We very much value the work done by the explosive ordnance disposal units of 33 and 101 Engineer Regiments. The veterans strategy recently launched by my right hon. Friend the Defence Secretary is groundbreaking. There will be a Government taskforce from Departments across the whole of Whitehall that will focus on exactly the sorts of issues that my hon. Friend raised. It will be assessing how we can help veterans to meet the financial demands of civilian life, crucially ensuring that mental and physical wellbeing is maximised and offering the best possible advice to veterans on housing. These are key issues for veterans and they are exactly what we will be focusing on in the strategy.
We have been rolling out universal credit at a pace that ensures we have been able to hear from those who have been affected by it and to make changes—and changes have been made in the way that universal credit is introduced in this country. We have ensured that we have reduced the seven days’ waiting time, for example. But what lies behind universal credit is the belief that the important thing to help to sustain families is to get people into work. The evidence on universal credit is that it is doing just that: it is helping people into work. I would have thought that the hon. Gentleman should welcome a policy that helps people to get into the workplace.
First of all, I join my hon. Friend in welcoming the return of commercial flights to Carlisle airport, which will allow more people to access the borderlands region. He talks about support for the borderlands. Of course, the borderlands growth deal that my right hon. Friend the Chancellor committed to is an important part of that. I would like to congratulate my hon. Friend on his recent appointment as borderlands growth deal champion. I am sure that he will be doing all he can to ensure that that Government support is there and that the borderlands continue to thrive.
We have been very clear that we will not see a border down the Irish sea. We have been clear about that in the joint report that was issued by us and the European Commission and adopted by the European Council in December. When the European Commission made a proposal for dealing with the border between Northern Ireland and Ireland that would have meant a border down the Irish sea, I was clear that neither I nor any British Prime Minister could accept that.
I can give my hon. Friend the reassurance that he is asking for. He is right that we are supporting the NHS in Boston and Skegness. Any decision taken by the trust about the services available will of course be made to ensure that the provision of services is safe for patients. The trust is continuing to try to recruit paediatricians to support the service. It wants to continue to provide paediatric services at Boston, and every effort will be made to ensure that that can continue.
The hon. and learned Lady might have listened to the answer that I gave earlier in Prime Minister’s Question Time. She might also have listened to the answers that I gave last week, and I was very clear in my apology to those of the Windrush generation who have been caught up in this issue. She talks about what has happened here. What has happened is that people who are here legally and who are British have found themselves caught up in this, and as I said, I apologise for that. What has also happened is that over the years, Labour, coalition and Conservative Governments have successively been taking action to deal with illegal immigrants, which is a different issue. This is an issue that has been dealt with by Governments of all colours.
May I take this opportunity to congratulate my right hon. Friend the Member for Bromsgrove (Sajid Javid) on his appointment to the Home Office, which is such an important Department in terms of not only security but ensuring we have a safe and fair immigration policy? The UK threat level remains at severe. Last year we had five terrorist attacks that got through, and 36 innocent people were killed. May I invite the Prime Minister to share our admiration for the extraordinary work and bravery of our counter-terrorism police, our emergency services and our security services, for which I know we are all grateful?
First, I am pleased to have this opportunity to pay tribute to my right hon. Friend and the work she did as Home Secretary. She did valuable work across all elements of the Home Office, including on issues like modern slavery and domestic violence. The work that she did with the internet companies to keep people safe on the internet was groundbreaking. I share her support and admiration for the work that all in our emergency services, our police, our counter-terrorism police and our security and intelligence agencies do to keep us safe, and I commend her for the work she did following the terrorist attacks last year to set in train action to ensure that we continue to give those services the support they need to continue to keep us safe.
What my right hon. Friend the Home Secretary said was that he absolutely shares the need to differentiate between legal and illegal immigrants. He also said that there was a certain phrase he was not going to use—a phrase that was first used by Labour Ministers in government. Across Government, we are clear that we are working hard to support and help those of the Windrush generation who have been caught up in this issue recently and across time, but we are also ensuring that we have a fair immigration policy which ensures that people who break the rules, play the system and try to jump ahead of others are not able to carry on being here in this country in the same way as those who play by the rules, are hard-working taxpayers and contribute to our society. That is only fair.
Does my right hon. Friend agree that it is only under the Conservatives that you get decision and vision? That is why Maidstone Borough Council needs to turn blue on 3 May.
My hon. Friend is absolutely right. If those who are taking part in council elections tomorrow and making those decisions look up and down the country, they will see that it is Conservative councils that support local communities, provide good local services and keep council tax low. The message is very clear: if that is what you want, vote Conservative tomorrow.
We are very clear that we are going to leave the European Union on 29 March 2019. We will be leaving the customs union, and we want to ensure that we can have an independent trade policy. We also want to ensure that we deliver—we are committed to delivering—on our commitment to having no hard border between Northern Ireland and Ireland, and that we have as frictionless trade as possible with the European Union. There are a number of ways in which that can be delivered—[Interruption.] There are a number of ways in which that can be delivered, and if the hon. Lady is so interested in the whole question of a customs border, she might like to ask her Front Benchers to come to a decision on what the Labour party policy actually is on this.
The European Scrutiny Committee, which I have the honour to chair, has invited Mr Olly Robbins to appear before the Committee on several occasions since February, but so far this has not been arranged. Will my right hon. Friend be good enough to use her charm to ensure that Mr Robbins does appear, as have already the Chancellor, the Secretary of State for Exiting the European Union and Sir Tim Barrow?
As my hon. Friend will know, it is not normally the case that any request to a civil servant to appear before a Committee is automatically accepted; decisions are taken about the levels at which civil servants should appear before Committees. As he said, he has had a number of my right hon. Friends appear before his Committee—I remember, I am not sure I can say with fond memory, the time when I appeared before the European Scrutiny Committee when I was Home Secretary—but I will certainly look at the request that he has made.
It was precisely to identify this sort of disparity in public services that I launched the race disparity audit when I became Prime Minister. In some areas that does make for uncomfortable reading for our society, but it is absolutely right that we have done it and it is absolutely right that we then address the issues that it has raised.
The hon. Lady talks about the interaction of people with mental health problems and the police. This is not something that I waited to do something about until the race disparity audit; I did something about it when I was Home Secretary. We have significantly reduced the number of people with mental health problems who are being taken to a cell in a police station as a place of refuge, and we have ensured that there is health support available for the police. As a result, people who are in a mental health crisis are getting better treatment than they did previously. There is more to do, but we have already started to take action.
The hopes of the 464 survivors of thalidomide in the United Kingdom, the Thalidomide Trust and the all-party group on thalidomide, which I chair, were significantly depressed at the weekend when we saw the media coverage, particularly in The Sunday Times, suggesting that the German Government are seeking to resile from their verbal pledge to make good the promise to compensate the UK survivors whose mothers were prescribed and took the German-manufactured drug thalidomide. Their lives are shortening, and they need support. Will my right hon. Friend use her good offices to augment the work of the Foreign Office in making the case for UK thalidomide survivors to the German Government so that they can finally get the justice they have for too long been denied?
I fully recognise why the survivors of thalidomide were so concerned at the reports that they saw because, although back in 2012 the Department of Health announced an £80 million grant for thalidomide survivors, they of course have been able and are able to apply to the German Contergan Foundation for Disabled Persons for funds. In relation to the particular point my hon. Friend has raised, I know that my right hon. Friend the Minister for Europe and the Americas met representatives of the Thalidomide Trust towards the end of last year to discuss this. The Foreign and Commonwealth Office is remaining in contact with the trust, and it is pursuing its discussions with the German Government on this point.
The hon. Lady sets out what is obviously a very sad and tragic case in relation to her constituent. I am happy to look at the background of what led to that particular outcome. We all want to make sure that patients are able to be treated in the NHS when they need that treatment, and get the appropriate treatment. That is why we have been putting extra money into the NHS, but, as I say, it is a very sad case that she has outlined, and I am happy to look at the details of it.
As voters go to the polls tomorrow, could the Prime Minister confirm that a green future is at the heart of our local government policies? Would she agree to meet me and others to look at our aspiration for the Chilterns area of outstanding natural beauty to become a national park so that we can increase the opportunities afforded for open-air recreation on London’s doorstep?
We are protecting our natural environment. We want to leave a cleaner, greener Britain for our children. That is not just something that Conservatives in national Government want to do; it is what Conservatives in local government want to do as well. That is why we launched our 25-year environment plan. I know the beauty of the Chilterns; I enjoy walking in the Chilterns, and I am happy to meet my right hon. Friend and others to discuss her proposal.
As the hon. Gentleman knows, we have been very clear that the blanket 1% cap that has taken place over recent years on public sector pay is not an approach that we are taking in the future. Obviously, Departments are funded at a certain level, and it is for Departments then to come forward with their proposals in relation to pay within their Department.
Today, council tax, on average, costs less in real terms than it did in 2010. Under 13 years of Labour in government, council tax doubled. Will my right hon. Friend confirm that the council tax referendum principles that this Government have put in place have been a resounding success?
My hon. Friend is absolutely right about the facts that he has set out in relation to council tax. That is a result of decisions that have been taken by the Government to have that council tax referendum in place and of Conservative councils actually making decisions to freeze or to lower council tax, or to ensure that it is kept lower than in Labour councils. Conservative councils, on average, cost a typical family £100 less in council tax than councils run by other parties. That is important, and the Government have played their part with the council tax referendum.
The hon. Gentleman has raised an issue I have not seen the details of, but I will ensure that my right hon. Friends the Chancellor of the Exchequer and the Secretary of State for Work and Pensions look at the issue he has raised.
This afternoon, the Treasury Committee will take evidence from TSB about the recent IT failures, which have left thousands of customers unable to access their accounts and unable to pay their bills, with some very severe consequences. Does my right hon. Friend agree that a robust and reliable banking IT infrastructure is essential in the modern economy? These failures are unfair to businesses that cannot pay in their takings, they are unfair to vulnerable customers, and they are particularly unfair when many banks are still closing branches.
I agree that a robust, safe and reliable IT system is essential to underpinning today’s world of modern banking. I am sure that my right hon. Friend and the Treasury Committee will ensure, through the evidence they take, that they get to the bottom of what happened in TSB.
Last Saturday night, an 83-year-old woman had a fall at home and was bleeding from a head wound. She waited for an ambulance for nearly three hours. Will the Prime Minister apologise to my constituent and promise the rest of the country that no one else’s elderly mum will suffer like that?
If the hon. Lady would like to provide more expansive details, I know the Secretary of State for Health will look very closely into the case that she identifies. I am sorry to hear of the circumstances of her constituent, but we will look into the case.
Last night at 9.08 pm, two men were shot outside Queensbury station on the edge of my constituency. One is dead and the other is in a critical condition. Queensbury station is an important transport hub for the people of Harrow East and Brent North. Will my right hon. Friend join me in thanking the police for their prompt action in securing the area and for the messages of reassurance they are giving to the community today? Will she also take every necessary step to remove guns and knives from society to prevent reoccurrence?
I recognise the importance that is attached to Queensbury station, and I join my hon. Friend in commending the actions of the police and emergency services in response to this and other such incidents. He is right on the importance of dealing with offensive weapons, which is why we announced, under my right hon. Friend the previous Home Secretary and taken forward by the current Home Secretary, plans to introduce an offensive weapons Bill. It is why we launched the serious violence strategy and the serious violence taskforce, which brings Ministers and representatives from across this House together with police and others to deal with this issue. It has met for the first time and it will continue to meet to address this important issue.
On a point of order, Mr Speaker.
Order. Points of order come after statements, as I think the hon. Gentleman knows. He has been in the House for quite a while now. We look forward to hearing from him later.
Breast Cancer Screening
I wish to inform the House of a serious failure that has come to light in the national breast screening programme in England.
The NHS breast screening programme is overseen by Public Health England and is one of the most comprehensive in the world. It screens 2 million people every year, with women between the ages of 50 and 70 receiving a screen every three years up to their 71st birthday. However, earlier this year PHE analysis of trial data from the service found that there was a computer algorithm failure dating back to 2009. The latest estimates I have received from PHE is that, as a result, between 2009 and the start of 2018, an estimated 450,000 women aged between 68 and 71 were not invited to their final breast screening.
At this stage, it is unclear whether any delay in diagnosis will have resulted in any avoidable harm or death, and that is one of the reasons I am ordering an independent review to establish the clinical impact. Our current best estimate—which comes with caveats, as it is based on statistical modelling rather than on patient reviews, and because there is currently no clinical consensus about the benefits of screening for this age group—is that there may be between 135 and 270 women who have had their lives shortened as a result. I am advised that it is unlikely to be more than this range and may be considerably less. However, tragically, there are likely to be some people in this group who would have been alive today if the failure had not happened.
The issue came to light because an upgrade to the breast screening invitation IT system provided improved data to local services on the actual ages of the women receiving screening invitations. This highlighted that some women on the AgeX trial, set up to examine whether women up to the age of 73 could benefit from screening, were not receiving an invitation to their final screen as a 70-year-old. Further analysis of the data quantified the problem and has found a number of linked causes, including issues with the system’s IT and how age parameters are programmed into it. The investigation also found variations in how local services send out invitations to women in different parts of the country.
The existence of a potential issue was brought to the attention of the Department of Health and Social Care by Public Health England in January, although at that stage, its advice was that the risk to patients was limited. Following that, an urgent clinical evaluation took place to determine the extent of harm and the remedial measures necessary. Public Health England escalated the matter to Ministers in March, with clear clinical advice that the matter should not be made public. This was to ensure that a plan could be put in place that ensured any remedies did not overwhelm the existing screening programme and was able to offer proper support for affected patients.
I am now taking the earliest opportunity to update the House on all the remedial measures that have been put in place, which are as follows. First, urgent remedial work to stop the failure continuing has now been completed according to the chief executive of Public Health England. This was finished by 1 April and PHE is clear that the issue is not now affecting any women going forward.
Of the estimated 450,000 women who missed invitations to a scan, 309,000 are estimated to still be alive. Our intention is to contact all those living within the United Kingdom who are registered with a GP before the end of May, with the first 65,000 letters going out this week. Following independent expert clinical advice, the letters will inform all those under 72 that they will automatically be sent an invitation to a catch-up screening. Those aged 72 and over will be given access to a helpline through which they can get clinical advice to help them decide whether a screening is appropriate for their particular situation. This is because for older women, there is a significant risk that screening will pick up non-threatening cancers that may lead to unnecessary and harmful tests and treatment. However, this is an individual choice and in all cases, the wishes of the patients affected will be followed. By sending all the letters to UK residents registered with a GP by the end of May, we hope to reassure anyone who does not receive a letter this month that they are not likely to have been affected.
It is a major priority to do our very best to make sure that the additional scans do not cause any delays in the regular breast screening programme for those under 71, so NHS England has taken major steps to expand the capacity of screening services, and has today confirmed that all women affected who wish to be screened will receive an appointment within the next six months. Of course, we intend the vast majority to be much sooner than that.
We have held helpful discussions with the devolved Administrations to alert them to the issue. Scotland uses a different IT system, and while the systems in Wales and Northern Ireland are similar, neither believe they are affected. However, we are discussing with each of them the best way to reach women who have moved to another part of the UK during this period. This is obviously more complicated, but we are confident that those affected will still be contacted by the end of May.
In addition, and as soon as possible, we will make our best endeavours to contact the appropriate next of kin of those we believe missed a scan and have subsequently died of breast cancer. As well as apologising to the families affected, we would wish to offer any further advice they might find helpful, including the process by which we can establish whether the missed scan is a likely cause of death and compensation is therefore payable. We recognise that this will be incredibly distressing for some families, and we will approach the issue as sensitively as possible.
Irrespective of when the incident started, the fact is that for many years, oversight of our screening programme has not been good enough. Many families will be deeply disturbed by these revelations, not least because there will be some people who receive a letter having had a recent diagnosis of breast cancer. We must also recognise that there may be some who receive a letter having had a recent terminal diagnosis. For them and others, it is incredibly upsetting to know that you did not receive an invitation for screening at the correct time, and totally devastating to hear you may have lost or be about to lose a loved one because of administrative incompetence. So on behalf of the Government, Public Health England and the NHS, I apologise wholeheartedly and unreservedly for the suffering caused. But words alone are not enough. We also need to get to the bottom of precisely how many people were affected, why it actually happened and most importantly, how we can prevent it ever happening again.
Many in this House will also have legitimate questions that need answering: why did the algorithm failure occur in the first place, and how can we guarantee it does not happen again? Why did quality assurance processes not pick up the problem over a decade or more? Were there any warnings, written or otherwise, which should have been heeded earlier? Was the issue escalated to Ministers at the appropriate time? What are the broader patient safety lessons for screening IT systems?
I am therefore commissioning an independent review of the NHS breast screening programme to look at these and other issues, including its processes, IT systems and further changes and improvements that can be made to the system to minimise the risk of any repetition. The review will be chaired by Lynda Thomas, chief executive of Macmillan Cancer Support, and Professor Martin Gore, consultant medical oncologist and professor of cancer medicine at the Royal Mardsen, and is expected to report in six months.
The NHS has made huge progress under Governments of both sides of this House on improving cancer survival rates, which are now at their highest ever. Seven thousand people are alive today who would not have been if mortality rates had remained unchanged from 2010, but this progress makes system failures even more heartbreaking when they happen. Today, everyone in this House will be thinking of families up and down the country who are worried that they may have been affected by this failure. We cannot give all the answers today, but we can commit to take all the necessary steps to give people the information that they need as quickly as possible. Most of all, we want to be able to promise that this will not happen again, so today, the whole House will be united in our resolve to be transparent about what went wrong and to take the necessary actions to learn from the mistakes made. I commend this statement to the House.
I thank the Secretary of State for advance sight of his statement and for his personal courtesy in directly briefing me as well. The thoughts of the whole House are with those whose screening was missed and who sadly lost their lives from breast cancer, or who have subsequently developed cancer. Anyone who has had a loved one taken by breast cancer, or indeed any cancer, will know of the great pain and anguish of that loss. I understand that the Secretary of State has referred to estimates, but when the facts are established, will he assure us that each and every case will be looked into sensitively and in a timely manner? Our thoughts also turn to the 450,000 women who were not offered the screening that they should have had, so I welcome the Secretary of State’s commitment to contact the 309,000 women who are estimated to be still alive.
Early detection and treatment are vital to reducing breast cancer mortality rates, which was why the AgeX pilots were established in 2009 and rolled out nationally from late 2010, when the Government expanded the screening programme. Given the problems that Public Health England has identified with its randomisation algorithm for those trials, will the Secretary of State tell us whether any evaluations and assessments of those pilots had been done by the Department before the national roll-out of the programme?
I welcome the Secretary of State’s candour in questioning why this problem was not picked up—eight years is a long time for an error of this magnitude to go undetected. Did the Department receive any warnings in that time? Is there any record of how many women raised concerns that they had not received the appropriate screening? Were there any missed opportunities to correct this mistake? He said graciously that oversight of the screening programme was not good enough. How does he intend to improve that oversight? What other trials are in place across the NHS and is he satisfied with their oversight?
We welcome the establishment of the national inquiry. Will it be hosted and staffed by the Department of Health or another Department? In the interests of transparency, will the Secretary of State place in the Library the Public Health England analysis from this year that identified the problem with the algorithm? Although the parallels are not exact, where the NHS offers bowel cancer screenings for women between the ages of 60 and 74 and cervical cancer screenings for women up to 64, what assurances can he give that the systems supporting those services are running properly, and what checks are being carried out to make sure that nobody misses out on screenings for other cancers?
The Secretary of State says that NHS England will take steps to expand the capacity of screening services. Will he say a little more about that? What extra resources will be made available to help the NHS provide the extra screening now needed? He will know that the NHS faces huge workforce pressures—according to Macmillan, there are more than 400 vacancies in cancer nursing, the Royal College of Radiologists has found that 25% of NHS breast screening programme units are understaffed, and there are vacancies for radiographers too. Will he assure us that the NHS will have the staff to carry out this extra work, and may I gently suggest that, if it needs extra international cancer staff, he ensures that the Home Office does not block their visas?
More broadly, does the Secretary of State share my concerns that screening rates are falling generally? The proportion of women aged 50 to 70 taking up routine breast screening invitations fell to 71.1% last year—the lowest rate in the last decade. There is also a wide regional variation in screening rates. The number of women attending breast screening in England is as low as 55.4% in some areas, and, as the all-party group on breast cancer found, there are stark inequalities in NHS services in England, with women in the worst-affected areas more than twice as likely to die from breast cancer under the age of 75. Beyond the problems identified today, what more are the Government doing to make sure that screening rates rise again so that cancer care for patients is the best it can be?
Finally, many of our constituents over whom breast cancer has cast a shadow will feel anxious and worried tonight. Members on both sides of the House want to see cancer prevented and those who have it fully supported. Transparency and clarity are vital. Will the Secretary of State undertake to keep the House fully informed of developments to offer our constituents the peace of mind they deserve?
I thank the hon. Gentleman for his constructive tone, and I want to reassure him that each and every case will be looked at in detail. The sad truth is that we cannot establish whether not being invited to a screen might have been critical for someone without looking at their individual case notes, and in some cases, sadly, establishing a link will mean looking at the medical case notes of someone who has died.
It is important to explain that the reason for these estimates, which are much broader than we would like, is that there is no clinical consensus about the efficacy of breast screening for older women. As I understand it, that is because the incidences of cancers among older women are higher, but a higher proportion of them are not malignant or life-threatening, which makes it particularly difficult. It is also the case that breast cancer treatment has improved dramatically in recent years and so it is less important than it was to pick up breast cancer early. None the less, we believe it will have made a difference to some women, which is why it is such a serious issue.
The evaluations of the AgeX trial, which brought this to light at the start of the year, have been continued by Oxford University throughout the trial period. I am not aware of any evaluations shared with the Department that could have brought this problem to light, but obviously the inquiry will look into that. We need to find ways to improve oversight, and modern IT systems can greatly improve safety and reliability—in fact it was during the upgrading of the IT system that this problem was brought to light.
I will share with the hon. Gentleman the advice the Department received from Public Health England in January, which was the first time we were alerted to the issue, and we will certainly provide any extra resources the NHS needs to undertake additional cancer screening. One of our biggest priorities is that women between the ages of 50 and 70, when the screens are of their highest clinical value, do not find their regular screens delayed by the extra screening we do to put this problem right. He is right that one thing that has come to light is the regional variation in how the programme is operated. It was previously operated by the old primary care trusts, under the supervision of strategic health authorities, and then brought under the remit of Public Health England, but the regional variations have continued for a long time, so this problem will be worse in some parts of the country than in others. I undertake to keep the House fully informed.
I thank the Secretary of State for the commitments and actions he has set out. Colleagues across the House will be thinking of the hundreds of thousands of women not called for their final screening test. They now need consistent, high-quality, evidence-based guidance so that they can make an informed choice about whether to take up the offer of screening. There is much material available setting out pictorially and clearly how they can weigh up the risks and benefits. Will he assure the House not only that a helpline will be in place but that it will be backed up with high-quality material available directly to patients and their GPs, many of whom will be directly counselling women following this news?
Yes, and I can reassure my hon. Friend that GPs will be briefed and that people will be referred for additional support to clinically trained staff at Macmillan Cancer Support and Breast Cancer Care. We have to be transparent with patients, however, about the absence of a clear clinical consensus on the efficacy of scanning for women in their 70s. The fairest thing is to explain that different people have different views and allow them to come to an individual choice, and that is what we are doing. It will of course cause considerable distress to those given that dilemma, but if anyone wants a scan, we will do that scan.
I thank the Secretary of State for my advance briefing, but, as a breast surgeon and co-chair of the all-party group on breast cancer, I gently take issue with his comment that we do not need to diagnose breast cancer early because of the changes in treatment. I would not like that message to stand: diagnosing early is still crucial.
Obviously this is horrendous for the women involved, but it will also create anxiety for women who are not aware whether they are involved and who might not have been part of the trial. Reassuring them will be a challenge. I welcome the independent review into how it happened and how it went so long without being picked up, and I am interested to know what will happen with the trial now—the loss of almost 500,000 women from it might have a major impact.
Given the normal pick-up rate of breast screening, approximately 2,500 cancers would have been picked up across England in the last round. As the Secretary of State says, this issue did not apply in Scotland, but some of the women affected might have moved and settled in Scotland, so when did he inform the Scottish Government?
The Secretary of State said that the Department knew in January. As far as I can establish, officers in Scotland were informed of a minor issue in March, were told only last week that it was actually more major, and were not told that it might affect women who now live in Scotland. There has clearly been preparation and talk about funding in England, but how many women who live in Scotland have been identified, and what efforts have been made to track them down? What preparations for funding or the expansion of services have been made for Scotland and, indeed, for the other devolved nations?
As was mentioned by the hon. Member for Leicester South (Jonathan Ashworth), radiology, and particularly breast radiology, is a huge shortage specialty. What funds will be provided to ensure that it can be delivered without messing up the normal system?
Will women who do not receive a letter in the next few weeks be able to telephone, or can the Secretary of State really guarantee that if they have not heard by the end of the month, they are clear? As a doctor, I find that a bit scary.
The hon. Lady has asked some important questions. I am sorry if what I said was not clear, but I do not think I said that there was no need to diagnose early. It is obviously incredibly important for cancer to be diagnosed as early as possible. What I said was that I had been advised that in many cases, because of advances in breast cancer treatment, it would not make a difference to the particular women affected in this case. I fully accept that in some cases it will, and of course it is very important to diagnose all cancers as early as possible.
I will find out from Oxford University the dates on which it expects to report the full outcome of the AgeX trial. Obviously we all want to hear the results as soon as possible. I will also inform the hon. Lady of the exact date on which Scottish Government officials were informed. Let me reassure her that if there are any additional costs to the Scottish health system, it will of course be recompensed.
We do not think that major pressures will be created in the Scottish screening programme, and we are confident that we will be able to contact everyone in the UK who is registered with a GP—whether in Scotland, Wales, Northern Ireland or England—by the end of May. We have had very productive discussions with Scottish officials about the IT exchange that will be necessary to ensure that women living in Scotland also receive their letters by the end of May. We cannot guarantee that every single one of them will have been contacted by then—some will have moved abroad, and some will not be registered with a GP for whatever reason—but we think that we can contact the vast majority, and the helpline will be open for anyone to call if they think they may have been affected.
I think that Members on both sides of the House have appreciated the measured way in which my right hon. Friend has come to the House and revealed detailed commitments to helping the women who have suffered as a result of this terrible, unfortunate IT event. I also think that the measured response from the hon. Member for Leicester South (Jonathan Ashworth) properly reflected the concern that everyone shares.
My right hon. Friend referred to additional screening capacity to ensure that there is no impact on other, younger women. What undertakings can he give to any women who have been affected, and who find that they are suffering from a malignant growth in their breast, that they will be able to receive the appropriate treatment as rapidly as possible?
I thank my hon. Friend for the work that he did on cancer when he was working at the Department of Health, and for his broader work in supporting the hospital sector. He is absolutely right: additional people will come forward for treatment, so one of the other matters that we have been looking into is our treatment capacity. We certainly intend to ensure that people are treated within the normal short period if a cancer is detected, and the first step in that process is to ensure that everyone has a scan in the next six months. During that period, we will make certain that they are able to look forward to the same rapid treatment that all other people whose cancers are detected can be confident of receiving.
We have an ethical duty to get screening right, because we are inviting well people into our health service and offering them an intervention. May I ask the Secretary of State whether the uptake of screening by 68 to 71-year-olds during the period concerned was any lower than expected? If it was less than expected, why was that not properly analysed?
I do not know the answer to that question, but I will look into it. If we find that the uptake was lower than expected in that age group, it will be a very important clue about something that may have gone wrong, and I am sure that the review panel will want to examine it. The overall uptake rate is about 80%, but I agree with the hon. Gentleman that we should look into what the rates were in specific age cohorts.
I thank the Secretary of State for his measured statement, and for all he is doing to ensure that the women affected are given the treatment and support that they need. I particularly welcome his independent review of the NHS screening programme. Will he also be looking at quality assurance programmes more widely within the NHS in relation to screening programmes? It is deeply worrying that the NHS did not identify this error for more than a decade, and there may be a need to review those programmes.
I am afraid that my right hon. Friend is absolutely right. The truth is that we do have a quality assurance programme, and it failed to pick up this problem for far too long. We need to understand why that happened. We think that a single IT mistake was made at the very start of the programme, and we understand that sometimes such mistakes are devilishly difficult to identify. None the less, as was suggested by the hon. Member for Stockton South (Dr Williams), there must have been clues that could have been picked up—or so one would think—and we need to get to the bottom of that.
I think that anyone who listened to the statement will be devastated and appalled to learn about this fatal failure, especially given that the UK’s breast cancer survival rate is below the EU average. The Secretary of State talked about the advice line that might be available to people who had been affected, but has he given any consideration to any emotional or mental health support that should be extended to those people and their families?
We are indeed talking to the charities operating in this sector about how we can best provide all kinds of support, including mental health support, as well as clinical guidance. We often talk in the House about the challenges facing the NHS, but it is important to note that breast cancer is an area in which survival rates have been improving, and have actually been catching up with those in other European countries. The NHS deserves great credit for that, despite today’s very serious failing.
I commend my right hon. Friend for the way in which he brought this very bad news to the House, and the hon. Member for Leicester South (Jonathan Ashworth) for the way in which he responded to it.
As my right hon. Friend will know, breast cancer is not just about survival nowadays; it is also about quality of life after treatment. Will his contact with those who have been affected extend to those who have been treated, but who may have had to be treated in a more radical way than might have been the case had their cancers been picked up earlier?
Absolutely. As my hon. Friend will know from his own medical background, it is impossible to know that until there is a detailed case note review, but we will certainly undertake that review for anyone who thinks they may have been affected.
I thank my right hon. Friend for his statement and for the work he is doing to ensure that women who are affected are supported and treated promptly, but what is he doing to ensure that people who are due for cervical and other NHS screening programmes are being properly called, and can he tell women who are affected—and, no doubt, very worried today—what they should do now? Whom should they call, should they be waiting for a letter, and how soon can they expect a scan if they wish to have one?
According to the advice that I have received so far, there is no read-across to other screening programmes, but obviously the independent review panel will look into that as it seeks to examine all aspects of the issue. We have made the commitment today that we will invite for scans all those who either should be scanned or should consider whether they wish to have a scan, and will offer them a date before the end of October, although we hope that in the vast majority of cases it will be much sooner than that.
What conversations has the Secretary of State had with the Welsh Secretary? Having long since passed the ages he mentioned, I certainly was never invited for a screening; I had to ask for one, and I eventually got the screening in England.
We have not had conversations at ministerial level, but we have had conversations at official level. The Welsh Administration do not believe this problem has affected them, even though Wales was using the same IT system we were using in England. Our concern is about people living in England who are registered with a Welsh GP or people living in Wales registered with an English GP. That is why we are having constructive discussions to share IT information and make sure everyone in England or Wales registered with a GP will get that letter.
To respond to the earlier question about what people should do now, anyone is free to call the helpline number, which will be made public today, but we are hoping to get the letters out as quickly as possible over the next four weeks, during the month of May, so that everyone can be pretty confident that they are okay if they have not received one of those letters.
I welcome the Secretary of State’s announcement today that there will be an independent review; it is important that women have confidence in the screening programme. As someone who worked in breast cancer for over 10 years before being elected, I gently say to women that the screening mammogram is just one tool in the early detection of breast cancer and that if they notice a change in the interval of three years between mammograms they must seek medical advice. Also, not all mammograms pick up breast cancers, so they must not just rely on screening mammograms.
I thank my hon. Friend for her excellent advice, which gives me the opportunity to repeat that the advice for women about looking after their breasts and making sure they are alert to potential breast cancer remains unchanged. All women should take great care over this and should always come forward to see their GP or local cancer service if they have any concerns or doubts.
I thank the Secretary of State for his statement. There is no other way to describe what has happened than utterly, utterly heart-breaking, and it is hard to imagine what some of the worst affected families will be going through over the next few weeks.
I am grateful to the Secretary of State for his assurance that capacity will be expanded to ensure that women can now access screening, but unless he puts further resources into the system, other people will go to the back of the queue as a consequence. In my region of the north-west, one in five posts are currently vacant, and for far too many women in this country where they live currently determines whether they live or die. So will the Secretary of State put in the additional resources needed to make sure all women can get the screening they need when they need it?
I thank the hon. Lady for her comments. We have many other occasions to have a broader discussion about resourcing of the NHS, but I recognise what she says: in the specific situation we are in now, with the people who will need additional scans and additional treatments over and above what the NHS would have otherwise done, we will need to find additional resources to make sure others are not disadvantaged.
May I add my words of support to the Secretary of State for the way he has approached this issue, and to Opposition Members for their approach too?
On the scope of the independent review, will it look at other screening programmes? It might be the case that this particular issue is not replicated, but I think people will want assurances about other screening programmes. Also, as the NHS looks to use IT as a powerful way to combat illness and disease, will the Secretary of State make sure that appropriate checks are in place so that there are proper assurances in the system and these kinds of problems do not arise in the future?
My right hon. Friend is absolutely right, and I assure him that the review being done by Lynda Thomas, one of the most senior cancer campaigners in the country, and Professor Gore, one of the most senior oncologists in the country, will look at what lessons can be learned for the entire cancer programme, and not just at the specific issue of why this particular IT problem occurred.
The statement the Secretary of State has made today is truly shocking, and many women and their families will be very worried this afternoon. The Secretary of State said that it is estimated that 309,000 women in this group are still alive and that the first 65,000 letters are going out this week. Why are the letters not going out this afternoon to all 309,000 women? Why are we having to wait until the end of May to put at rest the minds of these women and their families?
That is a reasonable question, and I assure the hon. Lady that we are sending these letters out as quickly as we possibly can, but we felt that, even though we are not able to send them all out this afternoon—for example, because we have to reconcile with the clinical databases in Scotland, Wales and Northern Ireland for women who have moved to those areas and that is going to take place later this month—it was important to come to the House as soon as possible, without delay, to inform Members that this was happening. There will be a period of a few weeks during which people will have to wait to see if they get one of the letters, and we fully appreciate that that will cause a lot of worry to the women involved.
This is a good time to pay tribute to all the excellent cancer support charities, counselling services, Maggie’s centres and so forth up and down the country. I am reassured that the Secretary of State has said he will be working with them, but will he commit this afternoon to contacting all these charities proactively and providing them with the resources they need to meet what will obviously be an increased demand over the coming weeks and months?
That is a good point, and we will get in touch with all the cancer charities that we think are going to be affected by what has happened and make sure they have the support they need.
When did the Secretary of State or the Minister with direct responsibility for screening last ask their officials about the accuracy of the screening programme and the robustness of the checks and assurances in place to ensure it was working properly and efficiently? When, before January this year, did he last ask his officials that?
I will have to get back to the hon. Gentleman with a detailed answer to that question. Ministers were informed of this issue in March, and we are responsible, as Ministers, for the effective functioning of that system—in the way all Ministers have responsibility for their various areas—so one of the questions we need to ask is whether the right escalation procedures and checks and balances were in place so that Ministers could be informed if there was likely to be a problem.
My constituency has many breast cancer sufferers who were victims of the rogue surgeon Mr Paterson, so I thank my right hon. Friend for setting up an inquiry chaired by the Bishop of Norwich, in which victims feel properly listened to, and, most importantly, are being compensated. Will any of the women caught up in this current situation who might have been harmed be eligible for compensation?
I thank my right hon. Friend for suggesting the Bishop of Norwich as a good person to help in the Paterson review, and the answer to her question is yes: if, because of a failing by the NHS, harm has happened, people will be eligible for compensation, and we will do all the necessary work to establish whether that is the case.
Breast cancer screening makes a real difference to outcomes for breast cancer patients by diagnosing early, so I applaud the Secretary of State for saying he will look at ways of improving performance in this area across the country, but what is he going to do to try to make women who have moved out of the UK who might be affected aware of what has happened?
We will look at whether we are able to get in contact with people and will get in contact whenever we can, but there is of course a helpline through which anyone can contact us. It is also important to say that, according to the advice I have received, missing the final screening will in many cases not make a difference to a patient’s cancer or the treatment they receive, but we will do everything we can to support everyone who thinks they might have been affected.
While it will be for the review to investigate and report on why the fault with the algorithm was not discovered earlier, can the Secretary of State throw any more light on the circumstances in which it eventually came to be discovered? He said, for example, that it was in the course of a computer upgrade. Obviously, the circumstances that led to its discovery could be a pointer towards greater safeguards for the future.
That is a very good point. The original issue—or the original potential issue—was identified by people working on the AgeX trial for Oxford University, who then brought it to the attention of Public Health England in early January. One of the issues seems to have been the confusion about whether the scans stopped when someone turned 70 or whether they should carry on until their 71st birthday. That is why we think the original coding error happened, but obviously this is a matter for the review, and we need to learn everything from it.
This is a hugely upsetting and serious issue, and I commend the Secretary of State for the great compassion and sensitivity with which he has delivered this very bad news for women throughout the United Kingdom. He mentioned the fact that the Northern Ireland breast screening scheme was slightly different, but he will appreciate that he absolutely must say more to reassure women in Northern Ireland at this time because we have no Health Minister. May we please have more reassurance for women in Northern Ireland?
I thank the hon. Lady for making that fair and important point. I will make a special effort in the case of Northern Ireland to understand what the situation is and to ensure that it is publicised to the people of Northern Ireland. Absent politicians are able to do that.
I also thank the Secretary of State for his measured and sensitive tone in delivering this afternoon’s statement. He mentioned that the figures of 450,000 and 309,000 were estimates. What is not an estimate, however, is that 65,000 letters will be going out at the end of this month. Will he assure us that his team in the Department will write to Members of Parliament to indicate the number of women affected in each constituency, so that we can prepare for the inevitable contacts that constituents will make with us?
I am very happy to make that commitment.
I hope that the independent review will investigate this, but is the Secretary of State aware of any instances of GPs inquiring why patients who should have had a final breast screen were not invited to have one?
That is a very good question. I am not aware of any such instances, but that is exactly what we want to look at in the review. It does seem strange that people who were expecting to be invited did not come forward, and that their not receiving an invitation did not set any hares running. That is one of the things that we need to look at.
How many cancers are detected for every 10,000 screenings, and what is the clinical consensus on the effectiveness of that?
My right hon. Friend is testing my clinical knowledge here; there will be other people in the Chamber who are better able to answer that question. I am ready to be corrected by eminent experts on this, but my understanding is that, in relation to women in their 70s, for every 1,000 women there are around 12 cancers, and of those 12 cancers, around three are potentially life-threatening.
Let us be clear that this is an utterly desperate situation. We know that some women may well have died who might not have done had they been identified. However, I would like to pay tribute to the Secretary of State’s statement. It was transparent, it ’fessed up and it made clear what the Department of Health and Social Care will be doing to remedy the situation. I appreciate that. What will the Department do to raise awareness of breast cancer screening among women who are not currently registered with a GP?
That is an important question. We have the Be Clear on Cancer campaign, which is a national advertising campaign but, as my hon. Friend the Member for Lewes (Maria Caulfield) said, it is important for people to recognise that, if we are going to protect them from cancer, they will have to take an active and proactive role in detecting any cancers they might have. Important though the screening service might be, they cannot rely on the screening service, because their own experience of how their own body is functioning is the most important detection method of all.
I thank my right hon. Friend for his statement, and for the urgency and sensitivity with which he is treating this issue. Women all over the country will be very anxious at hearing this news. Will he guarantee that all women who did not get invited for their scan will now be guaranteed their screening?
We are absolutely guaranteeing that all women affected who are still alive will be invited to have a screening if they want it. Only those under 72 will automatically be sent a date and time for their screening. Those over 72 will be invited to talk to the helpline so that they can form a judgment as to whether a screening is appropriate, but anyone who wants one will get one.
I should like to thank the Secretary of State for his comprehensive response. Can he advise me how many women who have moved to Scotland might be affected? If not, will he work double time to ensure that those who have been affected and who have moved to Scotland will get their letters timeously within the correct period?
I believe that the IT work, which is a collaboration between the Scottish NHS and the English NHS, will be completed in the week of 15 May. That is why we are confident that we will be able to get the letters out to people registered with Scottish GPs who have moved from England by the end of May, which is the same timescale as for getting the letters out to people living in England. We will then know that number, and I will of course let the hon. Lady know.
My grandmother died of breast cancer a few years ago, and my heart goes out to all women affected by this fatal IT malfunction. I welcome my right hon. Friend’s assurance that he is going to do everything he possibly can to ensure that this does not happen again. Has any consideration been given to the impact of this on GP surgeries? I expect that, during the next few days while women wait for their letters, they might make appointments with their GPs in anticipation, and in fear.
Yes, we are briefing all GP surgeries and all GPs about what the appropriate response is, because we recognise that that might happen. Of course, GPs are there for people to talk to at any time if they have concerns, and some people may choose to do that. We have also set up a specialist helpline that will be open seven days a week from 8 am to 8 pm, where people will be able to get advice straightaway by picking up the phone. We think that that will be the most practical option for most people.
Order. As colleagues know, I like to call everyone on statements, and I do not wish to make an exception today, but I remind the House that we also have a ten-minute rule motion and a very heavily subscribed Opposition day debate. In pledging to try to get all remaining colleagues in, I ask them to do us all the great favour of being extremely brief. I am sure that Mr Shannon has in mind just a short sentence without any preamble or subordinate clauses.
I thank the Secretary of State for his statement and for his compassion and care. Is he aware of any discussions on the continued alignment with the European Medicines Agency’s drug licensing process to ensure that our breast cancer patients, and indeed all cancer patients, have access to the benefits of the European trials and UK citizens are able to participate in clinical trials? This is very important.