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House of Commons Hansard
Westminster Hall
05 July 2018
Volume 644

Westminster Hall

Thursday 5 July 2018

[Steve McCabe in the Chair]

Backbench Business

Universal Health Coverage

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I beg to move,

That this House has considered the role of universal health coverage in tackling preventable and treatable diseases.

I would first like to thank the Backbench Business Committee for granting this debate. I have been lobbied fairly heavily on the subject and a number of organisations asked me to approach the Committee and request a debate. I am pleased to see the Minister in his place. He and I have discussed the matter before. It is probably one of those issues that involves not only the Department of Health but perhaps the Department for International Development. He once told me that he took part in a debate that covered five different Departments—I suppose he is a man of many talents—so he will be able to answer wisely for the Departments covered in this debate. I thank hon. Members for coming along to Westminster Hall on such a warm day, and given the almost end-of-season approach we seem to have to matters now.

I wish to begin, as we approach the 70th anniversary of our NHS, by thanking all those who have made that institution all that it is. I have said that in other places, but I wanted to say it publicly now in Westminster Hall. Many political parties have had the opportunity to be part of the creation of our great NHS, and many of us have had the opportunity to be cared for by it, both surgically—in operations—and through the care that nurses provide in hospitals, which I personally have had on three occasions over the past year. I am thankful to every person involved in the NHS, from the porter to the paediatric consultant, from the occupational therapist to the oncologist, from the scrub nurse to the surgeon, from the auxiliary nurse to the audiology clinician, and all people in between. I thank them all very much for all that they do for us as patients, but also for us as a nation. I want to put that on the record.

I thank NHS staff for making the NHS work in situations that often seem unworkable, due to stress and pressure. As the Democratic Unionist party’s spokesperson on health, I am frequently contacted by those who need more than the service has to offer. A great many times we focus on the problems of the NHS and where we are—that is the way life is—but we also need to reflect on how good it is and how much we owe it.

People often come to us with their problems; they do not necessarily come to us to tell us how good a job we are doing. Perhaps half a dozen people will call in a week to say what a good a job we are doing, but hundreds of others will come to us with their complaints. That is the nature of the job. It is not about complaining; it is part of the job. I believe that I must highlight where we are going wrong, or perhaps where we can do things better. We must see if we can do things along those lines.

Today it is my desire to thank all those who work in the NHS so tirelessly, who do not always get the recognition they deserve. The NHS is our nation’s greatest asset. A Member said in the main Chamber today during business questions that the NHS was probably our nation’s greatest accomplishment. I tend to agree, as I am sure would many others. The NHS embodies our British values of compassion and fairness. It represents our nation’s strong sense of justice and the desire to help those in need. With its quality of care and pioneering scientific research, it is a world-leading institution.

Across the whole of the United Kingdom of Great Britain and Northern Ireland, the NHS works in partnership with many universities and private companies on research and development for drugs that can help save lives. Queen’s University Belfast is one of those universities, and I know that because it is one of the institutions that I would call in on. Indeed, just three months ago I visited its cancer research team to see the scientific work they are doing. They were over here this week, along with staff from breast cancer charities, in the Attlee suite in Portcullis House, and we had a chance to catch up. What they are doing to try to find cures for cancer at all levels is incredible. There is also the complexity of breast cancer treatment to consider, because many people have different variations, so the drugs they take must be just as varied.

The NHS is the type of British export that can help underpin the UK’s global Britain vision, which I believe we lead the world on and which we can be the forerunners for. Health for all, which is the bedrock of this most beloved institution, is a principle that the UK originated in 1948, when it first embarked on the altruistic duty of creating a national health system to provide care to everyone, everywhere, without their having to experience financial hardship.

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I agree with everything the hon. Gentleman has said so far about the NHS. I saw its merits at first hand when I had a baby two years ago. However, I wish to make a point about the current shortage in the NHS of the BCG vaccine, which is used to treat tuberculosis. My constituent, Hussein, is 11 months old. He was born in Lebanon but is a British citizen. His parents have told me that their GP said that Hussein cannot have the BCG vaccine on the NHS because he was born outside the UK. Does the hon. Gentleman agree that although our NHS has a fantastic track record in tackling diseases and providing care, in order for it to have a successful future every British citizen must be entitled to the preventive medicines on offer?

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I thank the hon. Lady for that intervention. I know that the Minister, like me, listened carefully to what she said. If there is clearly the anomaly that she outlines, the NHS should reply and make the vaccine available. I am quite incredulous that someone who is a citizen of the United Kingdom of Great Britain and Northern Ireland cannot have it. That is almost impossible to understand. I am sure that the hon. Lady will receive a response from the Minister in whatever time is left at the end of the debate.

The NHS is the purest and simplest definition of universal health coverage, and it is the world’s oldest and most successful model. The World Health Organisation estimates that half the world’s population lack access to essential healthcare services and that 100 million people are pushed into extreme poverty by healthcare expenses. We have problems as well. I get frustrated sometimes when constituents come to me. I am referring to Northern Ireland, where health is a devolved matter and therefore not the Minister’s responsibility, but I believe that these cases illustrate some of the issues. A constituent told me this week that a consultant had said to them, “Well, you’re going to have to wait maybe 53 weeks for an operation.” If people want to have an operation through private healthcare, however, they are told that it could maybe be done before the end of the month. As always, if someone can pay for something, they can have it done. We have these problems within the NHS in Northern Ireland and, I suspect, across the rest of the United Kingdom.

As I said, the World Health Organisation estimates that half the world’s population lack access to essential healthcare services and that some 100 million people are pushed into extreme poverty by healthcare expenses. Behind these horrifying statistics are tragic human stories of unnecessary loss and suffering. My parliamentary aide, who does a lot of speech writing and research for me, has travelled to Africa to work every summer, usually in Swaziland but also in Zimbabwe over the past couple of years. That is through Elim Missions, which is a church group in my constituency. She used to visit Africa every summer, during the recess, but she now has two young girls and has not been for a few years. When she came home each year, the tales she would tell about the hospitals she visited would break your heart.

Let me tie together these two stories: first, our NHS; and secondly—perhaps this is for DFID—the responsibility that I believe we have to reach out and help other countries. I referred to that in my earlier discussion with the Minister. My aide’s stories would really have broken your heart. The children’s ward was full of the cast-offs from hospitals in the UK. I do not mean that disrespectfully, because we do that in Northern Ireland—Elim Missions and many other groups do it. We fill containers with second-hand hospital apparatus that might need repairs and we send it out to Zimbabwe, Swaziland and other countries around the world. The equipment can still be used, but sometimes it is worse for wear. We would not put our children anywhere near some of those conditions, but the staff we met made use of all that apparatus and all those materials.

Children in orphanages went without basic medical care until nurses from the UK gave up years of their lives to provide medical training to local communities, for example on the importance of sterilisation. Sometimes the issues can be small, but necessary, such as the simple effect of drops. The hon. Member for Stafford (Jeremy Lefroy) and I were talking this morning about some other things. He said that when he was in Africa his son was taken very ill with pneumonia at eight months old. They did not have the small antibiotic drops that were needed, but once his son got them he became much better and got over the illness. That shows how small things can make a difference and how important it is that we do them.

The Luke Commission is a charity that has been operating since 2005. It takes free healthcare and hope to the most isolated populations in Swaziland. Mobile hospital outreach sites are set up in the remotest parts of that small country. The population is scattered and dispersed. Patients are tested, counselled and linked to treatment for HIV/AIDS. Swaziland has some of the highest levels of HIV in the whole world, and the whole of Africa in particular. Those suspected of having TB are X-rayed and started on medication. Voluntary male circumcisions are performed in an on-site 11-bed operating room, as studies have shown that the rate of HIV transmission is cut by 60% in circumcised males. Those are practical actions that can be taken to change things. More and more evidence indicates that lack of male circumcision is one of the primary reasons why the HIV prevalence rate is so high. These actions can reduce that. Nurses travel back to rural communities to check on newly circumcised men to ensure that they are healing, to answer questions and to provide HIV prevention education.

At the mobile hospital sites, schoolchildren are treated for skin and intestinal problems. Young people are fitted with new shoes. Those are practical, small things that can make a difference. I put on record my thanks to the Elim church charity and to the many other charities and churches across my constituency that gather products, whether clothes, shoes, medication or hospital apparatus—whatever it may be—to help fit out some of these places in Swaziland, Zimbabwe and further afield.

Handicapped people are analysed by Luke Commission medical personnel and given bush wheelchairs—they need a wheelchair that is practical. Follow-up treatment for patients with HIV, chronic disease, complex medical disease and various cancers is offered. Those with poor eyesight receive vision services and glasses, if needed. There is an ophthalmic surgical programme primarily focused on the removal of cataracts, which are a serious issue in parts of Africa. Those practical changes can be made easily. They do not need a lot of money or investment, but they can change lives. Can you imagine, Mr McCabe, not having your eyesight? Of all the things in the world that you would never want to lose, it would be your eyesight. I say that as someone who has worn glasses since I was eight. I understand the importance.

Packets of medication are distributed by the thousands every day, each prescribed by a doctor with instructions on usage in the mother tongue so that they are understood. Psychosocial and grief counselling is available, too. The pain and the tears they have are no less than the pain and tears we have. Some of the things that happen to them happen because they do not have medical treatment available. The Luke Commission team of nearly 100 people treated more than 61,000 patients in 2015. We can do a lot more with small things, but how many more could we affect?

Most recently, a young lady from my constituency gave up her time during her summer to help the Luke Commission. So many others from the UK give up their time to make a difference. Would the Minister be so kind as to outline the initiatives that are in place? I understand his remit may not stretch to that, but it would be helpful if he could give us some idea. What initiatives are in place to encourage our knowledge and skills to be shared worldwide, like the schemes of Doctors Without Borders and the Luke Commission? How are the Government sharing and disseminating the expertise and learning generated from the NHS with Health Minsters in developing countries?

We have great partnerships and the wonderful NHS. We are celebrating the NHS’s 70 years of tremendous work, but we should be trying to show other countries what we can do. Will the Minister give us some idea of how we can help developing countries? I believe that is our duty, and I would like to better understand how we can fulfil it. We need to take up the mantle and do more in our constituencies. We are doing practical, physical and financial things through churches and other charities that directly help in Africa and other countries across the world.

Countries in the developing world are already showcasing their ingenuity and political will in delivering universal healthcare. For example, Bangladesh has achieved wonders in national health in the last 25 years. More than 95% of Bangladeshi children are now fully immunised—that is tremendous. There have been other massive improvements: breastfeeding is near universal, and the level of stunting in children under five declined from 51% in 2004 to 36% in 2014—a significant decrease, showing what we can do if we influence and help both physically and practically. Community outreach by a skilled cadre of female community workers was instrumental in achieving almost universal immunisation coverage, the world’s highest coverage of oral rehydration solution, greater uptake of family planning, and innovative solutions for community-based management of sick newborn babies and severe and acute malnutrition.

Bangladesh is a world leader in reducing child mortality, but pneumonia remains a major challenge for policy makers. Sadly, childhood pneumonia is prevalent across many countries. The stats are alarming: every minute of every day, including today, two young lives are lost to pneumonia; in 2016, it claimed nearly a million children under the age of five in developing countries—more than HIV, TB and malaria combined. If we had the antibiotics available, we could tackle a lot of those problems. Pneumonia is a killer that leaves children gasping for breath and fighting for their lives, but it is also a disease that we have the power to prevent, diagnose and treat. We can do that, so how can we do it better to save those million children’s lives?

We know that an accessible and free health system is the most effective way of treating pneumonia. A fully integrated universal healthcare model can care for a child from the moment they are born until they reach adulthood. That will prevent deaths from pneumonia, which is the biggest killer. We are here today to find out what more can be done to provide UHC in countries around the world, including those in Africa and the middle east, India, Pakistan, Bangladesh and other countries where these problems occur. Millions of people around the world are denied their most basic rights of access to healthcare. We have UHC in this country, and I would like to think that one day we will be able to make it available across the world. As beneficiaries of the NHS, everyone in this room must believe we want everyone to have what we have: a system that is fair and free. We must therefore take steps to change things.

Pneumonia is a prevalent issue within the Commonwealth, too. Save the Children has calculated that children under the age of five living in Commonwealth countries are two and a half times more likely to die from pneumonia than children living in non-Commonwealth countries. When we hear those stats, we realise how big the difference is that we have to try to reduce. Will the UK Government raise the subject at the next Commonwealth Health Ministers meeting? If the Minister is in a position to use that power, I ask him to do so. He should certainly contact the relevant Department to ensure that it happens. What leadership role can the UK Government play, given that the UK is the chair of the Commonwealth for the next two years? I would like to think we can use that influential role. I know we will, but perhaps we should be reminded that we have that opportunity. We should try hard to make things happen.

I am incredibly pleased to have one of the world’s foremost research and medical centres in the wonderful Queen’s University. The steps taken in improving healthcare worldwide have been tremendous, including the most recent breakthrough regarding the targeting of antibiotics for pneumonia using groundbreaking cancer treatment technology. I mentioned Queen’s at the beginning of my speech, but I mention it again, because it is at the coalface of breakthrough technology. I asked Queen’s for a little more in-depth information regarding the breakthrough. That information is certainly something to be proud of. The Queen’s research team indicated that our struggle against infectious diseases is far from over, but they, with other universities, research and development bodies and private companies, are doing their best to make things happen. Globalisation has increased the risk of pandemics, which we get regularly, reminding us that whenever we accomplish something, another disease and pandemic comes along, and sometimes existing drugs are useless.

Unsurprisingly, antimicrobial resistance—AMR—is included in the recently released UK Government national risk register of civil emergencies that may directly affect the UK over the next five years. Our Government have been instrumental in assisting and responding, and it is always good that they do that. More than 80,000 deaths in the UK are estimated if there is a widespread outbreak of a resistant microbe. Far from being an apocalyptic fantasy, a post-antibiotic era in which common infections and minor injuries can kill is a very real possibility for the 21st century. We can never rest on our laurels with what we have done. We need to step forward and be more aware of what we need to do in the time ahead. New diseases are always developing, and there is always a need to match them. We should pay respect and give credit to organisations that do that well.

The O’Neill review on AMR sets out the global threat by highlighting that drug-resistant infections already kill hundreds of thousands of people a year globally. By 2050, it could be as many as 10 million—one person every three seconds. If we needed a reminder of the importance of the issue, that would be the figure. I am not sure if anybody in the Chamber will be around in 2050—I certainly will not be—but those who are could well face one of the debilitating diseases that we need to research now.

Of particular concern is the mounting prevalence of infections caused by multi-drug-resistant gram-negative bacteria, in particular Klebsiella pneumoniae. That pathogen has been singled out as an urgent threat to human health by the UK Government, the US Centres for Disease Control and Prevention, and the World Health Organisation due to extremely drug-resistant strains. Notably, Klebsiella infections have increased by 12% in the UK alone over the last five years. That tells us how things are developing, and that we need to be prepared.

Professor Chris Scott, the interim director of the Centre for Cancer Research and Cell Biology, is an expert in nanotechnology. In June, he teamed up with Professor Jose Bengoechea, director of the Wellcome-Wolfson Institute for Experimental Medicine, who is a world expert on infections by multi-drug-resistant pathogens, chiefly Klebsiella pneumoniae. Professor Bengoechea’s team discovered that it is possible to use the nanotechnology approaches that Professor Scott is developing for cancer to try to treat the bacteria that reside inside human cells and combat that pathogen. We have to listen to the experts and ask them to take things forward in the right way.

Although there is clearly a need for new antibiotic drugs, which must be the Government’s main focus in tackling the potential tsunami of antimicrobial resistance that we face, Queen’s research shows that with effective delivery of antibiotics we will gain a better therapeutic effect against a main protagonist of pneumonia. The complex scientific work that Queen’s is doing should make a difference. Patients may need to take an inhaler of particles containing antibiotics, as opposed to a simple tablet, in the specific case of pneumonia. It is possible that an advanced formulation of drugs could slow resistance developing in some instances and generate better outcomes for patients. It may also mean that we could extend the useful lifespan of some of our current antibiotics. To take that to patients, we need to prepare clinical grade material, but advanced formulations such as nanomedicine are difficult to manufacture. Life is never straightforward, but when we are given a challenge we have to take it on.

Investment is needed in the UK to provide facilities that can advance these excellent therapeutic strategies before they can be tested on humans. We have a process to go through and we must walk along those lines. When we come to the end of the road, we want to ensure that the medication is appropriate and safe. Additional funding needs to be allocated to new approaches to treat infections. Again, the Minister may wish to tell us how the Government are working through the Department of Health and Social Care with universities, companies and research and development on how that process can work, and perhaps how it can work better.

By thinking outside the box, as exemplified by the Queen’s University Belfast research, we will find much-needed new therapeutics. Several projects at Queen’s University Belfast are reaching the pre-clinical stage and are being stalled by the lack of investment, since pharma are still not interested in supporting this essential work. There are ways of going forward, but we need a wee bit of security as well. The lady from Queen’s University who was here this week talking about breast cancer research was funded through one of the Government Departments in Northern Ireland. Queen’s University also gave her a position, which brought her a bit of income. That meant that she could do her research here in the UK, and we in the UK can get the advantage and try to advance that as well. Other UK Government schemes, such as those supported by Innovate UK, also fall short in supporting pre-clinical work because there is still no commitment from pharma. I ask the Minister to consider standing in the breach, if that is possible, and supplying the necessary support and funding for Queen’s and other research centres to help us to do better.

It is expected that by 2035 more than 500,000 people in the UK will be diagnosed with cancer each year. To ensure that our health service can meet future demand, action to prevent cancer and other diseases must be at the forefront of any approach. We have heard today some of the figures, certainly on the mainland in relation to cancer and some of the delays. There are many problems in the NHS, but we are here to help the Minister and to encourage him and the Department of Health to move forward.

The Government must train and employ more staff to diagnose and treat cancers earlier. We can be proud of what the UK Government—our Government—do on healthcare, but we strive to do more, and the Minister strives to do more. The Department of Health is already looking across the world to see how it can share expertise. The Department for International Development is helping countries to strengthen their healthcare systems. What else could we achieve if we joined up the dots and worked together more on implementing universal healthcare?

We should encourage countries to raise their own domestic resources for healthcare, which could have a transformative impact. DFID has been fantastic at supporting the health system to strengthen, but that is not always free, which leaves behind the poorest and most marginalised. I referred earlier to those who are unable to get their operation through the NHS, but are offered the opportunity to pay for it. I am very unhappy with that system; it suits some people, but not everyone. We have to be ever mindful that some of the poorest and most marginalised people in countries across the world are at the bottom rung of the healthcare ladder. We should share our expertise on domestic funding for the NHS with Governments around the world, encouraging Governments to spend more on healthcare.

From 2011 to 2015 there was a cross-Government strategy on global healthcare. An update strategy could include recommendations on domestic resource mobilisation. I understand that the Department of Health has a global health team. It would be helpful to know the remit of that team and how they co-ordinate with DFID on global health issues. What is the connection? Do they have any input to the policy, strategy and the way forward? Do they have regular meetings?

In February 2014, the world watched in horror as Ebola swept across many parts of Africa. We in this country did our bit immediately to respond. We sent our service personnel, our experts and our medication. We were not found wanting, and we never will be. The horror turned to pride as we saw that role that UK aid and our healthcare professionals played in stopping Ebola and saving lives. We should be immensely proud of what our people did, and what our Government did and continue to do. That was the UK Government at their best. They co-ordinated the response to a major global health crisis and supported a country’s health system. How well that was done! We owe thanks to those personnel and to our Government for leading the way. We would never wish for Ebola or something similar to return. What can be done to implement that sort of cross-Government approach to supporting health systems?

I thank hon. Members for coming along to support me, and the Minister for coming along to respond. I thank hon. Members for their time. How does the Minister believe we can excel, improve and achieve an even higher level of global care?

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It is a pleasure to serve under your chairmanship, Mr McCabe. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate. It is a thoughtful and appropriate way to mark NHS70. I pay tribute to him for his typically expert and heartfelt speech.

Whatever the difference between our parties and the Governments of the UK on the details of health policy, we all agree about the extraordinary benefits that the national health service brings as a universal healthcare service, and about its immense contribution in tackling preventable and communicable diseases in this country, not just through treatment but through immunisation and other public health measures. I pay tribute to all NHS staff for their immense dedication and service. Like other hon. Members, I have benefited from the NHS’s care on many occasions, and I will forever be grateful for that.

As the hon. Gentleman said, that is not to say that the job is done. There are things to improve, but we are fortunate to have been born in a country with such a system, given that so many others are not. In the absence of universal health coverage in some countries, many are excluded from the healthcare they need, sometimes including the most basic care. As the hon. Gentleman pointed out, as recently as December 2017, it was reported that at least half the world’s population cannot access essential health services, and almost 100 million people are forced to live in extreme poverty simply because of the expenses associated with healthcare.

It is not just a question of finance and infrastructure; it is also about the barriers caused by culture, prejudice and even draconian and inhumane laws. The hon. Gentleman set out some of the tragic consequences for the affected individuals. For example, the terrible incidence of pneumonia among children in certain countries is a tragedy for individuals, for family after family and for community after community. It is also a disaster for those countries’ economies and public finances. In short, it is a circle of despair.

That is exactly why the goal of universal health coverage is enshrined in sustainable development goal 3—“health for all”—and is a global priority for the World Health Organisation and other international organisations. In simple terms, that means we need to work towards ensuring access to skilled medical professionals in good-quality facilities. We still have a long way to go even in that regard, particularly in the poorest countries and the remotest areas, where even the most basic of issues, such as access to safe water, sanitation and hygiene, remain challenging. Without those things in place, facilities cannot function effectively.

That is not an end to the matter. The goal of universal health coverage will not be realised unless good-quality care is provided without discrimination. There is no point in having facilities and doctors if absence rates among healthcare staff are 60%, as sometimes happens in certain countries. The goal is fatally undermined if discrimination against the most marginalised people, some of whom are the most in need of healthcare, means that they cannot access its full benefits or that they receive substandard treatment. In short, the goal is not simply universal health coverage but effective universal health coverage.

Disease-specific programmes continue to have a vital role to play, but ultimately diseases such as malaria, HIV/AIDS and many others can be eradicated only by establishing universal health coverage, which we sometimes take for granted in our country. That also means ensuring that HIV services are part of a universal health coverage system. People with HIV can often be among the most marginalised in a country—for example, sex workers and men who have sex with men. That can mean that their ability to pay for treatment is even more limited, and they face additional hurdles, such as culture, prejudice and inhumane criminal laws.

I am not slow to criticise the UK Government when they get it wrong, so it is only fair that I praise them when they get it right. I will do that in a moment. The goal of extending universal health coverage around the world will not be assisted by poorly planned and abrupt withdrawals by the Department for International Development from countries without a proper transition. The Independent Commission for Aid Impact gave an amber-red warning to DFID’s transition programmes. The Government have responded to that warning, but it is vital that, as that work is taken forward, DFID ensures that its transition programmes promote UHC and prioritise access to services for the most marginalised communities before it makes its exit.

I recognise that the UK has been a key global leader on this issue in years gone by, and long may that continue. This Government, and any Government, will have our support if they continue to pursue the goals in the universal health coverage 2030 partnership. We need to use the NHS’s expertise and experience to help shape new universal systems in other countries. We should continue to use DFID to put other Governments in a position to support such systems and end reliance on charges and out-of-pocket spending. We want the Foreign Office to be used fully to argue for an increase in health spending and an end to draconian criminal laws that marginalise communities and make access to healthcare difficult. We should continue to support efforts to better measure progress on who has access to universal healthcare and the quality of care they are receiving, so that we can check, for example, that HIV treatment is reaching marginalised communities.

We should continue to support non-governmental organisations and civil society in helping people to access healthcare and hold their national Governments to account. We should continue to be a leader in research and development. The hon. Member for Strangford rightly highlighted the work at Queen’s University, but universities across the United Kingdom play a pivotal role in researching diseases that affect low and middle-income countries.

We need to work with other countries and the World Health Organisation to create a global road map on access to medicines, and to end what is sometimes a medicines rip-off. That means encouraging the de-linking of research and development costs from medicine prices, and defending the use of so-called TRIPs flexibilities—those under the agreement on trade-related aspects of intellectual property rights—by low-income countries seeking to access medicines. It would be particularly helpful to hear a bit from the Government about their commitment to pushing for protecting such flexibilities in the outcome document from the forthcoming high-level meeting on tuberculosis, which I understand is to take place in September.

If all that helps to achieve the universal health coverage goal for 2030, then the NHS’s 82nd birthday will be an even more significant and happier occasion than its 70th.

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It is a pleasure to serve under your chairmanship, Mr McCabe, on this historic day—the 70th anniversary of the founding of the NHS. I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate and for his passionate speech. I also thank my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq) and the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) for their contributions. Finally, I thank the Backbench Business Committee for granting time for this debate, especially on the NHS’s 70th birthday.

It is an honour to be here to speak about our NHS and the example it has set for the rest of the world. When introducing the National Health Service Bill to the House of Commons, Bevan said:

“I believe it will lift the shadow from millions of homes. It will keep very many people alive who might otherwise be dead. It will relieve suffering…It will be a great contribution towards the wellbeing of the common people of Great Britain.”—[Official Report, 30 April 1946; Vol. 422, c. 63.]

Seventy years on, those words still ring true in the UK. That is why the Labour party will always defend our NHS from Government funding cuts and from ever-increasing marketisation, which opens the door to unwanted privatisation. We remain committed to defending our NHS so that it continues to be the fairest and best healthcare system in the entire world. While we celebrate today, however, it is easy to forget that across the world, as we heard from the hon. Member for Strangford, some of the poorest and most vulnerable people are being denied the basic right to health services that we enjoy and indeed take for granted.

In December 2017 the World Health Organisation reported that at least half of the world’s population did not have access to essential health services. It also found that 800 million people spent at least 10% of their household budget on health expenses for themselves, a sick child or other family member, and that for almost 100 million people, the expenses associated with healthcare meant that they were forced to live in poverty.

That widespread lack of access to healthcare contributes to the global epidemic of vaccine-preventable diseases, widespread malnutrition and other health-related problems. Following on from the hon. Gentleman, I shall add some examples to the debate. Globally, 2.6 million children died in the first month of life in 2016, largely due to lack of quality care at birth or skilled care and treatment after birth. More than 20% of births throughout the world still take place without the presence of a skilled birth attendant, and in sub-Saharan Africa that figure rises to more than 40%.

Pneumonia is now the biggest infectious killer of children, claiming nearly 1 million lives each year, or two children every minute. Pneumonia is preventable and treatable; that so many children are dying because of it is shameful. Globally, only 4% of HIV-positive people who inject drugs have access to HIV treatment, and that also increases the risk of HIV transmission among those who use drugs. Behind such awful statistics are tragic human stories of unnecessary loss and suffering. When we invest in health, we invest in people, no matter where they are in the world.

Universal health coverage means that everyone can receive the healthcare services that they need without the worry of suffering financial hardship. It can therefore protect countries from epidemics, reduce poverty and the risk of hunger, create jobs—as we know, the NHS is the biggest employer in the country—drive economic growth and enhance gender equality. Given the world-class reputation of our NHS, the UK Government have a huge part to play in encouraging other countries to establish universal health coverage, and we should be proud that we have such a prestigious role in leading the way on health.

I am pleased that the Government are committed to delivering the UN’s sustainable development goals, which include universal health coverage. Indeed, we should all be committed to ensuring that people live healthy lives, no matter where they live. Will the Minister tell us whether his Department has worked with other Governments from around the world to promote universal healthcare coverage? Which countries has he worked with on that?

Public Health England has developed a global health strategy to look into building public health capacity, particularly in low and middle-income countries, as well as sharing excellence by working in partnership and building on the UK’s strengths. Does the Department of Health have any plans to develop a global health strategy with a specific focus on universal healthcare coverage? Does the Department have regular conversations with Public Health England and colleagues in the Department for International Development to discuss universal healthcare coverage and how to promote it around the world?

Seventy years ago everyone in the UK was granted access to free healthcare, regardless of how much they earned or where they lived. Sadly, millions around the world are still missing out on access to such a basic human right, and people are dying because of it. It should be the ambition of us all on this special day to ensure that that right is enjoyed by everyone around the world. I support the Government on any aims that they might have to do that.

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I am sorry for my musical chairs during the debate, Mr McCabe, but I could not hear everyone from the end of the Chamber—I think it is my age and the heat. I thank the hon. Member for Strangford (Jim Shannon) for, as always, an interesting speech. I congratulate him, especially today—birthday day—on securing the debate in his residence of Westminster Hall. He mentioned that he might still be here in 2050—I would almost hazard a wager with the hon. Gentleman about that one, but I hope we shall all still be here.

Was not 5 July 1948 a pivotal day for our country, with the inauguration of healthcare free at the point of use for all our citizens? Seven decades later, the NHS remains one of our nation’s most loved institutions. The NHS is often described as the closest thing we have to a national religion, and this lunchtime a service in Westminster Abbey proved the point. The NHS is one of our country’s crowning achievements, possibly the crowning achievement—along with the English football team, of course—and it is the envy of people across the globe. When I travel around the world in this job, people are fascinated by and envious of the NHS in equal measure.

As has been said by my shadow, the hon. Member for Washington and Sunderland West (Mrs Hodgson), and everyone else who has spoken today, the NHS is of course nothing without its fantastic staff, who show such a level of Christian compassion—some without even knowing it—day in, day out. More than 1.5 million people work each day to provide the best possible care for our constituents.

The questions that the hon. Member for Strangford asked are important. We are the proud owners of an excellent universal healthcare system, albeit one we continually strive to strengthen, as we must—the best friends are prepared to criticise, and the NHS is not above criticism in our struggle to make it better—but he asked what we are doing to share our experiences. I shall certainly be able to cover that point.

The health of UK citizens is not dependent only on action in the UK. Diseases do not respect borders, and we need to act internationally to protect ourselves as well as to help others. Not only is that relevant when an outbreak hits—recently we had an Ebola outbreak, which I have monitored closely—but we must keep working with other nations to strengthen their capacity to prevent, detect and respond to diseases. UHC is critical to that. Threats such as that of antimicrobial resistance, which the hon. Gentleman mentioned in his opening remarks, can be tackled only through global action.

There is much that we can learn from each other. The NHS has evolved a huge amount since the late 1940s, and the next 70 years will require ongoing adaptation and innovation as we deal with the challenges of 1 million more over-70s—the ageing population—and further reap the rewards of scientific advancements, which have been so central to the NHS in its first 70 years. Other countries develop innovative approaches that we may not yet have considered—it is not all about the great empire of Britain, telling the rest of the world how things shall be—and there are plenty of challenges that no one has yet cracked. We should work together, and we do. It is right that we support others who have not yet achieved universal health coverage to do so, including by sharing our experiences.

We are committed to delivering the sustainable development goals, which the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) mentioned, including SDG 3. That is crucial to tackling many other health challenges, including the improvement of maternal, newborn and child health, as he said, and specific diseases such as TB, HIV, malaria and—everyone rightly mentioned this—pneumonia, the single largest infectious cause of death in children worldwide.

Universal health coverage is a goal, not a blueprint. Country needs, plans and perspectives are central to our work, and we have no interest in imposing an NHS model. It is crucial for each country to find its own path to UHC, which may entail greater private sector involvement, if that is what the country wishes, or a national health insurance scheme if that is what the politicians are brave enough to do. That is not our choice, but it is the choice in some parts of the world. We cannot just go with our judgment in trying to help other countries achieve universal health coverage.

Poorer, marginalised populations must achieve better access to good-quality essential services without the risk of financial hardship, as we choose in our NHS. Support for UHC must also involve helping countries to achieve sustainable funding mechanisms for their system, whichever they choose. The countries in greatest need deserve our financial support, but the ultimate goal must remain to transition to domestic funding, so that countries can maintain health systems in the long term.

The UK engages on UHC in a number of international forums. We strongly support the World Health Organisation’s focus on UHC through its new general programme of work, and we provide funding through a number of DFID programmes. We engage on this topic at governing body meetings and our annual UK-WHO strategic dialogue. I have a good, open and direct relationship with the head of the WHO, as part of my responsibility for international health at the Department of Health and Social Care. Underpinning the WHO’s success is a strong and effective organisation, and the UK continues to promote reform of the WHO so that it is the best it can be. As the second largest donor to the WHO, we are in a very strong position in that regard.

We promote UHC as a priority in other forums such as the G20 and the G7; I attended the G7 Health Ministers meeting last year in Milan. We were pleased to see strong commitments on health in the recent Commonwealth Heads of Government meeting, including on eye care, which I am passionate about. We will continue to follow up with the Commonwealth secretariat on the implementation of everything that was agreed in London. The high-level meeting on UHC at the UN General Assembly in 2019 will be an important opportunity to share experiences and to drive greater collective action. I will pass on the hon. Gentleman’s request, which I agree with, for us to use our chairmanship of the Commonwealth to further the UHC agenda that we all believe is so important.

My Department has rightly taken on a global leadership role on patient safety, along with our German and Japanese counterparts, to whom I spoke directly at the G7 Health Ministers meeting last year. Hon. Members will know that patient safety is the central mission of the Secretary of State. It is crucial to universal healthcare—as the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East rightly says, the aim cannot just be universal healthcare but must be good-quality and safe universal healthcare. Providing access but not quality care is not truly delivering on the sustainable development goals. We hosted the first global ministerial summit on patient safety in 2016, bringing together political leaders and experts to galvanise action on this crucial issue. Subsequent summits in Germany and Japan have continued that legacy.

Another key but often overlooked facet of universal health coverage is addressing mental as well as physical health. Again, my Department is taking an international role: we will host the first global ministerial mental health summit in October. The summit will bring together political leaders, experts by experience, policy makers and civil society to share innovative and effective approaches to mental health care, which the Prime Minister has rightly said is one of her main priorities. The Department of Health and Social Care frequently receives ministerial and official delegations from overseas to look at topics as diverse as childhood obesity, on which we lead the world; emergency response, as we often send people around the world; and elderly care.

The international team, which the hon. Member for Strangford mentioned and which I look after, manages the Department’s bilateral and multilateral engagement, working closely with colleagues at DFID and across Government. The team also leads on co-ordinating global health strategy across Government and on the health implications of trade and of the UK leaving the European Union.

The hon. Gentleman asked about our support for low and middle-income countries. The UK has a number of programmes with those countries. They are largely led by DFID, although a number draw on my Department, the NHS and Public Health England, for which I have ministerial responsibility. The UK supports the aim of countries working towards universal health coverage, with priority given to ensuring that poorer, harder to reach populations achieve better access to good-quality essential services without risk of financial hardship.

We apply a health systems strengthening approach to all health investments. That includes addressing global health security issues such as antimicrobial resistance; scaling up nutrition interventions, which are about building up country resilience; improving reproductive, maternal, newborn and child health; and targeting specific diseases such as HIV, TB and neglected tropical diseases. One of the first things I was able to do in that space was to speak at the family planning summit organised by DFID over the road at County Hall, which was backed by Bill and Melinda Gates, about our record in driving down the teenage pregnancy rate in this country. Of course, getting reproductive health right often helps developing countries to make their health systems more robust and sustainable.

The hon. Gentleman mentioned the delicate subject of male circumcisions and HIV. He is right to say that circumcision is practised across many parts of Africa to prevent HIV. The WHO and the UN consider male circumcision to be effective in HIV prevention, where there are heterosexual epidemics and high HIV and low male circumcision prevalence. However, the practice provides only partial protection. The procedure should not be seen as a green light to risky behaviour; it should be one element of a comprehensive HIV protection package. It would be remiss of me not to mention that I get a lot of letters on this subject. A number of campaign groups in this country and around the world make arguments about the human rights elements of the matter, especially when children undergo circumcision surgery, and its impact later in life. It is important to recognise all those facts, but the hon. Gentleman is right to mention it as part of the toolkit used in certain countries, Tanzania being one of the most prevalent.

We provide support directly to countries, work through the WHO and scale up targeted, cost-effective preventive and treatment interventions through global initiatives such as the global health fund, Gavi and the global financing facility. We are the largest donor to Gavi, which provides developing countries with pneumococcal vaccine to protect against the main cause of pneumonia. Between 2010 and 2016, 109 million children received the vaccine; we estimate that saved about 760,000 lives.

The health partnership scheme is another good example of how the UK can use our expertise overseas. Since 2011, we have trained 84,000 health workers across 31 countries. The scheme relies on volunteers from the NHS who help to support the training of staff overseas and benefit themselves through gaining new skills and motivation. Last October, the Minister of State, Department for International Development, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), who I work closely with across Government, announced the new £30 million programme with the catchy title “Stronger Health Partnerships for Stronger Health Systems”. It will run for five years from 2019 and will support partnerships between leading UK institutions and those in developing countries.

One of the benefits of being the Minister in these debates is that sometimes I can mention the good things that happen in my constituency. Hampshire Hospitals NHS Foundation Trust, which covers the Royal Hampshire County Hospital in Winchester and the Basingstoke and North Hampshire Hospital, has two very good international links, including with Yei in South Sudan, where a number of medical professionals from that trust have worked on antibiotic resistance studies, looking at the bacteria that can cause pneumonia. In collaboration with the Rotary Club in Winchester and the Brickworks, which is a Winchester-based charity, it has secured funding for textbooks to repopulate a midwifery and lab training institution and funding to build schools for South Sudanese refugees in Uganda, so that refugee children can continue their primary and secondary education. There will be examples in the constituencies of Members throughout the House of health professionals using such expertise as part of their upskilling, but also to help those less fortunate than us.

The UK offers development opportunities for the medical workforce globally. The medical training initiative allows overseas medical specialists to train in the UK for up to two years, to see our system close up, so that they can return to their home country and apply their skills and knowledge to the benefit of their population. Of course, that benefits the NHS by providing extra staff, who we desperately need, and enhances the clinical capacities of health systems in low and middle-income countries. We estimate that just over 3,300 overseas doctors have taken part since 2009. I know the House will be interested in that positive programme.

We are passionate about tackling AMR, and we are committed to doing so. My Department is working across Government with a wide range of stakeholders to refresh our AMR strategy, which rightly gets a lot of attention in the House, with a view to republishing it at the end of 2018. I know that the hon. Member for Strangford will be interested in that. One of the ambitions we set out in response to Lord O’Neill’s independent review of AMR, which was established by George Osborne when he was at the Treasury, was to halve healthcare-associated gram-negative bloodstream infections. We are focusing on E. coli infections this year, but we are also collecting data on Klebsiella and Pseudomona pathogens.

I think there will be a lot of interest among Members in the refreshed AMR strategy. Health Question Time seldom goes by without AMR being mentioned. AMR is important. As the chief medical officer, who is busy in other ways today, has said, it is one of the greatest threats, if not the greatest threat, that our world—not just our healthcare world—faces.

We welcome all new research that contributes to our work to tackle AMR—especially great research such as that produced by Queen’s University Belfast, which the hon. Gentleman mentioned. There are a number of funding opportunities, and high-quality proposals are always welcomed. He rightly mentioned that people from Queen’s were at the House yesterday. He and I met them together—we had our photo taken with them—at an excellent Breast Cancer Now event, which was a great chance to hear about some of the incredible research that is being done on that disease in our United Kingdom.

Great research projects often start with relatively small grants from charities such as Breast Cancer Now, which act as the building block for other researchers to jump on board and get with the plan. That is very important. This is not all about the Government starting research projects; it is about institutions such as Queen’s being world-renowned. The lady I met yesterday was clearly on top of her game. She deserves great credit, and I thank her and all her colleagues at Queen’s for the work they do for our country.

We have strong join-up across Government. My Department, DFID, Public Health England and the Foreign Office in particular take a “one HMG” approach to global health, which was recently praised by the Independent Commission for Aid Impact. That includes regular meetings between Ministers, and a co-ordination group of senior officials meets very regularly to look strategically at our international activity and some of the programmes I mentioned. It includes joint delegations to WHO meetings and daily contact between our officials. It also includes joint working on projects such as the UK public health rapid support team. That is a partnership between the Department of Health and Social Care, Public Health England and the London School of Hygiene and Tropical Medicine that, at countries’ request, deploys people rapidly to some of the poorest parts of the world to investigate significant disease outbreaks and support capacity building. I mentioned examples of times when that has been invaluable, such as during the Ebola crisis.

In concluding, let me return to the incredible achievements of our NHS over the past 70 years, during which time life expectancy has leapt. Its staff work tirelessly to ensure that it remains the best in the world. We are committed to ensuring that it provides universal health coverage in the UK for generations to come, but we do not keep it all to ourselves—we are desperately keen to go on sharing our knowledge to help other countries do the same, so that people around the world can benefit from the incredible privileges we have in this country.

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Mr Shannon, would you like to make some concluding remarks?

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I certainly would, Mr McCabe. I thank you for chairing the debate so well. I also thank the hon. Members for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald)—my pronunciation is probably all wrong—and for Washington and Sunderland West (Mrs Hodgson), whose contributions were immense. The hon. Member for Hampstead and Kilburn (Tulip Siddiq) highlighted important issues with the BCG vaccine.

I thank the Minister for his comprehensive response. He always says that he is pleased to be in his position because he has a deep interest in the subject, and that was illustrated by his responses to everyone who spoke. He was right to say that we are celebrating the 70th anniversary of the NHS and its excellent work, and to focus on what we can do both here and around the world. I am glad he mentioned the importance of remembering, whenever we think about diseases and healthcare in this country, that we also have to prepare for the diseases that come into the country from outside. We have a joint approach, in which the NHS delivers great healthcare here and we share that healthcare around the world. For that, we are eternally grateful.

Question put and agreed to.


That this House has considered the role of universal health coverage in tackling preventable and treatable diseases.

Sitting suspended.

Equal Franchise Act 1928

[Ms Karen Buck in the Chair]

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I beg to move,

That this House has considered the 90th anniversary of the Equal Franchise Act 1928.

It is a pleasure to serve under your chairmanship, Ms Buck. I rise to mark an important date in British history: 90 years ago, on 2 July, this House ratified the Representation of the People (Equal Franchise) Act 1928. For the first time ever, women were afforded equal rights to men in formal political participation; for the first time ever, women over the age of 21 and women who did not meet arbitrary property qualifications were eligible to vote; and for the first time ever, women made up the majority of the British electorate.

According to the Electoral Commission, in 2017 women were four times more likely than men to cite people fighting to win them the right to vote as a motivation for casting their ballot. Three quarters of women say that they always vote in general elections. This year we rightly celebrate that it is 100 years since some women, through tireless sacrifice and struggle, attained suffrage in the UK, but it would be wrong to forget that many other women—around a third—had to wait another decade to participate fully in this country’s democracy.

During that decade, feminists made advances in their campaign for gender equality across different sectors of British society. On 1 December 1919, Lady Astor became the first woman to take her seat in Parliament. On 23 December 1919, women successfully lobbied Parliament to enact the Sex Disqualification (Removal) Act 1919, which prohibited women’s exclusion from most forms of employment and allowed them to obtain professional employment in any civil or judicial office. In 1920, women were finally afforded the privilege of being able to obtain a formal degree from the University of Oxford, despite having already contributed to its structures and studies for decades.

However, most working-class women did not have the opportunity to stand for political office or to seek professional employment in the judiciary or other such posts, and they certainly did not have the resources to study at any university, let alone Oxford. In fact, during the early 20th century the working class had few opportunities indeed. For that reason, the last century saw the intensification and politicisation of workers’ rights and the growth of the trade union and socialist movements whose values form the very foundations of my party.

Even by the time Ramsay MacDonald became, albeit briefly, the first ever Labour Prime Minister in January 1924, working-class women could still not vote. It pains me to imagine how much more could have been permanently achieved if more than one third of our population had not been disenfranchised for so long and at such a crucial time in the history of the British working class. Would we be further along the march to true equality? Would I still have needed to hold this debate?

Because of the hesitant start to the full enfranchisement of women and the working class, even today many of us in this room will have experienced, from a young age, a world that has not always been particularly inclusive or fair to women, minorities, the working class or, broadly speaking, those deemed to be “others” in society.

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I congratulate my hon. Friend on securing this important debate to mark the 90th anniversary of women attaining equal voting rights to men. Unfortunately, there are still some women who, because of their circumstances, feel unable to vote. One example is survivors of domestic abuse who feel unable to register because they do not want to risk their safety. They may not be aware that, thanks to the Electoral Commission, they can register anonymously. Does my hon. Friend agree that we should pay tribute to the charities, groups and organisations—including the Dash Charity and Hestia in my constituency—that work for women’s empowerment and support victims of domestic abuse?

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Absolutely. I am a champion of Hestia, so I know of its brilliant work. The Electoral Commission is making sure that women know that their vote is theirs alone.

While on this important date we note the lost potential and the pain caused by sexism and injustice, we also celebrate the tenacity, bravery and resolve of those who fought tooth and nail against the status quo to reverse the injustices of patriarchy, classism and all forms of discrimination. We must also look at what more needs to be done in the struggle for equality. Working-class women may have attained the vote, but many barriers remain to equal political participation and representation, and equality in all aspects of modern life.

This year has seen a number of cross-party initiatives launched to combat the gender pay gap, seeking to remedy an age-old economic injustice faced by women, much like the political disenfranchisement faced by the suffragettes. However, similar to the disparity faced by working-class women in the 1920s, working-class women and minority ethnic women are far more affected by the inequality of the gender pay gap than their middle-class counterparts. Recent Library research shows that women as a whole bear 86% of the costs of austerity, with working class, disabled and minority ethnic women disproportionately affected by cuts to public services and welfare.

I do not say that to create a rift among different groups of women or to sour the mood on this landmark date, but to remind us that it is our duty as parliamentarians to ensure that all women are adequately represented, both in this place and across the UK. On that note, I have learned since my arrival here a year ago, which I have really taken to heart, that those of us privileged enough to be in this place really are women first and partisan politicians second. We need—indeed, want—to work together to improve women’s lives and the future for girls growing up in this country.

It would not be right to celebrate without recognising that we still have a long way to go in our fight for equality. For example, we know that almost 52% of the UK population is female, yet we still make up only one third of all Members. As a representative of the excellent campaign group 50:50 Parliament, which was started by my brilliant friend, Frances Scott, I understand only too well how far we still have to go to achieve a true representation—or simply an accurate picture—of our nation’s population.

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I congratulate my hon. Friend on securing the debate. The first general election in which women could stand as candidates was in 1918; then, one female stood in Wales. Last year, 66 candidates in Wales were women, but only 11 of Wales’ 40 MPs are women. Does she agree that we still have a long way to go to achieve parity with our male colleagues?

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Absolutely. I am sure that the Welsh Government are doing their bit.

When the debate is reported and shared on social media, I know for certain the comments that will be made, because they always are. Men will type, “Why can women only be represented by women?”, “Why do we need more women?” or, “What difference does it make?” as well as other rude comments that I cannot say. I will tell them why. Do we really think that debates leading to legislation and policy change that focus on issues only or mostly affecting women would be on the Order Paper at all without the growing number of us here? Issues brought to the House by my colleagues in recent years include period poverty, the provision of affordable childcare, maternity leave, the gender pay gap, abortion rights, domestic violence, stalking and sexual harassment to name just a few. Could we really have left those issues in the hope that hundreds of male Members would one day stumble upon them and take them forward on our behalf? No.

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Does my hon. Friend agree that another example of that is the campaign of the Women Against State Pension Inequality? Without those women having the franchise and being able to raise their voices electorally, and without all the women MPs in Parliament, that issue would not be in the public domain in the way that it is.

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Absolutely. I was happy to meet some of my local WASPI activists yesterday on Parliament Square.

We know that men would not have taken those issues forward because they did not in the hundreds of years that they had this place to themselves, so we came here and did it ourselves. A recent and important Bill on upskirting was almost totally stopped in its tracks. It was tabled by a female MP, the hon. Member for Bath (Wera Hobhouse), and was talked out by a male MP, the hon. Member for Christchurch (Sir Christopher Chope), who frankly made a mockery of our Parliament and completely shamed himself. A female Minister is now taking the Bill through the House as the Voyeurism (Offences) (No. 2) Bill, in a Bill Committee made up mostly of women.

Sadly, women still often face societal discrimination and sexism in their everyday lives. Misogyny is rife and in full health. Rather than being consigned to history, it sits at the heart of even current legislation. One particularly disgusting example that is never far from my mind is the so-called two child policy: the epitome and very definition of sexist, disempowering, discriminatory and degrading prejudice towards ordinary working women who are, unlike most people here who get to create the policies, struggling to just get by. That particular policy would not have seemed so out of place 90 or 100 years ago before we marched, starved ourselves, chained ourselves to fences, broke the law, fought back and refused to give in until we got the right to vote.

Although many things have changed, and mostly for the better, so many other things really have not. We have to make sure that the change is not simply on the surface. Women must continue to fight for our rights, for equality, for a seat at the table and a voice in the decision-making processes—not only white, wealthy and middle-class women but working women, disabled women, black and minority ethnic women, lesbian, gay, bisexual and transgender women; women from all cultures, all religious faiths and every financial background. We must support each other, encourage one another and keep looking around the table to see if we are all represented.

One way in which we can practically commit to that aim is through cross-party solidarity on enacting and fully implementing section 106 of the Equality Act 2010. Section 106 would ensure that all political parties adequately report on the diversity of their candidates, allowing us to scrutinise discriminatory practices and hold parties to account when they fall short of what is necessary for real and true equality. This is an initiative recommended by the Women and Equalities Select Committee, the Labour party’s shadow Secretary of State for Women and Equalities, my hon. Friend the Member for Brent Central (Dawn Butler), the Fawcett Society, CARE International and many more.

Today in the Chamber we were due to debate proxy voting. Two weeks ago, a few of our women MPs, one seriously ill and two very heavily pregnant, were forced to go through the crowded voting Lobbies, which caused them considerable physical discomfort as well as being an extremely unpleasant experience. My hon. Friend the Member for Bradford West (Naz Shah) describes it in an article in today’s Guardian as,

“degrading, humiliating and downright horrible.”

I agree with her when she says,

“It should never have happened.”

That practice needs to change as soon as possible, and proxy voting is one option that would put an end to such practices. We need and want to encourage more women to come to this place, and some women have babies.

If we are serious about women’s representation and about celebrating the legacy of those fearless women who so vociferously fought for our right to stand here today, we must do our bit to ensure that those who wish to stand here do not face the barriers that many of us have had to. Ninety years ago, working women like my grandmother and great-aunts and their peers who served, cooked and laundered for the local landowners got to have their say. Our job here is to speak for those who are still not here but need to be, and to hold the doors of Parliament wide open to welcome them in to take their rightful place beside us.

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It is an absolute pleasure to see you in the Chair this afternoon, Ms Buck, and to speak under your chairmanship. I thank my hon. Friend the Member for Canterbury (Rosie Duffield) for securing the debate and giving us all the opportunity to talk about this issue today. She treated us to a really excellent contribution, which I look forward to reading in Hansard, because she touched on so many salient and important current political points.

I want to talk about the history of all women in this year of feminist anniversaries. The centenary of partial suffrage for women is important, but the centenary that means most to me will come in 10 years’ time. The women of my family were unable to vote in 1918, 1922, ’23 or ’24 because they were working class—they did not own property and they were not married to a man who owned property. As my hon. Friend has said, more than half the adult women in the UK were denied suffrage for a decade longer.

My family were proud of the right that they won. I was told at a really early age that they did not care who I voted for—as if!—but I had to vote. Only by voting would I respect the fight and the sacrifices made to secure my franchise. We sometimes forget that the story of suffrage is not just middle-class and white. Suffrage fighters were black, Indian, and disabled, like May Billinghurst, who once used her wheelchair as a battering ram to escape a police cordon when she had been trapped by a group of men.

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Does my hon. Friend agree that individuals such as Princess Sophia Duleep Singh are often left out of history and not celebrated as much as some of their counterparts, and that that is something that we need to remedy in our history?

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I am grateful to my hon. Friend for mentioning Sophia Duleep Singh. She was indeed a doughty fighter, and all too often women like her have been written out of our history. He does us a great service by bringing her name into the debate.

Above all, for me, suffrage fighters were working-class. The first branch of the Women’s Social and Political Union was opened in my constituency in Canning Town, where my family lived. It was opened by Sylvia Pankhurst, but equally by the working-class women Minnie Baldock and Annie Kenney, who was a mill worker. It is fair to say that the Women’s Social and Political Union had become quite autocratic over time and the leadership appeared increasingly intimidated by the strength of the heavily working-class branches of east London, so those branches were expelled, along with Sylvia Pankhurst, and they formed the new East London Federation of Suffragettes.

The success of the group was massive. They organised among workers, including more than 5 million women who worked in factories during the first world war. They fought against deprivation in working-class communities, opening free milk depots for mums with young children and canteens that served affordable, nutritious food. That was so important then—and sadly now. They even opened a co-operative toy factory that paid a living wage. It included a crèche and, unsurprisingly, it recognised the needs of working mothers. At the time, working women were generally on poverty wages in munitions factories or they were sewing uniforms at home. However, the east London suffragettes stepped up their support for working communities and refused to allow the war to stop their campaign, continuing to build momentum for genuinely universal suffrage when others had, frankly, given up.

It is true that Sylvia Pankhurst’s socialist convictions were important to the movement but, as she recognised herself, it was the working-class women who were key. She said that working-class women were:

“not merely the argument of more fortunate people, but...fighters on their own account, despising mere platitudes...and demanding for themselves and their families a full share of the benefits of civilisation and progress.”

She was proved right. After she had been imprisoned and was weak from force-feeding, it was the women of the east of London who offered her protection.

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Does my hon. Friend share my view that although it is brilliant to see the statue of Millicent Fawcett in Parliament Square, it would be as good to see a statue of Sylvia on Clerkenwell Green?

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I certainly do, and perhaps we could do something about the Payne family, who took Sylvia in when she was weak. The Payne family came from Old Ford, which is kind of Hackney, kind of Tower Hamlets, and kind of Stratford—so that makes it mine—and they were shoemakers. Police officers tried to surround the house that Sylvia was in, but they were confronted by really strong women who simply stood firm and resolute and refused to move. Special branch officers attempted to bribe the women to withdraw and to allow them to use their rooms for surveillance. They offered decent money, but every single woman and family, I am proud to say, stood firm and refused to accept the bribes. They refused to move. I believe that, if the East London Federation had not put working-class women first, the anniversary that we are celebrating today would have taken much longer to achieve.

Those women stood on the shoulders of the match women who went on strike. They were from the same area and of the same stock. History is clear: the match women’s success in organising for themselves and fighting for their rights inspired London’s east end dockers to do the same. Those women were the wives, daughters, sisters and mothers of the dockers who went on strike the year after. The match women did not plead for inclusion in the labour movement, because they created it. They organised, fought and won against massive odds. They were instrumental in founding a political labour movement that continues to fight for fair pay and conditions for all Britain’s workers today.

I am happy that people know about those events through the wonderful work of the amazing historian Dr Louise Raw, whose sixth successful annual match women’s festival took place last Saturday. Louise and I have been campaigning for a proper memorial for the match women at the Bryant and May factory site in Bow where they worked. Progress is slow, but I am glad to tell the sisters present—and the brothers—that I reckon we will make it within the next 12 months. We have strong support from residents, historians and activists.

We are making some progress with recognition of our history as working-class women. However, Members will agree that we have a way to go, because in the east of London we have a Jack the Ripper museum that glamorises misogynist murders and turns the working-class women victims into mere props. At the same time, one of the victims, Annie Chapman, is buried in a pauper’s grave in Newham, and one of the match women’s leaders, Sarah Chapman—no relation, as it happens—is buried just a few metres away. Those are the stories that we need to tell and remember. Those are the people we need to memorialise—not a sad, sick man.

Why do we have a Jack the Ripper museum? The building was originally supposed to be a celebration of east end women but, according to newspaper reports, the developers lied. The travesty of the Ripper museum in Cable Street, of all places, may have a positive outcome yet, because the campaign for an east end women’s museum is stronger than ever. The campaigners aim to secure a permanent home for their exhibitions, which they expect to open in 2020. They are still talking about putting the museum in Barking—but I still have my dreams.

Learning about our history is important, because unless we know where we come from and who we are, it is hard to know where we can go. The history we talk about today can play a part in inspiring a new generation. Remembering our past helps us to understand our present and imagine our future. If more people knew about the true contribution of working-class women to the suffrage and labour movements, and the rights and prosperity in this society today, they would be less likely to overlook the amazing women who do that same work now. The potential that my working-class sisters have is enormous. They need the recognition and the space to achieve it.

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I thank my hon. Friend the Member for Canterbury (Rosie Duffield) for securing the debate. She is a woman I am proud of, as I know many Members are.

It is vital in such a debate not only to celebrate the achievement of the 1928 Act, but to remember the stories of the women and fighters who campaigned for it and who won the battle for electoral reform, suffrage and equality. It is 100 years since some women got the right to vote—not all of them, but some. It was a good step forward. People often get confused between the different Representation of the People Acts. Were it not for the fantastic Voice & Vote exhibition in Westminster Hall, it would be easy for Members of Parliament, too, to be confused about when each piece of legislation was passed, and what it meant.

In 1918 the vote was given to some women—only those at the top of society. The 1928 Act gave the vote to all women over 21, rather than those over 30 who were landowners. That was a huge step forward, and it meant that 52.5% of the electorate in the 1929 general election were women. That was transformative. The fact that it took 10 years—two whole Parliaments—fully to extend the franchise shows just how scared the establishment was of giving proper representation to women and the working class across the UK.

I pay tribute to the incredible campaigners who continued to make the case for the legislation. Many gave up their freedom, faced imprisonment or went on hunger strikes. Many, such as Emily Davison, gave their lives for the cause, but the campaigners never gave up. They are an inspiration to all of us in this House and we pledge ourselves to further their cause. The story is often overlooked.

In Plymouth we are proud to be part of the suffragette story, and of the fact that the suffragette movement there was not just one of rich women campaigning for the vote. The women took things into their own hands. Members may be familiar with the beautiful Smeaton’s Tower on Plymouth Hoe. That lighthouse still stands proudly, but the suffragettes put a bomb in it and tried to blow it up. They wanted to attract attention to their cause. I am glad that the lighthouse still stands, but the story of how local women in Plymouth resorted to those means to try to gain attention and credibility for their cause should continue to be talked about.

I want to talk now about Nancy Astor. As my hon. Friend the Member for Canterbury said, the story of how we reached the point where only a third of our Parliament are women started with Nancy Astor taking her seat in 1919. She represented Plymouth Sutton and was introduced to the House of Commons flanked by Balfour and Lloyd George. It will be the 100th anniversary of her election—and of Plymouth’s voting for a woman—in November 2019. She and I would disagree fundamentally on nearly everything. She stood for many things that I could not stomach, countenance or go along with, and I am sure that that would be the case for nearly every Member. We would not share her views on slavery, anti-Semitism, fascism and LGBT equality, but her story, the fact that she was the first woman to take her seat in this place, and the fact that Plymouth was the first place to elect a woman who took her seat means we are intimately entwined in the story, which we must keep telling.

There are far too many girls and young women in schools in Plymouth and across the country who do not know about Nancy Astor. I do not want her political views to be advocated; I want the story of brave women, many of them standing alone, doing brave things and pushing the boundaries for women in general. She was initially known as the Member of Parliament for women, and we should talk about her role. There should be debate about the good and bad sides of all politicians. The first step that she took is important. It may seem odd for me as a Labour MP to speak here about a Conservative MP—especially one I fundamentally disagree with—but we need to tell the story. It frustrates me that the story of women in our politics is not told. We hear about men, and occasionally about the women standing behind them. We need to break that, and we can do so only when we—men in particular—start to tell the story. We cannot leave it to women to tell the story of women in politics. It is for all Members of Parliament, male and female, to talk up the role of women in Parliament.

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My hon. Friend is making an excellent speech. As to women pushing boundaries, does he agree that women, and especially those from ethnic minorities, are often not given much credit for their accomplishments? The first black lady mayor in the country, Lydia Simmons, was elected in Slough. She was an inspiration for many, yet often such individuals do not get the credit they deserve.

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My hon. Friend has proved my point precisely that we need male MPs speaking up as well as female MPs, and I thank him for taking the advice so quickly.

I recently visited the superb Voice & Vote exhibition in Westminster Hall. I pay tribute to the House authorities for putting it on. It really is a superb exhibition, and hon. Members who have not visited need to take the time to do so. They will notice that one exhibit is Nancy Astor’s dress, on loan from Plymouth museum. She picked the dress because it looked like a man’s suit; it looks like a double-breasted suit. Beside it is a little plaque explaining that she chose it because she wanted people to judge her by what she said and not for what she wore. It is therefore somewhat ironic that 99 years later I stand here, as one of her successors, talking about her dress and disagreeing with all her words, but perhaps those are the joys of democracy.

Parliament was a very different place when Nancy Astor became a Member. Voice & Vote tells us the story of a system that did not welcome women to Parliament. It did not afford them the equality and credibility that they deserved by virtue of their election. We can see that in the fact that in 1929 there was only one coat hook in the Lady Members’ Room for eight female MPs. That was simply unacceptable. However, there is still far too much that the women at that time, Nancy Astor included, were fighting for that we are still fighting for today.

Nancy Astor was not afraid to stand up for herself as a woman, even in the face of power. She had an incredibly canny sense of humour, and people who have spent time in Plymouth will know many stories about her. I will touch on just a few. In particular, I want to touch on her relationship with Winston Churchill. Many hon. Members will know one story about it, but there were so many glorious clashes between them. Apparently, Churchill once told Nancy Astor that having a woman in Parliament was like having one intrude on him in the bathroom, to which she retorted, “You’re not handsome enough to have such fears.” She is also said to have responded to a question from Churchill about what disguise he should wear to a masquerade ball by saying, “Why don’t you come sober, Prime Minister?” But perhaps the most famous exchange, which I am sure all hon. Members will know of, is the one in which Nancy Astor said, “Mr. Churchill, if you were my husband, I would poison your tea,” to which Churchill replied, “Madam, if you were my wife, I would drink it.”

So many stories are told about Nancy Astor, but so few are told about many of the other fantastic female MPs for Plymouth. I want to single out Lucy Middleton, who was the MP from 1945 to 1951 and a real tower of strength in the trade union movement. She is not remembered enough by my party in Plymouth, or by all of us here. Sadly, she lost her seat, to a male member of the Astor dynasty, Jakie Astor, in 1951, but it is good to see her name on the wall of female MPs in the Voice & Vote exhibition, because there is so much more that needs to be said in that respect.

One thing that frustrates me every time I come to Parliament—and that helps keep alive in me the fire so that I do not become accustomed to or cushioned by this place—is looking around the rooms in which we have our meetings and seeing all the old white men in wigs staring down at me. This place has a problem, because nearly every room—except, perhaps, this one—has too many pictures of men, too many pictures of old men, and too many pictures of old, white, rich men on the walls. Where are the women? Every single one of these rooms should have 50:50 representation. If there are not the paintings of women from our political history, commission them or borrow them and put them up. Take down those images of old white men, so that when young children from Plymouth come to visit Parliament they see pictures of people who look like them. Let us also ensure that there is not just male and female representation. Let us ensure that we have on our walls LGBT heroes, black, Asian and minority ethnic heroes, and disabled heroes. This place looks far too much like the old stale white male club that it sometimes was in the past.

We can change that. We need to do it by speaking up about equality. We need to continue to be restless about it to ensure that we keep fighting the misogyny that we see in our politics, in our parties and in our society. We need to give a voice to the single parents, to the WASPI women and to those people who are standing up for equality and want a fair day’s pay for a fair day’s work. That is what we all need to do. We can all do our bit to ensure that we get there by telling the story of women in politics, and the 1928 Act is a really important part of that. I look forward to my hon. Friend the Member for Canterbury still being in this place in 10 years’ time to lead the debate on the 100th anniversary of that Act.

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I thank my hon. Friend the Member for Canterbury (Rosie Duffield) for securing the debate. I will start my contribution by remembering Margaret Bondfield. Margaret was a shop worker and union official from Brighton who was foundational in extending the franchise to working-class women. She was the first woman Minister and the first woman Privy Counsellor, and she was a Labour MP.

As a campaigner for women’s suffrage, Margaret was part of a broader labour movement with other working-class suffragettes, fighting for all women to have equal rights with men. This year, of course, marks 90 years of the equal franchise, but it is also the centenary of the unequal franchise for women—that is probably what we should call it. Ten years previously, the Representation of the People Act 1918 was passed to give middle-class and upper-class women the vote. For Margaret and the millions of other working-class women, that meant one rule for the rich and another for the poor. A third of the least well-off women could not vote.

We cannot look at gender separately from class. The fight for suffrage and equality is a difficult journey. Margaret, after years of condemnation and even imprisonment because of trade union activities, understood that the struggles of unionisation and feminism went hand in hand. Let us be clear: it is thanks to the many sacrifices made by Margaret and fellow suffragettes that the struggle for gender equality has been transformed into law. Change can happen only when ordinary people organise together to fight to shape their future. We must remember those women who fought to shape their future, and in doing so helped others. We cannot forget either those who stood in solidarity with the suffragettes. Of course, male Labour MPs such as Keir Hardie and George Lansbury resigned their positions and faced imprisonment on this issue as well.

The struggle for gender equality has not yet been won elsewhere in the world, and sometimes the fight takes place vociferously on the streets as well as in parliamentary chambers. Earlier this year, I went to northern Syria, where I met the People’s Protection Units, the YPG, and the YPJ, the Women’s Protection Units, of the Kurdish fighters. They are not only fighting the Islamic State in the middle east, but building a feminist revolution, in which all positions are held jointly by women and men. Women hold 50% of all the positions in their organisation—that is better than we do in the UK. There is still a lot to learn. We must remember and show solidarity with the YPJ fighters and other feminist fighters around the world. Those women take up not only the torch against persecution and disenfranchisement, but the fight for a global humanity and against the fascism of ISIS. They remind us that each battle takes us a step closer to equality.

This year, of course, we have seen erected in Parliament Square the statue of Millicent Fawcett, who lived in Brighton and whose husband was the first non-Conservative Member of Parliament in Brighton. On the plinth are 58 names, but there are many more names that we must remember. Today, however, some of their greatest achievements of progress are being rolled back—progress not just for women, but for those with disabilities, LGBT people and BAME people. Severe cuts have landed disproportionately on women and ethnic minorities. Since 2010, 86% of the money raised from Conservative tax and social security changes has come straight out of women’s pockets. And of course the introduction of voter ID harms working-class women of colour the most.

The Young Women’s Trust found that young women are especially likely to be on low pay and in insecure jobs. One sixth of young women have been on less than the minimum wage, and almost half are worried about job security. The Office for National Statistics says that half a million young women are workless. Despite most wanting jobs, they cannot afford to work because of lack of childcare, direct discrimination, and lack of support to find jobs.

We cannot stop fighting for women, especially when, I believe, this Government are not doing enough; nor can we ignore the central role of working people in demanding social change. These rights are hard-won not by asking nicely, but by feminists’ and working class people’s continued commitment to equality. A campaign of equality will always find its home in the Labour movement.

When Margaret Bondfield and fellow suffragettes joined the labour movement to fight for equality, they found a home in the Labour party. Sewing machinists such as Rose Boland and Sheila Douglas, who fought for what became the Equal Pay Act 1970, found their home in the Labour party. Today, women make up half of our shadow Cabinet. A third of Labour Members are women—more than any other political party. Labour has always led the way in guaranteeing women’s representation through our party structures, but it still needs to do more internally, and I think other parties do, too.

We will always welcome those demanding social change for what they believe in. Equality fighters will always have a home in the Labour party. In Brighton we have a campaign to commemorate Liberal and Labour party women on blue plaques around our city this year. We hope to have a statue of the first suffragette to die, who was from Brighton, erected in Brighton. I believe every town should have a statue of a woman, because, as my hon. Friend the Member for Plymouth, Sutton and Devonport (Luke Pollard) said, there are far too many representations of men, not only in Parliament, but in our communities. Those struggles and fights will have a home in the Labour party. I hope that local Labour parties and other parties will fight for that across the country.

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It is a pleasure to serve under your chairmanship, Ms Buck. I thank the hon. Member for Canterbury (Rosie Duffield) for bringing this debate to the House and giving me the opportunity to speak on the subject today.

We have spent a lot of time this year marking the anniversaries of universal suffrage. Every time I think about this, what I find remarkable is not how long ago it was, but how recent. The beginning of the 20th century was an age of modernity—there were motorcars, aeroplanes, radios and televisions; there were new advances in thinking in science and technology; there was an avant-garde movement in the arts, architecture and music. Yet while all that was happening, half—in fact, more than half—of our population were denied the basic political rights given to the other half. On reflection, that is a monstrous injustice, and the fact that it could have existed for so long while our modern constitution was being shaped is a source of great shame, and a black mark on our collective history.

Universal suffrage had been a long time coming when it happened. I have spent some time recently looking at the political agitation of the late 18th century, from Thomas Muir in Scotland to Thomas Paine here and Wolfe Tone in Ireland. They were agitating for universal suffrage—basic political suffrage—in an age when there was none. The role of women was alive and present in those debates. Since we have time, I want to read for the record the opening lines of a poem by Robert Burns, written in 1792:

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

The fate of Empires and the fall of Kings;

While quacks of State must each produce his plan,

And even children lisp the Rights of Man;

Amid this mighty fuss just let me mention,

The Rights of Woman merit some attention.”

That shows that in 1792 there was a live discussion about the political rights distributed among men and women.

The exhibition just outside this Chamber in Westminster Hall shows that throughout the 19th century there was agitation, in the Reform Acts of the 1830s and driving on throughout that century. People were asking for reforms for a very long time. It is hard to imagine now the political organisation of men in this country and the degree to which that patriarchy practised misogyny and exclusion. It is quite phenomenal that it took so long—decades and generations—for these most basic of reforms to be achieved.

Having the right to vote is an end in itself, but increasing the franchise and bringing women into the electorate and then into Parliament achieved many other great ends. In particular, it overcame much exclusion, inequality and discrimination that pervaded every aspect of social policy. Even in the period 1918 to 1939, there were many advances in social and economic legislation, to the betterment of women and our society, and the task continues today. It is sad that we have to admit this, but it is a fact that there is a correlation between the involvement of women in the rules that govern our society and the effect those rules have on sexual inequality.

I hope we are nearing the end of this process. I hope we are getting to a situation where we have genuine equality and where our public policy is genuinely equal, but as colleagues have said, we are still at it. Government policy today still has a worse effect on women in our society than on men. The welfare cuts fall mainly on women. The rape clause means that women now have to prove that they have been raped to get child benefit for their third child. The WASPI inequality—I think that all of us would agree that men and women should have equal pension rights—was brought in in a ham-fisted way. The denial and breaking of an obligation and guarantee given to so many born in the 1950s is a monstrous act of Government policy. Those things are still with us today.

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The mistakes made with the WASPI women—not informing people about changes—are still happening today with the change in universal credit. If women transitioning with their families on to universal credit have more than two children, they are not being told that they will lose the benefit after the two-child cut-off. The opportunity of WASPI is to learn the lessons and to help women with three children especially to understand that cuts are coming for them. That is not being done by Government at the moment.

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Indeed. It would probably be unfair to expect the Cabinet Office Minister to respond to that point on behalf of the Government, but perhaps she will commit to take it back to discuss with colleagues.

It would be remiss of me to speak on behalf of the Scottish National party without saying something about the many great women who have contributed much to the politics not just of Scotland but of the United Kingdom as a whole. I shall mention only three: in 1967 Winnie Ewing tore the establishment apart by winning the Hamilton by-election, surprising everyone in British politics and beginning 51 years of unbroken representation by my party in this place; in the following decade Margo MacDonald did the same in not one but two by-elections, upturning the political firmament and in many ways creating the conditions that have led to the modern political dynamic in Scotland now; and of course Nicola Sturgeon, our First Minister in Scotland, who has been a beacon, an inspiration and a role model for young women in Scotland and throughout Europe and the modern world.

Nicola Sturgeon presides over one of the few Cabinets among Governments that is gender-balanced, made up half of women and half of men. It has been praised as a role model by the United Nations. The Scottish Government are also moving forward in many other respects to improve the representation of women in public life, setting targets and quotas for representation in our public board rooms, hoping to encourage the private sector to follow suit.

There has been a big debate about quotas—whether they are a right and proper thing and whether they genuinely advance women or are in some ways unnecessary or patronising to women. My experience is clear: quotas are a way of breaking the inertia and stasis that surround the existing system. It is a way of asking and answering a question about whether women are capable of doing the job. When given the chance, they are not just capable but in my view more capable than their male counterparts. That is the experience of the Scottish Government in action, which the rest of the United Kingdom might choose to learn from.

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The Labour party has the highest proportion of female MPs, which has been achieved through all-women shortlists—a mechanism that was put in place to make that change. Does the hon. Gentleman agree that similar mechanisms should be put in place across all political parties?

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Yes. I am not saying that we should necessarily copy the Labour party rulebook, but a similar objective and similar mechanisms should certainly be put in place. We have something similar in my party, although not for every seat. Many seats that we do not hold are designated as all-women shortlists so a female candidate is selected. In Scotland, that has resulted in 43% of the governing party, my party, being women—still not 50%, but further forward than many other parties can boast of. Those policies have obsolescence built in, because once they have achieved the desired effect, they are no longer necessary.

As we reflect on the 90th anniversary of universal suffrage and the 100th anniversary of the beginning of votes for women, we should also consider what we can do across the globe as an international player. In many countries, the rights of women resemble what they were in this country 90 years or 100 years ago. That needs to be built into our foreign policy much more—again, I do not expect the Cabinet Minister to respond to that—so that our relationship with other countries is conditioned and qualified by the way in which they treat their citizens and particularly women in their societies. We should not have beneficial relations, roll out the red carpet or sign arms deals, or whatever, with countries that manifestly practise discrimination within their own borders. That would bring long-overdue principle into politics and Government policy and, as we look forward on this anniversary, it would be a practical contribution that we could make to celebrate the gains already made and recognise how much still needs to be done throughout the world.

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It is a pleasure to serve under your chairship, Ms Buck. I congratulate my hon. Friend the Member for Canterbury (Rosie Duffield) on securing this important debate. It has been great to listen to all these names, which are now in Hansard in perpetuity, and know that we have done our bit to recognise working-class women who have been, and are still, often ignored.

In history, working-class women, the poorer suffragettes, were referred to as “women quite unknown”. My hon. Friend mentioned how few opportunities there were for working-class women. She talked about inequality and the gender pay gap, and the way that they are still poorer female citizens. She also mentioned 50:50 Parliament, which we campaign on with Frances Scott, who is here today. We need to ensure that upskirting and revenge porn become sexual offences so that women who suffer do not have to make themselves publicly known.

How can we achieve all that in this day and age? We can all play our part. We can use inclusion riders, like actors who say, “I will not star in a film if it does not involve diversity in its pipeline and creation.” We have also talked about various sections of the Equality Act 2010. I hope that when the Minister responds, she might be tempted to announce that the Government will enact section 1 of the Act, which would force public bodies to take into account socioeconomic disadvantage when making policy decisions. If we had more consideration of that when policies were being developed, we would see fewer policies like the third-child policy, and fewer policies like those under which 86% of cuts fall on the shoulders of women and black, Asian and minority ethnic women suffer more than any other group.

My hon. Friend also mentioned my hon. Friend the Member for Bradford West (Naz Shah), who is recovering. The proxy vote debate, which was supposed to be today, has been postponed. I had hoped that all the women MPs who were ready and poised to speak would come to this debate to at least listen or even make their speeches, because then they would not have been wasted.

There were many great contributions to the debate, and I will touch on a few. My hon. Friend the Member for West Ham (Lyn Brown) flew the flag for working-class women, the different types of women and the strength of east London women, which I can obviously attest to. She gave a voice to the match women and talked about the leaders of those times, who were buried in paupers’ graves after all their struggles.

My hon. Friend the Member for Plymouth, Sutton and Devonport (Luke Pollard) talked about Nancy Astor and how we have to talk about the journeys of women, even those we disagree with. Of course, I often talk about women I disagree with and the policies they make. Their story deserves to be told, just like everybody else’s. It is important that we stand up for other people’s rights. Let us imagine how quickly we would move towards equality if all men spoke about the rights of women, all white people spoke about the equality of black people, and all straight people spoke about LGBT+ people. We must all play our part in speaking up for equality, because we all play a part in each other’s journey. As Martin Luther King said:

“I can never be what I ought to be until you are what you ought to be. This is the interrelated structure of reality.”

My hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) spoke about Margaret Bondfield, the first female Minister under Labour, which made me think about all the firsts that Labour has achieved. I would like to read them out, but there are so many that it would take at least an hour, and I do not have that much time. Some of them are to be celebrated: we have had the first black female MP, the first lesbian Minister and the first black female Minister—that is me. There are also some sad firsts, such as Maureen Colquhoun, a Labour MP who was born in 1928, who was gay and outed by the Daily Mail, which still happens today. Newspapers still think that that is okay, which shows how far we have to go.

We also heard some great interventions about 1950s women. I thank my hon. Friend the Member for Slough (Mr Dhesi), who is no longer in his place, for wearing the colours of the suffragettes in his turban. He talked about Princess Sophia Duleep Singh and the hidden histories that have been ignored or forgotten, which this debate has shined a light on.

Poorer women were treated worse than middle-class women. They were treated more brutally by the police, prison wardens and magistrates. As I said, I am pleased that we are recognising them. To remember them and their struggle is to remember our own struggle and to adopt their struggle as our own.

As has been said, alongside the growing women’s suffrage movement was the women’s labour movement, which included groups such as the Women’s Protective and Provident League, the Co-operative Women’s Guild, the Women’s Trade Union Association and women in the young Independent Labour party, which would probably be known as Momentum today. Those women were referred to as “radical suffragists”. I cannot see what was radical about them, apart from wanting equality. However, those “radical suffragists” included people such as Sarah Reddish, Ada Nield Chew, Helen Silcock and Selina Cooper. Those women mobilised other women in the trade union movement—in fact, they mobilised almost 30,000 people to sign a suffrage petition, and that was without the internet, Twitter, Facebook, mobile phones and WhatsApp.

Ada Nield Chew said that if the National Union of Women’s Suffrage Societies’ request had been granted in 1884,

“the entire class of wealthy women would be enfranchised” ,

but, as she added,

“the great body of working women, married or single, would be voteless still”.

That message rings true with me. The radical suffragists, as they were known, began to move away from the NUWSS, as my hon. Friend the Member for West Ham spoke about. That reminded me of something that I did recently. I was a member of a women’s WhatsApp group, but I became so frustrated with trying to get members of that group to understand and consider the intersectionality of women that in the end I left the group, and I was not the only one to do so. It did not feel radical to leave that group; it obviously just entailed the click of a button. However, it reminded me of those powerful working-class women and it made me realise that the fight for recognition of, and equality for, all women is a constant struggle. We have to talk about it and fight for it constantly, otherwise we will be dragged backwards. That is really a stark realisation, because I would have hoped that we would have progressed.

I cannot confirm or deny whether I joined a new radical women’s WhatsApp group, but those working-class women broke away and formed “Womanhood Suffrage”, or the Women’s Social and Political Union. The WSPU’s strapline and objective was:

“A vote for every adult woman, regardless of whether she owned property.”

When working-class women fight, they fight for everybody; they do not just fight for a select group. That is a lesson that truly still needs to be learned in some feminist circles. What those women were fighting for sounds really simple now; it does not sound radical to me at all. As my hon. Friend the Member for Canterbury asked, if all women had received the vote earlier, how far towards equality would we be now? We might not even be having this debate.

As we have heard, the first march was from east London, and it included trade unionists such as Minnie Baldock, Sylvia Pankhurst and Dora Montefiore, who were working-class women using their non-working day to march. They worked six days a week and on the one day that they were not working they marched to Westminster and back. In a way, it can be said that working-class women committed more, in that they sacrificed more. They had the daily struggles of life. They had no home help; when they left to march on that one day off, they had to go back home afterwards and do everything else that they needed to. They had less time, less money and less formal education than many others, yet still they fought, and fought for everybody. They fought for food, they fought for their rights, they fought for dignity and respect, and they fought for every woman’s rights. And they were known as radical—I really do not get it.

Later, the WSPU was taken over by wealthy women, and it moved away from its roots in the labour movement and the trade union movement. It became ineffective and it was too far removed from its roots; some people would say that has been repeated in some circles. However, Sylvia Pankhurst reclaimed the movement, and I agree with my hon. Friend the Member for Canterbury that we should perhaps see a statue of Sylvia Pankhurst. Not all women were up for the fight. Some women described the working-class women’s movement in this way:

“A working women’s movement was of no value—working women were the weakest portion of the sex...their lives were too hard, their education too meagre to equip them for the contest.”

That was an insult, but let us hope that we are moving forward.

The fact is that the Representation of the People Act 1918 enabled the representation of less than half the adult women in the UK. However, the Equal Franchise Act 1928 was literally equal. Women fought not only for the right to vote but for economic and social rights, through the labour movement and the trade union movement. We are still fighting for those rights today, as we have heard from many hon. Members.

To forget the place of working-class women, disabled women and black women in history is to be complicit in the misogynistic class war, and to forget the interconnectivity of the Labour party and the labour movement in that is to do a disservice to the truth. In this day and age of fake news, the truth has never been so important, so it is vital that we correct the record and put on the record the names of these working-class women at each and every opportunity that we get.

This year saw the first statue of a woman in Parliament Square, and I am thankful to the Mayor of London for making that happen. There are about 58 or so names of women, mainly those of working-class women, around the plinth. However, I would like to see a statue of Sarah Parker Remond, the only black woman known to have signed the Representation of the People Act 1918. I am pleased to say that the Mayor of London and his team are meeting me to discuss that proposal. While I am there, I might even put in a plug for a little statue of Sylvia Pankhurst, as my hon. Friend the Member for Cardiff Central (Jo Stevens) suggested.

Our job here in Parliament is to give a voice to the voiceless.

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When I first got into Parliament, I tabled a question to the Department for Digital, Culture, Media and Sport, asking what the official figures were for the number of men and the number of women represented in statues and other public art. However, the UK Government do not keep those statistics. I think we should. Does my hon. Friend agree that we should encourage Ministers to start recording equality in our public art, so that we understand the scale of the challenge ahead of us?

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I thank my hon. Friend for that intervention and I absolutely agree, because only then will we be able to measure how far we have come and what still needs to be done.

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While my hon. Friend is advocating on behalf of the statues that we could build, maybe we could have a statue that had some of the working-class women around it, such as Minnie Baldock and Annie Kenney; maybe they could stand shoulder to shoulder with the other women she wants on the plinth. Maybe we could have a really big platform with lots of women from the suffrage movement standing tall.

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How amazing would it be to walk around different parts of London and the country, and see statues of women, and learn about their history, and know that we have made that happen? People always bang on about Britain having had two female Prime Ministers. Well, we have a female Prime Minister—I am not saying that I want statues of the female Prime Minister going up all around the place, but I am saying that the female Prime Minister can make the decision. She can say, “Right, I will give the money for this to happen, so that we can embrace our rich and colourful and socialist history”, because our job is to give a voice to the voiceless and to uncover the hidden stories. Should I have missed out the word “socialist” there? [Laughter.] Our job is to put a name to “A.N. Other” and to “Anonymous”, to ensure that history becomes herstory, and that herstory paints a true picture of a moment in time.

Working-class women fought for all women, so when women of today fight for the select, privileged few, I find it hard to refer to them as feminists, and when they use their voice to amplify their privilege and ignore the cries of the less fortunate, I find it hard to support the cause wholeheartedly. I hope that in time people will use their power and privilege for progress. People often talk about the legacy that they will leave behind; I think that we need to talk about the foundation that we will leave behind. Women who are on the ladder of success should leave behind them the foundation for an escalator, and the women who are on the escalator of success should leave behind them the foundation for a lift, so that those women who come behind us get to that destination, quicker and more smoothly.

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May I say how pleased I am to have you presiding over us today, Ms Buck? I will make a few remarks before ensuring that the hon. Member for Canterbury (Rosie Duffield) can wrap up the debate. I begin by thanking her for bringing forward this debate on the 90th anniversary of the Equal Franchise Act 1928. I am delighted to play my part in recognising that milestone. I will set out some of the work that the Government are undertaking to mark the anniversary and our plans for ensuring that all citizens feel empowered to be part of democracy as we enjoy it in this country.

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Will the Minister give way?

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Perhaps the hon. Lady should give me a chance to get started, but go on—make it good.

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The Minister specifically mentioned allowing people to participate in democracy. Would it not be a wonderful thing on this anniversary to give 16 and 17-year-olds the right to vote?

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The hon. Lady will need to wait for another 90 minutes in another Westminster Hall debate for the full discussion on that.

I thank the hon. Member for Canterbury for her commitment to equality for all members of our society. I am aware of the work she does with the 50:50 Parliament campaign, and I pay tribute to it. I am glad she shares my view and the Government’s view that no one in our society is more important than anyone else. Every individual, no matter their gender or background, has an equal role and, in relation to my particular brief, an equal right to vote.

As a fellow female parliamentarian, it is important to acknowledge the efforts of the brilliant women who paved the way for us to be here today. I thank the hon. Member for West Ham (Lyn Brown) for beginning the Back-Bench contributions with an exposition of the history that is at play here. It is important to think about the past as we consider our present and our future. Without the tireless efforts of those women and the men who championed their cause, perhaps most of us in this room would not have a voice in society, let alone in this place. I am proud to be part of the present, when we have the most diverse Parliament in British history, but there is a lot more to do.

We all welcome such initiatives as the 50:50 campaign, the #AskHerToStand campaign and Parliament’s own Vote 100 project, which make the goal of gender balance a long-needed reality. I thank the hon. Member for Edinburgh East (Tommy Sheppard) for reminding us that progress needs to be encouraged and supported internationally.

This week is National Democracy Week, which has been timed to coincide with Monday’s important anniversary. Many of the events happening up and down the country will be highlighting the role played by those who fought for equal voting rights, which included women from a diverse range of backgrounds. Our goal in running National Democracy Week has been to reach out to citizens from all backgrounds, especially those from groups less likely to be registered to vote. I am very passionate about that.

I understand, respect and acknowledge the arguments that have been made today about the difference between 1918 and 1928. In this year of suffrage, which encompasses both those anniversaries, it is valid and important that we test those concepts and have that debate. I would like to acknowledge that in my remarks.

The Equal Franchise Act 1928, which is what we are here to discuss, is as significant today as it was then. It cemented in law that no matter whether someone was a woman or a man, they had the right to vote on equal terms. We are celebrating that 90th anniversary in a number of ways, including the National Democracy Week awards, which were held in Manchester on Monday. They kicked off the week and were a fantastic way of recognising the exceptional work of individuals and organisations helping others to be involved in democracy. Just today, a “Women in Politics Hackathon”, supported by the Leader of the House and run by Shout Out UK, brought girls and young women to Parliament to work on creative ideas to get more women into politics.

This year the Government Equalities Office has provided £1.5 million for the women’s vote centenary grant scheme, which has already provided funds to 140 projects across the country. As a Minister at the Cabinet Office, I am delivering projects under the “Educate” theme of the suffrage centenary programme. The projects are being developed to increase knowledge of UK democracy and its importance among young people in particular, but not exclusively. It includes those from ethnic minorities and under-registered groups, so as to widen democratic participation.

Increasing participation has been facilitated by the Government’s commitment to making registering to vote more straightforward than ever before. In 2014 we introduced individual electoral registration alongside a digital service, and as a result we have seen record numbers on our electoral register, which reached 46.8 million people before the 2017 general election. I wonder what that might have looked like to someone looking ahead from 1928.

We are committed to making the service more accessible. For example, I am pleased to say that we are working with Mencap on an easy-read guide. Historically—I say this as a passing point of interest—figures suggest that women have been more likely to be registered to vote than men, with recent research on completeness of registers suggesting a 2% difference in the rates for women and men.

Last December, the Government published their democratic engagement plan, which sets out the ways in which we will tackle further barriers to democratic inclusion. I was pleased that the hon. Member for Canterbury widened her argument at the start and set the tone for the debate, because in many ways the issue goes beyond just gender. That gives me the chance to note that we have set up an accessibility of elections working group along with Mencap, Scope, the Royal National Institute of Blind People and many others, through which we are working on how we can make our registration and electoral systems and processes as smooth and secure as possible for people with specific conditions or disabilities.

The hon. Member for Slough (Mr Dhesi), who is no longer in his place, was right to reassure people that our recent changes to the anonymous registration system have made it easier for victims of domestic abuse to register to vote while protecting their right to remain anonymous. Those changes, which of course were welcomed by Women’s Aid and many others, will make it easier for an estimated 12,000 survivors of domestic abuse to register to vote without their name or address appearing on the roll and without the fear of former partners finding their address. I would like the message to go out loud and clear that that has been done, and I hope it is already making victims’ lives easier.

I was struck by some of the words the hon. Member for Canterbury used about the grotesque abuse that may follow her introducing the debate. She was right to draw that point out. I will shortly launch a consultation on intimidation in public life, which, as the Committee on Standards in Public Life noted, is directed disproportionately at female candidates for public service. I hope we can work together to improve the way our electoral law protects debate and welcomes everyone into democracy.

The hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) reminded us in his helpful remarks outlining the life and times of Nancy Astor that we should respect difference. I am delighted that hon. Members spoke so well about their political traditions, and I shall take the licence the hon. Gentleman offered me to speak about mine. I remind hon. Members that the first woman to sit in the House of Commons was indeed that Conservative, Nancy Astor, and we were the first party in the western world to elect a female Prime Minister. Here we are on our second, while the party in opposition is yet to have a female leader.

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Is the hon. Lady the next leader of the Labour party? I hope so.

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I am not, but let me correct the Minister. We have not had a female Prime Minister, but my right hon. Friend the Member for Derby South (Margaret Beckett) was a female leader of the Labour party.

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I am happy to stand corrected, but I still raise the hon. Lady two Prime Ministers to one Leader of the Opposition. I also raise her the Prime Minister who passed the Equal Franchise Act 1928—the Conservative Stanley Baldwin—and pay credit to Emmeline Pankhurst, who, had she not passed away before the election, would have contested a parliamentary seat for the Conservative party.

Turning to other matters in women’s lives, under this Conservative Government there are more women in work than ever before. The female employment rate is at a record high of 70.9%. Under the last Labour Government, female unemployment rose by 25%. Let us not forget that that represents nearly 1 million women. We are encouraging all companies to do more to eliminate the gender pay gap by publishing their data, improving their pipeline to ensure progress on female representation at senior levels, and making flexible working a reality for all employees. We introduced shared parental leave—my husband and I took it ourselves, and we agree that it is extremely important. I would love to see others taking it up as well.

Other political points were made that neglected to give the entire picture, so let me make a few more economic points before concluding. In Government, we have introduced tax-free childcare, providing working families with up to £2,000 per child per year. We have introduced universal credit, and increased support to 85% of childcare costs, 15 hours of free childcare a week for families with disadvantaged two-year-olds, and an additional 15 hours of free childcare every week to working parents of three and four-year-olds. We will be investing around £6 billion in childcare every year by 2020—more than ever before. That is the Conservative reality.

Furthermore, the increase in the national living wage in April from £7.50 to £7.83, with more to come, represents an increase in a full-time minimum wage worker’s annual earnings of more than £600. We all know that a higher proportion of women than men are expected to benefit from that increase, so there is no glass ceiling in the Government’s approach to improving the lives of all women in society. We practise what we preach—improving female representation and creating equal opportunities in the workplace.

I will leave time for the hon. Member for Canterbury to wind up. I thank her again for securing the debate on this important anniversary. We should use such opportunities to promote participation and work together, combining our traditions and interests and coming together to use our powerful positions in this place to deliver a democracy that is more accessible, inclusive and representative.

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Thank you, Ms Buck, for allowing me to lead today’s debate and for chairing it so brilliantly. I thank all hon. Members who stayed here on a horrible hot Thursday afternoon instead of going back to their constituencies. It is great to hear the Minister pledge to do so much for democracy, and to hear about the Government’s plans. Obviously Opposition Members will keep a close eye on those things.

I thank all Members who made contributions. I have learned a lot about the east end women. I share the view of my hon. Friend the Member for West Ham (Lyn Brown) that the Jack the Ripper museum is abhorrent. I cannot wait for us to find a space where we can celebrate the lives of the east end women permanently, rather than having to shift about all the time. It would be nice to have the money behind that that this horrible other place seems to have.

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Does my hon. Friend have any comments about women who are on zero-hours contracts, the gig economy and the rise in women among the working poor?

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Absolutely. Under the last Labour Government I was able to work and bring up my children as a single mum. Without tax credits, I would have had no hope. I would have been living with my parents, with my children in one room, unable to feed them easily. The last Labour Government made the lives of women a lot easier and a lot better, and introduced childcare and all sorts of things that get forgotten and overlooked. Yes, a lot more people are in work, but a lot of them are working for companies such as Deliveroo and McDonald’s on a very low wage. The childcare issue is a huge and growing problem, and nurseries are having to close.

It is worth saying that there is not equality. Working women are still the working poor, as the shadow Minister just mentioned. Zero-hours contracts do not help anybody, so there is still much to do to get equality. As some Members have said, we also must not forget our sisters around the world. Although we think we have done equality and feminism, we have not. We need to keep going, look around us, and do as much as we can for everyone.

Question put and agreed to.


That this House has considered the 90th anniversary of the Equal Franchise Act 1928.

Sitting adjourned.