I beg to move,

That this House has considered National HIV Testing Week 2023.

It is a pleasure to serve under your chairmanship for this important and timely debate, Mr Gray. It is 40 years since the untimely death of Terrence Higgins, who was not only the first recorded British person to die of HIV/AIDS, but a Commons Hansard Reporter—one of our own. Since then, we have made huge progress in the testing, diagnosis and treatment of HIV. Today, people living with HIV can continue to lead very normal lives. It is essential to remember, however, that HIV remains a critical global health issue, with millions of people living with the virus and many more at risk of infection.

Early diagnosis and treatment of HIV is essential in reducing the spread of the virus, improving health outcomes and reducing the stigma associated with the disease. Charities such as the Terrence Higgins Trust, the National AIDS Trust and the Elton John AIDS Foundation have worked tirelessly to lead the fight against HIV. I thank them for the phenomenal work they have done, and continue to do, to help those living with HIV and to achieve the goal of no new transmissions by 2030.

I thank the outgoing chief executive of the Terrence Higgins Trust, Ian Green, for his hard work and dedication to the charity over many years, and for his immense contribution to the fight against HIV. I also congratulate Richard Angell on his appointment as Ian’s successor. He has big shoes to fill, but I have no doubt that he is more than capable of doing so, stepping up to the challenge and driving this important work forward into the future.

As Members will be aware, human immunodeficiency virus, or HIV, weakens a person’s immune system and their ability to fight everyday infections and disease. HIV is passed from human to human and, if left untreated, can progress through a series of stages and lead to acquired immunodeficiency syndrome, or AIDS. Although there is currently no cure for HIV, there are treatments available that enable a person to live a long and healthy life. A person living with HIV has a similar life expectancy to an HIV negative person, provided they are tested and diagnosed in good time.

As the House knows, TV is one of the most powerful tools at our disposal to help educate the public, with award-winning dramas such as “It’s a Sin” bringing HIV to the forefront of the national consciousness again. I am not sure if there are any “EastEnders” fans in the Chamber, but, if there are, they will know that the character Zack Hudson, played by James Farrar, has recently been diagnosed with HIV. The story portrays Zack’s struggles in coming to terms with his HIV diagnosis and his difficulty in opening up to his friends and family. I encourage Members, perhaps over the forthcoming recess, to catch up on those powerful episodes of the Albert Square soap, which perfectly captures the stigma around HIV and the challenges those living with it continue to face. I also hope that the storyline will encourage more people to take an HIV test.

During my time in government, the work I am perhaps the most proud of is introducing the new national HIV action plan. It had the clear aim of reducing new infections by 80% by 2025 and, crucially, ending infections and deaths from HIV by 2030. As Public Health Minister, I was clear with colleagues across government, as well as in the NHS, that this goal could only be achieved if the plan was properly financed.

By securing over £23 million of new funding to support the work needed to deliver the action plan, including scaling up HIV testing in targeted, high-risk populations, including the black and African communities, and increasing access to the anti-viral drug, pre-exposure prophylaxis, or PrEP, I am wholly confident that we can, and will, eradicate HIV in the UK by 2030.

Despite progress over the years, the Terrence Higgins Trust estimates that there are still 4,400 undiagnosed people living with HIV in England. I challenge the Minister to play his part and commit to finding them so that we can achieve our goal of zero new transmissions by 2030. To do that, we need to encourage more people to test for HIV, and expand opt-out testing across the UK, especially in high-prevalence areas.

This week across the country, including on the parliamentary estate, we have been marking National HIV Testing Week with a number of events to raise awareness of HIV testing. This annual campaign aims to raise awareness of the importance of regular testing to reduce the number of people living with undiagnosed HIV and those diagnosed late. This year, the campaign’s new strapline, “I Test”, replaces “Give HIV the Finger”, which has been in place for the past five years. I urge everyone to take advantage of the services available during National HIV Testing Week and throughout the year to get tested and know their status.

Forty years ago, testing for HIV was limited and often difficult to access. We had only just begun to understand what HIV was, including its variants and its potential impact on health. Charities such as the Terrence Higgins Trust were established, but at that time could only offer support and advice to HIV-positive people. Fast forward to today, and the contrast is evident. For the first time this year, during National HIV Testing Week, in addition to the traditional test, people in England are able to order or collect a rapid home HIV test that gives results within 15 minutes. It operates similarly to a lateral flow test, which we all became familiar with during the pandemic. It only needs a few drops of blood from a small prick on the finger, and the results are known promptly afterwards. That means that, for the first time, HIV testing is quick, free, confidential, easy and will certainly save lives.

I turn to the steps the Government have taken to tackle HIV. Over the past few years, the Government and charities have worked together to try to achieve the goal of eradicating HIV transmissions in England by 2030. In 2019, the then Secretary of State for Health and Social Care, the right hon. Member for West Suffolk (Matt Hancock), set a goal to eradicate HIV transmissions in England by 2030. In fact, I think he was set the challenge by my hon. Friend the Member for Winchester (Steve Brine). That led to the launch of an independent HIV Commission, supported by the Terrence Higgins Trust, the National AIDS Trust and the Elton John AIDS Foundation. Its aim is to develop evidence-based recommendations to end HIV transmissions and attributed deaths within a 10-year period.

The commission’s report, which was launched on World AIDS Day 2020, made 20 recommendations. It outlined that the single most important intervention to meet the 2025 and 2030 goals was to make widespread HIV testing readily available across the NHS, delivered as opt-out, not opt-in, testing. At the current rate, it is possible, but not probable, that we will achieve that 2030 goal. There needs to be a concerted effort by the Government, HIV charities and the NHS to come together to turn that vision into a reality. As the HIV Commission outlined:

“Opt-out rather than opt-in HIV testing must become routine across healthcare settings, starting with areas of high prevalence.”

I firmly believe that if we want to be the first country in the world to achieve zero HIV transmissions by 2030, we must rapidly expand opt-out testing at the earliest opportunity.

In particular, opt-out testing, which is a scheme whereby a patient can explicitly decline instead of implicitly accept an HIV test, can help to ensure the UK is the first country in the world to eradicate HIV transmissions by 2030. An opt-out programme refers to when a patient visits an accident and emergency department and is offered a discreet test, which screens for HIV and hepatitis B and C when blood is taken for other tests. That is usually the case for most A&E attendances.

The hon. Lady is making an excellent contribution. Is not one of the real benefits of opt-out testing that it starts to chip away at what remaining stigma is left with HIV testing by normalising it?

The spokesman for the Opposition makes exactly the right point. One of the ways that we can achieve our goal for 2030 is by taking away the stigma that, sadly, affects people who test positive for HIV.

Nobody is forced to take the test, and the patient is allowed to opt out, but I am led to believe that very few people do opt out. There have been some notable successes since the adoption of opt-out testing in very high-prevalence areas, and it is clear that the way this is being carried out is saving lives. In the first 10 months, A&E departments in London, Brighton, Blackpool and Manchester have seen 261 people newly diagnosed with HIV, in addition to finding 137 who were previously lost to care. Additionally, 710 people were newly diagnosed with hep B, and 288 people were newly diagnosed with hep C. Crucially, this means that people can access the treatment they need to live a normal life, and that they cannot pass on the virus unknowingly.

Opt-out testing has a number of benefits for the NHS, too. At a time when the NHS is under increasing pressure in terms of both the backlog and funding, opt-out testing can help relieve both of these problems. Research from the Terrence Higgins Trust has highlighted that, in the first 100 days of the scheme, opt-out testing has cost the NHS only £2.2 million and saved an estimated £6 million to £9 million in healthcare costs. That is well illustrated at Croydon University Hospital, where opt-out testing has been taking place for some time now. Before opt-out testing, the average hospital stay for newly diagnosed HIV patients was 34.9 days. After two years of opt-out HIV testing, the average stay is just 2.4 days. That frees up hospital beds, which, in turn, will help to reduce the backlog, and it shows that opt-out testing can benefit the NHS and the patient.

The pandemic clearly had an impact on HIV testing and may have affected the possibility of reaching our 2030 goal. According to the UK Health Security Agency, the total number of people newly diagnosed with HIV in England decreased by 33% in 2020. Reasons for that include the impact of the unprecedented public health restrictions and the strain on health services, resulting in a decline in HIV testing. Although covid accounts for the fall in testing, we need to address a number of problems to give us a fighting chance of being able to meet the 2030 zero-transmission target.

I therefore ask the Minister to consider the following points. The first is about the roll-out of opt-out testing in high-prevalence areas and not just in very high-prevalence areas. Despite the fantastic achievements of opt-out testing in very high-prevalence areas, we need to do more to undertake testing in areas of high prevalence. An area is classified as having high prevalence if between two and five people per 1,000 are HIV positive. Currently, there are 32 areas of high prevalence outside London. Cities that are classified as being in this class include Bristol, Liverpool, Derby and Nottingham. With my constituency of Erewash sitting between Derby and Nottingham, I have a vested interest.

The National Institute for Health and Care Excellence, the British HIV Association, the British Association for Sexual Health and HIV, and the British Infection Association all recommend routine HIV tests in areas of high prevalence for anyone having a blood test for other reasons. Despite this guidance, there is no Department for Health and Social Care or NHS England funding, and no route map for opt-out testing in areas of high prevalence outside London. If we are serious about meeting the 2030 target, the Government need to expand opt-out testing across the country, and specifically in high-prevalence areas. This form of testing has been extremely successful across London, where a decision was taken to fund opt-out testing not just in the boroughs with very high prevalence, but in those with high prevalence. It is estimated that a further £18 million is needed to expand opt-out HIV and blood-borne testing in 40 hospitals in 32 areas outside London. Anyone leaving an A&E department who is HIV positive and is not diagnosed is a missed opportunity.

Secondly, we need to reduce the chances of late diagnosis. It is reported that in 2020 42% of all people diagnosed with HIV were diagnosed late. The impact of late diagnosis can be extremely damaging. As well as meaning that people might unknowingly pass on the virus, if someone receives a late diagnosis their chance of dying in the first year after diagnosis is ten times greater than if they had received an early diagnosis. Additionally, late diagnosis can have a detrimental impact on an effective response to treatment, which in turn leads to greater healthcare costs, at a time when there are already financial strains on the NHS.

Late diagnosis is particularly common among certain groups; 54% of heterosexual British black Africans and 29% of gay and bisexual men were diagnosed late. Opt-out testing has allowed us to identify that those groups are the most likely to be HIV positive. Although opt-out testing highlighted that those groups were most likely to have HIV, we need to encourage more people from them to get tested.

A simple solution to encourage more people from those groups to get tested could be to use public message campaigns. Targeted messaging across radio, television and social media could be created to encourage people to come forward and get tested. It could also specify the importance of testing and tell people where their local test centre is. Let us face facts: during the pandemic, it became second nature to go to a covid testing centre or a vaccination centre outside of the usual healthcare settings. In a similar way, pop-up testing centres could be a useful way of reaching out to the hard-to-reach communities.

Research by the British HIV Association has shown that many people have missed opportunities to test for HIV in primary and secondary care. The most common clinically related barrier is linked to the failure to appreciate HIV risk, or to properly diagnose HIV. Other barriers include time pressures, clinicians not seeing it as their role to test, the perceived need for pre-testing counselling and unfamiliarity with discussions about testing. Clearly, all those factors can lead to a late diagnosis and to greater health risks.

Ultimately, in order to address late diagnosis in both primary and secondary care services, HIV testing needs to become more prominent across the entire NHS primary and secondary estate. If we want to turn the UK into a science and health superpower, and if we want there to be no new cases of HIV by 2030, it is essential that we address the issues that I have highlighted today. In particular, it is vital that we rapidly increase testing levels in high and very high prevalence areas through opt-out testing. That will not only save the NHS money and reduce the backlog, but it will enable patients to know quickly whether or not they have HIV.

My challenge to the Minister today is for him to fight the corner for the funding needed to expand opt-out testing to all high prevalence areas. If we achieve such an expansion, then this time next year—when I am sure there will be another debate on this subject—we can report that we are back on track to meet the goal of zero new HIV infections, and zero AIDS and HIV-related deaths, in England by 2030. As well as saving lives, Ministers’ actions in this area would also save the NHS quite a considerable amount of money. If we implement this programme properly, our country will continue to lead the way in this area of healthcare and it will achieve the status of becoming the first country in the world to eradicate HIV.

Thank you for calling me to speak in this debate, Mr Gray.

I thank the hon. Member for Erewash (Maggie Throup) for setting the scene. As the health spokesperson for my party, I think it imperative that we speak out on these issues. I have done so in the past—indeed, I do not think I have missed any HIV debate, whether it was in Westminster Hall or in the main Chamber—so I am very pleased to come to Westminster Hall today and participate in this debate.

How wonderful our NHS is. It is instrumental in providing support and care for us all. Where would we be without it? Regarding HIV, we have come on in leaps and bounds since the late 1970s and the 1980s in terms of providing diagnosis, support and treatment, and indeed in removing the stigma around it. It is good that we are where we are today, because that shows there has been progress—positive progress—and I support that progress.

It is also a pleasure to see the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), in his place today. It seems like only yesterday—in fact, it was last Thursday—that we were here in Westminster Hall to discuss cystic fibrosis. And I am very pleased to see the Under-Secretary of State for Health and Social Care, the hon. Member for Harborough (Neil O’Brien), here today as well. I know that he will give positive responses to the questions that we ask; he always is positive and we very much appreciate that. There is always more we can do to improve diagnosis and keep people as healthy and safe as possible, so it is great to be here to discuss these important matters.

I also put on record my thanks to the hon. Member for Erewash for setting up the all-party parliamentary group for diagnostics this morning. I commend her for that; she has many supporters from within her party and others who wish to see things going in the right direction.

In 2021, 2,955 people in the UK were diagnosed with HIV. The number of people being newly diagnosed each year has been decreasing steadily for over 15 years, from a peak of 7,892 in 2005. That is down to the strategies pursued by the Government and the Minister, as well as by the local and regional Administrations, including my own Northern Ireland Assembly back home. Most people with HIV—some 95%—know their status because they have been diagnosed. We have a very clear strategic plan in Northern Ireland to make it easier to be diagnosed. I am sure the Minister has done his research, so he will know the success rate of our strategy. Northern Ireland has led the way for the rest of the United Kingdom.

In 2020, 60 people in Northern Ireland were diagnosed with AIDS; 47 of them were men and 13 were ladies. It is important to note that historically there was a stigma around being tested for AIDS and being diagnosed with it. I believe that stigma has disappeared. A large majority of people are eager to get diagnosed and then to start the treatment process. Today, in solidarity, we can encourage people to get tested. I want to make that statement, and others will want to make it as well. People in Northern Ireland can get a free HIV test and will receive comprehensive medical care and support. Provision is widely available in all health trusts, and HIV testing kits can be ordered online and delivered straight to the home. We can do this online as we do many things, such as shopping. Northern Ireland is leading the way.

The National AIDS Trust and the Terrence Higgins Trust have been in contact with my office ahead of the debate, and I am pleased to add some of their evidence and information into my contribution. They have emphasised the importance of opt-out testing being expanded to all areas with a high prevalence of HIV. Can the Minister tell us what has been done to address those areas of high prevalence? I am quite sure there is a direct strategy to address this. It is estimated that the first 100 days of that scheme cost £2.2 million, and saved the NHS an estimated £68 million in care costs, because those diagnosed were able to initiate treatment. It really is a win-win; people are diagnosed early and money is saved on the care down the line. It is estimated that a further £18 million is needed to expand opt-out HIV and bloodborne virus testing to a further 40 hospitals in 30 areas, which would in turn result in savings. As always, I ask the Minister in a respectful manner, as I am looking for answers, will the Minister’s Department set aside the further £18 million to ensure that happens?

Opt-out testing finds people who are more likely to be diagnosed late by other services. Fifty four percent. of people diagnosed with HIV in the first opt-out testing A&E pilots were of black African, black Caribbean or other black ethnicity—more than twice as many as the nationwide average, as the hon. Member for Erewash mentioned in setting the scene so well. Thirty five per cent of people diagnosed were women, and 10% were aged 65 or over. Again, the hon. Lady asked for that to be a target area. I reinforce her request.

Between 2021 and 2022, HIV testing did not return to pre-pandemic levels, with testing rates 20% lower in 2021 than in 2019, so there is something that needs to be done there as well. That has been driven by a 22% drop in testing among women and a significant 41% drop in testing among heterosexual men. I would suggest that someone who has not made use of HIV testing needs to do so. This debate, in HIV testing week, aims to promote regular testing, particularly among the groups most affected by HIV in England, including gay and bisexual people, men who have sex with men, and people in black African and black Caribbean communities. Testing options in the United Kingdom vary across Administrations. We are leading the way in Northern Ireland, and I am sure that everybody’s ambition is to catch up. It is important that our constituents know their first port of call, should suspicions of HIV arise.

I want to give a wee plug for what some of the organisations in my constituency are doing. I will give one example out of many. One of the churches, the Elim church in Newtownards, is very active with missionaries in Africa, in Swaziland—now Eswatini—and Zimbabwe. There is a high prevalence of HIV in those countries. They were keen to ensure help for those affected by HIV, first the orphans who have lost parents through HIV, by providing health treatment, an orphanage, education and job opportunities. That missionary-based church deserves to be commended for what it does in those two African countries. Every year the missionary society sends over some of the children and a choir to sing, and every year I attend those events. They remind us of how things were and how things can be. It is the ambition for change, which the Elim church clearly has.

I have a question about something that lies outside the Minister’s responsibilities, so I would be happy if came back at a later stage to keep us informed. What discussions has he had with the Foreign, Commonwealth and Development Office and the Secretary of State to promote the fight against HIV in other countries? I know they are doing it, but I am keen to know whether the same focus, attention and authority are given.

To conclude, it is important we do all we can to encourage early testing, for early diagnosis and better treatment. There is potential to live with HIV, to keep going and protect life from illness and possible death. I am encouraged by what Government have done, but I call on the Government to ensure sufficient access to HIV tests. I thank our health trusts and GPs for providing free testing for all, as many do, in particular in Northern Ireland.

It is a pleasure to see you in the chair, Mr Gray.

I thank my hon. Friend the Member for Erewash (Maggie Throup) for opening the debate so well. I echo her comments about the outgoing chief executive of the Terrence Higgins Trust. I have known Ian for many years. His leadership ensured that the trust was the first organisation to take the “U=U” message out there, along with “Can’t Pass it On”. Such a simple campaign and message came from the clarity of thought that Ian has brought to that organisation. The first home self-test postal service and the creation of the HIV Commission, which I will come on to, came through Ian’s leadership. He is also a lover of labradors, which makes him a good person in my book. We thank Ian, and wish him well and good luck in his new positions. I look forward to seeing him soon.

As has been said, HIV emerged some 40 years ago, when I was a mere slip of a schoolboy. The epidemic that followed still dominates some people’s lives, ended many too soon, and scarred many more. I knew nothing about HIV. When I became the Public Health Minister, I knew nothing beyond the tombstone advert on television, which I had seen as a schoolboy. I knew nothing, but I have learned a lot in a very short space of time.

Forty years ago, the situation seemed hopeless, as it did at the start of the covid pandemic in some respects, but we have seen improvements in treatments. Someone on effective treatment cannot pass on the disease. What we have achieved is incredible and a testament to the hard work of so many in our life sciences industry, as well as in the NHS, which the hon. Member for Strangford (Jim Shannon) mentioned. The all-party parliamentary group on HIV and AIDS, which I am proud to co-chair, has been at the forefront of the work for 36 years as one of the longest-standing all-party groups, and kept the subject high on Parliament’s agenda. I pay tribute to Mark Lewis, who is here today. He looks after us and keeps us on the right track and focused.

The push to end new HIV transmissions by 2030, which my hon. Friend the Member for Erewash mentioned when she opened the debate, is the right target. The UK, Scottish and Welsh Governments have all committed to meeting that target and building on the work that I have talked. We can get there. I emphasise that, so I hope that Hansard will emphasise it. HIV care in our country today is excellent. The number of people living with undiagnosed HIV has declined year on year. In the majority of people with diagnosed HIV, it is undetectable because of the treatment and the antivirals that they are on. Effective treatment and the combination HIV prevention, including the pre-exposure prophylaxis treatment, has resulted in a marked decline in new HIV diagnoses annually, but despite the fact that we have access to all the tools we need to eliminate new HIV transmissions, we will not meet the targets that the HIV Commission set out for 2030, nor the Government’s commitment to reduce new diagnoses by 80% by 2025 unless we improve testing along the lines set out by other Members today.

I agree entirely with what the hon. Member is saying. This might be a matter that the Minister can respond to or that the hon. Member’s Select Committee can take up. A lot of the arguments have been won on, for example, the availability of PrEP and making services accessible, but that has not been happening, partly as a consequence of monkeypox displacing other services and partly because of lack of resources, and that seems criminal. I have a sexual health clinic in my constituency in west London, where there is high prevalence, and people simply cannot get access to treatment. They cannot get appointments at clinics and cannot get on the escalator, as it were, to treatment. We can praise ourselves for having these solutions, but unless we solve those issues, they will not work.

The point I was making was that, compared with the hopelessness of 40 years ago, we now have the tools to deal with it, but the hon. Member is right. The all-party group visited the Dean Street clinic last year and heard about the impact that monkeypox has had and is still having on its day-to-day work. Access to PrEP through, say, community pharmacies would move the dial and be a game changer. I would very much support that, and as Chair of the Health and Social Care Committee, I might be able to help.

Some people have mentioned the HIV Commission. I was fortunate to have the proposition for that commission put to me when I was in the Minister’s job. For me and my right hon. Friend the Member for South West Surrey (Jeremy Hunt) and his successor as Health Secretary, my right hon. Friend the Member for Bromsgrove (Sajid Javid), it was an easy proposition to say yes to. When I left Government in 2019, I was asked by Ian Green of the Terrence Higgins Trust to join the commission as a commissioner, which I was delighted to do.

The Terrence Higgins Trust, the National AIDS Trust and the Elton John AIDS Foundation did incredible work to put together the commission’s report. As has been said, on World AIDS Day in 2021, we published our report that developed the evidence-based recommendations that are now the foundations of the HIV action plan, which my right hon. Friend the Member for Bromsgrove published in December 2021. Those recommendations were the foundations of the 2021 report by the all-party parliamentary group on HIV and AIDS, “Increasing and normalising HIV testing across the UK”.

The message from the HIV sector and public health professionals is test, test, test. As was said in the opening speech, late diagnosis remains way too high. There are still far too many people living with undiagnosed HIV who will not be reached through the existing testing strategies alone. If we are to find the estimated 5,000 undiagnosed people living with HIV in the UK, testing must be normalised through the health service and beyond. We have made great strides in doing that, but we will have to roll it out much wider to the high-prevalence areas, as has been said.

Everybody should know their HIV status. There must be equitable and easy access for everyone to that knowledge and to effective treatment, so they can live their full and healthy lives with undetectable HIV. Undiagnosed virus is a major contributor to onward transmission. It is therefore the driver of late presentation, all the impacts on people’s health and people’s lives, and the costs to the national health service; sadly, it also significantly increases the risk of death in the first year after diagnosis.

We know that HIV testing is reliable, cost effective and highly acceptable to patients across a range of settings. As we heard from my hon. Friend the Member for Erewash, HIV opt-out testing was an integral recommendation of the HIV Commission. We know that it works. The latest data available on HIV opt-out in accident and emergency departments in London, Manchester, Brighton and Blackpool shows 238 people newly diagnosed with HIV, and a further 124 people have been returned to care. That proves that it works. We have proved the concept. I will be honest with the House that, as a commissioner, I was concerned that people would opt out, or that they would take offence at the suggestion—that the patient would say, “What are you suggesting?” I was wrong. Routine HIV testing among pregnant women is completely normalised. That convinced me that it was right to make that our key recommendation.

That was our key recommendation, but opt-out testing is done only in London, Blackpool, Brighton and Manchester. I contacted my trust in Winchester today to ask whether we can have a conversation about rolling it out in our area.

Will the Minister give way?

The voice of Strangford must be heard.

Only at the hon. Gentleman’s behest, of course. In my contribution I referred to the success of the pilot schemes, and he has referred to that as well. There are also quite significant cost savings to the health service from people being diagnosed, so the small money spent now will be significant in the long run. Does the hon. Gentleman accept that?

Yes, and that takes us neatly on to my final point. With my Chair of the Health and Social Care Committee hat on, we have just launched a call for ideas on that, which closes in just under two hours’ time. We will be doing a major prevention inquiry, and there will be many workstreams in that inquiry, one of which will be sexual health, HIV and AIDS, and testing. This is a prevention issue—prevention of ill health, unnecessary suffering, and unnecessary cost the health service and therefore the taxpayer. The sector is responding to our call for ideas, and we will be getting that work under way and talking to the chief medical officer when we come back after half-term recess.

The opportunity to eliminate new cases of a long-term condition is very rare. We have the ambition to do it, but more than that, we have the tools to do it. We have to grab this opportunity; we would be missing the obligation upon us if we did not. I remain as optimistic as I was when the commission was put in front of me, four decades on from a subject I knew nothing about. I know a little bit about it now, and this is doable. We heard this afternoon from somebody who has shown what determination can do. We have the determination, I hope. Let us use the tools in the box and get this done. It is a great legacy that could sit on the Minister’s desk.

It is a pleasure to serve under your chairmanship, Mr Gray, and to follow my hon. Friend the Member for Winchester (Steve Brine); I pay tribute to him for all his great work in this area. I congratulate my hon. Friend the Member for Erewash (Maggie Throup) on securing the debate. A good number of colleagues applied for the debate, including me, and I congratulate her on being the one to secure it and lead it so well. It seems appropriate in this debate to mention the late Robert Key, the former Member for Salisbury who passed away last week and who did so much work on this issue while a Member of this House.

I welcomed the Government’s commitment in 2019 to ending all new HIV transmissions in England by 2030. Normalising HIV testing is essential to meeting that target. I have done my test this week, and I am sharing the video and the means of obtaining a test on social media. While new HIV diagnoses have continued to fall, late diagnoses remain stubbornly high in England.

This February marks the 22nd anniversary of the death of a good friend of mine from AIDS. He sadly died from many AIDS-related complications, but I am confident that, had he been tested earlier and regularly, he would have been given the right medication and would still be alive today, causing the mischief and merriment that he always did. I remember him and others at times like this.

Last week, I had the privilege of hosting an event here in Parliament, along with the Terrence Higgins Trust, and it was a pleasure to welcome a number of colleagues who are here today. We met a young man, Oliver Brown, and Ollie is here in the Gallery today. Following a cycling accident, he went to hospital here in London, where opt-out testing for HIV was under way. Had the hospital not tested him for HIV when it took a blood sample, Ollie believes that, to this day, he may not have found out that he is HIV-positive. Thanks to that opt-out testing scheme, he is now getting the treatment he needs and can look forward to a normal, long life.

The Terrence Higgins Trust impressed upon us the huge and beneficial impact that further roll-out of opt-out HIV testing could have. Opt-out testing for HIV has already been rolled out in emergency departments in the areas with the highest HIV prevalence in England—namely, London, Brighton, Manchester and Blackpool. This testing has been introduced alongside opt-out testing for hepatitis B and C. Already, in the first 10 months, it has led to more than 1,500 people being diagnosed with HIV and hepatitis B and C, so it is clear that opt-out testing works.

I am, believe it or not, old enough to remember the famous “Don’t Die of Ignorance” campaign of the 1980s, for which we have Lord Fowler to thank; he led the way on raising this issue throughout his ministerial and parliamentary career. There are generations of people who do not remember that campaign, and still, 42% of people first diagnosed with HIV are diagnosed late. People diagnosed late with HIV in 2019 had a more than sevenfold increased risk of death within a year of diagnosis compared with those diagnosed promptly.

We are simply not doing enough if we are serious about meeting our 2030 target. As we heard from my hon. Friend the Member for Winchester, we have so many tools at our disposal to tackle HIV. I welcome that PrEP is available, but we need to do more to roll it out. It is estimated that there are still more than 4,000 people with undiagnosed HIV in England, so we need to be testing more. We also need to ensure that everyone diagnosed with HIV accesses care so that they, like Ollie, can live long and healthy lives.

While we take action on those fronts, we also need to tackle the enduring stigma that dogs people diagnosed with HIV. Only 38% of the British public know that someone with HIV on effective treatment cannot pass it on. Undetectable means untransmissible. We must spread that message hand in hand with testing to end new HIV transmissions.

Expanding opt-out testing has the potential to save the NHS more money than it costs and further reduce pressure on services. The Terrence Higgins Trust estimates that in the first 100 days of the roll-out of opt-out testing, which has so far cost £2.2 million, the NHS has saved between £6 million and £8 million in care costs as a result of initiating treatment earlier for those who need it. That is a conservative estimate of the savings. We can infer that expanding opt-out testing for HIV and other blood-borne viruses nationwide would save the NHS even more in care costs.

Those savings come from the reduction in care that hospitals need to provide newly diagnosed patients as a result of detecting HIV sooner. When Croydon University Hospital first started opt-out testing, the average hospital stay for a newly diagnosed HIV patient was 34.9 days. After two years of opt-out HIV testing, the average stay has reduced to a mere 2.4 days. We can save the NHS money, reduce transmission further and ensure that those who need it get the treatment they need. In essence, opt-out testing delivers a win-win-win scenario.

National HIV Testing Week is all about promoting regular testing. It is disappointing that we have not yet managed to recover to pre-pandemic levels of testing. I hope the Minister will confirm that the Government will keep a laser-like focus on this issue so we can continue to normalise regular testing across the most at-risk communities. The Government’s HIV action plan is hugely welcome, but we must go further. I urge the Minister to recognise the huge benefits of opt-out testing and do all he can to ensure we to roll it out to the whole nation.

“Test, test, test” must be our mantra if we are to reach our goal in 2030. I know the Government will have the support of everyone in this House in achieving that aim. I know the Minister will have heard the Prime Minister at Prime Minister’s questions, and I believe he will be pushing at an open door to secure the necessary funding.

As always, Mr Gray, it is a pleasure to serve under your chairmanship. I thank the hon. Member for Erewash (Maggie Throup) for securing this important debate and for the detailed way she set out the issue—I do not think anyone could or would want to argue with her. She is a bit of a poacher turned gamekeeper, as a former public health Minister. In her and the new Chair of the Health and Social Care Committee, the hon. Member for Winchester (Steve Brine), we have two people who have been directly involved in formulating policy on stopping HIV transmission. I thank them and the current Minister for the work they do.

Like the hon. Member for Erewash, I want to refer to the new and outgoing chief executives at the Terrence Higgins Trust. Ian Green has led the organisation superbly, and its campaigns over many years have won successes from Governments. I look forward to working with my good friend Richard Angell, who will be superb in that job. I wish him and the whole team at the Terrence Higgins Trust the best for the future. I also thank Mark Lewis, who does so much work to facilitate the APPG. Those roles often go unthanked, but he puts so much time and effort into the group.

As has been mentioned, last year marked the 50th anniversary of the death of Terry Higgins, one of the first people in the UK to die of an AIDS-related illness. In those 50 years, we have come an awfully long way. Since Terry lost his life, we have seen major advancements in HIV treatment and testing, and in tackling bigotry, ignorance and misinformation. I acknowledge that those wins have only happened because of the tireless work of campaigners and researchers. The achievements of the last 50 years have been theirs, and when we do end all new HIV transmissions in this country, that victory will be theirs too. It is important to acknowledge that.

I thank the hon. Members for Strangford (Jim Shannon), for Winchester and for Darlington (Peter Gibson) for the way that they set out their arguments. I particularly thank the hon. Member for Darlington, who gave a very personal account, both here and at Prime Minister’s Question Time, about the loss of his dear friend. There are so many people who, like his friend, have died—probably needlessly—a very early death because of the failure to identify an HIV transmission before it was too late. The drugs have moved on massively. If we identify HIV, we can tackle it, get the viral load down and get the CD4 count back to normal levels, and that person can live a healthy and near-normal lifespan. That is a testament to the drugs that have been developed.

As the name suggests, this week is all about testing, which is a vital tool in our fight against HIV. Labour is proud to support the “I test” campaign, which sits alongside National HIV Testing Week. People can live with HIV for a long time without displaying symptoms—an estimated 4,400 people are currently living with undiagnosed HIV—so encouraging regular testing is essential to ending new cases.

Along with a number of other Members, I went to the national HIV testing drop-in yesterday and collected a free HIV self-test. They are being distributed this week and, after either a finger prick or an oral swab, they show the result within 15 minutes. That is transformational. Anyone listening to this debate can log on to freetesting.hiv and get their test. If the last three years have taught us anything, it is that getting to grips with at-home testing is surprisingly easy. If anyone has not tested, please sign up online.

Twenty per cent. fewer people were tested for HIV in 2021 than in 2019. That is having a knock-on effect on treatment and diagnosis. It is important that we do everything we can to drive up testing rates, which is why campaigns such as “I test” are so essential. Access to free at-home testing from a central source is only available during National HIV Testing Week; for the rest of the year, access can generously be described as patchy. Will the Minister set out the steps the Government are taking to improve testing rates? How can we get tests into communities with low take-up? Given the success of opt-out testing in areas of high prevalence, I would be interested in the Minister’s comments on the current scope of that testing and whether there are plans to broaden it.

Beyond testing, there is still a huge amount of work to do in tackling HIV. During a debate on World AIDS Day, I spoke about access to PrEP. Around 40% of people surveyed struggle to access PrEP, and there are huge issues with the resourcing of sexual health clinics. Unfortunately, the PrEP action plan still has not been published, despite being promised in 2021. From a recent response to a written parliamentary question, I understand that the Government still intend to publish the plan. That is all fine and well, but the HIV action plan covers 2022 to 2025, and we have already had a year of it without a proper PrEP-specific plan. We cannot afford another year without one. Will the Minister set out a timeline today? Do the Government plan to publish the PrEP action plan prior to the summer recess?

Last week, the Government announced its major diseases strategy, but there has been little or no clarity on what that means for the sexual and reproductive health action plan, also long promised by the Government. Recently, the Minister for mental health and women’s health strategy, the hon. Member for Lewes (Maria Caulfield), said that the Government were “considering the need” for that plan. Will the Minister update us on those considerations? We know that sexual health services have faced extreme pressure thanks to the mpox outbreak, and that the capacity to deliver vital services has been compromised. Given that situation, it is really not acceptable that strategies are being promised and then apparently disappearing into the ether.

On World AIDS Day last year, the Labour party committed to scrapping the outdated barrier that prevents people with HIV from accessing fertility treatment. This is really important. Is the Minister able to confirm today that the Government will match that pledge? If not, why not? We have come an awful long way, but there are still legislative barriers in place that are based on misinformation, outdated information and scientific ignorance. We in this place must remedy that.

I have no doubt that the Minister wants to see increased testing and wants the UK to reach the historic milestone of no new cases of HIV. We support him in that and will do all we can to support the Government in meeting that aim, but that shared goal requires action now. HIV is treatable. It is detectable. New transmissions can be stopped. I invite the Minister, during National HIV Testing Week, to redouble his Government’s efforts on HIV transmission, and to work towards a future where HIV is finally defeated. To take the foot off the pedal now, as we are right on the cusp of achieving something truly extraordinary, would be a profound tragedy. We support the Minister in keeping the foot on the pedal and ending all transmissions of HIV in this country.

I thank Members from throughout the House for taking part in this hugely important debate and congratulate my hon. Friend the Member for Erewash (Maggie Throup) on securing it. We heard excellent speeches from the hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for Winchester (Steve Brine); we heard a very moving contribution from my hon. Friend the Member for Darlington (Peter Gibson), who spoke about his friend; and we heard an important question from the hon. Member for Hammersmith (Andy Slaughter).

Throughout National HIV Testing Week, we are raising awareness of the importance of testing as part of HIV prevention. I thank the Members who took part in the HIV point-of-care test in Portcullis House yesterday, delivered by the Terrence Higgins Trust. I join others in paying tribute to Ian Green for his work on this subject.

Our campaign aims to address barriers and normalise HIV testing, and to remove stigma by empowering and encouraging more people to know their HIV status. As many Members have said, people can live with HIV for a long time without any symptoms. Testing is the only way for people to know their HIV status. This is one of the cornerstones of our HIV action plan, published in 2021, which includes the strong commitment to end new HIV transmissions by 2030 in England.

The first HIV action plan monitoring and evaluation framework, which was published by UKHSA in December, shows that there is much to celebrate in the collective progress we have all made, with extremely high levels of antiretroviral therapy coverage and viral suppression. Still, as a number of Members have mentioned, there are an estimated 4,000 people living with undiagnosed HIV. For those paying attention to this debate and listening elsewhere, testing for HIV is quick, free, confidential and easy. It is fundamental to finding and diagnosing the population of people who currently do not know their status in order to protect their health, and for efforts to stop HIV being passed on. The vast majority of people get the virus from someone who is not aware that they have it.

As my hon. Friend the Member for Winchester said, what it means to live with HIV has transformed over the past four decades, from a terminal diagnosis to a manageable long-term condition, thanks to huge medical improvements in treating the virus. As part of our plan, we are investing £3.5 million in the HIV prevention England programme between 2021 and 2024, through which we are delivering National HIV Testing Week. Last year’s results were promising: 30% of the almost 25,000 users who ordered a HIV and syphilis self-sampling kit during the campaign had never tested before, and a majority of the campaign’s target audiences reported having taken some form of preventive action as a result of seeing the campaign.

What is more, throughout National HIV Testing Week, for the very first time, free HIV home tests with a result in just 15 minutes are available England-wide. As my hon. Friend the Member for Erewash said, this is completely transformative technology—something we are now very familiar with because of the covid epidemic. The test works in a very similar way to a covid-19 lateral flow test, but uses a few drops of blood from a small prick of a finger. Alongside self-tests, there is also an option for people across England to order a test that is then sent to a lab and screened for both HIV and syphilis.

The success of National HIV Testing Week is the result of close and collaborative working between key partners in and beyond Government, and I take this opportunity to thank them for their invaluable work. That, of course, includes the HIV prevention England team at the Terrence Higgins Trust, which delivers National HIV Testing Week on behalf of my Department.

Our local authorities and regional directors throughout the country are co-ordinating placed-based and regional activities to further promote National HIV Testing Week, using posters, digital imagery and other creative resources, as well as their own local projects and initiatives on HIV testing and prevention. Community and voluntary organisations have a key role in engaging their local populations and will also be providing testing and information in their local area as part of National HIV Testing Week. I take this opportunity to thank them for their vital role in helping us to end new HIV transmissions.

We know that more still needs to be done to achieve our bold ambitions. As part of our HIV action plan and to improve testing, NHS England has made a £20 million investment in opt-out HIV testing in emergency departments in areas of extremely high HIV prevalence to ensure that people get the right treatment as early as possible. A number of Members asked questions about this. Opt-out testing is a proven and effective way to identify new HIV cases, as it promotes testing on the admission to hospital of anyone who has not previously been diagnosed with HIV, therefore helping to rapidly identify the virus. Thirty-three A&E departments are now live, delivering this important initiative. We have backed this measure with funding to provide hepatitis B and C testing as well, partnering with NHS England’s hepatitis C elimination programme.

We are working closely with the NHS to understand the progress, challenges, results and learning from the initiative. I am taking a personal interest in it and the results that are starting to emerge, and have been considering the emerging evidence, which is extremely interesting and exciting in lots of ways. We will consider the evidence from the first year of opt-out testing alongside the data on progress towards our ambitions, to decide whether to further expand the programme.

It is right that we are talking about testing and recommitting to targets, but this is part of a strategy on prevention. I will put to the Minister the same point as I put to the Chair of the Health and Social Care Committee, the hon. Member for Winchester (Steve Brine). I am sure the Minister has seen the briefing from the National AIDS Trust and the Terrence Higgins Trust on the fact that sexual health services were displaced by mpox, principally. About a quarter to a third of the routine work that they do, including testing and the prescription of PrEP, has gone and has not recovered a year on. What are the Government doing to ensure that clinics have the resources to do that?

I was going to address that point later in my speech but will do so directly. We are conscious of the challenges thrown up, particularly in some areas, by the huge volume of extra work caused by monkeypox. We have provided additional resources to the places that were challenged by monkeypox, but I am conscious that it has slowed down some of the progress we wanted to make.

To finish my point about opt-out testing, which a number of Members asked about, the reason for starting in the areas with the very highest prevalence was that there was a better opportunity to save more lives for a given investment. That is why we started in those areas rather than the low-prevalence areas. There is a point of balance in respect of how far we extend that out from the areas of the very highest prevalence, which is what the evidence we are gathering will help us to decide.

I am grateful for the Minister’s comments about opt-out testing in high-prevalence areas. Will he write to me and others who have attended the debate about what considerations the Department has given to tracking people who have lived in high-prevalence areas but no longer live in them? They may have been exposed to similar risks that make those areas high prevalence, but they no longer live in them.

That is an interesting question. I hope we can do better than that, because we will be sharing evidence as it emerges to help other areas of the country to make the case for implementing the same approach. My hon. Friend raises one new way of thinking about it, which we will consider. We will share evidence as it emerges, because there is a huge amount of interest in this extremely exciting new approach.

National HIV Testing Week gives us the chance to raise awareness of the importance of testing and of the powerful role that each of us has to play in ending HIV by knowing our own HIV status. It is also an excellent reminder of the need for a sustained, collective effort to achieve our shared ambitions and end new transmissions and deaths within England by 2030. Together, we can be the generation that beats HIV. Before I sit down, I should answer the question asked by the hon. Member for Denton and Reddish (Andrew Gwynne): the PrEP action plan will be published before summer recess.

I appreciate the opportunity to wind up the debate, which has been productive and knowledgeable. I thank Members from across the House for their contributions.

My hon. Friend the Member for Winchester (Steve Brine) brought to the debate a great deal of knowledge and expertise, which he has gathered over a number of years. To use the words of the Opposition spokesman, the hon. Member for Denton and Reddish (Andrew Gwynne), the fact that two poachers turned gamekeepers are present shows just how important the issue is.

My hon. Friend the Member for Darlington (Peter Gibson) spoke so gently about his friend who sadly lost his life due to complications of HIV/AIDS. It is for those people that we need to get it right now and eliminate HIV by 2030.

The hon. Member for Strangford (Jim Shannon) brought an international element to the debate when he spoke about the work that people local to him are carrying out in Africa. We must never forget that even though we are making great strides in the UK, other countries are quite a long way behind us.

I respect the Minister deeply and am really pleased that he has committed to continue his personal interest in this topic, but I do not think I heard from him that we will be rolling out to areas of high prevalence the opt-out testing that has been carried out in areas of very high prevalence. I am disappointed in that, because the boroughs across London have already done the work for the Department. The funding was just for the boroughs with very high prevalence, but London as a whole decided to roll it out across all the boroughs, partly because people move between them. There has been take-up of the testing and cases are being found in areas of London that were perceived to be just areas of high prevalence. I would appreciate it if the Minister could follow up on that to ensure that we speed up the roll-out to the high-prevalence areas. We should not wait too long, or we will find that more people—such as the friend of my hon. Friend the Member for Darlington—lose their lives.

We have in our grasp the opportunity to eliminate what has been a killer disease. We cannot let that opportunity slip through the net, so we must all do whatever we can to make that happen and make sure that opt-out testing is there, wherever we are in the UK.

Question put and agreed to.

Resolved,

That this House has considered National HIV Testing Week 2023.

I beg to move,

That this House has considered women’s football talent pathways and player wellbeing.

As ever, it is a pleasure to serve under your chairmanship, Mr Gray. I want to talk about women’s football talent pathways and player wellbeing. I have raised both issues before, including in a Westminster Hall debate on a similar topic almost exactly a year ago, but they require more attention as women’s sport grows across the board. I will start by considering the talent pathways available to young girls as a route from grassroots sport to the elite levels. I will then consider the experience of girls as they grow up playing football before possibly becoming professionals, while looking at the governance and structural issues they face.

Talent pathways, which are how players make it from being young footballers to professionals, are still experienced very little by young men and women. The first step in this journey is the grassroots game and in schools. For all sports—football, cricket, rugby and tennis—we need strong grassroots games to provide opportunities for our young people. Playing a sport offers health and social benefits, and young people may find that it is something that they love, that they are good at, and that they would consider making a career of. However, we have still not reached a point where the experience of sport at grassroots level is the same for girls and boys.

At school, only 67% of girls have equal access to football, and not all children are offered a minimum of two hours of physical education a week. I echo the Football Association’s calls for equal access to football at minimum PE levels, for long-term funding settlements for schools to ensure that PE is accessible, and for Ofsted to inspect whether schools are fulfilling the requirement of equality of access in PE. In the letter that the Lionesses sent to the prime ministerial hopefuls in the summer of 2022—it seems a long time ago—after the team’s triumphant win at the Euros, they asked the candidates to ensure that all girls have access to two hours of PE.

The hon. Lady is absolutely right: the success of the Lionesses, ably helped by the support of Prince William, must continue to be capitalised on. Our young girls and women are encouraged to play and enjoy the beautiful game, but greater funding is required than is currently granted. I join the hon. Lady in urging the Government and the Minister to set aside funding to enable schools to run programmes annually.

Yes, and as time moves away from the successful competition last summer, we do not want it to fall off the political agenda.

The letter from the Lionesses asked the prime ministerial hopefuls to secure the first step in the talent pathway into the sport for young girls. In response, a spokesperson for the current Prime Minister said that he

“passionately believes in the importance of sport for children’s development and would love to see all schools provide two hours of PE a week”.

I understand that this issue cuts across departmental remits—it is not just the responsibility of the Minister’s Department—but will the Minister say what progress has been made? Where are we up to with the commitment the Prime Minister made to young girls following the win at Wembley? If the answer lies in another Department —for example, the Treasury—will the Minister commit to take the matter up with that Department and get some answers as a matter of urgency?

This is a really important question, because finding interest in school is key to beginning any talent journey. It is therefore extremely welcome that this week the FA announced a new-look women and girls’ player pathway, which will come into full effect later in the year. It is a plan designed to make the game more accessible, more diverse and more inclusive, because this is undoubtedly an aspect of the game on which the sport most do more.

May I draw the hon. Lady’s attention to something fantastic that is happening in Darlington? FC Darlington Locomotives is led and spearheaded by three amazing people: Linda, Paul and Nathan Beadle. They have got more than 100 young girls in Darlington playing football each and every week, and they are a real springboard for the community, bringing people in from all across the town. Would the hon. Lady like to come to Darlington to see them in action?

I thank the hon. Member for that intervention and would love to come to Darlington; I pass through it twice a week on the train—it is not that far away from my constituency. The type of thing he mentions is happening all over the country. It is so exciting to see girls and young women coming together to play football.

Of 300 players in the women’s super league, only 29 are of black, Asian or mixed heritage. That is a symptom of the structural barriers that remain in place for so many when it comes to accessing formal pathways. There has been a problem of talent centres being typically based away from urban centres, which requires travel and time commitment, and therefore cost. That puts these facilities out of reach for many people who would otherwise benefit. The game has been missing the proactive approach that could make such a difference.

If we look at the current investment in this area of the game, we see that the central investment from the men’s game into academies via the Premier League is £88 million per year, whereas the FA’s overall budget for all women’s academies is reported to be around £3.25 million per year. That is not a sustainable budget for growing the game into what we want it to be, so it is great news that the FA has looked at the issue and brought forward the new women and girls player pathway. I would be interested to hear whether the Minister has any plans to make the funding settlement more equitable.

The inequalities in the game need to be rectified. I pay tribute to Fern Whelan, the former Brighton and England player who is now at the Professional Footballers’ Association as its first ever equality, diversity and inclusion executive. She has done some incredible work to address the lack of diversity in the game, including launching the “See it. Achieve it.” campaign, which has been backed by a number of other successful players. The campaign aims to use and highlight role models in the game to help to create supportive communities and encourage more diverse engagement in the sport.

There are good examples from other sports. In tennis, for instance, 49% of those on the performance pathway are women, because the performance pathways through regional development centres and national academies are the same for men, women, boys and girls. That is what we should be aiming to achieve in every sport. I am sure that the FA’s new women and girls talent pathway will go some way towards achieving it in football, but it will require investment, as well as reform through regulation.

When the Government publish their White Paper on football regulation, we will be able to see whether they have plans for proper funding settlements across the board. Such settlements will hopefully free up finances in the lower leagues for teams that are embedded in their local communities, potentially enabling them to open up their own pathways in the communities they represent. We know that the White Paper’s release has been delayed, but I am keen to hear whether the Minister can give us a definitive date for when it will be published. The sport needs regulation and the Government have promised it. I sincerely hope that the delay is not an indefinite one.

The issue of finances in football, and in this case women’s football, leads me to my next point about player wellbeing. The sport is growing and the experience of players now is much better than it used to be, especially in comparison to the time when I was a girl, when we were not allowed to play football at school. It is totally different now, but there are still massive concerns for players about job security and their working conditions.

We know anecdotally that too often players find that the idea of them being pregnant is informally discouraged because of the complications that would bring for the clubs they play for. We also know that players are reluctant to call out safeguarding issues, because they fear that complaining to their club about any such issue will damage their career. This is simply not good enough. We need the players to feel they can trust the system and to have trusted people they can go to who are independent and can help and advise them.

There has been a continuous growth in the uptake of the PFA’s welfare services in the women’s game, with support provided to address really important issues such as eating disorders and mental wellbeing. We need to ensure that safeguarding processes are trusted and independent, because with the rise in visibility of the sport, we have to recognise that welfare and safeguarding issues will become more relevant, too. New image rights deals, for example, bring vital revenue to players and the sport, but also new challenges, such as pressure on body image and issues such as online safety.

We already know the effect that that sort of concern has on teenage girls, where we often see in many sports a drop-off of young women playing through their teenage years. To keep growing the sport, we need better infrastructure for girls through those years, to ensure that all young women feel it is an environment they want to work and succeed in, and where they can have a viable career.

Of course, football is not the only sport with such problems. In English rugby union, for example, the lack of formal recognition from the Rugby Football Union to the Rugby Players Association is holding players back, and it is affecting the women’s game. As the women’s premier 15s look to move towards professionalism, players must be protected with standard contracts and supported in their needs to be dual-career athletes. I am keen to hear the Minister comment specifically on that and on whether there have been any conversations with the sport about it, as well as his view on the importance of players’ voices being heard.

Finally, through talent pathways, grassroots sports and even elite sport, it all comes down to facilities. They are being threatened by increased energy costs that risk them going out of business or being forced to reduce services. I am interested to know what more the Minister is doing to support these vital community assets. Community facilities play a key role in making sports accessible to a wide range of people, ages and ability. It is important that the sector is protected. Ultimately, today is a great time to be a female sportsperson. Visibility, revenue and participation are all massively on the rise, but the perils of precarious job security, health concerns and lack of investment make it a real challenge.

I will repeat for clarity the questions I have posed to the Minister. I would be grateful if he updated us on the Prime Minister’s commitment on access to football in schools, with equal access for boys and girls. When will we see action, not just words? Will the Minister tell us what plans the Government have for greater equity in funding between the men’s and women’s games talent pathways? What plans does he have to support vital community leisure assets that are struggling with energy bills? Finally, will he give us a definitive date for the publication of the White Paper on football regulation, or even narrow it down to a week or two? That would start to answer a lot of the sport’s long-standing questions.

It is a pleasure to serve under your chairmanship, Mr Gray. I thank the hon. Member for Sunderland Central (Julie Elliott) for securing time for this important debate. I have made it my personal commitment that inclusion in sport will be a high priority for me. That will, of course, include access to all sports for women and girls, not least because last summer we witnessed major successes in women’s sport, as our own Lionesses beat the German team at Wembley to lift the UEFA championship trophy.

That final at Wembley was attended by a record crowd of more than 87,000 people. Not only was that a new record for a women’s international in Europe, but it broke new ground for women’s and men’s Euro final tournament games. The tournament also became the most-watched women’s Euro ever, with a global cumulative live viewership of more than 365 million, which was fantastic to see. It was truly a groundbreaking moment for the sport and has supercharged interest in the women’s game, bringing it to the forefront of so many people’s minds.

The Lionesses’ fantastic performance at the Euros has inspired the nation. It is great to see that figures published by UEFA in October in its post-tournament flash report confirm that. For example, more than half of local residents and two in five spectators and tournament volunteers have been inspired to do more sport and physical activity generally, and 84% of those participating in UEFA women’s Euro 2022 legacy activities reported that it has improved their confidence and self-esteem, which highlights the importance of participation in this area.

We want to build on this momentum, to ensure that every woman and girl has the opportunity to take part in football if that is what they want to do and, more importantly, to get active in a way that suits them. Programmes such as Game On, Shooting Stars and Barclays Girls’ Football School Partnerships are engaging more girls in football at school. For example, over 3,200 primary schools are participating in the Shooting Stars programme. Initiatives such as Sport England’s This Girl Can continue to inspire millions of women to get active, regardless of their shape, size and ability.

We are investing over £300 million between 2021 and 2025 to improve grassroots facilities across the UK, to help more women and girls access the high-quality facilities that the hon. Member for Sunderland Central rightly alluded to. To commemorate the Lionesses’ incredible achievement, we are also working with the Football Foundation and the FA to name sites after the players in the towns and cities that shaped their careers. The Lionesses have become extraordinary ambassadors for sport, and we will continue to invest in grassroots sport to bring on the next generation of Lionesses.

We know how valuable PE is at school. It gives pupils an opportunity to excel, to be active and to lead healthy lives. We are actively working with colleagues in the Department for Education to understand the barriers that prevent the ambition of two to two and a half hours of PE a week from being achieved, and we will continue to work with them to ensure that girls have equal access to sport. I was struck by the meeting that I attended with the Secretary of State for Education and the Lionesses about shared ambitions to do that. There is more work for us to do to identify and address the different barriers to participation that exist, but we are working on that. We will continue to adopt a more targeted approach as part of our new sport strategy, which we are working on at the moment. Alongside that, the Department for Education is working on updating the school sport and activity action plan, which will set out actions to improve PE teaching in primary schools and help schools to make better use of their sport facilities.

I am pleased to learn that this week the FA will launch its revised women and girls player pathway, which focuses on providing a wide and diverse pool of players ready for senior domestic and international football. I am determined to strive for greater diversity and inclusion in women’s sport. According to the Professional Footballers’ Association, just 9.7% of footballers in the elite women’s game are from diverse ethnic backgrounds, compared with 43% of male players in the premier league. I am glad that the hon. Member for Sunderland Central mentioned this, because it shows that there is more work to do to ensure that all women and girls, no matter their background, have access to football and the opportunity to progress, if that is what they wish to do.

The pathway that the FA has been working on includes measures specifically focused on access for a diverse pool of talent, with the Discover my Talent referral programme already seeing a more diverse cohort of players, particularly at the under-17 level. This shows progress, but that work must continue, and we will continue to work with the FA to drive for further, immediate action in this space.

There is no doubt that the Lionesses’ win last year has inspired the next generation and was a turning point for women’s football. However, I recognise that much more still needs to be done to achieve parity with the men’s game and to drive progress more widely across women’s sport.

I thank the Minister for his positive response. There are good things being done across the four regions of the United Kingdom, in England, Scotland, Wales and Northern Ireland. My granddaughter is an example of that. She has taken up football and enjoys it, as does her wee sister. There are good, positive steps taking place across all the Administrations. Has the Minister had an opportunity to speak to them to see what they are doing to work together?

The hon. Gentleman makes a valid point. We have inter-ministerial groups with the devolved Administrations, so I would be keen to focus on that. He is right that there is no need for us to reinvent the wheel. If there are actions that work and deliver results, I am happy to learn from them, and I am happy to share our experiences with representatives in the devolved Administrations.

One area where we want to see more parity is in player welfare, as the hon. Member for Sunderland Central mentioned. Progress has begun. The England men’s and women’s senior players have been paid the same match fee for representing their country since January 2020, and professional female footballers in England will now benefit from a level of maternity and long-term sickness cover in recent changes to their contracts, but challenges remain.

Last year, UEFA doubled the women’s Euro prize money, but it is still a fraction of what the men get. The 16 qualifying teams for the women’s Euros shared a pot of €16 million last year, whereas the 2021 men’s Euros saw a prize pot of €371 million. In January last year it was announced that the FA would increase prize money for the winners of the women’s FA cup from this season. However, there is still some way to go for that to equal the prize money for the winners of the men’s FA cup. In the 2022-23 season, the winners of the men’s competition will receive £2 million, with the winners of the women’s FA cup receiving £50,000.

Historically, women’s sport has not had the profile or media coverage that the men’s sport has achieved over the years, but that is now changing. Attendances and viewing figures for women’s sport are growing at an extraordinary rate, and there is an opportunity to level the playing field when it comes to prize money.

Player welfare in terms of medical care is another key area of concern. The Sports Personality of the Year winner Beth Mead has called for more research into women’s anterior cruciate ligament injuries as a result of five of the top 20 women’s footballers suffering serious knee injuries at the end of last year. More needs to be done to understand why women appear to be more likely to suffer from those injuries than male footballers do. We need to protect female players from injury and ensure that they receive the same level of treatment as their male counterparts.

I am acutely aware that player welfare goes beyond prize money and medical provision into the space of safeguarding and mental health. I do not wish to pre-empt the findings of the future of women’s football review or comment on recent press coverage, but I am aware that the review is inviting evidence from current and former players on their experience of the professional environment. I will pay particular attention to any recommendations that the review makes, based on their evidence. I welcome the work of the PFA in providing support for female footballers, and of organisations such as Women in Football in challenging the status quo. I will certainly follow up many of the points that the hon. Member for Sunderland Central raised.

The ongoing review of the future of women’s football, which is chaired by former England and Great Britain footballer Karen Carney, will look at how to deliver bold and sustainable growth of the women’s game at elite and grassroots levels. There is now an urgent need to ensure that the basic processes and structures are in place to protect the interests of the game and the people working in it. This is a defining period for women’s football, and this thorough review will be at its heart.

The hon. Member for Sunderland Central mentioned the funding settlement. The FA is at an inflection point in the development of the elite game, and it has flagged issues in funding the elite pathway. The review of women’s football will look at the matter in great detail to see how payment is provided. As I said, I will not pre-empt anything that is said in that review, but given that such a formidable ex-player is chairing that important work, I am confident that football, talent pathways and player welfare will be cornerstones of its findings. I look forward to working with the chair as the review progresses towards its final report in the summer of this year.

The hon. Lady also raised facilities and the increasing costs they are facing. I have been holding a series of roundtables and have had regular engagement with a number of organisations up and down the country. Although we have provided a tremendous amount of support, I recognise that there are still challenges, and I am working with colleagues in the Department and other Departments to see what other work can be done to help.

The FIFA Women’s World cup in Australia and New Zealand this summer will continue to shine the spotlight on women’s football, and rightly so. We should use the opportunity to build on the tremendous momentum that has already been created and drive change forward.

May I press the Minister on a date or a timescale?

I thought I might get away with that one. All I can say to the hon. Lady is that it is extremely imminent. I keep saying it is imminent and that we are working at pace, but I assure her that there is no one more eager to get this White Paper out there than me. I hope I can give her some crumbs of comfort by saying that she will not have to wait too much longer.

I hope this debate has reassured hon. Members about our commitment to ensure that all aspects of women’s sport, including football, continue to flourish. We will continue to work with the sector to make that happen, building on recent successes such as the women’s Euros and looking ahead to future opportunities such as the FIFA Women’s World cup and, of course, the important sports strategy, which, if I get my way, will have inclusion right at its heart.

Question put and agreed to.

I beg to move,

That this House has considered climate change and biodiversity.

It is a pleasure to serve under your chairmanship, Mr Gray.

Climate change has triggered more extreme weather conditions, causing heatwaves, droughts, high precipitation and flooding. Adapting to the impacts of climate change in the UK and around the globe is necessary to keep the human population safer. Taking steps now to adapt to future change will make us more resilient and less vulnerable to its impacts. Adaptation can include traditional engineering projects, such as sea walls or other coastal defences as sea levels rise, but the natural environment also has a significant role to play. Adaption covers everything from water storage to drought resistant crops, from green urban areas to protecting and restoring natural, indigenous ecosystems.

Nature-based solutions are often cheaper to implement and maintain than alternative grey infrastructure adaption options. When their multiplier benefits are taken into account, nature-based solutions usually have a significantly higher benefit-cost ratio.

The Climate Change Committee reports on progress on adapting to climate change in England. Many of its recommendations for improving adaption planning and implementation in England have been taken up by the Government and their arm’s length bodies. They accept the committee’s central message that they must take greater action to build resilience to the impacts of climate change.

The Climate Change Committee has advised that the UK should adapt to a 2° warmer world for the period 2050 to 2100 and assess the risks for a 4° temperature increase. It identified the eight priority risk areas that need the most urgent action: the viability and diversity of nature; soil health; the release of sequestered carbon; crops, livestock and forestry; collapse of supply chains for food, goods and vital services; power system failure; human health and productivity; and risks to the UK from climate change impacts overseas. Nature-based solutions can help to address all these risks.

Analysis has shown that nature-based solutions can help to address 33 of the 34 climate change risks identified as requiring more action in the Climate Change Committee’s third “UK Climate Change Risk Assessment”, including the eight risks requiring the most urgent action.

The UK’s national adaption programme sets out potential actions to address climate change risks. A recent report from the Royal Society for the Protection of Birds and the WWF-UK, “Nature-based Solutions in UK Climate Adaption Policy”, highlights opportunities for nature-based solutions in the UK and provides recommendations on how best to use nature-based solutions to deliver widespread benefits to both people and wildlife. I respectfully refer the Minister to those recommendations.

The report highlights the opportunities and policy support needed to implement nature-based solutions across the UK in ways that deliver for nature, climate and people. It also outlines how nature-based solutions offer opportunities to mitigate the eight key risks to the UK identified by the CCC, while supporting the provision of public and private goods.

A wide range of nature-based solutions is being deployed in the UK. For example, sand dunes, salt marshes, and seagrass meadows are helping to protect against coastal flooding. Restored and in good condition, peatland can slow the flow of water during storms. Urban trees, parks and sustainable drainage systems can cool and retain moisture and reduce stormwater run-off, thereby cooling down our towns and cities during extreme heat and protecting against urban flooding.

One of the key recommendations of the RSPB-WWF report is that in the upcoming national adaptation programme—the NAP3, for 2023 to 2028—nature-based solutions must be properly integrated and given the opportunity to help us to adapt to a warming climate, while also providing other carbon and biodiversity benefits.

I agree with everything the hon. Lady is saying. I have two points to make about attracting private-sector investment for these nature-based solutions. First, we have to be very clear about the carbon offsetting value of the projects. Secondly, when the biodiversity net gain details of that strategy come forward, we need to be clear that they are creating more diversity. Does she share my concern that we are not really at the stage where we can properly measure the multitudes of benefits of investing in such schemes?

I completely agree with the hon. Member’s question. We need to measure metrics and outcomes more thoroughly as part of the process of using nature-based solutions to adapt to climate change. That is absolutely spot on.

My hon. Friend’s debate highlights that it is in areas such as hers, which are very vulnerable to flooding to the sea and other urban floods, that the expertise on such complicated issues is found. Does she agree that one answer to the question from the hon. Member for Bristol East (Kerry McCarthy) is that private investment could be attracted through recycling centres and former landfill areas? We cannot build buildings on contaminated land, but there is an opportunity to plant trees there, and that is exactly what is happening in Gloucester right now.

I quite agree with my hon. Friend. We have an issue with leaching from coastal landfill sites. We really need to think about that when addressing what we are going to do with them, and we also need to think about tree planting, not building developments.

I ask for the Minister’s thoughts on the key recommendation of the RSPB and WWF report. Nature-based solutions contribute to reducing our vulnerability to the impacts of climate change. They are no longer peripheral, and the Department for Environment, Food and Rural Affairs has already started to develop policies that should be rolled out across all sectors. Nature-based solutions need to be mainstreamed in policy by establishing common goals, harmonising policy support and overcoming barriers across all sectors.

Increased funding is required. There is reportedly a £5.6 billion gap in the funding required to cover environmental gains, challenges facing the food system, an integrated response to net zero and local community benefits. But funding does not have to be the sole responsibility of government. Three per cent. of private financing mobilised under the 2018 Paris agreement went into adaptation, with more than 95% going towards mitigation. Adaptation will increase resilience, benefiting businesses and financial institutions, as well as nature and people.

The UK needs a clear vision for the role of nature-based solutions. They can be measured and monitored for their effectiveness by using defined metrics, indicators and targets, and standards can be set for high-quality nature-based solutions, benefiting nature, our environment and people. They need to be utilised.

I thank my hon. Friend for calling this debate. She is a doughty champion for her constituents, who are very lucky to have her represent Hastings and Rye. On her point about metrics, clearly consumers want to invest in and buy products that are nature positive and that support biodiversity. At the meeting of the all-party parliamentary group on environmental, social and governance, which the Minister was at, we talked about placing a green tractor on everyday products—it would be an equivalent to the Red Tractor mark—so that people would know that they were buying British products that are aiding biodiversity in the UK and helping restore nature. Does my hon. Friend think that is a good way of encouraging the public and business to get behind a nature-positive solution in the UK?

I thank my hon. Friend for a very good question. He is right: the public do really appreciate it and really understand the need for biodiversity. A very good message has been sent out, but the green tractor route really highlights the importance of biodiversity on the goods that people buy. I think it would be a really good measure to take forward.

We have a window of opportunity to take action to adapt to climate change and avoid the worst impacts, and political commitment and follow-through across all levels of Government to accelerate the implementation of adaptation actions is vital. I believe that the Government have the will to do this. Climate change will increasingly cause extensive, sometimes irreversible, damage to ecosystems. This degradation of ecosystems increases the vulnerability of people. The rise in weather and climate extremes has led to some irreversible impacts, as natural and human systems are pushed beyond their ability to adapt.

Nature-based solutions offer opportunities for cost-effective adaption to climate change, while also providing benefits to people and wildlife. Safeguarding biodiversity is fundamental for climate-resilient societal development. Conservation, protection and the restoration of land, freshwater and coastal ecosystems, together with targeted management to adapt to unavoidable impacts of climate change, reduces the vulnerability of biodiversity to climate change and benefits us all now and into the future.

There are something like nine speakers and we have 38 minutes left, so I ask Members to take approximately two or three minutes each, please.

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate the hon. Member for Hastings and Rye (Sally-Ann Hart) on securing this debate.

The world is facing a global biodiversity crisis triggered by human disruption to nature and the destruction of habitats. Members across the House know the seriousness of the challenges we face, but we also know we are nowhere near where we should be given the critical condition our nature is in. One million species are at risk of extinction due to human activity, but it is not only individual species that are threatened. The collapse in the abundance of nature also means that many of our ecosystems are not functioning as they should. Climate change is driving nature’s decline, and the loss of wildlife and wild places leaves us ill-equipped to reduce carbon emissions and adapt to a changing climate. We must recognise that the climate and biodiversity emergencies are intrinsically linked and should be tackled together.

Britain has faced a catastrophic loss in its biodiversity, with 41% of species having declined in abundance in the UK in the past 40 years. Of the G7 countries, we have the lowest level of biodiversity remaining. Immediate action is required to reverse current trends. The biodiversity crisis requires greater ambition. I ask the Government to reconsider the ambition of their biodiversity and environmental targets. In my constituency, Cheshire West and Cheshire Council, along with local communities, schools, businesses and partners and other organisations, are committed to making Chester a greener city and to building a community that people want and are able to live in now and in the future.

We must see a more ambitious approach to nature recovery, with local communities at its heart. The success of a nature recovery corridor in my constituency, led by community groups and guided by conservation experts, is an excellent example of how this can work in reality. Does the Minister agree that conservationists around the UK, such as those at Chester zoo, are in prime position to empower local people to help tackle the biodiversity crisis? Will she comment on what concrete plans the Government are making to commit to more ambitious biodiversity and environmental targets? We cannot put this crisis off any longer, and we must work together to protect and recover our global diversity.

I welcome this important debate. It comes at a brilliant time. Only yesterday the Prime Minister set up the Department for Energy Security and Net Zero, which builds on the Government’s commitments in recent years to all those who live in the UK and around the world. Such an important development is welcome—and so soon after the publication of the Skidmore review on net zero. As I say, the formation of this Department is a clear commitment to caring for our planet and taking our responsibilities seriously to match and build on the commitments the Conservative Government have made since we legislated for net zero in 2019.

In this debate, we are recognising the critical role of biodiversity and nature-based solutions. We need to match our efforts to deliver decarbonisation with our efforts to recover nature and biodiversity. It would be a tragic shame to reach net zero but not reach our commitments to recover nature, which is why this debate is so timely and important. It can be done. We worry about food security and production in relation to nature recovery, but I believe there is no conflict—they can be done together and, in fact, they are co-dependent.

My hon. Friend is making a powerful argument. I completely agree; there can be no conflict between delivering the food production we need and reinvesting in the biodiversity we need. Does my hon. Friend not agree that the key to ensuring that there is no conflict is investment in new technology, which is something the Government need to look closely at?

I agree completely. Time and investment must be given to ensure that those technologies actually get to market and are commercially viable. I would go beyond that: it is about not just technology, but treating our land differently. A brilliant example of that in Cornwall is our use of herbal leys, which my hon. Friend will be familiar with, to increase the quality of the root structure of the grassland and retain moisture. There are all sorts of ways of providing better grazing land for cattle. It is certainly about devices and technology, but it is also about different ways of caring for the land from which we produce our food and which sequesters carbon.

I recently secured a debate in support of the nature and climate declaration, which embeds nature recovery in the road to net zero. The Climate and Ecology Bill is a natural instrument to build on this necessary approach. I am sure we will all be hearing more about how that Bill intends to deliver on the key things that were raised this morning by my hon. Friend the Member for Hastings and Rye (Sally-Ann Hart) who opened the debate. I will leave it there.

It is a pleasure to serve under your stewardship and oversight, Mr Gray. I congratulate the hon. Member for Hastings and Rye (Sally-Ann Hart), who made an excellent speech, on securing what is a really important debate.

In the two minutes I have, I want to talk about the uplands. They are massively important to us as a country and hugely important to our communities in Cumbria. They can be a massive contributor to our fight against climate change. They are where we see water management happen; 70% of our drinking water comes from the uplands. Think of the peatland and soils there, which are vital to carbon sequestration.

Very quickly on that point, the Somerset levels near my constituency contain 231 square miles of peatland, which store nearly 11 million tonnes of carbon. Every pound invested returns about four times that in economic and social benefits. The commitment to peatland restoration in the England peat action plan covers less than 20% of England’s peatland.

Order. Interventions must be brief.

Does my hon. Friend agree that we need better targets?

I am grateful for the intervention. Peatland is hugely significant. It is more quickly restored than woodland and therefore has greater capacity to tackle climate change as a carbon sink. Our uplands are critical. While I support the principles underlining the environmental land management schemes and the transition payment for farmers, I think the ELMs at the moment have badly let the uplands down.

I will give you some quick figures, Mr Gray. The current basic payment rate for the uplands is £240 per hectare. With the new sustainable farming incentive, the rate for the lowlands is down to £151 per hectare; for the uplands, it is £98. Why is that? There are many things we have lost from being outside the EU, but one thing we have gained is the ability to not continue the nonsense of providing support for farming through income forgone. The idea that we compensate farmers only for what they might have got out of that land use, had that been for food or other production, rather than giving them the actual value of what they do is a nonsense. I urge the Minister to do away with income forgone as a way of calculating the payment rate and stop the system that actively penalises farmers in the uplands.

I mentioned the value that the uplands can provide in the fight against climate change and the need to value biodiversity in such an important part of our country. We must also remember how important they are to the landscape—and the economy—of the lakes and the dales. There are 60,000 people who owe their jobs to the hospitality and tourism industry in Cumbria, and we have a £3.5 billion tourism economy.

Based on what the Lake district and the Yorkshire dales look like, it would seem wrong for the Government to—I hope—accidentally transform in a negative way the landscape of our communities, particularly in the lakes. My major ask is that the Minister reconsider the payment rates for the uplands so that we can value our upland farmers and tackle climate change in our most beautiful places.

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate my hon. Friend the Member for Hastings and Rye (Sally-Ann Hart)—an excellent MP—on securing this important debate. I welcome the environmental improvement plan from the Department for Environment, Food and Rural Affairs, although you will be delighted to know that I will not read all of it. It follows the Environment Act 2021, the Fisheries Act 2020 and Agriculture Act 2020 in laying out a path to improve our environment and to make this a better and more prosperous place for us and our wildlife.

Hedgerows are the perfect example of how the environmental improvement plan will positively impact climate change and boost biodiversity. As a hedgerow hero, I am proud to have worked with the Campaign to Protect Rural England to increase hedgerow coverage by 40% by 2050. The environmental improvement plan announced the target of 30,000 miles of new and restored hedgerows by 2037, and 45,000 miles by 2050. That will result in 360,000 miles of English hedgerows—10% above the 1984 peak. Hedgerows are a classic symbol of the English countryside, providing a sense of continuity across the changing seasons. They also provide biodiversity’s best friend—a stable home for a bounty of flora and fauna. One in nine of the UK’s most vulnerable species, such as the hazel dormouse, the hedgehog and the brown hairstreak butterfly, rely on healthy hedgerows.

Hedgerows also play a crucial role on our path to net zero. We all know that planting trees and protecting peatlands are key to capturing and storing carbon, but so are hedgerows. Unmanaged hedgerows are estimated to sequester over 140 tonnes of carbon per hectare, compared with 169 tonnes for a 30-year native woodland. If hedgerows are properly managed, they can sequester even more, both in their woody stems and in the roots below.

Strong hedgerows with healthy root systems also aid soil health and reduce flooding. Farmers recognise those benefits, and more are planting and restoring hedgerows. Some 86% of farmers believe that hedgerows are important to them and their business, recognising the benefits of developing a healthy and sustainable natural environment for their land and livestock. Last month’s ELMS announcement of the establishment of a hedgerow standard in the sustainable farming incentive scheme in 2023 was a welcome step.

As we go forward with our environmental improvement plan, it is vital that we continue to support farmers as they invest in sustainable practices. Leaving the EU has given us the freedom to move beyond the basic payment scheme to support farmers in a more targeted manner.

The Retained EU Law (Revocation and Reform) Bill gives us only until December 2023 to adopt or adapt 570 different pieces of legislation on environmental issues. Given the crises that we face, does the hon. Lady agree that we need to strengthen some of those laws rather than simply retain them?

As is so often the case, I need to correct the hon. Gentleman on the details of that legislation. We do not have to stop everything in 2023; there is an opportunity within the sunset clause to extend legislation beyond that point. Like my Conservative colleagues, I will continue to work to ensure that our environmental protections are strengthened and not reduced.

Order. We are outside the scope of the debate.

To come back to biodiversity and moving towards net zero, it is important that we boost our biodiversity to strengthen our rural economies. So many steps that we have taken, which are laid out in the environmental improvement plan, are key to that. It is fantastic that, as part of the plan, DEFRA recognises the importance of supporting green jobs and careers with apprenticeships across forestry, ecology, countryside management, the water environment and more, especially given that this is National Apprenticeship Week.

As we face more frequent extremes of climate change, we need to ensure that our natural environment is healthy and our relationship with it is sustainable. By doing what we can, we will support biodiversity and harvest the gains that the countryside provides on our path to net zero.

It is a pleasure to serve under your chairmanship, Mr Gray.  Climate change is an absolutely huge subject and massively important, particularly for our children’s and grandchildren’s futures. It is really important to Stroud, because we are the greenest constituency in the greenest county in the country, and people passionately care about this issue.

I have tried to focus on a few campaigns, such as creating a GCSE in natural history. I have also focused on wetlands and biodiversity, so I was really pleased to have the Minister visit us last week at the Wildfowl & Wetlands Trust in Slimbridge, which is the headquarters of the WWT. We got to show off our wetlands, show her all six varieties of flamingos and introduce her to Mr James, who is 70 years old.

I will get my asks in first, because I know we are short of time. As we explained last week, the first is for Ministers to work with the APPG for wetlands, which I chair, to reach our ambition to create 100,000 additional hectares of wetlands in the country. The second is for them to lead investment in natural flood management. We can do that through local authorities having a better strategic approach, through setting targets and through funding with blended finance options.

My third ask is for Ministers to assist us to develop the saltmarsh code, which is really important. As the hon. Member for Bristol East (Kerry McCarthy) pointed out, we want to get private investment into this work. To be fair to companies, they get a really hard time: if they do something, they are told they are greenwashing; if they do not do anything, they get into trouble. We want to put evidence behind what we are asking them to do, so that they can be confident when they are investing, and that is what our code will achieve.

I would also like to see a specific domestic wetlands team in DEFRA, because we have amazing, brilliant experts who focus on things such as peatlands and biodiversity. I appreciate that wetlands cross a lot of these areas, but giving us that focus, with a team behind us, will ensure that we meet all our ambitions.

Wetlands play a key role in helping to tackle climate change. The issue of climate change gets a bit shouty sometimes, and very shouty at other times, but when I talk to the public about biodiversity and things such as wetlands, which they can see, they get it. For the benefit of hon. Members in the room, I should say that one of the conversations we had with the Minister last week was about the carbon benefits of forests. The Minister asked to the local experts, “How do the carbon benefits of forests compare with the carbon benefits of wetlands?” The experts’ response was, “They’re about 18 times better.” That is absolutely extraordinary. It is not something that farmers or the National Farmers Union understand properly yet, and we need to get the evidence so that we can back it up.

We can do great things. We can help to hit this country’s net zero targets if the Minister really puts her shoulder behind the APPG for wetlands and all my asks.

My hon. Friend is making as powerful an argument for wetlands as our hon. Friend the Member for Hastings and Rye (Sally-Ann Hart) did for nature- based solutions. Does she agree that we can square all these things? She has fantastic wetlands, I have some contaminated land where we can put a new wood and have some green energy, and down in Hastings and Rye there are all sorts of different solutions to protect the sea. It is about recognising the value of this great environmental plan and then implementing it, as my hon. Friend the Member for Stroud (Siobhan Baillie) has in her constituency.

I thank my hon. Friend, who is my near neighbour. We need to be creative, to be open to ideas and to work together in our fabulous constituencies. The focus from DEFRA is absolutely brilliant—the Government and the country do not get enough credit for the progress we have made on the environment—but with things such as those I have suggested, we can also help the public to see progress.

I congratulate the hon. Member for Hastings and Rye (Sally-Ann Hart) on setting the scene so well. I am a huge supporter of biodiversity and, where appropriate, rewilding. I declare an interest as a landowner and a member of the Ulster Farmers Union. A number of years ago, I made use of a scheme to plant saplings on the family farm, and we planted 3,500. That was many years ago, and the area is simply teeming with wildlife and various plants and foliage.

It is my sincere opinion that, for landowners to dedicate space to promoting biodiversity or rewilding, there must be schemes to make it worth their while. I know that that is not the Minister’s direct responsibility—it is probably another Minister’s—but I ask that she pass it on.

Given the price of saplings and seedlings, few landowners can afford to voluntarily plant trees at this time, but I know several who would if they had them and there was a scheme to incentivise that. This is not the Minister’s responsibility, but my local council back home—Ards and North Down Borough Council—has taken a very successful approach to rewilding. It has taken significant steps in the last couple of years to benefit our borough’s biodiversity by altering and reducing our mowing practices. That is something that councils can do without a lot of expense—they can reduce mowing charges and rewild. The council has rewilded 22,000 metres of closely mown amenity grasslands to managed grassland habitats, which are capable of supporting a much more diverse range of floral species, pollinators and insects—how important it is to have our bees and pollinators in place! My colleagues and friends down the road, Valentine and Chris Hodges, gave us some native Irish black bees and five beehives—they are still theirs, but they put them on our land, and that adds to biodiversity. Councils are keen to do that back home, and I am sure that the Minister will endorse that.

The council needs to have public understanding, and support is key to the success of the project. Interpretive signage is part of that as well. Studies have shown that, as well as the biodiversity benefits, conversion from species-poor to species-rich grassland can significantly increase the soil carbon sequestration rate. In addition, a significant reduction in carbon dioxide emissions as a result of less frequent grass cutting—that is the key issue in what the council is doing—has reduced the council’s carbon footprint. That is one thing that can be done.

In conclusion, I know that there would be greater buy-in if tree planting was financially possible. Will the Minister therefore tell us whether consideration has been given to funding schemes that would allow for free plants and shrubs to be given to people? That would allow more people to perhaps look at that wee square in their back garden not as an extra piece of mowing to be done, but as a chance to help our environment.

I thank and congratulate Back-Bench colleagues; we have got a great deal into a short space of time. Thank you all for being so prompt and courteous. We move to the Front Benchers, with John Mc Nally.

It is always a pleasure to serve under your chairmanship, Mr Gray. I thank the hon. Member for Hastings and Rye (Sally-Ann Hart) for securing this important debate.

As our climate worsens, it continues to negatively affect our biodiversity and threaten the stability of our natural world. The issues that arise from that are inextricably linked to many of the challenges we face as a society, and it is impacting our health, wellbeing and prosperity. Given those growing threats, it is about time that the UK Government stepped up and joined Scotland in leading the world on the frontlines of tackling climate change. We must work together as we prepare for the worst effects of the climate catastrophe.

Climate change is simply an issue of justice; it disproportionately affects the most vulnerable communities and nations. Scotland was not only the first country in the world to declare a climate emergency, but the first to introduce a climate justice fund. That fund was set up to help the developing countries most at risk to tackle the effects of climate change on the frontline. Fulfilling our role in tackling the global climate emergency is simply a moral obligation. The climate justice fund was trebled to £36 million over this Parliament, in stark contrast to the espoused global Britain led by a Tory Government who would seemingly rather cut international aid. The Scottish Government believe that a just transition is at the heart of our nature recovery ambitions, which are focused on nature-based solutions that create a greener, fairer and more prosperous nation for all.

Meanwhile, the UK Government do not seem to believe in their own consultations. In March last year, a UK Government consultation produced a legally binding target to increase tree canopy and woodland cover from 14.5% to 17.5% of England’s total land area by 2050. That target was set to help to meet net zero ambitions by 2050 and provide many other benefits, including the creation of new wildlife habitats and a reduction in flooding by slowing the flow of water off hills—all admirable ambitions. Despite that, DEFRA decided to cut the target to 16.5%, claiming that a “review of our evidence”—from its own consultation—now showed that the lower figure was “the most ambitious target” that could be set. One per cent. may seem trivial, but that equates to a reduction of over 100,000 hectares in the total area to be planted by 2050 and, significantly, to an enormous 37 million fewer tonnes of carbon dioxide being removed from the atmosphere by the end of the century.

In response to the target being cut, DEFRA upped its recommended ratio of conifers in the overall tree-planting mix. Foreign conifers make much poorer habitats for wildlife than native broadleaf trees, but they grow more quickly and, in the early years, can store more carbon. However, even with the additional conifers, the 16.5% woodland target would still leave 1.9 million tonnes of CO₂ in the atmosphere by 2050.

It is no surprise to me and other interested parties that 75% of all the new woodland trees planted in the UK were planted in Scotland. That is more evidence that Westminster should follow the Scottish Government’s lead if it wants England to meet decarbonisation targets and put in place biodiversity protections.

In January 2022, the House of Lords Science and Technology Committee published its report on the role of nature-based solutions in mitigating climate change and achieving net zero by 2050. It argued that, although the Government’s plans for nature-based solutions were “ambitious”, they were at “severe risk of failure”. In addition, a report published in October 2022 by the House of Lords Environment and Climate Change Committee stated:

“Behaviour change is essential for achieving climate and environment goals, and for delivering wider benefits. The Government’s current approach to enabling behaviour change to meet climate and environment goals is inadequate to meet the scale of the challenge.”

Will the UK Government finally take heed, work with the Scottish Government and commit to restoring nature and decelerating the climate crisis?

In December 2022, the Scottish Government published the draft biodiversity strategy for Scotland, which set out what our natural environment needs for us to halt biodiversity loss by 2030, reverse it with largescale restoration by 2045 and protect our environment for the future. As part of that, the Scottish Government have made significant funding commitments to protect and restore biodiversity. That is important, and it includes the establishment of a nature restoration fund, which will provide at least £65 million over five years to support large-scale natural restoration. The Scottish Govt have also committed an additional £500 million towards the natural economy over the course of the Parliament.

I will finish by saying that if we want to change the world, we need to get busy in our own little corner, and I believe that the Scottish people and the Scottish Government are doing just that. I would like Westminster to follow that lead.

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate the hon. Member for Hastings and Rye (Sally-Ann Hart) on securing this important debate. I commend Back-Bench colleagues on their brevity, and I will prune my speech in a suitably nature-friendly way to fit into the time. I congratulate my hon. Friend the Member for City of Chester (Samantha Dixon), who praised her local organisations for seeking to green their city. I strongly commend them on their nature recovery corridor.

It is almost five years ago that the House of Commons approved Labour’s motion declaring a climate and nature emergency. Sadly, the acknowledgment of that twin emergency does not seem to have galvanised the Government into the kind of response that many hoped for. We all know that we must halt and reverse the loss of biodiversity by 2030 for the benefit of all people and the planet. However, I am afraid that the Government’s actions often seem to take us in the opposite direction, whether it is flirting with fracking, seeking to reopen coalmines or letting off the hook oil companies profit from the misery of war.

The Government are also threatening to allow 1,700 or so environmental regulations to fall under the retained EU law bulldozer. They breached the statutory deadline for setting Environment Act 2021 targets and watered down those they eventually did set. Five years into the 25-year environment plan, not one of its 23 targets was assessed as being on track by the Government’s own environmental watchdog. Frankly, the verdict of the Office for Environmental Protection and its chair, Dame Glenys Stacey, was completely withering.

As many have pointed out already this afternoon, our natural carbon stores—peatlands, trees, woodlands, salt marshes and wetlands in particular—are in decline; indeed, they are at high risk of degradation in the extreme climatic conditions that are, sadly, likely over the next 30 years. Wetlands in particular can accumulate carbon for centuries, but in some areas of the UK we have lost over 90% of our wetland habitat. As the hon. Member for Stroud (Siobhan Baillie) pointed out, restored wetlands provide rich habitat, clean water naturally and reduce flood risk downstream.

Will the hon. Member give way?

Given the time, I will not; sorry.

We do not believe that the current ambitions to halt the decline of species abundance in the UK are good enough. Frankly, the latest targets are too weak. We must be nature-positive; we should aim for a dramatic incline in species abundance. Nature fundamentally underpins human health, wellbeing and prosperity. By delivering for the planet’s nature, we also deliver for its people, and Labour has always understood the importance of viewing the environment through this twin lens. That is especially important now, as we live through the worst cost of living crisis in a generation.

We need to consider those living in communities plagued by dirty air and water, and acknowledge that disadvantaged communities are disproportionately impacted. These communities are also twice as likely to be neighbourhoods without nature-rich spaces. We want to see a UK in which everyone has proper access to wild places and wildlife. A healthy natural world and more equitable access to nature are key priorities for Labour.

We also understand the importance of doing our fair share to cut UK emissions, in order to try to keep global heating down. Our shadow Secretary of State for Climate Change and Net Zero, my right hon. Friend the Member for Doncaster North (Edward Miliband), has been clear on this, and the shadow Chancellor, my right hon. Friend the Member for Leeds West (Rachel Reeves), has pledged an investment of £28 billion every year until 2030 to tackle the climate and nature crisis, and to create clean, green and secure jobs for people in the UK.

In conclusion, we recognise that this is a cross-Government challenge that needs focus from all of Government, so we have committed to a robust net zero and nature test for every policy, to create certainty for business and provide leadership to seize the opportunities for the UK, while protecting nature here and abroad. It is a historic challenge, one that we absolutely have to meet, and Labour is determined to do just that.

It is an absolute pleasure to serve under your chairmanship today, Mr Gray, and a real pleasure to listen to my colleagues speak so positively about nature-based solutions, including wetlands, hedgerows and upland farming. However, I have to agree with the hon. Member for Westmorland and Lonsdale (Tim Farron), my constituency neighbour, that Cumbria is the greenest and most pleasant county. Nevertheless, I must also say to my hon. Friend the Member for Stroud (Siobhan Baillie) how beautiful her constituency is, in particular her wetlands at Slimbridge, which was the very first of the Wildfowl and Wetland Trust’s fantastic sites that I have visited; I will say more about it later.

The debate today has been so positive, or mostly incredibly positive, and I start, of course, by thanking my hon. Friend the Member for Hastings and Rye (Sally-Ann Hart) for securing it. How timely it is, straight off the back of the environmental improvement plan, which we published just last week.

I was really pleased to see that plan on the desk in front of my hon. Friend the Member for North Devon (Selaine Saxby) and to hear her speak so enthusiastically about hedgerows, because I recognise the value of hedgerows. I also recognise her value, as our very own parliamentary hedgerow hero, who champions the benefits of hedgerows for nature and carbon sequestration. Personally, I would emphasise their benefits for foraging, too, because a wonderful pie can be made from the brambles found in a hedgerow, as well as many other tasty dishes. However, I will return to the substance of the debate.

We absolutely recognise the urgency of climate change. Although we are accelerating our efforts to end our contribution to climate change, we must also continue to take action to ensure that the country is well prepared to face the challenges that the changing climate is bringing. Reducing emissions is key to reducing climate impacts in the long term and our policies to support net zero are crucial. However, climate change-related events, such as droughts, flooding and wildfires, are already impacting the natural carbon stores that we rely on to achieve net zero. We know that our country and our world is going to become hotter, drier and wetter, and that the impacts will be colossal. Our third UK climate change risk assessment, published last year, highlighted the risks and opportunities facing the UK from climate change. There are risks to all sectors of our economy, including the natural environment. We are addressing these through the third national adaptation programme—NAP3—which my hon. Friend the Member for Hastings and Rye mentioned. That will be published later this summer. We are working with many other Departments to produce the report.

Adaptation is mainstreamed across Government. All policies and programmes need to consider the risks that climate change poses to their success and build in adaptation actions to reduce these risks. Those are all brought together in NAP3, which looks at the 63 risks. NAP3 actions include restoring and creating new habitats for general resilience, as well as targeted actions, such as protecting species that will be particularly vulnerable to climate change. I have just been handed a note to say that I have confused my numbers. I said the number of risks was 63, but we are actually currently monitoring 61 risks in the national adaptation plan.

Many of these actions will be delivered through the environmental land management schemes. I want to thank my hon. Friends the Members for St Ives (Derek Thomas) and for York Outer (Julian Sturdy), and the hon. Member for Westmorland and Lonsdale for recognising the value that farmers will bring to the nature-based solutions we will need for adaptation. We can deliver this through environmental land management schemes, be that countryside stewardship plus, the sustainable farming incentive or landscape recovery.

To respond to the point by the hon. Member for Westmorland and Lonsdale about how we are going to look after the upland farmers, as an MP representing many upland farmers it is critical that we do. We have an opportunity now as we leave the common agricultural policy to move away from an area-based scheme and toward much more targeted support created by England’s politicians for England’s farmers. It is very much more targeted to environmental stewardship and those three schemes.

I am really grateful to hear the Minister say that. We differ on Brexit, but I think one of the silver linings of leaving the European Union is that we can construct our own policy and are not stuck on the old forms of income forgone as a way of paying farmers. Would she look again at the upland rate for the sustainable farming incentive, because that is what at the moment is going to push many hill farmers out of business altogether?

It will come as no surprise to the hon. Member that I am challenging how we best support our upland farmers. I am from a farming family myself and live in a farming community. In the Lake District national park I see how hard our farmers work. They are the original friends of the earth. They have created our countryside for our enjoyment, particularly across the national parks and areas of outstanding natural beauty. The hon. Member can be assured that I will continue to champion farmers while also reviewing policy. While the environment is important, farmers also need to be able to thrive and survive.

The Minister mentioned 61 risks, but does she worry, like I do, that low uptake of ELM schemes could be one of those risks? Or are there actually 62 risks?

It is absolutely the case that we need as many farmers as possible to take up ELM schemes, but from the discussions I am having in my constituency and with the Minister for Food, Farming and Fisheries, my right hon. Friend the Member for Sherwood (Mark Spencer) in DEFRA, and from the pilots we have undertaken with the sustainable farming incentive, we are optimistic about farmers taking up the schemes, but we will constantly look at them to make sure they are as attractive as possible to farmers, while also ensuring we provide best value to the taxpayer.

The Minister is being very generous. It is very important that farmers are incentivised, because they are the custodians of the land. They want to do better. Let us be quite clear about that. The thrust of the debate shows—and hopefully the Minister agrees—that incentivising farmers is how we can help them to achieve those goals.

Absolutely. There is no other industry or sector where knowledge and experience is passed down the generations as it is in farming. As a farmer himself, the hon. Gentleman will know that only too well.

There will also be adaptation benefits from the new England-wide system of local nature recovery strategies. That is how farmers can come together to create wildlife corridors. I really did disagree with the spokesman for the Scottish National party, the hon. Member for Falkirk (John Mc Nally), because doing this in our own corner just will not cut it. I can talk about the importance of the UK on the international stage and the success of the Secretary of State in encouraging countries right across the globe to protect 30% of their land and seas by 2030 and a whole raft of other measures. The climate sees no boundaries and we need to work together. I, for one, am looking forward to meeting with my counterpart in Scotland.

Local nature recovery strategies prioritise actions to drive nature’s recovery. Part of our work on adaptation is to make net zero policies resilient to climate risks, for example, by planting tree species that will cope with future climate conditions in their location; through ensuring nurseries are stocked with a high-quality, diverse range of species; and by ensuring that land managers have the right tools to make decisions for the future.

The hon. Member for City of Chester (Samantha Dixon) demanded more action. I thought it would be appropriate to set out what we have already achieved because that is sometimes forgotten. We have already put in place legislation, backed by action, to address the concerns that have been raised. That includes a suite of ambitious statutory environmental targets under the Environment Act 2021. Let us not forget that we were one of the first developed countries to legislate for net zero and then we set out the 25-year environment plan. Although all of those targets will help us to adapt to climate change, particularly relevant ones include: ensuring that species abundance in 2042 is greater than in 2022, and at least 10% greater than in 2030; and restoring or creating over 500,000 hectares of wildlife-rich habitat outside protected sites by 2042, compared with 2022.

Restoring our natural habitats has numerous benefits for helping communities to adapt to climate change risks: natural flood management, urban cooling and supporting the resilience of ecosystems to climate change. As part of our commitment to a nature recovery network, in May 2022, we launched five unique nature recovery projects spanning nearly 100,000 hectares. They will see the creation and restoration of wildlife-rich habitats, corridors and stepping-stones. They will help wildlife populations to move and thrive, provide nature-based solutions and enable people to enjoy and connect with nature. One of the more recent pledges in the environmental improvement plan is that no one should live more than 15 minutes away from nature—a green space or a blue space.

The debate is about climate change, as opposed to just climate change adaptation. I appreciate that adaptation is in the DEFRA brief, but I am a little concerned that there does not seem to be that joined-up thinking about the importance of nature-based solutions for climate change mitigation as well. Those can be incredibly powerful for carbon sequestration, whether that is wetlands or planting trees. Is the Minister talking to colleagues in the newly created Department for Energy Security and Net Zero about how to ensure that those two things work together?

I think, Mr Gray, that the debate is about the role of nature in adapting to climate change. I am prepared to stand corrected if I have got that wrong.

The debate is on “Climate Change and Biodiversity”, so I think we are all in order.

Jolly good. Yes, absolutely, I confirm that I speak regularly with my counterparts elsewhere in DEFRA, which has been one of the lead Departments, certainly for net zero, although the climate change national adaptation plan involves many Departments. However, mitigation is also a key priority in DEFRA, where I speak with colleagues, although it the direct responsibility of Lord Benyon.

Moving on to the point made by my hon. Friend the Member for Stroud, her request to look at a target of 100,000 hectares of wetland protected for nature was relevant. That is a worthwhile ambition, and I will certainly ask my team to look into how we ensure that we are sufficiently resourced in DEFRA to understand the benefits. She said that 18 times more carbon is sequestered in wetlands, compared with forestry, which is an impressive statistic. Wetlands not only store huge volumes of carbon, but act as natural sponges for floodwaters or as storm-breaks against extreme weather events. Furthermore, I have seen children and other people enjoying the wonders of wetlands, such as meeting the most marvellous Mr James.

That is important, and others referenced the importance of bringing society with us—I could not agree more. That is why goal 10 in the 262-page environmental improvement plan talks about ensuring that we work with people and communities to achieve what is absolutely necessary, as set out in the plan.

I have simply run out of time, although so much more could be said on the subject. I look forward to further debates on a whole raft of nature-based solutions, matters and the environmental measures that the Government are taking. I assure the House that we are committed to protecting nature, not just in England or the UK, but right across the globe. Nature sees no boundaries, and we are one of the very special places for migratory birds, as I learned at Slimbridge. We need to achieve our targets domestically, and to work with our counterparts across the globe. Finally, I again thank my hon. Friend the Member for Hastings and Rye for sparking such a wonderful debate this afternoon.

I thank the Minister for her response. Clearly, Members across the House, representing all parts of the UK, have left us in no doubt that biodiversity and nature-based solutions are vital to this country in the actions we take to mitigate the effects of climate change. I thank everyone for attending the debate.

Using biodiversity and nature-based solutions to adapt to climate change is key. I welcome the Minister’s understanding of the situation and the recommendations, and of our need to consider those and other policy measures by working closely with the organisations that are expert in the area on NAP3.

Question put and agreed to.

Resolved,

That this House has considered climate change and biodiversity.