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Westminster Hall

Volume 730: debated on Tuesday 28 March 2023

Westminster Hall

Tuesday 28 March 2023

[Sir Christopher Chope in the Chair]

25 Years of Devolution in Wales

I beg to move,

That this House has considered the matter of 25 years of devolution in Wales.

It is a pleasure to serve under your chairmanship once again, Sir Christopher.

Before I address the motion, may I speak on behalf of the House for the first time, and likely for the last time, in sending our condolences to the Welsh First Minister, Mark Drakeford, on the recent sudden passing of his wife, Clare? I never met Mrs Drakeford, but by all accounts she was a kind-hearted and compassionate lady, and I cannot begin to imagine how the First Minister and his family are feeling. I know that our thoughts are with them at this sad time.

I thank the Backbench Business Committee for finding time for the debate. I submitted the application last July in the hope of holding the debate in September. The eagle-eyed among us will note that although the debate is entitled “25 Years of Devolution in Wales”, the 25th anniversary of the establishment of the National Assembly for Wales—the Senedd—will be next May. However, 18 September 2022 was 25 years since the day of the referendum that brought about devolution and led us to this point. Sadly, the debate could not held then because of the sad passing of Her late Majesty. I am grateful to the Committee for finding time for the debate today.

As you well know, Sir Christopher, Wales is a small but proud country, with a unique identity and an unusual degree of political continuity. It ought to have been able to develop and introduce unique policies, implemented in ways that just were not possible prior to devolution. But the record goes to show that in so many measurable ways, devolution has simply not delivered in terms of its impact on the lives of our constituents. It is not good enough to keep blaming Whitehall 25 years on.

In the almost 25 years of devolution, Wales has fallen behind the rest of the Union in nearly all of its devolved policy areas, and has continuously fallen short on UK-wide priorities. Devolution has not resulted in a new form of politics, as proponents had hoped. Far from reinvigorating democracy, voters are underwhelmed by devolution.

What of the increased democratic representation that we were promised? The Assembly was established on a 50.2% turnout of the people of Wales, with an outcome of 50.3% in favour and 49.7% against. From a situation in which 25.3% of the people of Wales voted in favour of establishing devolution, Wales was thrust into a project of seismic proportions, which would change the constitutional make-up of the UK irrevocably. It is ironic that we had uproar and claims of illegitimacy about the recent 52% to 48% vote on the B-word, yet the 50.3% to 49.7% result, which has led to nothing positive in Wales, went ahead unquestioned and, crucially, with no subsequent assessment of whether it is actually working.

Since 1998, turnout in elections to the Welsh Assembly—subsequently renamed the Senedd at great but pointless expense—has declined continuously, reaching as low as 38.2% and never exceeding 46%. That woeful figure only goes to prove that voters have become apathetic and disengaged with the Welsh Government. Can we blame them?

My constituent Mikey Connolly pointed out to me recently that 23 out of the 40 Senedd constituency seats and three out of the five regional areas are covered by people who live in the Cardiff and Swansea regions. No matter what happens, or how bad things may get for people living in the remaining 75% of the country, even if every single one of those individuals voted for the same alternative party in every single election, Labour would never be voted out of power, so long as the majority of voters in Cardiff and Swansea are kept happy.

As Mr Connolly rightly asks,

“what incentive is there then for Labour in Wales to improve the quality of life of those in Mid and North Wales, or even create policies that adequately account for the vast differences in culture, population, needs and quality of life between the South and the rest of Wales”?

He is 100% correct: it is a flawed system that will leave the people of north Wales in particular with a permanent democratic deficit and feeling, as we already do, not like the poor relations, but like the forgotten relations.

The cost of the Senedd in 2021-22 was £62.9 million. There are proposals to increase the number of Members from 60 to 96, which would take an already inflated cost up by another £12.5 million, giving less value for money for the people of Wales time and again.

Recently, we saw a report saying that the buildings of the Betsi Cadwaladr health board in north Wales are only 62% operationally safe, with some £350 million needed just to bring existing structures up to scratch, without talking about any new ones. Now, the health board has been placed in special measures, which are special in name only, because this has been the case for the past eight years, with no noticeable improvement in service for the long-suffering people of north Wales. Had we not been paying the money for a devolved Administration for the past 25 years, we could have ensured that every one of our hospitals across Wales was properly maintained, not falling down around the ears of our dedicated and hard-working NHS staff.

Routinely in this Parliament, Labour MPs attack the Government on a range of perceived issues—rightly so; as Opposition Members, it is their duty to do that—but in Wales Labour has been front and centre since 1999, and failing to deliver since 1999. Since the advent of devolution, Welsh Labour has been virtually unopposed in government. Never having won an outright majority, Labour relies heavily on the support of Plaid Cymru and the Liberal Democrats, which are both seemingly as reluctant as Labour to accept the part they have played in mismanagement on a colossal scale.

Interestingly, on a visit to Llandudno last year, the Leader of His Majesty’s Opposition, the right hon. and learned Member for Holborn and St Pancras (Keir Starmer), said that

“a Welsh Labour government is the living proof of what Labour in power looks like. How things can be done differently and better… A blueprint for what Labour could do across the UK.”

What exactly does Welsh Labour have to show for almost a quarter of a century in power as a blueprint for the rest of the UK?

I want to examine some of the areas of life in Wales that have been devolved, and how they have developed and progressed over the period of devolution. First, let me consider the issue that is probably closest to most people’s hearts and most important in their lives—the health service. As we know, the Labour party in this Parliament relies heavily on scaremongering and unfounded soundbites such as, “Only Labour can save the NHS,” and, “The Tories will sell off the NHS,” while simultaneously going out of its way to ignore the scale of the crises in Wales, and pointing out everything that is wrong in England but never doing anything to fix the even worse issues in Wales.

I commend the hon. Gentleman for bringing this debate to the House, but I am aware that each region should have the opportunity to express its own ideas. I am sure he is not saying any different, but does he agree that the beauty of this United Kingdom is the ability to express our British strength through the lens of our individual nations, and that devolution and the ability for local issues to be determined locally by locally elected representatives are always goals that should be striven for? Will he join me in urging the Government to strive towards those goals, rather than the goal of appeasing the European Union, which we voted to leave, but which is determining the devolution process itself?

As always, the hon. Gentleman makes some excellent points. I agree with the sentiment of what he is trying to get to and trying to achieve, and that it is important for local areas and the regions to have their say on a hyper-local basis, but I am much more focused on outcomes. From my point of view, when we are having these debates and making decisions closer to home, the most important thing is whether people in those areas are benefiting from that process. I hope to go on to prove that they are not.

Especially in this place, we tend to get a little caught up on process and form, and on how we do things. We do not necessarily focus on what we have done, what the outcome is, and how that benefits the people we are here to serve. The hon. Gentleman’s points are well made. I hope I can show that devolution is not necessarily working in the way that it should. Hopefully we can improve it—let us see—but it is certainly not going exactly as it was planned.

Health boards are in special measures. As I mentioned, Betsi Cadwaladr University Health Board, which serves my Delyn constituency in north Wales, has been in special measures for eight years, except for a conveniently short period just before the most recent Senedd election. It was brought out of special measures in the run-up to the campaign period, despite there having been no actual changes, and then, interestingly, put back into a regime of targeted interventions shortly after the election. I am sure that was just a coincidence; I would not want to read anything sinister into that.

Labour’s rhetoric on the NHS hits closer to home than it would ever care to admit. Despite no modern-day Conservative Government ever having cut the NHS, Welsh Labour cut it in 2015. The King’s Fund expertly demonstrated that recently. It reported that under the Conservatives the NHS has had a budget increase of 39% in real terms since 2010, with planned spending for the Department of Health and Social Care in England at £180.2 billion. Welsh Labour has failed the NHS. A blueprint for what Labour can do across the UK? I hope not.

Secondly, Wales has the lowest achievement and poorest educational outcomes in the entire UK. Across the period, school spending per pupil has been consistently highest in Scotland and generally lower in Northern Ireland. In 2021-22, spending per pupil totalled £7,600 per head in Scotland, £6,400 in Northern Ireland, about £6,700 in England and £6,600 in Wales. Given the nature of the funding formulas, the funding in Wales should be a lot closer to that of Scotland because, for every £1 spent on services in England, there is around £1.20 for that service going to Wales—a significant uplift, yet Welsh schools are consistently underfunded. Again, Labour is turning its back on students and barely holding up an already struggling education system.

In 2019, it was discovered that out of the £2.5 billion earmarked for schools in Wales’s education budget, at least £450 million never even made it. Where has the money gone? It has been swallowed up by a wasteful bureaucracy and the inefficient spending that lies at the heart of devolution. That proves that Labour’s devolution plans were not fully thought through. A blueprint for what Labour can do across the UK? I certainly hope not.

Thirdly, in a 2019 Cabinet meeting the Welsh Government declared a climate emergency. It was not a priority—they just slipped it in under any other business at the end of the meeting. No real policy action was ever taken. In fact, their preservation of the natural environment is also flawed. In October 2018, Labour AMs voted against stopping the dumping of nuclear mud in Cardiff bay. They failed to invest in proper flood defences. They presided over a 28% increase in cattle slaughtering at the end of August 2019 due to a rise in bovine tuberculosis, causing huge damage to our agricultural sector.

Finally on the environment, a 2018 Senedd research briefing found that pollution was causing 2,000 deaths a year in Wales. Imagine pollution causing deaths in Wales, a land of nothing but fields, trees and wide open spaces. It beggars belief. Despite the UK as a whole being the fastest decarbonising nation in the G7, and despite Welsh Labour’s trumpeting—quite rightly—the amount of recycling done in Wales, Labour has cut carbon emissions in Wales by only half the rate of the UK. On climate and the environment, devolution has categorically failed. How can Welsh Labour be so far behind UK targets and still blame Westminster for its failings?

I will move on to housing, which is immensely important to my constituents and communities across Wales. As recently as the 2019 general election, the leader of the Labour party, who leads the official Opposition to the Government in Westminster, pledged 100,000 new council houses every year. It sounds like a wonderful figure, but we have to remember that the Welsh Government, under Labour management, released data detailing a meagre 57 builds by local authorities in 2019. I am lucky enough to say that 39 of them were in my constituency—but still.

Data from the National House Building Council confirms that, in 2020, there were 125 new homes built in my constituency. In 2021 there were 109, and in 2022 there were a massive 42 new houses. Bearing in mind that those are all new-build private properties rather than social housing, where are all the houses that the Leader of the Opposition pledged would be built under Labour? The Welsh Government have every opportunity to build them in Wales, but they do not materialise. Concurrently, there has been a 45% increase in rough sleeping in Wales under Labour. A blueprint for what Labour can do across the UK? I hope not.

When we delve deeper into the management of the Welsh economy, we see the failure of devolution for voters in Wales. Some £157 million has been wasted on reports and reviews on the much-needed M4 relief road in Newport—a policy that was shelved by the Welsh Government in 2019, despite the astonishing amount of money spent on it. If south Wales had that relief road, it would ease congestion and unlock a new era of opportunities in the area, allowing more people to travel in and out of Wales to work and set up businesses.

Other Members will know much more about that than I do, given that I am from north Wales, but there is a similar situation in the north, with millions of pounds having been wasted on new road plans—red routes, blue routes, purple polka-dotted routes and all sorts of things, such as compulsory purchasing of properties and unfinished road-building projects. I used to refer to one of the Welsh Government’s previous Ministers for the Economy and Transport as the “Minister for Documentation”, as his Department seemed to produce report after report, study after study and consultation after consultation, but never actually did anything to improve things in north-east Wales.

On the subject of business and transport, the Welsh Labour Government and Plaid Cymru want to deliver a hammer blow to our vital tourism and hospitality sector with a tourism tax for Wales. Just when the industry is building back from the pandemic, it needs our support, not to be punished. Thousands of jobs are at risk if we do not stop the tax on tourism. Opposition from the Wales Tourism Alliance and others, including over 400 responses from the tourism industry, has been completely ignored by the Welsh Government, which is frustrating the industry, as it continues to be sidelined and ignored. It is just not good enough. My constituency of Delyn in north Wales relies heavily on our tourism industry, and the Welsh Labour Government’s tourism tax proposals will be a tax on Welsh hotels, Welsh hospitality and Welsh jobs at a time when we need to be taking measures to tackle our cost of living crisis, not to contribute to it.

The Welsh Government are rolling out a 20 mph speed limit across Wales, which will—pardon the pun—slow the economy even further. It denies local bodies the ability to make policy decisions affecting their community on a more local basis, not to mention that the roll-out will cost over £32 million and increase emissions. It is just a bizarre policy.

The correlation between increased legislative powers and decreased political engagement is a sign of resentment and apathy, and it is incredibly disappointing compared with the rest of the UK. The Welsh Government seem hellbent on the ideals of high tax and state expansion, when they have been failing in Wales for a quarter of a century.

Every week we sit on the green Benches for Prime Minister’s questions as Opposition Members shout, “You have been in charge 13 years; why haven’t you changed anything?” The Welsh Government have been in place for nearly 25 years, with nothing but downward spirals and declining services, but that is okay, they never shout about that. They are not here today, interestingly, to shout that the Senedd is not doing its job, but they are more than happy to yell across the Chamber at the UK Government.

The Welsh Government’s insistence on raising council tax by pulling those on lower incomes into higher council tax bands, and their decision to pursue a tourism tax, despite one in seven Welsh jobs relying on that sector, show why Wales is consistently failing on UK-wide priorities.

In education, the OECD and the PISA—programme for international student assessment—scores ranked Wales the lowest of all devolved members of the Union in every educational standards category between 2006 and 2018. Running with the same theme, our economic data make for challenging reading. Wales is unique with around 20% of the workforce relying on public-sector employment. That alone is not necessarily a bad thing, but considering that the private sector is equally reliant on Government, it is a harsher picture.

Subsidies and grants mask Wales’s real economic value, and suppress competition, innovation and entrepreneurship. Our micromanaged economy is stifling any chance of increased investment in Wales, which is crucial to any self-reliant economy. The Welsh Government’s inaction in tackling business rates continues to devastate the Welsh high street, where shop after shop has been boarded up and abandoned. To add insult to injury, in 2021 the UK Government provided Wales with the largest annual funding settlement since devolution began, but the mismatch between revenue and properly directed public spending remains a heavily unbalanced picture.

Indeed, only yesterday we found out that the Welsh Government, at a time when there are problems all over Wales with creaking public services, in the middle of covid had to give £155 million back to the Treasury, because they did not spend it in the correct financial year. They sat on £155 million in the middle of the pandemic, when that could—and should—have been used for improving our hospitals and our response to covid, along with other crucial infrastructure. That money was squandered by the Welsh Government. Devolution is failing the Welsh economy. A

“blueprint for what Labour could do across the UK,”

the Leader of the Opposition said. I do hope not.

Another sad but prime example of the Welsh Government’s recklessness with money is the purchase of Cardiff airport for £52 million in 2013. In March 2021, it was announced that the airport was being given another £42 million of taxpayers’ cash, while the £42.6 million that it already owed in debt to the Welsh Government was being written off altogether. That was a total spend of almost £100 million in nearly a decade for an airport that is said to be now worth £15 million, less than a third of what the Welsh Government paid for it 10 years ago.

We continue to be told that it will be used to connect Wales with the rest of the world. I have not found a single record of any current Welsh Government Minister having used it for foreign visits. It has cost the Welsh economy millions by failing to keep scheduled flights to Qatar in the middle east. An estimated £200 million of good taxpayer money has been completely and utterly wasted. It would have repaired almost the entire health board estate in north Wales.

As I have touched on the subject of the coronavirus pandemic, it is worth mentioning the abject failure of the Welsh Government, their handling of the pandemic and their outright refusal—inexplicably—to have a covid inquiry on the matter, safe in the knowledge that any UK-wide inquiry will secure media scrutiny only of the actions of the UK Government, and the decisions taken by Labour in Wales mean they will escape scot-free, so they need to answer almost nothing, despite repeatedly saying that every decision was specific and unique to Wales.

The exercise of a range of emergency powers that curtailed the liberty and closed the economy of Wales and its people was bad enough, but for the Welsh Government then to avoid accountability at all costs through an inquiry that focuses on how decisions were made has never been and will never be a tenable position. Under Labour, the fact is that Wales experienced the highest covid death rate per capita of all UK nations, despite a population density significantly lower than other parts, and economically cruel and unnecessary restrictions were imposed. Those measures must be properly scrutinised in an independent inquiry.

The First Minister went on social media at every possible opportunity, every time the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) was on the TV, and every time he said, “These measures are England only. The Prime Minister does not speak for Wales.” He kept on saying that. If he and the Welsh Government are so confident about their actions and the steps they took, why are they against their being examined in a Wales-specific inquiry? The very nature of devolution means that those in power are held accountable locally for the decisions made: ducking that is shameful and cowardly. That is what people will be saying, when the UK and Scottish leaders have ordered investigations into their own handling of the pandemic.

As discussions are being had by a noisy minority in support of more devolution and even the ludicrous notion of independence for Wales, we must all be bold enough to look at these failures and ensure that above all else, Wales is not handed more powers by this UK Parliament without proper scrutiny from this House. That is not to talk down Wales, as I will now doubtless be accused of doing; it is the harsh reality of the situation.

Wales is subsidised by England—it is. There is no point denying it or getting away from it. The total tax revenue in Wales is exceeded by far by the amount of spending there. The difference comes, quite rightly, from the UK Government, because we are firmly and comfortably part of a United Kingdom, but where do these shouters for independence think they will get the money to pay for everything? None of the public services in Wales work. Where will the funds come from for Wales to have its own courts, police, emergency services, welfare systems, state pension, defence, infrastructure and everything that an independent state would need? It is absolutely pie in the sky.

Whatever participants in this debate think, and wherever they sit on the political spectrum, as I mentioned to the hon. Member for Strangford (Jim Shannon), outcomes should be their priority. What makes the lives of the people in Wales better? The people of Delyn do not give two hoots about idealism or political shenanigans or things that go on in this place or in Cardiff; they do give two hoots about being able to put food on their table. They give two hoots about having jobs and opportunities, being able to provide their children with a better start in life and being able to rely on a health service to help them in their most difficult times.

Finally—hon. Members will be happy to hear—a short mention for the proposed expansion of the Senedd from 60 to 96 Members. I do not even know where to start. It is quite astonishing that an institution that already has 60 people for a country of 3.1 million—one for every 52,000 constituents—would need another 36 elected representatives. What is it going to do with them? England has 56 million people and 533 MPs. That is one for every 105,000 people: double what we have in Wales. London has almost 10 million people and the London Assembly scrapes by with just 25 members.

The ridiculous situation does not end there. Not only do those in favour want to add another 36 Members to the Senedd, but they want to further strip them of accountability. We currently have a bunch of constituency Senedd Members who are elected on a first-past-the-post basis, as happens here. We also have regional Senedd Members: some across north Wales, south Wales, central south Wales, west Wales and so on. They will do away with the constituency ones altogether—or kind of—and introduce a proportional representation system for the whole thing. We will not vote for an individual any more but for a party, and then the party will fill the seats it wins with whoever is top of its list. Each constituency will have multiple Members, and no people will be elected, only parties, with the seats filled from their internal lists. Call me a cynic, and something of a traditionalist—as I know you are, Sir Christopher—but I think that is an affront to democracy, as people will not be able to vote for the person they want and just have a bunch of people forced on to them by political parties without the first clue as to who they might be.

I have probably spoken for long enough. There is a great discussion going on in the Cabinet Office and the Department for Levelling Up, Housing and Communities about regional devolution deals across England. I caution hon. Members who call for increased localism in decisions that having those decisions made closer to the source does not automatically translate into better outcomes. If there is one thing we can learn from the failed devolution experiment in Wales, that is surely it. I have said it before and I say it again: it is my abiding hope that the Minister in his winding-up speech will confirm that there are plans to let the people of Wales have their say: not on whether there should be enhanced powers or more devolution, but on whether devolution should be allowed to carry on at all, so we can redirect the money wasted on a failed institution into providing better services for the people of Wales.

With all due respect, it shows how much value is placed on debating the institution and the issue that, sadly, virtually none of my Welsh MP colleagues are in the room to discuss the nature of the Senedd today—which is fundamental and one of the most important things to have ever happened in the lives of our constituents in Wales. That just goes to show the contempt that both the people in Wales and, potentially, the people in this House hold for the Senedd as an institution.

I really do not recognise a lot of what the hon. Member for Delyn (Rob Roberts) has laid out. One great thing about devolution is that there has been far greater transparency and that enables him to make some of his analyses. Every region and council in England has things that have not always gone exactly as they should, and which could have been done better. That is obviously the case for Wales as well. People are not always going to get everything right first time. They are not always going to do everything the best way. However, the point is that they are democratically elected and closer to their communities, and they have the opportunity to improve and change things.

I want to put on record the remarkable progress that Wales has made over the last 25 years. Setting up the Senedd—or the Assembly as it was then—from scratch and gaining greater powers has been done in a remarkably short time. Considering that we were faced with the consequences of a world banking crisis seven years after it was set up it has not been an easy time.

In Wales, we have the opportunity to use powers imaginatively and to do things differently. Right from the start, we in the Labour party looked at who was going to represent us. We decided to go for a twinning process and put constituencies together so that we would have an even number of Labour women and men standing for election in winnable seats. Too often, women were confined to less winnable seats. That provided a strong degree of gender equality in the Assembly, which coloured debate. Why is it that Wales led on childcare provision? We have had a strong tradition of women speaking up in the Senedd. Why is it that Wales spends more on social care? Why does it provide better social care and a living wage for all in the care sector? That has been delivered by the Welsh Labour Government because we believe it is very important. Why have those issues been raised? It is because we have more women taking part. There has been a real shift in focus, and a real determination to do things differently within the powers we have. We do not have all the powers, but we use them imaginatively. For example, how did we ban fracking in Wales? We banned fracking through the planning laws, because that is where we have powers.

In Wales, we have taken up long-term issues such as preventive medicine, the results of which will not be seen for a very long time. We were the first to bring in a smoking ban. Smoking is at record lows in Wales. That is good, but it will be years before the long-term benefits to health outcomes are seen. We have concentrated on the foundation phase of education. Again, it may be a considerable time before we see the full benefit of that investment because we are starting with the youngest children. We have a very innovative curriculum.

What is important about devolution is the closeness of the Administration and the Ministers to the people they serve. Time and time again, whether it is business groups, trade unions or stakeholder groups, people in Wales feel that they can access the Welsh Government. They can have meetings with Ministers or officials. They are involved in consultations.

Take the recent consultation on business rates. People have talked about reform of business rates forever and a day across the UK, but the Welsh Government have got on and started consulting. No one thinks that finding a solution will be easy because there will always be winners and losers, but the important thing is having the consultation and the fact that people in Wales feel they have an opportunity to contribute. A good example occurred during covid, when Julie James, a Member of the Senedd who was then in charge of local government, had regular meetings with council leaders across Wales. Even Opposition party leaders recognised the value of that: nothing was a shock for those councils. Local authorities were under stress, having to deliver everything during covid: providing school meals during lockdown, ensuring social distancing in the workplace and preparing schools for reopening, to name but a few—not to mention the delivery of the test and trace programme, which cost so much less and was so much more effective in Wales because it was delivered by local authorities who knew their people well.

The hon. Lady used the words, “far greater transparency”. I mentioned the covid inquiry; from what she is saying, in Wales, everything was run quite well and all the Ministers made excellent decisions. Is it not therefore incomprehensible that Wales should not have its own bespoke covid inquiry to scrutinise whether those decisions were actually as good as she is making them out to be?

I find that comment surprising from somebody who purports to want to save money. We can do what the hon. Gentleman suggests at one fell swoop, with one covid inquiry. It can have specific studies of what happened in Scotland, Northern Ireland and Wales; there is absolutely no reason why that should not be the case. The National Audit Office gave Wales a clean bill of health on the way it purchased personal protective equipment throughout covid, whereas we have seen some shocking figures on UK Government money that went astray, and some dreadful accusations of cronyism in who won various contracts; companies in my part of Wales missed out because their emails were never even opened by the Department of Health. I can cite one company that, despite being a trusted supplier to the Ministry of Defence, police forces and health service in Wales, did not even get a look in from the NHS in England.

Getting back to the point, the Minister in Wales talked to the leaders of local councils; they knew that councils were facing the stress of having to deliver measures under covid, so they made sure that councils knew what was coming down the line. That contrasted very sharply with what happened in England; leaders in the north of England found out that their whole areas were being put under covid restrictions literally a couple of hours before it was announced on local radio. That was an utter disgrace. The situation in Wales reflects what can be achieved in a more devolved situation, where people can have greater access. We cannot expect people to have that same sort of access in a UK Government situation, in which we would clearly be dealing with a much larger country. However, there could have been a great deal more co-operation on covid restrictions and with councils.

There was a shocking disregard for the powers of the devolved Governments during covid. They were often not apprised of what was happening at Cobra meetings and found out about things very last minute. There could have been much better consultation, much better dialogue and actual interaction on how things could be done better. The same situation was repeated in the United Kingdom Internal Market Act 2020; instead of constructing a situation in which there would be proper consultation and discussion, the UK Government pushed through legislation that effectively ignores devolution and rides roughshod over the devolution settlement.

That has likewise happened in the distribution of levelling-up funding and the shared prosperity fund. It is quite extraordinary, because nobody logical would ever think of missing out the Welsh Government when deciding how to use the levelling-up fund and the shared prosperity fund. The Welsh Government have been central in the distribution of European funding, and they already have established partnerships with the local authorities. It is absolutely bizarre; there can only be a political motivation. Nobody in their right mind would think of missing out a layer of Government as important as the Welsh Government when managing those funds.

The other thing that the Welsh Government are prepared to do is step in. Again, that is one of the benefits of their being close to people, and being transparent. A Government can step in when they can see what is happening and what is not going right. In Ynys Môn, for example, the Welsh Government stepped in because the local council was failing. The Welsh Government have stepped in with Betsi Cadwaladr. The important thing is that they are being proactive and getting in there. Nobody pretends that everything is perfect; the important thing is that a Government be prepared to act and do something. They should not wait 20 years for somebody to produce a report on how terrible things are, particularly with hospitals. It is important to get in there now and work with the people there to improve things.

I think the hon. Gentleman has said enough on that issue; I am going to have my say. Perhaps I will let him come in on another topic.

I will move on to the situation that we are in now. We are clearly facing a major climate crisis. What are the Welsh Government doing? We are moving forward. We are moving forward on renewables very quickly, and we have set up a company to help drive investment in renewables because we recognise the challenge. We also recognise that we have some of the heaviest and dirtiest industry in the UK, so we have an even greater challenge. Of course we in Wales will find it more difficult to reduce our carbon footprint than areas without those challenges will, but we are motoring ahead.

I want to draw the attention of the hon. Member for Delyn to the Advanced Manufacturing Research Centre in north Wales. The Welsh Government plan to encourage investment in it. Most importantly, the Welsh Government are trying hard to work with people in Wales; we are trying to consult them and take them with us. That is why we have had fewer strikes in Wales than in England. Railway workers have not gone on strike in Wales because they have already managed to agree something, whereas they have carried on with strike action in England. Likewise, we have had a more constructive approach to workers in the health service; we recognise that standards can be raised only through partnership with everybody involved. That is important.

We could score points forever, looking at what is good in one place and better in another. The fact is that England is a large place. Many rural parts of England have similar challenges and difficulties to Wales; in those places, it is difficult to attract specialist staff. Difficult decisions have to be made about how to provide ultra-specialist services when there is not the population to support the models we have in places such as London, where lots of specialist hospitals are very close together. There are huge challenges, not just in Wales, but in parts of rural England. The same can be said about rural transport.

Let us be clear about some of the things we have done in Wales. We were the first UK health service in Europe to put nurse staffing levels into law, making a real difference to patient outcomes, experiences and quality of care. We were the first country in the UK to introduce a single cancer pathway, making sure everyone gets the best possible care and treatment, and cancer survival rates in Wales are increasing. We were the first part of the UK to introduce special, non-invasive tests for babies before they are born, helping to reduce the risk of miscarriage, and we were the first UK health service to commit to ending new cases of HIV by 2030. As I have mentioned, Wales was the first to ban smoking in public places, and the first to change the law for presumed consent for organ donation. Of course, we championed prescriptions, which continue to remain free in Wales despite many economic pressures.

I could go on, but the important point is that co-operation and consultation matter. We have a new curriculum in Wales. It is imaginative and different. It is not so focused on a narrow set of examination results; it is a much broader education. It reflects a lot of what is going on in many other European countries. It will take time for us to see its results, but it has been developed with teachers, pupils, communities and, most importantly, business and industry, looking at the rounded skills that are so often needed in addition to straight examination results.

As we move forward into the next decade and the challenges that it will produce, the important thing is that people have an opportunity to make their views known at the polls—to elect the people they want to serve them in Wales and on their local councils. To roll back on devolution—to try to centralise things—will not serve people’s best interests.

It is a great pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Delyn (Rob Roberts) on finally securing the debate, and I echo his sentiment that all our thoughts continue to be with the Drakeford family at this difficult time.

It was something of a shock to me when I realised that I had started being able to measure my involvement in politics not in years or decades but in quarter centuries—and perhaps even in greater increments. Among the first political campaigns that I was involved in, as a university student, were the 1997 devolution referendum campaigns. Obviously, I had been involved in political campaigns before that, but what I found inspiring about the campaign in Scotland was its cross-party nature. Whether people supported devolution or independence, and irrespective of which party people supported—there were even a few intrepid souls from the Conservative and Unionist party who wanted to see a Scottish Parliament of some kind—the ability to set partisan political and policy differences aside allowed us to build a campaign for, win the consent for and then establish that institution.

The referendums in Scotland and Wales were a week apart. It was such a relief to get the thumping result that we achieved in Scotland, and it was with some trepidation that we waited the next few days to see what would transpire in Wales. I remember watching the results that night; I went to bed quite despondent at the way that it looked like things would pan out, only to wake up and find that the good voters of Carmarthen had turned out in such numbers as to take the result over the line and deliver a yes.

It is fair to say that, for different reasons, devolution in Scotland and Wales got off to a slightly shaky start. London imposed a Welsh First Minister who was not perhaps the choice of the governing party in Wales; that was not the wisest piece of party management. That was perhaps an early lesson, for those prepared to take it, that excessive interference in Welsh politics from the London end of the M4 is not the way to go, and that it is best to leave it to the people in Wales to decide for themselves.

After that, the Welsh Government got on with a pretty solid programme of delivery. The hon. Member for Llanelli (Dame Nia Griffith) gave a comprehensive list of their measures; I would add that it was the first part of the UK to introduce a charge for single-use plastic bags. There were the predictable squeals of outrage from the usual suspects, but the charge is now regarded as the norm right across the UK. There was the abolition of prescription charges, and the provision of school breakfasts. Wales was an early adopter of a children’s commissioner to stand up for the rights of young people who often find themselves without a voice in institutional settings. There were also a range of other policy measures taken to address social and economic inequalities. I have to say, having viewed all that from several hundred miles away in Scotland, that it seemed to me for a time that although Wales had a less powerful version of devolution, the Government in Wales were doing so much with so little, while our Government in Scotland appeared to be doing so little with so much.

As I say, a lot was done in Wales with limited powers. Since then, devolution has evolved, and further powers have been devolved. I was very taken by the child poverty figures. Child poverty outcomes in the UK show us that child poverty rates are far too high. They are far too high in Scotland, at 21%. However, now that Scotland has used its devolved powers, its child poverty rate is much lower than the rate anywhere else in the UK, as a result of measures such as the introduction of the pioneering baby box. I am sure that we will see further push-down on that figure as a result of the increase of the Scottish child payment to £25 a week. I must pose a question: how much more might the Welsh Government be able to do if they had resources at their disposal, and the power to use them?

There is a similarity between much of what I heard the hon. Member for Delyn say this morning and what some of his counterparts in Scotland say. It comes down to a “What have the Romans ever done for us?” style of argument, if I can characterise it thus. I hear echoes of Michael Forsyth, as he was in old money; he is now Lord Forsyth of Drumlean. This is going back 25 years. When I was a student at Stirling University, he was for a short time my Member of Parliament, and in the lead-up to the 1997 general election, he said that devolution would create a costly and unnecessary tier of government. I am sure that the hon. Member for Delyn would agree with that assessment. I almost agreed with it at the time; it is just that, as a supporter of Scottish independence, I took a slightly different view about which tier of Government was the costly and unnecessary one. The argument used to be made: “What could devolved Governments do that an engaged Secretary of State couldn’t?” I would say that, first of all, there would have to be an engaged Secretary of State, which we did not always have, or they might not be engaged in a way that we liked. However, the fundamental point is about democracy; it is about people in Wales and Scotland always getting the Government that they vote for, and their being able to hold that Government to account, however they think best.

It is telling that despite people voting for devolution in Wales by a very slim margin in 1997, when the opportunity came along to empower the Welsh Assembly with legislative powers to make it a proper Parliament—the Senedd—people in Wales voted decisively for that. That showed that the institution had won its spurs, and that Welsh self-government had very firmly come of age.

The hon. Member is making some excellent points. However, I am interested in the idea that this thumping margin in 2011, when there was a vote for increased powers, somehow made things legitimate. The turnout in Senedd elections has never been more than 46%. How can he possibly say that such elections have legitimised the institution in the eyes of the people of Wales, when more than half of the country does not even turn out to vote in elections to the Senedd?

If turnout is low in Wales, then politicians there—perhaps even including the hon. Member—need to look at the prospectuses and the arguments that they are offering. If they cannot inspire people to turn out to vote, that is perhaps as much a reflection of some of the politicians and the quality of the debate being held as it is of anything else. Certainly, however, decisions in a democracy are taken by those who turn out, and there was a difference between the vote in 1997 and the vote to empower the Senedd; for me, a very clear message came out of the latter vote.

We have heard today a litany of woes about the alleged shortcomings of this quarter-century of various Welsh Governments. As a Front Bencher for the Scottish National party, I am certainly not here to defend the Labour party in any way, but my response to that charge is twofold. First, many of the complaints we have heard have been about the enactment and delivery of policies, rather than about the institution of the Welsh Government. Secondly, it really does not say a great deal for the Conservative party in Wales that, if things really are as dreadful as we are invited to believe, it has not been able to persuade enough people in Wales that it offers a compelling alternative to replace the Government. For all we have heard about Swansea and Cardiff, I know that Cardiff has elected Conservative representatives in the past. It is simply a question of providing a compelling prospectus, which is quite clearly not something that has been done.

We hear a similar refrain in Scotland from some quarters, which is to attack the institution and the party in power without offering a great deal that is positive in return. That is perhaps one of the reasons why the last time such arguments were put forward at a Scottish election, people in Scotland chose to re-elect my party to Government and came within a hair’s breadth of sacking the Conservatives as the official Opposition. I think that that is part of the political failure that goes some way toward explaining the current centralising tendencies in Westminster. As we have heard, there has been a power grab through the United Kingdom Internal Market Act, which was designed purely to undermine the democratic choices made directly by people in Scotland, Wales and elsewhere, and to make sure that the priorities they vote for are not the priorities they will necessarily get—all this led by a Conservative party in London that is incapable of persuading voters to elect it in sufficient numbers to govern in either Wales or Scotland.

Looking to the future, it is clear that devolution still has some significant shortcomings, despite the way that the institutions have developed. In Wales, I find it bizarre that a major infrastructure project such as High Speed 2 can go ahead without the consequentials feeding through to Wales for investment in Welsh infrastructure; and the failure to devolve the Crown Estate in Wales, as has happened in Scotland to great effect, is inexplicable. It seems to be a complete disjoint and mismatch in terms of the strategic nature of government. Given the apparent determination of the UK Government to reassert themselves in direct, day-to-day governance of devolved matters in Wales, it is absolutely bizarre that Ministers should be content to see the number of Welsh MPs elected to this place reduced from 40 to 32, further marginalising the voice of the people of Wales in this place.

I will address as independently and as gently as I can the argument from the hon. Member for Delyn against expanding the size of the Senedd, even though the Senedd currently has fewer Members than many local authorities in Scotland. Broadly speaking, the Members of any democratic institution can be subdivided into four categories across parties: those who are running it, those who could run it, those who used to run it, and those who we would not want anywhere within a million miles of ever being able to run it. Sadly, sometimes people in that last category even get to be Prime Minister. I am sure that each of us knows which category we would like to fall in; if we are very fortunate, perhaps our friends and colleagues might even agree with us.

My fundamental point is that the success of self-government, wherever it is, depends very much on the three Ps: the powers that you have, the policies that you enact, and the personnel who are elected. Perhaps unlike the hon. Member for Delyn, I have full confidence in the people of Wales to continue making what they see to be the best choices across each of these categories.

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Delyn (Rob Roberts) on securing the debate, and I associate myself with his condolences to First Minister Mark Drakeford and his family.

It is a shame that the hon. Member has used the debate as an opportunity to talk down devolution. It seems he has done so to score political points, which is such a shame. His view is also at odds with the views of the vast majority of the people of Wales. A large number of surveys on devolution have consistently confirmed that people across Wales support devolution and, in some cases, the devolution of further powers. Those who support rolling back devolution or, at the other extreme, independence, are very much polarised on the margins. The vast majority of people are supportive; they can see the benefits and the evidence of what devolution has delivered for Wales under the stewardship of Welsh Labour.

The Labour party is the party of devolution. The UK Tory Government have no respect for devolution or devolved Government, and have taken every opportunity to undermine the devolution settlement. Devolution is one of the proudest achievements of the last Labour Government. Unlike the Tories, a UK Labour Government would respect devolution and the Sewel convention. In a report by the commission on the UK’s future, led by the former Prime Minister Gordon Brown, Labour proposes ways of modernising and updating our constitutional arrangements, improving the process of intergovernmental relations and putting more power in people’s hands. The Tories have overridden the Sewel convention on several occasions in recent years, disrespecting the devolution settlement.

Tory attacks on Wales and on Welsh Labour are born from desperation. They are fiddling while Rome burns in order to deflect attention from the shambles at Westminster, their failure to tackle the cost of living crisis effectively and their mismanagement of the economy. Historic underfunding of Wales has torn billions of pounds out of the Welsh budget, while the Tory-made economic crisis has only brought greater costs.

The spring Budget makes no provision for public sector pay and includes no funding for health or social care. The Budget was the Tories’ chance to use their financial levers and capacity to provide comprehensive and meaningful support, as well as to invest in public services, public sector pay and economic growth.

I thank the shadow Minister for proving my point succinctly: we have already had 25 years of saying that everything in Wales is London’s fault, so can we not have another 25 minutes saying it is all Westminster’s fault and instead address some of the points of the debate? What are the Welsh Government doing? How is devolution working? What are the outcomes for people in Wales and how are they making our lives better? It is not working.

Yet again the Conservatives have fallen woefully short, failing the people of Wales. We know the Tories promised Wales would not be a penny worse off, with EU regeneration funds replaced in full, but that is far from the case, with huge uncertainty over the shared prosperity fund leaving Wales worse off, while the scandal of levelling up for Wales has meant a Tory smash-and-grab, wrapped up in a sustained attack on devolution, instead of collaborative work with the Welsh Government and local authorities in Wales.

In his opening speech, the hon. Member focused on health, so let me inform him about some of the things the Welsh Government are doing across Wales and the difference a Labour Welsh Government have made. They will always invest to protect health and social care. We spend 14% more per person on health and social care in Wales than in England. While 13 years of Tory Government have been ruining and running our public services into the ground, we have been taking difficult decisions to provide a higher level of NHS funding per head in Wales, where we know the population is older, sicker and less well off.

The NHS is facing similar challenges across the UK, yet performance at major accident and emergency departments has been better in Wales than in England for the last five months. Waiting lists are growing faster in England than in Wales. In the six months to December 2022, waiting lists increased 0.4% in Wales and by 6% in England.

I think the hon. Gentleman has said quite enough for now. In the last 12 months, waiting lists have increased by 7% in Wales and by 19% in England.

With the industrial action taking place, Welsh Labour Ministers have got around the table with trade unions, taking tough decisions to find whatever resources they can to negotiate a resolution to the current pay dispute. There is not enough money in the budget for a fully consolidated pay offer, but the Tories have not provided an adequate level of funding for years.

Welsh Labour is training more doctors and nurses year on year. As my hon. Friend the Member for Llanelli (Dame Nia Griffith) said, Welsh Labour has implemented the real living wage for social care workers, and has ensured that prescriptions and hospital parking are free, and care charges capped. Prescriptions are free in Wales, but people in England are being forced to go without medication they desperately need because they can no longer afford it. The NHS bursary was axed in England in 2016, but has been protected in Wales because of Labour’s values. In England, the 40% drop in student nurse applications over subsequent years has been widely attributed to the axing of the bursary.

In transport, despite having 5% of the UK population, 11% of track miles and 20% of level crossings, Wales receives only between 1% and 2% of rail enhancement funding. That is not a fair funding settlement.

The reality is that only Labour will devolve economic power and control out of Westminster. The next Labour Government will return power over its economic destiny to Wales, and the decision-making role for the Welsh Government on structural funds will be restored.

There is a number of examples of businesses in Wales receiving more support during the recent pandemic. Vaccination rates were higher, and delivery in Wales was consistently faster than in England. PPE procurement was transparent and cost-effective, in stark contrast to the experience at Westminster under the Tories. Welsh Labour’s trusted decision making protected lives and livelihoods, which was without doubt reflected in Welsh Labour’s historic 2021 Senedd election victory.

To work even more effectively, devolution needs a strong partnership between the Welsh Government and a United Kingdom Labour Government, working together to deliver the priorities of the people of Wales and ensuring that Wales has a strong part to play in a strong United Kingdom. I hope we will not have too long to wait for that, depending on when the Prime Minister calls the next general election.

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate my hon. Friend the Member for Delyn (Rob Roberts) on securing the debate, which has triggered a wide-ranging discussion on Welsh devolution.

As we have heard throughout the debate, devolution in Wales has evolved considerably since the incredibly close referendum in 1997, when I was still in school—quite possibly, my hon. Friend was too. Successive UK Governments have devolved further powers to Cardiff Bay in an attempt to place the settlement on a firmer footing and to put more responsibility and accountability at its heart. That has included providing powers to make primary legislation in devolved areas, and powers to introduce replacements for stamp duty land tax and landfill tax in Wales, as well as the introduction of a new Welsh rate of income tax and powers for Welsh Ministers to borrow to fund capital expenditure.

Nowadays, the devolution settlement is based on the reserved powers model, in line with that in place in Scotland. The devolved Administration have greater powers to manage their own affairs, as well as matters relating to elections, transport and natural resources. There has been a great deal of debate this morning about the future of Welsh devolution and whether the current boundary between devolved and reserved powers is correct. It is clear that different views exist, and we must acknowledge that they are reflected among the people of Wales.

In the debate, my hon. Friend the Member for Delyn focused on disappointing policy outcomes with reference to Betsi Cadwaladr University Health Board, education, transport and so on. He also talked of the north-south divide in Wales, and the sad disengagement with politics—turnout at the last devolved election was just under 47%, compared with 67% at the general election.

The hon. Member for Strangford (Jim Shannon) intervened to talk about his desire to see local representation wherever possible, and more positive comments came from the hon. Members for Gordon (Richard Thomson), for Llanelli (Dame Nia Griffith) and for Merthyr Tydfil and Rhymney (Gerald Jones). The hon. Member for Llanelli talked about the importance of the accessibility of Ministers at all levels of government, and co-operation too.

I am firmly of the opinion that the overwhelming priority of the people of Wales is not an incessant, one-way transfer of powers down the M4, or a route to more separatism, but delivery on the important matters of the day, such as health, the cost of living and education. Sadly, we continue to see poor levels of interest and awareness of the roles of our various and different levels of Government, and therefore often limited democratic accountability.

In the context of Wales, it is important to remember that 50% of the population of Wales live within 25 miles of the border with England, which does influence how many people view the devolved settlement. Bringing decision making on devolved issues closer to people affected by them is one of the real opportunities of the devolution agenda, but it would be remiss of me, as we reflect on the last 25 years of devolution in Wales, not to acknowledge that there are legitimate concerns among many in Wales about devolution and the direction of travel that has been taken in Cardiff Bay.

All too often, we have seen attempts to centralise decision making within the Welsh Government, which goes against the concept of true devolution. Contrary to some of the arguments that have been made today, it has been particularly pleasing to me to see this Government deliver on our promises of true devolution in the allocation of shared prosperity funding. I have seen that at first hand in Denbighshire, my own county, as a member of the county’s shared prosperity fund partnership group, which allows new and refreshing approaches to local problems and opportunities, driven by local people.

The Minister makes a good point. It reminded me of the point the hon. Member for Strangford (Jim Shannon) made about local decision making. About two years ago, the First Minister appeared in front of the Welsh Affairs Committee. I remember asking him whether he was going to devolve more powers to the regions—specifically, to north Wales—as he had previously said that he thought that was a good idea. I asked him when those powers were going to come and what powers they were going to be, as none had materialised. I think the First Minister was a little bit indignant at the question. Does the Minister agree that the current arrangement of devolution is not working, and a potential solution might be to give more autonomy to north Wales to make some decisions for itself?

My hon. Friend makes a strong argument. In fact, he will be aware that one of the Labour Members in the Senedd called for greater powers and autonomy for north Wales in response to the recent roads review, and today a representative of the business community in north Wales has called for a directly elected mayor for north Wales. It comes back to my point that devolution should be true in nature; it should be led by local people and local representatives, which is not always the case at present.

Under the Welsh Labour Government, the economy in Wales is growing at a slower rate than in the rest of the UK. In education, Wales is, sadly, at the bottom of the PISA rankings compared with other parts of the UK. In the health service, we see abysmal performance and outcomes data, and we also see what I regard as very detrimental policies on road building and tourism. All of that is despite the UK Government providing the Welsh Government with record funding, which is, as we have heard, higher per head of population than in England.

The UK Government have a duty of care towards all British citizens and it is important that UK-wide comparable data is used to justify and learn from different policy approaches across the country. The days of “devolve and forget” have to be over. I am deeply concerned that, despite the challenges the Welsh economy faces and failing devolved public services in Wales, the Welsh Government’s unrelenting focus is often on constitutional matters, including increasing the number of politicians in Cardiff Bay and changing its voting system, which some have suggested would be at a cost of £100 million over five years.

Devolution in Wales means that Wales has two Governments. Both should be fully focused on the issues that really matter: levelling up our economy, creating jobs and supporting people with the cost of living. The UK Government’s investment to address those priorities, through initiatives such as the levelling-up fund and our support with energy costs, highlights the benefits that Wales enjoys from being part of the United Kingdom.

I want to emphasise something that is not always said. A very clear majority in Wales believe in the United Kingdom and are proud to be part of it, and this place—Parliament—will always have a critical role in delivering for Wales and its people. Our approach to devolution is underpinned by our commitment to work collaboratively with the Welsh Government and all the devolved Administrations.

On the point about collaboration with the Welsh Government, does the Minister think the way the UK Government clawed back funding from the Welsh Government is unacceptable? My understanding is that issues around switching between revenue and capital have been agreed many times before. The level of underspend is significantly below that of some other UK Departments. Does he agree that was a pretty poor show by the UK Government?

The hon. Gentleman puts that in an interesting way. The other side of the story is that all who are entrusted with spending public money should do so carefully, and should make efforts to comply with the rules and arrangements around that money. The other way of looking at that is that the Welsh Government failed in their duty to spend wisely the money that was available to them.

Moving on from that, the landmark agreement reached last year between the UK and devolved Governments further strengthens our intergovernmental structures. The new structures provide a firm foundation to deepen our partnership working. Our joint work on city and growth deals in Wales, as well as our announcement last week that we will establish two freeports in Wales, following agreement with the Welsh Government, exemplify our approach to collaboration.

Over the past 25 years, we have seen dramatic changes in the way in which Wales is governed. It is clear that a wide range of views exists over how that might change in future, but I urge all to focus not on the constitutional debate, but on delivering on the real priorities for the people of Wales.

I thank all hon. Members, from all parts of the House, for their constructive approach to the debate. I would like to pick up briefly on a couple of points. The hon. Member for Llanelli (Dame Nia Griffith) spoke passionately and well about the Welsh Government, the Senedd and the structures. She said on a number of occasions that the Welsh Government have taken action. With the north Wales health board being eight years in special measures, taking action will sound a little hollow to my constituents, unfortunately.

The shadow Minister accused me of using the debate for nothing more than scoring points. I asked him about outcomes, but he ignored the point and did not address anything. He covered exactly the ground that I had mentioned in my opening remarks. His entire contribution was about what happens here, and nothing to do with the nature of devolution or what the Welsh Government do. I thank him for proving my point so perfectly.

The shadow Minister used the word “vast” several times: a “vast” number of people in Wales—a “vast” majority are supportive of the Senedd. In fact, 35% of people turned out in 2011 for the referendum that the hon. Member for Gordon (Richard Thomson) mentioned, with regard to increasing powers. That is hardly a shining example of legitimacy for an institution of which people are vastly supportive.

I am in danger of rehashing all the points I made earlier, so I will not do so. It is sad that the Minister was not able to commit to giving the people of Wales another say on whether that institution should persist. It should be okay; I am sure the Labour party would support it, because after all, the “vast majority” of people in Wales are in favour of the Senedd—I suspect not.

I thank everybody for their contributions. I hope this will be the start of a series of discussions on the constitutional future not only of Wales, but of Scotland and Northern Ireland. That is something we do not often debate, although it is so important to the outcomes, the lives and the day-to-day activities of the people we are sent here to serve.

Question put and agreed to.


That this House has considered the matter of 25 years of devolution in Wales.

Sitting suspended.

Hospital Provision: Tees Valley

I beg to move,

That this House has considered hospital provision in the Tees Valley.

It is an absolute pleasure to serve under your chairmanship, Sir Christopher. I start by thanking all the hard-working staff of the three main hospitals in the Tees Valley: the University Hospital of North Tees, the University Hospital of Hartlepool and the James Cook University Hospital, south of the Tees. They include my son, who I am proud to say is a student nurse at one of those hospitals.

While we have had some welcome new additions to provision in the Tees Valley, for example the new diagnostic and mental health care hubs in Stockton, in the light of the state of disrepair at the North Tees hospital, we are still in need of improved hospital facilities. The trust and the wider Tees Valley are experiencing severe challenges around current estate capacity, which is not suitable for the needs of the population it will serve over the next 10 to 20 years. For example, a significant volume of elective surgical procedures are performed within the private sector because of a shortage of resources within our NHS trust.

It is my contention that the University Hospital of Hartlepool could fill that provision gap, and that it is underutilised in providing services to the people of the Tees Valley. Not only can it play a greater part in delivering these services, but it can take some of the pressure off the other hospitals, which are undergoing renovations. It can do both those things with a relatively small amount of investment.

It should be pointed out that, in its heyday, Hartlepool hospital served not only the people of Hartlepool, but all the communities north of the Tees. Its position in the north of the trust’s geographical area meant that it also provided vital health services to the mining villages to the north and west, in County Durham, which saw Hartlepool hospital as their local hospital, too. It has provided much-needed healthcare to all those communities since it was founded in the late 19th century. The hospital’s generous 28-acre site has a lot of potential, with a significant amount of cleared land that we should use to build more services for the people of Hartlepool, of the Tees Valley to the south and of the ex-mining communities to the north.

I am grateful to my next-door neighbour for giving way. I congratulate her on securing the debate and her son on his role in the NHS. Does she remember that it was her Government who cancelled our new hospital 13 years ago without a plan for future health delivery? Recently, the Health Minister, who is in his place, wrote to the Labour candidate for Hartlepool, Jonathan Brash, turning down the funding for a centre of excellence in the town despite cross-party support, including from the Conservatives in Hartlepool. Does she have any thoughts about how we might change the Minister’s mind and deliver for Hartlepool and wider Teesside?

I am delighted that the hon. Gentleman has brought that up, because he has mentioned two things that I want to address. I will talk about the new super-hospital later in my speech. I think we dodged a bullet there, because it would have created another private finance initiative like the unsustainable one at James Cook University Hospital.

It was. The other thing I want to say is that this is an extremely good example of Labour putting politics above the people of Hartlepool. The Labour candidate in Hartlepool, the councillor Jonathan Brash, has had no interest in the hospital. He has had no interest in anything in Hartlepool for a long time. However, every time it looks like I am going to succeed in bringing something forward for the people of Hartlepool, Jonathan Brash is there, ready to have a photo opportunity or write a magic letter to try and take the credit. I am grateful to hon. Gentleman for raising that so I can clarify the situation.

Some may wonder why there is a need to invest in new services. If the hospital had been properly loved and maintained, there would be no need to do so. Sadly, Hartlepool has not been championed by my predecessors —the Labour MPs who went before me—resulting in a significantly lower amount of investment compared with surrounding regions. The Labour centralisation policy of the mid-2000s meant that it became Labour party policy to close down Hartlepool hospital. Indeed, the candidate who stood against me in the by-election, Dr Paul Williams, co-authored the report that recommended that critical care and other services be taken away from the hospital and moved elsewhere. As I have said, there was Labour talk of a new super-hospital, to be funded by one of Labour’s public-private finance initiatives, and we have seen the issues that have arisen from that at James Cook—a prime example of the huge amount of money that the schemes now leech from our NHS.

Labour’s health legacy on Teesside is a dodgy Labour PFI deal that still costs James Cook hospital £1 million every single week. Does my hon. Friend agree that that money would have been better spent on doctors and nurses supporting our residents?

I totally agree with my hon. Friend. In fact, less than a year’s-worth of the £1 million a week that goes into propping up James Cook’s PFI deal—£40 million—would be enough to upgrade and put in the services that we want Hartlepool.

Sadly, my constituents got caught in the political crossfire and were left with a shell of a hospital at Hartlepool and faced with long journeys to North Tees and James Cook for many hospital services. When the accident and emergency unit was closed down in 2011, local opposition was so strong that roughly a third of the population of Hartlepool signed a petition organised by the “save our hospital” campaign. It was incredible—there were more than 30,000 signatures, and there were marches through the town.

I was elected in 2021 on a promise of bringing positive change. That includes bringing education, skills, jobs and prosperity to the town, but there was also an overriding call on the doorsteps for the return of services to our much-loved Hartlepool hospital. I set about trying to find a solution for this long-standing and ignored issue. I have therefore been working directly alongside North Tees and Hartlepool NHS Foundation Trust and its excellent chief executive, Julie Gillon, for in excess of 18 months. During that time, I have built a strong working relationship with Julie. Sadly, she has recently announced her decision to retire from her role and pursue other things, but she intends to dedicate the next six months to championing our proposals for Hartlepool. She will be a sad loss to health provision in the Tees Valley, and I will be one of many who will miss her. She is a competent leader and a good, strong woman—the sort we excel at in the north-east.

I need to make some progress.

The first plan that Julie and I favoured was an upgrade and return of services to Hartlepool, new diagnostic hubs in Hartlepool and Stockton, and a new hospital closer to the A19 in Hartlepool, which would be the major trauma centre. This was a bold new model. It would allow people to access diagnostic and out-patient facilities very locally and to travel to the true central point of all the communities in the Tees Valley for major procedures in a state-of-the-art new facility. Sadly, with the huge pull on public funds created by the pandemic, the war in Ukraine and the rising cost of living, it has become clear that that project will not be possible in the near future.

Undeterred, Julie and I returned to the drawing board with a plan to upgrade Hartlepool further and maximise the return of services to that site. I mentioned that there is not enough capacity for the significant volume of elective surgical procedures in Tees Valley NHS sites. The upgrade at Hartlepool, with a proposed 40% increase in operating theatres, would address that lack of resources and increase capacity to perform those elective procedures in a new centre of excellence. That would be alongside a new, much-needed primary care hub and a community hub, which would enable patients to be fully rehabilitated before being discharged. That would free up hospital beds on wards.

I also point out to the Minister that, like most things that I inherited in my constituency, hospital services had not been championed by predecessor Labour MPs for too long.

My hon. Friend is a fantastic champion for Hartlepool and is doing incredible work to secure the hospital. Representing as she does the former lands of Mandelson, Milburn, Mowlam and Blair—all who are here today represent such places—does she agree that there is very little to show in our region for their years in office, save for costly PFI deals?

I totally agree with my hon. Friend. The fact that we are here now is the proof of the pudding; people got tired of being ignored by Labour MPs who took the heartlands for granted.

Exactly. The Minister might be surprised to learn that the trust has not received significant capital investment to improve its services since its initial construction more than 50 years ago, while neighbouring trusts have received funding more recently. That results in a significantly lower per capita spend for the population served by the trust—around £60 per head in the region, compared with neighbouring trusts that receive more than 11 times that amount, at £680 per head. I am sure I do not need to point out to him that positive change means productivity and prosperity. Those things are limited by a high local prevalence of chronic disease.

Our local population has a higher prevalence of 17 out of 21 chronic conditions recorded on the quality and outcomes framework in 2020-21. Both long-term and temporary sickness are cited as the main reason for unemployment in Hartlepool; at 33%, that is higher than the national rate of 25%, suggesting that poor health outcomes are the main driver of unemployment in the region and underlining the significant need for a return of good health services locally.

I am grateful to my hon. Friend for giving way once again; she is being incredibly generous with her time. We were all elected on a mission to level up, and levelling up is about delivering on those health outcomes. Does she agree that levelling up health inequalities in the north-east is a key part of why we are here?

Absolutely. It is incredibly important because, without levelling up health disparities, we cannot get growth or productivity, so it is very important to make sure that we have a happy, healthy population.

The historic lack of prosperity means that a disproportionately high percentage of the local population is in the lowest 10% for deprivation in England, based on the index of multiple deprivation. That puts Hartlepool in the bottom 10 of 147 local authorities nationally. High levels of deprivation also contribute to the fact that life expectancy in Hartlepool and throughout the Tees Valley is considerably lower than the national average in the most deprived areas.

It is the lack of prosperity and the deprivation that I was elected to fight. The people of Hartlepool voted for me to bring positive change. They wanted an MP who finally listened and did something about it. I will not rest until we get the local health services that we deserve and have been so cruelly deprived of. We have been ignored for too long. Will the Minister commit to meeting Julie Gillon and me to discuss the matter further?

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate my hon. Friend the Member for Hartlepool (Jill Mortimer) on securing this important debate about hospital provision in the Tees Valley. I know the issue is important to her and that she works tirelessly for the people of Hartlepool on not just healthcare but many other issues. As she knows, responsibility for the new hospital programme sits not with me but with Lord Markham, a fellow Minister at the Department of Health and Social Care. I am, however, hugely grateful to her for giving me the opportunity to update the House about the ongoing work in this area.

I have been trying to meet Lord Markham for many weeks. Will my hon. Friend commit to helping me secure a meeting as soon as possible?

I absolutely guarantee and assure my hon. Friend that I will get that meeting with Lord Markham arranged as soon as is practically possible, but certainly in the next few days.

I am grateful to my hon. Friend for giving me the opportunity to highlight how the Government are prioritising capital spend in our NHS in order to transform and improve healthcare outcomes for people and put healthcare financing on a sustainable footing. She understandably and rightly focused on the North Tees and Hartlepool NHS Foundation Trust, her local trust, and of course the University Hospital of North Tees in Stockton, which serves many of her constituents. I will, of course, turn to that, but before I do I will briefly reference our capital funding plans more broadly, because the context is important.

We have already provided record sums to upgrade NHS buildings and facilities so that trusts up and down the country can continue to provide the best possible quality of care. Currently, the Department’s capital budget is set to reach upwards of £36 billion for 2022-23 through to 2024-25—a record capital settlement—and we are using that level of investment to address current care delays.

My hon. Friend made a strong case for why new hospitals are important. As important as they are, the broader health economy is, of course, about far more than that. It is about surgical hubs; it is about community diagnostic centres such as the one in Stockton, as she rightly pointed out; it is about ambulance hubs, and it is about discharge lounges. It is about all those value-adding capital projects too. As part of our urgent and emergency care recovery plans, the 5,000 extra beds that are being added to existing NHS hospitals ahead of next winter are also hugely important.

As I said, new hospitals are, of course, important, and we are aware of the need for further investment in the NHS estate. We are investing an extra £1.7 billion to 2025 for more than 70 hospital upgrades. As my hon. Friend alluded to, the Government have committed to building 40 new hospitals, backed by an initial £3.7 billion for the first four years of the new hospital programme.

We are incredibly grateful for the £40 million invested recently in the North Tees and James Cook hospitals, and for Stockton’s new diagnostic hospital and mental health crisis hub, but the incredible, committed, dedicated, grade-A workforce at North Tees deserve grade-A facilities. Will the Minister ensure that North Tees’s bid to rebuild and upgrade the hospital is given the fullest attention?

I thank my hon. Friend for his question. I know from his persistence in campaigning for the community diagnostic centre that his continued persistence in campaigning for a new hospital and upgrades will not have been missed by the relevant Minister, Lord Markham. I will come on to talk about the new hospital programme and the selection of the next eight hospitals.

As I said, the Government are committed to building 40 hospitals, backed by an initial £3.7 billion. Two schemes are already complete and five are currently under construction. The programme is delivering facilities that are at the very cutting edge of modern technology. Critically, it is engaging with clinical staff to ensure that we provide a better working environment for them. We know that enables increased efficiency; importantly, it also promotes staff wellbeing and improves retention.

First, I apologise to the Minister—he was not, in fact, the Minister who turned down the funding for the centre of excellence in Hartlepool. I pay tribute to Julie Gillon, with whom I have worked for 16 years; she is a tremendous officer and I am sorry she is moving on. I very much welcome the diagnostic centre in Stockton, which is the result of many years of work between the local authority and the health trusts. We heard a tale of woe from the hon. Member for Hartlepool (Jill Mortimer), who spoke of a lack of capacity, difficult buildings, buildings falling down—all manner of problems after 13 years of Conservative rule. Does the Minister agree that we should work together to secure what we need: new hospital facilities to serve our communities on Teesside?

I agree with the hon. Gentleman that we need to invest in new facilities up and down the country. From spending time in Hartlepool speaking to residents, certainly during the by-election, I know how frustrated they are with public services more generally—or certainly they were, because they did not feel like they had a champion at the heart of Government making their case. However, they now have that champion in my hon. Friend the Member for Hartlepool, whose dogged persistence in campaigning for not just better health infrastructure locally, but broader investment in Hartlepool, is critical. My hon. Friend is making that case today, and I know she will continue to do so. On his point, the hon. Member for Stockton North (Alex Cunningham) is absolutely right that we need to work together to deliver better services for people.

Turning specifically to my hon. Friend’s constituency, I am pleased to say that we have received an expression of interest from the North Tees and Hartlepool NHS Foundation Trust for the University Hospital of North Tees in Stockton to be one of the next eight hospitals to be included in the new hospital programme. I can confirm that we have assessed the expressions of interest we have received, and the Government aim to make an announcement in due course.

I am sure my hon. Friend will understand, because we have had many such conversations in the run-up to the debate, that I cannot comment on individual bids while the selection is ongoing. However, she has made her case very articulately and eloquently, and certainly very strongly, and she has put it firmly on the record. I will ensure that her representations are brought to the attention of both the Secretary of State and Lord Markham, and that she secures the meeting for which she has been waiting too long.

If my hon. Friend will permit me to digress for a moment, I will take a couple of minutes to highlight some of the significant funding that North Tees and Hartlepool NHS Foundation Trust has been allocated recently, largely down to her campaigning efforts. The funding includes £23.9 million for a community diagnostic centre in Stockton-on-Tees—I note the nods from my hon. Friends the Members for Cleethorpes (Martin Vickers) and for Darlington (Peter Gibson); they too have been champions of that centre—£3.9 million as part of the targeted investment fund for elective recovery, which is really important because too many of our constituents are on waiting lists for surgery and out-patient appointments; £8.4 million from our community diagnostic fund; £6.5 million as part of the critical infrastructure risk fund to address some of the backlog maintenance issues in our hospitals; and £3 million from our A&E upgrades fund.

In addition, the Tees, Esk and Wear Valleys NHS Foundation Trust has been allocated £3.4 million from the mental health crisis fund to improve urgent and emergency care facilities for mental health, as mentioned by my hon. Friend the Member for Hartlepool. That is really important for taking the pressure off our accident and emergency departments. I know that my hon. Friend will agree that this investment has been invaluable in updating outdated infrastructure and ensuring that modern and sustainable facilities are available for both staff and patients.

Once again, I want to put on the record my sincere thanks to my hon. Friend for all the work that she is rightly doing to support her hospital and, more broadly, hospital and health provision in Tees Valley. She is absolutely right to champion the needs of her constituents and to hold me, Lord Markham and the Department to account on this important issue. Let me take this opportunity to reassure her that the Government are committed to delivering our improvement programmes and upgrades to hospitals and, importantly, to our NHS estate across the country. We very much look forward to delivering the step change in the quality and efficiency of care that we have promised.

Question put and agreed to.

Sitting suspended.

Bereaved Children: Registry

[Sir Gary Streeter in the Chair]

I beg to move,

That this House has considered the potential merits of a registry of bereaved children.

It is a pleasure to serve under your chairmanship, Sir Gary. I thank the House for this opportunity to discuss an issue that is very close to my heart. I also thank the Minister; when we spoke recently, she understood exactly why this issue is so important, not just to me but to so many people and families, and why I feel almost personally driven to highlight it. There are a variety of reasons for that, many of which I have only recently come to fully appreciate, along with the impact on my own family of something that happened several decades ago. That is why I feel that I need to do everything I can, and we need to do everything we can, to protect our current and future generations of children, not with a new service but, as I will explain, with a simple administrative change—a process to ensure that children benefit from the many services that are there for them.

First, I would like to explain why and how I came to this point—my own journey. As a 20-year-old, I lost my father suddenly from a heart attack one Saturday morning. I thought that I was an adult and that I was okay, and I focused on my two sisters, who were just eight and 13. I thought that they were doing well. For decades, I thought that we had all come through the trauma—because there was a trauma—remarkably unscathed. Gradually, though, I realised that perhaps I had not been as aware of what had happened to me—what had happened to us all—as I thought at the time, and that perhaps things had not been as smooth as they seemed.

It was only when my own daughter was eight, and I watched her and her dad and saw how they enjoyed reading “Harry Potter” together and playing, that I realised, probably for the first time, just how huge the trauma of suddenly not having the dad she idolised at that age had been for my youngest sister. I saw the trauma that she had been through in a very different light. Then, when my daughter was 13, I thought about my middle sister, and saw for the first time how the inescapable insecurities of your teenage years must be so much more complicated when the ground is shifted beneath the family and everything becomes uncertain, and the security that you knew is suddenly gone.

I think it was only when, by the cruellest twist of fate, my own husband died when my daughter was 20—exactly the age I had been—that I realised for the first time not only that I had been much less of an adult that I thought, but the impact that my dad’s death had had on me, not just then but now. I realised that everything I have done —everything that has driven me, and the sense of insecurity and uncertainty, and very often fear about the future, that I have felt throughout my life—stems from that Saturday morning.

I talked about that to my youngest sister, who pointed out that perhaps it was because none of us—myself included—had had any outside professional support. Yes, the girls’ schools were great, our family was wonderful and my mum—well, she just dealt with everything that life had thrown at her. But we never heard from any of the services that were probably available to us at the time. We were never offered any counselling, advice, befriending services or trips away—not because the available organisations did not care or want to help, but because they did not know and we did not know that we needed them. We had never been in contact with social services, so, bluntly, they did not know that we existed. We just got on with it. My sisters, I felt, were too young to realise. I thought that I was okay, and that my family were coping with their own grief and making sure that we were safe and looked after, like every family do. In so many ways, we were lucky, but maybe—just maybe—we could have benefited from something else.

I would love to stand here and say how many children are in that position today—how many children wake up every morning to the pain of knowing that the person they loved, and who cared for them, is not there. I would love to say that all the services that are available to them are getting to them, and that they have that support. But I cannot, because we do not know.

We do not know how many children there are, and we do not know where they are. That is not because the services are not available; of course they are. Schools, social services and fantastic organisations such as Winston’s Wish do a wonderful job of helping youngsters every day—but only the children they know about. They have no way of knowing, as I have no way of knowing—none of us does—how many young people need or would benefit from their help. They cannot reach out and offer them support. They do not know where they are.

Sadly, the reality for a child suffering grief is still that, unless their family has been in contact with social services, or social services have a reason to be in contact with them, they may not be able to benefit from all the help and support that we all want them to have. Schools do a fantastic job, but what if a child moves because their main carer has died? A new school might not know, and how many children really want to be different at school? How many children want to be singled out and for everyone to know how upset they are—to know that they are struggling, because someone has been taken from them, with the anxiety that grips their poor wee hearts every time they leave home about whether everyone they love will still be there at the end of the day? That is their reality.

In the past few months, I have spoken to the voluntary sector, written to the Scottish Government and sat down with the Minister who is here today to discuss the issue. Without exception, they have been supportive. Everyone recognises that there is a problem, wants to help and outlines the wonderful services that are there. But the problem is still that we do not know who needs them and where they are. Pinning down the solution—how to do it—is the issue that everyone seems to grapple with, but it should not be difficult.

In this country, we have registers and statistics for just about everything. A digital society makes a lot of things easier; it is often too easy to keep track of things. I can go online now and check my MOT, my car insurance, my postcode and my council tax. My medical records are online to make it easier for the NHS to know who I am and what I might need if I collapse somewhere away from home. I hate to think exactly what information could be scanned from my passport or my national insurance number. A quick Google search tells us a lot. But if, God forbid, anything were to happen to any of us in this room and we had children, there would be no way of checking if they were there and if they were okay—if they were safe, looked after, coping, or maybe just needing someone to talk to.

I have not met anyone in this place who does not want to address this problem and does not recognise its significance. There is no political issue. There is no divide over whether or not we should be supporting our children. We all want to do it, so what is stopping us? All we need to do, and all I ask the Government to do, is invest some time, thought and care into coming up with what really is an administrative solution and identifying which Department can best administer it and the easiest way to do it. Yes, there may be problems with GDPR and privacy, but we can overcome those.

The solution may be as simple as introducing a system whereby, when someone registers a death, they also register whether there are children who could be affected—upset by the death of a parent, carer, sibling or grandparent —and then sending out the available information, in a leaflet or a letter, to tell them where they can turn for support, checking that they have got it and making sure that the organisations know they are there. It would be a process—a way of collecting data, which we have become very good at in this country recently. It would be a way of making sure that we know where those children who may need the help that is available are, and making sure that we can reach out and offer it. It is the least they deserve.

Thank you, Sir Gary, for giving me the chance to speak in the debate. I am very pleased to serve under your chairmanship.

I thank the hon. Member for Edinburgh West (Christine Jardine) for raising this issue. She did the House proud in the compassionate way that she introduced the debate. I am grateful for the spirit behind the debate, which she showed, and I am thankful that she has chosen to use her own familial pain so openly to help others. She is very much deserving of our respect and gratitude.

The topic of the debate is very emotional—we all know that; it is hard not to be moved by it—and sensitive. I discussed with Naomi, my assistant, our approach to the research for this debate. I know that I keep her busy when it comes to speeches in Westminster Hall and elsewhere, but do we talk the matters through, because we like to be able to bring a local angle—a Northern Ireland angle—to debates. I will do so today by giving an example that we are aware of, which will hopefully add to the hon. Lady’s introduction and to the contributions by the Members who will follow me.

Naomi raised the very real and raw scenario of a little girl who comes to her children’s church. That little girl happens to be eight years old, the same age as the hon. Lady said her sister was, and her grandfather brings her to church on a Sunday. She is only eight, but her daddy was murdered by paramilitaries. She came back to children’s church a few weeks later. Outwardly, she appeared to be the same happy child for the most part. However, during the prayer time, she asked for prayers for her granny, who is always so sad. The little one lost her daddy in dreadful circumstances and yet is also carrying the burden of worrying over her granny, who is sad.

Of course the leaders in the church are sensitive to the wee girl, yet it is clear that, although they can and do pour in love, she needs more help. What is not clear is how to get her that help. Referrals to child and adolescent mental health services in Northern Ireland rose from 8,719 in 2020-21 to 10,675 in 2021-22—a 25% increase—yet capacity has not increased at all. Will we put this little one on the waiting list, with a nine-month wait to be seen initially? How do we provide a link to help for this little girl who is grieving, and watching her granny grieve, and who just wants her family to be happy again?

We all need to think about that question, as it affects us all in each constituency in the United Kingdom. It has been estimated that around 26,900 parents die each year in the UK, leaving dependent children. That is one parent every 20 minutes. By the age of 16, 4.7%— around one in 20—young people will have experienced the death of one or both of their parents.

The Childhood Bereavement Network has come very succinctly to the crux of the issue, saying:

“No-one knows exactly how many children are bereaved each year. Data is collected each year on the number of children affected by the divorce of their parents, but not on the number affected by the death of a parent.”

As I say, I think that is the crux of the matter. The Childhood Bereavement Network continued:

“This information is urgently needed, to plan for service development and to make more sense of research on the impact of bereavement on children’s lives.”

The hon. Member for Edinburgh West made that point very clearly, and I make it too.

I look to the Minister for a response. I do not think that it is impossible to collect the data and try to help. If we do not know who and where these children are, how can we get them the help and support that they so desperately need? The answer is that we cannot. I have a request for the Minister. I know that she is a lady of compassion; we are all compassionate in this House, and we all bring our own individual stories to this Chamber. I ask the Minister very respectfully and gracefully to take our request on board, if she can, because these are things that we should be doing and we need to do.

The surviving parent or relation can take the step of asking the school. The school can ask the parent if they have spoken to a GP. The GP can ask if the school is providing counselling. But the fact is that none of those bodies has a duty to do those things. My fear is that children like the little one I have mentioned are simply lost in their grief if they are not acting out and drawing attention. In other words, we may not see the pain of that wee eight-year-old and others—the hon. Member for Edinburgh West referred to her sisters. We may believe that they are good and must be handling it all okay, but very often that is not the case.

Any child that is grieving needs to be given support without having to ask for it. That is why I thank the hon. Lady for her speech, offer my support and ask the Minister to make the change so that we have a registry and the automatic action that should come with that. I know the grief that I felt as a grown man over the death of my father. Life gave me that experience when I was much older, allowing me to acknowledge and deal with the pain in a healthy manner. Some of these children have no chance when it comes to that process, and that is why I believe help must be offered.

Again, I ask the Minister to do what I know she still wants to do, and what I believe she will do: to start off the support process with a registry of bereaved children. I support the hon. Member for Edinburgh West and sincerely thank her for bringing this issue to our attention. I look to the Minister to reach out and help bereaved children, who we all know really need that extra little bit of help. I know that families and friends are there in most cases, but sometimes we need to reach deeper; on many occasions, more is needed. Will the Minister respond in the positive fashion that I believe we all want her to?

It is a pleasure to speak in this important debate on a subject that I think many of us had not considered. I thank the hon. Member for Edinburgh West (Christine Jardine) for bringing the debate forward, and for drawing the House’s attention to what is clearly a very big issue. I also thank her for talking about her personal experience. It is when hon. Members talk personally or, indeed, as the hon. Member for Strangford (Jim Shannon) said, talk about people we are aware of that we start to get a sense of how such issues affect the people we serve. He summed the subject up when he talked about the eight-year-old who was more worried about her granny than herself. That internalisation of grief will obviously have an impact on the little ones we are talking about, so we need to start looking at this subject properly.

Bereavement affects many aspects of our lives and we have to put proper care and support in place for those who are bereaved; that is crucial for the health and wellbeing of anyone who is grieving, but particularly for children. It is difficult to get the statistics on this issue, as has been mentioned, but it is reckoned that by the age of 10, 60% of children and young people have experienced the loss of a family member in some way. Perhaps it is not a very close family member; possibly it is a grandparent, aunt or cousin. By the age of 16, between 4% and 7% of children in the UK will have lost a parent. That is quite a stark statistic. That will affect children from low-income households more than those who are born into wealthier ones. They may lose a parent or a sibling. The key factor for a grieving child is having a supportive adult in their life. Some parents might not be in a position to provide that support if they are overwhelmed by their own grief, so other adults, such as teachers and support workers, can do that.

In Scotland, we have done a lot of work with care-experienced children and young people; we have identified them and made sure that support is in place, but that was possible only because we identified them. We have to do the same for bereaved children, so that we can unlock available services. The Scottish Government have awarded the charitable organisation includem a contract to deliver the national childhood bereavement project, which will develop a curriculum in bereavement. It was created to improve support for those who are bereaved during their childhood.

During the pandemic, many children and young people not only suffered major disruption to their life and potentially lost a parent or grandparent prematurely, but were affected by social distancing measures that did not allow them the normal grief they would have had. Limits were put on numbers of people attending funerals, and there were barriers to the usual support. Even simple things such as getting hugs from family members were not possible. The project has tried to understand the experiences of children, young people and young adults in Scotland. The hon. Member for Edinburgh West mentioned that a 20-year-old is an adult. Is an adult really ready to cope with everything life can throw at them? In most cases, no. It is important that we look at how the issue impacts young adults as well.

To ensure that support is available to all young people who experience a bereavement, we need to know who those young people are. Schools have an important role to play. They are often aware of young people’s bereavement, and they will have a guidance teacher to whom the young person can speak, or pupil support assistants will be assigned to that young person to ensure the support is there. Schools are probably where there is good support, but are we sure it is always provided? We need to be careful about that. Ensuring that high-quality, person-centred care and support is available requires us to know who has to access it, and how do we sort that?

I have been dealing with a case over the last few months. I will not mention a great deal of detail, but this young person was bereaved as he was about to sit his exams. He actually did incredibly well in them, apart from one, in which he did not do so well. Often, exam boards do not properly take into account the impact of grief and bereavement, and the process that young people go through to get themselves back up and running. Of course, exam results can determine future chances, so it is not just schools and social services that should be aware. A register of the kind that the hon. Member for Edinburgh West is talking about would ensure that when young people were sitting exams, there was a flag or highlighter to show that they have gone through—and are still going through—a traumatic experience.

I have been involved in school records in Glasgow. When parents are filling in start-of-year information, there is now a box to tick to show whether the child or young person comes from an armed forces or veteran family. That allows support to be put in place, if required, for that young person. It would be easy to add another tick-box on the school register. I know that the hon. Lady is talking about far more than that, but it would be an easy, simple thing to do at the start of the year, so that we know that the issue is definitely recorded. With the best will in the world, while the school might be aware of the death of a parent, other family members can also have an important role in a young person’s life. This is about getting support in place, and being a voice for young people who would not necessarily have that voice themselves.

Finally, I pay tribute to the hon. Member for Edinburgh West for the work she has done. I was not aware of how important this issue was until I started looking into it. As she said, this change should be a straightforward, easy thing to do. We can register people to vote in elections; we can register people with GPs; and we collect all sorts of information, so let us get that tick added to the box for these young people, to ensure that support is available when and however they need it.

It is a pleasure to see you in the Chair, Sir Gary. I thank the hon. Member for Edinburgh West (Christine Jardine) for securing this important debate, which I believe should have cross-party support. This should be a win-win solution for children. I pay tribute to the work done in support of bereaved children by charities and campaigners, which do such important work helping those in need.

The hon. Member for Edinburgh West spoke with real passion and insight about her experience. We are all very grateful to her for sharing her personal story of the trauma, uncertainty and insecurity of losing a loved one as a child, and the impact that has on someone throughout their life. I pay my respects and tribute to her for her constant campaigning on this issue. The hon. Member for Strangford (Jim Shannon) also shared his insight and his concern about the challenges faced by bereaved children, and spoke of the need for mental health support in Northern Ireland. I thank him, and am grateful for his important contribution; his constituents will be proud of him today.

Losing a loved one can be devastating for any child, but unfortunately it happens to young people every day. While there are no official statistics on the number of children bereaved in the UK, according to the charity Winston’s Wish, one in 29 children—around one in every classroom—has experienced the death of a parent or sibling. A report by researchers at Cambridge University’s faculty of education found that those bereaved in childhood have an increased risk of being unemployed at age 30, and are more likely to report that they

“never get what they want out of life.”

The study found that although schools say bereavement support is a high priority, provision is “patchy”, with staff admitting that they lack the skills and capacity to help grieving children.

That is why it is so important that support structures are in place for struggling children, particularly when they lose a loved one, so that someone is there to talk to them, provide the support that is needed, and let them know that they are not alone in dealing with their loss. As we know, teachers are often the people children turn to when they do not know where else to go. It is therefore crucial that schools provide a truly compassionate culture for our children, and that teachers know how to speak with struggling children in a way that is sympathetic, careful, caring and helpful. On the whole, teachers and school support staff do an incredible job of that. Sadly, owing to the pandemic and the cost of living crisis, they have gained more experience of speaking with struggling children in recent years. We should not forget that school staff are not mental health staff; they are not bereavement or trauma experts, and we should not expect them to be.

The Government rightly ask that teachers direct struggling children towards expert resources in their community to help them deal with serious concerns and issues such as bereavement. However, for that system to work, those resources must be properly funded and actually accessible to those who need them. We need only speak to any teacher or school leader to know that, unfortunately, that is not the case. Right now, many children are dealing with loss and struggling with their mental health. They are struggling without support, unable to see a GP, stuck on a CAMHS waiting list for years, and left in limbo without support.

Mental health support teams are reaching only a fraction of the children whom they could benefit. No child should be left without the support that they need to be happy and healthy. That is why Labour has committed to giving children access to professional mental health counsellors in every school. We will ensure that children are not stuck waiting for referrals, unable to get support, and that children struggling with bereavement have someone to turn to—a specialist in that support. Teachers would not be expected to provide expert mental health services that they are not trained to deliver. We will make sure that every child knows that help is at hand.

For those young people for whom accessing support in school is not the right choice, we will deliver a new model of open-access youth mental health hubs, building on the work already under way in Birmingham, Manchester and elsewhere. That will provide an open door for all young people. All that means getting support to children early, preventing problems from escalating, improving young people’s mental health and not just responding when they are in crisis.

Alongside that investment in children’s mental health, Labour will oversee an expansion in the mental health workforce, resulting in more than 1 million more people receiving support each year. Labour will set a new NHS target to ensure that patients start receiving appropriate treatment, not simply an initial assessment of needs, within a month of referral.

For many children, losing a loved one can be an overwhelming loss. As we have heard, for some children that sadly spirals into more problems in the immediate and longer term. It is therefore essential that support is in place to help those children, and to ensure that the safety net is ready to catch every child in every school in every corner of the country, should they need that. Sadly, in recent years the Government have failed to provide that safety net for so many, with thousands of children across the country waiting far too long for support. We have set out our plan to make mental health treatment available to all in less than a month. In her response, I hope that the Minister will outline when her Department will start treating the matter with the urgency that it deserves. I hope that it will put a plan in place to ensure that all struggling young people, including bereaved children, receive its support.

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

I thank the hon. Member for Edinburgh West (Christine Jardine) for securing this debate on an important subject. I know that she has had personal experience of the issue, which is very close to her heart. I thank her very much for sharing that with us. I also thank the hon. Member for Strangford (Jim Shannon), who spoke movingly and eloquently about his own experiences with bereaved children. I know that many of us here will have experienced that and we share that profound sympathy for anyone going through bereavement.

The Government take the issue of supporting children and young people very seriously. As the hon. Member for Edinburgh West rightly pointed out, different elements of that support fall across Whitehall. I have a particular responsibility for children’s social services, which the hon. Member mentioned in her speech. Responsibility for responding to the needs of bereaved children ranges across the Department of Health and Social Care and the Home Office, and I will touch on that in my response. I should point out that the provision of support for bereaved children in Scotland is primarily a matter for the Scottish Government, and I am grateful to the hon. Member for Glasgow North West (Carol Monaghan) for her contribution. My response will primarily focus on support provided in England, however, and I will reference the figures and policies that apply to England.

Losing a parent is heart-wrenching experience for anyone. I have experienced that as an adult, but it is profoundly disturbing for children to lose a parent. I welcome the work of Winston’s Wish—funnily enough, my father was called Winston—and that of many other people. How families, children and young people respond to the loss of a loved one is very personal to them. As a Government we recognise the deep impact that bereavement can have on a child’s life and the far-reaching consequences it may have on their mental health, which has been touched on, their wellbeing and their academic performance, which might require additional support.

The hon. Member for Edinburgh West is right that there are no official statistics that record the number of bereaved children in the UK. The Childhood Bereavement Network—it too has been mentioned and I welcome its work on the issue—has estimated that 26,900 parents die each year in the UK, leaving approximately 46,300 dependent children aged zero to 17. Those figures are based on sources such as the census and mortality statistics in the absence of other data, so they can provide only a rough estimate.

Not all children will need access to services when they experience bereavement, which is largely testament to the wider family network support that so many children receive. Where additional support is needed, the Government are committed to ensuring that it is provided. It is important that we draw on all arms of Government, including the Department of Health and Social Care, to provide mental health support and services, as well as many other Government Departments working on programmes for families, which includes the Department for Work and Pensions and the Department for Levelling Up, Housing and Communities, to ensure that we provide that joined-up support.

We are always looking at how we can improve support for bereaved children. As a result, the Government are committed to ongoing engagement with the voluntary sector and across Government to assess how we can provide further support for children who have been bereaved. Before coming to the issue of the register, I want to set out some of that support. One of the most important ways we can support bereaved children is through providing support for their family. Early help services play a pivotal role in supporting families, and can be used in some cases to support children through bereavement.

We have taken a number of actions to prioritise such services. “Stable Homes, Built on Love”, published earlier this year, sets out our bold and ambitious plans to reform children’s social care. Family help reforms are central to delivering our vision of a reformed system, will provide effective and meaningful support for families and will feature multi-disciplinary teams, bringing all those different partners together to meet the whole needs of a family. We are providing more than £45 million of additional funding to pathfind family help.

That builds on our wider support for families, including the £695 million supporting families programme, which this year sees its 10th anniversary. It has helped more than 650,000 vulnerable families by supporting the whole family to achieve positive and sustainable outcomes. The Government have also invested more than £300 million to establish family hubs and transform Start for Life services in 75 local authorities. Those family hubs will provide mental health support for parents and young people, with guidance on where to reach more access to mental health and emotional wellbeing support. Further, the statutory guidance, “Working Together to Safeguard Children”, is clear that local areas should have a comprehensive range of effective evidence-based services in place to address needs early.

I want to turn to mental health support, which has been rightly mentioned today. Hon. Members will be aware that that falls under the Department of Health and Social Care, but we are looking at expanding the help that young people can get in schools via the Department for Education. We are expanding specialist mental health support by investing an additional £2.3 billion a year into mental health services by 2023-24, so that 345,000 more children and young people a year will be accessing mental health support by then.

In schools, we are introducing mental health support teams, which will offer support to children experiencing common mental health issues such as anxiety and low mood, and will offer smoother access to external specialist support that we know can be so helpful. They cover 26% of pupils in England, a year earlier than originally planned. That will increase to 399 teams, covering about 35% of pupils, by April 2023, with more than 500 planned to be up and running by 2024.

More than 11,700 schools and colleges have received senior mental health lead training grants so far, which includes more than six in 10 state-funded secondary schools, backed by £10 million this year. In May 2021, £7 million was invested in our wellbeing for education recovery programme, building on the success of our 2020-21 £8 million wellbeing for education return programme. More than 14,000 state-funded schools and colleges in England benefited from the two programmes, which provided free expert training, support and resources for staff dealing with children and young people experiencing additional pressures from covid-19, which included a focus on supporting pupils with bereavement.

We have announced £1.3 billion recovery premium funding for the 2021-22 and 2023-24 academic years for schools, which on top of pupil premium can be used to support pupil mental health and wellbeing. That can include counselling and other therapeutic services. As part of the support we offered in response to the covid-19 pandemic, we have provided a list of resources for schools to draw on in supporting pupils’ mental health and wellbeing, which includes signposting to the Childhood Bereavement Network, Hope Again, and resources from the Anna Freud Centre.

Bereavement is also considered in our thinking on the mental health and wellbeing part of the relationships, sex education and health curriculum, so that can be taught in schools. We are all aware that attendance is an issue post pandemic, and it is in our minds that bereaved pupils might find it harder than others to attend school, and to think about how schools and partners should work together with pupils, parents and carers to remove any barriers.

As the hon. Member for Edinburgh West is aware from our recent meeting, responsibility for the registry of bereaved children sits primarily with colleagues from the Home Office. The Home Office has recently confirmed there are no plans to change the law in that respect, but I would encourage the hon. Member to continue having such conversations with the Under-Secretary of State for the Home Department, my hon. Friend the Member for Derbyshire Dales (Miss Dines), who is the Minister responsible for safeguarding. Everyone will agree that support for bereaved children is incredibly important. I know the hon. Member has already had some good conversations, and there is a lot of sympathy for the work that she talks about. I look forward to working with her, and continuing to talk about how we can best support children who have experienced profound loss, across the whole of Government.

I thank the hon. Member for her eloquent and emotional speech, and for securing a debate on this important subject. Loss, and other traumatic experiences, have a profound impact on children, and I pay tribute to the children and their families who are dealing with unimaginable grief. The Government are committed to providing support through early help services as required. That is more effective in promoting the welfare of children than reacting later, as has been mentioned. I look forward to the further work we can do in this area.

I thank the Minister for her comments, and everyone for their contributions. The thing that I take away from the debate is that we all agree. There is no dispute about the need to get the support that the Government are providing to those who need it. The family hub sounds like an excellent idea. The mental health support is there. Charities and organisations such as Winston’s Wish, as we have all mentioned, are doing tremendous work. They are running special camps for children to help support them; they are doing everything they possibly can. There is just one missing link in the chain, which is knowing where the children are.

We have learnt a lot of lessons from covid. As the hon. Member for Strangford (Jim Shannon) mentioned to me, one of them is about safeguarding. As the hon. Member for Glasgow North West (Carol Monaghan) said, children were deprived of hugs at a time when, for many of them, hugs were what they needed most. From today’s debate I have taken away a great deal of comfort, reassurance and belief that we will manage to do this. I will take the Minister’s advice and speak to the Minister responsible for safeguarding at the Home Office, and hopefully we will move on and achieve what we all want to achieve.

Question put and agreed to.


That this House has considered the potential merits of a registry of bereaved children.

Sitting suspended.

P&O Ferries Redundancies

[Relevant document: Oral evidence taken before the Transport Committee and the Business, Energy and Industrial Strategy Committee on 24 March 2022, on P&O Ferries, Session 2021-22, HC 1231.]

4 pm

In a moment, I will call Ian Lavery to move the motion. I will then call the Minister to respond to the debate, but I think that in between the two Mr McDonald will make a very short speech. There will not be an opportunity for the Member in charge to wind up, as is the convention in our 30-minute debates.

I beg to move,

That this House has considered lessons learned from redundancies at P&O Ferries.

I refer to my entry in the Register of Members’ Financial Interests, with regard to my trade union membership. It is a pleasure, as always, to speak under your chairmanship, Sir Gary.

It is worth looking back at what actually happened to the 786 staff who were dismissed by P&O Ferries and DP World on 17 March 2022. We remember watching staff on the television who reported being sacked in a pre-recorded Zoom call, without prior warning or indeed any consultation whatsoever. P&O had callously prepared beforehand, recruiting handcuff-trained private security guards in balaclavas to frogmarch employees off the P&O vessels.

The P&O chief executive, Peter Hebblethwaite, admitted to the Transport Committee that the company had deliberately ignored the law and that some of the agency crew replacing those sacked would be paid below the minimum wage; and astonishingly, he said that the company would do it again, given the opportunity.

I commend the hon. Gentleman for securing this debate. Does he not agree that the disgraceful treatment of P&O Ferries staff, which he outlined, has reminded this House of the importance of employment legislation, that any loopholes must be sealed, and that no one should be able treat decent and hardworking people so contemptuously, with no redress and complete legal impunity? As I say, I commend the hon. Gentleman; he does well and congratulations to him on securing this debate.

I thank the hon. Gentleman very much for that intervention; I will cover the points he has raised.

To get back to Mr Peter Hebblethwaite: Minister, how on earth is he still in position? I must ask that, as my first and probably most interesting question. A man who agreed that he was breaking the law; a man who said that he would not expect the trade unions to agree with what he was doing; a man who said, despite the fact that he was breaking the law, he would do it again —and he is still in position. Why? That is the question.

The right hon. Member for Uxbridge and South Ruislip (Boris Johnson), the former Prime Minister, claimed from the Dispatch Box on 23 March last year that the Government were taking legal action against P&O Ferries, but they have not done so as yet. So my next question to the Minister must be: why has no action been taken against P&O for how it acted back on 17 March 2022? Parliament must correct that injustice. The purpose of today’s debate is to learn the right lessons from P&O’s breathtaking act of corporate aggression against British workers, and to take the right actions, particularly where they are missing from the Government’s response.

My concern and that of colleagues is that the Government’s responses to date will neither close loopholes nor, crucially, challenge the anti-trade union mindset at the heart of P&O and DP World’s despicable actions. Ex-P&O seafarers and their trade unions—the National Union of Rail, Maritime and Transport Workers, and Nautilus—are increasingly frustrated at the Government’s failure to penalise P&O Ferries, DP World or the flag states involved in this injustice, as early-day motion 954 highlights. As a result, UK seafarers and trade unions across the maritime industry cannot be certain that a similar assault on jobs and employment rights will not happen again.

The first anniversary of the Government’s nine-point plan in response to P&O Ferries is on Thursday. Although the Seafarers’ Wages Act 2023 is welcome, it is unnecessarily narrow and will not come into full legal effect until next year. The Transport Committee has correctly observed that, on its own, the Act

“will not be sufficient to ensure proper treatment of seafarers.”

I ask the Minister: where is the review of the Equality Act 2010 (Work on Ships and Hovercraft) Regulations 2011, which provide limited protection for seafarers from nationality-based pay discrimination? That is what P&O, Irish Ferries and Condor Ferries and other businesses base their model on. That review was supposed to have started by the end of 2020. Minister, when will it start?

For all other employment conditions, including tackling roster patterns of up to 17 weeks on P&O’s fleet, the Government propose a voluntary seafarers charter. The agreement was to base standards in the charter on the collective agreements between the RMT, Nautilus International, Stena Line and DFDS. The charter still has not been agreed, and there are very real concerns among the unions that it is not fit for purpose. Repeated efforts to amend the Seafarers’ Wages Bill to give the charter legal force were defeated by the Government on the grounds that it would effectively mandate collective bargaining. In reality, that is what we need now, and not another review in a year’s time.

As the Transport Committee’s excellent report on the “Maritime 2050” strategy observes of the seafarers’ charter,

“the Government’s current plan to ask operators to sign up voluntarily will not give the assurances and protections that seafarers want and deserve. We therefore call on the Government to make signing up to the charter a mandatory requirement for all UK maritime operators.”

Labour’s prescription of mandatory rights and standards cuts to the heart of the problem. Restoring trade union collective bargaining agreements, safe roster patterns and dislodging the supply of cheap agency labour on flag of convenience vessels is the way forward and will increase seafarer jobs in this country.

I would like to ask the Minister a whole number of questions. Forgive me; I am sure he will not have the time to respond to every one from the Dispatch Box, but I will put them in writing so that we can get a written response. When will the Government make the seafarers’ charter a mandatory requirement for all other operators in the ferry sector? Will the Minister give the trade unions a formal role in assessing the compliance of operators’ policies with the standards in the charter? What assurances can he give that the charter will not undermine existing collectively agreed terms and conditions in the ferry industry? When will the independent research on roster patterns from the Department for Transport report to Ministers?

The P&O scandal affects the 19,000 mainly retired seafarers in the merchant navy ratings pension fund, a multi-employer scheme to which P&O Ferries owes around about £130 million. It is a liability that it is trying to avoid. What are the Government doing to ensure that DP World meets its liabilities to the members of the MNRPF?

P&O Ferries knowingly and unashamedly breached section 188 of the Trade Unions and Labour Relations (Consolidation) Act 1992. It has benefitted from weaknesses elsewhere in the Act, especially in the Government’s interpretations of sections 193, 194 and 285. Section 285 was cited in the Insolvency Service’s decision not to proceed from the evidential test to the public interest test of prosecuting P&O Ferries for criminal offences, because it was said that section 285, in the judgment of the Insolvency Service, provided only an “even chance” of a successful prosecution. Yet there is nothing in the nine-point plan to close the loopholes in the 1992 Act, despite the urgent need to equalise redundancy rights, as a starter, for land-based workers and seafarers.

The protections that P&O breached were introduced in 2018, with the support of the trade unions, with the express intention of strengthening seafarers’ basic employment rights. There were no protections before, which is why P&O Ferries’ decision to breach them must be the start of a fightback against this despotic approach to industrial relations in the ferry industry. Will the Government therefore commit today to strengthening the Trade Union and Labour Relations (Consolidation) Act 1992 by amending section 188 to ensure that it clearly applies to seafarers working regularly from UK ports on international routes, and commit to outlawing ex gratia payments to employees connected with an intentional breach of section 188 of the Act ?

Will the Government amend section 193A(2) to legally require employers to notify the Secretary of State for Transport, regardless of the flag of the vessel, of an intention to make more than 20 seafarers redundant, and amend section 194(3) to ensure that the definition of “body corporate” applies to overseas owners, such as DP World? Will they also amend section 285 to provide these protections against instant dismissal for all seafarers working regularly from a UK port, regardless of nationality or the flag of the vessel? Will the Minister make absolutely sure that the Retained EU Law (Revocation and Reform) Bill does not strike out these minimal protections for seafarers in the 1992 Act?

I return to the shocking decision of the Insolvency Service not to pursue criminal damages and charges against P&O Ferries, effectively letting the company and its chief executive Peter Hebblethwaite off absolutely scot-free. It is essential that we get to the bottom of this chronic regulatory failure, so will the Minister commit to looking at that? Will the Minister commit to reforming the Insolvency Service so that a public interest test informs the evidential tests in cases like P&O where a company director blatantly breaks the law to dismiss directly employed seafarers in collective bargaining agreements, and even say they would do the same again? When do the Government expect the Insolvency Service’s civil investigation of P&O Ferries to conclude? The RMT estimates that UK seafarers hold around only half of the 5,300 ratings jobs on cargo and passenger ferries regularly working on a number of international routes, including Crown dependencies. The union believes we are heading in the wrong direction.

The picture across all sectors of shipping is still worse. The Government’s own impact assessment for the Seafarers’ Wages Act 2023 observed that over the past decade UK-resident seafarers have held, on average, 17% of the total number of ratings jobs across the UK shipping industry. That is a national scandal. This rampant profiteering from exploitative crewing contracts is a fundamental lesson from the P&O scandal, and it has serious safety implications. We need to know what action has been taken to assess seafarer fatigue levels on the P&O Ferries fleet, and what the Maritime and Coastguard Agency is doing to monitor the effectiveness of DP World’s safety incident reporting tool, H-SEAS?

P&O Ferries moved its fleet of six ROPAX—roll-on roll-off passenger—ferries from the UK ship register to the Cyprus register in 2019. The Cyprus register has said nothing on the unlawful sackings, in a clear indication of the effects of deregulated shipping registers on decent employment standards. Will the Minister tell us why the Government have signed an agreement with the Shipping Deputy Ministry of Cyprus to co-operate on shipping matters, including seafarer employment and welfare conditions? The Cyprus register is increasingly popular with ferry operators, which is a real source of concern for those UK seafarers working on Cyprus-registered vessels. Is the Minister promoting the Seafarers’ Wages Act 2023 and the seafarers’ charter as part of this agreement?

It is hard to square that with the ambition in the nine-point plan to grow the UK ship register, unless Ministers intend to further deregulate the red ensign. Earlier this month, DP World reported record profits with £3 billion in dividend payments and £15 million in bonuses to directors, including those at P&O Ferries. It is a scandal that the £11.5 million that P&O Ferries received in furlough payments from the UK taxpayer has not been repaid and that DP World will benefit from lucrative Thames Freeport contracts. I also ask the Minister to investigate urgently the delay in P&O Ferries Ltd submitting accounts for the year to 31 December 2020-21, as my hon. Friend the Member for Sheffield, Heeley (Louise Haigh) raised in a written question.

The future of the UK as a maritime nation, with secure ferry operations supporting full seafarer employment, is at stake here. P&O is introducing new sailings and ferries, and others, such as Cobelfret, are introducing new services that are likely to fall outside the scope of the Seafarers’ Wages Act. How can anyone have faith that the correct lessons will be learned from last year’s scandal while this injustice is allowed to persist?

I refer the House to my entry in the Register of Members’ Financial Interests. I thank the Minister and my hon. Friend the Member for Wansbeck (Ian Lavery) for his forensic speech, and for granting me permission to say a few words about the appalling redundancies of those 800 seafarers, and the lessons that have not been learned from the experience.

My hon. Friend outlined the outrage we all felt when Peter Hebblethwaite, the CEO, made an incredibly shocking admission in Parliament that he knowingly decided to break the law. I was on the Joint Committee when he told us:

“There is absolutely no doubt that we were required to consult with the unions. We chose not to do so.”

They made a calculated decision to break the law because they reckoned, rightly, that the unions would not accept an offer that would slash workers’ wages. They considered it more expedient to absent themselves from their legal obligations and price in the cost of law-breaking, and engage agency staff on pay as low as £1.80 an hour. They did that safe in the knowledge that any compensation that they would have to hand out to former unionised workers would be offset by the benefits of paying poverty wages to their replacements. They belong in the pages of a Dickens novel, not in 21st-century Britain. The fact that Mr Hebblethwaite remains in post at P&O is staggering. He should be disqualified from being a company director.

Does my hon. Friend share my concern that agency crews are working unsafe roster patterns, being at sea for up to 17 weeks? That has implications for everybody who travels on those ferries.

My hon. Friend is absolutely right. It is utterly staggering that those are the terms and conditions that these major companies are prepared to inflict on workers. It does not matter whether they are from Britain, Poland or wherever in the world. That they would treat human beings in that way is beyond barbaric. Sadly, the Government have simply not learned the lessons from that scandal. The action taken has been insufficient. The Secretary of State passed the buck to the Insolvency Service, which, after months of prevarication, said it would take no further action.

In lieu of that, Ministers could have imposed an unlimited fine on the company. The Opposition made it clear that we would have supported any necessary changes to legislation, but the Tories let P&O off the hook, I am afraid. Thanks to that inaction, we are witnessing a race to the bottom, which is likely spelling the end of any residual UK maritime workforce. All the while, P&O’s parent company, DP World, announced earlier this month that it had received record profits and a £3 billion final dividend for 2022. It also gets financial help from the Government for the berth at London Gateway.

I fear it is not just companies in the maritime industry that will follow suit; there will be others. Businesses across the economy will know that they can blithely commit such crimes of corporate thuggery, and decimate workers’ rights and protections in the process. I am going to finish, because I want to give the Minister the opportunity to respond. The events of the P&O Ferries scandal serve to underscore how much we need reform of employment rights and protections in this country.

It is a pleasure to speak with you in the Chair, Sir Gary. I thank the hon. Member for Wansbeck (Ian Lavery) for bringing forward this important debate.

G. K. Chesterton said:

“Too much capitalism does not mean too many capitalists but too few capitalists”.

I absolutely agree with that. I think there is agreement across the House that the vast majority of employers are decent people who treat their employees properly. However, some of the egregious behaviour we have seen in this case, and in others as well, happens when there is too much power in the hands of a few very large operators that dominate certain sectors. The title of this debate is absolutely right, in that there are lessons we can learn from the case of P&O.

The hon. Member for Wansbeck made lots of points. He said to me before that he did not expect me to respond to them all today, and I probably cannot, but I will write to him about the ones I do not pick up on. Some are dealt with by other Departments such as DFT, but I am keen to facilitate responses on all his points where I can. We are in total agreement here: the behaviour of P&O and its chief executive was disgraceful and gratuitous, running roughshod over UK legislation, as I saw in the testimony referred to by the hon. Member for Middlesbrough (Andy McDonald). That is absolutely appalling, and we must deal with it. Yes, we need to learn the lessons, and we have learned some already. We are determined to look at this issue carefully and to go further where we need to. I think the hon. Member for Wansbeck knows that we have taken some action already, but I fully understand that he might want us to go further.

So much attention has been drawn to this appalling behaviour because it is very unusual. I was an employer for 30 years, and most employers would never have considered not carrying out the requirements around consulting the workforce. That is because it was the right thing to do and because we wanted to have a good reputation as an employer with our existing staff and any staff who would join us in future. There is something fundamentally wrong when an employer can set aside the clear requirements to consult the workforce in these instances.

It is fair to say that the Government were very clear in their condemnation early on. The Secretary of State wrote to P&O to ask it to reverse its decision and asked the Insolvency Service to investigate whether the law was complied with. That investigation has not yet concluded. The criminal side of the investigation has reported back. A senior prosecution barrister looked at the matter and decided there were not sufficient grounds to take forward a criminal prosecution. The civil investigation is still live, and it is important we give it the opportunity to run its course.

We all believe in the principle of due process in these cases. Certainly, there is still a chance, as the hon. Member for Middlesbrough noted, of an up to 15-year ban of a director if there are sufficient grounds, so we should let the Insolvency Service conduct its work. Like others, I urge the service to do that work as quickly as possible so that it can come to a resolution and more lessons will hopefully be learned. Indeed, if lessons are learned, I am keen to take further action where necessary to clamp down on such behaviour.

Does the Minister accept that we were told that action would be taken urgently and it was not? In that vacuum, there is no reason why DFDS, Stena and other ferry services could not do the exact same thing and more seafarers could lose their jobs.

The hon. Gentleman raises an important point. I do not accept that no action has been taken, and we are consulting on some things now to try and beef up the requirements in terms of consultation. We have already done some things.

The hon. Member for Wansbeck referred to the Seafarers’ Wages Act and the requirement to pay a minimum wage in UK waters. He is right to say that the seafarers’ charter is a voluntary code for now, and we want to see how that operates. I fully respect his perspective that this should be mandatory across the piece, but when there is a proportionate approach—we do not feel at this point that it is. Nevertheless, we have legislated in that area. That legislation has received Royal Assent and is now law, but the hon. Member for Wansbeck is right that some secondary legislation is required for it to be fully and effectively implemented.

On the Thames freeport, let me clear: we have not given any money to DP World, but we have given money to Thurrock Council. However, some of the land needed to operate a Thames freeport includes land owned by DP World. It would be cutting off noses to spite faces if we said, “You can’t use that land, because of its ownership,” and we do not believe in compulsory purchase, except in certain circumstances. I think that would be the wrong—

Well, that is a slightly different case.

It was interesting that none of the contributions suggested that we would ban fire and refire. Interestingly, the deputy leader of the Labour party, the right hon. Member for Ashton-under-Lyne (Angela Rayner), said Ministers would not ban the behaviour, judging that it is “acceptable in some circumstances”. So I think we are probably all on the same page in terms of making sure the bar is high on the requirements for anybody using these kinds of tactics and making sure that people cannot just run roughshod over them.

New guidelines from ACAS in 2021 were clear that this kind of action should be taken only as a last resort. In terms of a statutory code of practice, there is a 12-week consultation from January 2023. The principle behind that is that there is a 25% compensation uplift in employment tribunals if consultation requirements are not adhered to. We think that sets a sensible balance between the two. Having said that, I am keen to go further, where we can, and to look at the different provisions we can put in place to make sure that the requirements on employers work in practice. It is clear that has not been the case in this case, which is why we have gone further.

To conclude, I thank the hon. Member for Wansbeck again. He knows I am as incensed as he is by the actions of this employer because they bring into disrepute the good name of many other employers, which cannot be right.

Just briefly, on fire and rehire, we have to be clear about what we are talking about here. This was not firing and rehiring the same workers; this was firing workers and replacing them with cheaper workers. That is the point that concerns us. If companies get into financial difficulties, there has to be a proper mechanism for protecting people if they have to have lower terms and conditions. That is the point we are making.

We are totally on the same page. The fire element is the worry here. Setting aside the consultation requirements, hon. Members will remember the case of British Airways, which threatened fire and rehire during the pandemic. It did not go ahead with that tactic, as P&O did, but consulted the workforce and found a way through. That shows why the consultation period is so important. Making sure that the provisions we have work in practice is key.

As I say, we already have the Seafarers’ Wages Act. We will keep the issue under review. We are keen to see the outcome of the Insolvency Service investigation and, as far as I am concerned, where action can be taken, it will be taken. We should bear it in mind that we want to act in a proportionate way. Most employers do the right thing. I have never heard of a case like this one before. Most employers do adhere to consultation requirements. We should celebrate the good employers we have in this country, as well as clamping down on the bad ones, and I am determined that we do so.

Question put and agreed to.

Medical Technology Regulations and the NHS

I beg to move,

That this House has considered medical technology regulations and the NHS.

It is a great pleasure to serve under your chairmanship, Sir Gary, and to talk about the importance of medical innovation and medical technology in our NHS. We know that the NHS faces significant challenges, but medical technology—or health tech, as it is often called—holds many of the solutions that are necessary to achieve things such as delivering improved patient outcomes and facilitating the transition to more sustainable models of health and care delivery. It also has massive potential to drive economic growth.

Health tech includes everything from laboratory tests to wound care dressings, mental health apps, implantable defibrillators and critical technology—everything that is absolutely fundamental to the diagnosis and treatment of health conditions. Life-saving and life-enhancing health technologies, such as cardiac pacemakers and artificial knees and hips, are already highly regulated products. While we were part of the EU, UK-based health tech was subject to CE marking, but now there is a need to develop sovereign regulatory arrangements that provide equal levels of patient safety while protecting timely access to global life-saving and life-enhancing health technologies.

The Medicines and Healthcare products Regulatory Agency is solely responsible for regulating the UK’s medical devices market and is mandated to ensure that patient safety is protected, irrespective of where a product is manufactured. The MHRA has a huge responsibility on its shoulders, and it is for that reason that I welcome the Chancellor’s commitment in the spring Budget to reform regulations around medicines and medical technologies. In fact, that was the thrust of why I asked for this debate, so it is lovely to be able to welcome that announcement rather than to be pushing for it. It is a much more comfortable position for me to be in.

The Chancellor confirmed that the MHRA will receive £10 million of extra funding over two years to maximise its use of Brexit freedoms and accelerate patient access to treatments. He also confirmed that the MHRA is moving to a new model, which will allow near automatic sign-off for medicines and technologies that have already been approved by trusted international partners in places such as the USA, Japan and Europe. That is important, because the US Food and Drug Administration—the FDA—is recognised as delivering high-quality, innovative health tech to its citizens in a timely manner while maintaining high standards of patient safety. Those product regulation-equivalent routes, which recognise the decisions of trusted jurisdictions that have already looked at medicines and technologies very carefully, can protect NHS patients’ access to high-quality products and allow our own regulator to focus resources on where they can make the most impact.

I thank the hon. Lady for bringing this issue forward, and I apologise to her and others for not being able to stay—I have another meeting at 5 o’clock, as I mentioned to you, Sir Gary.

I am my party’s health spokesperson, so I am very aware that regulation is essential to our health service. I strongly believe that regulation and demand should go hand in hand on health. Regulating the use of apparatus, instruments, tools, scanners, drugs and monitors is one thing, but does the hon. Lady agree that accessing them is another? It is imperative that we ensure that patients can make use of life-saving treatments. Aspiration is good, but delivery is better.

It is always a great pleasure to see the hon. Gentleman, who always make very sensible interventions on these issues. He is absolutely right: we need the right regulation in place, but we also need to have the facilities to make sure that, once technology and treatments have been approved, they are easily and quickly accessible to those who most need them.

I will be the first to admit that I was not the biggest advocate of Brexit. However, the freedoms afforded by Brexit allow us the opportunity to recognise approvals from any jurisdiction that we deem appropriate. Of course, any products that enter the UK market via regulatory equivalence routes from trusted international jurisdictions will need to be approved by the MHRA and to be subject to strict vigilance and post-market surveillance requirements, so a number of checks and balances are in place for British patients. However, this new system post Brexit gives the UK more control to determine what products can be placed on the market.

As the hon. Member for Strangford (Jim Shannon) said, we must ensure that the regulatory system is robust but also prevent the UK from becoming a secondary market, where patients and clinicians have less access to technologies. The right system not only increases the UK’s access to the newest innovations but increases patient safety by maintaining access to the widest possible range of thoroughly regulated and already available health technology from around the world.

Therefore, my first question to my hon. Friend the Minister—I should warn him I have two or three—is whether he can confirm the timescales for the new model to ensure continued patient access to health tech and whether there will be a sense of urgency about this. The Minister and you, Sir Gary, will know that the pandemic, through the early innovation of the vaccines and the remarkable work done by British scientists, demonstrated the UK’s ability to be a real science and technology superpower. However, there is an urgent need for action to ensure that we do not lose the opportunity to impact patients’ lives and effectively deliver on this ambition and this ability.

We have the potential to make the United Kingdom the most attractive place in the world for innovation and, in particular, medical innovation. We know that medical technology helps to deliver better patient outcomes, improves care pathways, drives cost savings in the NHS, reduces the burden on the workforce and, critically, can help to reduce the backlogs. This matters to people’s lives. In the Hampshire and Isle of Wight integrated care board area, more than 54,000 people are waiting to start treatment. The average time people are waiting in my local area to start their treatment is 16.9 weeks, with 47% of patients waiting more than 18 weeks. That is why we need to capture the potential of every way possible of ensuring that people get access to treatments as effectively and quickly as possible.

In Gosport, 1,500 people have a dementia diagnosis. Dementia is one of the biggest healthcare challenges facing us as a nation, but there are some exciting and innovative developments there too. The EDoN—Early Detection of Neurodegenerative diseases—project will use wearable tech to detect signs of dementia even 10 to 15 years before symptoms appear. Too often, a dementia diagnosis comes far too late—once symptoms are already well advanced. This technology could be game changing by allowing people to make advance lifestyle interventions that might minimise the impact of the condition. However, it will also enable scientists to make a huge contribution to research and clinical trials of drugs and interventions that will work, inevitably in the long term, through to treatments and cures.

This is also an area where we need to see the rapid approval of new treatments as they become available. In January, the FDA—the US regulator—approved the first treatment shown to slow degeneration in dementia. Two drugs are currently on trial in the UK, and the people conducting the trials expect to publish their findings later this year. Neither drug has an easy name to pronounce: donanemab and lecanemab. Can the Minister please assure me that the MHRA stands ready to accelerate the approval of these schemes as soon as they become available—it sounds as though one is imminent; it may be in the next couple of months—so they can start supporting patients at the earliest opportunity?

If I may just flag one issue with the Minister, one obstacle to these drugs being available on the NHS is the National Institute for Health and Care Excellence guidelines, which often approve medicines based on their cost-effectiveness. In this case, it will be remaining years of healthy lifespan versus the cost to the NHS. The cost of dementia is of course largely not borne by the NHS—the cost to it is only about £1.5 billion a year, compared with the £26 billion borne by the adult social care system and the informal care sector.

Will the Minister kindly agree to meet Alzheimer’s Research UK to discuss how we can best ensure that UK patients get swift access to the best possible dementia drugs as soon as they are available and that the systems designed to offer checks and balances, such as NICE, do not prove to be an obstacle to that?

Will the Minister assure us that every effort will be made to engage with the global health tech industry to ensure that the UK proactively seeks innovations for the benefit of UK patients while encouraging UK-based innovation? There is a lot of innovative practice going on right under our noses. Health tech will play such a key role in driving not only UK national economic growth but great amounts of regional growth. There is an organisation called SIGHT, or Supporting Innovation and Growth in Healthcare Technologies, which is a business support programme developed by the University of Portsmouth to provide help and guidance to small and medium-sized businesses in the healthcare technology sector. In the Wessex region, which is where Gosport sits, 10% of the workforce is employed in the health economy, and more than 300 health and life sciences companies are focused on medical technological innovation. The SIGHT process will provide an important boost to the regional economy through its support for the sector. What steps is the Minister taking to encourage local innovation and entrepreneurship in the medical technology sector, and how can he enable the implementation of innovation in the local care system, which can sometimes be quite risk averse?

To maintain the NHS’s access to the 600,000 currently available CE-marked products, it will be important not to add unnecessary burdens on to manufacturers that already supply a relatively small market, so transitional arrangements provide for a dual regulatory regime, with the unilateral recognition of CE marking in place until July 2024, subject to legislative approval. That recognition could be continued and expanded for the benefit of the NHS and patients across the country. Perhaps the Minister could talk a bit about that.

We need to act fast. A recent survey by the Association of British HealthTech Industries—the ABHI—shows that one in five products is expected to be removed from the market over the next five years, and one in 10 companies is halting all innovation activity. That has been driven by persistent uncertainty, constrained capacity in the system and increasing costs. The ABHI survey also highlighted that 67% of the health tech industry expect a delay in bringing innovation to the UK, and the figure rises to 86% for those manufacturing in vitro diagnostic medical services.

The right kind of regulation will be key in setting the standard as to whether the UK is an attractive place to do business and promote innovation. It will ensure that UK patients continue to receive world-class technologies such as surgical robots and digitally enabled remote care, and it will protect our ability to react swiftly and effectively to any further pandemics by developing the latest diagnostic tests.

In addition, I understand that the Government are already committed to a medical device information system. That will collect key details of the implementation of all devices, which will be linked to a specific register to research and audit patient outcomes. That will deliver a system that allows the UK to record and access device safety and patient outcomes. That medical device roadmap lays out an ambitious vision for how the UK can become world leading in this space and a real global superpower in digitally enabled health tech. Will the Minister assure us that its delivery will be prioritised to ensure that we build on the positive reaction to its publication?

There are concerns that existing capacity constraints may impact the MHRA’s ability to deliver and most effectively use the additional funding that the Chancellor has made available. Making the most of expertise and capabilities across the ecosystem will be crucial. As well as the development of more product regulation equivalence routes to allow for the recognition of approvals in other trusted jurisdictions, we must explore all other options to ensure the expansion of existing capacity, including by reviewing the role that the MHRA can take in direct regulation, providing it with both the resource and political impetus to increase UK regulatory ambition, and enabling the development of recognition and innovation systems.

The recent commitment by the Chancellor and the Prime Minister is welcome, and it indicates that the Government truly recognise the need to ensure that there is appropriate focus and support for the ambitious innovation programme that supports clinical and patient need, availability, and choice. It is by investing in developing the skills required that we can ensure that the UK continues to be a leader in regulating the technologies of the future.

The freedoms afforded by Brexit allow us to seize the once-in-a-generation opportunity to deliver a best-in-class regulatory system and enable the health tech industry to support the drive for the UK to become, and continue to be, a global science and technology superpower.

I am grateful to the hon. Member for Gosport (Dame Caroline Dinenage) for securing today’s debate, and for the manner in which she summarised the case. I may disagree with her optimism on the Brexit side, but I think there is a lot here that we can agree on.

This issue is of great concern to all our nations. Medical devices are used in the diagnosis, treatment and management of a wide range of diseases and conditions. Across these islands, it is estimated that one in 25 people has an implanted medical device. The regulation of medical devices is reserved to the UK Parliament and regulator, and the Medicines and Healthcare products Regulatory Agency covers all medicines and medical devices used in the diagnosis and treatment of illnesses. Under the current UK regulations, manufacturers must report any adverse issues involving medical devices to the MHRA.

In the Scottish context, Health Facilities Scotland assists the MHRA in providing technical and operational support to the Scottish Government health and social care directorate, and to NHS Scotland. In February 2018, the independent medicines and medical devices safety review was launched to investigate how the health system responds to concerns about the safety of treatments. The review, chaired by Baroness Cumberlege, focused on vaginal mesh, sodium valproate and hormone pregnancy tests. The review’s report, published in July 2020, made nine recommendations. My colleagues in the Scottish Government have committed to implementing all the recommendations of Baroness Cumberlege’s review, including the appointment of a Scottish patient safety commissioner.

As we have heard, patients, families and campaigners brought to light those horrific medical disasters: the use of the hormone pregnancy test Primodos; the use of the antiepileptic drug sodium valproate in pregnancy; and the use of vaginal mesh. It is clear that the same underlying issues have driven all three disasters. There were four main features: a failure of licensing and regulation in the first place, particularly regarding implantable devices, such as vaginal mesh; a lack of accurate information to enable doctors to discuss the risks of those devices and allow patients to give informed consent; a weak system for doctors or patients to report the adverse events, which would have resulted in action; and, in some cases, a failure of doctors to listen to the affected women who raised concerns.

Health technology, medical devices and equipment are crucial in delivering services in NHS Scotland, and they must meet clinical and information governance requirements to minimize the risk of adverse events. To provide high-quality patient care, medical technology must be procured, managed and maintained appropriately. Although the regulation of medicines and medical devices is currently a reserved matter for the UK Government, the Scottish Government support ongoing reform of the assessment of medical device safety. However, there are concerns that the UK Government intend to compound the Brexit harms in the NHS by removing many European standards and regulations from the statute book with their Retained EU Law (Revocation and Reform) Bill.

The Scottish Government are concerned about the impact of the UK’s departure from the EU on the regulation of medicines and medical devices. The Scottish Government believe that regulatory reform must include the systematic incorporation of patients’ experiences in decision making. There have been shortages of medicines since the UK’s departure from the single market, and they have resulted in price increases and the use of serious shortage protocols. It will come as no surprise that the SNP opposes the Retained EU Law (Reform and Revocation) Bill, which could remove important protections, such as food labelling, animal welfare, and environmental controls. Scotland wants to maintain EU standards for medication safety and controls.

It is a pleasure, as always, to serve under your chairmanship, Sir Gary, especially now that this radiator down at my ankles is working. It is also a pleasure to contribute on behalf of the Labour Front Bench in this important debate.

I commend the way in which the hon. Member for Gosport (Dame Caroline Dinenage) presented the case for medical technology. She is absolutely right, because whether it is diagnostic or surgical devices or the digital tools that assist us in making healthcare more accessible, medical technology underpins much of the work that the NHS does. It is also, as has been highlighted in this debate, a key contributor to the UK economy. Medtech generates an annual turnover of over £27 billion and provides around 138,000 jobs. The importance of supporting and, indeed, turbocharging this sector cannot be overstated.

Labour has been clear that it wants to see Britain leading medical science and technology on the world stage. That ambition will be at the heart of our 10-year plan for change and modernisation, which will revolutionise care in this country, transforming our healthcare system from one that just treats the symptoms of illness to one that addresses the root cause of ill health. Imagine a country where we could get out into communities and harness new technology to spot cancer cases early or support individuals at potential risk of developing rare diseases—a country where, using genomics, we do not just treat illnesses such as cancer, diabetes and heart disease, but predict and prevent those conditions.

All that might sound a little far-fetched or sci-fi, but the technology to do it exists in British laboratories and research centres today, and it is ready and waiting to be realised fully. It is therefore extremely welcome that the Government have finally published their medical technology strategy. That is an important step in better utilising this sector, but it must be followed up by concrete action. Crucially, it must come alongside targeted work to reduce waiting times and the elective care backlog. I note that the strategy states that medtech will help the NHS to use

“fewer resources…through informing effective healthcare purchasing, championing sustainability, embracing innovative technology and improving health data”.

I do not disagree. We must maximise the use of medtech across the NHS. It is not a party political point; it is a common sense one for the future.

For medtech to realise its full potential, we need staff—an area on which the Government have had little to say. I am hoping that something will come in the weeks ahead. In fact, the Government have the opportunity to nick Labour’s workforce strategy; they did not do it in the spring Budget, but I am sure the Minister is on the case.

Put simply, there is no one silver bullet to solve the crisis in our NHS—we need a whole-system approach—but medtech has a massive role to play in the future. What does a whole-system approach mean? It means giving the NHS the tools, staff and reform it needs to survive. Without all three, we will not be able to rebuild our health system, which is sadly under enormous pressure right now.

With regard to the strategy, I would appreciate some clarity on a few points from the Minister in his response. The first relates to the adoption routes for new technologies. The Health Tech Alliance estimates that it takes approximately 17 years for a device to be adopted into the NHS. The Government strategy mentions adoption rates, but it is relatively light on detail. If new technology is safe and effective, we should be doing everything we can to get it into the hands of NHS clinicians. What further work is he planning to undertake in that respect, and will he provide more detail on how he plans to improve technology adoption rates?

I will touch on regulatory requirements, which the hon. Member for Gosport mentioned, and the speed with which we get new treatments to patients. Last year, we had an agonising to and fro over the pre-exposure prophylaxis Evusheld. The drug was designed to protect those who are acutely vulnerable to covid-19 and still shielding, but the process for approving it for use in the NHS took far too long. By the time the drug had been fully reviewed, it no longer responded as effectively to covid variants, and it was therefore not recommended for use.

NICE recognised that fact in recently published guidance, and it has committed to developing a new review process to streamline approval for covid-19 treatments. Has the Minister had any discussions with NICE on the timeline of that process, and what action is he taking to ensure that future safe and effective treatments and technologies do not face similar regulatory delays? Similarly, with unwelcome reports that the antivirals taskforce is being wound up at the end of this week, what steps is he taking to ensure that suitable provision of those essential treatments continues?

Finally, I will press the Minister on small and medium-sized enterprises. A recent study found that up to 24% of UK-based health tech SMEs are now looking to launch their innovations outside the United Kingdom. That would be a travesty, and I am sure it concerns him as much as it concerns me, the hon. Member for Gosport and the SNP spokesperson, the hon. Member for Linlithgow and East Falkirk (Martyn Day). The UK should be empowering home-grown tech, not missing out on it because of neglect and miscommunication. Despite the problem, the medical technology strategy made little reference to SMEs, aside from saying that the Government would support improved management of SMEs and upskilling of workers. That is just not good enough for companies that make up 85% of the medtech sector.

What more is the Minister doing to ensure that SMEs are sufficiently supported to launch their innovative new products here in the United Kingdom? I appreciate that he will be required to work across Departments to ensure that this growing sector, which has so much potential to grow further, is as supported as we would expect. What more can be done to streamline the regulatory processes that many SMEs are grappling with?

To close, we need to ensure that Governments of whatever political colours are not too slow to harness the medical technology sector. If we are, ultimately it is patients—the people we are sent here to represent as Members of Parliament—who pay the price. We need to build an NHS that is fit for the future, where patients are seen on time and technology is employed to tackle ill health and inequalities. That is something that I and the Labour party support, and I suspect the Government will say they support it too. Let us just get on with it.

It is a pleasure to serve under your chairmanship, Sir Gary. I congratulate my hon. Friend the Member for Gosport (Dame Caroline Dinenage) on securing this important debate. I am grateful for the opportunity to update her and the House on the subject, and I am proud to showcase the investments that the Government are putting into life sciences.

My hon. Friend showed eloquently and articulately that medical technology is of huge importance to the UK and its health and care system. As she rightly said, the regulations that govern medtech have to protect patients and ensure public safety. It is also important that they encourage investment and drive innovation in the sector. The NHS spends an estimated £10 billion a year on medical tech, and the sector is an essential provider of jobs and specialist skills across the UK. The hon. Member for Denton and Reddish (Andrew Gwynne) set out the value of medtech to UK plc; there are no fewer than 138,000 jobs in the sector in this country.

My hon. Friend the Member for Gosport rightly highlighted how the UK’s decision to leave the EU, coupled with huge advances in life sciences and diagnostics —many of which the hon. Member for Denton and Reddish set out—has presented a great opportunity for us to reform our medical devices regulatory regime. We are well placed to do that, and we have to seize the opportunity.

We have a dynamic and pioneering medtech sector and a world-renowned regulator in the Medicines and Healthcare products Regulatory Agency, which most people know as the MHRA. I know that there have been challenges with the MHRA, as my hon. Friend the Member for Gosport set out, and I will come to that in a moment. Before I do, I want to touch on the work that the MHRA is doing to update the medical devices regulatory regime.

The first set of changes will be delivered this year—in fact, by the summer. The updated regime will deliver improved patient safety, greater transparency and closer alignment with international best practice, as my hon. Friend rightly pointed out, and it will ensure that regulation is proportionate. I am still very much alive to the scale of change and the huge importance of giving the sector—as the hon. Member for Denton and Reddish set out, many of its businesses are small and medium-sized enterprises—the time that it needs to adapt. Certainty of supply and access to medical devices in the NHS is critical, so we will intentionally phase in the regulatory changes in stages to give industry certainty.

I want to touch on two other areas, both of which are really important to the industry: artificial intelligence and new routes to market. In both cases, the new regulations will support innovation in the UK’s life sciences sector and, importantly, accelerate access to innovative medical devices for UK patients.

We are improving the regulation of novel and growing areas such as AI to ensure that our systems are responsive to technological advances. We have to ensure that we continue to be best in class and world class in this space. I want us to be world leaders in the regulation of new technologies and new approaches, such as AI. At the heart of that ambition is our desire for patients here in our United Kingdom to have access to the very latest innovations in medical technology. I want them to have that as quickly as possible, and agility is key to ironing out the bureaucratic processes that historically have caused delay.

New routes to market are important because they will enhance the supply of devices, including the most cutting-edge products. The regulations will introduce a new pathway to support the use of real-world evidence in the conformity assessment process, with proportionate regulatory oversight for these devices. To be absolutely clear, though, because we cannot lose sight of this, the focus of the MHRA must be patient safety. That must remain paramount.

Importantly for UK plc—I turn directly to the point made by the hon. Member for Denton and Reddish—I believe that these improvements will help to create opportunities for small and medium-sized enterprises, including by ensuring that UK businesses have the ability to supply their UK-made and UK-developed products to the NHS and get them in use for patients more quickly.

I mentioned that my Department’s priority is to ensure that innovative, safe and effective devices reach patients as quickly as possible. That is an area of real focus and one where I want us to improve. Our inaugural medtech strategy, which was published last month, has been mentioned by everybody who has spoken. The strategy is key, because it recognises many of the systemic challenges to adopting innovative products that hon. Members across the Chamber have set out. It sets out a clear ambition to provide a streamlined pathway from pre-registration through to adoption in the NHS, which the hon. Member for Strangford (Jim Shannon) rightly pointed out. Importantly, it will ensure rapid progression for priority innovative products, including drugs, as my hon. Friend the Member for Gosport rightly said. The medtech strategy sets out our ambition and clear signals as to what we want to achieve.

Both my hon. Friend and the hon. Member for Denton and Reddish asked how we identify the products needed for the future, so that we can set innovators off to design products that tackle the challenges we face. We are working closely with senior clinicians across the NHS. It is our ambition to set out the big challenges in the health and care system, and then to give those challenges to innovators—ideally, but not exclusively, in this country—and set their minds, businesses, organisations and capital to work to design the products and devices that we need. That will allow us to introduce novel products to the NHS, and therefore our patients, faster.

I genuinely believe that medtech has the most enormous potential to improve patient outcomes, and I know that my hon. Friend the Member for Gosport does too, as a former Health Minister and a former Digital Minister—two areas that are very much combined in this debate. I see that potential already on my visits around the country —from a particular type of plaster that enables a wound to heal faster, to robotic surgery equipment that costs many millions of pounds. They have very different functions, but both fall under medtech regulations. It is therefore vital that we work more closely with industry to ensure that we have a robust pipeline of innovations that can be adopted at pace and scale, and can then support the delivery of our and the NHS’s key priorities.

The inaugural medtech strategy is an important milestone, but it is also important to back it with funding. As my hon. Friend rightly pointed out, the Government recognise the opportunities that we have before us and the importance of this topic. That is exactly why, in the Budget—the evidence is there—the Chancellor of the Exchequer announced £10 million of additional funding for the MHRA over the next two years. That will help us to bring innovative medicines and medtech to patients more quickly. It will support the development of a shortened but still thorough approval process for cutting-edge treatments such as cancer vaccines, which is an area that we are investing in considerably alongside industry. There is also AI-based technology. I know that I have mentioned AI a number of times, but it is the most exciting area of medtech. For example, the relatively new AI-based app Sleepio, which provides tailored therapy for insomnia at the touch of a button, is the kind of technology that will transform the lives of patients in our NHS.

My hon. Friend rightly mentioned international recognition, which I recognise is so important and is one of the Brexit opportunities that has come about. The funding will also be used to establish an international recognition framework, which will allow the MHRA to fast-track the approval of medicinal products that have been approved in other trusted countries. That will address the unnecessary duplication of regulatory processes from countries with the same standards as us and therefore reduce the time it takes for essential products to reach our market. It will make the most of the MHRA’s resources. Finally and critically, the additional funding put in by the Chancellor only a week or so ago will ensure that the MHRA has the resource and infrastructure more broadly to deliver on our ambitious vision for UK patients, by increasing the availability of life-saving medtech devices on the UK market while maintaining proportionate regulatory oversight to protect patients.

My hon. Friend asked three specific questions. The first was about the timescale and the fact that we need to act fast. She is absolutely right. We have published the medtech strategy, which has largely been welcomed by industry. The first set of changes will come in this summer. Then there will be a transition period for CE-marked devices into law. Later this year, we will introduce post-market surveillance requirements. Other updates will follow, but I am acutely aware that industry must have sufficient notice, and I will ensure that it has that throughout.

My hon. Friend’s second question was in relation to dementia and Alzheimer’s drugs. I will look very carefully at that. Understandably, the MHRA and NICE are independent, but of course I would be very happy to meet representatives of Alzheimer’s Research UK, because I understand the importance of potential new drugs. If a drug has received FDA approval, we would want to look very carefully at it and consider how it might benefit patients here.

The third question was about the global tech industry. I covered that off a little by saying how we plan to set out our big challenges and then say, “This is the innovation that we need you to come up with.” Of course we want to drive local innovation too, so if there are particular local challenges, we want to empower integrated care systems and integrated care boards to encourage local businesses and local innovators to come up with solutions to supply their local NHS.

My hon. Friend’s final question was about the ability of the MHRA to deliver. I referred to the £10 million. We have also recently increased the fees for the MHRA, which come directly from industry, because it is largely self-funding. I keep a real watchful eye on this. I regularly meet the chief executive officer and others from the MHRA. I have also visited the MHRA twice, which was fascinating. If anyone has not done so, I encourage them to arrange a visit with Dr June Raine; I know she would be very happy to set that up. It is an absolutely fascinating place, based in South Mimms.

In conclusion—I am conscious of time and I know that my hon. Friend would like some time to respond—I again thank my hon. Friend for securing this important debate. Dare I say that this is probably not an issue being discussed widely around dinner tables across the country? Nevertheless, it is of vital importance to UK plc, it is hugely important to our NHS, and of course it is really important to patients, too.

This afternoon, my hon. Friend has drawn on her personal experience as a former Health Minister and a former Digital Minister to highlight the importance of medtech, and in doing so she has done her constituents and patients across the UK a huge service. I very much look forward to working with her and others to seize the opportunities and break down the barriers, so that we can bring the very latest innovation to patients as quickly and as safely as possible.

Thank you, Sir Gary—I will be very brief.

I start by thanking the Minister for so comprehensively answering all my many questions and for showing his huge commitment to and understanding of this issue. It is a bit technical, as he said, but it is very reassuring to know that we have a Minister in place who gets it. It is also reassuring to know that we have a Chancellor in place who, like myself, was in a digital role and in a health role for many years, and really understands this issue and has a desire to put the weight of the Government behind it to make sure that we get it right.

The medtech strategy is a great starting point; we just have to make sure that we do not let it lose impetus. We have to build on it and make sure that it really delivers its potential in terms of saving lives, improving people’s quality of life and health outcomes, and immeasurably impacting people’s experiences in our NHS. However, as the Minister and the Opposition spokesman, the hon. Member for Denton and Reddish (Andrew Gwynne), both said, the strategy also has massive potential for our economy, nationally and regionally.

In fact, the Opposition spokesman summed things up really well when he talked about some of the technology; is seems almost unimaginable or something from a sci-fi movie, but it is out there already, and we need to be nimble and agile, and lean in to harness its potential. We just have to do everything we can to ensure that all the obstacles that would stand in the way are removed. We all know that prevention is better than cure, and we now have technology on our side that can really ensure that that prevention happens.

The Minister said that this is not a subject for conversation around dinner tables. I know that it is wildly technical, but some of its implications are the sorts of things that people talk about around their dinner tables. If one was able to predict whether one might be susceptible to developing dementia, would one want to know? Those are the sort of moral and ethical questions and conversations that people have. In many ways, people may feel that they would not want to know. In other ways, however, if people could make lifestyle interventions that would prevent or delay the onset of dementia, they might want to know. And if we could then monitor those people and conduct the clinical trials and observations that may lead us to find cures that change immeasurably the lives of both those living with dementia and their families, that must be worth embracing.

One of my big concerns is that we just do not adopt these technologies and innovations early enough, and that we certainly do not get them into the NHS early enough. There is a whole raft of issues around risk aversion and proving cost-effectiveness, and local areas wanting to be early adopters of innovation. We have a load of obstacles to overcome, but I am really grateful to the Minister for setting out his stall and articulating how we are going to tackle this issue.

Question put and agreed to.


That this House has considered medical technology regulations and the NHS.

Sitting adjourned.