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House of Commons Hansard
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Westminster Hall
08 January 2019
Volume 652

Westminster Hall

Tuesday 8 January 2019

[Mr George Howarth in the Chair]

Cancer Workforce and Early Diagnosis

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I beg to move,

That this House has considered early diagnosis and the cancer workforce in the NHS long-term plan.

It is a pleasure to see you presiding over our business this morning, Mr Howarth. I wish everyone a happy new year. I thank the Backbench Business Committee for supporting the bid of a number of colleagues for this debate, and the Chairman of Ways and Means for allowing it. I was lucky enough to be chosen as the chief sponsor, but I recognise the support of other Members in this Chamber. I will try to keep my remarks to 10 minutes or thereabouts.

I am grateful for the many briefings on that we have had—we have had briefings from the House of Commons Library, Barts Health NHS Trust, Cancer Research UK, Breast Cancer Care, the Fire Brigades Union, Macmillan Cancer Support, Breast Cancer Now, the Royal College of Pathologists, Maggie’s, the British Lung Foundation, the Royal College of Physicians, CLIC Sargent and the Royal College of Nurses. I have had more briefings from interested parties on this debate than on any other in my 21 years here. Interestingly, they virtually all agreed on two basic points. First, they welcomed the fact that the Government have addressed their issues in the 10-year review and, secondly, they welcomed the new investment but asked for more detail about staff training, recruitment and retention.

Running through most of the briefings I received were questions about the publication of the NHS long-term plan, which was promised by the end of 2018. In very timely fashion, the Government published it yesterday. It has focused the debate but not eliminated the need for it.

I want to highlight some of the issues raised in the briefings. The Royal College of Pathologists cited disturbing statistics. Notably, just 3% of services reported that they have enough staff to meet clinical needs, and more than three quarters of departments reported vacancies for consultants. The royal college emphasised the need for early diagnosis and called for increased investment in pathology services, particularly in the recruitment and training of pathologists and scientists. It said that histopathologists should be listed on the shortage occupation list as there is a shortfall in that speciality. The Migration Advisory Committee currently includes no pathology specialities on the shortage occupation list. Placing histopathology on that list would help overseas qualified pathologists to obtain a visa to work in the UK.

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I lost my mother to bowel cancer last year, and I have been campaigning to reduce the bowel cancer screening age to 50. I understand from my campaign and the debates I have had that it is important that we get the pathology capacity right. Otherwise the reduction in the screening age will not work. Does my hon. Friend agree?

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I certainly do. I am sorry to hear about the fatality in my hon. Friend’s family. I am sure the Minister will talk about staff and I will come to it later in my speech. Without staff in diagnosis and pathology services, the reduction in the screening age will be pointless.

The Royal College of Pathologists identified a growing demand for pathology services and predicted a 28% shortfall in staff by 2010. Cancer Research UK said, as we all know, that the earlier a cancer is diagnosed, the more likely it is that it will be treated successfully. The Labour Government’s initiative to reduce the time between an urgent GP referral to seeing a cancer consultant to two weeks was a success in ensuring swifter treatment, but 2018 was the first year in which that target was not met. I would be grateful if the Minister told us how the Government expect to address that slippage.

Cancer Research UK added that it expects new cancer cases to reach 500,000 a year by 2035—right now, it is 350,000. With more cases and more thorough screening measures, our NHS will need more diagnostic and treatment staff. Cancer Research UK highlighted that the promise to produce a workforce implementation plan after the 2019 spending review leaves the status of Health Education England’s upcoming cancer workforce plan unclear. Will the Minister give us more information about how the two initiatives relate to each other?

Macmillan said that it recognises and welcomes the focus on cancer in the NHS long-term plan, including the Prime Minister’s commitment radically to improve early diagnosis. However, it has concerns that the long-term plan will not adequately address the immediate and long-term pressures facing the NHS cancer workforce. It also asked when the workforce implementation plan can be expected this year. I note that the Health Secretary said yesterday that he expects Baroness Dido Harding to report to him by the end of March. I would be grateful therefore if the Minister can confirm that we can expect the publication of the workforce implementation plan by summer this year.

Breast Cancer Now made the point that only 18% of breast cancer screening units are adequately resourced with radiography staff, in line with breast screening uptake in its area. My area of north-east London is covered by Barts Health NHS Trust, the NHS North East London Commissioning Alliance and the East London Health and Care Partnership. Many of the points made by the national charities are apparent locally. Those bodies have made their concerns clear. They have raised the basic issue that cancer outcomes in north-east London are among the poorest in London and the country, and that presentation via the emergency route remains high and is clearly associated with advanced cancer and low one-year survival rates.

In my borough of Tower Hamlets, the one-year survival index of people diagnosed with cancer is 4% lower than the England average, and diagnosis through the emergency route remains high. The local NHS trust has plans to attack that problem with a new early diagnosis centre, which is due to open in December; the introduction of multi-diagnostic clinics, which were first introduced in Denmark and were supported here in the pilot phase by Cancer Research UK; and new faecal immunochemical testing for colorectal cancer in primary care from April this year. It plans a health and wellbeing school spread across the whole of north-east London, based on the principle of making every contact count. It is raising population awareness and screening initiatives, including placing staff to promote screening in GP practices, promoting text reminders for cervical cancer screening, video competitions for schools to promote vaccinations, prostate cancer targets, breast and bowel cancer target ads on Muslim TV channels, and the reintroduction of bowel screening reminder calling and other initiatives.

The North East London NHS Foundation Trust conclusions are relatively simple. The workforce is a key factor in delivering a faster diagnosis standard, expected by 2020 and beyond; earlier diagnosis of cancer needs a resilient and sustainable radiology, endoscopy and pathology workforce; the high cost of living, the lack of affordable housing and the disparity in salaries across London are barriers to recruitment; and there is a need to look at technology such as artificial intelligence and digital pathology, and innovations in careers.

CLIC Sargent raised the problem of diagnosing child cancer and said, worryingly, that more than half of young people diagnosed visited their GP with their parents at least three times before their cancer was diagnosed. That is of particular concern.

Breast Cancer Care also raised the workforce plan, and asked how the commitments of the current cancer strategy and the ambitions of the long-term plan will be met. The Royal College of Physicians told me that, in London in 2018, 27% of physician consultant posts advertised were not filled, and that across the UK a total 45% of advertised consultant posts went unfilled due to a lack of suitable applicants.

The British Lung Foundation made two key points: that early diagnosis is essential because almost half of lung cancers are diagnosed at stage 4 when survival rates are very poor; and that there is an urgent need to train and employ more NHS staff to diagnose lung cancer earlier. The Royal College of Nursing stated that in England there are nearly 41,000 vacant registered nursing posts in the NHS. It predicts that the number will increase to almost 48,000 by 2023 if the Government do not take action.

The Commons Library briefings said that the cancer workforce plan devised in 2017 recommended that action be taken to ensure that enough staff with the right skills are trained to deliver the cancer strategy by 2021. In November last year, the highly respected Professor Sir Mike Richards—NHS England’s cancer director—announced that cancer screening would be overhauled as part of the long-term plan. He also announced a review team to assess current screening programmes and a report is due this summer. I ask the Minister whether that timetable might coincide with the publication of the Government’s workforce plan. The Library stated that there is no measure of the total NHS cancer workforce. Will the Minister comment on that anomaly?

I would be grateful if the Minister addresses the fundamental issue raised in all the briefings: how the workforce implementation plan fits in with the strategy, and when it can be expected. I look forward to his response. He is highly regarded in his post. I look forward to the responses from the hon. Member for Central Ayrshire (Dr Whitford), the Scottish National party spokesperson, and from my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), the shadow Health Minister, and to other colleagues’ contributions.

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Order. This is an important subject and many Members have signified that they wish to speak in the debate. I will not impose a time limit straight away. I will see how it goes. If hon. Members co-operate, I am sure that everybody will be able to speak.

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Thank you, Mr Howarth. It is a pleasure to serve under your chairmanship. I wish everyone a happy new year and congratulate the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) on securing this incredibly important debate, which is timely in the light of yesterday’s announcement of the NHS long-term plan.

I will restrict my remarks on the cancer workforce to the radiotherapy workforce and other issues relating to radiotherapy. Sadly, at some point in our lives, one in two of us will have cancer of some form or other, and one in two of those with cancer will receive radiotherapy treatment, so one in four of us will need radiotherapy. Roughly speaking, 1,500 people—clinicians, medical physicists and therapeutic radiographers—make up the entire radiotherapy workforce of the United Kingdom. In the plan that we have been digesting since yesterday, there are many things worthy of remark and which are to be welcomed, but many questions remain unanswered.

On radiotherapy, the focus on survival and early detection is clearly crucial. The United Kingdom is very low down in the league table of European countries when it comes to early detection of cancer, which is the chief reason why survival is so poor compared with other nations of similar prosperity. That is tragic on a personal level and deeply humiliating on a national level. If the Government, the National Health Service and we all are successful in our bid to detect cancer earlier at stage one and stage two, treat it effectively and cure patients—radiotherapy is eight times more likely to be curative than chemotherapy and 50% of those with cancer are already having radiotherapy—it stands to reason that the need for capacity for radiotherapy will increase manifold.

There are 52 radiotherapy centres in England with a number of other satellites. There is nothing in the plan that scopes forward how the national health service will cope with the additional work required if early diagnosis becomes more successful. It is worth bearing in mind that, as things stand, there are significant pressures with a workforce of 1,500. There are two ways of looking at it: one is that the workforce is a very small and precious resource that we need to protect, and the other is to remind ourselves that those are relatively small figures, and that with a relatively small amount of investment, we could make a significant difference to increase that workforce. Relatively small numbers equals a huge percentage, which equals the ability to tackle many more cancers and, indeed, to cure many of them.

I will focus briefly on one profession within the radiotherapy workforce—therapeutic radiographers. I do not know whether hon. Members are aware, but in the current academic year, there has been a 50% drop in applications to therapeutic radiography courses at UK universities. One of the leading universities had to cancel its entire intake altogether due to under-recruitment. The cause is almost certainly—99% certainly—the removal of the bursary from that programme. The standard applicant is a mature student who chooses to do something different with their life, having done something else first, and the withdrawal of the bursary has had a huge impact on those people. If the Minister wanted to do something quickly to tackle that workforce issue, I will throw out there the suggestion that he could reinstate the bursary for radiographers.

I am chair of the all-party parliamentary group on radiotherapy, and one of our vice-chairs is here—the hon. Member for Easington (Grahame Morris). We and many other hon. Members had a really good meeting with the Minister at the end of November last year. I am very grateful to him and to his staff for their time and attention. They have yet to respond to the manifesto that we presented to them that day, although I did not expect them to have done so by now. That manifesto calls for a number of things: new investment and more money—it would be surprising if we did not ask for that, but I will put it in context.

As I have said, half of those who have cancer in the United Kingdom will require radiotherapy, yet only 5% of the cancer budget goes on radiotherapy. That compares poorly with other countries. In Australia, the figure is about 5% but the European average is something like 7% or 8%. Our cross-party proposition is that the Government invest £100 million every year into machine upgrades for high-quality, targeted, stereotactic, and other advanced forms of radiotherapy. That fund would cover all trusts, which would not have to delve into their own reserves. We also propose a £250 million up-front, one-off investment so that people who live in communities like mine an awful long way from the nearest treatment can have a satellite unit developed close to them.

Many of my constituents in south lakeland have to make three or four-hour round trips to get good treatment at Preston, but a large percentage—up to 50%—of those who could have radiotherapy in my constituency and in other parts of south Cumbria do not get it because they are considered to be too far away for it to be a reasonable journey time. Radiotherapy is so often more curative than chemotherapy, ergo people do not live as long because they live too far from treatment. That is why the radiotherapy satellite centre at Westmorland General Hospital in Kendal is a key example. Access and travel times are a problem in other parts of the country, which is why investment in satellite units is important. They do not necessarily involve that much more staffing because, with proper IT networking, we would be able to do many of those things remotely.

In conclusion, the NHS plan announced yesterday contains much that is interesting, but when it comes to radiotherapy, it is entirely a rehash of things that we already know. Some things are welcome, but there is nothing new. I look forward to the Government’s response to its consultation on radiotherapy, which closed 12 months ago, and I ask for an update on that. I also ask that the National Cancer Advisory Group’s 2018 report is released as soon as possible. Finally, I very much look forward to the Government’s response to the manifesto by the all-party parliamentary group on radiotherapy, which was presented to them in November.

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I call Grahame Morris.

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Thank you very much for calling me to speak in this important debate, Mr Howarth. I congratulate my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick), and I thank my friend the hon. Member for Westmorland and Lonsdale (Tim Farron), who chairs the all-party parliamentary group on radiography, of which I am also a member.

I do not want to repeat the arguments that have just been made, but some key threads run through the whole of the debate. Although the motion refers to “early diagnosis and the cancer workforce in the NHS long-term plan”, we have to marry some concepts. Yes, early diagnosis is important, but it has to be married with a skilled and effective workforce, as well as the most effective treatment available, by which I do not mean the treatment available in our capital city only, but across the whole country. I will touch on that issue as well.

I declare an interest: I am a cancer survivor. I was successfully treated with both chemotherapy and radiotherapy, thanks to a relatively early diagnosis. I am vice-chair of the all-party parliamentary group on radiotherapy. I am not alone in having benefited from radiotherapy. As was mentioned earlier, during the course of our lifetimes, almost half of us will suffer from cancer at least once, and about half of those people will receive radiotherapy.

Although I was fortunate and count my lucky stars, I am acutely concerned about particular cancers, notably prostate cancer, pancreatic cancer—yesterday, we heard a terrible story from the hon. Member for Crawley (Henry Smith) about his caseworker who passed away as a consequence of pancreatic cancer—lung cancers and breast cancer. For a modern industrial nation, our cancer outcomes are poor. They should be far better. I hope that the 10-year forward plan that was published yesterday is an opportunity to address some of those fundamental problems. It is important for us to invest in modern accessible cancer diagnosis and treatments.

I want to talk about the long-term plan that the Prime Minister announced yesterday, on which we had a statement in the House. I will refer in particular to chapter 3, especially section 3.62, on treatment and radiotherapy. I must admit that I was optimistic after meeting the Minister, who I have known for some years. I think he is a decent and honourable individual, and he and his staff were very positive in our meetings. I therefore hoped that, based on the evidence presented, we would have a much more positive outcome from the 10-year plan.

The Government have promised to complete the £130 million investment in radiotherapy machines and to commission the proton machines—the two proton-beam machines, at the Christie in Manchester and at University College Hospital, London—but, in all honesty, that is not a new commitment. Those machines are already or almost completed, so the commitment is a recycling of an existing announcement.

If we are to have a step change and to achieve a world-class set of outcomes and a world-class cancer treatment service, we need a modest increase—modest in relative terms—for advanced radiotherapy. As set out in the “Manifesto for Radiotherapy”—which I recommend that all Members read, because if they are not affected themselves, many of their constituents certainly will be—we ask for an initial one-off investment of £250 million, with an additional £100 million in each successive year for workforce, running costs and so on.

Radiotherapy is required in 50% of cases, but access is patchy. Access varies from 25% to 49%. For example, the hon. Member for Westmorland and Lonsdale represents a rural area, where the figures are low. The average is about 38%. Ideally, according to Cancer Research UK, patients should not have to travel more than 45 minutes to access such treatment and, if we are to achieve that, considerable investment is required. The Minister might be able to elaborate on this, but I do not think that anything concrete in the plan addresses that serious issue.

I welcome the Government commitment on early diagnosis to increase the number of patients diagnosed with stage 1 and 2 cancer by 25% and, for lung cancer, to increase the diagnosis of stage 1 patients by 47%. In practical terms, however, the Government will need more advanced radiotherapy machines to ensure that many of those stage 1 tumours can be cured, as well as additional radiotherapy machines to treat the stage 2 patients. The Government will need to rapidly expand the number of advanced radiotherapy facilities around the country, and how to do that is set out in the manifesto, which would achieve not only early diagnosis but improved survival and outcomes.

I want to give the Minister credit—he is looking a bit quizzical, but I had not intended to beat him up, because we are trying to be helpful. The aspiration and wish to improve cancer outcomes and to see a first-class service is shared in all parts of the House. I am therefore very pleased that he has recognised the representations made on hypofractionated treatment and the perverse incentive in relation to the tariff. The Government have said that they will address that issue, but I would like an assurance that it will be addressed quickly and not in 10 years’ time. The evidence is clear about that disincentive to the most appropriate form of treatment.

Many people want to speak in the debate, so I will wind up. I am pleased that the Government have admitted and accept that advanced radiotherapy is more effective and has fewer side effects. I would like to see a specification come out and to ensure that, when it comes out, we do not see what we have in effect at the moment, which is the rationing of effective treatment. Specialists in the field have told me that the specification under discussion now is in essence no different from that available a year ago. I therefore press the Minister to respond to our submissions.

I want to see an increase in the budget for advanced radiotherapy—fairly modest as part of the NHS budget, or even the cancer budget—from 5% to 6.5% of the cancer budget. That would enable large numbers of cancer patients to live longer and more fulfilling lives and would achieve better NHS outcomes and positive economic benefits. I commend that proposal to the Minister, and I urge him to look at it as part of the ongoing cancer strategy and the NHS 10-year plan.

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It is a pleasure to serve with you in the Chair, Mr Howarth. I thank my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick) and other hon. Members for their contributions.

I will focus on cancer affecting children, teenagers and young adults. As hon. Members know, I have personal experience of breast cancer, but more expert people in the Chamber will talk about that, so I will discuss the form of cancer for which I recently set up the all-party parliamentary group on children, teenagers and young adults with cancer.

I set up the group because each year in the UK, 4,450 children and young people under 25 are diagnosed with cancer—that is 12 children and young people every day somewhere in the UK. Four out of five of them will survive for five years or more, but for the parent of a child such a survival rate seems minuscule. Most of us expect our children to survive far longer than that, so the survival rate can seem quite hard. Those of us who have had adult cancer might think, “Oh good—five years! I’ll still be around in five years’ time.” For adults, that feels like a success; for children, not so much.

Cancer remains the biggest killer by disease of children and young people under 25 in the UK. That is important, because one of the reasons why cancer is the biggest killer is that other diseases have declined. That is a good thing, but cancers still affect many children. We want the incidence to decrease, and the number of children surviving and being diagnosed earlier to increase. The all-party parliamentary group wants things to be better. The Minister knows that, because he has been good to the group and worked closely with us. We understand that the small number of children affected can make it difficult to identify real specifics that could make a big difference, but because the number is small, some of the things that we want might be relatively straightforward to do.

Last year, we held an inquiry into young people’s experience of childhood and young adult cancer. We now call on the Government and the NHS long-term plan to look at the impact of a young person’s route to diagnosis. Recent research by CLIC Sargent found that more than half of young people had to visit their GP at least three times before their cancer diagnosis. Katie, the young woman who was a panel member in our inquiry, said that because childhood and young people’s cancer is so rare, GPs did not expect to see it, so frequently signs and symptoms were misunderstood. I have the greatest sympathy for GPs and clinicians, and because those cancers are so rare, we would like a training and e-learning module for healthcare professionals.

CLIC Sargent and the Teenage Cancer Trust have teamed up to create such a module on the signs of cancer in children and young people, developed in partnership with the Royal College of GPs. We would like more support in the NHS workforce to improve recognition of the signs, whether that is the e-learning module or something different. I hope the Minister will say something about that when he sums up. In the NHS long-term plan published yesterday I was really pleased to see a specific mention of childhood cancer, but I was disappointed that there was not more emphasis on skilling up the healthcare workforce to recognise the signs and symptoms. We all know that often the consequence of failing to make an early diagnosis is a very poor survival rate.

In our inquiry we recommended many measures, which the Minister has very kindly agreed to go through with his officials and respond to in some detail. Perhaps after the debate, will he liaise with my office about a time to meet? I am grateful to him for his willingness to do that, but we would like to make some progress in the first half of this year. Some of our recommendations are relevant to this debate. We say that the Secretary of State for Education should ensure that every young person receives health education that includes cancer signs and symptoms, done in an appropriate way. The Teenage Cancer Trust has developed an education module, which many of us will have seen recently when it was demonstrated in Parliament. I would like to see something such as that being used.

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The hon. Lady makes an excellent case for education. As co-chair of the all-party parliamentary group on breast cancer, I want to raise the fact that about 3,500 breast cancers go undetected each year due to women not understanding the risk due to breast density. Education would seem critical as part of the long-term plan to get world-class outcomes, so that people understand their personal risk.

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The hon. Gentleman is absolutely right; education is critical across all cancers, particularly breast cancer. Many young women need more under- standing of how their risk can be reduced by certain lifestyle choices. I say that carefully, without wishing to blame cancer survivors, because there is a difficult balance. Education is important, because the health service we want for the 21st century is about health rather than sickness. I wanted to see more emphasis in the NHS long-term plan on prevention.

Will the Minister respond to some of our recommendations in his reply to the debate? The all-party group thinks that an emphasis on prevention is critical to young people’s long-term survival and long-term health—not long-term sickness. We are concerned about the shortage of radiographers and radiologists, but other Members will discuss that. If more children and young people with cancer are to survive longer than five years, early diagnosis is critical. Health professionals may see only one childhood cancer in their entire professional life, so they will need help. I ask the Minister to talk to us and to his officials about how to help the professionals to do better. We would like more education for young people on a range of cancer indicators and on ways to change their lifestyle, such as exercising more, reducing alcohol consumption and so on. We all know about those actions, but quite often it is too late; we could do with knowing them from an early age and building them into our way of life, starting when we are young.

I want to conclude, without getting too emotional, by paying tribute to CLIC Sargent and to the Teenage Cancer Trust in particular. They do so much, not just for children and young people but for parents and families. Members of my family received help from CLIC Sargent. My dear sister-in-law works for CLIC Sargent and she has been an inspiration to me on childhood cancer. I want the work they have done to be embraced by Ministers other than this Minister, who already has, to take that forward in the NHS long-term plan.

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It is a privilege to serve under your chairmanship, Mr Howarth. I thank the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) for securing this important debate.

I will keep my remarks brief because quite a lot of people want to speak, so I will focus on one area of early diagnosis—that of bowel cancer. There are two reasons for that: bowel cancer is the fourth most common cancer, and it is the second biggest cancer killer, yet bowel cancer is not only treatable but curable, especially if diagnosed early. The Minister will know that since my re-election I have pressed him and the Department hard to reduce the bowel cancer screening age in England from 60 to 50. I was delighted when, a few months ago, the Minister agreed to that and announced that the reduction would take place.

I pay tribute to my constituent Lauren Backler, who started the campaign to reduce the screening age three years or so ago. Sadly, her mother died in her mid-fifties; it is very likely she would not have died had she lived in Scotland and had an early diagnosis. That prompted Lauren to launch a campaign, and it has been an unbelievable success in numbers alone: more than half a million people across the country have signed her petition. Colleagues in the room and I have campaigned avidly for it for the last couple of years, and the Minister and the Department of Health announced the change a few months ago.

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The hon. Gentleman will be pleased to know that in Northern Ireland, following the introduction of bowel cancer screening kits, participation is 60%. It is a fantastic result for Northern Ireland and we need to do more of it.

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The hon. Gentleman is right. The introduction of the new faecal immunochemical test kits will make a huge difference.

I am speaking in this debate because, as the Minister will know and one or two people have alluded to, in yesterday’s announcement there was no clear announcement about additional staff and capacity to ensure that the bowel screening age is brought down from 60 to 50. I commend the Government for listening to Lauren, hundreds of thousands of people across the country, my colleagues here and I, and reducing the age—it is quite clear statistically that many thousands of lives will be saved—but I am anxious that there was no announcement yesterday about the additional budget that will be required for new staff, and a plan for it to happen. I am keen to hear from the Minister not just that the Department of Health is behind it, but detail of when the announcement will be made about additional staff capacity. I urge that particularly because, as the Minister knows, the budget decisions will be announced in March. I want some flesh to be put on the bones.

This is an issue where we know we have a solution. We in this room understand that there are capacity and finance issues. We applaud the Government and the Department of Health for publicly stating that they will bring down the screening age limit. What we all need now is flesh on the bone and detail, so that Lauren Backler, following her remarkable campaign in tribute to her mother, can see in the next few months the first roll-out of the age reduction in screening for bowel cancer.

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I congratulate my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick) on securing this important and timely debate.

We very much welcome the NHS long-term plan. It is a once-in-a-generation opportunity to improve cancer care significantly in this country. The plan rightly recognises that one of the biggest actions the NHS can take to improve cancer survival is to diagnose cancers earlier, and sets out welcome commitments to radically improve early diagnosis. I hope that as the plan develops there will be more specific plans for the less survivable cancers—pancreatic, brain, lung, stomach, liver and oesophagus—that account for more than 50% of all cancers.

As chair of the all-party group on cancer I was pleased to chair the Britain Against Cancer conference last month, which focused on future priorities for cancer care. There were many reasons to be cheerful, but one big concern was whether the workforce will be sufficient to deliver the care that will be needed in the future. There is still a lack of clarity about that, despite efforts in the long-term plan, so it is useful to have this opportunity to focus on that.

We know that the number of people diagnosed with cancer in the UK is increasing and that the changing needs of cancer patients present a challenge for professionals working in cancer care, who are dealing with rising case loads, and increasingly complex needs. The plan’s ambition to diagnose three in four cancer cases at an early stage by 2028 is welcome, but unless we have a plan to deal with staffing shortages, backed up by significant investment, the NHS will struggle to maintain today’s standards.

In NHS North Lincolnshire clinical commissioning group, only 71.9% of cancer patients receive their first treatment within 62 days of an urgent GP referral. That is well below the England average and below the national target of 85%. Delays to cancer waiting times are often caused by a diagnostic bottleneck, where there is not enough capacity to carry out the tests needed to confirm a cancer diagnosis so that the patient can begin treatment. I therefore welcome the announcement made just before Christmas of capital investment for Northern Lincolnshire and Goole NHS Foundation Trust, and of diagnostic equipment for Diana, Princess of Wales Hospital in Grimsby and Scunthorpe General Hospital. I hope that will make a significant difference.

To improve early diagnosis and match the best cancer outcomes in Europe, it is crucial to have the workforce in place to support growing patient need. Although the NHS long-term plan sets out ambitions for the future workforce, funding available for additional investment in that workforce in the form of training, education and continuing professional development through the Health Education England budget, has yet to be set out by the Government. Will the Minister—he is an excellent Minister—set out when that budget will be confirmed and say whether the Government intend to set out further funding arrangements as part of the comprehensive spending review?

NHS staff shortages in primary and acute settings have been consistently highlighted by organisations in the sector in recent years, and there is an urgent need to grow the cancer workforce. Cancer Research UK estimates that the cancer workforce needs to double by 2027. Similarly, Macmillan Cancer Support has estimated that the supply of adult cancer nurses must increase by 45% in the next 10 years. Those are big numbers.

Macmillan’s workforce census last year highlighted considerable variation in vacancy rates for cancer nurse specialists across the country. That is also true for specialist chemotherapy nurses, with vacancy rates as high as 15% in some areas. A recent survey of healthcare professionals working in breast care in hospitals by the charity Breast Cancer Care painted a worrying picture, with 87% of respondents stating that job shortages in their hospital could affect breast cancer patients. A freedom of information request from that charity found that two-thirds of hospital trusts in England do not provide a dedicated nurse for people living with incurable breast cancer. It is therefore crucial that a fully costed plan is produced to demonstrate how the health and care workforce will be sustained and grown. The long-term plan states that there will be a separate workforce implementation plan in 2019, but more detail is needed about the timeframes. Will the Minister say when the plan will be published? “Soon” is not quite good enough. We would like a date, please.

The 2015 cancer strategy recommended the publication of a cancer workforce plan, yet the sector is still waiting for the publication of phase 2 of that plan by Health Education England. Will the Minister outline how the implementation plan relates to the long-promised phase 2 HEE plan on the cancer workforce? If the ambitions of the long-term plan and the 2015 cancer strategy are to be realised, a comprehensive and fully funded workforce plan must set out how the cancer workforce can be upskilled and developed to meet the needs of the growing number of people living with cancer.

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I thank the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) for securing this debate, and for giving us the opportunity to discuss this important issue. I am the Democrat Unionist party spokesperson on health, so such matters are at the top of the tree for me. I am pleased that the Minister and shadow Minister are here to respond to our concerns, and we appreciate the Backbench Business Committee kindly granting us this debate.

Cancer is a word I hate; it is a disease I hate. A respecter of no person, it indiscriminately attacks and takes from us those who we love and rely on. I truly believe that a cure must be found and found soon for this dreaded disease, but while that work is taking place, we must focus on the best use of the limited resources available. I congratulate the Government on their NHS 10-year plan and their commitment to a cancer strategy within it.

As hon. Members have said, we all have family members and friends who have been stricken by cancer. I have a good friend who will have breast cancer surgery on Friday, and my father survived cancer on three occasions due to the expertise of the surgeon, the nurse’s care and, critically, the prayer of God’s people. My hon. Friend the Member for Upper Bann (David Simpson) referred to the bowel cancer testing kit in Northern Ireland, and probably because of my father’s history, I carry out screening with that kit every year, and therefore I would know early on whether any cancer has been detected. That is what we are doing in Northern Ireland, and hopefully it is something that other parts of the United Kingdom can take on board.

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Does my hon. Friend agree that, given the almost universal acceptance of the importance of early detection, the long-term plan like any other plan will be judged against an increase in early detection? That is the key.

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I agree wholeheartedly with my hon. Friend and colleague, and although many people are dying from cancer, a larger number are surviving that diagnosis.

I wish to thank the tremendous staff who work well above their paygrade and the hours they are paid to make a difference to the quality of care and support for cancer sufferers. I also thank the wonderful charities who aim to step into the breach where at all possible. We all know of such charities, and if I do not mention some of them that does not make them any less important. Many charities, including Marie Curie, do tremendous work.

Macmillan Cancer Support is an amazing charity. In 2017, it had more than 5,700 nurses supporting 658,000 people, with a further 2,000 healthcare professionals throughout the United Kingdom. In 2017, 1.6 million people received personal, high-impact support from one or more Macmillan professionals or services. While broadly welcoming the Government scheme, Macmillan has expressed serious concerns that the plan does not adequately address the immediate and longer-term pressures facing the NHS cancer workforce. Those concerns are put forward in a constructive fashion, as they should be:

“The NHS long-term plan makes clear that the funding available for additional investment in the workforce, in the form of training, education and continuing professional development through the HEE budget has yet to be set by the Government. This is a key priority and must be urgently addressed. The plan states that there will be a separate Workforce Implementation Plan in 2019, but more detail is needed about the timeframes, and how the implementation plan relates to the long-promised phase 2 HEE plan on the cancer workforce. It is essential that we build on the ambitious foundations of the NHS long-term plan and put in place a fully-funded strategy for the workforce that will deliver truly world-class cancer care.”

That is what Macmillan Cancer Support expressed before this debate. Perhaps the Minister will respond to those points.

I agree with the sentiments expressed by Macmillan, and that more detail is needed to deal with funding gaps to address the issue of speed of diagnosis in quick-moving cancers such as pancreatic cancer. My hon. Friend the Member for East Londonderry (Mr Campbell) and the hon. Member for Bristol West (Thangam Debbonaire) spoke about early diagnosis, and nearly every Member who has spoken in the debate has said it is critical—and so it is. Pancreatic cancer is the quickest-killing cancer, with one in four people dying within a month, so we need a faster pathway to diagnose and treat it, as the hon. Member for Scunthorpe (Nic Dakin), who is particularly interested in it, will know. Early diagnosis is essential in the case of pancreatic cancer, as it offers the only chance for potentially curative surgery. However, fewer than 20% of people with pancreatic cancer are diagnosed at an early stage, and fewer than 10% will receive surgery. The capacity does not currently exist, and there must be an increase in the cancer workforce to ensure timely diagnosis and treatment. Every Member who has spoken in the debate has supported the point of view expressed by Macmillan, and it is critically important.

Prostate cancer has been mentioned. When men are ill we are, by our nature, the illest people in the world, but sometimes we just do not know when we are ill. I make that point in relation to prostate cancer because we do not do the checks, although we know what has to be done. Needing the toilet more frequently, a burning sensation and passing blood are some of the symptoms, and men perhaps need to look out more for them. We need to raise awareness of prostate cancer. To be fair, I think that the Government do that, but perhaps there is a need to do more.

I hope I will be forgiven for repeating some comments that have been made, but these issues are important. The hon. Member for Bristol West referred to CLIC Sargent, and I want to make some comments on children’s cancers. CLIC Sargent is a wonderful charity and has asked me to use this opportunity to stress something that shocked me when I first read it, and which underlines the point about the workforce. Children make up the highest proportion of cancer patients diagnosed through emergency admissions, and many young people and parents have a poor experience of diagnosis. The 2016 “Best Chance from the Start” research report on experiences of diagnosis found that more than half of young people and almost half of parents had visited their GP at least three times before the cancer diagnosis.

As the hon. Member for Bristol West said, there is a particular need for early diagnosis for children. Nearly half of young people felt their GP did not take their concerns seriously. I do not think that is a criticism; it is how they felt. A third of parents felt that their GP did not take into account their knowledge of their child. We should not ignore what parents know and say about their child. It is important to do something to raise GPs’ awareness in relation to children. Just over a third of young people and a quarter of parents felt that their GP did not have enough time to listen to them talk about their symptoms. I want to ask the Minister what has been done about that. I am mindful of the pressure on GPs, who have a lot of work to do. However, something needs to happen for children diagnosed with cancer and their parents. Like the hon. Member for Bristol West, I am requesting that something be done. The urgent change that is needed can be achieved only through funding to take the pressure off diagnostics, allowing GPs to refer before the third repeat visit. They must be allowed to go with their gut and send anything suspicious to be tested further, rather than playing a numbers and probability game. Cancer does not respect the numbers game—it strikes where it might be least expected.

This is my last paragraph, Mr Howarth. Time has beaten me. I heartily welcome the strategy, but we need more detail and more action, and soon, to make a difference, and so that we can make a worthwhile attack on the plague of cancer, which affects families throughout the United Kingdom. That is why the debate is so important.

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It is a pleasure to serve under your chairmanship, Mr Howarth. I congratulate my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick) on securing this important and timely debate.

Lives are saved when cancer is diagnosed early. I know we all are united in wanting all cancers to be caught early so that survival rates can be drastically increased. However, to diagnose and detect cancer early, we need a sufficiently skilled workforce and full staffing. NHS staff do amazing work, but they are under extreme pressures. We are one of the richest countries in the world, but lives are being lost because of under-investment in our NHS workforce. If we are to come anywhere near to achieving the Prime Minister’s target of diagnosing three in four cancers at their early stages by 2028, we will need to have a long-term plan that will deal with the staffing shortages, which will no doubt get worse post Brexit.

Cancer Research UK estimates that by 2035 a person will be diagnosed with cancer every minute. At present nine out of 10 people will survive bowel cancer if it is diagnosed at an early stage, but that figure reduces to only one in 10 if it is not diagnosed until stage 4. Currently between 46% and 61% of cancer sufferers are diagnosed at stage 1 or 2, which means that people are slipping through the net and dying needlessly owing to a lack of resources. With 40% more people being referred for diagnostic cancer tests than four years ago, cancer diagnostic services are struggling to keep up with demand. They have already missed their cancer waiting time targets over the past three years.

I am the co-chair of the all-party parliamentary group on breast cancer. The rest of my comments will focus on breast cancer, for which the situation is even worse than I have been outlining. The breast imaging and diagnostic workforce are critical for the early diagnosis of breast cancer, but Breast Cancer Now has discovered that only 18% of breast screening units are adequately resourced with radiography staff to meet demand. Taking into account the ageing workforce of breast imaging radiographers and the increase in demand, we have an exacerbation of pressures that will only get worse. For every three breast radiographers who retire over the next five years, only two are expected to replace them, which means that imaging and diagnostic services will be unable to keep up with demand. That will cause delays, which in turn will cause greater anguish for those waiting to be tested.

Fifty-five thousand people are diagnosed with breast cancer in the UK every year, yet the survival rates lag behind those of Sweden, Portugal, Germany and France. We have a declining workforce and an increase in demand. Unless the Government invest in a fully funded workforce plan, patients will suffer. We need a new approach to workforce planning based on best practice and clinical need. Health Education England must produce phase 2 of the cancer workforce plan, which looks at how many staff are needed to meet growing patient demand, and set out a 10-year cancer workforce strategy. The plan must be backed with appropriate funding. Breast Cancer Now has called for the Government to invest £39 million in recruitment to the breast imaging and diagnostic workforce as part of the plan to cover the cost of training to fill clinical radiologist vacancies and to address the current shortfall in radiographer numbers.

The Government’s decision to scrap bursaries for allied health professionals and nurses is a factor in making it harder to recruit. Someone who wants to become a mammographer must self-fund an MSc following a three-year radiography degree. Prior to the 2017 bursary cuts to allied health professionals courses, including for diagnostic radiographers, the undergraduate degree was covered by a bursary. Following that disastrous cut, there was a 20% decrease in the number of applications to allied health professionals courses and a further 9% cut in 2018. That under-resourcing, directly linked to the Government’s bursary cuts, has undoubtedly cost lives. I urge the Minister to reverse the cut to bursaries to ensure that the financial barriers to becoming a mammographer are removed and that more applicants are encouraged to apply for allied health professionals courses.

Funding for early diagnosis is not just about staffing levels and recruitment. It is also about new technology. There are new improved ways of detecting breast cancer, such as via tomosynthesis, which is far more effective in detecting breast cancer in some women. Artificial intelligence could also be used to assist in analysing the vast data capture involved in screening, but that would require the commitment by the Government of investment in new technologies and training. Risk-stratified breast screening is another way of making better use of technology to assess a woman’s individual level of risk by using algorithms to assess various risk factors. Once an assessment has been done, a more personalised service can be given for women at higher risk, which could again help to save lives.

I will finish by asking the Minister whether he will commit to getting Health Education England to produce phase 2 of the cancer workforce plan, which will be based on need, and confirm that it will be properly funded. Will he reverse the cuts to bursaries for courses for allied health professionals and nurses, and make sure that recruitment levels are up to the levels that are required, especially with Brexit looming? Finally, will he commit to exploring and funding new technologies and training that will help to detect cancer earlier, target those who are at higher risk, and alleviate the pressures on the workforce? If the Government do not get things right in relation to the shortfall in funding for early diagnosis and the cancer workforce, some people will inevitably die an avoidable death from cancer.

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Thank you very much, Mr Howarth. It is a pleasure to serve under your chairmanship. I, too, congratulate the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) on securing the debate. It is a slight pity that it is less than 24 hours after the publication of the long-term plan, but people seem to have done lots of fast reading last night.

Like others, I welcome the plan and particularly the extra funding for the NHS, but it is important to remember that this brings it back to 3.4%, which was the average over many years—indeed, below the average over many years—prior to 2010. As the Secretary of State highlighted yesterday, with a million extra patients, the money per head of the population is actually going down. That is something that should be looked at, because it is a much better comparative measure.

In Scotland, we spend £163 per head more on health than here in England and £113 per head more on elderly social care. We know that if we do not fix social care, then unfortunately any money put into the NHS is haemorrhaging out because of elderly people trapped in hospital, where they do not want to be. We see money focused on the NHS, because that sounds good to the public, but also further reductions in public health, despite all the talk in the plan about prevention. That does not make sense.

I welcome the Making Every Contact Count initiative. In Scotland, we have had Making Every Contact Count for years. As a breast cancer surgeon, I have discussed issues around smoking with all of my patients, because they inevitably ask, “Why did I get breast cancer?” We do not have the answer for breast cancer, but we do have the answer for the majority of lung cancers. I do not make my patients give up smoking immediately, when they are under stress, but I get them to promise me that they will do it in the long term, and quite a number of them do that. I do not have time to support them through that journey. We still need smoking cessation services, to which they can be referred. Those services are being cut, and that is a problem.

In the plan and in the Secretary of State’s letter yesterday, we again have a focus on cancer, which, as a breast cancer surgeon for over 30 years, I welcome. In his letter he talks about early diagnosis, but not about prevention, yet smoking is still the biggest cause of cancer, with obesity chasing it up as a close second. We need to tackle childhood obesity and we need a 9 pm watershed for advertising foods that encourage it.

Half of us will get cancer. As all the speakers have said, early diagnosis is crucial. It is particularly important to avoid diagnosis as part of an emergency admission, as that tends to result in a very poor outlook. For symptomatic cancers, as the Member for Shannon highlighted—[Interruption.] I keep saying that; I mean the hon. Member for Strangford (Jim Shannon). It is because the Shannon is another body of water in Ireland; I always get mixed up. We will just change it—you can be the Member for Shannon. [Laughter.] As the hon. Gentleman said, it is important to know the symptoms, but the public and sometimes GPs are too focused on late symptoms. Weight loss, jaundice and even, for some cancers, bleeding are not early enough. We need to educate people about that.

In Scotland, we have used humour. There was a testicular cancer advert over Christmas talking about men’s baubles. I do not care what kind of humour people need, whether it is toilet humour for bowel cancer or talking about boobs for breast cancer. If it gets people talking about it, that makes it easier for them to come forward. Many years ago we did an audit in Scotland looking at the whole patient pathway. It showed that for particular cancers, including bowel cancer, the longest step was from the first sign or symptom to going to the GP. The plan talks a lot about the pathway after going to the doctor, but there are only a couple of lines about educating the populous about what to look out for. That means we have to get people talking about it.

In Scotland, we have had bowel cancer screening starting at the age of 50 right from the beginning. I am sorry that the hon. Member for Torfaen (Nick Thomas-Symonds), who is no longer in his place, lost his mother in her 50s. In the last year or so we have also had celebrities diagnosed late with bowel cancer, who might well have been picked up if the screening had started at the age of 50. Last August, I welcomed the Government’s commitment to making that change, but there has been no discussion in any announcements or in the plan about when that change will happen.

When I turned 50 and the poo-in-the-post envelope landed on the mat within two days, I found it a bit harsh. As my birthday is Christmas Eve, I got another one last week. I would not mind if they were a bit more sensitive, but it is something that people have to do. In Scotland, we have already changed completely to the faecal immunochemical test, which involves only one sample. We have already seen a 10% increase in uptake. Again, the Government have committed to that and the roll-out has commenced, but when will it be complete?

It is important to be prepared for the impact that that will have on the NHS here. If the starting age for bowel screening is dropped from 60 to 50, there will be an increase of two thirds in the screening population. If there is then the same 10% increase with FIT, together that will mean an increase of three quarters in the colonoscopies required. The NHS will have to be prepared with endoscopists and, as mentioned earlier, pathologists, who will analyse the samples. In Scotland, we have seen an increase in waiting times for colonoscopies, just with the change to FIT, so it is important to be prepared.

There is a similar impact with public education campaigns. Intense campaigns alone are no use. When we did the first Detect Cancer Early campaign, an audit of the breast cancer units across Scotland found that there had been a doubling in referrals, but not a significant change in the number of cancer diagnoses. Women are pretty breast aware, but the adverts need to be trickled throughout the year, or the chances are that there still will not be an advert when someone is sitting and ignoring a symptom.

As well as endoscopists and pathologists, the other workforce is radiologists. Not all radiologists can be identified as cancer radiologists; they will find cancer in all sorts of parts of the body. This diagnostic workforce is critical. If we look at the waiting time performance across the UK, people are struggling, particularly with the 62-day target, which has fallen below 80% in England. Everyone is struggling with it. Looking at the 31 day target—from diagnosis to treatment—most cancers are over 90%, or indeed 95%. Once the NHS knows that someone has cancer, the pathway is relatively swift, but there is long gap to be diagnosed.

In my own speciality of breast cancer, radiologists are critical for the initial test, the investigation and the follow-up. For every three breast cancer radiologists who will retire in the next five years, they will be replaced by only two. The problem is that breast screening came in around 1990, so all the young consultants who were appointed at almost the same time will all, sadly, be retiring at the same time. The clinical radiology workforce census report shows that the UK has a shortfall of 1,000 full-time radiologists at the moment, which will grow to 1,600 by 2022. Some £116 million is being spent on outsourcing and overtime. The issue is not even money, because that amount would fund 1,300 full-time radiologists; the issue is that we do not have the workforce. Yet we see in the plan that health education has had its funding cut over recent years, despite grand statements about all the extra nurses, radiographers, allied health professionals and doctors who will be trained.

The plan talks a lot about IT, but instead of focusing on digital GPs it should be focusing on internal IT. We have had electronic prescribing, referral and response letters for years in Scotland, and one of the things we have that can help with the radiology shortage is the picture archiving and communication system, where imaging is shared right across Scotland. Every hospital uses the same system, which means that if one place is short of radiologists or is very rural, an image can be sent hundreds of miles to be looked at by someone else. The plan talks about generalists, and they are needed, but we also need specialists. The workforce plan is critical.

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It is a pleasure to serve under your chairmanship, Mr Howarth. In case anyone wonders why I am shivering a bit, I have to say it is a bit cold in here.

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But it is a very warm atmosphere.

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Oh, good—we do try.

I start by congratulating my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick) on securing this important and timely debate and on his excellent speech. I wonder whether he has a crystal ball and knew something that we did not; I am sure if he does, it will be much in demand, because we have an important vote next week and somebody might want to have a borrow. I thank all the other hon. Members who have spoken this morning—the hon. Members for Westmorland and Lonsdale (Tim Farron), for Eastbourne (Stephen Lloyd), for Strangford (Jim Shannon) and for Central Ayrshire (Dr Whitford), and my hon. Friends the Members for Easington (Grahame Morris), for Bristol West (Thangam Debbonaire), for Scunthorpe (Nic Dakin) and for Enfield, Southgate (Bambos Charalambous)—for their excellent contributions to the debate.

As we know, the long-term plan was launched yesterday. We had waited several months for it to be published, but I am pleased that, after a few setbacks and delays, we now have it and are able to move forward. I was also pleased to see that cancer is a key priority in the plan; I am sure the Minister played a large part in that. Cancer is important, but it is an emotive issue. One in two of us will face a cancer diagnosis in our lifetime, which is a sobering thought, and many of us in this Chamber will know someone who has been affected by cancer. Some of us, I know, have been affected by cancer individually, and no doubt some of us will have lost someone to cancer.

What led me initially to join the all-party parliamentary group on breast cancer as a new MP was losing my mother-in-law to breast cancer over 20 years ago. I notice that in this debate there is a gathering of former co-chairs of the all-party parliamentary group on breast cancer, as well as the current co-chairs of that group and the current chair of the all-party parliamentary group on cancer. Once this subject takes hold and catches our interest, it stays with us for the whole of our parliamentary career—as it should, because it is so important.

It is estimated that by 2035, one person every minute will be diagnosed with cancer. That is why cancer diagnosis, treatment and care and their workforces should play an important role in our NHS now and in the future. The Prime Minister set out in her conference speech last September the Government’s ambition to see three in four cancer patients diagnosed at an early stage within the next decade. Currently, just more than half of the people diagnosed with cancer are diagnosed early in England, so the Government have a long way to go to achieve that welcome ambition.

Early diagnosis improves the likelihood of survival, as we all know. For example, if bowel cancer is diagnosed at an early stage, nine in 10 people will survive, but if it is are diagnosed late, at stage 4, only one in 10 will survive. Early diagnosis also increases the likelihood of responding well to treatment. Target Ovarian Cancer, which I am proud to say I am the chair of the all-party parliamentary group for, found that as many as one in every five women in England are too ill to treat by the time they receive their ovarian cancer diagnosis. Awareness and screening programmes are crucial to early diagnosis, but breast screening uptake, for example, is the lowest it has been in 10 years, with stark variations across the country. The percentage of women taking up their screening invitation within six months fell from 71.1% in 2016-17 to 70.5% in 2017-18. Some might say that is only 0.6%, but analysis by Breast Cancer Now has found that upward of 1,200 additional deaths could be prevented per annual cohort of eligible women if we were to increase screening uptake to the current target of 80% for individual breast cancer screening units. With 500,000 people projected to be diagnosed with cancer in 2035, it is clear that we must do more to ensure that cancer is diagnosed early so that it can be treated effectively.

The long-term plan, as I am sure everyone has read and the Minister will be aware, says:

“We will build on work to raise greater awareness of symptoms of cancer, lower the threshold for referral by GPs, accelerate access to diagnosis and treatment and maximise the number of cancers that we identify through screening. This includes the use of personalised and risk stratified screening and beginning to test the family members of cancer patients where they are at increased risk of cancer.”

That is all great, but the Government cannot make those improvements without improving the workforce, and they must not be complacent about the role our NHS workforce have to play in this. As we all know, that workforce do a wonderful job every day, treating, caring for and supporting us and our loved ones, as those who have witnessed it at first hand will attest. Unfortunately, the cancer workforce is at breaking point and already struggles to keep up with increasing demand. There are chronic staff shortages across the NHS, with vacancies for 102,000 staff, including nearly 41,000 nurses. As anyone who has ever worked somewhere with staff shortages will know, the pressure that places on an individual is huge. I cannot imagine what it is like for the NHS staff who work day in, day out under those pressures, when so much depends on their being able to do their job properly.

Cancer Research UK has pointed to chronic shortages in the diagnostic workforce, with more than one in 10 positions unfilled nationally. According to Breast Cancer Now, for every three breast radiologists who retire over the next five years, only two are expected to replace them. I know that others have already stated a lot of these facts, but they are worth stating twice. There is a similar problem with breast cancer clinical nurse specialists; Breast Cancer Care states that they are an ageing part of the workforce, with 45% of breast cancer clinical nurse specialists aged 50 or above. The Royal College of Radiologists has warned of a shortage of cancer doctors, with 5% of clinical oncologist posts vacant during the course of last year, up from a 3% vacancy rate in 2015. The Royal College of Nursing also warns that in England there are nearly 41,000 vacant registered nursing posts, and it predicts a dangerous increase to almost 48,000 by 2023 if the Government fail to take urgent action now.

The Government must take the issue of the cancer workforce incredibly seriously, as nearly every person who has spoken so far in the debate has said. Will the Minister provide a progress report on Health Education England’s cancer workforce plan, which was published just over a year ago? Additionally, can he please provide us with a date for when he expects the second workforce plan to be published? As others have said, “soon” is not good enough. The NHS long-term plan makes it clear that the funding available for additional investment in the workforce, in the form of training, education and continuing professional development through the Health Education England budget, has yet to be set by the Government. Can the Minister assure us that any workforce plan will be properly funded, so that the workforce gap can be filled as a matter of urgency?

The NHS long-term plan says:

“We will complete the £130 million upgrade of radiotherapy machines across England and commission the NHS new state-of-the-art Proton Beam facilities in London and Manchester”,

but staff will need to be trained on both how to use those new facilities and how to read the results. Education and training must be high on the agenda for the second workforce plan, including the reinstatement of the training bursary, removing any financial burdens and barriers so that we can recruit the nurses that we need for the future. It also means offering further training opportunities once qualified, so that staff can keep up to date with technological advances.

Our NHS should be the most attractive employer in the country, but without the financial backing and support from the Government we are failing to recruit and retain our hard-working NHS staff. Of course, as the Secretary of State continues to say, prevention is better than cure, but £96 million has been cut from public health budgets this financial year.

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Order. I call the Minister.

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That was very decisive of you, Mr Howarth. It is quite cold in here, but the ministerial radiator next to me is doing very nicely. Note to the Box: must get radiator for shadow Minister.

It is a pleasure to serve under your chairmanship, Mr Howarth. I wish everybody a happy new year. I congratulate the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) on securing the debate. It is good to see him again. He has impeccable timing; I am not sure if he knew that the plan would be published when he applied for the debate. If he could let me know how managed that, I would be very grateful.

The hon. Gentleman and everybody else talked about cancer survival rates. The truth is that they have never been higher and have increased year on year over the last decade or so. The reason for that is not only the investment and policy decisions by the last Government and this Government but, as the shadow Minister said, the hard work of NHS staff up and down our country. They work tirelessly, going over and above to give cancer patients the care and compassion that they need. I place on the record my thanks to them, which was perhaps not said enough in the Chamber yesterday. We are not in the slightest bit complacent, though. At the end of the day, one death from cancer still devastates somebody’s life and their family’s life. We know that we need to do so much more to ensure that we deliver the world-class cancer outcomes in England that all of us want and expect for our constituents.

In introducing the debate, the hon. Gentleman set the tone when he talked about the workforce. He said that the workforce is, in a way, the rock on which to build the church. I will start with that. Where we cannot prevent cancer, which I will come on to, we must ensure that we have the right staff with the appropriate skills and expertise to ensure that patients receive the best care. The NHS is nothing without its 1.3 million staff. It is the biggest employer of trained staff in the world. In 2017, Health Education England published the first ever cancer workforce plan, in which we set out ambitious plans to expand the capacity and skills of the NHS cancer workforce, committing to invest in 200 clinical endoscopists in addition to the 200 already committed to, as well as an extra 300 reporting radiographers, by 2021. However, we know that we need to go much further and do more than that. The Prime Minister set out our new ambitions on cancer in her party conference speech, and we also set out our early diagnosis targets in the long-term plan and our survival targets. As the Secretary of State set out yesterday, the long-term plan is the next step in our mission to make the NHS the world-class employer that delivers the cancer survival rates that we want.

To deliver on those commitments, we have asked Baroness Dido Harding, chair of NHS Improvement, to chair a rapid programme of work for the Secretary of State. She will engage with staff, employers, professional organisations, trade unions, charities in this space, think-tanks, Members and all-party parliamentary groups to build a workforce implementation plan that matches the ambition set out in the long-term plan. She will provide interim recommendations to the Secretary of State by the end of March on how supply, reform, culture and leadership challenges can be met, and then final recommendations later in the year, around the time of the spending review, as part of the broader implementation plan that will be developed at all levels to make the long-term plan a reality.

The hon. Gentleman and others asked about the work of HEE and Baroness Harding. The announcement of the long-term plan superseded HEE’s plans to publish a longer-term cancer workforce plan. HEE will now work with NHS England and Baroness Harding’s NHS Improvement under the plan, led by the Baroness, to understand the longer workforce implications for the development of the plan. As I said, recommendations will be made in March, with a full implementation plan published later in the year. I did not say, “Soon.” I cannot give the House an exclusive this morning.

The hon. Gentleman also talked about Sir Mike Richards’s screening review. That will make initial recommendations by Easter this year and be finalised in the summer to, as it says in the plan,

“further improve the delivery of the screening programmes, increase uptake—

I know that the shadow Minister is concerned about that; I am too—

“and learn the lessons from the recent issues around breast and cervical screening, and modernise and expand diagnostic capacity.”

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Will the Minister give way?

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I will, but it will mean that other Members will not get a response.

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Does the Minister agree that a crucial part of success in early diagnosis is for both the NHS and local authorities, with their public health budgets, to have specific strategies to engage with minority ethnic communities to raise awareness of cancer symptoms, and to encourage them to take part in screening programmes? That is an essential part of an effective strategy to improve cancer treatment in this country.

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Yes. That is why the House gave all upper-tier local authorities the power to be effective public health authorities with ring-fenced public health budgets—£16 billion during this spending review period. Decisions will obviously be made about that going forward. One reason why we did that was because we believe that, for example, my right hon. Friend’s borough will have different priorities and demographics from mine in Hampshire.

It is a statement of fact that I will clearly not be able to respond to every Member’s points in the short time that we have left. I will respond to everybody in writing, as I always assiduously do. I will try to take a few themes in the minutes that I have.

The hon. Members for Easington (Grahame Morris) and for Westmorland and Lonsdale (Tim Farron) touched on radiotherapy. I very much enjoyed our meeting, and I thank them again for their work. I will send the hon. Member for Easington a note with more detail on his point on tariffs, because I know that he and the hon. Member for Westmorland and Lonsdale are concerned about it.

The hon. Gentlemen also talked about the manifesto response. We await the publication of the new radiotherapy specification before we respond. It is an excellent piece of work that will address many of the recommendations made, and we expect it to be published very shortly. I am afraid to say that the long-term plan makes no commitment to a one-off investment. However, it commits to improving access to safer and more precise medicines, including advanced radiotherapy. That document is not the final word. It is a living document that I will work on while listening to all-party parliamentary groups such as his own.

The hon. Member for Westmorland and Lonsdale also talked about the radiotherapy review. There was a phenomenal response to NHS England’s consultation, not surprisingly, with a lot of those were from the west country of England. The NHS will plough through that. I am putting great pressure on it to publish its report in response to that, which I am hoping, and am told, will be in early 2019.

The hon. Member for Central Ayrshire (Dr Whitford), otherwise known as the Member for the Irish sea, talked about prevention and smoking and child obesity and humour. I loved her reference to “poo in the post”. There is a great charity that talks about men’s bits called It’s in the Bag, which is good at promoting awareness of testicular cancer. She is right to talk about prevention. I am the Minister for Public Health and Primary Care, looking at prevention. The Secretary of State has made prevention one of his top three priorities, and she knows that it is key for me.

Smoking is still the biggest preventable killer in our country today, as I said in the House last night in the statutory instrument debate. We have published a world-leading plan on child obesity. We will consult very shortly. I try to be honest with the House at all times, and I hoped to get it out before Christmas, but there is an awful lot else going on and there is only so much I can get out the door at one time. However, I will get the 9 pm watershed consultation out the door. It is damned important that we do that. We said that we will, so we will.

The hon. Lady is absolutely right that prevention is better than cure, which is why the child obesity plan and Cancer Research UK’s work in that space has been very helpful.

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I remind the Minister that he ought to leave a little bit of time for the mover of the motion to speak.

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Okay. I will have to close. There is a lot of ambition in the long-term plan, which some people have very kindly said I may have had something to do with. That may be so. However, that ambition is matched by finances, and finances need to be matched by people. We understand that, but it is also about the much wider, holistic approach to prevention, and about staff being part of that. We get that. I hope I have given some reassurances around the work that will be done on that. I will write to Members on the rest of the points raised. I thank everybody for their—as usual—incredible and passionate contributions.

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I am grateful to all colleagues for their contributions, which were pertinent, personal, knowledgeable and clinical. I thank the Front-Bench spokespeople for their contributions. The Minister knows that we all want the same things—success for the Government’s programme, better and earlier diagnoses, adequate and professional staff and better survival rates. We are here to help him.

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

Togo: Human Rights

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I beg to move,

That this House has considered human rights in Togo.

It is a pleasure to serve under your chairmanship, Mr Howarth. I am grateful to have been allocated this debate. I am saddened by its necessity, but necessary it is, as I wish to raise the serious and worsening human rights situation in Togo. At present, according to the Foreign and Commonwealth Office website, the United Kingdom does not have permanent representation in Togo, but covers it remotely, from Ghana. I would be grateful if the Minister, in responding to the debate, outlined how the current system works, because I have a number of constituents from Togo who say that it is ineffective.

The human rights abuses occurring in Togo rest heavy on the shoulders of my constituents who left that country to settle in the UK, because although they are far from home, news of the continued abuse of their relatives and fellow countrymen and women at the hands of the authorities and security forces reaches them nearly every week. It is not only the case that the authorities heavily curtail people’s right to freedom of expression and freedom of assembly for peaceful protest; it has also been well documented that security forces use excessive force against demonstrators. Last year, Amnesty International stated that during one of the mass demonstrations organised by opposition groups, at least 11 people were killed by security forces. In addition, the random arrests, detentions, torture and other ill treatment of prisoners, human rights defenders, journalists and civilians continue. It appears that, in Togo, human rights violations continue with impunity. The Government and the security forces have a blatant disregard for justice and the rule of international law.

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I thank the hon. Lady for bringing this matter to Westminster Hall for consideration. Does she agree that the shocking report of the death of a 12-year-old in the run-up to the elections in Togo in December is an example of the fact that human rights are still supressed to a great extent in Togo, and that we in this House must do more to encourage human rights? I suggest that it may be possible to do that by using the Togolese ambition to be a Commonwealth member nation; that may be a way to influence what is happening there.

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I thank the hon. Gentleman for his intervention, particularly as it has given me time to catch my breath, because I have just run all the way across the parliamentary estate—there are not many things that a 63-year-old woman would run across the estate for, but I will for human rights in Togo. The issues in relation to the election are very important, and I will touch on them later.

It is time for the Government of Togo to practise what they preach and fulfil the promises that they have made to the United Nations, to the international community and, most importantly, to their people. Togo is a United Nations member state. As is protocol, the UN conducts a universal periodic review of the human rights records of all UN member states. The first cycle of the UN universal periodic review of Togo took place in October 2011. Of the 133 recommendations made, Togo rejected a number, including a recommendation to amend or repeal the laws used to crack down on journalists and human rights defenders, a recommendation regarding the protection of lesbian, gay, bisexual and transgender people in the country and a recommendation regarding the inclusion of laws that criminalised defamation. There has been some progress in the ratification of crucial international instruments, but there is so much more to do. It is imperative that Togo live up to the recommendations that it has agreed to within the universal periodic review. Things must happen not just on paper, but in practice.

Togo was elected to join the UN Human Rights Council for the period 2016 to 2018 and was expected to use that mandate to strengthen its human rights commitments. Combating torture was one of the key recommendations made in the review. The country ratified the optional protocol to the UN convention against torture by rolling out capacity-strengthening workshops to combat torture for criminal investigators and prison and rehabilitation officers, but torture remains a practice in the country that is used by security forces against participants in anti-Government demonstrations.

Many hon. Members will be aware that between August and December 2017 the authorities continued violent crackdowns during mass protests. Those protests were led by the political opposition, calling for, among other things, the end of President Faure Gnassingbé’s tenure as President. Freedom House is an independent watchdog organisation that dedicates itself to the expansion of freedom and democracy around the world. In its country overview for 2018, it stated:

“Togo’s politics have been dominated since 1963 by Gnassingbé Eyadéma”—

apologies for my pronunciation—

“and his son, the current president…Advantages including a security service dominated by the president’s ethnic group, disproportionately drawn election districts, and a fractured opposition have helped President Gnassingbé and his party hold on to power. In 2017, protests calling for the reintroduction of term limits were harshly repressed.”

The President has been in power since 2005. His predecessor—his father—held on to power for 38 years before his death. Claims of the repression of protests that call for the reintroduction of term limits are supported by many human rights organisations and institutions. According to Amnesty, protests were met with excessive use of force by the security forces. Among other instances, security forces used live ammunition in 2017 to disperse a protest against rising oil prices in the country. Several people were injured, and many were surprised that only one death was recorded. In June 2017, videos posted on the internet showed members of the security forces, armed with shotguns, beating students on the ground with batons at a student demonstration calling for improved living conditions. That outrageous act occurred at the University of Lomé within the student union. As if that were not enough, security forces arrested at least 19 students, 17 of whom were later released. Several students stated in court that they had been beaten during their arrest and transfer.

Members of the political opposition held mass demonstrations in major cities across Togo. There are reports that those demonstrations were, again, broken up by security forces, which used tear gas, batons, water cannon and live ammunition. It is simply not humane to use water cannon to disperse crowds and most certainly not for people who have a right to protest peacefully under the UN declaration of human rights, to which Togo became a signatory on 20 September 1960.

One of the main things that Togo seems to have refused to address or improve is the authorities’ repression of people’s right to freedom of expression. The Freedom House report entitled “Freedom on the Net 2018: The Rise of Digital Authoritarianism” stated:

“In almost half of the countries where internet freedom declined, the reductions were related to elections.”

Unsurprisingly, that is true in the case of Togo. In September 2017, the authorities shut down the internet for nine days in retaliation to opposition-led protests. In doing so, they disrupted the organisation of protests and heavily disrupted the work of human rights defenders and journalists who were monitoring the protests. Those reports were later verified by the digital rights group Internet Without Borders. Togo is a signatory to the international covenant on civil and political rights, and its shutdown of mobile phone services and the internet is a violation of article 19 of the covenant.

In a year in which human rights defenders are operating in a shrinking civil society space, I hope that the House will agree with me that disrupting the crucial work of human rights organisations and human rights defenders is detrimental to democracy and should not be allowed to continue. Many cases have been brought to my attention to highlight the gross extent to which the Togolese Government curtail people’s rights. They do so by arbitrarily closing down media outlets and arresting community and opposition leaders to crack down on anyone who expresses dissent.

One such case is that of Robert Kossi Avotor. Robert is a journalist who was viciously attacked with batons in the city of Lomé by the police. He was also handcuffed in a successful attempt to prevent him from photodocumenting an eviction that was taking place. He was subsequently detained and had his images deleted, before being released without charge. Although he filed a complaint with the prosecution service, he received no response. This is a classic example of the security forces using extreme force and brutality to curtail the legitimate work of journalists and human rights defenders. They are propped up by the general prosecutor, who issued a warning stating that anyone who reported on Robert’s attack would face criminal prosecution for disseminating “fake news”. When a Government that do not respect human rights are propped up by a judicial system that does not respect the rule of law and intimidates those seeking justice for crimes committed against them, what hope is there for the people of that country?

I would like to thank the Minister for the attention in the written answers she has already provided to me. In November last year, the Minister responded to one of my written questions on Togo, saying that the UK Government supported the President of Ghana and that they encouraged both the Government and the opposition in Togo to work towards ensuring that the elections to be held on 20 December would be free, fair and void of any violence. Sadly, as many will be aware, the elections were anything but that. According to various news sources, in the days leading up to the elections, many people were killed by security forces. Despite advice given by Ghana and the UK, protesters still gathered and organised demonstrations in the lead-up to the elections, which in turn flared into violence. Some 14 opposition parties joined forces to call on their supporters to boycott the elections, amid fears that the President would put forth legislation to allow him to run again in 2020 and 2025.

During the mediation talks held by Ghana and Guinea to resolve the crisis, the opposition asked for an overhaul of the electoral commission and for term limits to be set, but this was not to be. Elections are a major source of contention and strife in Togo. How many more people will be arbitrarily arrested and detained? How many more people will tell us their tales of torture, simply because they exercise their human right to freedom of expression or opinion?

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I congratulate my hon. Friend on securing this important debate. Like her, I have many constituents, some of whom are in the Public Gallery, who will be watching this debate closely, and who have real concerns about their friends and family still in Togo. Does she share my concern about the repressive cyber-security law that the National Assembly recently passed, which human rights campaigners around the world agree will have a chilling effect on freedom of expression?

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I do have major concerns about that. If people are not free to access information and communicate with each other, it puts Togo in the same position as many other regimes, such as China. The Togolese Government beat their opposition for expressing dissent, and silence the media and journalists. In November, the Minister replied to a question that I raised, saying that the UK Government recommended that allegations of arbitrary arrest and detention, and allegations of torture, be investigated thoroughly. Reports from Amnesty International and other human rights organisations dispute that that has taken place in Togo.

I have five questions for the Minister. If she cannot answer them now, I request that she sends me a written response. First, what can the Foreign Office do—what will it do—to encourage Togo to end its security forces’ excessive use of force and for their authorities to respect people’s right to peaceful protest? Secondly, does the Minister join me in condemning the Togolese Government for shutting down the internet, and contravening article 19 of the international covenant on civil and political rights? Thirdly, what assistance is the UK giving to support human rights defenders and civil society in Togo? Fourthly, how might the Foreign Office encourage Togo to ensure that perpetrators of human rights abuses are held accountable and prosecuted in a court of law? Finally, will the Minister ask the Togolese Government when the high commissioner for reconciliation and strengthening national unity will action the plan to implement the truth, justice and reconciliation commission of Togo’s 68 recommendations?

The 70th anniversary of the universal declaration of human rights was marked on 10 December 2018. Togo is a signatory to that declaration. On paper, Togo is doing the right things to show that it cares about and is committed to human rights values and principles—I have touched on those things throughout my speech. However, in reality, the Government and the security forces there fail to adhere to human rights standards. Togo seems to be a country open to improvement when it comes to its human rights failings. That is why it was elected to the Human Rights Council. However, we seem to be dealing with a Government that make assurances to protect human rights and adhere to human rights standards one day, and abandon those values when they think that nobody is looking.

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I congratulate the hon. Lady on securing this excellent debate. The UN and, to a lesser degree, other international organisations are somewhat distant from Lomé. Does she agree that, in addition to the leadership that Ghana is showing, it would be good for the Economic Community of West African States to take a greater role in Togo and provide some leadership on what the international community wants? That local, regional leadership sometimes works better than distant people from New York telling individuals how to run their country.

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I agree that this is not a job for just one country, but for many. The UK cannot act alone, but together with others it can. Anybody who can apply pressure and alleviate the suffering of the people of Togo should be welcomed and encouraged. I would be interested to know the Minister’s view on that issue.

It is my sincere hope that the UK Government will work closely with the Togolese Government to ensure that they are respecting human rights values not just on paper, but in reality too. In a year’s time, I do not want to be sitting in my constituency surgery with my constituents who come from Togo telling me yet more stories like the ones that we have heard. I am sure that we are all appalled. I am sure that the Minister will do everything she can, and I am interested to hear what that might be.

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It is a pleasure to serve under your chairmanship, Mr Howarth. I congratulate the hon. Member for Erith and Thamesmead (Teresa Pearce) on securing this important debate and, through her, I thank her constituents who have rightly brought these important matters to her attention and thus to the attention of the House.

Promoting human rights worldwide is generally part of the UK’s foreign policy. We believe that everyone everywhere should enjoy equal rights and protections under the law. We believe that human rights are the essential foundation for a fairer, more secure and more prosperous world. Standing up for human rights is not only the right thing to do, but the smart thing to do. In our work, we promote respect for human rights in various ways, from quiet diplomacy and private discussions to leading and supporting international public campaigns with our international partners. With regard to media freedom and in particular the internet, we are campaigning very much this year for media freedom worldwide. The hon. Lady will be aware that we have also increased our support to the BBC World Service and our overall coverage across Africa in a variety of languages.

On the political and human rights situation in Togo, and UK Government action, I will start by recapping the political situation as we see it. President Faure Gnassingbe has been in power in Togo since 2005 following the death of his father, who had held the post for 37 years. The current president was elected for a third term in 2015, having set aside the term limits set out in the 1992 constitution. Togo is now the only country in the Economic Community of West African States that does not currently have presidential term limits. There have been increasing demands in recent years for that to change. A referendum on the issue was planned for September 2017 but did not go ahead.

Since late 2017 Togolese opposition parties have joined together to form a 14-party coalition, and have begun to stage protests in Lomé and across the country, to demand electoral reform. These protests are ongoing. Unfortunately, as the hon. Lady said, violence has been associated with the protests, mainly in the north of the country, perpetrated by both security forces and protestors. At least 12 people, including some members of the security forces, have been reported as killed since August 2017.

Reports are difficult for us to corroborate because, as the hon. Lady notes, we do not have a permanent diplomatic presence in Togo, and media reporting is often contradictory or biased. Nevertheless, our non-resident high commissioner, who is based in Ghana, continues to monitor the situation in Togo. In the last 18 months, he has visited Lomé twice and he keeps in touch with partners and multilateral institutions.

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Iain Walker does a fabulous job, as did Jon Benjamin, but with the expansion of the network across Africa, is there a possibility that we could get greater representation in Lomé, perhaps within three years? Is that in the pipeline?

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I was going to mention our honorary consul in Lomé, Sitsu Curterello—I will make sure that Hansard gets the right spelling. As my hon. Friend mentions, we are increasing the range of roles and our diplomatic presence across a range of African countries. Under current plans, we are not anticipating opening an outpost in Togo directly, but we are anticipating increasing representation in Ghana. As he will know, the coverage of political affairs is done from Abidjan, so we are increasing our presence across west Africa.

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On that point, my constituents have expressed dissatisfaction with how that system works. If I meet them again and they give examples of where it is ineffective, and I write to the Minister, will she respond?

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I would welcome that. As the hon. Lady knows, the more specific the better—that is always helpful.

One point that I have raised with the Togolese chargé d’affaires in London is the accreditation of our representative from the high commission in Ghana and of the honorary consul. We would like that paperwork to be finalised because it has been outstanding for longer than it should have been.

In terms of regional mediation, as my hon. Friend the Member for Rochford and Southend East (James Duddridge) said, we believe that ECOWAS has an important role to play. It is best placed to mediate in the current political crisis, as it did so successfully in Gambia. We support the efforts of the Presidents of Ghana and Guinea to that end. Indeed, a road map was brokered by ECOWAS in July 2018. We urge the Togolese Government and the Opposition parties to implement that road map, and we encourage all parties to resolve the crisis peacefully through a political agreement.

Regarding the political situation more broadly, it was encouraging that legislative elections took place on 20 December and that they were assessed by ECOWAS monitors to have been credible and non-violent. However, it is concerning that local elections, which were due on 16 December, were postponed for an unspecified period. It is also regrettable that more Opposition parties did not stand in those elections.

On the wider human rights picture, the UK welcomed Togo’s positive progress during its last UN universal periodic review in 2016, which included taking steps to prevent torture and other human rights violations by the security forces, and releasing a number of political detainees. Clearly, where such allegations have been made, it is important for them to be fed in so that they can be reflected in future United Nations universal period reviews. We also welcomed Togo’s election to the Human Rights Council from January 2016 and its decision to impose a complete moratorium on the use of the death penalty, as announced at the UN in September 2016.

We have raised concerns, however, about child trafficking, prison policies, prison overcrowding and the treatment of detainees in prison. At the time of the universal periodic review, we urged the Togolese authorities to thoroughly investigate all allegations of torture, arbitrary arrest and detention. We also remain concerned about the Government of Togo’s continued resistance to provide legal protections for lesbian, gay, bisexual, transgender and intersex people. We have urged them to ensure that the human rights of every individual in Togo are protected by law.

When I met the Togolese chargé d’affaires in London recently, I raised our concerns about human rights and took the opportunity to emphasise the importance of implementing the road map and of holding free, fair and peaceful local elections. We also discussed UK support for the economic development of Togo. The UK recognises that Togo is a country with a low average income. We provide about £12 million of development assistance annually, not directly through the Government but through a range of non-governmental organisations. In 2018, that included £1.6 million for the UN population fund, which supports reproductive healthcare and development across the country.

In conclusion, the UK Government welcome the steps taken by the Togolese Government to improve human rights in some areas, but we remain concerned about reports of violence, human rights abuses and violations associated with political protests. The treatment of detainees and the lack of protection for LGBTI people are matters of continued concern. We have said to the Government of Togo that they must now step up and deliver real progress on human rights, including on the ECOWAS road map, which will benefit all the people of Togo.

Question put and agreed to.

Sitting suspended.

Apprenticeships and Skills Policy

[Sir David Amess in the Chair]

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I beg to move that,

This House has considered apprenticeships and skills policy.

It is a pleasure to serve under your chairmanship today, Sir David. The title of the debate is as broad as possible so that colleagues may join in and give their own perspective. I will address the problems in the apprenticeship levy and regional skills imbalances in our country; the mismatch between the skills system and the needs of the economy; and the need to give tools to places such as Bradford to help us to close the productivity gap between us and London.

In June last year, I held a business and jobs roundtable in my constituency. Business leaders and representatives of trade unions, the Bradford Economic Partnership, the Northern Powerhouse Partnership, Bradford Chamber of Commerce, Bradford University and Bradford College all attended, as well as my hon. Friend the Member for Bootle (Peter Dowd). The overall theme for the roundtable was how we could boost economic opportunity for all in Bradford South. Although the discussion ranged over a number of issues, a significant amount of time was spent discussing schools, training and apprenticeships. Later in my speech, I will address the specific issue of the apprenticeship levy, but first I will briefly outline the challenges and opportunities facing Bradford.

Bradford is a great northern city with a proud industrial heritage. That heritage was created by successful businesses, which used new technologies and the city’s pioneering drive to build a world-leading economy. We are still home to many successful and enterprising businesses. In my constituency of Bradford South, we have a strong manufacturing sector. Bradford has 1,200 manufacturing businesses, employing more than 25,000 people in the district, which accounts for 13% of all employees locally compared with 8.3% for Great Britain as a whole.

We face a significant challenge with the interconnected problems of low skills and low wages, and I will give a few figures relating to my constituency to illustrate that. In Bradford South, 15% of the working-age population have no qualifications compared with the UK average of 8%; 14% of our working-age population are qualified to degree level and above, compared with 31% nationally; Bradford South has 600 jobs per 1,000 people in the working-age population, compared with 840 nationally; average weekly workplace earnings stood at £480 in April 2018, compared with a UK average of £570; and Bradford South ranks 520th out of 533 constituencies in England in the social mobility index from the House of Commons Library. Many people in my constituency do not have the skills they would need to access good-quality, well-paid and secure jobs.

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I understand the point that the hon. Lady is making about her constituency. Does she believe that schools in her constituency have something to contribute to redressing the imbalance she is describing?

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I agree that schools have a lot to offer when it comes to redressing the imbalance. I will address schools a little later in my speech, when I will speak about the specific situation in Bradford and the specific project that we have there.

That situation is something of a vicious cycle. The lack of skills makes Bradford a less attractive place for businesses to locate and invest in. A good example is Her Majesty’s Revenue and Customs, which cited the lack of appropriate skills as one of the reasons to relocate its offices from Bradford. That is why getting the skills policy right is essential to give places such as Bradford the economic boost that they so badly need.

The issue is becoming ever more urgent as we face the impact of new technologies in the world of work. The Future Advocacy report places Bradford South in the top 40 constituencies that are likely to be affected by automation in the coming years. It also says that 35% of jobs in Bradford are in occupations that are likely to shrink by 2030. It is clear that Bradford will need to adapt to secure good-quality and sustainable jobs.

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The Federation of Small Businesses has raised concerns about the 40-day requirement for placements associated with T-levels. Is that a concern for employers in the Bradford South constituency?

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That certainly is a concern for employers in my constituency.

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My hon. Friend has mentioned that modern technology plays a major part. Does she agree that the restoration of the education maintenance grant would help students in relation to apprenticeships? Furthermore, cutbacks in further education do not help—it seems to be treated as a Cinderella industry.

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I thank my hon. Friend for the wise words and I certainly welcome them. I say to the Minister that now is the time that we must act to create a better skills and training system if we are to prevent disruption further down the line.

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One of the problems we face in my constituency with training centres is that 20 to 25 students will start training, but only four will finish. How can we encourage young people to stay in apprenticeships, or is the apprenticeship scheme not fit for purpose?

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That is a very interesting and pertinent point. I know that some apprenticeships are paid so poorly and offer so little training—apprenticeships are supposed to be jobs with training—that they are not really worth the paper that they are written on. In my view, they should not be called apprenticeships.

At a local level, a significant amount of work is under way to meet the challenges that I have spoken about, with the Bradford Economic Partnership setting out a local economic strategy with a focus on increasing the number of productive businesses in the district through investing in skills provision.

We recently had Bradford manufacturing week, which I was delighted to support. It aimed to show the young people in Bradford the many exciting opportunities in manufacturing that are right on their doorstep to get them thinking about the skills that they will need for the future. Over half of our secondary schools took part. In just one week more than 3,000 children crossed the doors to get that first-hand manufacturing experience in workplaces.

Another exciting area of work that is being developed locally in Bradford involves the industrial centres of excellence—or ICE—approach to post-14 careers and technical education. ICE gives business a partnership vehicle with local schools, colleges and the University of Bradford to ensure that education and learning in Bradford meet the skills demands of businesses in the local and regional economy within given sector footprints, which opens up opportunities for our young people and improves social mobility.

Those centres are good examples of how schemes that are locally led can deliver for businesses and encourage social mobility. I would welcome the opportunity to discuss them further with the Minister, but Government policy is making it more difficult for places such as Bradford to bring about a transformative change in their labour markets. I will start with the specific issues that Bradford businesses and education providers have raised with me about the operation of the apprenticeship levy.

I fully support the principles behind the levy, but its implementation has compounded the problems of underinvestment in training rather than improving the situation. As the Minister will be aware, the apprenticeship levy aims to encourage employers to invest in apprenticeship programmes, but apprenticeship starts have been significantly down since the introduction of the levy in May 2017. In July 2018, the total number of apprenticeship starts nationally was 25,200.

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I congratulate my hon. Friend not only on securing the debate but on her generosity in giving way. I am sure it will help the new year planning for the keep fit programme.

Skills, education and training are devolved matters in Wales, where there has been a 23% rise in the uptake of apprenticeships—obviously, we are doing something right. I wonder whether the UK Government are talking to the Welsh Government, perhaps about sharing good practice so we can make the success in Wales a success right across the United Kingdom.

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I thank my hon. Friend for making that point, which is definitely one for the Minister to address.

As I was saying, in July 2018 there was a total of 25,200 apprenticeship starts nationally, which represents a 43% drop from July 2016. Starts in Bradford South have fallen from 1,370 in 2015-16 to just 680 in 2017-18 —very nearly a 50% drop. Several Bradford firms have told me that the complexity of the system is a major barrier to entry, and that seems to be a particular problem for small and medium-sized businesses. That was clearly set out to me when I had the privilege of attending the apprenticeship awards evening at Bradford College late last year. While we were discussing the fantastic successes of apprenticeships at the college, it raised a number of difficulties facing both the college and the many SMEs it works with. Many of the latter find the administrative demands of the new apprenticeship system extremely difficult to manage, and the college itself is experiencing cash-flow difficulties, caused by changes to the apprenticeship contract and the digital payment process, with payment times having increased to an average of 14 weeks from an average of seven before the reforms. The college has had to create four new posts to help it to navigate the changes and support its employers.

In his recent Budget, the Chancellor acknowledged some of the shortcomings identified in the current apprenticeship policy. For example, he announced his intention to reduce the requirement to contribute to the costs of off-the-job training from 10% to 5% for non-levy employers, which should help a little. In Bradford South, I have levy employers asking if the same 5% reduction in fees will apply to them once they have exhausted their levy funds. They currently deliver the extra apprenticeships under Solenis, which also requires a 10% core contribution from employers.

I recognise that a new system takes time to bed in, but the Government’s approach needs more than just a little fine tuning. We need a more radical overhaul of our skills policy to help places such as Bradford get the growth and prosperity we deserve. We have a situation where public policy, whether intentionally or unintentionally, has turbo-charged the London economy to the detriment of other towns and cities outside the capital. The Government need to address the failure over decades to tackle persistent regional skills imbalances. We need a mechanism to support industries and individuals in areas that face economic decline and need help to adapt to the demands of the global economy.

The jobs of the future will require people to work more closely with advanced technologies. Workers will need support to adapt and retrain, to secure decent and sustainable work; otherwise, in many places in the UK we will face a lasting legacy of low qualifications, low productivity and low pay. Yet the Government have no convincing strategic framework for identifying sectors and areas in which large numbers of jobs are at risk from technological and economic change. In fact, the apprenticeship levy contributes to further regional imbalances, as more funding is raised per head in London and the south-east than in the rest of the country. London has the lowest skills need in the country, yet the levy will raise more funds there, as the capital has both a greater proportion of workers employed by large employers and far higher pay. The Social Mobility Commission’s “State of the Nation 2017: Social Mobility in Great Britain” report identifies that as an emerging risk, and the commission urges the Government to develop education and skills policies to better support disadvantaged young people in areas such as Bradford South, stating that that could be done

“by targeting any used apprenticeship levy funds at regions with fewer high-level apprenticeships”.

According to the commission, apprenticeships are a more common path into employment for young people in many youth coldspot areas, where there are higher barriers to social mobility than in hotspots, but those apprenticeships are often of lower quality than in the hotspots. If we are to rebalance our economy, we urgently need reforms to the apprenticeship levy to ensure that it meets the needs of the most disadvantaged areas and those with a legacy of underinvestment, such as my constituency of Bradford South.

A debate about skills policy must not be just about how to support young people to enter the workplace; it also must consider those who are already working. To achieve a sustainable supply of skills with the flexibility to meet the ever-evolving needs of business, industry and the public sector, the UK must maximise the potential of its existing workforce. That is why the 45% reduction in spending on adult education since 2010 is so short-sighted and damaging to our economy. If Government want business and individuals to see training as an investment and not as a cost, they must lead by example. To meet the wider training need of the economy, we need more focus on how the apprenticeship levy can be used to tackle the overall skills shortage.

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I agree with a number of the hon. Lady’s points, but while I accept what she says about individuals gaining access to education as adults, does she not agree that employers have a duty to their staff to ensure that they are properly trained, that their careers are developed, and that appropriate adaptions are made if they transition into another career or a different role in the organisation? It should not necessarily be down to the Government to do that. Employers have an important role and a moral obligation to their staff.

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Yes, everyone has a wider responsibility to train and retain. Lifelong learning is, in fact, a mantra going back some decades.

The Chartered Institute of Personnel and Development comments:

“The Government should consider broadening the apprenticeship levy into a wider training levy. The training levy could be reconfigured to cover a much broader range of organisations…whereby all businesses with more than 50 employees would contribute, with larger businesses contributing more to the pot.”

That would allow levy funds to be used to fund people with low qualifications to access pre-apprenticeship training.

A wider problem that has affected this country for decades is overreliance on individual learners to make informed choices about their training in an environment that is not well structured and where independent advice is not freely available. Unlike much of Europe, we do not have a strong industrial sectoral voice to drive collective action from employers. To pursue the high-skills route to business success, more effort must be made to develop that voice. The Government must no longer rely on responding to individual employers and instead work to build up strong sector skills bodies, which will be more able to forecast skills needs and encourage the collective commitment to skills that we have heard about in the debate.

Sectoral institutions should include a range of key stakeholders able to build a wider commitment through an entire industry. That model is found in other western European countries, such as Germany and France, where it is common practice for employers, civil society groups and trade unions to co-operate to achieve mutually agreed goals. Achieving that requires the Government to take both a more active and a more supportive role and to devolve greater power and responsibility to key sectoral bodies. Places such as Bradford need more tools and resource to close the productivity gap with London. Investing more in skills and devolving more to our cities would be a significant step forward in building an economy that works for everyone.

In conclusion, I ask the Minister to answer my questions about apprenticeships and skills. In particular, will the Government reduce the administrative burden and the costs of operating the apprenticeship system to the pre-May 2017 levels? What will she do to address the regional imbalances that are built into the apprenticeship levy? Does she intend to develop a strong sectoral voice to articulate and stimulate the demand for skills?

If we get the skills policy right, we can give young people the tools they need to secure high-quality jobs, and we can boost productivity and rebalance the economy so that it works for all places and all people in our country. That must be our absolute priority, and I hope that today’s debate and the Minister’s responses will contribute to getting that right. Finally, I would like to place on record my thanks to the Minister for her welcome interventions in helping to secure a future for Bradford College. I very much look forward to working with her.

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It is a great pleasure to serve under your chairmanship, Sir David, and it is an even greater pleasure to follow the hon. Member for Bradford South (Judith Cummins). I will take advantage of the way in which she has drawn the subject so widely because I want to answer a fundamental question: how do we get students who are still at school to focus on the options of an apprenticeship and skills training rather than going to university? Those Members who know me may think that that is a rather surprising thing for me to say—I went to three universities and had attachments to two foreign universities while doing so. She will have to forgive that, but I ask the question seriously.

There are two aspects to answering that question: schools, and the method by which we get people attracted to the options of apprenticeships and skills training, which is through work placements. I will start by looking at work placements as a precursor to people going on apprenticeships. I am sure that we have all had people on work placements in our offices; I know that for much of the run-up to the summer holidays, I have a person on a work placement every week. I wonder how many people we are trying to line up to be politicians when we are supposed to be cutting back the number of MPs.

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The hon. Gentleman’s eyes might care to drift towards the Gallery, where he will see a young person from St Dominic’s college in Harrow—just north of my constituency, but she does live in my constituency—who is the living embodiment of the ideals and ambitions that the hon. Gentleman has just expressed.

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I am grateful to the hon. Gentleman for pointing that person out, and for the way in which he described them. It is fitting to include them in the debate.

It is important to get other people involved in providing work placements—it is not just something for politicians to provide. We need to encourage small businesses to become involved in that, so that people get a feel for the entrepreneurship that is involved in setting up and running a small business. There are a couple of examples of companies in my constituency that do that, such as Williams Jet Tenders, which makes boats to go on other boats. It has a scheme of taking 10 people from the most deprived area of the constituency each year, some of whom go on to do apprenticeships. That training provides them with a lot of experience, and also with a lot of fun, because they end their experience by building little boats that they race against each other. I have been along to present the prizes to the winners, and all of that might sound like great fun, but there is also a seriousness to the skills that they learn: how to make model boats, and how to scale them up from that. Other companies provide that experience as well, including a cabinet and kitchen maker that I have also visited.

Those work placements take a whole lot of learning away from the apprenticeships. I am principally going to mention three areas of learning, the first of which is working well with other people. That may sound obvious, but for young people, working with other people and dealing with the dynamics of that is a skill that needs to be learned. Another skill that is crucial to learn and which work placements can provide is how to cope with criticism. Of course, coping with criticism is something that we as politicians take for granted, so maybe the work placements in our offices do have a purpose, but that is an important thing for people to learn. The third thing is people managing their own time, and making sure that that is part of how they approach life. Those are three examples of skills that work placements can provide, which will take away the need to pick up on those areas of learning during apprenticeships and will also help to make apprenticeships more attractive.

Having dealt with the work placement side, let me turn briefly to the schools side. Schools need to participate. We have been only partially successful in encouraging schools to encourage people to go into apprenticeships and skills training rather than to university. Certainly, among the schools in my constituency, there is a huge variety of attitudes towards encouraging students to go into apprenticeships. Some still have a very old-fashioned view of life and only measure success by the number they send to university.

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I am an MP but I am also a former careers adviser. Does the hon. Gentleman agree that it is about time that we re-establish a careers service—formerly the Connexions service—that will help people make well-informed and realistic decisions?

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I am open minded. I just think back to my time at university when there was a careers service. I will not tell the House the advice that I was given, but I did not follow it at all—not one iota. I am not sure whether that was down to the quality of the advice or my own sheer cussedness, but I take the hon. Gentleman’s point.

It is important that schools focus on promoting apprenticeships as a legitimate option that is equal to going to university, and we need to judge where people go according to their own skills and inclinations. I am pleased to have been able to contribute on the topic of how we get people to go into apprenticeships in the first place. I think we need to put a little more finesse into the work placements that are offered around the country.

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Order. The closing speeches begin at 3.30 pm and there are five colleagues wishing to catch my eye, so I appeal to Members to share the time out, with about six or seven minutes each.

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What better way could there be to start the new year than being in Westminster Hall under your benign guidance, Sir David? If there were a better way, it could only be being here to discuss matters of such moment, and I give enormous credit to my hon. Friend the Member for Bradford South (Judith Cummins) for having raised this important subject. J. B. Priestley composed endless panegyrics to the proud city of Bradford—which he called Bruddersford so as not to confuse people—and there was a time when we thought of Bradford as being exemplified by J. B. Priestley. However, my hon. Friend has now adopted that crown, and she is the spokesperson for that city.

I was delighted to hear from the hon. Member for Henley (John Howell). I was a little surprised by his comments about the more deprived areas of Henley—presumably, that is a place that is down to its last Jaguar. I had not previously thought about the teeming stews and slums of Henley, but I am here to be educated. I was also interested to hear about the careers advice that the hon. Gentleman received. I remember the careers teacher at my school encouraging me to leave at the earliest opportunity, saying that I could go into the Royal Navy at the age of 16. He did say, “By the way, they will take anybody.” One of my colleagues, I seem to remember, thought that he was being advised to become an author when the careers master said to him, “Have you ever thought about being a man of letters?” He ended up, of course, as a postman. [Interruption.] There is nothing wrong with that; there are some distinguished postmen.

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indicated assent.

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There has been a slightly unpleasant anti-London undercurrent to the debate, with talk about this proud metropolis sucking in all the apprenticeship levies and doing better than other parts of the country. I want to talk about one sector that is reflective of the whole United Kingdom, from Northern Ireland to every other part of the nation, which is the ornamental horticulture and landscaping sector. In our modern workforce, we have this extraordinary problem of a skills shortage. Lest anyone think that ornamental horticulture and landscaping is a minor add-on to the economy, it contributed £24.2 billion to GDP in 2017 and supports 568,000 jobs. It is a crucial sector, but we have a terrible skills shortage. In the absence of the hon. Member for Taunton Deane (Rebecca Pow), I pay credit to her work on the all-party parliamentary gardening and horticulture group, particularly the report it produced last year. I know the Minister is familiar with it and received several copies. I am sure she has many a spare hour in the lonely garret of the Ministry when she is looking for some exciting reading, and the APPG’s report will provide that.

The great joy of horticulture, particularly in the fields of ornamental horticulture and landscaping, is that it offers a route into a skilled profession. Someone who has an aptitude for ornamental horticulture and landscaping—they do not necessarily have to have an enormous amount of academic qualifications, although they help—can access that strand and grow within it and become virtually anything. There is no limit to what someone can achieve. Capability Brown started somewhere. I am not entirely sure where, but it was probably in London, judging from comments today.

We would like to see the Government doing a few things. The Minister will be aware of the modest Christmas wish list, which we have already sent her copies of, but we need to better promote roles in ornamental horticulture and landscaping. People do not understand what the roles are, and we can do much better. There is a lack of horticulture education in UK schools. Current careers advice—I cast no aspersions against present or former careers advisers; they are without a doubt a fine body of women and men—is not giving students knowledge about the sector, which is crying out for entry-level people to work in it. Many would love the idea of an outdoor, creative job that brings about some product at the end of the day—something that they can show and be proud of. We as Members of Parliament are often denied that pleasure, but people who work in horticulture and landscaping certainly have it. The severe skills gap has a knock-on effect for the economy and the environment. When it comes to managing the environment, we need people with knowledge, particularly in landscaping. There is so much that can be done.

I draw the Minister’s attention to a mere two of the recommendations in the APPG report issued in October last year. One is to ask the Government to

“work with sector leaders to promote horticulture as a highly skilled and desirable industry to enter, through encouraging the inclusion of horticulture within the national curriculum…and providing more high-quality horticulture advice through the National Careers Service.”

Recommendation 8 was for the Government to adequately fund FE training, and I think we are as one in this room on that demand. We all call for that. That recommendation also calls on the Government

“to adequately fund FE training in horticulture to ensure the consistent delivery of high-quality training…the Government should ensure the Apprenticeship Levy is more flexible…to fund the work experience requirement of the T Levels and short-term traineeships.”

I am acutely aware of the strictures of time, Sir David, and I am grateful for your typical generosity, so I will conclude. My hon. Friend the Member for Bradford South has raised a crucial issue. If we do not get things right, we will fail a future generation and a future workforce. I am probably one of the older people in the room. The days when people could leave school at 15, work for the same company for 50 years, have 10 years of retirement and then drop dead are long gone. My son and daughter will probably have 15 or 20 different jobs in their lifetime. People dip in and dip out of different jobs, but they have to have the skills and training. They no longer have a job they can do simply out of sheer muscle. Those days of mass employment are gone.

Nowadays, we are a highly skilled, specialised economy, and highly skilled, specialised workers will not grow on trees. They have to be nurtured, encouraged, supported and financed and their worth has to be recognised. Today’s debate fires the starting gun on that process. It shows how, with a growing GDP and a more skilled, more flexible workforce with areas of expertise growing from FE and careers advice in schools, we can make not only the workforce happier and more productive, but the country a better place. It is not a bad ambition.

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It is a pleasure to serve under your chairmanship, Sir David. I am not quite sure how I follow that tour de force, not least because towards the end of his comments, the hon. Member for Ealing North (Stephen Pound) expressed— and expanded on well—sentiments that I share, but also because I have very little to say about ornamental horticulture.

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To pick up on the horticulture point, Capability Brown made his name with his work at Stowe in Buckinghamshire, which is not a million miles from the Henley constituency that the hon. Member for Ealing North (Stephen Pound) so derided.

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Excellent. I have none of the one-liners, wit or repartee of either my hon. Friend or the hon. Gentleman, so I will move straight on to the debate as a whole.

I congratulate the hon. Member for Bradford South (Judith Cummins) on securing this valuable and necessary debate. We need to have more such discussions. It would be better to talk more about this issue than some of the other subjects we seem to obsess over in this place and elsewhere.

I want to talk about apprenticeships and skills. I thank my hon. Friend the Minister for her time over the past few months when I have been to talk to her about apprenticeships. I am a strong supporter of what the Government are doing on apprenticeships, and the direction is very positive. A number of months ago, I had the opportunity to go to Rolls-Royce, which is a major employer in the south of my county, so I have seen what a good-quality apprenticeship programme does to raise the aspirations of people in the local area and equip them with the skills they need to succeed in the workforce for the next 50 or so years.

The Minister knows the feedback I have received from a number of people and organisations in and around my constituency. Chesterfield College is a large training provider in my part of the world. Smaller training providers, such as Stubbing Court Training, say that there have been problems with the introduction of some of the measures. Some of that is understandable—changes are never easy—but she knows some of my underlying concerns. I have passed them on to her, and I ask her to continue working to resolve them.

The debate on skills is one of the most interesting that we need to have in this place, and it speaks to a much bigger point. I was pleased when the hon. Member for Bradford South discussed the challenge of automation within five minutes of talking about skills. I see automation as a challenge and an opportunity. I wanted to congratulate the hon. Member for Ealing North on his final comments because it was refreshing to hear a speech where automation was not seen just as a problem, but as something that is coming, is inevitable—there is no point arguing about that—and is an opportunity to grasp, because it brings many opportunities for people.

The challenge I see is that we have to start equipping those in the workforce and those coming into the workforce for the next 50 years. That is a truism—everyone knows that—but I was with a member of my family yesterday. He is 11, and he had just gone to an interview to decide what secondary school he wants to go to from December. He came back and was telling me about all the things he wants to do. It struck me that he will probably still be in the workforce in 2060 or 2070, a long time from now.

I differ slightly from the hon. Member for Bradford South on one point in her introductory remarks. She talked about the Government having a knowledge of what skills are needed and the changes to come. I am not sure we can look that far ahead—I do not suggest the hon. Lady suggested otherwise. Ultimately, for 11 and 12-year-old children, who will still be in the workforce in 2060—hopefully, I will still be in the workforce in 30 years’ time—we must equip them with the skills to be able to still work and take advantage of what the workforce brings. The hon. Lady talked about automation, so I will throw in a few more statistics: the OECD estimates that 15% of jobs will be fully automated and another third partially automated; McKinsey talks about half of all tasks in the workforce being automated; the World Economic Forum talks about 7 million jobs going in our country, but potentially more than 7 million jobs being created. That is the fundamental challenge that we have to try to work through. We cannot plan for it in the traditional way. We cannot execute it from the centre. We have to equip people with the skills to be able to deal with it in the next 20, 30 or 40 years. Partly it is about core knowledge, and the Government have done an enormous amount in terms of reforms in schools over the past 10 years, but part of it is a different set of skills: flexibility, problem solving, persistence and agility. Those are the things I used to look for when I employed people in my old industry, and they are the most difficult things to work out in an interview process.

An interesting discussion needs to be had in Parliament and other forums, including in industry, about how we start codifying and understanding skills. I am not saying we will get to an NVQ level 3 in persistence or anything like that, but we have to have a better understanding of how we define and measure such things so that we can help to teach people or at least develop such skills.

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Does the hon. Gentleman agree with me—I know this applies to you, Sir David—that anyone who has been in the scouts or guides who applies for a job, as is the case in any area that I have ever been employed in, will always get an interview? Does he not agree that that is an excellent thing to have on a CV?

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As a former scout, I completely agree.

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Once a scout, always a scout.

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I am conscious of time, so I will make my other two points. The first has already been made by others, so I will not dwell on it, but it concerns the need for skills training to be as close to the workplace as possible, not because education is not an end in itself, which we must never forget, but because we need to ensure that we equip people with the right skills that are necessary in today’s and tomorrow’s workplace.

My hon. Friend the Member for Henley (John Howell) talked about entrepreneurship. It is telling that when I left university in 2002, we all wanted to go and work for big companies and do well on the corporate ladder. When people come out of university now, they want to be their own boss, set up their own company and do their own thing. We have to recognise that what people want to do in the world of work is changing. When we debate skills, I hope we can consider equipping people to be able to have the skills that they will need for the next 60 years. They will need different skills—soft skills, particularly—and we need to train them in ways different from how we have trained them historically.

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It is a pleasure to serve under your chairmanship, Sir David, and to follow the hon. Member for North East Derbyshire (Lee Rowley).

I see apprenticeships as exciting. We have an exciting opportunity and a chance to put something right that has been wrong for an awfully long time. Every political party talks about parity of esteem, which often feel like words that are just trotted out. When we ask people what their children do, we find that lots of MPs’ children went to university and did not go anywhere near an apprenticeship. If we are serious about wanting to create parity of esteem, we need to have parity of outcomes, which needs a really clear pathway, and I will focus my remarks on that.

One brilliant solution to achieving parity of esteem is degree apprenticeships. Someone can leave, having done an apprenticeship as a degree, and have exactly the same qualification as someone who went to university, so there we have our parity of outcomes, but there is a problem because people join a degree apprenticeship after doing A-levels. We still do not have a clear apprenticeship pathway, so that—judging by the people I have met and talked to—the people who take degree apprenticeships tend to be people whose parents have the knowledge and are perhaps from a middle class background.

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Will the hon. Lady give way?

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I will finish this point first. Such people see the advantage of taking a degree apprenticeship and perhaps are not the people the policy was aimed at.

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I thank the hon. Lady for giving way. Having been an apprentice in a previous life, I can tell her the value of an apprenticeship is not necessarily seen by society today. Unless someone has a degree, they are a nothing. It is how we have interpreted it. In third level education, someone must have a degree or they will be a pleb. We must put the emphasis back into an apprenticeship that starts at 16 with a career pathway that ultimately can give someone a degree, as I got through the course that I went on.

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I thank the hon. Gentleman for that point. I think he will agree with me as I move on in my speech.

On the parity of outcomes, at the moment, as I said, the degree apprenticeship can be achieved only by having A levels, so we have to look at how we build a clear apprenticeship pathway such as we see in Germany, where someone can leave school at 16 and do a level 2 apprenticeship, which then takes them to a level 3 apprenticeship, which takes them to level 4, and if they wish they can then do a degree level apprenticeship. We do not have that system at the moment. I am sorry to say that I disagree with the Minister, who I normally agree with: I regard T-levels as an unnecessary distraction.

At the moment we do not say GCSEs are nothing, because we see them for what they are: a tool for going through and getting A-levels, which are a tool for going through and getting a degree. Yet we dismiss level 2 apprenticeships, seeing them as a nothing qualification, or a qualification that is not viewed very highly. In part, we dismiss the qualification because we do not see level 2 apprenticeships as the tool that gets someone to a level 3 apprenticeship, which is the tool to get to level 4. We know—I include myself in this—people are ready for education at different points in their lives, and perhaps the apprenticeship pathway model that I advocate takes a lot longer than the traditional path of going through GCSEs and A-levels. Perhaps it takes a lifetime, because someone might take a level 2 apprenticeship and then work for a couple of years. Then they do a level 3 apprenticeship and work another few years. Then they do a level 4 and so on and they find it takes 10 years, and then they end up with their degree apprenticeship at the end of it. We need that pathway to be clearly defined.

I have raised this before, so the Minister will be aware that Hull College and Hull University have worked together to create a pathway for nursing so that nurses can do apprenticeships. Hull College has told 16-year-olds, “You can start on a level 2 apprenticeship at Hull College. If you pass, within five or six years you will be a fully trained nurse with a degree in nursing from Hull University.” It has been clearly set out and the college has been inundated with people wanting to apply. Why can we not look at creating such clarity for many other professions? Why can we not say to someone, “You do not need to get GCSEs at 16 and then get A-levels to go and do a nursing degree. You can go down the apprenticeship route instead. If you want to get off the conveyor belt and just get a level 4 and be a healthcare assistant instead of an apprentice nurse, that’s fine, too, because you can pop back on that conveyor belt later and get your nursing degree apprenticeship.” That is exactly what happens in Germany, where they talk about having no dead ends, because there is always an option to move forward if people want.

I am a member of the Education Committee and we did a report called, “The apprenticeships ladder of opportunity”. That is what we need to have clarified by Government. I have significant concerns that we have so many young people doing a level 2 apprenticeship and they get stuck there; they do not move forward and do not progress. The Sutton Trust also found a lack of progression between the different levels of apprenticeship. A level 2 apprenticeship is not a full apprenticeship. It is a stepping stone, but not a full apprenticeship in its own right.

On the clarity of pathways, I will quote the Sutton Trust’s chief executive, who said,

“on the academic route...everything is signposted, you know the options, you get supported at transition points.”

In apprenticeships,

“there are lots of dead ends...there are pitfalls. Sometimes it is a very confusing route. I think we just need to almost map out steps.”

London South Bank University has also suggested that standards

“should include reference to the anticipated career trajectory of learners”.

We need that map, and it needs to come from Government. There are practical steps that they could take to achieve it.

The Government should mandate the Institute for Apprenticeships to include clear paths to progression within apprenticeship standards; those paths should be linked to a system of progression maps created and promoted by the institute and Government, with complete clarity on how to go from a level 2 apprenticeship to a degree, if someone wishes to. They should also create a UCAS-style website to advertise higher level apprenticeships, so that apprentices working in small and medium-sized enterprises will not be disadvantaged if their employer is unable to provide a higher-level apprenticeship. The Government should encourage and promote universities that have already established that clear apprenticeship pathway. Perhaps they should say something about doing a degree apprenticeship not being enough if everyone starting the course has A-levels.

I want people to get on to degree apprenticeships through the apprenticeship route. No one will ask, when someone has their degree, whether they did an apprenticeship degree or an academic degree. They will just be pleased that they have a degree. If we want parity of esteem, the Government need to do more to create that parity and improve clarity in pathways.

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I thank my hon. Friend the Member for Bradford South (Judith Cummins) for securing this important and timely debate.

The future of our country depends on how well we are able to equip younger generations to face the challenges ahead. An effective apprenticeships and skills policy is crucial to closing the productivity gap and boosting our competitiveness globally. As we face critical questions about our trading relationships with the rest of the world post Brexit, it is important now more than ever to reflect on the skills we want the workforce of tomorrow to have. Sadly, eight years of Tory Government have been eight long years of failing to invest properly in young people. Members need not just take my word for it: at the last election, the Tories lagged 40 percentage points behind Labour among voters aged 18 to 24. That says it all. Young people know that they are being poorly prepared for a jobs market that is increasingly fragmented and insecure.

Small businesses also suffer as a result of inadequate education and training policy. Anyone with a background in business will know that having a skilled, well-trained workforce is indispensable to long-term success. However, research published by the Federation of Small Businesses suggests that too many small businesses are struggling to fill skilled jobs, with almost a third of recruiting firms facing skills shortages. In a report on England’s qualifications gap last year, the London School of Economics revealed that skilled trades comprise nearly half—43%—of all occupations reporting skill-shortage vacancies.

The apprenticeship levy is a welcome measure, but it only begins to address the scale of the problem. Measures must be taken to ensure that the levy funds apprenticeships of a high quality. Labour has proposed achieving that by requiring the Institute for Apprenticeships to report annually to the Secretary of State on the quality of outcomes of completed apprenticeships. In that way we can ensure that it delivers skilled workers for employers and real jobs for apprentices at the end of their training. Does the Minister support the proposals and, if not, will she clarify what measures the Government are taking to oversee the delivery of high-quality apprenticeships?

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I am grateful to be called to speak in this important debate, Sir David, and I congratulate my hon. Friend the Member for Bradford South (Judith Cummins) on securing it.

As Members may be aware, the Scottish Government are responsible for apprenticeships and skills development policy in Scotland, but I will link my remarks to the UK. For young people who do not want to go into further or higher education, apprenticeships are a vital means to secure the skills and work experience needed in later life. As the economy continues to change, skills development opportunities become increasingly important for the reskilling and upskilling of workers. Therefore, it is vital that we get our policy on apprenticeships and skills development right, so that we cannot only help young people succeed, but encourage lifelong learning—something that I did through the trade union movement in the Post Office.

I was concerned about recent statistics about modern apprenticeships from Skills Development Scotland. Apprenticeships should be accessible to those who need them, but those statistics, covering the period April to September 2018, show that there are still issues to overcome. There is still a clear gap between men and women in the uptake of modern apprenticeships. In Scotland, only 35% of modern apprentices during the period in question were women. That is in direct contrast to the experience in England where in 2016-17 54% of apprenticeships were undertaken by women. In England, the number of apprenticeships started by women has been higher than the number started by men every year since 2010-11. Individuals from ethnic minority backgrounds were just 2.1% of modern apprentices in Scotland while the equivalent rate in England stood at 11.3%, in 2016-17.

We often hear of the difficulties that young people whose backgrounds involve experience of care have with educational attainment and securing employment. That is why it is particularly disheartening to me that just 1.7% of modern apprentices in Scotland come from such backgrounds. With 13% of modern apprentices self-identifying as having a disability or learning difficulty, it is clear that there is still much to do in Scotland to ensure that modern apprenticeships are accessible and that they reflect our country.

Skills Development Scotland has confirmed that achievement rates fell by 3% in quarter 2 of 2018 when compared with quarter 2 of 2017. Achievement rates have fallen for modern apprenticeships regardless of the participants’ age, but I am particularly concerned about the 4% drop among modern apprentices aged 16 to 19. Those young people are the future of our country, and we should not be letting them down in that way. Redundancies among modern apprentices were disproportionately concentrated in the construction sector, and made up 83% of all redundancies. It is particularly disappointing that there has been a fall in achievement rates given that there was an increase of more than 10,000 in the number of achievements in apprenticeships in England in 2016-17. In fact, it was the highest volume of achievements in any academic year. Because of the funding changes introduced by the UK Government, the number of apprenticeships started in England has started to fall. If the Scottish Government cannot tackle the issues relating to access and achievement, I fear that the number of apprenticeships in Scotland could suffer a similar decline.

In my area, North Lanarkshire, we have the second highest rate of modern apprenticeships in Scotland and almost 10% of all the female modern apprentices in Scotland, although there is still more progress to be made. I am proud of the fact that Labour-led North Lanarkshire Council’s modern apprenticeship programme offers a wide range of opportunities. Apprenticeships can be undertaken in areas ranging from community arts to social services, enabling young people to develop vital skills for a successful future. As a North Lanarkshire councillor and a Member of Parliament, I am proud of our modern apprenticeship programme and will continue to ensure that it delivers for young people in our community, and helps others across the whole UK.

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It is a pleasure to see you in the Chair again, Sir David, in the new year, chairing this very interesting and far-reaching debate, in which there have been widely differing views. I congratulate the hon. Member for Bradford South (Judith Cummins) on securing an important debate. I am a member of the Select Committee on Education. Many of the topics she discussed are close to my heart. I have learned very much from being on the Committee in the past three years about English education and about the differences within education.

There are huge differences between Scotland and England with regard to the ways in which modern apprentices are trained, and how apprenticeships work. In fact, when I was a further education lecturer at West Lothian College, I delivered programmes as part of modern apprenticeships, and it was always a delight when the college took on modern apprentices who went right through the programme and also picked up academic qualifications. Some also worked hard to gain a degree in their chosen subject.

It is always a pleasure to be part of people’s development, and the Scottish Government feel strongly about apprenticeships and skills development in Scotland. One of the first things that happened when Tata Steel was sold was the securing of apprentices by Dalzell Works in my constituency to ensure that they were able to continue and finish their apprenticeships. It is important that Scotland is seen as a world leader in that area, so let us ensure that the figures are correct. In 2015-16, 2016-17, and 2017-18, the Scottish Government beat their own targets for apprenticeships. In England over the same period, apprenticeship targets fell, which is an absolute disgrace.

This morning the Education Committee took evidence from experts on the fourth industrial revolution. It is imperative across the UK that skills are fostered and encouraged so that we can meet the challenges of the future. I must give credit to the hon. Member for Ealing North (Stephen Pound). I did not know anything about ornamental horticulture and landscaping, but he gave such an eloquent performance that I feel I must mention it as it I sum up the debate.

Jamie Hepburn, the Minister for Business, Fair Work and Skills in Scotland, stated:

“Apprenticeships are a fantastic way for all employers to invest in their workforce and provide the skills the economy needs now and in the future…We are continuing to enhance the apprenticeship opportunities available to provide the right balance of skills to meet the needs of employers and the economy, including prioritising higher skilled apprenticeships and STEM occupations.”

Some Members have mentioned schools. Last year I had the pleasure of attending a meeting at Dalziel High School in Motherwell along with the Deputy First Minister, John Swinney. Prizes were given to students who were doing work placements. Those placements were not just for one or two weeks a year—pupils went from that school every week to work with Morgan Stanley in Glasgow, or the engineering firm WorleyParsons, which does a lot of work in the energy sector in Scotland and across the UK. The enthusiasm and experience that those young people gained from that weekly commitment was outstanding, and they fed that back into the school. There is an ongoing programme between that school and education and industry trusts in Scotland, and they are all to be commended on their work.

I do not think anyone in this room underestimates the issues involved, but as the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) said, this is about parity of esteem. When, years ago, I did my teaching qualification in further education, I made a comparative study between vocational education in Scotland and in Germany, although because there was not yet a Scottish Parliament, it was really about UK-wide education. The lack of esteem, especially in a country such as Scotland whose engineers are renowned all over the world, given to people who worked with their hands was amazing. We still need to break down those barriers and show parents, students and pupils that there is a good future for them if they take on an apprenticeship. Indeed, last year I saw the enthusiasm and interest of apprentices at Gateshead College who were doing degree apprenticeships. The fact that they had to persuade their parents that it was a good idea to do those courses is testament to the work that still needs to be done.

I thank all those who have contributed to the debate. I have learned a lot. I realise that many issues are still to be covered, so I will let the hon. Member for Blackpool South (Gordon Marsden) sum up on behalf of the Labour party and ask hard questions of the Minister.

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It is a delight to serve under your chairmanship, Sir David, and if it is not too late, I wish you and everyone here a happy new year. We have had a superbly balanced and broad-ranging debate. We must thank my hon. Friend the Member for Bradford South (Judith Cummins) not simply, as she put it, for making this a wide-ranging debate, but for her strong and important points. She gave a powerful critique of the current apprenticeship programme, and outlined the direction in which it needs to go to assist somewhere such as Bradford, which, as many have said, has a fantastic history but needs a powerful future as well.

I was impressed by the huge range of contributions from colleagues across the House. The hon. Member for Henley (John Howell) spoke about the importance of work placements. After a voyage around his witticisms, my hon. Friend the Member for Ealing North (Stephen Pound) found more fertile ground in horticulture, for which we thank him. The hon. Member for North East Derbyshire (Lee Rowley) rightly spoke about the need to look to the future and different sorts of skills, and showed an intelligent understanding of where the tensions are between such skill sets. My ever-forceful colleague, my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy), talked about apprenticeship pathways to get to degree apprenticeships and spoke strongly about the importance of level 2 in terms of progression—I shall come to that later in my remarks.

My hon. Friend the Member for Warrington South (Faisal Rashid) raised concerns about how the Government will have a lost generation if they do not properly prepare for apprenticeships, and said that the Institute for Apprenticeships should be focused on outcomes and be supported. My hon. Friend the Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) spoke about the importance of ethnic minorities not missing out in Scotland, and he raised some significant concerns. Finally, the hon. Member for Motherwell and Wishaw (Marion Fellows) shared her experiences as a former FE tutor and lecturer and spoke about the need to promote modern apprenticeships. All those contributions have added to this debate.

We know that we are entering a period of extreme uncertainty regarding our skills base because of a cocktail of challenges: Brexit, automation—I take that point from the hon. Member for North East Derbyshire, which is why I said “challenge” rather than “problem”, but it nevertheless focuses our minds strongly—and the damage already done by the neglect of older as well as younger people in adult education, the dramatic fall in take-up by adult learners, and cuts to the adult skills budget. If we are now faced with the impending scenario of a no-deal Brexit, the need for home-grown skills is strengthened yet further.

Despite consistent warnings from ourselves, and the university and FE sectors, the Government have been neglectful of the impending damage—especially through the drift to no deal—that Brexit could cause to our world-class FE colleges and universities, and to skills as a whole. This is an issue for FE in particular, because of the deep engagement of community projects that are funded via the EU. Thousands of UK jobs, and tens of millions of pounds that the UK earns from our EU links with universities, further education colleges and training providers, are in jeopardy as a result. The Government need to get to grips urgently with spelling out how their shared prosperity fund will replace the funding from the European Social Fund and the Research Development Fund, on which our community-focused higher education institutions and colleges so rely.

What is the Department for Education doing—the Minister will have heard me speak about this before—to ensure that the needs of skills and apprenticeships are at the top table? Why have we seen so little proactivity? The Secretary of State seems to have thought that Erasmus was a second-level issue. That is what I have been told, but I hope the Minister will reassure us that it is not a second-level issue, because it is crucial to the skills processes that we need, whether in Bradford or Blackpool.

The already growing skills shortages in areas such as the health service are becoming catastrophic. We heard the national health service plans yesterday. That was all well and good, but the unanimous comment in the media has been about where the 100,000 extra jobs will come from. Where will those people come from if we do not have a progressive integrated policy? We have a Department—it is new year, so I will try to be charitable to the Minister—that is struggling with the consequences of nursing bursaries being scrapped. I entirely support the Royal College of Nursing’s campaign in this area, and have heard from constituents who have been seconded via the NHS to Blackpool hospital about some of their concerns. We have world-class colleges and providers, but they are being consistently let down by cuts to budgets and funding streams. Unfortunately, apart from the eventual money pledged for the introduction of T-levels, there has been no reversal to those damaging reductions made by the Government.

The Minister urged MPs and the sector to lobby before the Chancellor’s Budget. They did, but they got precisely nowhere. It is imperative that we use apprenticeships and our skills network to help people be trained, but we have to fund them properly. We are being told to look at the spending review, but as the former Minister David Willetts observed on Saturday, when talking about the Augar review, the chances at the moment of the Chancellor focusing his eye on education as opposed to the NHS appear to be minimal.

Fine words we have had plenty of, but they butter no parsnips. That is particularly important in smaller towns and cities, such as Bradford, Blackpool and many of the places that Members who have spoken today represent, the people of which feel that they have been let down. We hear rumours that the Augar recommendations will pin all hopes and money on the cut in university fees. I sincerely hope that the Minister, in whatever capacity she is able to, will raise her voice against the focus simply on higher education, to the detriment of further education.

One of the potential avenues that we need to explore to achieve all that is, of course, the devolved skills and adult education budget implications. There are clear opportunities via those new structures that could be utilised, and should be, if we are to have proper progression in the devolution of adult skills funding. We need a much bigger debate about the devolution of broader apprenticeships than we have had so far.

We need proper infrastructure and long-term thinking. The Government have been poleaxed by Brexit, and are looking only to scrape to 2020 in their funding and policies. While they do that, our new national education service will look at devolving apprenticeships and other skills funding, not just the adult education budget, and our lifelong learning commission will expose and explore new ways of collaborating on the ground with the third sector and the unions to get those skills up and running.

Skills devolution is not just a smart thing to do economically; it is the right thing to do for community growth and cohesion. If apprenticeships are to have strong, positive outcomes for local economies and workforces, far more young people need to get to the starting place to begin with. It is important to grasp the potential for high-quality apprenticeships in the service sector. As others have said, that means supporting our small and medium-sized enterprises and starts at level 2, and ensuring a properly funded and promoted traineeship programme.

We have been banging on about that to a succession of Government skills Ministers for two years; the current Minister is the third to hear me speak on it. The latest statistics from the Department for Education show a significant drop in level 2 apprenticeships—just 161,000 starts at level 2 in 2017, down from 260,000. The proportion of overall starts has fallen to its lowest level yet. As Mark Dawe of the Association of Employment and Learning Providers said,

“major mistakes in the implementation of the levy have resulted in a serious undermining of the government’s social mobility agenda”.

He also said:

“Level two starts are now the biggest issue we face”.

I can only make reference to the briefing that Members have had from the British Hospitality Association about the importance of progression in that area from level 2 and onwards. Recently I was glad to welcome representatives of Stonegate to Parliament, and a person in my constituency who has gone from being a barperson to running the new refurbished Manchester hotel, which will be reopened shortly.

Level 2 apprenticeships have fallen, but we have seen a huge rise in management apprenticeships. I do not know what the real story is there. Does the Minister? Has the Government’s failure on level 2 been a market consequence of the way that they sold the levy? I do not know; perhaps the Minister can enlighten us. What we know from the Sutton Trust is that about a third of those apprenticeships are converting existing employees and skills. If that is the case, we are in an even more dire position than the Government’s figures show.

Anything that simply rebadges or validates normal training will not get us where we need to go. To create that step change we must ensure that people can get to the starting point, because level 3 is one of the most telling points for SMEs or self-employment. Whether someone is a hairdresser—I hope that the Minister has managed to get the Secretary of State off the unfortunate prejudices about hairdressing in his Battersea speech—a social care provider, a brickie, an electrician or a plumber, those are the people we need, and the skills that we need. Level 3 is a de facto licence to practise. That is why it is so important that the Government should not neglect traineeships.

There are issues regarding the overspend. The Minister knows that the Institute for Apprenticeship’s chief financial officer recently presented a forecast of a £500 million overspend. Can she tell us whether those figures are accurate? The Education Committee published an all-round critique of the Government’s apprenticeship record, and highlighted the importance of not only apprenticeships, but apprentices. That is a long-overdue priority for the Government. I know that the Minister agrees about the importance of world skills, skills competitions and skills champions. She has banged on about it, and it is very good that she has, but her Department has not always seemed to share the same enthusiasm for taking on board the opinions of apprentices. I urge her to do so, and to utilise the talents of the IfA’s panel.

That is the right way to promote the social mobility that we will need in the 2020s, when bespoke skills and enabling ones will have to combine in people’s lives with more traditional qualifications. We need to encourage young people to take up their curiosity for future jobs and apprenticeships at a much earlier age. We have been saying that for some time. It needs hardwiring into careers advice to go beyond the Baker clause and to have a sustained, holistic strategy.

The Government’s consistent failure to support under-represented groups, whether black, Asian and minority ethnic, people with disabilities or care leavers, has to be addressed. We would address it directly by giving it strong positioning in our new national education service. We have been very clear that if we are to get to the right position on T-levels, they cannot be seen simply as a competitor with A-levels. The Sainsbury review pointed in the right direction in that area, but unfortunately the Government have ignored that holistic approach and turned it into a beauty contest.

The concerns that we have heard today about regulations not being fulfilled in key new pathways—employers say they are not currently—and there not being the number of work placements illustrate the point. It is important that we get T-levels going properly, but they must be part of a broader strategy. That is the problem with so much of what the Government have told us. We are not short of potential “ladders of opportunity”, as the Minister’s predecessor, the right hon. Member for Harlow (Robert Halfon), put it, but we now need more resources, simplifications and long-term strategies—not the short-term targets that have tied the Government in knots and led to the issues that my hon. Friend the Member for Bradford South raised in this excellent debate.

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It is a pleasure to serve under you today, Sir David. I wish all hon. Members a happy new year. I say to the shadow Minister that I do not feel tied up in knots.

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Not personally.

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Not personally, certainly. I feel quite clear about what I am trying to achieve. I congratulate the hon. Member for Bradford South (Judith Cummins) on securing the debate. I wish I had more time; I do not. I will debate this matter weekly if that is what Members want, because there could be nothing more important for the productivity and success not just of this country, but of individuals.

I am incredibly fortunate in my job. I get to see so many young people who are passionate and incredibly enthusiastic about the careers that they get through apprenticeships. Their sense of enthusiasm strengthens my faith that we are on the right road. It tells us not only that the direction of travel is right and that parity of esteem between the academic and technical routes is achievable, but that apprenticeships open an alternative door that would not otherwise exist for people—often bright and very gifted young people, but also older people—for whom school and exams did not work.

T-levels and apprenticeships will form the basis of our new technical offer, building the skills of the population. They will be mirror images—one predominantly work-based and the other predominantly study-based, but both leading to skilled employment and opportunities for further study up to and beyond degree level, through apprenticeships or otherwise.

The hon. Member for Bradford South is absolutely right that Bradford is a great city, but 15% with no qualifications is quite a shocking figure in comparison with the national average. She raised the issue of apprenticeships not being worth the paper they were written on, but that was what sat behind all the reforms. We have brought in money from the levy, protected the term, mandated 20% off-the-job training and introduced end-point assessment.

The hon. Lady is right that apprenticeship starts are down, but this is not just about numbers; it is about quality. Before the reforms, a lot of people doing apprenticeships did not even know that they were on them. It was a way of bringing in cheap labour, and we wanted to change that. It is not surprising that the starts went down to begin with, because it was a very big change, but they are now rising, and that rise has been significant at level 4, level 5 and above. I urge the hon. Lady and her businesses in Bradford to contact the National Apprenticeship Service, which I know will be very happy to work with her and with businesses locally.

We are bringing non-levy paying small and medium-sized enterprises into the apprenticeship system. I assure the hon. Lady that I am working closely with the Federation of Small Businesses to ensure that we get it right for SMEs, which often find it quite difficult to navigate the new system. I point out that the money raised by the levy is available for redistribution to non-levy payers, so money raised through the levy in London might well end up being redistributed to smaller employers in Bradford, Hull or anywhere else in the country. From April, large levy payers will be able to transfer 25% of their levy pot without restriction, so the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) might like to have a word with hon. Members for London constituencies to see whether that money can be redistributed.

The hon. Member for Bradford South also mentioned the risk to workers from automation. Some 35% of jobs are set to go in the next 10 years, so the Chancellor has announced the national retraining scheme, a joint venture between the TUC, the CBI and the Government to ensure that we can upskill lower-skilled workers. We are doing much to ensure that this works, especially for workers who may have had a bad experience of education or for whom undertaking more training might cause practical as well as financial problems. We need to ensure that lower-skilled workers get the skills they need and that business gets them as well.

I am glad that my hon. Friend the Member for Henley (John Howell) has lots of university degrees to make up for the fact that unfortunately I do not have any. He is right that schools play a critical role, but schools do not work for everyone, and apprenticeships are often a vital route for young and older people to get a second chance.

I praise the role of unionlearn, which I should have mentioned earlier and which often offers excellent in-work training. The Government give it quite a substantial amount of money, and it will be important to the national retraining scheme. I must also mention work experience, because the 45 to 60-day industry placement is a critical part of the new T-levels. The careers strategy has the Gatsby benchmarks at its heart, so that schools can measure their success. Meaningful encounters with the world of work are an important part of that, and the Careers and Enterprise Company is doing a great job of linking schools to local employers.

Doing a school exam or maths homework makes sense if students can see the jobs that will be out there when they leave school—otherwise it is just another exam or another boring class. For those going into a career in STEM, there is nothing not to like about apprenticeships, which give the skills and work experience needed. Some engineering companies have cut their graduate schemes and are now offering only apprenticeships at level 2 and up to level 3.

The hon. Member for Ealing North (Stephen Pound) made me smile, as he always does, and mentioned horticulture and landscaping. Only today, I saw some fantastic examples of the apprenticeships that the national parks are offering. I would be very happy to work with him and the all-party gardening and horticulture group. Landscaping is one of the disciplines tested at the WorldSkills competition, which I was privileged to see in Abu Dhabi. He might like to visit the WorldSkills website and see the amazing work of landscapers at the competition.

My hon. Friend the Member for North East Derbyshire (Lee Rowley) spoke about the skills gap, which the skills advisory panels will be looking at to give us a clearer picture. The reason why apprenticeships are getting such traction is that employers want more than just knowledge; they want skills as well. Many are moving away from graduate schemes, because a degree apprenticeship, for instance, combines both knowledge and skills.

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Will the Minister give way?

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Yes, but briefly, because the hon. Gentleman is taking my time.

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I am grateful. The Minister mentions the skills advisory panels; the reason why we need them is that in the previous Parliament the Government abolished the UK Commission for Employment and Skills. Does the Minister regret that the commission is no longer there to give the Department a holistic view?

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I do not have regrets. What matters is what we do next, and that we make sure we identify the skills we need. In case I do not have time later, let me note that the hon. Gentleman mentioned devolving skills budgets. In fact, skills budgets are devolved down to the lowest possible level: to local employers. Firms in Bradford and Hull—the levy payers—have the money at their disposal, and we will redistribute it to SMEs.

Time is short, and I do not have time to mention everything, but the hon. Member for Kingston upon Hull West and Hessle mentioned nursing, a perfect example of the pathway for progression that I want to see from level 2 right up to level 6. In construction, an employer in Gosport has done a wonderful map that shows young people where they can progress—right up to project manager and beyond. When I was in Bristol, where a lot of work is being done on diversity in apprenticeships, I saw what looked like a tube map, where people can see where they can get on and off their route. Of course, people can go in other directions: they might well do a level 2 in business admin and then go into nursing or end up doing a level 6 in a completely different discipline. That is exactly the area that I want to concentrate on. I spent a lot of time getting business working with the levy and getting the system up and running, but now what matters to me is progression.

With respect to the drop in level 2 apprenticeships, which was mentioned earlier, we are not absolutely sure what is behind the figures. Some 90%[Official Report, 9 January 2019, Vol. 652, c. 6MC.] of starts are still at levels 2 and 3, and of course employment is high, but we need to dig deeper. What matters to me is the people I meet, like the young man I met who got chucked out of college twice, got a level 2 apprenticeship with Virgin Media, skipped level 3, did a level 4—

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rose

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I know—you have 30 seconds.

That young man skipped level 5 and is now doing a level 6. He said to me, “I am a miracle.” That is what this is about: giving people that second chance. I am sorry that I do not have time to say any more.

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I am really grateful to all hon. Members who took part in the debate. I agree with everybody who said that this is such an important subject and that we should concentrate much more on it, because it is about the future of our country, of our children and of our economy.

The Minister mentioned the national retraining scheme, a joint initiative with the TUC and the CBI. I look forward to seeing the details of that scheme, which will be really important.

When I said that some apprenticeships were not worth the paper they are written on, I did say “some”—I commented that I meant those apprenticeships with little or no training.

It is fantastic that we all agreed on the urgency of getting our skills policy right, to ensure that our economy delivers for everybody in all places. The jobs and skills mismatch is not down to individuals on the supply side. We have to stimulate and organise demand for skills through the Government empowering sectors and regions; it cannot just rest on the shoulders of individuals.

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

Armed Forces: Angus

[Siobhain McDonagh in the Chair]

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I beg to move,

That this House has considered the future of the armed forces in Angus.

It is a pleasure to serve under your chairwomanship, Ms McDonagh. I just want to say that I am overcoming a flu virus, so my delivery may not be as clear as it might have otherwise been.

Over the last century and more, the history of Angus has been intertwined with the armed forces. In 1913, the first operational military aerodrome in Britain was established at Montrose. That station served as a vital base, first for the Royal Flying Corps and then for the RAF, through two world wars. More recently, in 1938, what was then known as HMS Condor was opened as a base for the Fleet Air Arm near Arbroath. More than 80 years on, Condor remains the home of the armed forces in Angus and has become an integral part of Angus life. Condor contributes to Angus’s economy, and those who are based there are welcomed into the local community.

The past eight decades have seen Condor and the personnel based there contribute to the defence of Angus and the entire United Kingdom. Condor endured bombing during the second world war, and between 1954 and 1971 served as home to the Royal Navy Aircraft Engineering Training School. Since 1971, as RM Condor, it has been home to the Royal Marines of 45 Commando. In that time, 45 Commando has, among other operations, served multiple tours in Northern Ireland during the Troubles, yomped across the Falklands to fight for the liberation of Port Stanley and protected Kurds from Saddam Hussein in the first Gulf war. More recently, it has served with great distinction in Afghanistan, working under tremendous pressure to bring greater peace and stability to the region.

It was during those more recent conflicts that, in 2003, 45 Commando received the freedom of Arbroath and Angus—a small token of gratitude from the people of Angus, who are keenly aware of the sacrifice that 45 Commando and the armed forces more generally have made to keep this country safe. The true extent of that regard was further demonstrated in 2011 when the unit and the local community raised more than £250,000 for the establishment of a woodlands garden in memory of the 13 service personnel who made the ultimate sacrifice for their country as part of Operation Herrick.

In early 2017, the people of Arbroath turned out in their droves to celebrate 45 years since 45 Commando moved to Condor, just as they had turned out to celebrate the return from conflict many times before. At that celebration, the then Commanding Officer of 45 Commando, Lieutenant Colonel Tony Turner, said that 45 Commando had been

“privileged over the years to have had such great support from the local community of Arbroath and Angus”

and that that shared history is what makes 45 Commando’s organisation and its connection to Arbroath “so unique”. That view is shared by the base’s current commanding officer, Lieutenant Colonel Duncan Forbes.

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Does my hon. Friend agree that the great respect given to the armed forces in Angus is replicated across the country? In Moray, with RAF Lossiemouth and 39 Engineers at Kinloss, we have the same community spirit that supports the armed forces. As my hon. Friend said, the armed forces do not just protect our country. They also have great involvement in the local communities where they are stationed.

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My hon. Friend is absolutely correct. It is not just the way in which the armed forces serve our nation—they also serve our communities and are an integral part of those communities. I will go on to explain how they are fully integrated into Arbroath and the wider Angus area.

Fundamentally, it is clear to me that Condor, and 45 Commando’s presence there, works. It works for Angus, it works for 45 Commando and it works for our military capabilities as a nation.

I am glad to have worked recently with this Conservative UK Government to ensure that armed forces personnel based at Condor and across Scotland were able to receive compensation protecting them from the Scottish Government’s income tax rises. I hope that, in the upcoming reprioritisation exercise of the better defence estate programme, I can once again work successfully with Ministers to support our brave servicemen and women. There should be no doubt that I welcome the programme, and that I firmly believe that the armed forces, and the use of the defence estate, should be as efficient and effective as possible. Everybody would agree with that.

Recent years have demonstrated how turbulent the world can be, how threats can materialise and subside quickly, and how our military should therefore be as well placed as possible to deal with all eventualities. I believe in a strong, cost-effective military, but I also believe, as a Conservative, that a long-standing fruitful relationship should be treasured and preserved, and so I look at the last half century, where 45 Commando has, from its base at Condor and its home in Angus, served so effectively and admirably in theatres around the world, protecting this country while helping to grow the local economy of a thankful and welcoming county.

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I thank the hon. Lady for securing this debate. She will have similar concerns to me, given that we come from the same part of the world. Does she agree that military personnel are best served when we take into account the needs of the whole family, such as schooling in a local community? It is crucial that family-friendly facilities are considered in any future investment, which is a point that has been acknowledged by our local paper, The Courier.

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The hon. Gentleman is absolutely right. Condor includes and welcomes not only the family of personnel into the base, but also the wider community. He is absolutely right that it is a vital asset that each base should have.

It is clear to me that Condor should remain home to 45 Commando as part of this country’s defence infrastructure, and I hope that that is also the view of the Ministry of Defence—I and thousands of people across Angus would more than welcome an additional assurance from the Minister today that that is the case, which would reassure us of the continued presence of a pillar of our community and our economy. As a minimum, the forthcoming review should confirm that RM Condor will at least be maintained in its current form. That would not only allow the existing and successful relationship between 45 Commando, Angus, and the Ministry of Defence to continue, but would also secure the future of the Arbroath Division of the Royal Marines Volunteer Cadet Corps.

The Royal Marines cadets are a great opportunity for young people in Angus to develop skills and attitudes that will stand them in good stead for a lifetime. Meeting twice a week, they make use of Condor’s facilities. I understand they held their first, if rather cold, camp out at the beginning of last December. The foundation of the Arbroath Division of the RMVCC in December 2017 has further supported a long-standing relationship between RM Condor and multiple cadet groups. The impeccable reputation of the base means that demand for places in these groups is rightly high. In 2018, intakes took place in both August and October, and recruitment for a third intake is currently under way.

In addition, 45 Commando’s assault engineers and students from Dundee and Angus College recently collaborated to transform one of the hangers into a vital training asset. I know the Secretary of State was incredibly impressed at that innovation during his visit to the base last year. Moreover, there are the plethora of football, skiing, rugby, and competitive boxing clubs that make use of Condor’s facilities. Those benefits, both social and cultural, are further evidence of why the base and personnel should stay. However, the reprioritisation should commit to maintaining 45 Commando’s presence in Condor.

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I am sure my hon. Friend would agree that today’s military personnel are a fighting force to be reckoned with, but they are more than that, in terms of military aid to the civil community for things such as firefighting, dealing with adverse weather conditions, flooding and so on. We should commend them for the good work they do throughout the United Kingdom, including in Scotland.

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My hon. Friend is absolutely right to say that they go above and beyond the role they are asked to do.

The reprioritisation exercise should commit to ensuring that Condor can continue to provide all the facilities that 45 Commando needs to continue to operate as effectively as it does today. We need clarity on the future of the base. I recognise the importance of an efficient defence estate, and nobody is calling for the Ministry of Defence to hold on to land that it does not need and cannot put to better use. Although the airstrip at Condor has been out of use for some time, the wider airfield and hangars are vital to many of 45 Commando’s training objectives, including driver training, combat training and small arms firing.

Confirmation that 45 Commando will remain at Condor will be welcome, and I would be pleased to hear that backed up by firm commitments on the airfield. There is concern that, even if 45 Commando’s future at Condor is confirmed for now, over-zealous cuts to the airfield will compromise its ability to operate effectively. The review must not suggest confirming the future of 45 Commando at Condor with one hand, while the other make decisions that might eventually force it to move. I am sure that it does not need to be stated that, should that transpire, it will have a negative impact on the base’s personnel, their families and the wider community.

The review should include clear, practical steps towards securing Condor’s long-term future as the home of 45 Commando. The Ministry of Defence should take a long-term approach to the review, and it should consider how greater investment in Condor can ensure that 45 Commando has a stable home, with all the facilities it needs, for decades to come, and how that investment can save the Ministry from greater costs in future.

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I congratulate the hon. Lady on securing the debate. At the moment, recruitment to the Army is very low. Newspaper reports today say that 20% of Army personnel are unfit to go to theatres of war. Clearly the hon. Lady is outlining that her local detachment is very capable of going to war. Does she agree that, when the soldiers can deliver something effectively to the Army and to the Ministry of Defence for overseas activities, every consideration must be given to retaining the base and to recruitment?

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The hon. Gentleman is absolutely right. The issue is twofold: it is about keeping our fantastic personnel on board as well as making new recruits. The Ministry of Defence is doing a huge swathe of work on recruitment, which we obviously need to do continually to attract the brightest and best into our armed forces.

The review should also consider what more Condor can contribute to our country’s future defence infrastructure on top of serving as a home to 45 Commando. The Minister has heard multiple representations on behalf of Condor from me and from people across Angus over the past 18 months. He knows that this issue is close to my heart and the hearts of my constituents. I hope he recognises from the Ministry’s perspective the common-sense case for Condor, and reflects it in his response.

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I make no apologies for mentioning the huge military tradition in Angus. We must remember that it is the home of the 26th regiment of the Army—the Cameronians—which was disbanded in 1968 because it refused to amalgamate. It was one of two regiments of the British Army that said, “We’re not amalgamating; we’re the Cameronians. We are a fighting force—we come from Angus, and we’re Scottish. We are not disbanding.” Good for them.

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I saw that the Minister was listening avidly to the case that my hon. Friend put across on my behalf.

I have made the case for keeping a well-established base in an area with a long and proud military history, where 45 Commando has been truly welcomed into the local community, and where the cadets have added a new dimension to that unique relationship between military and community. The base has worked well for decades for the personnel stationed there. Provided support is maintained, it can continue to do so for decades to come.

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It is a pleasure to respond to this debate I congratulate my hon. Friend the Member for Angus (Kirstene Hair) on securing the debate and I commend her commitment, diligence and persistence in supporting both the Royal Marines and RM Condor in her constituency, which is the home of 45 Commando. I had the pleasure of visiting the base only a few months ago to see the incredible work that is being done by Lieutenant Colonel Forbes and his fantastic unit, as well as other assets based up there.

Before discussing RM Condor, I would like to acknowledge the critical and unique role that the Royal Marines play in the wider spectrum of our armed forces capability. Formed in 1664, during the reign of Charles II, they celebrate their 355th birthday this year. The Royal Marines have much to be proud of in their long history: playing a vital role in Lord Nelson’s victory at Trafalgar; securing and defending the Rock of Gibraltar in 1704; the infamous raid on Zeebrugge in 1918, which earned two Royal Marines the Victoria Cross; as well as the D-day landings at Normandy, where 17,500 Royal Marines took part in the largest amphibious operation in history. More recently, they were essential to the recapture of the Falkland Islands in 1982.

Today the Royal Marines are the UK’s specialised commando force—an elite unit held at very high readiness and trained for worldwide rapid response. They can deal with a wide spectrum of threats and security challenges, and operate in often dangerous and extremely difficult circumstances, including amphibious operations, littoral strikes and humanitarian relief as well as specialist mountain and cold weather warfare and jungle counter-insurgency. When diplomacy fails, the Royal Marines provide Government with an impressive spectrum of hard-power options with which we can respond. On behalf of a grateful nation, I thank every Royal Marine who has earned the coveted green beret.

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I thank the Minister for allowing me to point out, as the secretary of the all-party parliamentary group on Gibraltar and as a real friend of the Royal Marines, it is the only unit in our armed forces that has a place name on its badge. It says “Gibraltar”, because that is where the unit made its name.

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While serving as a regular officer, I had the pleasure to be based in Gibraltar, and I became very familiar with the treaty of Utrecht and the role that the Royal Marines played in securing the Rock. May it forever remain British. Gibraltarians are very proud people, and we have a strong relationship with the Royal Gibraltar Regiment.

Looking to the future, the 2015 strategic defence and security review mapped out our commitment to the Royal Marines. I am pleased to say that following the modernising defence programme, the future of HMS Bulwark and HMS Albion as amphibious workhorses has been confirmed. The Royal Marines winter deployment programme in Norway will continue, as will their training with US counterparts. We will shortly see women join the ranks of the Royal Marines in ground close-combat roles for the first time.

Turning to the base, my hon. Friend the Member for Angus will be aware that the Royal Navy first forged a valuable relationship with Angus during the last war. The Fleet Air Arm occupied the base in 1940 as a training field to train aircrew in aircraft carrier deck landing operations. In 1954, the base became the home of the Royal Navy aircraft engineering training school. In 1971, as my hon. Friend mentioned, the base became the home of 45 Commando and was renamed RM Condor. Today it also houses 7 (Sphinx) Battery, which is part of 29 Commando Regiment Royal Artillery, 2 Signal Regiment, 30 Commando Information Exploitation Group, and the Royal Military Police detachment. It is also home to a number of cadet operations, so it is vital for us to encourage recognition and understanding of what our armed forces do, and perhaps to introduce the idea that a career in the armed forces—specifically the marines—is worth pursuing.

Turning to the future, colleagues will be aware of the wider need to rationalise our defence real estate. The Ministry of Defence owns 3% of land across the United Kingdom, much of which is surplus to our requirements. We have conducted a wide-ranging study into what can be utilised, what needs to be continued, what is vital for training, what is needed for the future and what we can dispense with. We are transforming the estate into one that better supports the future needs of our armed forces. We will be investing £4 billion over the next 10 years to create a smaller, more modern and more capability-focused estate.

On our military presence in Angus, I can confirm that there are no plans to dispose of RM Condor as an operational base. As part of our review, we have been investigating how best to ensure that 45 Commando continues to have access to the facilities it requires to live, work and train. We are considering whether there are opportunities to undertake more defence tasks. What more can we add to our military capability in that neck of the woods to ensure we make the most of that important facility?

The MOD is investing not just in Angus but in Scotland as a whole, as other hon. Members have said. Wider afield, we have the Clyde naval base—another location I was pleased to visit not long ago—which will soon be home to all the UK submarines in the submarine centre of specialisation. The first of nine P-8 maritime patrol aircraft will be arriving in Scotland very soon. Boeing and the UK Government are working together to build a new £100 million operational support and training base in RAF Lossiemouth. In essence, Scotland is important to the defence of the United Kingdom—not just our military capability but our procurement. The Type 26 and our offshore patrol vessels are being built in Scotland, too.

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The Minister will know that during the independence referendum campaign, the Ministry of Defence made two promises about Scotland. It promised 12,500 regular personnel based in Scotland—the Government are way off that target at the minute—and a frigate factory based on the Clyde, which still has not appeared. When does he expect those promises to be fulfilled?

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The hon. Gentleman will be aware of the pressures on us in recruitment and retention. It is a competitive environment. Per head, our footprint in Scotland is higher than anywhere else in the United Kingdom, and Scotland does very well indeed from the investment we make, despite the extra taxation that the Scottish National party has sadly decided to inflict on our armed forces personnel—[Interruption.] The hon. Gentleman is signalling, “Carry on, carry on,” but he knows exactly what I am talking about. My hon. Friend the Member for Angus raised that important issue. We have had to step in and fill the gap to prevent the impact it would have had on individual soldiers, sailors and air personnel if it had been allowed to go ahead without our reacting to it.

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Will the Minister give way?

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We are wandering off the subject of Angus, but I will give way very briefly if the hon. Gentleman’s intervention relates to Angus. I do not want to have a debate about taxation in Scotland. The SNP has lost the argument. We have had to fill the taxation gap. Is the hon. Gentleman sitting down, or does he still want to intervene?

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As the Minister is aware, I cannot stand up at the same time as him. He raised the issue of taxation. The military personnel in my area make a fantastic contribution, as I know the Minister recognises. If he is talking about the pay gap for higher earners, will he make it up to those who live elsewhere in the UK who are at the lower end of the pay scale and would benefit from a higher income in Scotland?

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You will call me out of order shortly, Ms McDonagh, but I will just respond to that point. We need to ensure that people do not suffer, no matter where they are based in the United Kingdom, and people moving to Scotland would have suffered had we not intervened to make up the difference. They support and represent their country, whether they are in Scotland, Northern Ireland, Wales or England. That is the bottom line, and that is what should matter. With your permission, Ms McDonagh, I would like to continue.

Across our estate, we will continue to combine military and infrastructure expertise to transform the places where our armed forces live, work, train and operate, but we know that we cannot do that alone. We have touched on the importance of working with our stakeholders. As we continue with our basing requirements, we will engage constructively with all relevant stakeholders at every level to ensure that sites are considered for use in a way that benefits defence and the surrounding local communities.

In summary, RM Condor plays a vital role in Scotland’s defence footprint and the defence of the United Kingdom. On a point that was made in an intervention, from where I sit in the Ministry of Defence, I see that the world is becoming more dangerous, not less. It is important that our defence posture grows to match our desires and capabilities to help shape the world as it becomes more dangerous. I fully acknowledge the impact that the changes that we are making to our real estate will have on local communities, but I reiterate our commitment to 45 Commando: our intention is to keep it in RM Condor.

I thank my hon. Friend the Member for Angus for her commitment and support for our brave Royal Marines and their families, who do so much to support those in uniform. I hope she will be satisfied with the assurances I have given her today.

Question put and agreed to.

Uganda: Democracy

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While hon. Members take their places, they may notice that the monitors are not working. I assure them that if there is a Division, the Doorkeepers will come in straight away and let us know. We are anticipating one at about 4.55 pm, so the debate may be interrupted.

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I beg to move,

That this House has considered democracy in Uganda.

Serious concerns have been raised internationally about the Ugandan Government systematically undermining democracy in their country. MPs have been arrested, institutions that should protect the democratic rights of citizens are being weakened, and the voices of ordinary Ugandans are being ignored. The United Kingdom is a friend of Uganda—we are important partners in trade, development and security—and I am a friend of Uganda too. Uganda and the UK have a shared past, and I hope that we will have a strong and prosperous shared future together as well.

At the start of this debate, it is important to ask what the UK’s interest in Uganda is and whether that gives us a legitimate right to make any comment about its democracy. I firmly believe that Uganda should be valued as an equal partner to the UK, but it has not always been an equal partnership. Our relationship began in 1894, and until 1962, Uganda was a British protectorate, as it was known then. Now Uganda is an independent sovereign nation, and it has been throughout my lifetime. It has a constitution that describes a balance of power between an executive, a legislature and other independent bodies. I respect the Ugandan constitution—it is right for Uganda and the Ugandan people. It protects the Ugandan people, and is the rock on which Ugandan democracy is built. The relationship between our two countries should always respect the Ugandan constitution.

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The hon. Gentleman makes some good points. I wonder whether he has seen the Ugandan press coverage of this debate, which has essentially approached the whole of the subject from a position asking, “Why is the British Parliament trying to tell us what to do in our own Parliament? What gives them the right to do that?” Does that not show that we face an uphill struggle in getting our points across in the measured way he describes? How will we do that?

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I thank the hon. Gentleman for his intervention. Having seen that press coverage, I thought it right to ask what our legitimate interest is and to establish why our relationship is important and how Ugandan democracy impacts on that relationship. I hope to develop that argument as I progress through my speech.

Our relationship is one in which we have worked together, for example to respond to the refugee crisis from South Sudan. It is a relationship in which we trade with each other and in which the UK provides development assistance to the people of Uganda. As countries, we have shared goals and shared interests in those areas.

I also have a personal interest in Uganda. In 2006, I moved to Uganda, where I spent more than four years living and working in a rural part of the country in Kanungu district, next to the fantastically named Bwindi Impenetrable Forest. I worked as a doctor with local health workers and the local community to transform a small health centre into a fantastic, thriving hospital and community health programme. I did this without pay, as a Voluntary Service Overseas volunteer, and played my small part and used my skills to leave a sustainable healthcare system. In case anyone watching from outside wonders—I am sure a few people are watching—I no longer have a stake in Uganda, whether through financial interests or otherwise. I am, however, a friend of the country, and I have many Ugandan friends. I want to speak today in that spirit of friendship and as an equal partner.

Living for a long time in a different culture gives you particular insight. I learned to speak some of the language, Runyankole-Rukiga, although not very well, and I learned a lot about local cultures and beliefs. I saw many of the successes of President Museveni’s National Resistance Movement Government. I saw significant efforts to improve education, with the ambitious programme of universal education, which was really positive. I saw economic growth, albeit in a country with significant inequalities. Ugandans are slowly getting richer, which is a good thing too. I saw growth in infrastructure, the remarkable spread of mobile phones, improvements to road networks, and improvements to power. Those should help the future economy to grow and help everyone to become more prosperous.

I also saw things that did not work well, however. The Government-run health service, which failed to get the basics right, did not work well in the area that I lived in. Health worker morale was low and absenteeism was extremely high. There was a centrally run system to supply drugs, but a combination of underfunding, theft and bad planning meant that supplies often ran out. As people had little confidence in the institutions of government to deliver the healthcare that they needed, they had to take matters into their own hands. Patients went to private drug shops, while health workers took second jobs. The poorest people were left behind, getting no care and suffering devastating consequences. That failure of the Ugandan health service is not because of the people—there are many fantastic, talented Ugandan health workers—but because of the system, which relies on patronage and is, sadly, riddled with corruption and centralised decision making that leads to paralysis.

While living in Uganda, I also got to witness how the political process worked. Locally, I was introduced to GISOs—Government internal security officers—living in every community. Ostensibly, they are there to collect evidence of people trying to destabilise the country, but in practice that extends to any act of political opposition to the President. Alongside every local council leader sits a resident district commissioner—or RDC—the President’s own appointed person, who monitors everything happening in that district. That is done in the name of security, but RDCs are used to gather intelligence and stop political dissent.

I learned that the Internal Security Organisation is there to protect the President. Legitimate criticism of the policies of the President have been deliberately conflated with criticism of the state. The state has become personalised. Ugandans see that system for themselves—they do not need me to point it out. Some people know no different: this month, President Museveni will have been in power for 33 years. Three-quarters of people in the country have never lived under a different leader. Ugandan people see that the institutions of their democracy are slowly being eroded.

First, the Government have closed down critical media outlets. There are credible reports that television stations were interrupted during the 2016 elections when results favouring the opposition were being reported. There are also credible reports that social media, including Facebook and Twitter, are shut down by the Government during sensitive times.

Secondly, the Government have used the military to attack Parliament. When MPs were debating the extension of presidential term limits, Parliament was attacked and MPs, including Betty Nambooze, were beaten by armed forces. Thirdly, there is evidence of serious human rights abuses, including serious and credible reports about a 2016 attack on the palace of King Charles Mumbere in Kasese, and the massacre of 150 civilians by Ugandan forces. According to those reports, the solider who led that attack has been promoted, and no independent investigation has taken place. I hope that the Minister will explain the Government’s position on that attack.

Fourthly, elections have been described, in diplomatic language, as

“short of being free and fair”.

Serious allegations have been made about the conduct of elections in Uganda over many years, but the most recent EU report on the 2016 presidential election made 30 recommendations that should be enacted before the next election in 2021. They include taking clear steps to differentiate the state from the ruling party and to strengthen the independence of the electoral commission, and systematic checks on the integrity of votes. As of March 2018, none of those EU recommendations had been implemented. There are credible stories of vote-rigging, with the police preventing access to “rigging houses”, and electoral bribery is common. Ugandan politicians routinely hand out money or gifts at election rallies.

The interference in elections does not happen only on the day of an election. I have friends who stood for elected office in Uganda. They were subjected to constant low-level intimidation. Police or soldiers were stationed outside their home, and they were followed. After they visited villages to talk to people, soldiers went to threaten those people with reprisals if they voted against the Government. Furthermore, radio stations, the main media in most areas, are owned by Government-backed politicians and report clearly biased information. Perhaps most disturbingly of all, people who engage with politics are subjected to arbitrary arrest and detention. The institutions that are supposed to protect democracy, the police and the military, are used to undermine it. Finally, the Public Order Management Act passed in 2013 has further diminished the political space, requiring police approval if three or more people want to gather to discuss political issues. What kind of democracy curtails politics in that way?

Many Ugandan opposition politicians have struggled bravely to use the democratic process to win power. I do not have time to mention them all, but I will draw attention to two such people. Kizza Besigye has stood for President on three occasions. He has been arrested, beaten and harassed so many times that he has lost count. I had the pleasure of meeting Dr Besigye when he visited our Parliament last year. His sacrifices in the pursuit of democracy in Uganda should be lauded.

I also want to mention Robert Kyagulanyi, also known as Bobi Wine. He is a young, charismatic musician with a large popular following. He was elected to the Ugandan Parliament at about the same time that I was elected to the UK Parliament. While I, in a friendly way, get to be critical of our Government without harassment, Bobi has been the target of totally undemocratic behaviour by his. In August last year, he and four other MPs were arrested by the military while campaigning for a by-election. His driver was shot dead, and he was severely beaten by soldiers before being brought to court on trumped-up charges that were later dropped. Bobi Wine was eventually handed over to the police and released, but that was just another example of the Ugandan Government using the military to prevent democratically elected politicians from doing their job.

Why are all such attacks on democracy important? They are important for the Ugandan people, the people who might one day want to see a different Government in their country. They have no hope of ever seeing a different Government if this one undermines democracy to cling on to power. The attacks are also important because of international standards and accountability. Uganda is a partner to our country in the United Nations, in the Commonwealth and, in multilateral relationships, through the European Union; and partners hold each other to international standards. The attacks are also important because they undermine the ability of the UK and the Ugandan people to work together on shared goals.

The attacks on democracy also allow a small group of people to retain power, a group of people who are illegally benefitting from that power and patronage. The corruption has meant that the UK’s Department for International Development has stopped direct budgetary support to the Government of Uganda. In 2012, €12 million was channelled out of the aid budgets from Ireland, Denmark and Norway directly into the bank accounts of officials working in the Prime Minister’s office. We now have to provide our UK support through private sector and non-governmental organisations. We cannot pretend that that is a good thing—it is always better to work with Governments—but, to be honest, we know that if want to help the people of Uganda, we cannot give money to their current Government.

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When I worked in aid in Uganda, we ensured that the aid got to the people by delivering it ourselves, refusing to give it to any officials. We took it directly to the villagers or the people who required it. I know that is difficult, but I am sure that the hon. Gentleman agrees.

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It is a terrible state of affairs. If we want development to be sustainable, that is much more likely to happen through a democratically elected Government and by building the institutions within a country. Some people are so desperate, however, that they still need aid, and we cannot trust their Government to give that aid. I thank the hon. Gentleman for highlighting that point.

Transparency International ranks Uganda as 151st out of 180 countries in the world for corruption. That is worse than Kenya, which is 143rd, much worse than Tanzania at 107th or Ethiopia at 103rd, while Rwanda is ranked as high as 48th. In 2013, Transparency International stated:

“Corruption in Uganda is widespread and seen as one of the greatest obstacles to the country’s economic development as well as to the provision of quality public services....Such corruption challenges are exacerbated by weak law enforcement, which fuels a culture of impunity, particularly with regards to high-ranking officials involved in corruption schemes.”

The attacks on democracy, as well as undermining our shared development objectives, are important because Britain wants to provide military support to the country of Uganda. We want Uganda to have secure borders and to contribute to peace in Somalia. We cannot have that, however, unless we have confidence in Uganda’s democracy and rule of law. I ask the Minister: when there are questions about the Ugandan army’s use of cluster bombs in South Sudan, when the army is used to enter Parliament and, allegedly, to massacre people in Kasese, or when special forces are used to hunt down and arrest politicians campaigning in a by-election, how can we be sure that the people whom we are training engage only in peacekeeping activities?

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I welcome what the hon. Gentleman is saying, and I thank him for bringing the issue before the House. Will he also, however, pay great tribute to those Ugandan soldiers who have given their lives in Mogadishu and wider Somalia in the cause of peacekeeping? Very brave men and women have done so to bring peace to that country.

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I thank the hon. Gentleman for making that point. I join him in paying real tribute to all the east African forces working in Somalia for the peacekeeping mission.

We need to know that the UK is not enabling the atrocities being committed within the country of Uganda by Ugandan forces. Of course, that would never be our intention, and I am sure that it would be argued that our training of its military forces helps them to become more professional and to meet international standards, but when soldiers are given orders from the top, they have to follow those orders. When the Ugandan Government deliberately use the military to undermine democracy, it is right for the UK to look carefully at our involvement.

Before he became President, Yoweri Museveni published a book called “What is Africa’s Problem?”, in which he wrote:

“The problem of Africa in general and Uganda in particular is not the people but leaders who want to overstay in power.”

I want to see a Uganda where it is possible for the Ugandan people, should they want a change of Government, to achieve that through democratic means.

Opposition politicians find themselves in an impossible position. It is hard to build good policies and to get widespread support for them when the democratic space is so curtailed. Between now and the next election in 2021, it is crucial that a united opposition builds a potentially winning manifesto with popular policies, that opposition politicians are allowed to campaign freely and enthuse the people of Uganda, and that the opposition is given an equal chance to persuade people that they have an alternative platform for Government, on a level playing field.

There is no level playing field, however, because so many profoundly undemocratic occurrences have become normalised in Uganda. In a democracy, it is simply not acceptable for the military to arrest, beat and torture opposition politicians, for soldiers to enter Parliament and use physical force against MPs, or for elections to be rigged. Uganda’s democracy is under threat. The institutions that in a normal democracy would have the power to hold a Government to account have been systematically undermined, intimidated, bullied and cajoled by Government. Let no one be fooled: Uganda has a military Government in civilian clothes.

How can the UK, as a friend to the Ugandan people, best help to support their democracy? We are already supporting good governance and anti-corruption initiatives through the Department for International Development—I am sure the Minister will talk more about that—but when democratic institutions are systematically undermined, is that enough? Ugandan opposition leaders are asking the UK Government to place targeted sanctions on Uganda, to freeze the assets of Ugandan officials who are known for violations and abuses of human rights, to enforce a travel ban on Uganda’s leaders who are known for corruption and violation of human rights, and for Britain to condemn in the strongest terms the attacks on and abuse of Ugandan parliamentarians and all the activists inside and outside Uganda.

I would like the Minister to respond to those requests. I do not necessarily believe that all those things are needed. I certainly would not want to do anything that put at risk our relationship with the people of Uganda. Sanctions would be a last resort, but I understand why people are calling for them. Unless significant change happens in Uganda, the UK should take no option off the table.

I end by addressing the people of Uganda, some of whom are in the Public Gallery. We want the UK to work with them on security, sustainable development and business growth, but we are watching their Government closely. Our support for their Government comes with conditions. Members of Parliament such as myself and my colleagues here today will ask our Government to invest in their country if there is a thriving democracy and international standards are met. The United Kingdom must be on the side of the Ugandan people.

Democracy—the means by which we debate and create laws—is a process that requires the diligent engagement of citizens. Democracy fails when people cannot criticise their leaders, or if they do not feel confident that they can throw them out of office if they are not doing a good job. A healthy democracy can unlock so much potential in a country. But right now, the hopes of the Ugandan people are not being met by the people who govern them. That is why I say to the Ugandan people, whether in this Chamber in London or watching on their phone screens in Kampala: I am with you. We are with you.

We are watching and hoping for a brighter future for the Ugandan people. There are democrats across the world who know that that is possible, and we offer our solidarity in their fight for a Uganda governed by and in the interests of the Ugandan people—a Uganda guided by the unrestricted voices of its people. We are with them because that is what a truly democratic Uganda could be: prosperous, peaceful and secure. If they work for it and their institutions are protected and defended, nothing can stand in the way of the millions who are desperate for change.

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It is very good to serve under your chairmanship, Ms McDonagh—I think it may be the first time in eight years that I have. I do not disagree with a word that the hon. Member for Stockton South (Dr Williams) said. He has lived there and has been steeped in the culture—he knows exactly what happens there. I, too, am a friend of Uganda.

Sitting suspended for a Division in the House.

On resuming

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We restart. I apologise, but I am now imposing time limits of four minutes for all speakers.

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Thank you very much. As I was saying, I am a friend of Uganda. I have been to Uganda about 15 times and have even spent personal holidays there. I love the country and have found the people incredibly friendly.

I find the lack of democracy disturbing. The President and his troupe, so to speak, are making sure that they win the elections, which I do not believe are free and fair. As the hon. Member for Stockton South said, they go out and pay villagers to vote for them. I know that that happens. When we send observers for the election, the deals have already been done. The people feel intimidated and that they must vote for Museveni and his MPs.

I have personal experience. I have a friend who was a Member of Parliament—not when I first met him, but he became a Member of Parliament. He had to contest that election because it was done badly and it was shown in the High Court that he had won. He won the election again, but recently lost it. He is a medical doctor and since then he practices medicine privately—Museveni will not employ him because he is from the wrong party. He has been looking after the people that he used to represent in his home area for free. He has been treating them for nothing, giving them drugs and looking after what were his constituents. He has been beaten up and he has been put in prison. I have seen photographs of the beatings. The only reason he is still alive is that he managed to get himself transferred to hospital.

I have always said that people who put themselves up for election for opposition parties in countries like Uganda are incredibly brave. The worst that can happen to us in this country is that we lose an election. The worst that can happen over there is that they die. What is worse is that they die because the state is beating them, punishing them and ultimately could kill them.

We should be very careful about how we give money and the relationships we have with the Government of Uganda. I am very pleased that international development money has been reduced and we are not giving it directly to the Government, but to third party organisations. We need to monitor that extremely carefully. If we do not, the money will get into the wrong hands and will be used for the wrong reasons.

I am concerned about the whole idea of democracy in Uganda. Uganda needs to prosper and it needs a good democratic system. It should have a good democratic system, but it does not, because it is abused. Until the abuse stops, we will not be able to stop elections being rigged. That is the truth of it and there is no point in beating about the bush. The elections are genuinely rigged. The hon. Gentleman spoke about political parties not being able to meet in groups of more than three. That is ludicrous. How can there be a democratic process when people are not able to meet in groups of more than three? It is just ridiculous to have to get the state’s permission to be able to do that—and why would the state give it? It does not want big rallies.

Uganda is not like here, where we might have a church hall rally. They have huge rallies in the villages, because the only way the people can meet their candidates is to go out and see them. It is important that they do that so that they can weigh up one against the other, as happens here. That is not happening properly in Uganda anymore and we need a proper democratic system to be fair to the people there. There are so many things wrong in the Ugandan Parliament and the Ugandan system that we need to monitor them very carefully.

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It is a pleasure to see you in the chair, as always, Ms McDonagh. I warmly congratulate the hon. Member for Stockton South (Dr Williams) on a passionate speech and pay tribute to his previous work in Uganda.

I visited Uganda as part of a Westminster Foundation for Democracy trip in February last year, facilitating training for young candidates. It was there that I observed a number of things that gave me concern about the situation for democracy in Uganda. One of my first observations on going to observe proceedings in the Parliament was that the military has seats in the Parliament. I was shocked and horrified when I saw someone in military uniform speaking at the Dispatch Box. I cannot possibly imagine having military in the House of Commons. I think it sends a very deep signal. The hon. Gentleman spoke about a military Government in civilian clothing, but the reality is that we saw them in military clothing in the Ugandan Parliament, and that is alarming.

I spent a couple of days facilitating training for young candidates for the People’s Progressive party. One young guy that I met was taking part as the candidate for the PPP in the Jinja East by-election, which took place in March this year. That young guy, Mugaya Paul Geraldson, is now a good friend of mine. For the two days that I was there in an official capacity I facilitated the training, and on my free day I travelled at my own expense from Kampala out to Jinja East, largely to be a friend to Paul and go around as he was doing his rallies. One thing I observed was that there were hundreds of people turning out to his rallies—he was a young candidate who projected hope, ambition and energy. On election day he polled 48 votes, but there were hundreds of people at his rallies.

The final observation I offer—I am keen for the hon. Member for Strangford (Jim Shannon) to get to speak as well—is that at the second of the two rallies I attended with Mugaya Paul, I was speaking to some of the people in that village when I was quickly bundled into a car by the people I was there with, because Museveni’s thugs had turned up and made it clear in no uncertain terms that the rally was alarming to the Government and that this young candidate was a threat to Museveni’s forces. That is deeply worrying.

I wanted to come here today and place on record a real experience of the suppression of democracy in Uganda. What that young candidate, who I hope will have another run at office, experienced in the course of that election was nothing short of appalling. I welcome the comments by the hon. Member for Stockton South today, and I hope the Minister takes on board my personal experiences. I leave hon. Members with that view of the military in Parliament. Surely that does not represent a good sign for democracy in any country in the world.

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It is a pleasure to serve under your chairmanship, Ms McDonagh. I pay tribute to my hon. Friend the Member for Stockton South (Dr Williams), who made a powerful and eloquent speech. His long association with Uganda puts him in a position to be an authoritative advocate for human rights and democracy there, and I thank him for bringing this debate to the Chamber.

The Ugandan people have long suffered from tyrants who have committed crimes against their own people. The name Idi Amin will live long in infamy. The rule of Milton Obote was also mired in human rights abuses, with Amnesty International estimating that the regime had been responsible for more than 300,000 civilian deaths across Uganda. After Obote, Museveni became President in 1986. He said in his acceptance speech:

“The people of Africa, the people of Uganda, are entitled to a democratic government. It is not a favour from any regime. The sovereign people must be the public, not the government.”

Those are his own words—words that he should heed now.

President Museveni’s tenure has always been problematic, but his attempts to constrain democracy have been creeping. First came the repealing of the two-term limit on the presidency, which was introduced in 1995 under his own presidency. The lifting of the term limit led Bob Geldof to say:

“Get a grip Museveni. Your time is up, go away”—

not untypical of Bob Geldof, we might think. The arrest of the main opposition leader Kizza Besigye, as my hon. Friend mentioned, in the lead-up to the third presidential election was another stain on an election that Museveni should not have been contesting. In December 2017 he succeeded in getting the presidential age limit of 75 removed, just as he was approaching that age himself. The hallmark of a dictator is stripping away the impediments to his becoming leader for life, and that is exactly what Museveni has done.

In 2017, shortly after I was elected, I had the pleasure of being invited to a meeting of Ugandan exiles in the UK who support the main opposition party, Forum for Democratic Change. I was invited by my old friend Jimmy Sydney, who is here today and who became a social entrepreneur in Leeds after leaving Uganda. At that event I met Nandala Mafabi and through him found out about the conditions under which Ugandan MPs have to function. Nandala told me how the Parliament had been entered by Government troops, who had arrested MPs opposed to the life presidency; their symbol of a red hat and ribbon made it easier for the troops to spot them. I sat there imagining that happening to us here, today—troops coming in and stopping us having this debate because the Government did not like what we had to say. I found it unbelievable. It still is unbelievable to me that that could have happened in a country that calls itself a democracy and that MPs could be arrested in Parliament for exercising their democratic rights. This is surely a sign that democracy has died.

Just a couple of weeks after that event, I heard that Nandala had been arrested and spent two nights in the cells. His alleged crime was that he was part of a group of protestors demonstrating against the proposed amendment of the constitution to remove the presidential age limit. That is just the story of one MP; my hon. Friend told the stories of other MPs and the hon. Member for Glasgow East (David Linden) told that of yet another.

We must heed the words of the Ugandan community in the UK. Will the Minister commit to meeting their requests? I echo the requests made by my hon. Friend the Member for Stockton South for the Government to place targeted sanctions on Uganda, including on military materials; to freeze assets of Ugandan officials known for violations of human rights and abuses of power; to enforce a travel ban on Ugandan leaders known for corruption and violations of human rights; to condemn in the strongest terms the attacks and abuse of Ugandan parliamentarians and all activists, whether in or outside Uganda, including in this country, and to apply conditionality to aid to the Ugandan Government.

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I congratulate the hon. Member for Stockton South (Dr Williams) on bringing this debate to the House. I speak as the chair of the all-party parliamentary group for international freedom of religion or belief and as my party’s spokesperson on human rights. I hear some incredibly disturbing stories regarding breaches of human rights, and the stories coming from Uganda most certainly bring a chill. I am a friend of Uganda and its people, but when I see wrongs, they must be spoken of in this place and the voice of its people heard. We are the voice for the voiceless, for those discriminated against, abused, attacked or brutalised.

As a democratically elected Member, I have had my share of social media attacks on the run-up to election. Unfounded or grossly exaggerated tales, media spin—you name it, I have seen it. I accept it because there is a reason people say politics is a dirty game, and no family member is safe from the mud-slinging, but when I read the stories of the so-called elections in Uganda, my skin crawled. When I realised that the UK Government have no way to be certain that UK relief funding is not being spent on training forces that go on to arrest and torture elected Ugandan MPs, my skin crawled some more and I must admit I questioned our ongoing support of Uganda.

I must be abundantly clear here. I am not questioning the relief that is given to on-the-ground bodies for humanitarian aid. Between December 2016 and February 2018, we provided food for over 1,000,000 people, supported 64,000 women and 146,000 under-fives with immunisation and food supplements, ensured that 2,000 children have access to education services, ensured that 73% of the refugee population in Uganda accessed water through sustainable water systems, at an average of 17 litres per day, and provided relief items—blankets, kitchen sets, jerry cans and mosquito nets—to 11,000 people. We also challenge UN agencies to reform and to ensure that they deliver effectively for the most vulnerable and provide value for money for the UK taxpayer. We are clear in what we say here.

As of March 2018, contributions to the global goals and other Government commitments in have achieved 248,000 children under 5, women and adolescent girls being reached through nutrition-related interventions; 572,000 additional women and girls provided with modern methods of family planning; 56,000 children supported to gain a decent education; and 130,000 people given sustainable access to clean water and/or sanitation. That is right and proper, but a Department for International Development report outlined that only 25% of projected aid to Uganda goes to humanitarian projects. It is clear that a huge amount of aid goes elsewhere, which raises questions. We in this House have every right to ask those questions and to seek the answers. How much of the money is used for the training of troops and officers? How do we justify training a military that seems to do simply what the President demands, without any evidential base? That is completely incredulous and unacceptable. How can we, as a true democracy, turn a blind eye to the absolute desecration of democracy, and support a Government who allow—indeed, carry out—abuse and beatings of elected representatives for opposing the Government?

The hon. Member for Stockton South referred to the alleged massacre, which I did not know about. Let us in this House do something about that today. I am proud that we help those who cannot help themselves, which we highlight in debates all the time. However, our role is not to prop up or support regimes that flagrantly disregard the basic principles of democracy and seek merely to wear a cloak of democracy over a decrepit body of dictatorship.

There are questions to be answered. I look to the Minister, for whom I have great respect, to assuage my fears, and the fears of everyone here, and outline how we will ensure that every penny of funding for Uganda is for humanitarian aid and not for training an army to be used against any dissenting voices, which is completely unacceptable.

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I call Chris Law, spokesperson for the Scottish National party. Convention gives you five minutes.

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It is a pleasure to serve under your chairmanship, Ms McDonagh. I thank the hon. Member for Stockton South (Dr Williams) for such an eloquent and powerful speech, particularly when he said that “the state has become personalised” under President Museveni.

As we have heard, President Museveni has held power in Uganda since January 1986 through brute force, election-rigging and corruption. In 2005, Ugandans voted to return to a multi-party political system, but the presidential elections held the following year were marred by intimidation, violence and voter disenfranchisement— features that remain present in Ugandan political life and were also clearly noted in the 2016 general election. Museveni has most recently been accused of heavy-handed tactics in dealing with political opposition. In August last year, a group of opposition MPs led by pop star-turned-MP Bobi Wine were arrested while campaigning at a parliamentary by-election and subsequently tortured. The UK has addressed this issue before and must be prepared to do so again. In 2005, the UK diverted £15 million of aid meant for the Ugandan Government because of alleged human rights violations, and withheld an additional £5 million until fair, multi-party elections were held.

I recently visited Uganda with award-winning playwright, friend and former colleague—from when I worked in film making—Jaimini Jethwa, who is from my city of Dundee. Her play, “The Last Queen of Scotland”, explores Asian identity in a Scottish context and tells her story as a young child refugee who in 1971, along with her family and 60,000 other Asians, was given only 90 days’ notice to leave the country by its then-ruler Idi Amin. During that visit I was assured that Uganda had come a very long way since the early 1970s under Idi Amin, during whose ruthless eight-year regime an estimated 300,000 civilians were massacred. I learned a lot about the people, listened to many stories and made some great friends, but it is clear that Uganda still has a long way to go in its democratic journey to ensuring an electoral system capable of enabling all citizens to participate peacefully in politics, free of intimidation and violence.

I will turn to the US and the UK’s relationship with Uganda. The United States has long turned a blind eye to human rights violations in Uganda, primarily because of its military and economic interests in the region. However, the historical relationship between Uganda and the UK means that the UK has both the power and the responsibility to uphold and support democracy and human rights, and at the same time, through its special relationship with the US, influence US policy on Uganda. Will the Minister tell us what recent discussions have been had, either by DFID or the Foreign Office, with the US on improving democracy in Uganda, and what changes, if any, the US has made to its foreign policy in Uganda to improve the situation on the ground?

Uganda also hosts 1 million refugees, mostly from South Sudan. It is the third-largest refugee-hosting nation in the world. I discovered during a more recent visit, with the International Development Committee last November, that it has one of the most progressive attitudes to immigration, as refugees have the ability to work and settle in Uganda. This open-door policy has been seen as a role model throughout the world. However, the number of refugees is expected to continue to increase. Support for refugees is the largest financial contribution that DFID makes in Uganda and, owing to the sensitivity of the situation, we need to ensure that that stays in place, to prevent escalation or humanitarian crisis. I strongly suggest to the Minister that the continuation of humanitarian aid to Uganda is vital and must continue. What steps are being taken by the UK Government to ensure that aid to Uganda is used responsibly, and that breaches of the democratic process are addressed?

Furthermore, it was recently confirmed that the Ugandan armed forces have received intelligence training provided by the UK, and there is concern that Ugandan forces trained at Sandhurst may have been used in the arrest of opposition politicians. Only a year ago, I stood in this Chamber speaking out against UK Government funding of Burmese military training programmes—the same military that went on to commit a relentless and systematic campaign of violence against the Rohingya Muslims described by the UN as a

“textbook example of ethnic cleansing”.

Will the Minister tell us how the Government can be certain that UK Government money is not being spent on training forces who go on to arrest and torture elected Ugandan MPs?

Finally, the UK has a strong historical relationship with Uganda in the form of the Commonwealth and, today, in the form of aid. That relationship has previously been leveraged to support a stronger democracy in Uganda. The UK should be prepared to do so again, to ensure that democracy and the rule of the law are protected.

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I call the Labour Front-Bench spokesperson, Liz McInnes. Convention gives you five minutes as well.

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It is a pleasure to serve under your chairwomanship, Ms McDonagh. I thank my hon. Friend the Member for Stockton South (Dr Williams) for securing the debate and for his eloquent description of the political situation in Uganda. Uganda is clearly a country about which he has a great deal of knowledge, arising from the time that he spent living and working there as a doctor, as he described.

There is no doubt that there are real problems with the democratic process in Uganda, as my hon. Friend has clearly outlined, particularly with President Museveni’s record on the oppression, imprisonment and torture of political opponents. The President has changed the constitution, scrapping the presidential age limit so that he can stand in the 2021 elections, when he will be 76 years of age. However, as a young radical in the 1980s, he publicly scorned African rulers who clung to power and was involved in the rebellions that toppled Idi Amin and Milton Obote. Now, after more than 30 years in office, he is clearly clinging pretty hard himself.

In 1986, when he was sworn in as President, Museveni was seen by the west as one of a new generation of African leaders. He proclaimed upon election that Uganda would return to democracy. It is clear that the President’s views have undergone a change since then. I think we can all agree that the imprisonment and torture of opposition activists has no place in a democracy.

The treatment of musician-turned-politician Bobi Wine has brought the Museveni regime to the attention of the west. As we have heard, Bobi Wine was arrested while campaigning last August and was badly injured while in detention. Three people were killed and around 100 injured in the unrest that followed Wine’s arrest. The international music community united in their condemnation of Wine’s treatment, with Chris Martin, Chrissie Hynde, Brian Eno, Damon Albarn and Femi Kuti among the 80 signatories of a statement strongly condemning the arrest, imprisonment and life-threatening physical attack by Ugandan Government forces on Bobi Wine.

Uganda is falling down on its commitment to human rights. It is a member of the United Nations and the African Union. It has ratified many UN human rights conventions and has thus made binding international commitments to adhere to the standards laid down in universal human rights documents. Press freedom is also threatened in Uganda, with the country coming 117th of 180 in the World Press Freedom Index. It has actually fallen since 2017, showing that the situation is getting worse.

It is reported that acts of intimidation and violence against reporters are an almost daily occurrence in Uganda, with many instances of journalists being arrested when covering stories, particularly around opposition politics. One example is that of Reuters photographer James Akena, who was beaten by Uganda People’s Defence Force soldiers while photographing protests against the treatment of Bobi Wine.

Uganda also, notoriously, has draconian anti-LGBT laws, with both male and female homosexual activity being illegal and liable to lead to imprisonment on charges of gross indecency. Activists who tried to open Uganda’s first LGBT centre in October last year were warned by the Minister for Ethics and Integrity that opening such a centre would be a criminal act. Uganda is a Member of the Commonwealth and as such has a commitment to the protection of human rights, freedom of expression and equality of opportunity. Ironically, these commitments were reviewed and agreed as part of the core criteria for Commonwealth membership under the Kampala communiqué, which was formulated at the 2007 Commonwealth Heads of Government meeting held in Uganda.

We must also consider the role of the Department for International Development in Uganda, which is providing £100 million in aid in 2018-19, which goes to support the many refugees from countries such as the DRC and South Sudan, education and family planning services, and supporting Uganda’s anti-corruption and accountability institutions. I hope that when the Minister responds she will be able to outline what pressure we can bring to bear on Uganda to fulfil its commitments as a member of the Commonwealth and how bilateral aid from DFID is helping in the fight against corruption.

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It is very good to serve under your chairmanship, Ms McDonagh. I add my congratulations to the hon. Member for Stockton South (Dr Williams) on securing this debate. In all the contributions to this debate, the strong friendships that exist between parliamentarians in the UK and parliamentarians in Uganda, between people in the UK and people in Uganda, have come through loud and clear. He set the tone of the debate in that spirit of friendship. I pay tribute to his work, over many years, providing healthcare to the corner of Uganda that he so descriptively told us about. A number of hon. Members spoke with great personal passion and from experience through their own links to, and friendship with, Uganda. As I go through my remarks, I will try to pick up on the questions asked in the debate.

The UK shares Uganda’s ambition to move from low-income to middle-income status. As long-term friends and partners, we believe that Uganda’s success really matters to us in the UK. Our strong, genuine friendship and partnership enables us to develop a wide range of mutual interests and to speak frankly to each other about issues of mutual concern, whether in a bilateral context or in the Commonwealth meetings. In recent years, political contact has been revitalised. President Museveni visited the UK twice last year, not only for the Commonwealth Heads of Government meeting, but for the illegal wildlife trade conference. Over the last two years, 11 UK Ministers have travelled to Uganda, including myself, and I know that the International Development Committee was there very recently as well.

First, I want to pick up on the point that the hon. Member for Stockton South made about the Kasese massacre and bring him up to date on that. In March 2017, the UK, along with EU missions, released a statement deploring the violence and calling for a comprehensive independent investigation. The UK and EU partners continue to raise concerns over the lack of progress on the investigation with the Government of Uganda, including in the recent article 8 dialogue with President Museveni.

When I visited in October, I met with some of the more than 1 million refugees, who have been referred to in the debate. Uganda has a very progressive refugee policy. In Uganda, 82% of refugees are women and children. The country enables those refugees to live in much the same way as its own citizens. When I was in Uganda, I was pleased to announce up to £210 million of funding to help those refugees and to help Uganda to provide refugees with nutrition, vaccinations and schooling. I also saw how the new biometric system for refugee registration is helping to verify refugee status and reduce fraud.

A number of hon. Members raised the question of how we deliver aid within Uganda. I reassure colleagues that this is always done with trusted partners. Wherever we find concerns, as we did recently with the UNHCR report, we take steps to suspend future payments until we are sure that the method by which we are delivering our support is free from corruption. We are very concerned when we discover that there has been a reduction in the money that is getting to the frontline, to those who need it most.

On the point about the conditionality of aid, I beg to differ with the hon. Member for Leeds North West (Alex Sobel), because we allocate based on need and reaching the very poorest. That is the spirit in which we deliver our development assistance. The hon. Member for Strangford (Jim Shannon) asked about the proportions in terms of the percentages. I reassure colleagues that there is no Department for International Development money spent on any military training. Some 40% of what we spend goes to human development, including education. Some impressive statistics were read out and are available on our website. Nearly 30% is spent on economic development. About 25% is spent on humanitarian assistance and about 6% is spent on addressing governance and security—if I have time, I shall go into more detail on that. About 1% is spent on climate and the environment.

We believe that Uganda is making important efforts to help to address the conflicts from which those refugees have fled. We welcome Uganda’s role in brokering the 2018 South Sudan peace deal, for example, the success of which will depend on Uganda’s continuing work to support its implementation. We should also remember that Uganda was the first country to provide peacekeepers to the African Union mission to Somalia. Uganda remains the largest contributor of troops to the AMISOM mission. I pay tribute to Ugandan peacekeepers, who work for security and stability in Somalia, often at great personal risk. Colleagues may wish to enquire further about the work of the Ministry of Defence in this area, but the training that we do is to support those missions. The work that we do alongside the United States is to train the troops for the AMISOM mission and to provide some counter-IED capability. There are frequent P3 meetings to discuss that joint work, but that is the focus of the training. All of that training includes a human rights training element.

Regarding trade and development, we are working hard in partnership with Uganda to boost its economic development, improve healthcare and education, and create jobs, all of which are needed if Uganda is to realise the huge potential of its young and growing population. We are doing that through DFID’s economic development programme and by providing UK export finance. In terms of export finance, we have already provided £210 million through the Department for International Trade for the construction of Kabaale international airport, and UK companies are helping to deliver nearly $1 billion-worth of infrastructure projects in Uganda, with an emphasis on championing local content and skills transfer. In his first year, Lord Popat, the trade envoy, has seen an increase in trade between our countries of 60%.

Our continued support, and our desire to increase UK investment in Uganda, will rely on strong institutions that uphold the rule of law and democratic principles, which gets to the heart of today’s debate; that deliver professional, expert advice to support the business environment; and that tackle corruption. That would benefit all Uganda’s citizens, not only foreign investors.

In terms of the wider democratic issues that have been raised, clearly, as a sovereign, democratic nation, Uganda’s political and economic choices are matters for the Ugandan Government and people. As the hon. Member for Stockton South has advocated, however, we believe that coherent and effective institutions will underpin Uganda’s development. As a parliamentarian, I pay tribute to the examples that have been given and the bravery of people who put their names forward for Parliament.

That is why, during the 2016 presidential election, the UK worked with the international community to support the electoral environment in Uganda. Our programmes will continue to support democratic accountability at local and national levels ahead of the next round of elections. It is also why we have spent more than £30 million since 2014 on helping to strengthen the institutions of Government that buttress democratic freedoms and advocate the equal treatment of all Ugandans under the terms of their constitution and laws.

Clearly, a free and accountable civil society is a vital part of any successful democracy. We salute the resilience of the media sector and the willingness of journalists, bloggers and citizens to voice their opinions. I urge the Ugandan Government to embrace and encourage such genuine meaningful debate.

Similarly, democratically elected representatives must be free to voice their opinions during election campaigns and once they have been elected. We heard the concern of Ugandan MPs from across the political spectrum expressed in a parliamentary debate last month about the treatment of Mr Kyagulanyi, and their calls for him to be able to operate freely and for an investigation into the cancellation of a number of his concerts. That follows his arrest and that of other opposition figures, and allegations of torture by the Ugandan security forces, at the time of the Arua by-election in August 2018.

Our high commissioner joined EU colleagues in calling on the Ugandan Government, political parties and civil society to work together to investigate the allegations swiftly and transparently, in accordance with the rule of law, and to emphasise that there could be no impunity. As a long-standing and close partner of Uganda, we will continue to emphasise that strong institutions and a functioning democracy are essential to its aspirations for trade, investment, jobs and growth. We will continue to raise concerns with the Ugandan Government, while building a long-term partnership that supports those aspirations.

I am a bit confused about the time remaining, but if I have more time, there is more that I could add.

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Unfortunately, the debate has finished; it is slightly confusing. I apologise to Dr Paul Williams for not being able to wind up.

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