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Westminster Hall

Volume 691: debated on Wednesday 24 March 2021

Westminster Hall

Wednesday 24 March 2021

[Stewart Hosie in the Chair]


Virtual participation in proceedings commenced (Order, 25 February).

[NB: [V] denotes a Member participating virtually.]

[Relevant Documents: e-petition 300073, Increase pay for NHS healthcare workers and recognise their work, e-petition 316307, Award all Nursing Staff in the NHS a pay rise of 10% backdated to 1 April 2020, and e-petition 560253, Recognise all members of NHS nursing profession by giving them a 12.5% pay rise.]

I remind hon. Members that there have been some changes to the normal practice in order to support the new hybrid arrangements. The timings of debates have been amended to allow technical arrangements to be made for the next debate. There will be suspensions between debates. I remind Members participating, physically and virtually, that they must arrive for the start of a debate in Westminster Hall and are expected to remain for the entire debate. I must remind Members participating virtually that they are visible at all times, both to one another and to us in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address. Members attending physically should clean their spaces before using them and before leaving the room. I remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall. Members attending physically who are speaking in the latter stages of the call list should use the seats in the Public Gallery initially and move on to the horseshoe when seats become available there. Members can speak from the horseshoe only where there are microphones. Sadly, because this is a very well subscribed debate, there will be a three-minute time limit for all Back-Bench speakers.

I beg to move,

That this House has considered NHS pay.

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friends the Members for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for co-sponsoring this debate. I am pleased to have been allocated such a generous amount of time for the debate. That is entirely justified given the importance of the subject at hand—NHS pay.

I thank all those who have taken the time to sign the following petitions: e-petition 300073, signed by more than 170,000 people and titled “Increase pay for NHS healthcare workers and recognise their work”; e-petition 316307, titled “Award all Nursing Staff in the NHS a pay rise of 10% backdated to 1 April 2020” and signed by more than 140,000 people; and e-petition 560253, which is titled “Recognise all members of NHS nursing profession by giving them a 12.5% pay rise”, has been signed by more than 19,000 people and does not close until 7 June.

I sought before the debate the hon. Lady’s permission and your permission, Mr Hosie, to intervene. The petitions before us are an indication of the numbers of people across the whole United Kingdom who feel strongly about this issue. The people emailing me are not just NHS workers. They are families; they are people who have been recipients of the goodness of NHS workers. I believe that there is a moral obligation on us—I have said this to Government as well—to deliver a satisfactory pay increase for nurses. We need to give them a rose of appreciation in the springtime, not a dandelion.

I completely concur with what the hon. Gentleman has said.

The figures that I have given lay bare the strength of feeling that people in our communities have for our incredible NHS staff as a whole. People who know me and have listened to any of my previous contributions on the public sector will know that I like to set the historical context, that context being the last decade and the political decisions taken by the Conservative party in office during that time, especially on matters of public spending and public sector pay—matters that are very close to my heart. During debates such as this, the Government may like to pretend that the pre-pandemic world does not exist. According to them, decisions that they take during the current economic crisis should be taken in the context of spiralling debt and deficits, as well as the looming prospect of inflation. But we have been here before, have we not, especially given that the last economic crisis was not too long ago? The Government are starting to sound like a broken record stuck on repeat, using the same smokescreens that they used in the early part of the last decade, which laid the pretext for an outright assault on public sector pay.

Public sector workers, and not least the brave women and men who staff our national health service, have long memories. What is it that I am referring to that existed at the front and centre of the NHS worker psyche going into this pandemic? It is the fact that nurses’ pay is down £840 in real terms since 2010. Further to that, the likes of the Health Foundation have stated that at the start of the pandemic, NHS wages were £600 lower per employee in real terms than in 2011-12. It is the fact that staff morale is at rock bottom, with many leaving certain NHS professions and the Government failing most spectacularly to fill the gap in staff shortages—nearly 50,000 combined vacancies exist across doctor and nursing professions. It is the fact that workers have had to endure rising demands on their work with less reward.

That is what NHS workers, who make up 4% of our entire labour market staff, have had to suck up since 2010 in order to pay for an economic crisis—a crisis in the casino economy that they had no part in creating. According to research delivered by London Economics for NHS trade unions, pay levels at every single Agenda for Change spine point have lagged behind inflation since 2010-11, resulting in a significant decline in total pay in real terms. Most spine points have exhibited a decline in excess of 10%, and total pay on the Agenda for Change spine point with the highest incidence of staff, at the top of band five, has declined by 15%. That is three times the decline in median earnings experienced by full-time private sector employees across the UK over the same timeframe.

Let all of us here today contextualise the debate by reflecting on the picture faced by our brilliant NHS staff before and going into the pandemic. They have had their pay cut, their spending power slashed, their living standards squeezed, and their morale smashed. That is the so-called old world that the new kids on the block—the Prime Minister and the Chancellor—would rather us all forget, one built by their predecessors. However, no amount of rebranding will disguise the fact that the current Government intend to continue the same legacy of making public sector workers pick up the tab for a crisis they had no part in creating. Indeed, this time it is even worse than that. They are paying for a crisis that they have ensured we have, and will, overcome. Some thanks, I say, and shame on this Government.

In this new decade, the message being received by NHS workers from the Government is this: brace yourself for more of the same. Staff in our NHS have had to endure all of that, and then 12 months ago were asked to once again go above and beyond, to gravely enter the unknown, risking their mental and physical health. They have sacrificed their family and personal lives. Some have paid the ultimate sacrifice of their own lives in the line of service, duty and compassion.

Let us cast our minds back to how terrifying the news headlines, the newspaper stories and social media chatter were when the virus first emerged on these shores. The virus was the absolutely terrifying unknown for all our people, except for our NHS workers who were not afforded the luxury of watching this public health crisis unfold from the sidelines as passive observers; they were the frontline against the great unknown.

To this day, their unrelenting commitment to the public service still moves me, as it should all people here today in Westminster Hall. I am not one to often quote Winston Churchill, or indeed make wartime references, but never was so much owed by so many to so few. If any of this brave few were able to come up for breath for just a moment, maybe because of their shift patterns, and sit in front of a TV screen on a Thursday evening last year, they would have seen many ordinary folk applauding their efforts. They would also have witnessed the galling sight of the occupiers of No.10 and No.11 clapping for the photo op, with little intention of rewarding them for their work, their sacrifice or their trauma.

Appreciation of NHS workers is not about rhetoric, warm words and pats on the head. Let me be absolutely clear. Claps and smiles do not pay the bills. It is about deeds and actions, and when it comes to NHS pay, the only deeds and actions made by the Government have been a fresh round of insulting pay offers, or, in real terms, pay cuts.

The Prime Minister recently told the House of Commons that the Government have delivered a 12.8% increase in the starting salary of nurses. It may well be true to say that some—but not all—nurses have received a pay rise of more than 12% since 2017-18. However, that is in cash terms, not in real terms, and it does not account for the fact that inflation erodes the spending power of workers’ wages over time. It is a flattering figure in other ways: it applies only to one group of nurses rather than reflecting the experiences of all NHS workers in England, and it does not take into account the years of austerity that defined the years prior to 2017-18. The Government cannot spin an assertion that they are awarding pay rises when millions of NHS workers know the exact opposite is true.

All we ever hear from the penny-pinchers that occupy the Government Benches is that we cannot afford this or that—basically, anything of social value or any moral good. The old mantra that public sector equals bad and private sector equals good is making a return. This tired politics draws the economic orthodoxy to the conclusion that suppressing public sector pay is of economic benefit in times of crisis, rather than the opportunity to grow the economy that it represents. It is almost as if a decision has been taken according to the same logic that public wages are a drain on the public purse and therefore a resource to be tapped into in order to control public finances when it suits.

It is sound economics to deliver a just and fair pay rise for NHS staff and a decent pay rise is affordable. Currently, just over 1 million nurses, midwives, allied health professionals and NHS support staff are covered by the Agenda for Change pay framework in England. The same aforementioned research conducted by London Economics concluded that a 10% increase to the NHS England pay bill amounting to £3.4 billion would result in the net expenditure of only £0.66 billion when including factors that are offset against the original figure.

Such offsets include increased tax receipts, because public sector workers pay taxes, and increases in direct, indirect and induced tax receipts, because public sector workers spend money in their local areas that helps to grow local economies and support communities. A pro-public sector agenda is a pro-business agenda. It is a miracle that public and private sector workers exhibit similar economic behaviours—who knew?

There would also be savings in recruitment and retention, because better paid staff are happier staff. There is even an extra £130 million in savings from the lower student debt write-offs for nursing students. This is the sort of sensible, moral and longer-term economic thinking the Government are totally incapable of. Instead, we have crumbs for midwives and support staff; their dignity, livelihoods and take-home pay is unaffordable, according to this Government, but not lucrative, publicly funded contracts for the friends of Tory Ministers to deliver personal protective equipment shortages and botched public health projects to the tune of billions of pounds. Apparently, that sort of spending is every bit affordable: in fact, we are told, it should be celebrated. Not only do we have a Government guilty of cronyism, but of skewed priorities. We see that only too well today when not a single Conservative Member apart from the Minister is here for this debate.

Government policy on the NHS tells us everything that we need to know. Nurses, midwives and support staff are left neglected, their immense contributions disregarded, forgotten by a Government and party intent on reverting to type. There is no policy impact assessment, as the real burden for public sector pay restraint will once again fall on the shoulders of women who make up so much of the public sector, especially our NHS. There is no regional impact assessment on areas more reliant on public sector spending, such as my city of Liverpool—so much for the levelling-up agenda.

To round up, the public overwhelmingly support a pay rise for NHS staff because they, like me, understand and appreciate their service each and every day; in times long before covid, during it and long after. They are out on the frontline, as I speak here today, delivering vaccine shots in the arms of millions of people, as well as catching up on the huge backlog of urgent elective care procedures while the Government parade around this place telling us that the economics will not permit just recognition and reward. If any group of workers in our National Health Service collectively decide that enough is enough and they embark on a course of industrial action, they will have unwavering solidarity. I appeal to the Government to change their course, walk the walk on NHS pay and give the NHS staff the pay rise that they so deeply deserve.

It is a pleasure to serve under your chairmanship, Mr Hosie. I am very pleased to have secured today’s debate alongside my hon. Friends the Members for Liverpool, Wavertree (Paula Barker) and for Birkenhead (Mick Whitley).

Workers across the public sector have faced unprecedented challenges during the pandemic, and NHS staff have been at the forefront of our response to the coronavirus, spending long hours in suffocating PPE in overwhelming environments. A nurse described to me that it felt like they were part of a horror movie. Frontline NHS staff at Luton and Dunstable hospital have told me that colleagues have broken down on many occasions, and that the past year has had a severe psychological impact on them owing to stress associated with separation from their families, sleep deprivation and heavy workloads. The whole of society is extremely thankful for their work in protecting us, looking after our loved ones and keeping the country going.

The country came together to clap for our carers, but claps do not pay the bills and NHS workers deserve to be rewarded for their dedication. The Government’s recommendation of a 1% increase for NHS staff in England is truly shameful. After a decade of austerity, TUC research shows that if the 1% increase goes through for 2021-22, nurses’ pay will be £2,500 less than in 2010 when adjusted for inflation, with an equivalent fall of £3,330 for paramedics and £850 for porters. Experienced nurses will take home only an extra £3.50 a week. Not only does the 1% pay proposal reflect the Conservative party’s complete undervaluing of NHS staff, but it even breaks their previous measly promise of a 2.1% pay increase set out in the NHS long-term plan.

The British Medical Association, the Royal College of Nursing, the Royal College of Midwives and Unison have all told the Government to reconsider the pay offer. A recent poll from Opinium found that 72% of UK adults believe the Government’s 1% pay proposal is too low.

We have heard already that there is a nursing vacancy crisis that is compromising staff safety. Although the Government state that they are recruiting more nurses, there are still more than 36,000 nursing vacancies, including 3,314 in the eastern region where my constituency is, which has barely changed over the past year. The issue is retention. How do the Government expect to retain experienced nursing staff who have suffered a sustained real-terms pay cut over the past decade? How can the Government expect people to aspire to a future career in the profession when there are reports of nurses having to access support from food banks?

A nurse at Luton and Dunstable hospital told me that they deserve proper recognition of the level of skill and responsibility needed for the roles that they do. They also said that there is no motivation, no incentive, no value or appreciation.

The latest figures from the NHS staff survey show that more than 300,000 staff worked unpaid over the past year. That is 13,000 more staff working overtime than in 2019. The Government might point to the uncertain financial situation and current low inflation for the real-terms pay cut, but that is economically illiterate. If affordability is the Government’s main contention, they should consider the knock-on benefits. The Government hope—

Apologies. We know the NHS staff will spend pay rises in their local economy, and that will help to rebuild as well.

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for leading this important debate, and I thank the Members who co-sponsored it. I especially thank my fantastic fellow Luton MP, my hon. Friend the Member for Luton South (Rachel Hopkins). I know that her commitment to the NHS and every healthcare worker in it runs deep. Together we will keep fighting for every healthcare worker in Luton to get the recognition, pay and protections that they deserve. It should run deep for everyone, not just during the pandemic, and it should certainly last longer than the minute that the Prime Minister stands on his steps to clap for the key workers who saved his life and the lives of countless others, and who held the hands of the 126,000 loved ones lost this year.

Among those who lost their lives were healthcare workers, going into battle with covid-19 under-resourced, underfunded and overworked. After the year we have had, I cannot fathom why the Chancellor thought a pay cut was good enough for healthcare workers. It is not good enough. Frankly, it is a disgrace, and I am embarrassed at the excuses that have been given. One Conservative peer even suggested that nurses were lucky to have their jobs, which is an insult. What porters, cleaners, paramedics, nurses, carers, healthcare assistants, operating department practitioners, administration staff, midwives and doctors need and deserve is not Ministers putting their hands together, but Ministers putting their hands in their pockets and their money where their mouth is. Give our healthcare workers a pay rise!

I pay tribute to healthcare workers’ hard work, commitment and sacrifice. It has taken a toll, not only on them, but on their families. A Facebook memory flashed up for me today. It is eight years to the day since my mum, Siew Owen, retired from being a matron. That did not mean she stopped working; she went back to be a staff nurse for the last eight years of her career and only fully retired this year. She worked for a total of 47 years for the NHS after coming from Malaysia when she was just 19. She and thousands of other nurses like her come from all over the world to care for our sick and build our healthcare system. However, if she had come today, under this Government she would have faced a number of unnecessary and unjustifiable barriers, because it is not only pay that is an issue for NHS healthcare workers; there are also hidden costs.

This is the third time in probably as many weeks that I have sat opposite this Minister, and I will ask her again whether she believes that it is right to continue charging healthcare workers who have come here from overseas to use the very system they work in. Is the pause on the immigration health surcharge for NHS workers and care workers temporary, or will it continue post-pandemic? How is it right that a nurse at Luton and Dunstable University Hospital had to borrow money from other nurses to pay the IHS? I have asked the Minister this question before, and I have also put it to the Secretary of State, so I would be grateful if we could get a straight answer today for the healthcare heroes, to whom we owe a great debt. Healthcare workers prioritised our health during the pandemic; it is high time they were prioritised by this Government.

It is a pleasure to serve under your chairmanship, Mr Hosie. I pay tribute to my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for securing this crucial debate and for her tireless efforts to ensure that our key workers get the fair pay they deserve.

Yesterday, we came together to reflect on the tragic events of the past year. We remembered the family members and friends we lost. We also paid tribute to those who cared for them. My constituency is home to the renowned St Thomas’ Hospital. That is the hospital that saved the life of the Prime Minister and the lives of countless other people during this pandemic. The hospital’s staff are now working hard to deliver the vaccine, while still maintaining the hospital’s regular services to the local community and to people from right across the country. I admit that I have a personal bias for St Thomas’ Hospital, as I received excellent care from the team there throughout my two pregnancies.

This past year has undoubtedly been one of the most difficult years for our NHS workers. They are physically and mentally exhausted. I recently had the pleasure of meeting the staff team at Saint Thomas’ when I was invited to speak at the Unison branch annual general meeting. I am proud to be a Unison member, and I am proud to have such an iconic hospital in my constituency. The staff team—including the dedicated nurses, security team, porters and junior doctors—told me about all the challenges they face while working day and night during this pandemic.

During the lockdown, I participated in the weekly clap for our carers, along with my son and daughter, because I genuinely wanted to show my appreciation. But clapping does not pay the bills. I know that, in some cases, nurses have to rely on food banks as they struggle to make ends meet. Many of my constituents who have been caught up in the cladding scandal are NHS key workers. They have been working long hours and making personal sacrifices to keep us safe, but now they face extortionate costs that they cannot afford.

A 1% pay rise is not a meaningful pay rise; after inflation, it is essentially a pay cut. It sends all the wrong signals to the NHS workers who have kept our country going during this dreadful pandemic. It is an utter betrayal by this Government not to give our NHS workers a bigger pay rise. The Prime Minister spent three nights in intensive care, on a ward for patients who needed specialist attention. He said afterwards:

“I can’t thank them enough. I owe them my life.”

Jenny and Luis stood by the Prime Minister’s bedside, watching him during the night. The NHS protected him. It protected us. Now is the time when we must protect it.

It has been a year now since hospital beds started filling up. Since then, there have been more than 126,000 deaths: our mothers, fathers, brothers and sisters, friends, neighbours and colleagues—in the NHS, more colleagues than most. Last night, like many others, I reflected on a heartbreaking year of loss, but while last year was tragic, what happened was not unavoidable. Implementing the first lockdown just one week earlier, as advised, could have halved the early mortality rate. Our hospitals and NHS staff weathered a storm of the Government’s making.

Let us cast our minds back to March 2020. It seems implausible now that the Prime Minister was boasting about shaking hands with every person he met on a visit to a hospital with covid-19 patients. Edwina Currie compared him with Princess Diana. Others were less favourable. It has been revealed by the BBC this week that the Prime Minister said that the best thing would be to ignore the virus and that overreaction would do more harm than good.

The NHS is facing immense challenges, and overcoming them will be fundamental to its survival. There is the pandemic, of course, and the small matter of rolling out the most ambitious vaccination programme in the nation’s history. Not only is our NHS asked to bear the brunt of the pandemic; it is forced to do it with one hand tied behind its back. In February, NHS hospitals, mental health services and community providers were reporting a shortage of nearly 84,000 staff; 38,000 of those vacancies were for nurses—the enduring backbone of our national health service. A decade of underfunding, lack of accessible training and failure to prioritise healthcare workers have hit the NHS hard, but the Minister knows that—it is a situation of Government design.

The NHS is sick. It is underfunded and understaffed. Just as a sick patient is not aided by removing their medicine, the NHS will not be healed by cutting the pay of its workers. The Government’s and their spin doctors’ praise for the NHS has been almost evangelical. We have seen the Prime Minister clapping on our TV screens. We have heard Tory Ministers refer to NHS workers as heroes and angels. We saw the hyperbolic outburst reach fever pitch when the Health Secretary cried on national breakfast television. Most of the NHS workers I know have no desire for constant praise and adoration. They do not want to be called angels. They are skilled professionals who have worked and are working through a deadly pandemic. Most would be happy for their hospitals to be properly funded, for their patients to be given the best chance of survival and, finally, for a pay packet reflecting their workload. To cry hero, and then cut pay, is as manipulative and cruel as it is unsurprising, from a party that has systematically sought to undermine the health service and its workers.

The NHS has done so much more than just jobs during the pandemic. Its staff risked their lives every single day for our most vulnerable. They held the hands of those in the their final moments whose loved ones could not. They have been a bright flame of hope in a year filled with anxiety and fear. NHS workers have given us more than we can ever give back. Their compassion, bravery and will is something we may not ever be able fully to repay. The recognition of their work can be fulfilled by a decent pay rise.

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friends the Members for Liverpool, Wavertree (Paula Barker) and for Luton South (Rachel Hopkins) for their hard work in securing the debate. I draw attention to my entry in the Register of Members’ Financial Interests.

I want to begin by paying tribute to the healthcare heroes who continue to fight on the frontline of the pandemic. In recent weeks I had the great honour of meeting local members of the Royal College of Nursing. Despite the terrible toll that the fight against the disease took on every one of them, their professionalism and commitment to their patients never faltered. While many of us eagerly await a return to normal, they will continue to grapple with the deadly after-effects of covid for years to come, as the NHS struggles to address a backlog of nearly 4 million people.

What has been their reward for their unceasing efforts and tireless self-sacrifice? It is a miserable 1% pay rise that amounts to a real-terms cut and that will barely cover regulators’ registration fees or parking charges. Over the past year, Ministers who have built careers gutting the NHS have spouted warm words for our national health service, and Tory MPs have indulged in shameless photo ops, applauding on their doorsteps, but when the time came to crunch the numbers, they refused utterly to give healthcare workers the pay rise they deserve. They should hang their heads in shame.

At the very moment when the Government should be shoring up the foundations of the NHS, they risk blowing them up entirely by driving thousands of people out of the profession with this insulting real-terms pay cut. Already, too many NHS workers are struggling to make ends meet. Some 39% of nurses have been forced to skip meals to feed their families. Those who make up the bedrock of our health service—the healthcare assistants, cleaners and porters, to name but a few—are some of the most financially precarious workers in the country, all too often surviving on poverty pay and turning to rip-off payday loans just to get by.

Meanwhile, the NHS is facing a staffing crisis that risks seriously jeopardising patient safety. There are already more than 5,000 nursing vacancies in the north-west alone, a figure that is likely to soar in just a few short years, and that is not taking into account the 30% of nurses who will be driven out of the profession by this shameful pay deal.

Our healthcare workers deserve so much better. They know it, the Opposition know it and the British public know it. What we need now is a substantial, well-earned pay rise for health workers that, at long last, recognises all they do for our country and that sets our NHS on a confident footing to face the great challenges of the difficult years ahead.

It is a pleasure to speak in this important debate with you in the Chair, Mr Hosie, and I congratulate my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) on securing it.

We are all, rightly, incredibly grateful for the work that NHS staff have done over the last year. They have consistently gone above and beyond to cope with surges of demand in hospitals, to care for people with covid and to support family members who could not visit those patients. Now, the NHS is running the largest vaccination drive we have ever seen. As a reward for this, the Government have proposed a miserly 1% pay rise. With inflation set to rise over the next year, that will mean that NHS staff who have done so much will actually receive a real-terms pay cut. That is shameful and insulting. Ministers should have recommended a real-terms pay rise for NHS staff.

The pay proposal for NHS staff manages to be both wrong and unpopular. More than two thirds of those surveyed, including nearly 60% of Conservative voters, think that a 1% pay rise is less than our NHS staff deserve—but some NHS staff are even more underpaid. Last week, I met healthcare assistants from the north-west to listen to them talk about their roles and their pay. Band 2 healthcare assistants are among the lowest paid NHS staff. In theory, they carry out personal care tasks for patients, such as feeding, bathing and dressing. However, many healthcare assistants are in fact carrying out more wide-ranging and demanding tasks, such as casting broken bones, washing and sealing wounds, and carrying out observations or cannulations—tasks that should be carried out by a band 3 healthcare assistant, who would be paid nearly £2,000 a year more.

In one NHS trust in Greater Manchester, 98% of the healthcare assistants are employed on band 2, compared with a regional average of only 55%. That is straightforwardly keeping costs down by employing staff on one band and asking them to do the work of a higher-paid band. They are being systematically underpaid for the work they do. It is not acceptable. All NHS staff deserve to be fairly paid. When the Minister sums up, can she confirm that Ministers will ensure that all trusts have the funding they need to pay healthcare assistants fairly for the work that they are doing?

Finally, I want to come back to the 1%. For a healthcare assistant I talked to last week, who earns £9.80 an hour, the 1% increase will mean 9p an hour extra. A better pay rise is needed if we want NHS staff to stay in their vital roles in the vaccine roll-out, on covid wards and in handling the big backlog of elective surgery, screening and routine services. A better pay rise is deserved by NHS staff, who went above and beyond in the pandemic, who risked their lives and those of their families, and whom we applauded week in, week out. Clapping does not pay the bills. NHS staff are worth more than the miserly 1% on offer, and the public overwhelmingly agree.

It is a real pleasure to see you in the Chair, Mr Hosie—and looking so well. I thank my hon. Friends the Members for Liverpool, Wavertree (Paula Barker), for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for securing this debate.

For the last year, as has been said, our NHS staff have been toiling night and day, working bravely and selflessly to protect us from this terrible virus. Even before this pandemic, NHS staff were working an extra 1.1 million hours of unpaid overtime—it is a disgrace. It is those same nurses, doctors, porters, ambulance drivers, paramedics and so many more who have kept our wonderful NHS going. Even when they were on the brink of being overwhelmed by the fifth highest covid death rate in the world, and despite the terrible trauma they have experienced, our doctors and nurses have held people’s hands as they died alone. They have watched the fear and borne the grief of 126,000 people and families, and counting.

Now our NHS staff are on the brink of being overwhelmed too—they are simply exhausted. They have done their jobs bravely night after night, day after day, and they are still doing their jobs, with barely a break, a full year on. My gratitude is beyond words. But we must recognise that NHS staff bear scars from the past year that will last. Almost 60% of nurses experienced a mental health problem during that first wave. In some trusts, the proportion of staff absences relating to mental ill health has doubled.

Our NHS bears the scars too. In January, more than 300,000 people waited more than a year for treatment in hospital, and that figure will have only grown. Our NHS will recover its full health and wellbeing when its staff can recover theirs. That requires action to guarantee decent pay, conditions and, basically, respect. After all our NHS has gone through, if we offer real-terms pay cuts, rather than what our NHS heroes deserve, our gratitude will prove hollow, superficial and meaningless, and it will damage our NHS further. How disgraceful is that? How much more will the health of communities suffer?

The people who have cared for us deserve so much more. This Government must understand the needs of the NHS, deliver for its staff and deliver now.

In the time-honoured words, it is a pleasure to serve under your chairmanship, Mr Hosie, and to see you in rude good health. To follow that, if I can—almost everything has been said—I heartily congratulate the hon. Member for Liverpool, Wavertree (Paula Barker) for securing this debate.

Let us take this down to brass tacks. First, one of my best friends very, very nearly died of covid, and it was NHS staff who hauled him back from the edge. He is a pal of mine and, in a personal way, I am deeply grateful. All of us will have had similar experiences.

Secondly, it is a sad, true fact that another pandemic will come one day, because that is the nature of human life and the world—these viruses mutate and will come at us again. Therefore, we want to be even better prepared next time, so we have to have our NHS staff at tip-top levels of performance—they have to be absolutely ready. There is no doubt that if people do not get the pay they think they deserve, or the public, in this case, think they deserve, that demoralises NHS staff. When they are demoralised, some people will leave the profession; they will retire early and pack it in, and that is not what we want. As others have said, the general public expect better than 1%. In the Scottish Parliament, Liberal Democrat colleagues will work in a positive way with the Scottish Government to secure a better deal—pay is of course devolved north of the border.

I have one lesson, which relates to when I came to this place nearly four years ago. I said to myself then, “What was austerity all about?” I say that because, now that we have gone into the pandemic, money seems to just appear. So my final point is that the Government can give a better pay rise than 1%—it can be done. Strategically, for the health of the nation, and for the defence of the nation against a killer virus and another pandemic, that should be put in place as soon as possible.

It is a pleasure to serve under your chairship, Mr Hosie.

I thank my good friend the hon. Member for Liverpool, Wavertree (Paula Barker) for securing this debate just days after the Government’s shameful decision to give our NHS heroes a paltry 1% pay rise. My hon. Friend has a long track record of championing workers’ rights during her time as a regional convenor for Unison North West, where she fought for better pay and conditions for all public sector workers.

I also pay tribute to Unison North West, which has done so much for tens of thousands of members across our region, many of whom are NHS staff. Its One Team2k campaign has highlighted the need for every worker in the NHS to be given a £2,000 pay rise and to bring the minimum pay to £10.23 per hour, taking the NHS pay float above the real living wage.

It should come as no surprise that during this debate we have heard repeated criticism of the Government’s decision to award NHS staff a 1% pay rise. After the most challenging year for the NHS since its inception, when staff have been stretched to breaking point to keep our country safe and deliver first-class care, despite a chronically underfunded health service, this is no way to reward them.

The Government should hang their heads in shame. To put all of this in context, a 1% pay rise amounts to just £223 million a year, or 2.23% of the £10 billion set aside for new nuclear warheads, and just 0.22% of the £37 billion for the failed Test and Trace programme. If we combine that with the £30 million that the Health Secretary squandered on covid contracts for his former neighbour, we will see that the decision not to give money to those who deserve it most is quite clearly an ideological one.

One of the many lessons the Government should take away from this pandemic is that their death by a thousand cuts approach to the NHS prior to this crisis left it exposed and struggling to cope. We are far from being out of the woods, and now should be the time for not only investing to deal with the current pandemic, but planning for the future. That means retaining existing NHS staff.

Given how they have been treated by this Government, is it any wonder that research by Unison has found that 52% of NHS workers are considering leaving their position within the next year, with one in 10 considering that option very seriously? That is a staggering statistic, and it is not simply because those staff feel overstretched after an incredibly difficult period; it is because 70% feel worse off than a year ago. That is simply unacceptable. They include staff at Stepping Hill Hospital in Stockport and Mr David McAllister, who runs the Unison health branch at the hospital. The Government’s policy right across the public sector should be fair pay for fair work.

It is also unacceptable that staff are being expected to do more for less. There are countless stories of healthcare assistants being employed at band 2 while being trained to do band 3 work. The situation is made even worse by the fact that band 2 staff earn less than £10 an hour, which in many parts of this country, particularly London, is a poverty wage. That is often stretched further still, as almost half of the people served by Unison revealed that they were the main breadwinner in their family. I hope that the Minister will listen and that the shameful 1% figure will be revised.

May I say what a pleasure it is to serve under your chairmanship, Mr Hosie? I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for raising this important debate.

I am proud to be a member of GMB and Unite, two of the trade unions in the NHS, and have had extensive consultations with constituents in the Royal College of Nursing who are rightly appalled at the 1% offer being floated.

Talk is cheap, but retaining the NHS’s status as the jewel in our national crown is not. Ten years of austerity and real-terms pay cuts for our NHS staff left our NHS on its knees when the pandemic struck. It is a credit to the incredible efforts of our NHS staff, who put their own lives on the line every single day, that we are now at a point where we can talk about what life after covid might look like.

Two nurses in Warrington gave their lives caring for others through this pandemic: Andy Collier, a nurse practitioner at Hollins Park Hospital, and Joselito Habab, a nurse at Warrington Hospital. May their memories forever be a blessing.

Beyond the ultimate sacrifice that they paid, I have spoken to dozens of NHS workers in Warrington about their own sacrifices, including an intensive therapy unit nurse who has been living in a caravan, away from her family home and children. She is terrified about bringing covid home to her family, as she sees the reality of this virus every single day at work. Other NHS workers moved into the Peace Centre to keep their families safe as they cared for the families of others. They are overworked, overwhelmed and yes, underpaid.

NHS staff are among those accessing support from Warrington food bank, and thousands are suffering the mental health effects of their experiences not only in dealing with the pandemic but in trying to make ends meet.

A real-terms NHS pay cut is not only a kick in the teeth for our NHS frontline; it is also economically illiterate. The NHS is the country’s largest employer and putting pay in the pockets of our NHS staff means more money circulating around all of our communities as we recover from this pandemic, as it will be spent in our local shops, local tradespeople, childminders and supporting local economies.

Last year’s claps will not pay this year’s bills, so the Government need to come up with a figure that not only recognises the incredible national contribution that our NHS staff have made during this pandemic, including the thousands of hours of unpaid overtime, but that begins to close the gulf between their pay and inflation over the past 10 years. Anything less is an utter betrayal.

It is a pleasure to serve under your chairship, Mr Hosie. I congratulate my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) on securing this debate and on standing up for the millions of NHS workers who have put their lives on the line during the covid crisis.

NHS workers need a pay rise not just because they have worked hard for the last year, but because they have had repeated real-terms pay cuts for the past 10 years. The pandemic has shone a light on the fact that for more than a decade, we have failed to value the work done by people in the NHS and care sectors. That has had real consequences.

We have all read the stories about empty Nightingale hospitals. Some of those hospitals were never used because we did not have the workers to staff them. It was a misunderstanding of the long-term crisis in recruitment and retention in the NHS—a crisis with no mystery, as successive pay freezes have had serious consequences on our ability to recruit to the NHS.

For example, pay rates for nurses in the UK are extremely uncompetitive internationally. As a member of the Public Accounts Committee, I have heard evidence that Australian nurses are paid double the amount paid to those in the UK and that those in the US are paid one third more. Experts have even warned of a brain drain abroad. That is disgraceful when the cost of giving our NHS workers a pay rise is so low.

Based on the Treasury’s own figures, London Economics calculated that the net cost of the RCN’s proposal of a 12.5% pay rise is only £0.82 billion. Given that £37 billion has been found to fund Test and Trace for two years, when the annual NHS wage bill has been estimated to be £34 billion, questions should rightly be asked about what can and cannot be afforded.

Instead of investing in staff, the Government’s offer of 1% is only enough to buy NHS workers an extra cup of coffee a week. That is not valuing the work they do, and it does not make up for a decade of pay stagnation. It is no wonder that there are tens of thousands of nursing and other vacancies in the NHS. Instead of investing billions into underwriting profits for private companies, Ministers should be investing in our NHS and the workers who keep it running. The pandemic has shown us what happens when we do not do that.

It is time to end pay stagnation, to back the calls from the RCN, Unison, my own union the GMB and campaigns such as “NHS workers say no to public sector pay inequality”, and to give our NHS workers the pay rise they deserve, which can be achieved with the right goals.

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friends the Members for Liverpool, Wavertree (Paula Barker), for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for securing this important debate.

I pay tribute to NHS staff across the Jarrow constituency for all they have done and continue to do in our fight against covid-19. I also pay tribute to all the South Tyneside District Hospital and Queen Elizabeth Hospital workers who have delivered vital care to many of my constituents throughout the pandemic.

NHS staff up and down the country have worked tirelessly in extremely challenging circumstances for the past 12 months, which makes the proposed 1% pay rise completely unacceptable. It is basically a slap in the face for more than a million hard-working NHS staff. I agree with the 14 health unions representing 1.3 million health workers who have called for a significant pay rise for NHS workers. It has been encouraging to see in my inbox messages of overwhelming public support for them. I am sure that colleagues have had the same experience.

As highlighted by my hon. Friend the Member for Sheffield, Hallam (Olivia Blake), a fair and decent pay rise is supported by recent independent analysis by London Economics. It found that the net cost of a pay rise is only around one fifth of the Government’s stated cost once factors such as the additional tax gained and the economic impact of extra consumer spending are taken into account.

There are currently an estimated 100,000 vacancies in the NHS. It is crucial that the NHS can recruit and retain existing staff to assist with the national recovery from the pandemic, because as we recover, the NHS faces new challenges such as the continued delivery of the vaccine roll-out, the potential for further waves of infection, the long-term increased demand on NHS services from long covid, as well as the clearance of the backlog of care that has built up over the last year. I hope the Minister will agree that a significant pay rise for NHS staff would make the NHS a more attractive career option, as well as help to retain those already working within it.

Many of us have applauded NHS staff from our doorsteps for keeping us safe throughout the pandemic. But sadly, clapping on our doorsteps does not put food on the table or pay the bills for those who have suffered 10 years of a real-terms pay cut under Conservative Governments. I hope the Minister will agree that a significant pay rise would finally reflect and respect the value we place in their work. Throughout the pandemic, the Government have wasted billions on failed track and trace and given hundreds of millions to their friends and donors in contracts for faulty PPE. If they can do that, there is no reason why a decent pay rise cannot be funded for people who put their lives on the line every day throughout this pandemic.

It is a pleasure to serve under your chairmanship, Mr Hosie. I would like to begin by congratulating my hon. Friends the Members for Liverpool, Wavertree (Paula Barker), for Birkenhead (Mick Whitley) and for Luton South (Rachel Hopkins) on securing this debate.

An extra £16 billion for the military, £37 billion for the private Test and Trace system, and billions more in dodgy contracts handed to Tory donors. But for nurses just £3.50 a week. The Prime Minister says it is all we can afford, but the fortunes handed to arms dealers, Serco bosses and the Health and Social Care Secretary’s former neighbour and pub landlord tell us something different. When inflation is factored in, the 1% “pay rise” for NHS workers is really a pay cut—from clapping for carers to cutting their pay. Even for this Government, this is shameful.

While Tory donors have been getting rich off this pandemic, it has been NHS workers getting us through it. On the frontline, nurses, doctors, cleaners, porters and all of our healthcare workers have been truly incredible, battling the virus, working overtime, enduring stress and trauma.

Nearly 1,000 health and social care staff are estimated to have died from the virus, with workers too often not provided with the protective equipment they needed. Nearly half of intensive care staff report symptoms of post-traumatic stress disorder, severe depression or anxiety. All of this comes after a decade of NHS staff being overworked and underpaid, with nursing vacancies in the midlands alone standing at 7,500 and pay down as much as 30% for some staff. Now, according to research, two in three nurses have to work overtime to pay the bills, and reports of nurses forced to rely on food banks are far from uncommon.

Tory Ministers call them heroes. They clapped for them while cameras were watching, but now they think they can get away with a cut in their pay. They pit NHS workers against other workers, saying that if one group has had their pay frozen, it is not fair for another group to have their pay raised. They say that if private sector workers are losing their jobs, others should make sacrifices, too. It is classic divide-and-rule tactics. It is an attempt to turn working people against each other, leaving all of us worse off, while their donors and wealthy mates laugh all the way to the bank.

Here is an alternative plan: instead of spending billions more on new weapons of war or giving more fortunes to private Test and Trace consultants, we could give NHS workers the pay rise they deserve—15% to make up for a decade of lost pay. Instead of letting tax dodging run riot and corporate greed dominate, we could bring in a new windfall tax to make the likes of Amazon pay their fair share and to raise the pay of all our key workers, public and private sector alike. NHS workers are always there for us. Now it is our turn to stand with them.

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for securing this important debate. As a former NHS worker and a current member of the Select Committee on Health and Social Care, it is undeniable that I feel passionately about this issue. I know that my constituents in Coventry North West share my strength of feeling towards this subject, as expressed by the hundreds of emails I have received and the thousands of rainbows still dotted in the windows of homes across Coventry.

The last year as been the toughest year in the NHS’s 72-year history. NHS workers have been pushed to the limit and stretched beyond our wildest imagination. They have worked 1 million hours of unpaid overtime and sacrificed more than should ever have been asked of them. They have done this to keep us, the public, safe. In the last year, at least 230 NHS workers have tragically paid the ultimate sacrifice and lost their lives to covid while serving others. My thoughts are with their families, their communities and the colleagues they have left behind.

After a year of intense sacrifices and unprecedented pressures, it is clear that NHS workers deserve better than the real-terms pay cut proposed. Indeed, our NHS heroes deserve a pay rise. The nation, including members of this Government, clapped on their doorsteps every Thursday to applaud the work of our NHS covid frontline workers. As has been touched on today, however, claps will not pay NHS workers’ rent or bills and cannot be exchanged for weekly food shops.

It must also be emphasised that the ramifications of this pay cut are not just confined to the household finances of our NHS workers. It will exert further pressures on our local high streets at an already precarious time for our local and regional economies. A proper pay rise for the staff of University Hospital Coventry would feed directly into the shops and businesses in my constituency. I have heard at first hand from small business owners that high streets such as Jardine Crescent, Holbrook Lane and Wolseley Avenue would warmly welcome the rise in local spending power to ameliorate the conditions of the last year.

In addition to the impact on our local high streets, I feel compelled to touch on the staff vacancies crisis that our NHS faces. It is alarming but unsurprising that the mental and physical toll of being overworked and underpaid is driving too many NHS workers out of the profession. The extent of this crisis is vast, with an estimated 100,000 staff vacancies, and it is clear that we must act quickly to retain current NHS workers and recruit many more to reduce the significant over-reliance on expensive bank and agency workers. No clearer message can be sent to current and prospective NHS workers about their value than fair remuneration.

Finally, I want to highlight the inequalities that this pay cut will exacerbate. The effect of the pay cut will be heavily skewed against women. Some 76% of workers—nearly 1 million NHS staff—affected by this Government pay cut are women. Surely this is not the message we want to send about the worth that our society places on the work of women. A pay rise will not begin to cover the personal sacrifices made by NHS workers while caring for strangers at a time of need. It is incumbent on the Government to ensure that NHS key workers are paid fairly.

It is always a pleasure to serve under your chairmanship, Mr Hosie. I, too, pay tribute to the hon. Member for Liverpool, Wavertree (Paula Barker), who secured and opened this debate so eloquently.

As we know and has been said before, this week marks the first anniversary of the beginning of lockdown. This anniversary gives us all the chance to reflect on the past year and the tragedy and hardship that we have all experienced. We have had an opportunity to remember all those who have lost their lives due to the virus and to recognise the grief of their families and friends.

This year has thrown up unprecedented challenges to us all, with people across these islands facing financial hardship, mental health struggles and tragic loss. However, it has been the NHS staff who have seen the very worst of the pandemic. I pay tribute to the hard work and sheer dedication of NHS staff across Scotland and, indeed, the rest of the UK who have worked tirelessly during the pandemic. They include the nurses at Glasgow Royal Infirmary, the doctors at the Queen Elizabeth University Hospital, the caterers at the New Victoria Hospital, the auxiliaries at Stobhill Hospital, and the cleaners at Lightburn Hospital. Every single one of them has put in a shift and deserves our thanks and recognition.

I also thank all those working in vaccination centres across Scotland, including the armed forces, who have been utterly invaluable. The vaccination numbers have been truly astonishing, with 2,214,672 first doses administered in Scotland as of yesterday. I particularly want to thank the staff working in the six vaccination centres across Glasgow, including in my own constituency at Easterhouse. After a difficult year, we can see light at the end of this tunnel. It is clear today that we are all thankful for the work of NHS staff during this crisis, but, as many Members have said, warm words alone are not enough.

I have sat here today and listened to Members from different parts of the room—I would not say all parts of the House, given that there is only one Conservative Member here—the Minister—and I remain to be convinced about how much attention she has paid to the debate. All Members have lavished praise on the NHS and its staff. The Prime Minister stood outside 10 Downing Street and clapped for the NHS, but, as has also been said, nurses and doctors cannot be paid in rounds of applause. The NHS has faced a once-in-a-lifetime event. Its staff have risked their lives facing a previously unknown disease and now the UK Government’s proposed financial recognition falls way short of what is acceptable.

We know that this UK Government have been incompetent throughout the pandemic—not delivering on vital PPE, handing out contracts to friends and Tory donors, producing a test-and-trace system that has proven ineffective, locking down too late and endangering too many people’s lives. Now, with the vaccination programme in full swing and the UK Government publishing their road map out of lockdown, it seems that they have all forgotten about the NHS staff who work every day to save lives.

We in the SNP are proud of our record on NHS pay. Staff receive the most favourable pay settlement anywhere in the UK. Moreover, Scottish nurses are the best paid in the UK. To give an example, the salary of a band 5 nurse at the top of their pay scale is currently 3.38% higher than the English equivalent, and social care staff in Scotland are already paid better than those in England and Wales, but we have not stopped there. In Scotland, the SNP Government have delivered a £500 bonus—a thank-you payment—to NHS staff after an unprecedented year treating and responding to covid-19.

The £500 payment is for Scotland’s NHS and social care workers employed during the pandemic. It includes staff who have had to shield or have since retired and includes final-year nursing students who have worked on temporary contracts during the pandemic. The Scottish Government have repeatedly called on the British Government to allow the payment to be exempt from income tax. Sadly, the ability to exempt the bonus in this way is not within the current gift or the current powers of the Scottish Government.

We in the SNP just want a simple payment of £500 to go to all NHS staff in Scotland, to reward them for their unprecedented work during the pandemic. The best and most straightforward way of doing that is by exempting the payments from income tax and national insurance. I again call on the UK Government to step up and ensure that that £500 is exempt from income tax and national insurance. The UK Government have to put their money where their mouth is and truly recognise the sacrifice of our NHS staff, not just with claps, but with cash.

It is a pleasure to see you in the Chair, Mr Hosie. I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for securing this important and heavily subscribed debate today. She gave an excellent, impassioned introduction. She summed the issue up very well when she said that NHS staff are being asked to do more for less. That really does sum up the Government’s approach to a lot of things: more for less.

I thank all other hon. Members for their contributions today. There are too many to mention individually, but I will pick out one or two during my speech. I particularly thank my hon. Friends the Members for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for co-sponsoring the debate.

Every Member spoke with great passion, sincerity and knowledge about why the Government’s approach to the NHS pay deal is flawed. It is disrespectful and ultimately self-defeating. Members who spoke showed clear support for and appreciation of the NHS workforce. Every single Member had that in common. They also have in common that they are all from Opposition parties. Not one Back-Bench Tory MP has come today to defend their party’s policy—not one. Worse still, not one has come to defend the NHS workforce. That says it all, doesn’t it?

I am sure we all agree, certainly among Opposition Members, that our amazing NHS staff have been the ones who have kept this country going during the pandemic, who have kept us safe and who have looked after our loved ones. They have been on the frontline looking after not just the 450,000-plus people who have been hospitalised with coronavirus, but everyone else who has needed medical attention, while at the same time putting their own lives on the line. Our NHS staff are feeling the strain. Do not forget that we entered the pandemic with a record 100,000 vacancies in the NHS, and with a health workforce smaller than many other countries, meaning that our NHS staff have worked longer and harder than others during the covid crisis.

For many people, the added pressure has had a profound impact on their psychological wellbeing. Almost half of NHS staff in England have reported feeling unwell from work-related stress—the highest rate recorded in the past five years—and NHS staff took 3.5 million sick days off between March and October last year due to mental health issues. The latest figures from the NHS staff survey, published this month, show that 300,000 staff have worked unpaid hours, and that almost 13,000 more staff reported working unpaid overtime compared with 2019, suggesting that over 1 million hours of unpaid overtime have been worked during this pandemic. It is little wonder that NHS staff are exhausted and that they are leaving.

My hon. Friend the Member for Liverpool, Wavertree made a strong case that pay increases can have a positive effect on retention levels, which is something that urgently needs addressing. The Minister will know all about the shocking number of healthcare staff who have left their NHS roles for better pay conditions and work-life balance in recent years, because she has seen the data—it is the Government’s own data that say this. She will be well aware that over the last year, 31,000 nurses and health visitors left the NHS—an increase of 50% since 2010-11.

I am sorry, but I will not have time to take any interventions.

The Minister will know that since 2010-11, there has been a 181% increase in nurses and health visitors resigning due to their work-life balance, and an 82% increase in the number leaving for health reasons. She will be aware that there has been a 57% increase in resignations since that time because people found a better reward package elsewhere.

Years of pay freezes, record vacancies and relentless pressure have had a devastating effect on our NHS workforce. Not surprisingly, as a last resort, hard-pressed staff are voting with their feet. That should ring alarm bells loud and clear that Ministers are not getting things right, that they need to change course and that they need to start listening to the NHS workforce. It is simply unacceptable that instead of giving our NHS staff the pay rise that they were promised, the Government are recommending that they should receive just 1% this year, an amount that the Government are fully aware is actually a real-terms pay cut. NHS staff are not being properly rewarded, as the Secretary of State said they would be. That is not what is set out in the legislation passed by this House, which the Government voted for in the NHS long-term plan.

As the Minister knows, the plan set out a 2.1% pay increase for all NHS staff. The head of NHS England, Sir Simon Stevens, has confirmed that the NHS did indeed budget for that 2.1% pay rise, so the Government have broken their promise. The Office for Budget Responsibility forecasts that inflation will rise by 1.5% this year, so instead of a pay rise that was budgeted for and indeed voted for, NHS staff will see a real-term pay cut of hundreds of pounds. Experienced nurses will see a paltry £3.50 per week extra in their pay packet, which is just 50p a day. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) told of a healthcare worker who will get 9p an hour extra.

Counting for inflation since the Conservative party took power in 2010, some NHS workers have seen their pay slashed by thousands of pounds a year. The starting salary for nurses, physiotherapists, radiographers and numerous other NHS roles has seen a real-terms pay cut of £841 per year, and average salaries have reduced in real terms by around £2,379. That is not being properly rewarded; it is not being rewarded at all. It is not good enough for those who have performed heroically over the last year to be rewarded in this way. For many, a real-terms pay cut will be the last straw. My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) made the point that we are in an international market for healthcare staff and cannot afford to be complacent in such matters.

It could not be clearer that we need investment in our workforce. Waiting lists have spiralled out of control, and we will need the staff more than ever. The Government urgently need to reconsider their approach; otherwise, the exodus that we are seeing at the moment will become a flood. Hon. Members, the public, UNISON, other unions, the NHS Confederation and other bodies are all urging the Government to reconsider their 1% pay rise proposal, so what is stopping them? It cannot be a lack of money, because, as we have heard, £37 billion can be found for Test and Trace, millions can be spent on unusable PPE, and we have had £2.6 million for the Prime Minister’s new media centre. It is a political choice, and it is a choice that cannot be defended. Indeed, as we see today, it seems that no Conservative Back Benchers want to defend it.

I am sure that the Minister is well aware of the anger the proposals have generated, but let me read out a few quotes from bodies representing the workforce so that she can see the strength of feeling. The British Medical Association said it is a

“total dereliction of the Government’s moral duty”

and a kick in the teeth. The Royal College of Nursing said:

“This is pitiful and bitterly disappointing”

and “dangerously out of touch”. Unison said it is the “worst kind of insult” and “some kind of joke.” The TUC said it is

“a hammer blow to staff morale”

and Unite described it as “unyielding contempt”. So I do not think there is any mistaking how NHS workers feel.

That mood is matched by the public, who overwhelmingly oppose the Government’s position. A poll showed that 83% of the public and 78% of Conservative voters think the Government should increase their pay offer. For a Government who routinely pit people against one another when it comes to pay, that must surely tell them they are on the wrong side of the argument. If it does not, they must surely know they should think again when the former Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), calls their offer a “miscalculation”. As understatements go, that is right up there. We do not know whether that view is widespread on the Tory Benches, because no Conservative Member is here to tell us what their view is. I am not surprised that the Prime Minister wants to avoid putting the proposals to a vote, because how could any Conservative Member look their constituents who work for the NHS in the eye if they vote for that? I do not know.

It should not have come to this. The Government really need to think again. The whole country is watching and waiting for them to do the right thing. It is not enough to say, “Wait for the pay review body” without giving a guarantee that, should the pay review body recommend a real-terms pay rise, that will be honoured by the Government. If the Minister confirms at least that today, that would be a start.

After the last year, we should not have to fight a battle to ask the Government to consider more than a 1% pay rise. It says everything about how little value those efforts over the last year have been appreciated. Our NHS staff deserve more than that. They deserve an agreed fair and sustainable pay settlement. Ministers should admit their mistakes and undertake to agree a multi-year pay deal with NHS staff. In starting talks, they should take the pay cut off the table and not set a ceiling. Time and again, the Prime Minister said that the NHS would not pay the price for the pandemic. The Chancellor promised that the NHS would get whatever it needed. It is time to put those words into action. It is time to ditch the empty promises and gestures. It is time to do the right thing.

We stayed at home to protect the NHS. We clapped for our carers during the pandemic, and we on the Opposition side meant it. As my hon. Friend the Member for Liverpool, Wavertree said, claps and smiles do not pay the bills. That is why the Opposition will not rest until our brave NHS staff get fair pay and the long-term settlement that they truly and honestly deserve.

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank the hon. Member for Liverpool, Wavertree (Paula Barker) for securing the debate on this important issue and giving me the opportunity to talk about our NHS staff. I come from a family of doctors and nurses, and before I became an MP I spent years working in hospitals and other NHS organisations, particularly to make the NHS a better place to work, because NHS staff are our health system’s greatest asset. In normal times, they go the extra mile, but in the pandemic they have done so time and again.

I welcome many of the points made by hon. Members this morning. Many have talked about the huge sacrifices that staff have made during the pandemic—not only them, but their families. Some, for instance, moved out of their family home to ensure they did not bring coronavirus home with them.

Colleagues have talked about not only nurses but other members of the healthcare workforce, including healthcare assistants, who are often overlooked in these conversations but are a vital part of our health service.

Some Members have talked about vacancies in the NHS workforce, of which I am well aware, and I will provide some reassurance on that in my remarks. Hon. Members have talked about PPE, but I do not see it as a choice between paying the NHS workforce and providing PPE—we must do both. PPE is not a choice; it is essential to protect those working in the NHS, and to me, it is non-negotiable. The shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), spoke about the need to invest in our workforce. I wholeheartedly agree with that, and the Government are doing so.

As I said, NHS staff are the NHS’s greatest asset. In fact, the NHS is, in essence, its people. The Government are determined to ensure that the NHS can retain and recruit the staff it needs. Over the last few years, the have worked with trade unions to deliver multi-year pay and contract-reform deals for more than a million of our NHS staff. Over the last three years, nurses specifically have seen their starting salaries increase by more than 12%. We have increased the lowest starting salary in the NHS by more than 60%.

We all know that our NHS staff work around the clock to provide care. That is why, on top of the basic salary, NHS staff earn premium rates of pay for working at night and over the weekend, and for agreed overtime. That increases individual pay by around £4,000 on average. On top of that, the NHS reward rightly includes benefits that go beyond the statutory minimum on holidays, sick pay and pensions.

We have also invested in our junior doctors, recognising the huge contribution that they make to the NHS. The deal that we have agreed with the British Medical Association improves junior doctors’ working lives, protecting rest requirements and reducing the number of consecutive shifts worked. By the end of that deal, junior doctor pay scales will have increased by at least 8.2%, and around one in eight junior doctors will receive more as they reach a new higher pay point to reflect their level of responsibility. For our nurses and non-medical staff, this is the final year of the multi-year “Agenda for Change” deal. We have asked the independent pay review bodies to make recommendations on the pay of our NHS staff for 2021-22.

As the Government have set out, the coronavirus pandemic has placed a huge strain on public finances, and the economic outlook remains uncertain. The Government’s written evidence to the independent pay review bodies set out that, in settling the Department of Health and Social Care and NHS budgets, the Government anticipated a headline pay award of 1% for NHS staff. That compares with the pay freeze for the wider public sector and, as we all know, with the context of many people facing unemployment and pay cuts in many parts of our economy.

The Minister is setting out the bleak fiscal picture for the Government and the tough financial choices that have to be made. Will she explain, then, why they have seen fit to invest in more nuclear warheads but not in pay for NHS staff?

The hon. Gentleman will recognise that although the Government have to make some difficult decisions, various things are non-negotiable. One of those things is ensuring that the NHS is there for all our constituents who need it, and another thing is ensuring that we have the defence that we need to protect people from threats from overseas.

Let me return to the matter in hand and set out a bit more about the process that we are going through on NHS pay. As I mentioned, the evidence that we recently submitted to the NHS pay review covered a wide range of data that was relevant to the decisions that that pay review body will make. The pay review bodies themselves are independent advisory bodies made up of industry experts. Their recommendations are based on a comprehensive assessment of evidence from a range of stakeholders, including trade unions. The wide range of factors that they will consider includes the cost of living, recruitment and retention in the NHS, affordability and value for money for the taxpayer, and comparisons with wider public and private sector earnings.

As the pay review bodies are independent, I cannot, and would not wish to, pre-empt their recommendations. We have asked the NHS pay review body, and the review body for doctors and dentists, to report later in the spring, and we will carefully consider their recommendations when we receive them.

The Minister is setting out the pay review process, but it is also the case that she voted for a 2.1% pay increase only last year. Why has that changed?

I am very glad that the hon. Gentleman has brought this point up. There have been no changes to the 2.1%. I specifically looked into that, and we are absolutely consistent—the 2.1% in the long-term plan will be invested in the workforce as planned. That 2.1% includes the funding not only for the pay agreements that we will reach through this process, but for existing pay deals and further workforce development, so we will be standing by that 2.1%.

As would be expected, I have had many conversations with NHS staff, from porters to healthcare assistants, nurses, allied healthcare professionals, junior doctors and consultants, both during the pandemic and for many years before. I have asked many times what would help; what do staff most want? Pay is rarely mentioned in those conversations—[Interruption.] The hon. Member for Warrington North (Charlotte Nichols) may laugh, but I am describing the many conversations I have had over many years with NHS staff, including during the pandemic. What is most often mentioned to me is that staff want more colleagues. They want more staff working alongside them so that they can have more time to give patients the care that they want to provide.

I will make some progress, as time is limited. Staff have told me many times that they want to feel genuinely supported and valued in their work. Someone said that one of the upsides of the pandemic is that when a colleague asks them how they are, they feel that the question is actually a meaningful one at the moment. If they say, “No, I’m not okay”, it has led to a conversation in which they have talked about what would help. I would like to see that continued in easier times.

Staff told me many times that they would like more autonomy in their jobs, and to be able to really make a difference and make improvements in the area they work in. Most recently, staff told me how much they want to be able to take time off, to have some time to spend with their families and time to recover and recuperate from the stresses and strains of the pandemic. I am determined that we shall deliver all those things for our NHS workforce.

Throughout the pandemic, I have worked with NHS England to make sure that all possible support is in place for staff. That includes practical support, like hot food and drinks and the free parking that has been much talked about; and psychological support: mental health support, “wobble rooms”—which I have spoken to staff about and they value them—dedicated support lines and helplines, and access to specialist support through new mental health and wellbeing hubs. As set out in the people plan, we are working with the whole NHS to build a more supportive, compassionate and inclusive culture. A culture in which those who care are cared for in turn.

On the first of the asks that I mentioned, that NHS staff want more colleagues, we are making real progress. In the NHS there are now over 6,500 more doctors, almost 10,600 more nurses and over 18,700 more health support workers compared with a year ago, and we are well on our way to delivering 50,000 more nurses for the NHS by the end of this Parliament.

We estimate that there are 70,000 nurses and midwives in training at the moment, and that includes 29,740 students who began nursing and midwifery courses this academic year. That is an increase of 26% from last year. Forty-eight thousand students have applied to start nursing and midwifery courses later in the year. That is an increase of over a third compared with the number of applicants at the same time last year, so I can assure hon. Members that the supply of people training and coming forward to train to work in the NHS is strong.

Vacancies in the NHS—indeed, there are vacancies, but they are decreasing—have fallen by over 11,000 since last year. There are 2,500 fewer nursing and midwifery vacancies and 1,800 fewer doctor vacancies.

NHS and social care staff do a fantastic job, and they continue to go the extra mile time and again, especially during the pandemic. We must recognise their skill and dedication and make sure the rewards of work in the NHS support the recruitment and retention of the workforce our health service needs. That is why we have the independent pay review bodies. They will properly assess all the evidence, and the Government will consider their recommendations and respond in due course.

Those of us who have spoken today may disagree about many things, but we all care deeply about our NHS and our NHS staff. I thank all the hon. Members who spoke today for showing their support.

I thank all the hon. Members who spoke today and all the hon. Members who applied to speak but were unable to do so because the debate was over-subscribed. I hope today’s debate will go some way towards demonstrating to our incredible NHS workers that they are valued by some people in this place.

I am astounded that the Minister has come here today to try to defend what is, frankly, indefensible. I extend an invitation to the Minister to meet the NHS staff that I speak to, because they will tell her that what they need and want is a pay rise.

I am horrified to hear that some things are non-negotiable, yet NHS staff do not seem to fall into that category. I assure every worker who has held the hand of someone in their last moments, who has comforted family members who were unable to be with their loved ones at the end or who is currently vaccinating people to ensure that the spread of this virus comes to an end, that I, and my colleagues on the Opposition Benches, will continue to fight for the pay rise they deserve, and the dignity that they should be afforded, because that is what we believe is non-negotiable.

The Minister’s Government has the power to do the right thing. They do not have to wait for the pay review body to tell them what the majority of people in this country already know. If there are billions of pounds for Serco’s failed Test and Trace and for failed PPE contracts, there is money to reward those who have personally given so much during the pandemic. Our NHS staff must be awarded a decent pay rise because nothing less will do.

Question put and agreed to.


That this House has considered NHS pay.

Sitting suspended.

Luton Airport Expansion

I remind hon. Members that there have been a few changes to normal practice in order to support the new hybrid arrangements. I remind Members participating virtually that they are visible at all times, both to anyone else on the call and us in the Boothroyd Room. Members attending physically should clean their spaces before they use them and as they leave the room. I remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall, except when speaking.

I beg to move,

That this House has considered the planned expansion of Luton Airport.

It is a real privilege to serve under your chairmanship, Mr Hosie. I am pleased to have secured this debate and to welcome the hon. Members for Hitchin and Harpenden (Bim Afolami) and for North East Bedfordshire (Richard Fuller), who are keen to speak. I will keep my remarks to around 10 minutes, so that others can contribute.

Let me start with the history and background. Luton airport is poorly sited on top of a hill, with no direct access by mainline trains. Although the M1 is close by, there are very poor east-west transport links. The passenger transport modality still favours cars and taxis.

My constituency of St Albans lies some distance to the south of Luton airport. Until the latter part of the last decade, the existence of the airport was of little consequence to the residents of St Albans. However, two main changes have taken place in that time, causing significant disruption to residents of the city and the surrounding towns and villages. First, in the 10 years to 2019, passenger numbers have doubled from little more than 9 million to a record 19 million in 2019. That has resulted in a 50% increase in aircraft movements over the same period. Secondly, the ever-increasing number of flights arriving and departing the airport are being concentrated in a very narrow corridor between St Albans and Harpenden. The area navigation, or RNAV, system, introduced in 2015, has exacerbated the misery of my constituents by directing planes to fly over the same homes and communities over and over again.

Let me start with aircraft noise. It will come as no surprise that the most pressing concern of my constituents is the noise from those flights. For many, the noise disrupts their peace and quiet and their sleep and rest, and is a major distraction from work and recreation. There is also increasing evidence that this noise can have a profound effect on physical and mental health. A study carried out by Queen Mary University of London for the Airports Commission in 2015 identified increased incidences of heart disease, stroke, obesity and diabetes in the areas studied, as well as negative effects on psychological health and overall wellbeing. More research is needed, but I raise that study to shine a spotlight on how seriously we must take all the legitimate complaints of local residents.

The next issue is expansion and consultation. Luton set out a very aggressive growth plan a decade ago. It was egged on by the Department for Transport’s aviation policy framework of 2013, which encouraged airports such as Luton to make best use of their existing capacity. That led to a free-for-all for regional airports, squeezing in as much traffic as possible into often inappropriate locations. Luton airport and its owners, Luton Borough Council, appear during that period to have ignored the expectation in the framework that

“growth in aviation should ensure that benefits are shared between the aviation industry and local communities.”

When the last major expansion application was approved in 2012, it was to double passenger capacity from 9 million to 18 million. At that time, the growth was envisaged to be over a period of 15 years to 2028 but, pre-pandemic, that capacity had already been maxed out. The approval went hand in hand with noise control limits, to be achieved by the modernisation of the operating fleet over that period. Community campaigning groups such as St Albans Quieter Skies and the Luton and District Association for the Control of Aircraft Noise were both given assurances by the operators that expansion plans were to be mitigated by that revolutionary technology. They understood that as the skies got busier they would also become quieter.

In fact, those groups tell me that the opposite has happened. The uncontrolled growth of operations means that the 2028 limits were not only reached but exceeded in 2019. The huge spike in passenger numbers has meant greater numbers of aircraft, and even larger, noisier ones. That has resulted in the noise control limit being breached with increasing severity in 2017, 2018 and a record-busting 2019, the same year in which the number of permitted passengers was also breached. Trust from community groups and residents has therefore completely broken down. They describe how they have been fobbed off with talk of the introduction of quieter planes, and asked to ignore real-world data showing that they are at best only marginally quieter than the ones they replaced. What measures will the Minister take to compel Luton to keep its promises on real, meaningful noise mitigation? What can he do to speed up the much needed improvements to already congested airspace, to reduce the noise impact on Hertfordshire residents?

I will turn now to the question of the climate emergency, and emissions. The newer aircraft were supposed to be quieter, but there was also a requirement that they would be less polluting. Any further expansion to the airport must take into account the devastating impact of increased air traffic on climate change and the grave health consequences of further air pollution for neighbouring districts. Once again, community groups such as LADACAN and STAQS have pressed Luton airport on what progress is being made on reducing emissions from its operations; once again they are being given the runaround. The operators are keen to espouse the improvements that they are making to airport operations, but the airport buildings account for only 3% of emissions. The overwhelming majority of carbon emissions are from the aircraft themselves, and the surface transport to get to the planes—cars dropping off and picking up passengers. The airport tells me that those 97% of emissions are out of its control. What can the Minister do to reconcile the further expansion of operations at Luton with the recommendations of the Climate Change Committee that

“demand cannot continue to grow unfettered”?

Will he commit to making sure that there is no further growth in capacity at all until the promised noise reductions are delivered and aircraft have switched to sustainable aviation fuel?

Finally, I want to touch on a real or perceived conflict of interest. We have been told that the rapid growth to 2019 was unprecedented and unexpected. We are apparently expected to ignore the incentivisation deal by Luton Borough Council, the owner of the airport, which encouraged airport operators and their airlines to deliver consistent year-on-year growth. All the while, I and my constituents look on as Luton Borough Council spends tens of millions of pounds preparing an application for a development control order to more than double capacity—again—to 32 million passengers per annum. At the heart of those plans is a complicated arrangement whereby Luton Borough Council owns the airport but the airport supposedly has an arm’s length company running it, and contracts an apparently independent operator. Somehow we are expected to believe that the owner of the airport, Luton Borough Council, has no input into the strategy of continued expansion.

The reality, as I have demonstrated, is that the authority is more than happy to incentivise growth at its airport. That is where the whole arrangement becomes most troubling. The authority charged with making impartial judgments on planning and enforcement matters at the airport stands to lose the most from rejecting applications for expansion, and from enforcement. There is understandable concern that although noise control limits were breached over the three years to 2019 no apparent enforcement action has been taken by the planning authority to remedy the situation in the same period. Instead, we see the submission of a further planning application to regularise the breaches to make the problem go away.

I do not accuse the local authority of any legal or procedural impropriety, but it is very difficult for a casual observer to be persuaded that there is no predisposition for Luton Borough Council to be in favour of expansion. It is well documented that the airport is an enterprise that keeps the council solvent; in fact, there have been accusations that it is too reliant on it as an income stream.

When the expansion of the airport was last debated in this place just over three years ago, it was in the context of the medium to long-term proposal to increase the passenger limit at Luton to 32 million. I was encouraged by the Minister who responded to that debate, the hon. Member for Blackpool North and Cleveleys (Paul Maynard), who said that the Government would take the decision about expansion out of the hands of the local authority as a nationally significant infrastructure application.

Today, I take the opportunity to ask the Minister if he will ensure that the decision on the current planning application, which would increase the passenger limit to 90 million, is called in by the Secretary of State. That is absolutely critical to restore the trust of our local communities; a first step on that journey would be to make sure that the decision is not only impartial but seen to be impartial.

In conclusion, I accept that this debate takes place in the shadow of the pandemic. Luton, like other airports, has seen an extraordinary reduction in the demand for flights as we have faced rolling lockdowns and indeterminate travel restrictions. However, the airport tells me that it wants to ramp back up as soon as it can. That is all the more reason to put the brakes on these irresponsible expansion plans.

The airport operators have voiced concern that there will be an oversupply of capacity at many airports for some time as we recover from covid. I would like to ask the Minister whether the situation presents a unique opportunity to re-evaluate Luton’s suitability as a high-capacity air hub in light of the airspace constraints, its poor location and its highly irregular ownership structure.

Thank you very much indeed for calling me, Mr Hosie, and it is a pleasure to serve under your chairmanship.

I also thank the hon. Member for St Albans (Daisy Cooper), first for permitting me to speak in this debate, but more importantly for her consistent campaigning against the further expansion of Luton airport. She is right to call out Luton airport for its excessive and rapid growth and consistent breaches of noise limitations, and because expansion is inconsistent with our environmental goals and our pathway to net zero. Minister, the current application for further expansion of Luton airport is an egregious example of a disregard of the principles of net zero, and that alone is sufficient reason for the Government to oppose it.

The other issue that she rightly mentioned is the conflict of interest between Luton Borough Council—Luton’s unitary council—and the airport expansion. As the Minister knows, it is a great concern for local residents in Bedfordshire and Hertfordshire that somehow Luton’s local authority has a major conflict of interest and it is right and responsible for the Minister to act. In fact, the Minister has an opportunity to act. He has an opportunity to stop the consultation on air flight pathways between Luton and Stansted. That would give him further time to consider what should happen. As the hon. Member for St Albans said, he can call in this expansion plan and provide confidence to residents in Bedfordshire that due diligence and a proper appraisal of it will be undertaken.

Thank you for calling me to speak, Mr Hosie; it is a pleasure to serve under your chairmanship. I welcome the opportunity to contribute to the debate and I thank the hon. Member for St Albans (Daisy Cooper) for giving me that opportunity.

Quite simply, there should not be any further expansion of Luton airport—no ifs, no buts. It is in the wrong place to have a larger airport. As has been outlined by both the hon. Member for St Albans and my hon. Friend the Member for North East Bedfordshire (Richard Fuller), the airport has consistently shown disregard for local residents and their views. In particular, there is a conflict between Luton Borough Council’s largely financial interests and its need for Luton airport to grow and grow for financial reasons, and the interests of local residents in my constituency, and indeed those in many other surrounding constituencies in Hertfordshire and Bedfordshire.

This process should not go on any longer. I urge the Minister to outline how we can stop any further expansion. In addition, I would welcome an update on the flight path reorganisation work being done over the coming years, not just from Stansted but from all the different airports in the south-east, because that will significantly impact the lives of my residents.

It is a great honour to serve under your chairmanship, Mr Hosie. I congratulate the hon. Member for St Albans (Daisy Cooper) on securing this important debate on Luton airport expansion. I recognise the importance of this matter to her constituents, and to those of my hon. Friends the Members for Hitchin and Harpenden (Bim Afolami) and for North East Bedfordshire (Richard Fuller). I know it matters a great deal to them and I welcome the chance to respond on behalf of the Government.

For context, the UK enjoys one of the best connected, best value and safest aviation industry of anywhere in the world, and that strong industry is vital as we build a truly global Britain and level up the country. It is important to recognise at the outset the great social and economic benefits that the growth of the aviation sector has brought. Airports serve local communities, support thousands of jobs, and connect places and people across our Union and the world. Before the pandemic, the sector contributed at least £22 billion to GDP each year and supported approximately half a million jobs in the UK.

Turning specifically to Luton airport itself, the Government welcomes the ambition of airports to provide better facilities and choice for passengers, and there has been significant investment in the terminal, airside and surface. I look forward to the opening of the Luton DART, or direct air-rail transit, in 2022. That £225 million infrastructure will support more sustainable travel to the airport. Pre-covid, Luton airport provided impressive connectivity with 128 routes serving destinations across Europe, the middle east and north Africa, illustrating the importance of global travel and spreading global understanding. Luton airport is a key employer in the local area, supporting around 30,000 jobs in 2019, and contributing £1.5 billion to the UK economy and £500 million to the local economy surrounding the airport.

The Government are supportive of airports making the best use of their existing facilities. However, we recognise that the operation and development of airports can have negative, as well as positive, impacts for local communities. In particular, I have listened to the comments made by my hon. Friends the Members for Hitchin and Harpenden and for North East Bedfordshire. They made excellent points in their speeches and I will continue to consider them in the weeks and months ahead. I look forward to working with them.

The Government’s position is that proposals for development should be judged by the relevant planning authority, taking careful account of all relevant considerations, particularly economic and environmental impacts, and proposed mitigations. Specifically on noise, the Government’s aim is that any management strategies and necessary mitigation are developed and decided on locally, wherever possible. The Government’s involvement should be where there are strategic decisions to be made, such as the national night flight policy currently being consulted on.

I am aware that Luton’s proposed application for a development consent order would involve construction of a new second terminal to the north of the runway. Local people have had the opportunity to consider and comment on that proposal, as part of the statutory consultation undertaken by Luton. That consultation ran between October and December 2019 and asked for feedback on all aspects of the proposal, including the layout, surface access, environmental mitigation, land assembly and compensation. I welcome the ambition and the proposed further investment from Luton, but, as the final decision on Luton’s proposed development consent order rests with the Secretary of State for Transport, I hope hon. Members will understand that it is not appropriate for me to comment any further at this stage.

Turning to airspace, I am aware of the proposed new Luton airborne holding stack and the arrival arrangements. I am also aware of the concerns about increased overflight and noise in those communities that may be affected. That has been mentioned by all hon. Members today. I am conscious that some of that arises out of the earlier performance-based navigation changes, which is the corridor to which the hon. Member for St Albans refers.

The Civil Aviation Authority is the consenting authority for airspace changes. It is important to distinguish between the planning process with regards to land, and the airspace changes that are linked, of course, but are separate from the planning process. None the less, local authorities have the opportunity to consider and comment on proposed changes that could affect them. The Air Navigation Guidance 2017, which was itself subject to a major public consultation in early 2017, is embedded in the Civil Aviation Authority’s CAP1616 process. It is relatively new and is just beginning to take effect, but it requires airspace change sponsors to undertake air pollution and noise impact assessments of their proposals. It requires airspace sponsors to actively engage and consult with key stakeholders, including communities, on their proposals.

When determining those proposals, the CAA will consider the environmental benefits, the operational requirements and the impact on communities. The CAA will also consider how the sponsors have reacted to the consultation feedback that they have received. We will expect a proposal to be submitted to the CAA over the summer. I hope hon. Members will understand that, given the potential for Ministers to call in the airspace change proposal, I am unable to make any further comments on Luton’s specific proposal.

I turn to climate change, which has quite rightly been raised by all hon. Members who spoke today. The Government of course recognise that the fight against climate change is the greatest and most pressing of the challenges facing our modern world. All hon. Members will know that the UK was the first major economy to pass laws to end our contribution to climate change by 2050. We will be setting out ambitious plans in the run-up to COP26 this year. The jets that we see today are approximately twice as efficient and half as polluting, not to mention much quieter, than the ones that looked similar but were flying 20 years ago. However, we know that more can be done. The Government’s starting point is that emissions, not aviation—emissions, not flights—are the problem.

We are taking decisive action in establishing, for example, the Jet Zero Council. The council, whose plenary met again last week, is a partnership between industry and the Government, with the aim of delivering zero emission transatlantic flights within a generation. It is focused on developing UK capabilities to deliver both net zero and zero emission commercial flight. That includes considering how to develop and industrialise clean aviation and aerospace technologies, establishing UK production facilities for sustainable aviation fuels and developing a co-ordinated approach to the policy and regulatory framework that is needed to deliver net zero by 2050.

We are the first major economy in the world to pass laws to end our contribution to global warming by 2050. We have recently launched the green fuels, green skies competition, which is a £15 million funding programme to support the development of first-of-its-kind production plants, with the aim of producing sustainable aviation fuel plants at scale in the UK. That builds on the success of the earlier future fuels for flight and freight competition. In addition, £3 million will be used to establish a sustainable aviation fuel clearing house, alongside the commitment to consult on a SAF blending mandate later this year.

I am keen to stress that the Government recognise that we cannot act in isolation. Aviation emissions are an inherently global issue. For a country where more than 90% of those emissions originate from international flights, co-ordinated global action is especially important if we are effectively to tackle the sector’s climate impact. The UK continues to take a leading role in the work of ICAO, the International Civil Aviation Organisation, to reduce emissions from international aviation. We are determined to see ICAO’s carbon offsetting and reduction scheme for international aviation succeed. The UK volunteered to take part in that scheme from the start. We continue to advocate for increased environmental integrity within CORSIA.

Although airports are a key part of our commitment to global connectivity, we are also a Government who are committed to a greener future. We take our commitments on the environment, clean air and reducing carbon emissions very seriously, and the expansion of any airport must always meet our climate change obligations. In the coming months, the Department will be consulting on a net zero aviation strategy that will set out the steps we will take to achieve net zero ambitions by 2050, and I warmly welcome contributions from all hon. Members present and their constituents as part of that consultation.

In conclusion, the Government are committed to a world-leading aviation sector. We are also committed to ensuring the sector can grow in a sustainable way, and I look forward to discussing that further in the weeks and months ahead.

Sitting suspended.

STEM Subjects: Science and Discovery Centres

[Mrs Maria Miller in the Chair]

I remind hon. Members that there have been some changes to normal practices to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate, and there will be suspensions between each debate.

I remind Members participating physically and virtually that they must arrive for the start of the debates in Westminster Hall. Members are expected to remain for the entire debate. I must also remind Members participating virtually that they are visible at all times, both to each other and to us in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerk’s email address.

Members attending physically should clean their spaces before they use them and, please, when they leave the room. I remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall, except of course when people are participating in the debate. Members attending physically who are in the latter stages of the call list may use the seats at the back—I do not think that will be a problem for us in this debate.

I will not need to set a formal time limit for this debate, but I encourage Members to be aware of the call list and the time. I will call Front-Bench speakers from about 3.28 pm. With that, let us move on to the main debate.

I beg to move,

That this House has considered the Science and Discovery Centres’ support for education in science and careers in STEM subjects.

It is a pleasure to speak with you in the Chair, Mrs Miller, and to have the opportunity to discuss this vital subject.

The debate is timely, as we talked this week about the road map to recovery and our ambitious plans to consolidate the UK’s position as a world leader of science and innovation. I start by thanking the Association for Science and Discovery Centres for its work and support, in particular Dr Penny Fidler, Chas Bishop, Linda Conlon and Professor Alice Roberts for their work and for their discussions with me, and every staff member, volunteer and everyone who teaches and inspires science. I will talk about science’s role in our society before moving on to the role of science and discovery centres and support for our education, workforce and careers in STEM subjects—science, technology, engineering and maths.

Science brings hope and progress towards a better future. Throughout the pandemic, we have seen that the solutions and the way out have been driven by science. Now, we talk about new vaccines and new treatments, built on the back of thousands of hours of research and development and an immense scientific and engineering workforce. Throughout history, the UK has been central to many scientific innovations and discoveries, from Jenner’s work on the smallpox vaccine to Watson, Crick and Rosalind Franklin’s discovery of DNA—the seed that grew to offer hope today in our world-leading genomic sequencing programme surveying new covid variants.

Science also offers hope for the future when we look at the broader challenges that we face. For climate change, we look to science to clean up our pollution and to provide sustainability. For novel threats, we look to science to respond and defend us. For economic pressures and dropping productivity, we look to science to innovate. Even for how we talk in this debate, with Members appearing on Zoom, we look to science to keep us connected.

Scientific method is founded on the principle that one can never prove, only disprove, which means that we always strive for better understanding, ever challenging and changing, and ever improving. Science is a deeply human endeavour that dares, with uncompromising audacity, to hope that nothing is beyond the reach of mankind’s understanding, that knowledge can be gained and the world and the universe understood with the tools of hard work, discipline and careful observation. Each discovery builds on the work of others, all part of this great human endeavour—striving, yearning, learning and progress.

We depend on science for our future prosperity, for our health and wellbeing, and for our very survival. We need a future workforce ready to build on the work that we do today, to make new discoveries, build the machines and buildings, and offer new hope for generations to come. We must invest in science and ensure that it sits centre stage in our national plans, beginning with education and reaching right through our social, cultural and economic policies.

The Government have rightly made science, innovation, research and development the backbone of their plans for economic recovery and sustainability, to turn us into a science superpower—or, I would argue, to return us to being a science superpower. We must celebrate science and we must teach it to our children, but most of all we need to build and consolidate our scientific workforce for the future.

We know that women and people from disadvantaged backgrounds are under-represented in science, technology, engineering and maths—the so-called STEM subjects. Stereotypes and social barriers can mean that many young people are not exposed to science, or consider it alien. Science, maths and engineering can be portrayed as “unfeminine”; sadly, Hansard cannot record me tutting in disgust at the nonsense of that statement, but there we are.

This is where science and discovery centres come in, playing a vital role in breaking down these barriers. Science and discovery centres—community hubs of science engagement—showcase the wonder of science. They take a lead role in our nation’s engagement with science. They are places where people of all ages can learn and discover for themselves what science is, and they also support schools in bringing the science curriculum to life.

Science can often be seen as dry and intellectual, and —dare I say it—geeky, but at its core is the experimentation with and observation of the world and its natural phenomena. Science and discovery centres reintroduce this link and its wonder in a way that is interesting and exciting, but above all accessible. As with all engagement activities, it is the staff and volunteers who are the beating heart of the institutions, transferring their wonder at science on to the next generation. That can come through launching a water rocket, touching a lunar lander or building an earthquake-resistant tower or through something as simple as watching leafcutter ants demolish a plant.

Science and discovery centres allow us all to discover science and nature. Pre-pandemic, over the course of a year they showed almost 10 million school-age children the wonder of science. They inspired disadvantaged and under-represented groups into education, and set the path to careers in STEM subjects.

Of course, science engagement is not limited to science and discovery centres. In my constituency, Royal Holloway, University of London, and Brooklands College do great science and engineering engagement activities respectively, and today I want to celebrate all centres of learning and science engagement. In particular, I call on the Government to support all these centres as we open up again, and as part of our plan for the recovery of education after covid.

The covid pandemic has hit everyone hard, and science and discovery centres, like many other charities, have had to close their doors. Many of their staff have been made redundant. Some centres have shifted their offering online, but it is just not the same as being in the centre and seeing science in action, up close and personal.

We have heard a lot about the impact that the covid pandemic has had on children’s education, and rightly the Department for Education has focused on how we can ensure that our children do not become the covid generation. We have worked very hard over the years to support and broaden access to careers in STEM to disadvantaged groups. The Minister for School Standards has rightly worked hard to increase uptake in STEM subjects at A-level for women. Science and discovery centres are a key part of our educational offering, enriching the school experience and inspiring people to consider the opportunities of a career in science.

I have spoken many times about the pandemic being a pandemic of inequality, as it has accentuated existing health inequalities; those who were already worse off in our society are being hit the hardest and sadly, that is also the case in education. I regularly hear from teachers in my constituency their worries about the differential impact on children, and that those who are already disadvantaged will have the inequalities they experience entrenched.

That situation also affects the enrichment offered by science and discovery centres. With school trips called off and centres closed, teachers have to make careful financial decisions, given the costs of education during the pandemic. Of course those pressures will be highest in deprived areas, where the need for educational enrichment is greatest and where visiting a science and discovery centre could be the spark of wonder that leads someone on to a different path towards a career in science, technology, engineering and maths.

Science and discovery centres have benefited from the main headline financial support schemes, such as furlough, but many of them have missed out on sector-specific support as a result of not being seen as cultural institutions. Consequently, they are really struggling. They need to open their doors again to all of us, but in particular to schoolchildren.

I ask the Minister, who I know is passionate about ensuring equality of opportunity for all and the role of education in achieving that aim, to ensure that in a world of competing pressures the vital work that science and discovery centres do is supported within our plans for the recovery of education.

This debate is very personal to me. As a young boy growing up, I was inspired by the wonder of science by my parents. This was nurtured and reinforced by the trips I took to science museums and nature reserves, many of which would now be seen as science and discovery centres. I try to pass on the wonder of science to my own children, be it through watching tadpoles turn into frogs or seeing dinosaurs and space rockets at the science and discovery centres.

The debate today is a celebration of the amazing work of our science and discovery centres, and all those who inspire a love of science across our communities. It is also a plea to ensure that the current generation of school children do not miss out on these amazing opportunities to discover and explore the possibilities that science offers, to pursue careers in STEM subjects and to be the ones to lead future innovation and provide hope and inspiration for future generations. Every child needs the opportunity to discover science. We cannot let the pandemic extinguish science’s spark of wonder for our next generation.

I congratulate the hon. Member for Runnymede and Weybridge (Dr Spencer) on securing this important debate.

The Catalyst Science Discovery Centre in my constituency is a unique hybrid, combining a museum and a science centre. It plays an important role in promoting STEM—the fields of science, technology, engineering and maths—and learning to young people. I will concentrate mainly on that in my speech today, but we also have the brilliant Sci-Tech Daresbury in the borough of Halton as well.

Catalyst is on the cusp of dramatic changes that will transform lives and create a new and exciting visitor attraction for the north-west of England and beyond. It will have a Liverpool city region-wide impact, and draw in visitors from across the country and internationally. I am pleased that the city region Mayor, Steve Rotheram, is a huge supporter of Catalyst.

It all began in 1982 with an exhibition in the old town hall in Widnes to celebrate 100 years of the Society of Chemical Industry. The museum finally opened in the old Gossages building in the West Bank area of Widnes in 1989 as the Museum of the Chemical Industry. The Catalyst building stands tall on the banks of the River Mersey, looking towards Runcorn and close to our three magnificent bridges—the silver jubilee bridge, the new and huge Mersey gateway and the historic railway bridge. A stunning glass observatory was added to the top of the Catalyst building, giving spectacular views across the Mersey. It has a unique collection and has won many awards over the years.

The Mersey is about much more than just Liverpool. The heritage of the towns of Runcorn and Widnes, and their chemical industry, is tied to that great river, just as much as the city of Liverpool. There is a strong case that in Widnes and Runcorn we saw the birth of the chemical industry in the UK, an industry that since the 19th century was responsible for many innovations, inventions and products that improve all our lives.

ICI became the largest Halton chemical company, but it has now gone. Today, the largest chemical company is INEOS, whose operations at the Runcorn site are of strategic national importance to the UK and which is also a strong supporter of Catalyst. For a long time the chemical industry provided thousands of jobs, many taken up by immigrant workers, mainly from Ireland and eastern Europe, as well as workers from other parts of the UK moving to Halton. In fact, my own family’s heritage has huge connections to Ireland and many of my relatives worked for ICI, including my dad who was a process worker. The industry also brought its problems, with dangerous working conditions and pollution. Catalyst does not shy from that part of our heritage.

The chair of the friends of Catalyst, my constituent Professor David Hornby from the department of molecular biology and biotechnology at the University of Sheffield, wrote to me and said:

“The Catalyst SD&HC is a unique repository of historic documents and artefacts relating to the Industrial Revolution in the UK. The contribution of the Chemical Industry sector to the UK’s dominant global economic position over the period up to and including WWII is remarkable in itself.

In addition, following Fleming’s discovery of antibiotics and Florey and Chain’s translation of penicillin for the treatment of bacterial infections, the Chemical Industry paved the way for the Pharmaceutical sector, which remains one of the UK’s most lucrative sectors. Without which, the battle to overcome the current pandemic would have left the UK (and the world) much more exposed.”

So, no Brunner Mond, no ICI; no ICI, no AstraZeneca. He went on to say:

“The parallels between the last 50 years in Silicon Valley, California and the first 50 years of Halton’s chemical industry are compelling.

Both have arisen from the coalescence of a small group of highly educated and cultured pioneering individuals around a set of favourable geographical and logistical factors together with the rapid deployment of a largely migrant workforce.”

The conversion of Catalyst’s paper archive into a digital one is critical to secure the amazing legacy of the place for the future. I pay tribute to the museum’s trustees and friends group and the staff who have worked tirelessly over the years to keep it going through many financially challenging times. I pay special tribute to Chris Lewis, who recently stepped down but was the longstanding and highly effective chair of the friends of Catalyst.

On what Catalyst can do to promote STEM, I could not do better than quote Dr Diana Leitch MBE, chair of the trustees of Catalyst and one of its most longstanding supporters. She says:

“We at Catalyst strive to inspire younger generations to become scientists and engineers and believe in themselves and their futures through improving their education and their well-being.

By a combination of heritage and vision of the future, we can achieve much and put the Catalyst as a ‘Visitor Experience’ at the heart of Halton and NW England’s great developments.”

It is important that funding is secured for Catalyst’s future. Last year, the Government awarded it a grant of £162,000 as part of the £1.57 billion culture recovery fund, and the National Lottery Heritage Fund awarded it £8,600. However, it continues to face a real financial challenge. Martin Pearson, its chief executive, told me:

“We play an active role in supporting all the STEM subjects that schools do not have the ability to teach any more and work closely with industry partners to stimulate young people into work in our area.

However, being an independent Science Centre and Museum means we are totally reliant on visitor income and local company sponsorship. Our own estimates show that the income stream for 2021/22 will be 50% of that in the 2019 pre-Covid year. We are not out of the woods yet. We employ 18 staff and have a small but dedicated group of volunteers.”

Catalyst is a brilliant interactive museum and science centre. It is vital to our heritage and to encouraging future generations of our young people to take up careers in science, research and engineering, and we need to support it. I leave the final words to Professor David Hornby, who wrote to me and said:

“It seems to me to be vital not only to acknowledge the importance of Halton to this country’s manufacturing past but to support the Catalyst in stimulating a younger generation to become creative scientists who will be vital to this country’s future success.”

I will be brief. If hon. Members can hear any background noise, it is because I have a 16-month-old baby in a high chair next to me watching “Paw Patrol”. I am hoping she will be okay. I want to make some comments both as a former Science Minister who recognises the importance of science and discovery centres and as chair of the all-party parliamentary group on museums. We have seen the impact of the culture recovery fund and what that has meant for keeping museums afloat over the past year. Science and discovery centres have been unable to access the culture recovery fund. I wrote to the Minister about that, but it was not possible to achieve change.

I want to talk about We The Curious, the science and discovery centre in Bristol. I remember it as the Exploratory from when I was growing up, and I have vivid memories of the wonderful experience I had visiting it several times. I would be taking my children to We The Curious if it were open now. Before covid, it had 300,000 visitors a year, of which 70,000 were school visits, so Bristol schoolchildren had huge opportunities to visit this centre right in Bristol city centre. However, it has lost £2.7 million of revenue since the pandemic began. It has had to restructure, making 46% of its education team redundant. The restructuring of staff has led to £1.1 million-worth of savings, but it is in dire straits.

We need to recognise that there were 60 science and discovery centres in the national network across the country. There have been several closures as a result of covid, but they had 25 million visitors a year, 11 million of whom were schoolchildren. Of those 11 million visits, 20% were organised through the STEM curriculum directly delivering lesson plans in science, physics and chemistry. We have seen an enormous loss over the past year, and we have to make sure that this loss is not compounded by the closure of centres, which means that children in local areas will miss out on the potential for science and discovery centres to enrich their curriculum and inspire the next generation of scientists.

Some will be unable to access the cultural recovery fund. I say to the Minister that this is the year of COP26 and this is the generation that is going to actually deliver on net zero. I have young children—a five-year-old and a six-year-old—and they have talked about the coronavirus and are acutely aware of science on the back of the pandemic. We have an opportunity to train the next generation of scientists. Science and discovery centres must play a key role in that, but they cannot do so when they are on their knees. The Government need to support these centres. Perhaps this year alone we could set them a specific mission with regards to COP26. It would help plug a funding shortfall if we were able to task the centres with local missions to engage young people on the back of an educational recovery plan that is needed for schools.

Whether it is the Department for Education, the Department for Digital, Culture, Media and Sport or the Department for Business, Energy and Industrial Strategy, I urge the Government to look at the opportunities that COP26 provides for sustainability. Ultimately, science and discovery centres are well placed to teach the lessons and the science of sustainability, and to train up a future generation of new scientists and responsible citizens who will take the future of the planet incredibly seriously. Science and discovery centres can help them achieve that.

It is a pleasure, as always, to serve under you in the Chair, Mrs Miller. I thank the hon. Member for Runnymede and Weybridge (Dr Spencer) for securing this incredibly important and timely debate, and for his passionate opening contribution.

I will focus my remarks on the Eureka! national children’s museum, which I am incredibly proud to say is located in my Halifax constituency. I am an ambassador for Eureka! and in my maiden speech I spoke about my memories of its opening back in 1992. I was six years old, so hon. Members can imagine my excitement at the time. It is a real privilege to advocate for Eureka! as an adult, with no less enthusiasm than I had for it as a child.

As I am sure hon. Members will agree, science and discovery centres play a crucial role in inspiring the next generation of scientists and researchers, as well as in broadening access to STEM subjects by making them more accessible. That is absolutely essential for people from disadvantaged backgrounds and more marginalised communities. If it was not already obvious, the past year has shown just how crucial it is to nurture the next generation of scientists and big thinkers. Without them, the covid vaccine would simply not have been possible.

Eureka! is the only fully interactive museum for nought to 11-year-olds anywhere in Britain. Prior to lockdown, Eureka! attracted 315,000 visitors every year, with my two-year-old and me regularly among them. Significantly, however, 19% of those visitors were from areas with high levels of deprivation. Having recently met Leigh-Anne Stradeski, the chief exec of Eureka! it is clear to me that although every attempt has been made to be diligent and to build up reserves and financial resilience for the future, the museum will be in trouble in the next few weeks. It has been unable to access support during the pandemic and has received no Government recognition of the role it plays and the important work it does.

Up until now, the museum has spent more than £1 million of its available reserves. It has reduced the workforce by more than a third, through a redundancy programme, and it has been forced permanently to close the Eureka! nursery and, significantly for the current debate, the education department. Based on the current plans to reopen on 21 May, and assuming it will be able to remain open thereafter, it forecasts visitor numbers of 127,000 through to the year end and a drop in reserves to just above the amount required by the board to support the costs of winding up, should that become necessary. If for any reason the museum is unable to open as planned, that will inevitably result in a further deterioration of the financial outlook, so we can see what an anxious time it is for all involved at Eureka!

It was able to take advantage of some of the local government covid grants, the furlough scheme and reduced VAT rates for hospitality businesses but, like all other science museums, it has remained ineligible for any significant support. It has, however, applied for a grant of £112,00 via the most recent round of DCMS funding through the Heritage Lottery Fund, on the basis that we have heritage assets on the site with a significant cultural and economic impact on our region, so I very much hope that the decision makers for that fund are taking note of the debate.

The reason that the loss of the education team at Eureka! is so worrying is that prior to the pandemic just 15% of scientists were from working-class backgrounds. We are faced with an attainment gap that is increasing for the first time in 10 years, and it is clear that science and development centres such as Eureka! are more important than ever. STEM-based education programmes are delivered to an average of 32,000 key stage 1 and 2 children every year on school visits to Eureka! and the visits are undertaken by schools from across the region and beyond.

Another exciting project under way is Eureka! Mersey, a second Eureka! children’s museum in the Wirral, which is set to open in 2022. That project is secure, but retaining and utilising the expertise of the Halifax staff will be instrumental if we are to assist in unlocking the potential of even more children in that part of the world as well as our own.

Eureka! is the national children’s museum, and if any museum ever deserved support it is surely the national children’s museum. It does not receive any funding from the Government. I have met various Ministers about the issue and several have visited. Some genuine dialogue about that in the long term would be welcome. Right now, if the Government are serious about enhancing the accessibility of STEM subjects, which will be vital to the country’s future, they would not get a better return on their investment than by backing Eureka! the national children’s museum.

It is a pleasure to serve with you in the Chair, Mrs Miller. I congratulate my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) on bringing this important debate. I do not have a science and discovery centre in my constituency. I wish I did. However, I am sure that the vast majority of the residents are well aware of the fantastic Life centre in Newcastle. My daughter went many times to Eureka! in Halifax.

My constituency has a fabulous university technical college at Newton Aycliffe, supported by great companies such as Hitachi and Gestamp, as well as an amazing science and innovation-led business park at NETPark—the North East Technology Park—in Sedgefield. We are the home of such innovations as the first passenger railway, introduced almost 200 years ago by George Stephenson. I am absolutely convinced that it is through the stimulus of places such as the Life centre that young local minds can be open to considering careers in such exciting areas as research and innovation or engineering and science. We have all seen, in recent months, the difference that scientists can make to our life on this planet. The more young minds we can encourage, the better off we will be.

My constituency’s businesses and colleges are the opportunities through which young people can develop and grow and have stimulating and fulfilling careers and lives, but it is places such as the Life centre that open the first door on that route. It is difficult to overstate their importance. Whichever primary school I visit, the importance of aspiration and the opening of a mind to a world of discovery is precious. Those things can be the catalyst for aspiration to a life that youngsters could not previously have imagined. Later this week I shall be at Ferryhill Station and Bishopton Redmarshall primary schools and will make that point again.

Young minds engaged in STEM through science and discovery centres are stimulated regardless of gender, and that adds enormous value to the scientific community. For example, Universal Technical College South Durham inspires young women to go into science, technology, engineering and maths. A STEM-focused curriculum and experiences with employers put aside traditional stereotypes and allow youngsters to divine their own career path. Some 75% of the young women who go through the UTC have gone on to degree-level STEM apprenticeships in design, engineering or accountancy, or have done STEM at university.

I have visited many of the businesses in Newton Aycliffe and Sedgefield. They are all enhanced by the supply of young people with an interest in STEM subjects. It is through places such as the Life centre that seeds are planted to grow our scientists, engineers and mathematicians. I cannot overstate my desire that we support their efforts.

It is a pleasure to contribute to this debate under your chairmanship. I congratulate the hon. Member for Runnymede and Weybridge (Dr Spencer) on bringing this important debate to the House. It goes without saying that our nation’s regional science and discovery centres play a crucial role in the country’s STEM success, delivering inspirational science learning to schoolchildren and families, and working in partnership with schools, teachers, universities, businesses and local communities.

As a London MP, I know that many children in my constituency have been inspired on visits to the very popular Science Museum in South Kensington. Indeed, our own Mayor excelled at science and maths at A-level, and his original desire was to be a dentist. Look what happened to him: he is now the Mayor of London. Such inspirational visits have helped herald a generation of children and young people captivated by science and intent on a career in the UK’s promising scientific industries. It is these scientific industries we need to be doing our utmost to foster and support right now. I know this all too well as a recipient of the Oxford-AstraZeneca covid-19 vaccine. Professor Sarah Gilbert from Oxford University, who invented the vaccine, would have been inspired by the Science Museum, and I wonder whether she visited as a girl.

Many of those involved in the Oxford vaccine pipeline will have come through the state education sector and will have been inspired to pursue their dreams through visits to science museums, but I am deeply concerned about their future. Due to covid-19, science centres have mainly been closed since March and have had to make 50% to 80% of their education teams redundant in order to protect the long-term survival of their charities. These closures and redundancies have come when we most need our regional science centres to help with the educational recovery, to reduce inequality, to inspire young people from our most disadvantaged communities into science, and to encourage our young people into science and technology careers to support our industry and our learning.

At the same time, the Government have abandoned any pretence of having an industrial strategy and, as the Chair of the Select Committee on Science and Technology, the right hon. Member for Tunbridge Wells (Greg Clark), has made clear:

“It is deeply concerning that at the very moment when the whole country recognises the importance of scientific research… that the science budget should be facing immediate and substantial cuts involving the cancellation of current research.”

We know that these cuts will undermine UK productivity. Every pound spent on research in the UK reaps a return of £1.60, and any cuts end up costing our economy millions.

Rather than saying, as the Prime Minister has done, that we have a successful covid-19 vaccine due to “greed” and “capitalism”—which could not be further from the minds of people such Professor Sarah Gilbert—the Government are well placed to recognise the contributions of British science and address the myriad challenges facing the sector. This must start with restating an industrial strategy with science, research and development and international collaboration at its heart. It must also have a holistic approach, recognising the challenges to the pipeline if science and discovery centres are unable to reach out and inspire the next generation of scientists.

British science has played a key role in shining a light out from the darkness and despair of this pandemic. Without action, we risk extinguishing the lights that will show us a path away from future challenges before they even begin.

May I first thank my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for securing this debate, which gives us a brilliant opportunity to champion the impact of science centres in our constituencies?

In Wrexham, we have a brilliant science discovery centre called Xplore! It was formerly called Techniquest and I took my child there many times when he was growing up. In September last year I was honoured to be invited to the Xplore! rebrand event at its new location in Wrexham town centre, and to see at first hand its brilliant facilities and demonstrations. I saw children and adults wide-eyed, laughing, playing and learning—indeed, I was one of them. The most accurate analogy I can think of is being let loose in Willy Wonka’s chocolate factory. Xplore! has myriad interactive installations akin to Wonka’s chocolate factory—for inquisitive minds but without the calorie count.

I am proud that Wrexham has one of the 29 golden-ticket interactive science and discovery centres in the UK. Particularly for Wrexham, it is critical that these centres survive and thrive post covid. Science centres such as Xplore! are essential not only in promoting and inspiring the next generation into STEM careers, but in aiding the teching up of our older generation. It was only a few weeks ago that I stood in the main Chamber and asked the Prime Minister whether he agreed with me that Wrexham is an excellent hub to lead the charge for the STEM revolution. There are very few positives to have come out of covid, but the production and roll-out of the UK vaccine is one of them—a Union vaccine, created in England, trialled in Northern Ireland, bottled here in Wales and distributed in Scotland and across the rest of the Union—which means that this is a unique moment in time to promote and invest in opportunities and jobs in STEM sectors.

I would like the young people of Wrexham to learn and remember that Wockhardt in my constituency has bottled the Oxford-AstraZeneca vaccine. I want them to be inspired by that. We have numerous pharmaceutical companies here on the Wrexham industrial estate. We have a major hospital, the Maelor, for those who seek a career in healthcare, and brilliant higher education facilities at Wrexham Glyndŵr University and Coleg Cambria, which are able, keen and willing to facilitate STEM education. And we have Xplore! to provide the perfect foundation for the promotion of those careers from an early age.

The science centres are more important now than ever. Not only should we be using them to promote STEM; we should also be using them as a key component for educational recovery post covid. The majority of children have had a limiting year learning at home. Within our collective aim to build back better, there must be an element of recapturing the lost hands-on education. For those children who are tactile learners, home schooling is hugely detrimental and utilising the centres for educational recovery will be vital.

With science and discovery centres having the potential to be such crucial players in the covid recovery education system, their funding model needs to reflect that importance. Over the past year, science centres in Wales have struggled. Xplore! has received minimal covid funding from the Welsh Labour Government. Ordinarily, Xplore! receives funding via the Welsh Government’s school programme in order to offer reduced cost visits and workshops. Thankfully, that funding scheme, which was due to end this month, has been extended until early next year. That is most welcome, but what happens in 2022? The fear is that children will lose out not only in terms of the catch-up agenda but on ongoing interactive learning which in turn promotes the take-up of STEM subjects. There is a domino effect.

We have the opportunity to be forward thinking in our approach to protecting our science and discovery centres. I urge the Welsh Government to contractually embed school visits within the national curriculum for the benefit of future generations of Welsh children.

It is a pleasure to see you in the Chair, Mrs Miller. I am delighted to speak in today’s debate and I thank the hon. Member for Runnymede and Weybridge (Dr Spencer) for calling it.

As people step inside the National Railway Museum, which is undergoing its biggest refit since first opening 50 years ago, their passion for engineering will be ignited. Steam, engineered almost 200 years ago, captured global attention and was soon used to advance trade, travel and engineering. In 2023, the museum opens its new Wonderlab in the heart of York. We believe it will catch global attention once more, not just displaying the achievements of a great engineering past but birthing a new generation of great engineers who will one day rival any the world over.

The UK’s economy, already facing an annual shortfall of around 59,000 engineers and technicians, is dependent on science and discovery centres to engage young people to reach into a new world of possibilities. While the dissected Ellerman Lines engine shows how steam-powered trains, through combining heat and water, drove forward the engineering of the past, the new Wonderlab, which is part of the museum’s £55 million upgrade, will enable young people to explore modern engineering, equipping them with the curiosity to find solutions to pressing critical and global challenges.

I do not want the experience to be just a memory; rather, I want it to be a journey for young people. The National Railway Museum’s “Future Engineers” programme is a start to that. How we continue to engage all who visit will be key. Nurturing a passion for engineering, from the moment of the first visit into a movement of budding engineers, is the next step for science and discovery centres. Does the Minister see that ongoing relationship as a central pillar of this work, especially for local children?

I also want to see the centres secure stronger links with local universities and colleges. Imagine what could be developed in fostering a young engineer. A significant programme focusing on inclusion could ensure that future engineers are representative of the country we live in. Those who would otherwise write themselves off might embark on a path into engineering. As so many others have said, those who have struggled with their education this year might re-engage in the curriculum. Girls, as much as boys, might realise the opportunities that engineering opens up. I want those sparks of imagination to catch fire.

Engineering is not theoretical but practical, so the way science and discovery centres link to the economy is also vital. In York, we are fortunate to have some of the greatest rail engineers in the country, working for predominantly specialist small and medium-sized enterprises, designing stations, rail systems, future infrastructure and high-tech digital rail. York is also home to one of Network Rail’s operations. Imagine one of our young engineers experiencing that.

The National Railway Museum is the centrepiece of the York Central brownfield site adjacent to York Central station, which is about to undergo major development. It opens up new opportunities, so rather than suffocating the site with luxury apartments, it must be used to build York’s future economic footprint, including a national engineering hub, not least because that was the heart of the site when British Rail engineered carriages there.

Imagine stepping out of the science and discovery centre and walking into an engineering company. That is what we should be striving for: not just investing in science and discovery centres, which are desperately needed now, but building science and discovery communities and consolidating engineering, with young residents, museums, schools, universities and industry all working together to create a pathway into engineering.

Will the Minister commit to working towards building science and discovery communities and providing seed funding for that work, so that we can build for our future? If we are serious about investing in science and discovery centres, and about growing our economy with the necessary skills, the Government have to get serious about growing the whole pathway, from Wonderlab to wonderful global engineers.

I welcome the debate and congratulate my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) on making the running and on his excellent opening remarks.

I will not detain the House for long, but I want to make a few comments about the Winchester Science Centre, which I am very fortunate to have in my constituency. It is an independent educational charity that receives no statutory funding from local authorities or Government and raises more than £3 million every year to supports its core purpose of sparking curiosity in STEM. Many of your constituents will no doubt have visited it over the years, Mrs Miller.

It is all the more disappointing, then, in the context of the debate, that the Winchester Science Centre will lose an expected £2.5 million in revenue because of this dreadful pandemic. I place on record how incredibly grateful we are to the Government for their support with the furlough scheme and the many other support packages for businesses, which, it is no exaggeration to say, have prevented what could have been a much worse outcome. The Winchester Science Centre charity, however, has been excluded from applying for additional Government support—namely, the culture recovery fund, which I have spent a lot of time scrutinising as a member of the DCMS Committee. Other organisations in the local area that do similar activities have received large grants, which has created an uneven playing field.

Some excellent research published by University College London in 2017 clearly states that informal science education must start at primary school age, which is good, because the Winchester Science Centre has been focusing on five to 12-year-olds since 1986. That means that almost 4,000 children, who might otherwise not have had the opportunity, have taken part in free, informal science activities this past year, thanks to the centre’s widening participation in STEM outreach programme.

The facts speak for themselves. Some 170,000 visitors enjoy live science, hands-on activities, and an immersive 360° planetarium show each normal year—it is a fantastic show. Forty-five thousand school visitors engage with the activities every year, from 16 different counties across the south-east. That includes, of course, constituents of my hon. Friend the Member for Runnymede and Weybridge.

Just to touch on the careers part of what we are discussing today, we in Winchester have strong STEM relationships across the extremely sci-tech rich M3 corridor, including a multi-year partnership with Airbus, memorandums of understanding for public engagement with the University of Southampton and the University of Surrey, which is in Guildford, and many collaborations with industry through, among others, the Enterprise M3 local enterprise partnership.

Going back to covid—as, regrettably, we always must—I know that the BBC gets all the plaudits for singing its own praises for its home learning work in the past year, but I would argue that science centres have more than done their bit. Winchester’s digital Science@Home campaign reached over a million people during a crisis where many organisations were not able to operate at all. Almost a quarter of a million children from across the UK watched a digital Christmas coding pantomime—it sounds such fun. That was developed as part of our “Get with the Program”, and promoted through Winchester’s schools network in last December.

We have heard today about the Association for Science and Discovery Centres, and I suspect that the Minister will be aware of that organisation. Winchester is, of course, a respected member of it, regularly participating in special interest groups to share best practice for the things they are doing. I know that, during the first lockdown, the Winchester team co-created a new website offering other science centres around the country best advice on how to make their experiences more accessible to all.

The future should be very positive and strong. We have not come this far to go down now. I know the team at Winchester, led by the excellent Ben Ward, are determined to move on from covid and come back stronger.

The truth is that, whatever the restrictions say, the school trips are not coming back any time soon, possibly not even in September—no matter my view on the over-caution that that would represent—so I would like the Minister, when she sums up, and colleagues across Government and at the Department for Education, to make the positive case for school trips later this year, and to give school leaders the confidence to get back out there.

As we have heard today, science centres will benefit from that because their main customer base is back, but the country will also benefit because of their obvious support for education and careers in STEM subjects—and boy, has the past 12 months shown how much we need them.

We now move to the Front-Bench speakers. I remind the Minister that, when she makes her contribution, she will need to wind up by about 3.58 pm to enable Dr Spencer to make his winding-up speech.

The debate has given lots of Members the opportunity to speak fondly of science centres in their areas. I congratulate the hon. Member for Runnymede and Weybridge (Dr Spencer) on bringing forward this debate.

We have heard today from Members talking about Eureka! the national children’s museum in Halifax, Xplore! in Wrexham, the National Railway Museum in York and the Winchester Science Centre, among others. We are painting a picture of the role science centres can play in highlighting STEM opportunities to young people.

As we look to economic recovery post covid, we need young people with STEM expertise to play an active role. According to the all-party parliamentary group on diversity and inclusion in science, technology, engineering and maths, 65% of the STEM workforce are white men, so any initiatives we can take to improve diversity will be of economic benefit to us all.

The Scottish Government are determined to improve the take-up of STEM subjects in schools and to encourage diversity in STEM careers, and we are making progress on that. Compared with 2007, we now have 20% more female undergraduates and 36% more female postgraduates in STEM courses. However, a 2017 survey commissioned by the Scottish Government found that young people from the most deprived areas were 20% less likely than those in the least deprived areas to choose to study STEM courses. There is a continuing need to reach out to young people in whatever way we can, with a focus on girls, black, Asian and minority ethnic students and those from deprived backgrounds.

With that in mind, the role of science centres in Scotland is key and they work in partnership with local authorities to provide outreach and programmes that complement the school curriculum. That is recognised by the UK Association for Science and Discovery Centres, which states:

“The arrangement in Scotland seems particularly fruitful, whereby Scottish Science Centres have an agreement with the Scottish Government to reach children in schools and support teachers and families with inspirational STEM as part of the National Science Engagement Strategy. The Scottish Government particularly wants to reach families and communities from its most deprived areas… especially now, and contracts science centres to do this for them, as they already have the relationships, the centres, the science, the activities, the means and the passion.”

That is something that we have to see more of. I would like to talk a bit about Glasgow Science Centre. The centre is 20 years old and I first visited it as a physics teacher when I took youngsters there to enjoy it, which they did. It was a great day out and they had fun. At that point, there were a lot of activities that did not really lead to anything; it was not joined up. Over those 20 years, much more has been done and there has been great development in linking better with the curriculum and linking activities to careers and opportunities, so that it is a much more holistic experience for young people rather than just a fun day out.

The work of the centres during the pandemic has continued, albeit in a different format, and I will talk about some of the activities taking place at Glasgow Science Centre over the last challenging year. When lockdown first commenced, the centre committed to broadcasting new science content for every day of lockdown. By the end of the first lockdown, it had created and broadcast over 100 pieces of new science video content, which has been viewed more than 1 million times on social media. The centre created a printed magazine of science activities called The Spark, which was included in care packages and distributed to vulnerable families. It broadcast weekly on Sunny G and Paisley FM radio.

With no organised school visits possible, the centre developed a learning lab with lesson plans, experiments, videos, homework activities and “meet the expert” sessions, which are all packaged together to create a fully supported and interactive eight-week programme in STEM. Already nearly 3,000 pupils from 72 schools have taken part, with 77% from deprived areas. The centre has adapted its employability programme, STEM Futures, for online delivery and initiated a foundation apprenticeship programme to provide opportunities for young people when they need it most.

The Scottish Government have continued to support the work of science centres throughout the pandemic. Scottish science centres have received £2 million in emergency funding from the Scottish Government in addition to their usual contributions. To see centres in England excluded from the arts and heritage rescue package is concerning. We hear that 96% of science and discovery centres say they will not be able to cover costs when they reopen, and the Science Centres for Our Future campaign warns that the sector is at “imminent risk”.

The UK Government must support the science and discovery centres in England and ensure their success. Not only are the Government failing to support science and discovery centres, but they have removed other opportunities for STEM research through Brexit, whether through the Erasmus programme or faffing about with the funding for Horizon Europe. The hon. Member for Hornsey and Wood Green (Catherine West) was right to highlight the brutal cuts to the science budget.

I am sure that hon. Members have gathered that Glasgow Science Centre is one of Scotland’s most successful and loved visitor attractions. As the world recovers from covid-19, visitors will return, but we need to look at a blended approach between in person and digital content that better serves our communities. Science centres can create long-term and sustained relationships with young people and build supportive ecosystems in schools, families and communities. Those centres are much more than a good day out, but they need support. I hope this Government, which professes to support science, will support those vehicles that are driving our future talent.

It is a pleasure to serve under your chairship, Mrs Miller. I congratulate the hon. Member for Runnymede and Weybridge (Dr Spencer) on securing this important and timely debate. I agree with his comments on the differential impact on young people of the pandemic, particularly in education. I agree, without exception, with the contributions from around this virtual Chamber on the challenge and opportunities that the pandemic brings, and the impact on these centres.

We heard about the impact on the Catalyst Science and Discovery Centre from my hon. Friend the Member for Halton (Derek Twigg); on the National Railway Museum from my hon. Friend the Member for York Central (Rachael Maskell); on the Xplore! Centre from the hon. Member for Wrexham (Sarah Atherton); on the Winchester Science Centre; on the Eureka! Centre in Halifax, and on the Bristol Exploratory Centre, which the right hon. Member for Kingswood (Chris Skidmore) discussed. I was not aware of its being known as “the Exploratory”, but I did once visit it when it was known as At-Bristol.

All those centres, as we have heard, provide the spark that encourages young people to think about the world around them. I quote a particular individual who said, “Be curious”. Those are the words of the late Stephen Hawking in that powerful moment of opening the Paralympic games in 2012, when the world’s gaze fell on our country. His message was somehow amplified by the sight of his crumpled frame, because he did not just encourage us, he urged us. To quote him fully,

“look up at the stars and not down at your feet. Try to make sense of what you see and wonder about what makes the universe exist. Be curious.”

It was a rare public appearance for someone so famous in the scientific community, but less well known beyond. His global message sought to inspire the world through hope and optimism. That invitation—that urgency—was to create a brave, new and better world for everyone by challenging perceptions and stereotypes that limit the potential of the human body, mind and spirit. It was a special moment.

If we needed telling—and perhaps we did—science is all around us. It is only a matter of opening our eyes, of what we are able to see, what we are trained to see, or what we have the innate talent to see. For some, such as Stephen Hawking, that talent was able to flourish. It may have developed in the classroom, but it was his observation of the universe that made him wonder. So much great scientific thinking has come from observing the world around us and asking why or how. Those reflections can spur deep thought as we ponder the natural world and have spurred, through the centuries, the work of Archimedes, Galileo, Leonardo da Vinci, and, closer to home, that of Newton, Mary Anning, Charles Darwin, and countless others—all by asking the simple question of why.

The UK has a proud history of science and innovation, though many scientific discoveries, including penicillin by the Scot Alexander Fleming and the structure of DNA by Franklin, Crick and Watson. UK inventions include Stephenson’s steam engine, as we heard from my hon. Friend the Member for York Central; the television, by another great Scot, John Logie Baird; the jet engine by Coventrian Frank Whittle; the World Wide Web by Sir Tim Berners-Lee; the modern bicycle; the flying wing that led to the development of Concorde and ultimately the stealth fighter; the jump jet; the lithium-ion battery; graphene—all British or co-developed with other nations. I could go on.

Through time, these discoveries have helped to improve our understanding of the natural world and the science that forms it. So much of that has originated from the observations of curious minds: Newton observing how apples fell perpendicularly to the ground; Boyle observing in a laboratory as those early scientists sought to explain the relationship between pressure, volume and temperature that would ultimately lead to the development of power and engines; Baird, who built what was to become the world’s first working television set, using items including an old hatbox, a pair of scissors, some darning needles, a few bicycle light lenses, a used tea chest, and sealing wax and glue that he had purchased; and Sir Frank Whittle, who became fascinated by the gas engine and the work of pistons in his dad’s small workshop in Leamington—those observations ignited his interest in propulsion and ultimately led to his work in developing the jet engine. Few of us have those workshops or garages, or the courage, in the case of Baird, to conduct experiments in the kitchen or lounge. In fact, Baird’s landlord threw him out of his rented property when he discovered what he was doing.

For all these reasons, having places to observe and appreciate the physical and scientific world is so important, and that is why the value of centres of science and discovery cannot be overestimated. Some 15 years ago, I visited the discovery centre—that was how it was known —in Bristol. It was a triumph, appealing to young and old minds and demonstrating the fascination of physics and the workings of the natural world. In total, the UK boasts a network of almost 60 science and discovery centres, including science museums, science centres, discovery centres and natural history and environment centres. Rather impressively, some 19% of the UK population said that they had visited a science and discovery centre once or more in 2019, with 33% claiming that they had visited a science museum.

These centres do a terrific job in stimulating young minds, as so many hon. Members have commented. That is important, particularly in encouraging the uptake of related subjects in our schools. I will just look at the statistics for England, if I may. The proportion of A-level students entering for any maths or science subject has increased from 35% in 2015-16 to 46% in 2019-20. That increase in interest is important if we are to build on our established reputation, renowned around the world—a reputation that underpins a science sector that is worth £63.5 billion and provides jobs in research institutes and universities and in businesses of all sizes across the country.

As my hon. Friend the Member for Hornsey and Wood Green (Catherine West) said, we have only to look at the leadership of Dr Sarah Gilbert and her team at Oxford University and its tie-up with AstraZeneca to understand how important this is and how vital it is that we attract more women, and indeed black and minority ethnic students, into the sector.

The centres themselves are threatened, as so many Members have said in the debate. According to a survey conducted by the UK Association for Science and Discovery Centres last June on the impacts of the pandemic, some 96% of science centres felt that they would not be able to cover costs at 30% capacity. Revenues are down by 50%, as my hon. Friend the Member for Halton mentioned. There are staff cuts across the board. In the case of the Eureka! centre, as my hon. Friend the Member for Halifax (Holly Lynch) said, the staff are down by one third.

The financial uncertainty was underlined by the Government’s announcement that these centres would be largely excluded from the arts, heritage and culture rescue package of £1.6 billion. In October 2020, the UKASDC, chaired by the brilliant Professor Alice Roberts, wrote to the Government and called for £25 million of emergency financial support for the sector. The letter, signed by 160 professionals working in STEM, said that the sector was at imminent risk; 62% of the facilities have said that they could cease to be a going concern in the next 18 months.

Let me turn briefly to the wider issue of this country’s recent record on science, where unfortunately the Government’s warm words have often not been matched by deeds, and where their industrial strategy seems to have been mothballed. Indeed, the Chancellor of the Exchequer did not even mention such a strategy in either of his Budget statements. That failure has seen the UK lose during the past decade a significant amount of its world-leading pharmaceutical manufacturing capabilities—capabilities vital for drug and medicine development. And the failure has resulted in the north receiving less than half the life science investment per head in the south of England, despite having great teaching hospitals and significant health inequalities. In the midlands, the investment is as low as £16 per person.

This is not simply a question of geographic inequality; there is also inequity by gender and ethnicity. Presently, 65% of the STEM workforce are white males, and more directly the STEM workforce has a lower share of female workers than the rest of the workforce—27% versus 52%. It is therefore striking when we hear of those women who have broken through and excelled in their field, such as Professor Sarah Gilbert. Just the other day, we heard of the latest young woman engineer of the year, Ella Podmore, who spends her days pushing the boundaries working in material composites at McLaren. But they are sadly rare in the science sector, with women representing only 9% of people in non-medical STEM careers. Elsewhere, BAME men are less likely to work in STEM than white men, yet we face a shortfall of 173,000 STEM workers, costing the sector £1.5 billion a year.

This gap was highlighted last year by the all-party parliamentary group on diversity and inclusion in science, technology, engineering and maths, which published a report following a 15-month inquiry on whether the education system and schools provide equal opportunities for students of all ages to learn STEM subjects in England. Its recommendations included the need for a Minister responsible for adjusting inequity in the education system; STEM education that is more relevant to the lives of all young people; and greater action to address teacher shortages in STEM subjects. We can therefore understand why the centres that we have discussed today are so important.

We must invest in a science future and not rely on this Government’s science fiction, where promised research investment has been cut. We need to ensure that young people have the opportunities to be curious to discover in the classroom. This is why Labour is more ambitious than this Government. We would build on the UK’s science successes and ensure that we continue to be an innovation nation by spending 3% of our GDP on research and development, because it is a no-brainer for our economy.

The Campaign for Science and Engineering has shown that, for every £1 invested by the Government in research and development, we get back 20p to 30p each and every year. Likewise, research by King’s College London and Brunel University London has shown that for every £1 invested in medical research, we get back 25p to the economy each and every year. The Labour party would also seek to champion our universities as engines of regional progress, strengthening regional economies by rebalancing R&D investment. We would address the shortfall of STEM workers by helping to encourage women and those from BAME backgrounds into STEM, starting at school level, to ensure there is the pipeline of talent we need for the future. Widening access is not just the right thing to do for individuals; by tapping this talent, we will strengthen the sector by diversifying decision making and we will encourage continuous lifelong learning and reskilling.

Labour has a long and proud history of supporting science—judge us on our record. In the first 10 years in government, we more than doubled the science budget. If we are to meet the challenges of the future, it is vital that we excite our young people in science and encourage them to be inventive in every sense. While STEM is important, I would add words of caution: we cannot all be coders or scientists and we must also value our arts, which are so important to us culturally and economically. As Stephen Hawking said: “Be curious.” To that I would add: “Be inquisitive.”

I congratulate my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) on securing this important debate. I want to reassure him, and other Members who have spoken today, that this Government are absolutely committed to having a strong STEM workforce and in fertilising the pipeline for that workforce. As a Back Bencher, I ran the Wiltshire festival of engineering and manufacturing, which targeted primary schools to encourage and inspire local children to engage in these areas, and to seed a thought about aspiring to a career in those sectors. In my constituency we are not lucky enough to have a science centre, but I encourage constituents to visit those in neighbouring areas, including the fantastic We The Curious science museum in Bristol, which my right hon. Friend the Member for Kingswood (Chris Skidmore) rightly spoke extremely highly of.

It is absolutely imperative that we challenge the negative stereotypes that some young people might associate with STEM, including any notion that these should be male-dominated careers. Some of the centres even have programmes to do just that, including the Catalyst Science Discovery Centre in the constituency of the hon. Member for Halton (Derek Twigg), which holds free careers events for years 8 and 9 to inspire the next generation.

It is also vital that we ensure that the education system feeds the skills shortage. On that point I disagree with the hon. Member for Warwick and Leamington (Matt Western), whom I welcome to his post, because it is far from the case that the Government have simply offered words and not deeds. In fact, we have spent the past 10 years seeking to do just that with the EBacc; reforms to further education, including the introduction of T-levels; higher technical qualifications; the internet of things; and a drive to raise quality and investment in STEM in higher education. That said, we recognise the value and importance of working in partnership with communities and our treasured community assets, especially science discovery centres.

The Government were elected on a manifesto to level up. We absolutely believe that anyone, regardless of their background, should have the opportunity to pursue a rewarding career in STEM. My hon. Friend the Member for Runnymede and Weybridge and others pointed out how much of a role the science discovery centres play in that objective, especially in encouraging those from disadvantaged backgrounds to discover a love of science and STEM more broadly. My hon. Friend the Member for Sedgefield (Paul Howell) put it correctly when he said that they can be a catalyst for aspiration. They not only bring science alive, but make it accessible for all. When I was at school, I had several trips to the Eureka! centre. I completely agree with the hon. Member for Halifax (Holly Lynch) on how amazing and inspirational that is.

Science is vital not only for the economic good of our country, but for the prospects of individuals. The Winchester Science Centre and Planetarium, as my hon. Friend the Member for Winchester (Steve Brine) outlined, runs innumerable fantastic initiatives, including workshops for primary schools, with computer program classes where children case use code to explore solutions to deep-sea noise pollution, getting the next generation not only able to progress skills in these areas, but excited about saving the environment. As my hon. Friend pointed out, they have had various initiatives to reach out to more than 1 million during the pandemic. I agree with my hon. Friend the Member for Wrexham (Sarah Atherton) that it is vital that these centres survive and thrive post covid, including the Xplore! centre in her constituency.

As hon. Members have explained today, the network of publicly accessible UK science and discovery centres provide an important role in inspiring people of all ages to discover the vital role that science has played in creating the world we now live in, and how it can help to create the world that we want to live in in future. They also offer invaluable support to schools, colleges and universities.

The pandemic has challenged us all, and science and discovery centres have certainly not been immune. That is why the Government supported all the science centres, which are accredited museums, that applied for funding in England through the culture recovery fund. The £1.57 billion support package is the largest ever one-off investment in UK culture, and we have continued to support national museums and galleries with £100 million of targeted support for national cultural institutions. That support was announced last year, and a further £90 million was announced at the recent Budget. Also, the Department for Digital, Culture, Media and Sport sponsors numerous museums that are also members of the ASDC.

Visitor attractions, which are not categorised as museums, will continue to benefit from the reduced rate of VAT, which the Government have temporarily applied to visitor attractions, as well as the pan-economic measures such as the coronavirus job retention scheme, Government-backed loans and business rate deferrals. I am sure that my counterparts in DCMS will meet Members to discuss the cultural recovery fund in more detail, and I am sure BEIS will respond to the ideas illuminated by my right hon. Friend the Member for Kingswood. I am more than happy to co-ordinate and lead a meeting with any Members who would find it useful.

As I previously stated, covid-19 has had a profound impact on the country. Despite the progress that we have made, research published by Engineering UK suggests that the pandemic has disrupted our efforts to widen the demographic and encourage more people to pursue STEM subjects and occupations. Demand for jobs in science, research, engineering and technology are going only in one direction. To meet the demand, it is crucial that we not only attract the brightest and best in these jobs, but improve the diversity of our workforce to meet the demand for the skills that will underpin the UK economy’s recovery and our mission to build back better.

In fact, engineering-related sectors contribute at least £280 billion in gross value added to the UK economy, some 20% in total. In 2018, however, EngineeringUK reported an annual shortfall of 59,000 engineering graduates and technicians to fill core roles. In 2018-19, only 17% of engineering and technology undergraduates were female, meaning that the vast majority were male. That translates into the engineering workforce, where women represent only 12% of those in engineering and technicians, and ethnic minorities represent just 8%.

We know that studying engineering and technology degrees leads to increased employability and earning potential. In 2015-16, the earnings of those who had studied engineering and technology were 18% more, on average, for first-time degree graduates in the first six months of leaving university. The hon. Member for Glasgow North West (Carol Monaghan) was right to say that we must encourage the next generation to consider STEM-related pathways, especially those in under-represented groups.

Science and discovery centres can play a key role in that but, as we know, remote teaching for children and young people has been substantially impacted during the pandemic. It is crucial to ensure that our children can catch up, so that no child is left behind as a result of the pandemic. To address that challenge, the Prime Minister has committed to developing a long-term plan to help schools support pupils to catch up on their learning over the course of the Parliament.

We have appointed Sir Kevan Collins as education recovery commissioner. He is engaging with parents, pupils and teachers in the development of this broader approach, and is reviewing how evidence-based interventions can be used. We have made available £1.7 billion funding to support the education recovery, which began in June 2020. We have announced a £1 billion catch-up programme, including a national tutoring programme and a catch-up premium for this academic year. In February 2021 we committed a further £700 million to fund summer schools, the expansion of the tutoring programme and a recovery premium for the next academic year.

We are also funding programmes to increase the take-up of maths, computing and physics, and to support improved teaching in schools. That includes more than £80 million for computer education, through the National Centre for Computing Education, and more than £100 million for teaching for mastery programmes. The Government also fund STEM learning to deliver a national network of science-learning partnerships, providing high-quality continuing professional development for science teachers.

As has been raised in debate, last year, for the first time, girls made up more than half of the science A-level entries, and there was an increase of more than 30% in girls’ entries to STEM A-levels in England since 2010. Unfortunately, despite our best efforts, girls continue to make up relatively small proportions of entries to maths, physics and computing at A-level. We are therefore funding research programmes to investigate ways to tackle the gender balance in those subjects.

I agree with hon. Members that science and discovery centres can play a part in the catch-up mission, by enhancing learning and reigniting that love of learning, which may have waned while some have studied predominantly online throughout the pandemic. I can confirm to my hon. Friend the Member for Runnymede and Weybridge and other hon. Members that I shall raise the role that those centres can play directly with Sir Kevan Collins and the Minister for School Standards, my right hon. Friend the Member for Bognor Regis and Littlehampton (Nick Gibb).

I also look after opportunity areas, including Opportunity North East, and I pledge today that I will raise the points made in this debate with the chairs, including the value that those centres can play in raising attainment in STEM subjects and career aspirations.

I agree with my hon. Friend the Member for Runnymede and Weybridge and others that we must seize the opportunity to do everything we can to encourage more people to study and take up careers in STEM, especially where they are from under-represented groups. Science and discovery centres should play an integral part in that. They already inspire 5 million schoolchildren and their families with science every year. Their curriculum-linked STEM workshops support more than 1.5 million students.

I will end by urging all parents and schools to consider visiting their nearest centre, when restrictions allow. Many are free and, as detailed by hon. Members today, they can bring science to life in innovative and exciting ways.

I thank the Minister for her speech and, in particular, for reaffirming the importance of science and discovery centres, and for the points that she will take forward. I would very much like to take her up on the offer of the meeting that she agreed to convene.

As an aside, I noted the comment of the hon. Member for Warwick and Leamington (Matt Western) about the separation of arts and science. Personally, however, I see that as a false dichotomy—what is Beethoven’s “Moonlight Sonata” without the invention of a piano; and what is rock and roll without the pickup and the amplifier? For so long, we have differentiated and created artificial divisions, but at their core, arts and science are one and key to us as human beings and to our society.

I thank Members for their fantastic contributions to the debate. What came out for me and, I suspect, for the people watching at home who work in the science and discovery centres and who inspire and teach children about science and discovery, was the personal stories that so many Members brought out—bringing their children to science and discovery centres. Hearing about the National Railway Museum, it is difficult not to conjure up images of steam trains, with the smells and seeing the pistons, thinking back over the changing industrial age. Science is such a personal experience, and what makes science and discovery centres—what makes them special—is not just the machines, the ants, the space rockets or all the different bits of tech or kit to be seen when there, but the people. It is about the volunteers and staff who work in the centres, who are passionate about science, teaching, learning and innovation —as passionate, or more passionate, as the Members who took part in the debate, who talked with such love about their science and discovery centres and about the role of science in our society going forward.

The centres are so important to all of us, to our future and to our future workforce. They need to be open, and they need the financial support and backing to stay open. My hon. Friend the Member for Winchester (Steve Brine) made such a strong point—the centres should not just be open; we have to ensure that kids get back into them, and as soon as possible. Particularly over the next few months, that will be such a challenge—inspiring the confidence and getting back into the centres, back learning and having the great experience and opportunities that they offer.

In wrapping up, I again thank Members for taking part in this important debate. In particular, I thank everyone who works in science and discovery centres and everyone who inspires our next generation about science.

Question put and agreed to.


That this House has considered the Science and Discovery Centres’ support for education in science and careers in STEM subjects.

Sitting suspended.

Bakerloo Line Extension

I remind hon. Members that there have been changes to normal practice in order to support the new hybrid arrangements. We do not have anybody participating virtually in this debate. I remind Members who are here to clean their spaces before they leave the room. I also remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall other than when you are speaking.

I beg to move,

That this House has considered Government funding for the Bakerloo Line extension.

It is a pleasure to serve with you in the Chair, Mrs Miller, for the second time—it might be the Minister’s first, but it is my second. We are limited in time and very limited in number today, but it is quality that counts—I am speaking about the Minister, rather than myself. Many colleagues have sent apologies, including my neighbours, my hon. Friends the Members for Vauxhall (Florence Eshalomi) and for Lewisham, Deptford (Vicky Foxcroft) and my right hon. and learned Friend the Member for Camberwell and Peckham (Ms Harman), the Mother of the House. Well they might send apologies, because the Bakerloo line extension was first mentioned in 1913, so our constituents have been waiting more than a century for this debate and for Bakerloo line trains to arrive a bit further than the Elephant and Castle, where they end currently.

I start by thanking the Secretary of State for Transport and the wider Government ministerial team for the safeguarding work. The land above and below ground for the Bakerloo line extension has been protected. I am grateful that the Government acted swiftly on the safeguarding directions, in response to my question in December, and I was glad to see that published on 1 March. This is a decisive milestone for the project. It is important that the time and resources already spent on the extension are not wasted and that the Government remain committed to the next stages of development for this vital and hugely popular scheme to progress.

I say it is hugely popular, because there is so much evidence to back that up. The Transport for London public consultation saw a tiny fraction—less than 3%—of the people who responded objecting to the extension. The public overwhelmingly see the benefits of the scheme, and more than 20,000 people have signed the “Back the Bakerloo” petition online, including many of my constituents.

The project has the backing of the leaders, mayors, councillors and councils of five London boroughs. Southwark Labour has campaigned collectively on it for years. The planning and preparatory work is already well under way and delivery for the extension is embedded into the local development plan for the borough. In Southwark alone, it is estimated that the extension will help deliver more than 2 million square feet of employment space for a range of new work. It also features heavily in Lewisham’s local development plan. The BakerLewisham extension campaign was a brilliant success for Damien Egan, the mayor, and outgoing councillor Joe Dromey. It is a fantastic campaign with lots of public support.

I and eight other local MPs whose constituencies are directly affected by the extension have all been campaigning together to see it delivered. It is a cross-party campaign. The hon. Member for Bromley and Chislehurst (Sir Robert Neill) is a prominent backer of the Bakerloo line extension and, of course, the former Mayor of London, now the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) and the Prime Minister, has backed the campaign for some years. The Bakerloo line extension formed a major part of his 2011 London plan and, since then, it has been embedded in successive London plans, highlighted as an integral piece of infrastructure within the economic, environmental, transport and social framework for the development of all London. Indeed, in 2015, the Prime Minister said:

“The extension of the Bakerloo line will provide a vital new transport link for people living and working in south London…We’re now firmly on track to get construction on this major project underway by 2024 and have it up and running by 2030.”

He now holds the key to unlocking all the benefits that the extension could bring. He flagged up today at Prime Minister’s questions that the Government are spending £640 billion on national infrastructure—an amazing sum. I am genuinely impressed. It is good to see infrastructure coming forward. We need nuclear investment, we need other infrastructure investment and the Bakerloo line extension should form part of that infrastructure development.

One reason the extension is so universally popular is all the benefits it would bring. It is not just about transport—it is about regeneration, the delivery of housing, jobs and the post-covid economic recovery, and tackling the climate emergency. Of course, it does have transport benefits. Improved transport links and reduced journey times would benefit my constituents and hundreds of thousands of people across south London. It would bring capacity for 87,000 more people every morning in peak time. It would mean that a tube train every two to three minutes between Lewisham and central London is possible.

It has environmental benefits. The Bakerloo line extension would help reduce air pollution and congestion on the roads by increasing capacity on the tube and taking many journeys off our congested streets, including the Old Kent Road. Improving and expanding public transport options is also central to the Government’s plans to tackle the climate emergency and meet our carbon emission targets, a priority that is particularly significant given that COP26 is rapidly approaching in Glasgow later this year.

It also has significant housing benefits. The extension of the Bakerloo line from Elephant and Castle would mean 20,000 new homes for the Old Kent Road alone, including 7,000 genuinely affordable homes in my constituency and that of my right hon. and learned Friend the Member for Camberwell and Peckham. Across London, it would mean the development of 110,000 new homes, which would be a significant contribution to the Government’s commitment to deliver 300,000 new homes a year. This is and should be seen as a partnership between national Government and the devolved authority in London.

Of course, it brings many jobs: 10,000 new jobs in the immediate area of the extension, but 130,000 jobs across London. It would create a new work space along the whole route, generating a growth corridor from the Elephant and Castle right out to Kent. That route takes the extension through some of the most disadvantaged parts of London. Parts of south Bermondsey and north Walworth have 40% child poverty. There is a reason why the Old Kent Road is the cheapest square on the classic Monopoly board.

The next steps to success are to reach a single preferred option, and all of it is contingent on funding. Since 2016 Sadiq Khan has been an excellent Mayor for London. He has stabilised Transport for London’s finances, reduced the operating deficit by 71% and increased the cash balance by 30%, while delivering the Hopper fare, which has benefitted more than 200,000 people on routes through Southwark. All Londoners—millions of people on routine journeys—have benefitted from the fares freeze, but we cannot ignore the last year, which has been devastating for Transport for London’s finances.

The pandemic has meant a 90% drop in passenger revenue in 2020, meaning a loss of £2.4 billion in fares and rendering Londoners entirely reliant on Government for funding for future capital projects of this scale and for smaller projects. I hope that we are not going to see the Minister try to pass the buck for these costs on to Londoners. In his letter to the Mayor of London in October, the Transport Secretary acknowledged that Transport for London will need support for capital projects even when Transport for London becomes self-sufficient in running costs again under Heidi Alexander’s excellent leadership. That self-sufficiency target is set for 2023-24.

The Government could help by returning the annual operating grant to the capital city. The last payment in 2015 was £700 million, before the previous Mayor gave away the operating grant, which was perhaps a foretaste of his negotiating abilities. That money would go a long way to meeting the projected costs for the extension from Elephant and Castle to Lewisham, which are estimated to be between £4.7 billion and £7.9 billion. The range of cost reflects the contingency and uncertainty that a major capital scheme like this requires at this stage of the development.

No other major city operates on this system. In Paris and New York fares account for just 38% of revenue, in Hong Kong for 37% and in Singapore for 21%. Londoners are being asked to shoulder far more cost for their underground system than people in any other major city. That system, built on uncertainty, has been added to in the last year by covid. On Monday, the Government agreed another short extension to the Transport for London funding deal, on the same conditions. This temporary extension will now end in May, with a new agreement needing to be negotiated by 18 May, following the mayoral election.

The Minister may wonder why the Government’s candidate is languishing in the polls in London. It is partly because Londoners are not stupid. They have seen the contrast between being punished with a deal for Transport for London, which has restrictions and a cost imposed for Londoners that we did not see in any other deal for any other part of the country, and rail companies being provided with £3.5 billion of public money with no conditions. Londoners were told to stay at home to protect the NHS. They did their bit and they are losing out through a deal with terrible conditions attached.

As part of the current negotiations, Transport for London is making the case for continued funding to close out the current stage of design, to protect the Bakerloo line extension safeguard from challenge, and to develop a single preferred option that would be shovel-ready. That would put the scheme in a position where it would be ready to be taken forward to planning, if and when funding was identified. Transport for London hopes to provide an update on that by the end of May, by which point the next funding deal should have been agreed.

We obviously cannot ignore the context; we all know what has been happening. The vaccine is providing a jab in people’s arms, but the whole country needs an economic shot in the arm. We need an economic boost and the Bakerloo line extension would deliver just that for the whole country. By supporting London, the Minister would support the whole country. When London is operating at full capacity, it delivers a net contribution to the Treasury of £39 billion a year. The Government need that money coming in and Londoners want to get back to work. The Bakerloo line extension helps to rebuild post-covid, and by investing in London’s infrastructure the Minister and the Government would support regeneration across the United Kingdom.

I will give just one example of how the Bakerloo line extension would contribute to the national recovery. The Prime Minister has visited the Siemens plant in Goole up in Yorkshire—more than once, I think. That site is the expected place of manufacture of the trains and carriages that would run on the Bakerloo line in London. Investing in the Bakerloo line extension provides a boost for London, but it also provides jobs in Goole.

Of course, the Government talk a lot about levelling up. Levelling up does not just apply outside London. Ministers must not just talk the talk; they need to walk the walk, or better still take the tube, perhaps. I hope that the Minister will agree that the Bakerloo line extension is an excellent example of levelling up. I invite her to come and see these sites, to see where these jobs, housing and transport infrastructure would be. I hope that if she made such a visit, I and others who support the extension would be able to prove to her that the best way to level up is to get the Bakerloo line extension track down. That would be a fantastic opportunity for her to see.

In conclusion, I look forward to hearing how the Minister will ensure that her Government meet their housing targets, environmental agenda, infrastructure plans and levelling up agenda, and I also look forward to hearing how we will work together to deliver this project to boost the national economy.

It is a great pleasure to serve under your chairmanship for the first time, Mrs Miller. I am extremely grateful to the hon. Member for Bermondsey and Old Southwark (Neil Coyle) for securing this debate on Government funding for the Bakerloo line extension. I agree with him—I think the debate is definitely about quality. He has demonstrated that in his remarks, in which he set out his passionate case to represent his constituents. I commend him on that wholeheartedly.

Of the 270 operational London Underground stations, only 29 are in south London. As I am sure the hon. Gentleman already knows, there are more underground stations in Hertfordshire and Buckinghamshire than there are in his home borough of Southwark. We agree that transport infrastructure is critical in ensuring that communities can work together to achieve their ambitions of having prosperous, safe and vibrant places to live. Indeed, it has never been more important than in the period of recovery from the covid-19 pandemic.

The proposals for the Bakerloo line would extend the route from Elephant and Castle to Lewisham. Transport for London’s plans include new stations along the A2 Old Kent Road and at New Cross Gate, a new Bakerloo line ticket hall at Elephant and Castle, and an improved interchange at Lewisham station. It is important to note, as I know the hon. Gentleman already understands, that this is a Transport for London project and Transport for London is devolved, so this is the responsibility of the Mayor of London and Transport for London, whose responsibilities include capital projects. Therefore, it is for the Mayor of London and Transport for London to assess the merits of capital projects and make decisions on investment.

As the hon. Gentleman has discussed already, the Secretary of State has recently issued safeguarding directions for the proposed extension route. Safeguarding does not represent a Government commitment to fund the project, but it does ensure that the route is protected for the future, because without safeguarding the project’s costs could become significantly higher over time.

Safeguarding directions have been issued because the Government agree with the hon. Gentleman that the Bakerloo line extension has the potential to unlock housing and economic growth. Therefore, it is key to understanding the opportunities that the Bakerloo line extension, and other projects in London and across the country, present for our goals on housing supply.

The hon. Gentleman will know that Transport for London is yet to secure the funding required to progress this project and Transport for London’s commissioner confirmed to the London Assembly earlier this month that the extension is on hold for the time being. We believe that safeguarding has provided Transport for London with the opportunity to take the extension forward at a future time. 

I will use this opportunity to briefly reflect on the broader context in which we are having today’s debate. The hon. Gentleman has referred to some of these matters. Our focus right now remains on responding to the pandemic, and there are significant challenges facing the whole country, including the transport network. In London’s case, the Department for Transport is continuing to work closely with Transport for London to ensure that the transport network can support the restart and recovery of the city. The Government have already shown a significant commitment to supporting London’s transport network and Londoners throughout the pandemic, including more than £3 billion in emergency funding since May 2020. That is a significant amount of money that has been provided to help Transport for London keep the essential networks going. On Monday, the Government agreed an extension to the current Transport for London funding deal, which had been due to expire on 31 March.

I am keen to explore the future funding specifically. from the, Point 5 of the letter from October from the Transport Secretary to the Mayor of London says:

“In relation to any long-term plans, HMG define financial sustainability as TfL’s ability to cover, from sources available to it (including, the consideration of potential new sources of income but excluding government grant): operating expenditure; capital renewals; servicing and repaying debt; and capital enhancements. For major capital enhancements and major renewals (i.e. replacement of life expired rolling stock and signalling), TfL would not be expected to solely finance these from operating incomes; as is consistent with other transport authorities.”

It is about that next step, rather than the immediate temporary measures to carry the capital through the covid crisis. I am keen for the Minister to move on to that agenda, if possible.

I fully understand the hon. Gentleman’s desire to move on to the future of the project. What I wish to say on that point is that, obviously, the Government will be working very closely with Transport for London on the future funding settlement, so that we can continue to ensure the sustainability of the transport network. I very much encourage him to continue his work and his communications with my noble Friend in the other place, Baroness Vere, who is intimately involved in the discussions, and with the Secretary of State for Transport, because the Government absolutely wish to ensure that there is a sustainable transport network for London and the whole country.

I thank the hon. Gentleman for securing the debate on this topic; it is a very important matter. The issuing of safeguarding directions has protected the proposed route for the future, which is a very positive step. It provides Transport for London with more time to put together a funding package without the cost of the project significantly escalating. That is a very important step in the right direction. I also encourage the hon. Gentleman to aim his questions about funding at the Mayor of London and Transport for London following May’s election.

Question put and agreed to.

Sitting suspended.

UK Rare Diseases Framework

I remind hon. Members that there have been some changes to the normal practice, in order to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate, so there will also be suspensions between each debate. I remind Members participating physically and virtually that they must arrive at the start of the debate in Westminster Hall. Members are expected to remain for the entire debate. I must also remind Members participating virtually that they are visible at all times, both to each other and to us here in the Boothroyd Room. If Members attending virtually have any technical problems, they should email Westminster Hall Clerks. Members should clean their spaces before they use them and before they leave the room. I remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall except, of course, when speaking.

There are no more notes from me but a reminder that we shall move to winding-up speeches at about 5.28, and after the first speech I am afraid I shall have to put in a formal three-minute time limit, because it is a heavily subscribed debate.

I beg to move,

That this House has considered the implementation of the UK Rare Diseases Framework.

It is a pleasure to serve under you in the Chair, Mrs Miller. About one in 17 people will during their lifetime be affected by a rare condition. Around 70% of such conditions begin in childhood and are lifelong. Genetic Alliance UK estimates that rare diseases are responsible for about one third of infant mortality in the UK. Those living with a rare condition can face significant challenges in getting a diagnosis, getting access to treatment, and receiving co-ordinated care, as well as challenges with employment, education, social life and mental health.

The UK rare diseases framework, which was published earlier this year, presents an opportunity for the rare diseases community. There is hope that the framework will enable people living with rare, genetic and undiagnosed conditions to get access to the appropriate care and the treatment that they need to manage their condition. However, we have been here before. In 2013 the UK strategy for rare diseases was published, with the promise that no one would be left behind just because they have a rare disease. When the strategy expired last year, people living with rare conditions were confused and disappointed. Although the strategy had made some progress, it had failed in its commitment to transform the lives of all those affected by rare conditions.

A major factor that prevented the true potential of the strategy from being realised is the long delay from the Department of Health and Social Care or NHS England in developing and publishing an implementation plan. The strategy was published in 2013, yet an implementation plan for England was delivered only in 2018. Not only did that prevent progress in England; it also stymied developments in the devolved nations, which were unable to collaborate effectively without a plan. As yet, the Department of Health and Social Care and NHS England have not published the outcome of the strategy. If we are to learn from the mistakes of the past, we must evaluate what happened with the strategy. Will the Minister comment on whether the Department of Health and Social Care and NHS England will in fact report on the outcome of the strategy?

The UK rare diseases framework is the beginning of a new chapter. For it to be implemented effectively, the Department of Health and Social Care and NHS England must work together to deliver a timely and comprehensive action plan. That action plan is needed now more than ever because the rare diseases community has been waiting long enough for improvements in care and treatment. The pandemic continues to bear heavily on the health and wellbeing of those with rare conditions, who are among the most vulnerable to covid-19 impacts. There is a gap in detailed policy to drive improvements for people living with rare conditions in the UK, until action plans are published to implement the framework.

The framework covers four key areas and seeks to make progress. The first priority is to help patients to get a final diagnosis more quickly. On average, rare disease patients wait four years to receive a diagnosis, with some waiting over 20 years. For people with a rare condition, it is often a long journey, frequently with several misdiagnoses, until a final correct diagnosis is reached. Often this journey is labelled as the diagnostic odyssey. The framework describes what is already happening to improve diagnosis, but it does not talk about improving the screening service for people living with rare conditions. The UK National Screening Committee currently screens for just nine conditions using the heel-prick test. That compares poorly with many European countries: Italy and Iceland screen for more than 40, Poland and the Netherlands screen for more than 30, and Hungary, Slovakia and many others screen for more than 20 conditions.

Earlier this month, the National Institute for Health and Care Excellence approved access to a new gene therapy for spinal muscular atrophy. NICE said that for some babies who are diagnosed before they have symptoms, it might come close to being a cure. For it to have the chance to be a cure, however, we need to identify the babies before they begin to be affected by the condition. To do that, we need newborn screening for spinal muscular atrophy. We need joined-up thinking that allows a screening programme to be developed in parallel as such medicines come over the horizon. Will the Minister confirm whether we will increase the scope of newborn screening in the UK or make changes to the UK National Screening Committee’s processes?

The framework also talks about Genome UK and the NHS genomic medicine service helping patients to get a final diagnosis more quickly, but it does not talk about how patients will access such services. The framework recognises that people with non-genetic conditions needs to be diagnosed through other means. We will need an action plan that sets out a realistic way to improve this, and we will need to demonstrate that the system becomes better at diagnosing everyone, not just those who are found through genome sequencing. Can the Minister confirm that that will be done?

Moreover, the framework does not talk about what happens after a diagnosis is delivered. We cannot abandon people after we have given them their diagnosis. My final point on diagnosis is this: what about the people who are stuck on the diagnostic odyssey? Do we know how many people have been waiting for five, 10 or 20 years for a diagnosis from the NHS? Will we track such people? Will we monitor whether everyone is receiving equitably the tests to which they are entitled? Will the Minister please comment on that?

The second priority of the framework is to increase awareness among healthcare professionals of rare diseases. People affected by rare conditions meet many healthcare professionals on their journey to find a diagnosis, and beyond while they live with their rare condition. For some it is a positive experience; for others it can be particularly challenging. This year, Genetic Alliance UK received an inquiry from an individual whose GP had told them that they could not possibly have the genetic condition that they were concerned about, because it is just too rare. Any individual clinician cannot be expected to know about all rare conditions, but they can be empowered to understand how to handle such cases. The framework does not address in detail how it will increase awareness among healthcare professionals of rare diseases. It does not provide details of how education programmes will be delivered, nor does it explain in detail how success will be measured. What measurements will be put in place to ensure learning for healthcare professionals in the NHS? Will there be a survey of experience now and in the future, to demonstrate improvement? Will that be included in the English action plan?

When clinicians do not engage with an individual who has a rare condition in order to understand their diagnosis and ensure that care is compatible with their needs, it can and has led to life-threatening situations. One way to prevent such situations from occurring is by providing rare disease patients with alert cards, which include information about the patient’s rare disease and any particular aspects of the treatment of that rare disease that need to be taken into account in providing care. In January 2018, NHS England promised that all rare disease patients in England would have access to a rare disease alert card. May I request an update from the Minister on alert cards specifically? How many rare disease patients have been issued with an alert card?

The third priority of the framework is to improve co-ordination of care. Many patients have numerous professionals involved in their care and therefore it is essential that there be co-ordination and communication among healthcare professionals, their patient and the family. The framework does not address how care co-ordination can be mainstreamed within rare condition care in the NHS. There are no details as to how the challenges of ensuring continuity of care during the complex transition between rare condition services might be addressed. Again, how will success be measured? Will there be outcome measures demonstrating increased care co-ordination services in the NHS, and will there be a survey now and in the future to demonstrate improvement in the experience of people living with rare and genetic conditions?

The final priority of the framework is to improve access to specialist care, treatment and drugs. Only about 200 medicines are specifically available for rare conditions, and fewer than that are available on the NHS now. Small patient populations and accelerated market authorisation mean that rare disease medicines can rarely have sufficient evidence to meet the expectations of health technology assessors in the UK. Few life-saving treatments are reaching rare disease patients, which means not only that the UK is falling behind other European nations in terms of treatments available, but that patients and their families can be left in the dark, unsure of what is next.

We have extremely frustrating situations such as that faced by families affected by phenylketonuria, who, 12 years after marketing authorisation for the drug, are not receiving access to Kuvan, despite the Prime Minister’s promises to work on the issue and the treatment being available in 24 European countries. Again, the framework does not talk about how success will be measured. Will there be outcome measures demonstrating increased access to specialist care, treatments and medicines, and will there be a survey now? Will the Minister comment on that?

My final point is this. Understanding the experiences and preferences of people affected by rare conditions is fundamental to providing care and treatment and to ensuring that support, information and services are available and targeted to meet needs. The national conversation on rare diseases on which the UK rare diseases framework is based does not reflect the whole rare disease community. It is important that the English action plan is created in consultation with a more diverse and inclusive group, so that we can understand and meet the needs of all those affected by rare, genetic and undiagnosed conditions.

I want to finish by talking about something that happened yesterday. I want to mention Norman Clayton, who watched Prime Minister’s questions last week and heard me ask my question on access to Kuvan for those with PKU. Norman is 91 years old and was moved, after all these years, to contact NSPKU—the National Society for Phenylketonuria—and tell us about his daughter, Denise, who was born in 1958, before newborn screening, and whose PKU was diagnosed late. Despite the best efforts of Norman and his wife, Denise’s development suffered and she disappeared off the radar of the NHS. She still requires a huge amount of care, because her condition was not recognised from birth. That story speaks to so many rare diseases and to the need to get the implementation of this framework right.

It is a pleasure to serve under your chairmanship, Mrs Miller. I congratulate the hon. Member for Blaydon (Liz Twist) on securing this important debate.

Motor neurone disease is a devastating and rapidly progressing neurological condition that leaves individuals unable to walk, talk, eat and, ultimately, breathe. It is a rare disease in this sense, because sadly one third of people die within one year of receiving their diagnosis, but at present one in 300 people will develop it in their lifetime.

There is currently no cure, but as chairman of the all-party parliamentary group on motor neurone disease, I have had the privilege of hearing about the pioneering research that is under way to find effective treatments. Huge progress has already been made, particularly in terms of understanding which genes cause the disease and of subsequent pioneering gene therapy trials such as that conducted by Professor Chris McDermott at the University of Sheffield.

It would be disappointing, when scientific advancements are at their most promising, to see Government funding for MND research plateauing. Although charities have picked up the shortfall, this source of funding is under more pressure than ever because of covid-19. In this context, the Government’s recent announcement of the rare diseases framework provides a welcome and much needed opportunity. It is encouraging that one of the framework’s key priorities is to improve access to specialist care, treatment and drugs, and that one of its underpinning themes is to encourage and support pioneering research into rare diseases. Key to successfully delivering this will, in part, be the completion of ongoing NICE methods and a process review changing how we access new medicines. It will also come from close partnership between the devolved Administrations and the voluntary sector, which is already working to support pioneering research.

In the same vein, MND Scotland and My Name’5 Doddie Foundation are asking the Government to consider investing £50 million over five years to establish a virtual MND research institute. It would be designed to create a world-leading drug discovery and development programme, to establish a sustainable MND trials platform and to implement a rigorous clinical research programme. The institute and the funding would help the national and local delivery of this new framework’s key aims of improving the lives of those living with MND and embedding personalised care in the UK healthcare system. I thank the Government for the support they have already shown, and I look to them for more regarding the research institute.

It is a great honour to serve under your chairmanship, Mrs Miller. I congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing the debate and on her excellent opening speech. The rare diseases framework is welcome, but in order to deliver on the vision it is important to reflect on the experiences of those with rare diseases over the past year.

I chair the all-party parliamentary group on muscular dystrophy, and last month our meeting brought together people living with muscle-wasting conditions, leading health professionals and charities representing relatives to discuss the impact of covid-19. It came after a month-long survey conducted by Muscular Dystrophy UK to assess the impact of covid-19 on people living with muscle-wasting conditions and their families and the effect on accessing healthcare services. There were over 400 survey responses and they were very concerning. The comments made at our APPG meeting backed up many of the survey’s findings.

We heard that the delivery of standard care had been put on hold and essential services were interrupted, and that it was proving very difficult to regain muscle strength after losing six months to a year of physiotherapy. Some had experienced diagnostic tests being put on hold as resources were diverted because of the pandemic and a number of clinical trials were also halted. Worryingly, the physical and mental impact of shielding has left many people reluctant to go out even to hospitals when restrictions are relaxed.

Our APPG also considered what might happen when restrictions are relaxed and we return to some kind of normal life. Infrastructure challenges for service provision still remain, and there is concern about if and when staff and resources redirected to covid-19 will return to neuromuscular services. Virtual clinics have had a positive impact and there are benefits to be taken forward of continuing these for some people, especially taking into account issues such as long travel times. However, not everything can be assessed or picked up virtually. Routine face-to-face appointments are still critical.

Members of the APPG are always grateful for the support of our secretariat Muscular Dystrophy UK, medical professionals and those with muscle-wasting conditions. On their behalf, I ask the Minister to outline how the action plans for the framework will learn from patient and health professional experiences during the pandemic, and will also shape the priorities for accessing essential specialist care and mental health support.

I thank the hon. Member for Blaydon (Liz Twist) for securing this important debate on the challenges faced by people living with rare diseases. I am delighted to have the opportunity to speak about phenylketonuria, which has been mentioned already, and to put on record my own concerns about access to treatment for this condition, including the drug Kuvan.

I am raising this issue on behalf of constituents who have been in contact with me about it. In particular, I am grateful to Leanne Barnett for meeting me to discuss the impact that PKU continues to have on her twin daughters, who were born with the condition, and on the family as a whole. I really appreciated gaining an understanding of the extraordinary challenges of living with rare diseases such as PKU, and I believe that Leanne’s case illustrates the problems that many people face, which are unacceptable problems in a modern society.

I will not go into the details of the condition, but we know that the main treatment available at the moment is a strict low-protein diet. For anyone who is a parent of young children, babies or toddlers, managing any diet is challenging, but managing a diet with low protein is extremely difficult. Everyday life becomes filled with anxiety, putting incredible strain upon the parents, who know that one mistake might cost the child their life or lead to brain damage. Leanne explained to me that

“PKU life can feel extremely isolating as the condition is so rare. It’s exhausting having to explain the condition and even then most people think it’s just a food allergy”.

She told me that managing her daughters’ diets is

“difficult and time consuming to manage and almost impossible to adhere to well enough for optimum treatment”.

She explained that, as her daughters grew, she would have to

“measure and monitor everything they eat, restricting the amount of natural protein they consume, which was really…stressful”.

This dietary treatment can also be incredibly costly for families, particularly if they are on a low income, which is a real barrier. The drug Kuvan, having been licensed to treat PKU back in 2008, has not been available to patients in the UK, except in limited circumstances.

NICE has published its preliminary assessment on the use of Kuvan, recommending its use for children up to the age of 18, which is welcome, but not necessarily its use for people over 18. I say to the Minister that this is a lifelong condition and therefore we need lifelong treatment of Kuvan on the NHS. Anything less than that will cause enormous distress for those young people with PKU who are making the transition to adulthood, so I urge the Government to consider placing Kuvan within the framework as a priority for the future.

It is a pleasure to serve under you as Chair, Mrs Miller. I was not aware of the rare metabolic disorder phenylketonuria, or PKU, until my constituents with PKU explained that it prevents them from metabolising phenylalanine, or PHE, which is an amino acid in protein foods. The standard treatment is a low-PHE diet, removing almost all natural protein and replacing it with prescribed medical dietary proteins to ensure adequate nutrition.

The PKU dietary regime is very complex, very restrictive and very difficult to manage. I joined the all-party parliamentary group on phenylketonuria, which was formed by my hon. Friend the Member for Blaydon (Liz Twist), and became vice-chair. I congratulate her on securing another PKU debate today. The National Society for Phenylketonuria, a charity set up in 1973, is remarkable. It has no premises and no full-time staff, but is run by wonderful volunteers with personal experience of PKU.

Managing PKU is extremely demanding. Every meal, snack and drink must be planned in advance. People with PKU and their families spend on average 19 hours every week preparing their diet. Many of them have applied for personal independence payment, which is assessed on the basis of how much help is needed with ordinary daily living activities, one of which is managing therapy or monitoring a health condition.

The Department for Work and Pensions has not accepted that the PKU diet is a therapy, so many people, including my constituents, have been denied the daily living activities component of PIP, even though they need hours of help from relatives every week to manage their diet. However, in 2020 a tribunal decided that the PKU diet qualifies as a therapy, following a legal challenge by a 21-year-old man whose PIP application had been refused by the DWP. He appealed to the first-tier tribunal, but it agreed with the DWP that his PKU diet was not a therapy. He appealed again to the upper tribunal, which found that the first-tier tribunal should re-examine his case, because the reasons it gave for reaching its decision were not adequate. The case re-examination found that his PKU diet was a therapy under PIP criteria, because he needed more than 14 hours of help per week and therefore met the criteria to qualify for PIP, and should receive £87.65 per week. That is good news, but it remains to be seen whether this will govern future DWP decisions about PKU. I sincerely hope that it will, to help the brave PKU sufferers who struggle every minute of every day to live with such a challenging rare metabolic disorder.

It is a pleasure to serve under your chairmanship, Mrs Miller. I congratulate the hon. Member for Blaydon (Liz Twist) on securing the debate. It is a welcome debate and an opportunity to discuss those rare diseases that, by their very nature, do not have the large advocacy organisations to speak about them. This week I received a mailshot from one of the UK’s leading cancer charities. While that is a welcome and worthwhile effort, rare diseases—those that affect fewer than one in 2,000 people—do not have those resources and it is important that we speak about them.

I welcome the publication of “The UK Rare Diseases Framework”, which has four priorities. I will speak briefly on priorities 2 and 4. Priority 2 is to increase awareness of rare diseases among healthcare professionals, which I think is crucial. I am co-chair of the all-party parliamentary group on axial spondyloarthritis, which is not a rare disease—it affects one in 200 people—but the eight-year delay in diagnosis has been attributed, in part, to a lack of knowledge by healthcare professionals. I fully support any increased awareness of rare diseases.

Priority 4 is to improve access to specialist care, treatments and drugs. As others have said, I have seen that myself with phenylketonuria, which I had not heard of until I met the parents of Hurley, one of my youngest constituents. They came to see me to discuss Hurley’s condition. PKU affects fewer than one in 10,000 babies. As we have heard, it means that the body cannot process protein, which results in a severely restricted diet.

The drug Kuvan has been available but was not widely licensed despite promising results. I welcome the news that Kuvan is now available, but it is not available for over-18s. That causes understandable concerns not only for adults, but for those in their late teens who are approaching a point when their treatment will become unavailable. I will add my name to those calling for the wider licensing of Kuvan for those with PKU.

This is a welcome debate and there is a responsibility on all MPs to speak up for their constituents who have rare diseases, to make their case heard. I look forward to continuing to do so with colleagues.

Order. After the next speaker, I will move to a two-minute time limit, in an attempt to get more speakers in.

It is a pleasure to serve under your chairmanship, Mrs Miller. I pay tribute to my hon. Friend the Member for Blaydon (Liz Twist).

PKU is a disease that leaves people unable to break down protein. It can lead to severe brain damage. Kuvan is a life-changing drug that can help people cope with PKU. NICE’s decision to offer Kuvan only to patients up to the age of 18 is wrong. There is no miraculous cure for PKU when patients turn 18.

The transition to adulthood is a tough time already; 18-year-olds are moving away from school and often away from parental support, whether attending university, beginning an apprenticeship or starting a career. It is a difficult time. NICE’s decision strips young people of a life-changing drug when they are at their most vulnerable. Giving patients Kuvan and then taking it away turns an 18th birthday into a day of dread. Never mind the joy of a Greggs sausage roll, PKU patients cannot even grab a healthy salad or a vegetarian sandwich. The disease requires an exacting regulation of food intake.

I met Liam, a 20-year-old constituent who has PKU. The first thing that struck me was Liam’s mother bringing him bags of special ingredients. Careful planning is essential. Everything is homemade and all the ingredients have to be measured out, for Liam’s safety. Preparing the food is a full-time job. Liam has never had Kuvan and is in his second year at university studying policing. He is planned and worked hard to contribute to society, but he fears that without Kuvan this would not happen. There are hundreds like Liam who want to make a positive contribution. I asked him for his thoughts on the decision. He said:

“The overwhelming feeling right now is one of betrayal. We have spent 12 years fighting for this drug, seeing it within our sights, our hopes finally rising at the prospect of receiving such a life changing drug, only to have it snatched from us.”

I ask BioMarin and the Government to put people like Liam at the forefront of their decision making. People are being denied the quality of life that is possible and that they deserve.

It is a pleasure to serve under your chairmanship today, Mrs Miller. It was also a pleasure to listen to the hon. Member for Blaydon (Liz Twist), who opened this evening’s debate. She has been a tireless campaigner for those who suffer from phenylketonuria and I congratulate her on securing this important debate.

One in 10,000 babies across the United Kingdom is born with PKU. That rare inherited disease means that individuals cannot break down phenylalanine. If the condition is untreated, it can lead to damage of the brain and nervous system. Sadly, a number of my constituents suffer from the disorder, including, as I learned today, a three-month-old infant. I thank Samantha Parker, Kelly Thompson and Amy Duston, who suffer with PKU or have a child who does, for their engagement with me.

It was a bittersweet moment last month when NICE released its draft recommendation that, following discussion with the manufacturer of Kuvan, it could be used for children up to the age of 18. It was bittersweet because it means that as those children turn 18 they will face a cliff edge in their treatment. I fear that NICE has not fully considered the problem of an 18-year-old abruptly stopping treatment with Kuvan. The decision will lead to further difficulties down the line, and it does not address the treatment of adults with PKU.

I am hopeful on three counts for my constituents. I am optimistic that children will soon be able to access that life-changing drug, that NICE will reconsider the use of Kuvan for adults, and that as the exclusivity of Kuvan to BioMarin comes to an end it will become cheaper and more cost-effective as a treatment for all who suffer from PKU.

I, too, congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing the debate. I chair the all-party parliamentary group on life sciences and want to raise a couple of wider points. I am grateful to the Association of the British Pharmaceutical Industry and the UK Bioindustry Association for advice.

We are all familiar with the figure of Sir John Bell on our television screens, but in the current circumstances would the Minister tell us a little about the status of the life sciences industrial strategy and sector deal? It seems that the industrial strategy has gone by the wayside. What is going on? Will she also tell us how the various initiatives, including the NICE methods review, the innovative medicines fund and the recently published commercial medicines framework will work together to support access to medicines for rare diseases?

There has been a long-running issue around the NICE process review in relation to the single technology appraisal programme, which many feel is not very suited to the specialised medicines world. It led to the highly specialised technologies programme, but there is a continuing gap between the two, and perhaps she can shed some light on that.

Professor Lucy Raymond was professor of medical genetics and neurodevelopment at the department of medical genetics in Cambridge, and has welcomed me on Rare Disease Day in previous years. She made a couple of important points, saying that despite the welcome work done by the 100,000 genomes project at such places as the Wellcome Sanger Institute, there are still long delays, and testing is limited by resources and NHS England funding. Secondly, there is the question of making sure there is sufficient access to clinical trials. Professor Raymond suggests that as we have a limited number of nationally funded genomic laboratories, it could be possible to introduce a statutory obligation to notify, which would produce a bigger group for clinical trials.

Finally, on the question of our relationship with the European Union, what progress has been made on developing a rare disease trial protocol?

It is a pleasure to serve under your chairmanship, Mrs Miller. I draw attention to my entry in the Register of Members’ Financial Interests.

NICE was established to determine cost-effectiveness, and it quickly became the best at this in the world. Given the pandemic, the importance of the life sciences sector to our country has never been clearer. If we want to retain our global reputation, however, NICE needs to alter the way it works. The rare diseases framework should be seen in this context. Its themes of pioneering research and being a global player are the right ones. I am encouraged that NICE recognises the challenges we face. That said, I am not yet convinced that NICE has got to the right place on the detail. Unless we get it right, we risk reducing the number of new medicines arriving to treat patients.

Within the framework, priority 4 is all about improving access to specialist treatments. The review has identified the need to change and update the discount rates, but less helpful are the suggestions in the current process review consultation on how we evaluate new health technologies. Essentially, there are two routes: the regular single technology appraisal process; and the highly specialised technology option, which is far more flexible. Medicines for rare diseases need that flexibility and the higher threshold for cost-effectiveness. If they do not meet the HST criteria, new technologies are stifled. NICE is risking needlessly complex and convoluted criteria that will not allow for transparency on why particular medicines are put into the programme. I hope it will register the concerns expressed by the ABPI and others.

The Medicines and Healthcare Products Regulatory Agency is talking about new pathways to licences. Such work needs to be joined up and supported by NICE’s processes. Early engagement is positive, but NICE must avoid premature decisions, including about the commercial aspects and pricing.

To ensure that we can get all Members in, the Minister has very generously given some of her time, so I hope that I can bring in every Member on the list.

It is a pleasure to serve under your chairmanship, Mrs Miller. I congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing this important debate and on her excellent opening speech.

As chair of the all-party parliamentary group on sickle cell and thalassaemia, I know that this subject is of great interest to people with thalassaemia. I will focus my speech on one of the four high-level priorities of the framework: improved access to specialist care, treatment and medicine. People with rare diseases say that the tantalising prospect that one day there will be a cure for the rare diseases affecting them is something that gives them hope and huge motivation, and that drives them to campaign passionately for the development, and then approval, of that medicine or therapy. When it comes to assessing the effectiveness of such drugs or treatments for rare diseases, however, the approach taken by NICE leaves a lot to be desired.

Recently, NICE gave a provisional negative appraisal to a ground-breaking gene therapy treatment that would have eliminated the need for the chronic treatment of many people with a severe form of thalassaemia. One of the contentious issues with NICE’s assessment has been the inflexibility of the arbitrary discount rates. The small number of people with rare diseases means that there is often insufficient evidence available to satisfy NICE’s assessors. I note that NICE has undertaken a methods review process in which the discount rate is a key area of potential reform, which I very much welcome. Additionally, I want to ask NICE to take greater account of the testimony from patients, because only by understanding patients’ lived experience can a committee properly assess the effectiveness of a drug or treatment.

For people with rare diseases such as thalassaemia, the approval of a drug or treatment can be the difference between life and death. It is imperative that we get this right, and that means things have to change quickly. We need the implementation of an action plan for the rare diseases framework, and we need it now.

It is a pleasure to speak with you in the Chair, Mrs Miller. I wish to speak about neurofibromatosis, which for obvious reasons is more commonly known as NF1. As far as rare diseases go, it is pretty common. It affects one in 2,700 people born today, and it is more common than cystic fibrosis, Duchenne muscular atrophy and Huntingdon’s disease put together. I particularly want to echo the words of the hon. Member for Blaydon (Liz Twist), who made an excellent opening speech, and I really appreciate the opportunity to speak on these issues.

My focus is on diagnosis and monitoring. I came across NF1 because the Watts family in my constituency had a son, Chris, who had the condition since he was born. He was 31 when he took his life, having managed to pursue a career and live independently. The thing about NF1 is that it can be mild, but then it can become quite severe. He had a tumour that started to grow and was painful, but he was nevertheless told, “Nothing to worry about; it’s cosmetic.” Sadly, it ended up being malignant and he passed away. I think this illustrates the fact that we have a divided approach to NF1. It is seen as either complex or non-complex. For non-complex, there is very little monitoring of what happens, even though it can become complex, and there is very little treatment for the complex conditions other than a couple of specialist treatment centres in London and Manchester. However, there is no clear pathway for one assessment—the non-complex to the complex.

I am very grateful to Vanessa Martin at the Childhood Tumour Trust. They have set up some simple changes they would like to see, and I urge the Minster to engage with them to implement those changes.

Thank you, Mrs Miller, for chairing this debate. I thank the Minister for allowing us to get in.

Whatever the rare disease, it cannot be right that families are spending their time and energy fighting for treatments when they should be spending precious time with their children. I congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing this debate, and I echo the concerns about Kuvan, particularly the recommendation for its use only by children. One of my constituents whose daughter is living with PKU raised very legitimate concerns with me about the detrimental impact this could have on the mental health of children and teenagers whose lives are transformed by this drug, but know the clock is ticking towards it being taken away from them as they turn 18.

One of the themes underpinning the UK Rare Diseases Framework is patient voice, which the Department for Health and Social Care says is essential to its implementation, and I could not agree more. However, we must understand that there is a long way to go before families coping with the impact of rare diseases truly feel valued by the system. Gail and Matthew Rich from my constituency fought a long campaign that I supported to access Brineura on the NHS for their daughters Nicole and Jessica, who have CLN2 Batten Disease. Ahead of this debate, Gail told me:

“Patients and parents are not included or listened to enough, and children are suffering as a result of following an antiquated system which seems all about number-crunching and balancing figures rather than what is essential and morally acceptable.”

Those affected by rare diseases too often feel that they are struggling alone, so as we move from publication of the UK Rare Diseases Framework to the development of action plans, I urge the Minister to ensure that patient voices are truly heard, and positive outcomes reflect patient needs, not just those of the healthcare system.

I, too, extend my congratulations to the hon. Member for Blaydon (Liz Twist) on securing the debate and my gratitude to the Minister for the extra time.

The devolved nature of health and the need for proper planning and co-ordination between the nations of the UK have been brought into sharp focus as a result of the covid-19 pandemic. For people living with rare diseases, planning and co-ordination within health systems is key, as they face additional barriers to receiving a diagnosis and treatment, compared with those people who are suffering more common illnesses. In Wales, around 175,000 people will be affected by a rare disease at some point in their lives. A Welsh action plan that commits to proper joint working and collaboration between the four nations will be imperative in ensuring the best outcomes for people living with rare and genetic conditions in Wales.

That should involve data sharing between Wales’s Congenital Anomaly Register and Information Service and other rare diseases registries in the UK to help researchers identify non-genetic rare diseases that are not picked up through screening and genomic testing. It would also involve better cross-border co-ordination for care and treatment between Wales and the other nations, including education for clinicians and healthcare staff.

There is a question as to how the Welsh plan will integrate with health entities with a UK-wide remit, and challenges associated with decision making. I urge all national Governments to commit to publishing their action plans within 2021 so that we avoid delays in implementing the framework, to ensure that there is equitable treatment for those living with rare conditions.

I would like to mention my constituent Mark Edwards of Llanegryn, who has proved to be such an excellent ambassador for PKU, and to add my voice to the call for wider licensing of Kuvan.

Thank you Mrs Miller. It is a pleasure to serve under your chairmanship. Congratulations to the hon. Member for Blaydon (Liz Twist) on securing this important debate; she is a doughty fighter.

Around 437,000 people in Scotland have a rare disease. It is therefore important that the NHS and other services provide this large and diverse patient population with the best possible care. The UK Government published the new UK Rare Diseases Framework in January, listing the priorities and underlying strategic themes and detailing how the four nations of the UK will address the challenges faced by those living with rare diseases.

As part of that ongoing commitment and with the support and advice of the rare disease strategic oversight group, the Scottish Government published their final progress report, which assesses the implementation and progress against the 51 commitments in the UK strategy and their own implementation plan, “It’s Not Rare to Have a Rare Disease”.

In developing a new action plan for Scotland, the Scottish Government will work closely with the rare disease community to ensure that their needs are appropriately reflected across wider Government policy too, including mental health and social care, that all the commitments are actionable and measurable, and that the patient voice remains at the heart of the new action plan. The Scottish Government will establish a new rare disease implementation board to oversee the action plan and further details will be in the action plan due to be published this year.

Recognising a gap in Scotland’s population health charter, work is now well under way and established on a national congenital anomalies register for Scotland—CARDRISS. Once fully established, it will register babies affected by a major structural or chromosomal anomaly or recognised syndrome.

While the congenital anomalies register is still being developed, a great benefit has already been seen just by linking historical datasets to provide, for the first time in Scotland, a record of congenital anomalies. The dataset and the register are beginning to help inform the planning of services for individuals and families affected by congenital anomalies and rare diseases. Once the register is live, it will also allow NHS Scotland to support the prevention of anomalies where possible, understand the impact of antenatal screening and support research.

The Scottish Government have also made great progress in delivering genomics medicine in Scotland. An allocation of £4.2 million over a two-year period by the Scottish Government supported the transition of genomic testing of inherited rare disease from the research setting into regular genetic testing services. As a result, more families have been able to get the right genetic test and receive an often long-awaited diagnosis, enabling them to get the support and treatment they need. A well-established network of clinicians and clinical scientists has been delivering evidence-based genetic testing for NHS Scotland patients for more than 30 years. Continuing advancements in genomics medicine improve a range of factors for rare disease patients, including diagnosis, access to treatment and co-ordination of care.

In Scotland, access to new medicines for rare, very rare and end-of-life conditions is significantly increased through a new ultra-orphan medicines pathway, introduced in October 2018, ensuring that those with the rarest diseases will get faster access to new treatment where appropriate. In the light of the benefits seen from the use of genomic medicine, the Scottish Government are increasing their investment in this area to £2.3 million, as announced in the new Scottish Budget. The investment will support the implementation plan and the plan will set out actions aligned with the three pillars in the strategy—diagnosis and personalised medicine, prevention and research. The Scottish Government will work closely with NHS Scotland laboratory genetic services to continue their approach to embed genomics in routine healthcare. Families and patients need to know that wherever they live in the UK, their Government are committed to the framework and to making it work. Does the Minister agree?

It is a pleasure to serve under your chairmanship, Mrs Miller. I congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing the debate, and on the case she made and her inspiring work championing those with rare diseases through the all-party parliamentary groups that she has chaired, currently the APPG on rare, genetic and undiagnosed conditions and previously the APPG for phenylketonuria. She set out a very strong case. She started by saying that we have been here before. If we followed some of the suggestions that she made, it would make sure that we are not here forever.

I want to pick up on the point around childhood screening. I hope the Minister will address the points on the report and the outcome of the strategy. That learning is really important.

It is hard not to be struck by the wide range of conditions that colleagues raised—NF1, raised by the hon. Member for Thirsk and Malton (Kevin Hollinrake); thalassaemia, raised by my hon. Friend the Member for Enfield, Southgate (Bambos Charalambous); motor neurone disease, raised by the hon. Member for Northampton South (Andrew Lewer); and muscle wastage, raised by my hon. Friend the Member for North Tyneside (Mary Glindon). The right hon. Member for Kingswood (Chris Skidmore) and the hon. Members for Gedling (Tom Randall) and for Darlington (Peter Gibson) raised PKU, as did my hon. Friends the Members for Neath (Christina Rees) and for St Helens South and Whiston (Ms Rimmer). They made important points around welfare reform and the accessibility of Kuvan.

I hope that the Minister will also cover the more general points around NICE, made by the hon. Member for Peterborough (Paul Bristow) and on the life sciences sector deal, made by my hon. Friend the Member for Cambridge (Daniel Zeichner).

The debate tells us that while rare diseases are rare individually, collectively they can affect up to one in 17, so they are not rare at all. That is more than 3.5 million people in the UK. We will all know someone with a rare disease and we will all have constituents for whom we need to advocate. Rare diseases can be life-limiting and life-threatening. As was mentioned, three quarters of them affect children, and sadly more than 30% of children with a rare disease die before their fifth birthday. That is a truly heartbreaking statistic. With that in mind, we welcome the Government’s plans, but I want to test some of the detail.

On the first priority relating to diagnosis, I am keen to know what the Government’s plans are in greater detail. Will the scope of newborn screening in the UK be increased? Many countries screen for more than 20 conditions; indeed, Iceland and Italy screen for more than 40. Here in the UK, we screen for nine. Will that be revisited? How do the Government intend to measure success in diagnosis more broadly?

On the second priority, awareness, we need to skill up our wonderful healthcare professionals. I find that, whoever I speak to—especially those whose diseases were not diagnosed at a very young age—lack of awareness often prevented diagnosis and access to the correct treatment and care pathways. A couple of weeks ago I met a wonderful group of people from the Pernicious Anaemia Society who do great work for people struggling with pernicious anaemia. As we went around the room—virtually, of course—it was striking that everybody had been diagnosed with something different at some point, and often multiple things, incorrectly. What will we do about that? Do the Government intend for rare diseases to have a larger part in undergraduate courses? Will they be part of continuous professional development for already qualified medical professionals? More importantly, because there is no new money with this strategy, from where will the resourcing come to increase training and develop additional tools?

I want to touch on priorities three and four on improved co-ordination and access to care treatment and drugs. I will lean less on the latter, which was covered by others, but, on priority three, well co-ordinated care is crucial to patients and their families. Last year, a Genetic Alliance UK report found that more than 70% of respondents were responsible for their own or a family member’s care. That means reduced work—or giving up work—and reduced education and other opportunities that the rest of us take for granted. We need a family-centred holistic and equitable approach to care. It would not change everything, but it would make their lives much better. Again, I know the Government have committed to that, but how will they measure progress?

Finally, on understanding the action plans, health is devolved and it is important that we take the different nations approach, but when do Ministers intend to hear back? When do they think they will hear back? What will we do to ensure that the care pathways are properly co-ordinated?

I will finish there to give the Minister a chance to address all the points raised. This has been a great debate, and hopefully those with rare diseases, who do not always think their voices are heard, will feel that today they have been heard and not missed or forgotten. If we come together, we can do something really special in this space.

It is a pleasure to serve under your chairmanship, Mrs Miller. I am afraid that I have been asked a huge number of questions. The shadow Minister just said he hoped I could answer them, but I am afraid that is not going to be possible. However, I will write to the hon. Member for Blaydon (Liz Twist) and answer her questions in detail. I congratulate her on securing this important debate. I think someone described her as a doughty campaigner, and I pay tribute to her tireless work championing the rare disease community as chair of the all-party parliamentary group on rare, genetic and undiagnosed conditions. I will try to answer a few of the points in the short time that I have and I will write on the rest.

First, I will answer a more general point. Many hon. Members brought up the drug Kuvan, which is indicated to reduce blood phenylalanine levels in patients with phenylketonuria. PKU is an inherited metabolic disorder. NICE published draft guidance on 25 February recommending Kuvan for people with PKU who are under 18. Hon. Members have quite rightly acknowledged that when children and young people reach the age of 18, that is a problematic step.

NICE’s draft guidance is a huge step forward for children who stand to benefit from Kuvan as a treatment, but I understand that it will be disappointing for adults. It is important to stress that this is not the final guidance. NICE will carefully consider all comments received during the recent consultation. The Government encourage the company to continue working with NICE, NHS England and NHS Improvement to ensure that Kuvan is priced affordably, so that more patients may benefit. That is a sort of round-robin answer to a number of the questions that have been asked.

I would like to pick up the first question that the hon. Member for Blaydon asked about the report to be published on the outcomes of the UK strategy for rare diseases. We have published yearly updates on the UK strategy for rare diseases implementation plan. Those updates highlight areas of progress and ongoing action against the commitments described in the strategy. The Department is constantly engaging stakeholders to learn what has worked in the strategy and the implementation plan.

We are constantly engaging and looking for areas of improvement, and we took the learnings into consideration when we developed the UK rare diseases framework. The framework builds on the previous strategy, outlining clear, concise and actionable priorities that were developed in close collaboration with the rare diseases community, including patients themselves.

The shadow Minister asked about screening newborns in the UK. As part of our screening improvement programme, the Department is considering how better to integrate targeted screening of high-risk groups in our population-based screening programmes. The chief medical officers of the UK have established a screening advisory working group to consider the scope and remit of the single screening advisory body proposed by Professor Sir Mike Richard. We have committed to making better use of technology to develop a more personalised screening offer, including important genetic testing, inter-screening and diagnostics. In the 2019 report, “Generation genome and the opportunities for screening programmes”, the UK National Screening Committee concluded that there is “clear potential” for genomics in the testing for many of the conditions currently included in the blood spot test. I think that all of us here today would agree on one fact: screening and medical science are moving forward at a rapid pace.

Only last month, we marked Rare Diseases Day. We have heard many touching stories today from Members, but last month we also heard many touching stories and how rare diseases, including PKU, can have an impact on patients and on their family members. As many Members of this House know, while rare diseases are individually rare, they are collectively common: one in 17 people is affected by rare disease at some point in their lifetime. In the UK, that amounts to more than 3.5 million, which is a significant group of people.

I am sure that the hon. Member for Blaydon would like to respond to the debate, so I will end. We will write to her with detailed responses to her thoughtful and detailed questions. I hope she will be able to share that information with the rest of the people who have spoken.

I thank the Minister and all hon. Members who took part in the debate. The diseases we have mentioned—motor neurone disease, muscular dystrophy, PKU, thalassaemia, neurofibromatosis and Batten disease —are all important, but there are so many more rare diseases that we could have mentioned. I look forward to the Minister’s detailed reply, and I will certainly circulate it to all those Members who have taken part today.

Question put and agreed to.


That this House has considered the implementation of the UK Rare Diseases Framework.

Sitting adjourned.