Westminster Hall
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Housing Supply
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
John Redwood (Wokingham) (Con)
I beg to move,
That this House has considered the supply of homes and affordable homes to buy.
Home ownership has been people’s preferred way of living and enjoying their home comforts for many years. All the surveys tell us that an overwhelming majority of UK people are either pleased to own their own home or would like to own their own home, and the reasons for that are obvious. Owning a home makes people free of landlords’ special rules and regulations. They are free to do in their own home anything that they wish, subject only to the rules of decency and their conduct towards other people in their home and towards their neighbours. They are also free to amend, decorate and improve the inside of their home in more or less any way they see fit, subject to safety standards, while suitable improvements can be made to the outside, subject to planning consent.
For most people, home ownership has also turned out to be an extremely good investment. Not only does a home represent security for themselves and their family, and a place where they can create and enjoy their own environment; it is a store of growing value. Since 1980, house prices have risen by 7% a year on a fairly steady basis. There have been a few setbacks, most notably during periods of recession. The last severe setback was a 7.6% fall in 2009, on the back of the banking crash. However, that tells us something very interesting: even when shares and the values of banks were crashing dramatically, the average home did not fall in value much against the background of the average steady 7% growth. It is therefore not surprising that 86% of our fellow citizens want to own their own home; it is perhaps more surprising that fewer and fewer currently achieve that goal.
Home ownership reached its peak as people’s preferred form of tenure at 71% in 2003. Since then, there has been a sharp decline. Now, only 64% of our fellow citizens own their own home, according to the official figures. I submit that those figures overstate the reality. Because of the way the figures are calculated, if an adult with a job still lives at home with their parents, they do not count as a separate household. They are not in a rented household, so they are invisible in the totals, even though they are, to all intents and purposes, in a rented household under somebody else’s rules, although they may not pay any rent to their generous parents.
Dr Rupa Huq (Ealing Central and Acton) (Lab)
The right hon. Gentleman is making an interesting point. To illustrate it, I asked the Library for the home ownership figure for Ealing Central and Acton. Apparently it is 46%, not 64%. Does he accept that there is a bigger imbalance in London, and that things are worse than the global figures he is quoting? Apparently, the average price a first-time buyer pays in the London Borough of Ealing is £490,421, on an average salary of £27,000. Does he accept that the inflated house prices in London are part of the problem?
John Redwood
I very much agree, and I will go on to look at how we deal with that, at the Government’s answer and at what more can be done. The hon. Lady is absolutely right that the figures exaggerate the homeowner percentage. Given the way the figures are calculated, if a group of young adults co-rent and share a property, for example, that does not appear as a series of independent rented households, but as one rented property. The figures therefore understate the number of people living in the rented model compared with those living in the owner-occupied model, because it is measured by housing units rather than individual households. The Government should bear it in mind that we are probably dealing with more people whose aspirations are not being fulfilled, rather than fewer, because the overall 64% figure undoubtedly overstates the reality.
We all know from our own experiences that many under-35s not only cannot afford to own a home, but find it extremely difficult to afford a rented home in London and the south-east because rents are extraordinarily high. They may still live with their parents, but it would not be their preferred way of proceeding; it may not be their parents’ preferred answer either, but family loyalty and love come before individual preferences, given the financial positions people find themselves in.
That decline in official home ownership—from 71% to 64%—is more pronounced when looking at the age-related figures. According to the official figures, 54% of under-34s owned their own house or flat in 1996, but that fell to just 34% by 2016. We have gone from a majority of the under-34s being able to afford their own home—so we know it can be done—to a minority of around a third in the more recent figures.
For most people, the financial case for owning is extremely strong. By definition, at the moment it may be cheaper to buy a house and pay a mortgage at very low interest rates than to pay rent, because rents are so high. Looking at it over a lifetime, it is obviously much cheaper and better to make the effort and buy a house, if people can, because they may have only 25 years of paying the mortgage, whereas they may have 50 or 60 years of paying rent, which will cost an awful lot more. Rent is a good way to keep people poor.
Siobhain McDonagh (Mitcham and Morden) (Lab)
To give the right hon. Gentleman a picture, in my office in Portcullis House, I have Ross, who bought his own home and pays a mortgage of £600 a month, and Dan, who pays £650 a month to rent a room in a flat. For the first it is an investment; for the second it is an impediment to ever owning his own home.
John Redwood
That is a very powerful individual illustration that bears out my general point that maybe half of people today would be no worse off month by month if they were able to get a deposit and buy a property, compared with renting. If we look forward 30, 40 or 50 years, they should be massively better off, if for no other reason than that the mortgage stops once it has been repaid, whereas rent carries on.
Worse still is the cruelty of renting for those in old age, when the rent will be at its maximum, because rents are likely to carry on inflating as they have done in recent years. Not only is rent paid for many more years, but people are charged the maximum rent when they are deep into retirement and least able to pay it, and when they will worry about how far their pension will stretch to meet their daily bills. That leaves out of account the possibility that, if someone buys a property, its value will go up, which is an added bonus. As I pointed out, that has been true since 1980. It might not always be true, but if it were true again over 25 years, the owner would be the double winner: they pay less by purchasing rather than renting, and their asset rises in value.
That rise in value gives homeowners more freedoms. If they buy early enough in life, that asset is there, normally rising in value, as possible collateral if they want to raise a loan for some other purpose—to help their family set up a business or whatever it may be—but it is not there for the person in rented accommodation. It is undoubtedly true that a person who manages to buy a property is, rightly or wrongly, usually treated as a better proposition for loans and business activities, which is another injustice for the person continuously paying rent.
I detect some cross-party agreement, which is excellent, that home ownership is the preferred form of tenure for many people—for very good reason—and that we need to make more efforts to get people into it, to deal with their high rental costs.
Siobhain McDonagh
Does the right hon. Gentleman agree that the other advantage of owner-occupation is security? In the private rented sector, where an increasing number of families with children are living, a landlord simply needs to secure a possession order for eviction. That has become the main route for the eviction of families, leading to children being insecure and living in temporary accommodation, far away from their homes and schools, with all the consequences that holds for public services.
John Redwood
I entirely agree, and I mentioned security for families at the beginning. That is a point well made.
We need to ask what we can do. House prices in many parts of the country, most especially in London and the south-east, are extremely high, and it is very difficult even for someone on average earnings, let alone below-average earnings, to raise a sufficiently large deposit, meet the requirements to raise the loan and meet the interest payments on it. One driver of these very high house prices is undoubtedly the big imbalance between demand and supply in housing. I know the Government accept that and are trying to work on the supply side. If more houses can be produced, all other things beings equal, that should help ease the house price pressures.
There is also the question of demand. I think all of us wish to be generous to refugees and to invite in people of talent who can make a good contribution to our community. There is everything to be said for allowing companies investing here to bring in their executives and so forth, but Government Members feel there has to be some control on overall numbers. When we are being generous, as we should be, we have to take into account the strains being put on the housing market, which may mean that the people coming here cannot get the quality and price of housing that we would regard as important for the lifestyles we wish for all the people in our country.
We need to look at the number of people who need housing vis-à-vis migration, as well as supply. I know the Government are considering that and will be freer on it in due course, once we come to debate in the House of Commons a UK migration policy that meets demands for decency and labour mobility for business, but that also understands the stresses placed on housing and other services if we have very large numbers. Those stresses run the risk of us not being able to offer people the standards we think are appropriate for anyone settled here in our country.
The Government have attempted to tackle the housing problem by driving the construction of more homes and to tackle the issue of affordability by working particularly with first-time buyers on how to get the first deposit and raise sufficient money to buy what are expensive properties. I welcome the Government’s initiatives. They are all well-intended, and some have been doing good things. My main purpose today is to raise two questions. Can the initiatives that already exist be beefed up and better advertised, so that we get more people to use them? It is still slower than we would like. Secondly, are there new initiatives we should add to them, given the general imperative to get on with solving the housing scarcity problem in general and the shortage of affordable housing to buy in particular?
Through the help to buy ISA, the Government are offering a £3,000 top-up to someone who can save £12,000 for a deposit on a house. Although £15,000 is a lot of money for someone on a low income who is trying to save, it is not a lot of money for a house deposit. I wonder whether, through the Minister, the Chancellor might think a little more about those figures. The more help that can be offered, the faster someone can get a deposit and the better that is for their ability to access the housing market.
The Help to Buy equity loan scheme is admirable, but it is limited to new homes only, and I wonder why. Most people buy a second-hand home. By definition, the stock of those homes is massively bigger than the new supply in any given year. I know it would be a lot more expensive if we opened up the scheme to a wider range of houses, but it would also be a lot more useful, because many people buy a second-hand home as their first home. Indeed, for some, the pleasure of buying a first home is in buying a second-hand home that is not in great shape, so that they can put their stamp on it. It may be a way to have a more affordable home, because they may wish to spend their own time and effort on improving the house, rather than spending money to get others in to improve it for them. It might be worth looking at whether we can provide more of a bridge for people who want to buy second-hand homes.
The affordable housing fund was set up to generate more construction of affordable housing. Again, that is a great initiative. I would like the Minister to give us more up-to-date information on how many homes that scheme might achieve and what the approved build rate under it is. One issue with the affordable housing fund is the cost of building the properties and the quality of their construction. I am all in favour of really good-quality construction, and modern homes are built to a much higher standard in many ways than older homes. However, one way to match the need for higher quality and affordable cost may well be to build on the initiatives of the house building industry, by having more construction in the factory before things are brought to site. None of us wish to recreate the old prefabs. They were a necessary and welcome development in the immediate post-war crisis, when so much of our cities had been devastated by bombing, but they are not the kind of thing we want to build today. People want elegant, well-insulated homes that meet all modern standards.
Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
The right hon. Gentleman talks about prefabs and the old style. In my constituency the Peabody housing trust developed as a millennium product pre-built buildings on Murray Grove. People are still living there now, and very happily so. There is a modern way of developing that could be cheaper. Does he think the Government should consider that?
John Redwood
I agree. There is not a public-private sector divide, in my view; it is something the private sector is beginning to adopt and needs to look at just as much as the public sector. If done well, it can improve the quality. Indeed, some of the most expensive properties that individuals can buy are modular German or Swedish houses, which are imported in kit form and put up in a week or two on a suitable piece of concrete, on a nice plot of land, at quite a high price, with extremely elegant finishes.
The reason we can both drive quality up and drive cost down is that in the factory environment we can engineer and produce the larger parts of the house to high specifications and low tolerances, so that they are very accurate. When the houses are then on site, they are in good order and we do not need all the site labour. We do not have problems when it rains, because it is all being done in a controlled environment, where dust and dirt can be controlled and there are not the wrong wet or dry conditions. We can have perfect conditions for manufacturing to a high quality. The more we can achieve in the factory, and the less we have to do on site, the more we speed up the build time. Months can be taken out of the build time, and if we take out time, we take out cost.
I hope that more can be done. Persimmon, for example, is producing very high-quality homes for private sector buyers. Its Space4 factory does quite a lot of prefabrication work for a number of homes in its range. I hope there will be more initiatives. I mention that to the Government because, through their affordable housing fund, they have the money and they are the customer, as well as the final customer for the property. They can therefore use that intelligently, as a buyer, to drive the process in the way I have suggested, so that we get quality up and cost down—a double benefit.
The Government have a rent to buy scheme. I would like to hear more about that and whether it can be made more generous. The idea is lower rent when someone takes on the tenancy, to give them more scope to save for a deposit. They then have the right to move in and switch from renting to buying. That is an excellent idea.
I think that the Government could do more on their own estate and on brownfields in general. That is partly a planning issue and partly an investment or encouragement issue. By Government, I mean local as well as national, because the two need to work in partnership, which often requires national Government to lead the way. A large number of properties, particularly in our towns and cities, are in use but are in decline, or the buildings may be empty because their use has terminated. Given the pace of change in retail, there will be redundant retail space, and given the pace of change in office employment and some industrial employment, there will be redundant older buildings. Older warehouses and industrial plants have been elegantly converted into homes, for example in docklands. When those buildings are down on their luck or become free, we must ensure that the public sector does all it can to make permits and proposals available so that people can transform them.
Perhaps the Government could look at a scheme to back individuals who want to transform a property of their own—a sort of modern homesteading scheme for which they can be given support if they want to take on a poor property—or if a group of people want to take on a larger property and convert it. We could have more action to deal with dereliction, which is often close to valuable real estate in some of our leading cities, but we need to back that with an initiative. It should not always be large companies that eventually get around to doing that and taking all the property; there may be an opportunity for individuals, smaller businesses, co-operative arrangements or whatever to take on property problems and turn them into opportunities.
On brownfield sites and in urban redevelopment there is generally scope for central and local government to have a bigger vision—some are good at that, but some are rather slow—and to use it to identify suitable sites for more affordable housing for sale.
Dr Huq
There is another level in London—the Mayor of London. The right hon. Gentleman was asking for more up-to-date statistics. A press release today from the Mayor announced 50,000 new affordable homes, 1,823 of them in Ealing, with two thirds for first-time buyers and one third at social rent levels. I am curious to hear from the Minister whether the Government will also commit to social rents. On the whole, does the right hon. Gentleman welcome that breakdown, which might go towards counteracting the feeling of many young people that the housing ladder is being kicked away from them?
John Redwood
As I have said, I am pleased with any initiative that provides more affordable housing for sale. London is the centre of the crisis, because it has the most unaffordable housing for most people, but it has considerable scope for the sort of developments that I have been talking about, where there are brownfield areas or property that needs change of use or that can be extended or improved where suitable schemes could work.
I cannot sit down without mentioning my constituency, which has its own housing issues. I live in part of the country where quite a lot of people would like to buy a home. My council, Wokingham Borough Council—my constituency also includes parts of West Berkshire Council—feels that it has done more than its fair share by identifying large sites for new house building and our building rate in the constituency is almost 1,000 homes a year, which is a very fast pace of change to accept.
The council wants two things to make that a bit more tolerable. First, it wants reassurance from planning Ministers that the housing will be in places only where the council is making provision. It is making plenty of provision, but there is a temptation for inspectors to grant permission for houses not where the council is planning, so not with the road, school and health facilities that we would like.
Secondly, as the Minister will recognise, given the phenomenal pace of change, the council needs financial help to put in the infrastructure. It is no good getting the private sector to finance a lot of new homes if there is no extra primary school, doctors’ surgery or, above all, more road space, because our roads are now totally congested. The local council had to put in three new primary schools in a hurry a couple of years ago when the numbers had built up and changed rather rapidly because the new people coming in to buy the new homes had rather more family members than had been anticipated when the first forecast was run. There is a real issue with maintaining a decent quality of service and finding the money for it.
When a council or area is co-operating, the Government, in turn, should co-operate with it and local people and provide infrastructure and some sort of order and pace to the development, because otherwise the pace of change becomes disruptive and difficult and turns people against the idea of more housing, which nationally we clearly need. There need to be fair shares.
I obviously welcome the Government’s initiatives to promote more prosperity and development in the north, because that suits us as well. We have been carrying a lot of the brunt of development and growth. Growth and jobs are welcome in many ways, but they must be at a sensible pace. We on our side of the argument would like to see fairer shares across the country, just as much as many Members representing seats further away from London would like a bigger share of the growth that the country is capable of.
Perhaps a more contentious note is the right to buy. I am an enthusiast for the right to buy because it is a good way for people to acquire their own home, but I wonder whether the access arrangements are sufficient. Why do we limit access under the right to buy to post-1997 houses in some cases? Are the discounts large enough? I do not buy the argument that selling a socially provided house reduces the supply. The number of houses remains exactly the same after the transaction with the same people living in them as before it took place; it is just that the form of tenure of the one that is sold changes and there are all sorts of restrictions on resale to ensure that they are still properly used and the system is not exploited.
Under the system we are now developing, which I welcome, if a publicly owned house is sold and someone takes out a private sector mortgage, the state gets a receipt. I want that money spent on producing another house, so that right to buy can become an ally of more housing provision because the money can be recycled. That is what developers do: they undertake a development with their capital and then sell it on because they need the capital to do the same again and to build more houses. The state should be more agile at doing that. It should be recycling the capital, thereby fulfilling more people’s wish to be homeowners by allowing them to transfer from renting to purchasing.
My final comment about the state sector—it is not specifically within the Minister’s remit, but is part of the general housing problem—is on the provision of service housing. I have always favoured the idea that we should try to replicate the opportunity to buy within the confines of service life. I think that the way to do that is by having a home base concept in all the services, so that a soldier, sailor or airman knows what his or her home base is and has quarters or property there.
There should be an option: either they buy private sector property nearby, perhaps with help from the Government and their services employer, or, if they are in the military estate, there should be a proxy arrangement whereby they could take a mortgage on their quarters, flat or house. They would have the financial interest in it, but they would have to sell back to the state when they ceased to be in the military and would do so with the benefit of any rise in house prices by some suitable index or local arbitration. While they were in the services they would be collecting the money for a deposit and participating in the housing market, which they otherwise would be debarred from by virtue of their service tenure and need to rent service property. That could help. I do not like to see people coming out of the services after 20 years with no deposit and having rented service property all their life, and then local authorities say, “Well, you’re not our responsibility because you haven’t lived in our area long enough or at all,” so they find it difficult to find housing. We need to do better by our service personnel.
Those are some thoughts for the Minister on how to improve and beef up the initiatives to get more people enjoying the benefits of home ownership. We seem to agree that the benefits are generally there. If we in politics can bring a bit more joy into people’s lives and give more of them the things they would most like, it would be a worthwhile day’s work. I offer those thoughts to the Minister in that spirit.
Rachael Maskell (York Central) (Lab/Co-op)
It is a pleasure to serve under your chairmanship, Mr Bone, in a debate that is important for my constituency. I welcome the Minister to his place and trust that we can have a constructive relationship in working around the housing crisis in the city of York.
After 60 years without a local plan, the Tory and Lib Dem parties in coalition on City of York Council have proved that political expediency is far more important to them than addressing the needs of my community. That has an impact not only on the housing crisis and people desperately needing a home they can afford to live in, but on our public services and the local economy, because local businesses are also feeling the heat.
On Monday, the council’s local plan working group approved a plan, after a further two years of delay, to focus on high-density, luxury developments in Labour areas of the city and to minimise development in the Tory and Lib Dem areas. That strategy will fail to deliver the minimum number of affordable units needed in York, as the coalition has taken the absolute minimalist approach to development and will not even meet its quota for affordable homes. The local plan does not build on the evidence presented by independent experts to build the right number of homes and the mix of housing desperately needed in York, and it will not meet York’s requirements for social housing, which is now at such a premium.
Owing to issues in the local economy, the city is not working; the local economy is struggling. Public services—I can name the healthcare sector and the NHS—are struggling to recruit the staff needed to support the city, because people simply cannot afford to live in York. York has many brownfield sites to develop. They are not ready for immediate development, because they need to go through a decontamination process, which we all understand takes time. However, housing on those sites and, in particular, the York Central site, with which I am sure the Minister is familiar, will be completely unaffordable for local people, because the City of York councillors have determined that the homes will be luxury apartments, which our city does not need. People who are already struggling to find and afford a home they can call their own will be unable to access that housing.
In fact, people on low incomes in York now have to find 8.9 times their salary for the cheapest properties in the city. That is out of their reach, so they are either leaving the city altogether, creating the crisis that we are seeing in many sectors, or having to rent privately. In York, 26% of housing is now in the private rented sector. The cost of renting a two-bedroom property is £838, and renting a three-bedroom property costs more than £1,000. The average cost of a house to buy is more than £300,000. The Minister can already see that York is becoming inaccessible for local people. The average wage in York is just over £22,000—it is a low-wage city because of the decline in its industrial base. There is an economic challenge as well as a housing challenge, which means that our city is altogether challenged. That is why I appeal to the Minister to look at how we can put solutions in place.
Dr Huq
I wonder whether my hon. Friend has had a similar experience to me. The cost of private rent is punitive, and buying is even worse. I do a lot of school assemblies, and every school I go to says that it has recruitment problems because people cannot afford to stay in west London. The schools can get good trainee teachers in their 20s, but the minute those people want to put down roots, they are off to Milton Keynes, Slough or wherever the nearest affordable place is, which creates an uneven age structure in the teaching staff and messes everything up.
Rachael Maskell
My hon. Friend is absolutely right. In teaching and right across our public services, it is a real challenge for public servants to be able to live in these premium spots to provide the vital services for the next generation. That is the position particularly in our schools, but also across our health and care services and other vital services.
In York, there is a real shortage of the housing required. In 2015-16 alone, York suffered a 52% fall in affordable units delivered. The need is getting greater and access is getting further away. Over the past five years, house prices have increased by 27.6%. The right hon. Member for Wokingham (John Redwood) is right to highlight the real issues with access to housing, but for my constituents it is only a dream.
In the council’s debate on Monday, the Tory and Lib Dem councillors did not mention social housing once, yet 1,600 people are on the waiting list. I have met many of them, and they are living in very cramped conditions. Just last week a constituent told me that they were sleeping on the settee and their child on the floor in their parents’ house because they cannot access housing of their own. They are being moved from their accommodation and have nowhere to go, but the council cannot provide any housing for them. There will be a challenge in meeting people’s needs, particularly the educational needs of their children, as a result of the housing situation. Whether we are talking about damp accommodation, which I come across, overcrowded accommodation or the rising number of homeless people in York, we must address the need for a supply of social housing and not just what is called affordable, because for people in York a quarter of a million pounds is totally unaffordable.
We will see this problem increase. Universal credit is being introduced this week, which will have an impact. There is also a real challenge with the amount of housing allowance that people get, because for the broad rental market area the calculation is based on an area broader than just York itself, so the amount of financial support that some families can get comes in under the rate they should get.
Bizarrely, the site of Imphal barracks was included in the local plan. Under this Government, Imphal barracks is due to close in 2031. There is a 15-year window for the local plan, so the window will close well before 2031 and that site should not be in the plan, because no housing will be put on it before the end of the local plan era. But the council saw that as a way of boosting the numbers—it is a false way. Those homes cannot be counted, so our housing crisis will be even greater.
The so-called local plan will be a total disaster for our city, but it is also an absolute scandal. I am talking about its focus on all these high-value, luxury apartments, which our city does not want or need. Where they have been developed in our city, they are used as assets. People do not live in those homes but just purchase them as an investment, or they are used just for holidays and race days or weekends. We hear about the story in London, but that practice is becoming more and more prevalent in York. That will not address the needs and the crisis that people are having to face in their own housing situation in York.
I would say that we are seeing an experiment in social cleansing—if not social cleansing itself—in what is happening in the development of York. This is the wrong kind of housing, in the wrong place, and it does not address local needs. We need social housing and truly affordable housing to meet the needs of our community, but it is at a level far lower than that which the Government have set. The local plan is the worst example of political manipulation at the cost of ordinary people I can think of, and the Government should not even allow it to hit their desk.
In the light of recent events, which have shown the needs of the poorest in our society being totally ignored by the elite, it is time for the Housing Minister to decide which side he is on. I have raised these issues with his predecessors on many occasions, but we have not been able to make any advance. That is why I trust that this Minister will be able to offer some hope to people in my constituency.
The people who live in my community need homes. That is basic. They are not looking for more; just homes where they can live and raise their families. I trust that these appalling proposals will be rejected, and that the needs of my constituents, our public services and my local economy will be met through a proper proposal for the housing that York needs.
Several hon. Members rose—
Mr Peter Bone (in the Chair)
Order. Before we continue, it might be helpful to Members to know that I am required to start the winding-up speeches at about 2.30, and that three Members are seeking to speak.
Jim Shannon (Strangford) (DUP)
I congratulate the right hon. Member for Wokingham (John Redwood) on his helpful presentation on affordable homes, which included some good ideas about how the Minister can address the issue.
As a father with three sons and two granddaughters, I well remember having a full house while my son and daughter-in-law lived with me. That is the way it was, because that is what they needed to ensure they could be on the site and then move. I declare an interest as a landowner; I have had a couple of sites passed that I have then given to my children to help them. Not every child has that opportunity. I remember when they lived with us, with their baby, while they built their house. There was a period when they accumulated money to finance themselves, get a deposit and move on. They did not fall into a category eligible for social housing, which would have enabled them to pay less for rental accommodation. Things in Northern Ireland are very different; the matter is devolved, as the Minister will know. My son Ian and his partner Ashley also lived with us before they got their first home so that they could accumulate some cash for their deposit.
I understand that time is of the essence, Mr Bone, and I will speak about a couple of points. Young people need their own space and their own lives. Sadly, social housing is so strained that many young people who work are unable to get a foot in and are therefore stuck either paying someone else’s mortgage by renting—as the hon. Member for Mitcham and Morden (Siobhain McDonagh) mentioned—or living with parents for longer than they would like.
Couples who both worked while they had young children used to be an oddity; now, the family in which one parent can stay at home and look after the children is fast becoming the oddity. That is due not to extravagant lifestyles but to the cost of getting on the housing ladder and of running houses that were bought when prices were high. In my constituency, and perhaps across all our constituencies, there are homeowners who now have negative equity, and it will be a long time before they get out of it, if ever.
Getting on the property ladder can be difficult for a young family. That is where the Government must step up and step in to assist first-time buyers. One of my staff members here in London is buying a house at £575,000. How on earth can they do it? Only with the good will of family connections is it possible to get on the first level of housing in this city. The sister of a girl who used to work for me lives in London. They are both accountants and probably fairly well paid, but the house that they are buying is £700,000. Where do people in London start if they want to buy a house?
The total housing stock in England increased by around 190,000 dwellings last year, as I am sure the Minister will mention. That is 12% higher than the previous year’s figure, but well below the 250,000 that the Government said would be built. I heard someone in my constituency ask recently how we planned to fill all the homes that we are building in Newtownards—1,000 new homes on a 100-acre site on the east of the town. Lagan Homes will build some 550 houses on two sites in Bangor, and another major developer, Turkington, is developing a site at the foot of Scrabo in the middle of Newtownards.
House prices have increased slightly over the years, but there is an undersupply of affordable private rented accommodation, as every one of us here can attest. An increasing number of applicants on the social housing waiting list are in housing stress, all of whom pose particular challenges and must be dealt with using the framework for councils provided by the community planning process.
My council area, Ards and North Down, has a population of 158,000 and is still growing. Almost 19% of the population is aged 15 or younger, 61.6% are 16 to 64 and 19.5% are 65 and over. The issue is not just houses but whether accommodation is suitable to the age of the people living there, including pensioners and those with disabilities. New build starts in my council area increased by 66% between 2012 and 2014, but they fell again in 2015. The urgent housing wait list—people who need houses right now—is 1,300 people long, which indicates the scale of the problem.
No one has yet talked about co-ownership. My son and his partner have a house today because of co-ownership. That is what got them on the ladder; they had to start somewhere. We have not heard either about the option of living above shops. There are lots of shops in many cities and towns across the United Kingdom of Great Britain and Northern Ireland with options for upstairs developments of flats, and we should consider that.
I am mindful of the time, Mr Bone. Major investment is needed in all constituencies across the United Kingdom. It will help local construction industries, and therefore the local economy, and allow families an adequate standard of living. It must be driven by Government initiatives. With great respect to the Minister, who I know will have a good response, as will the Opposition spokesperson, we should subsidise developers providing smaller pensioner homes, and help first-time buyers to get on the property ladder without increasing their long-term debt to an unmanageable level.
This debate is about not simply allowing houses to be built, but Government help, encouragement and involvement at every level, from social housing to affordable private housing. There must be a team within the Department to focus on the end goal of merging the two sectors to deliver for all the families in the United Kingdom of Great Britain and Northern Ireland. They are crying out for fit-for-purpose affordable homes, and we have a duty to deliver them.
Mr Peter Bone (in the Chair)
I thank the hon. Gentleman for his self-restraint.
Siobhain McDonagh (Mitcham and Morden) (Lab)
The figures are these: home ownership among under-25s has dropped by 50%, and home ownership among 25 to 34-year-olds has dropped from 58% in 1997 to 37%. The multiplier between income and property price was 3.5 in 1997; today, it is 8.5. That is the reality.
In my very brief time, I will share the story of my constituent Jonathan, who is doing well in HR. He earns £38,000, which is £10,000 more than the London average. He thought that he could benefit from a London and Quadrant Housing Trust shared ownership scheme, only to find that a one-bedroom flat in Morris Court in my constituency would cost £500,000. That scheme is supported by the Government. Affordable by whom? Not Jonathan on £38,000 a year.
We need big thoughts, not little thoughts. We do not need to tinker; we need to think about the impact of buy to let on our economy, and particularly on our housing market. London is the only capital city in the world that does not restrict international investment in its residential property market. How can a young first-time buyer ever fight their way through?
We need a crusade in the public sector for councils and public sector bodies to make it a priority to use their land for low-cost home ownership and social rented accommodation. As long as they can sell it to the highest bidder, they will do so to subsidise their other services. I am not saying that they are wrong; I am saying that that is a consequence of what is going on.
The person I would like to pray in aid is not a natural ally; it is Paul Smith, CEO of Haart estate agents. He said in City A.M. yesterday that
“as the average loan size increases whilst the average income decreases”,
despite first-time buyers’ desire to buy, young people are being forced
“beyond their means, and government should intervene with a tax break as a quick and straightforward way to help them get onto the ladder…Theresa May’s legacy on home ownership has so far been a disaster. The ‘just about managing’ are further away from owning their own home than they ever have been, and the government’s feeble housing white paper did not go anywhere near enough to get housebuilders building and the market moving.”
I could not have put it better myself.
Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
It is a pleasure to serve under your chairmanship, Mr Bone. I congratulate all Members for their measured tone in this debate, which is so important to our constituents. I declare an interest as a London homeowner and as a private landlord.
We need to see this debate in the context of the overall shortage of homes, particularly in my city and my borough, where home ownership is a desire for many but a pipe dream for nearly everybody. As my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) and others highlighted, the multiplier effect is now so high that even people on a very good income in London cannot afford to buy a property; I was interested to hear from my hon. Friend the Member for York Central (Rachael Maskell) that the situation is the same in York.
The right hon. Member for Wokingham (John Redwood) made a point about recycling and right-to-buy receipts. The situation is very difficult in areas such as Hackney. We have a shortage of land to recycle, and land is expensive. Since the ’80s, we have lost 10,000 homes to right to buy, yet the waiting list for social housing now stands at 12,100—the highest figure in 12 years. Up to 500 new people are applying to be added to that waiting list every month; if I have time, I will give some of their stories.
In my borough, more people rent privately than own their own homes—not because they do not want to own their own homes, but because they have no option. However, given rent levels in the private rented sector, it is amazing that they can afford to do so. A typical two-bedroom property costs £420 a week, while a four-bedroom property costs £683 a week. Those were the median values of London rents in January this year, according to data from the Valuation Office Agency. People are squandering money on private rented accommodation, unable even to think about putting aside a deposit, even if on their income they could afford to get on the housing ladder.
We need to examine the fact that so many people now need social housing because they cannot get on the ladder. The knock-on effect of this cost shunting is immense. Hidden homelessness is growing massively in my constituency: in many households, one family live in the bedroom while another live in the living room. Does the Minister have access to any figures on that?
This is one of the new big scandals. When I started out as a young councillor, I used to visit families in bed and breakfasts. There was then a cross-party consensus, driven by the Labour Government, to get rid of the practice of putting people in bed-and-breakfast accommodation. We are now seeing a huge cost in homelessness. My local newspaper, the Hackney Gazette, which comes under the umbrella of Archant, has done a good investigation on how much is being spent on homeless families. Hackney Council alone—just one London borough council—spent £35 million last calendar year to house homeless families in temporary accommodation, where they spend three to four years on average.
I used to say to people, “If you qualify as in need of housing, you might be in a hostel for six months, but hang in there and you’ll get something,” but increasingly they are now there for not just a year, but 18 months. I have known mothers come out of hospital with their newborn baby and go into a single room in a hostel with their other half and their toddler, alongside many other people with different vulnerabilities. That is not acceptable, as I am sure the Minister agrees. We want practical answers from him about how the Government will tackle the problem.
This comes down to the supply of housing. It is important that we build that supply to ensure that there are homes in the right places, as the right hon. Member for Wokingham said. Average prices in Hackney have risen by 85% over the last five years. The average price for a semi-detached property is now £920,000, while the average price for a flat is more than £500,000. Another important aspect of the problem is that many people are trapped in flats because they cannot afford to borrow the additional money they need to move into a house. As my hon. Friend the Member for Ealing Central and Acton (Dr Huq) said, that is how we lose key public sector workers: they may need an extra bedroom or want a different lifestyle, and they do not really have the option in Hackney.
Earlier this year, the Public Accounts Committee produced a report called “Housing: State of the Nation”, which was driven by our concern about the Government’s programme to release enough public land to build 100,000 homes over the last Parliament. That programme has improved thanks to the Committee’s scrutiny, but I warn the Minister that our report is part one of a series—not too long a series, I hope, if he listens to our concerns and takes on board our serious points. The report highlights the human costs of the homelessness problem: 120,000 children in England are living in temporary accommodation today. That is not only a cost to the public sector, but a human cost for those concerned and their communities. The consequences to individuals and to the taxpayer are immense. Having families moving around, changing schools and health providers, adds cost and stress to the system.
More affordable housing for ownership is vital, but so is ensuring that affordable housing for rent really is affordable. Even for working people, it can be very difficult to afford a council rent in Hackney, particularly if they are on minimum wage or are not working full time. Housing benefit is taking the strain, along with the private sector. Some £21 billion a year is spent on housing benefit. As a new Minister in his Department, I am sure the Minister is aware of that figure. I hope that over the summer recess, when Parliament is not there to subject him to detailed scrutiny—don’t worry, we’ll be back—he will take the time to think about how that £21 billion could be better recycled and spent to serve those in need of social rented housing, as well as those who want to buy.
Let me touch on some potential solutions for the Minister. Community land trusts are a really good opportunity to maintain the value of land for the benefit of the community in perpetuity. Public land is often sold off to the highest bidder, because that is how Departments balance their books, but if the Minister can get a double dividend, surely that is worth pursuing: decent homes for people that are affordable to buy or rent and that bring money into the public sector.
Planning clearly needs to be revisited, and so does shared ownership, because so many people are trapped in it. In fact, there was a shared ownership property for sale in my constituency for more than £1 million. When I pressed the housing association on it, it said, “It’s okay: four sharers on incomes of £70,000 each could buy it.” That is ludicrous. It is not what the whole model should be about.
We need to look at new models of ownership. Speaking as a Labour and Co-operative MP, I think we should be looking at co-operative ownership. That would require some legal changes, but I do not think that the House would resist such changes if they were proposed by the Minister. I am aware that the Government are worried about losing votes, but I think there would be strong cross-party consensus on this issue.
Finally, we need to raise the borrowing cap for councils, so that they can be more innovative in how they provide housing. My borough is doing a good job. It has 3,000 homes for building in the pipeline, of which 1,500 are for council housing at affordable rent, but the other half are for sale at high prices to subsidise the rest. Would it not be better to give the council the capacity to put that housing out there at a lower price?
I ask the Minister for answers on some specific points. Will he update us on the progress of the voluntary right to buy for housing association homes and particularly on the impact on councils, such as Hackney, with high-value council homes, which, under the original proposals, were expected to backfill the discount for those housing association sales? We are anxious to know what is happening, because we do not want to lose more of our affordable homes in an area of such high housing need. Will he also update us on the release of public land for new homes, which the Public Accounts Committee has scrutinised in detail? Will he give us the assessment of double households—hidden households—that I asked for? Have the Government really got a grip on that? I do not blame the Minister if not, because he is new to his brief, but it is vital that he gets a grip of it, because it gives an idea of the latent demand as well as the social cost.
My hon. Friend the Member for Mitcham and Morden highlighted overseas absentee purchasers. Will the Minister consider holding serious discussions with the Treasury about taxing those overseas purchasers for buying properties that sit empty next door to the very hidden households that I represent? It is a complete injustice that in a city as rich as London, people are living in massively overcrowded conditions, unable to get on the housing ladder and unable to move from their small flat to a bigger home, while just down the road whole blocks are sold off overseas over a weekend and are never lived in.
Martyn Day (Linlithgow and East Falkirk) (SNP)
It is a pleasure to serve under your chairmanship in this important debate, Mr Bone. I am grateful to the right hon. Member for Wokingham (John Redwood) for securing it. A range of interesting and informative points have been made. From the contributions we have heard, there can be little doubt that housing is important for people and communities throughout the nations of the UK.
I completely agree with the right hon. Gentleman that aspirations are not being fulfilled. Everyone deserves a decent and affordable home to live in. Unfortunately, many people are being priced out of the communities they grew up in, either because of rising house prices and rents or, in some areas, simply because of the lack of available properties.
My own area is no exception, although the challenges we face are very different from those of London and the south-east. When we compare average house prices with the average salary in my local area, we find that house prices in the Falkirk area are around five times higher than salaries, and around six times higher in the West Lothian area. House prices continue to rise faster than local incomes, making a house a good investment for someone if they can afford it, but not everyone can.
There is more to housing availability than the supply of deliverable housing land. For many local residents price is not a factor, as they are simply unable to obtain a mortgage to buy a property in any case. We need a full mix of housing tenures for our communities to be vibrant, which means market-value properties for purchase, affordable homes for purchase, and homes for rent, which are also essential to the mix. Affordable homes are essential in preventing homelessness, improving family wellbeing and tackling inequality. For example, last year in West Lothian there were 1,360 homeless presentations and there are 9,409 people on the council housing waiting list, which is a clear indication that local demand exceeds supply.
Undoubtedly, a range of contributory factors have led to the shortage of available homes. For example, we have an ageing population, and in my constituency it is anticipated that we will have a 130% increase in the over-75 population within the next 25 years. When that is coupled with the growth in single occupancy for younger people, it puts massive pressure on the number of available homes. However, I am in little doubt that the roots of the housing crisis stem from the Housing Act 1980, which resulted in sales that wiped out large swathes of housing stock across the UK. In this respect, I very much differ with the right hon. Member for Wokingham. Ensuring that the receipts from the sale of housing stock were either used to offset debt or reclaimed by the Treasury made it virtually impossible for councils to replace their housing stock. If councils had been able to do that, we might be in a very different position today.
Of course, housing and planning policies affecting Scotland are devolved. Under the Scottish National party Government, Scotland has scrapped the right to buy, and in doing so we have helped to preserve housing stock, protecting up to 15,000 social homes from being sold over the next decade. Government investment in housing, in partnership with councils, housing associations and developers, will generate economic activity in the region of £1.7 billion per year, on average, supporting around 14,000 jobs in construction and related industries across Scotland.
Between 2011-12 and 2015-16, the Scottish Government exceeded their target of building 30,000 affordable homes by more than 10%, with 33,490 affordable homes being built, including 22,523 for social rent, 3,473 for other affordable rents and 7,494 for affordable home ownership, all of which creates an important mix. The Scottish Government’s affordable housing supply programme has a target to deliver 50,000 affordable homes by 2021. In addition, the Scottish Government are undertaking a wide-ranging review of the planning system in Scotland to improve its effectiveness.
I will highlight some of the Scottish Government’s achievements. The Institute for Fiscal Studies has highlighted that the Scottish Government spend 85% more per head on social housing than England and Wales do. Also, the latest figures on housing completion rates show that across all sectors in Scotland we are achieving 73 completions per 100,000 of the population, which compares very favourably with 47 in England, 39 in Wales and 56 in Northern Ireland.
In conclusion, the provision of affordable housing is fundamental to tackling inequality and ensuring sustainable communities, and it is important for the maintenance of social mobility. While the situation in Scotland is not perfect, the SNP understands that providing more affordable housing and more social housing must be a priority. I hope that UK Ministers find some examples of good practice in the positive work that has taken place in Scotland over the past 10 years.
Tony Lloyd (Rochdale) (Lab)
It is a pleasure to serve under your chairmanship, Mr Bone. I am told that I ought to declare an interest for the record: as the outgoing Mayor of Greater Manchester, I had responsibility for strategic planning and strategic housing.
I strongly welcome this debate and the opportunity to contribute to it. The right hon. Member for Wokingham (John Redwood) might be either glad or dismayed to know that I probably have a considerable measure of agreement with him in both the way he set out his case and the specific points he made. However, there was perhaps one sin of omission and one of commission.
I will deal with the omission first. I will quote Pete Redfern, the chief executive of Taylor Wimpey, who made a strong point in a review that he carried out last year, in which he said that
“it is vital that policy focuses…on all tenures”,
because the impact of the rented sector on the home ownership sector and vice versa is still very powerful, and we must not neglect that. We must also recognise—in fairness, the Minister’s predecessor had begun to take it on board—that there are some people for whom it will almost certainly never be possible to join the home ownership queues, and we must ensure that there is an adequate provision of high-quality affordable social housing.
I will pick up at an early stage the point that the right hon. Gentleman made about ensuring that our councils have adequate control, because one of the realities at the moment is that far too often developers win on planning appeal; he is right in that regard. However, such wins are massively against the interests of the rational planning of our communities, particularly in areas of dramatic growth of the kind he described in his own constituency. We must ensure that our local authorities have the capacity not only to determine where new homes are located, but to ensure that with that new housing comes the infrastructure to create liveable communities rather than just housing units. That is a very important point.
We have heard some powerful comments from my hon. Friend the Member for York Central (Rachael Maskell), the hon. Member for Strangford (Jim Shannon), my hon. Friends the Members for Mitcham and Morden (Siobhain McDonagh) and for Hackney South and Shoreditch (Meg Hillier), and the hon. Member for Linlithgow and East Falkirk (Martyn Day) about the reality of housing on the ground. We have a housing crisis in this country. It may not affect everybody—it does not affect me as an individual homeowner—but for members of my own family and certainly for many of my constituents there is obviously a crisis.
There is a homelessness crisis and a crisis for those who are inadequately homed—the “disguised” homeless —as several hon. Members have recognised. We are not seeing a high number of new homes built; we now have a crisis of building. One of the most dramatic features has been the major decline since 2010 in the number of people under 40 who are homeowners, because nearly a million people in that age group have disappeared from home ownership. I recognise that it is a moving age group, but that decline is still significant, showing that things are not as they ought to be.
The Government have to take some responsibility for this situation, including for a White Paper that, frankly, is not fit for purpose. I think that anybody who examines housing over any period recognises that short-term fixes simply cannot and will not work. We really need some consensus on both house building and house supply over about a 25-year or 30-year period. We ought to look with ambition at building 250,000 new homes ever year, which is the kind of figure that over time can make a material difference to supply. If we do not do that, the crisis that exists in London, and increasingly in cities such as York, will become the norm throughout our country. We must have an ambitious and radical move on house building.
Jim Shannon
It is important that we underline the type of accommodation that is needed in the future. Does the hon. Gentleman recognise—I think the hon. Member for Linlithgow and East Falkirk (Martyn Day) referred to this—that those who are getting older need specific accommodation? In many places there does not seem to be much provision for that specific accommodation. Does he feel that it needs to be a central part of the Government’s strategy as our population grows older?
Tony Lloyd
The hon. Gentleman brings me on to an important point. One thing that we must begin to recognise is that we do not actually have a housing market; we have many different segments of housing, all of which have different features. Of course we must recognise the needs of vulnerable people and older people—older people are not necessarily vulnerable, but they have different housing needs. Those needs must be recognised in a long-term housing strategy, and we must ensure that provision is across the piece.
I have the current figures on new starts. In their 2015 manifesto, the Government committed to building some 200,000 starter homes over the Parliament, which is 40,000 a year. Quite frankly, the figures are so dismal and so insignificant that we are failing not simply to hit the statistical targets, but failing real families and real people.
Meg Hillier
I hesitate to repeat myself, but, as my hon. Friend just said, the Government are building 40,000 starter homes, and I remind Members that the waiting list for housing in Hackney is 12,000. That is just one London borough. That demonstrates the stark gap between demand and supply.
Tony Lloyd
My hon. Friend is absolutely right. We have got to have a radical shift in how we deliver things.
In the few moments I have at my disposal, I want to talk about some of the things we have to do. I applaud a number of comments made by Members from all parts of the Chamber. London is probably a special case, but there certainly has to be an examination of the capacity for people to move speculatively into the London housing market. They might not simply be overseas investors; in some areas it might be about recognising that institutional investors, or even private investors, have a detrimental impact on the capacity to house our population. A real issue has been raised about London in particular and the position of people on low pay in public services. We want them to work in our inner-city schools, but frankly they cannot afford to pay the rents or mortgages considered to be the norm.
When we still have the concept that a £450,000 property is affordable, we are living in the realms of fantasy. The traditional lending ratio that building societies offer is 4.5:1. By definition, that means that someone needs a family income of £100,000 for that affordable property. Most of us would not regard that as being the income of the people we want to target affordable housing towards.
Tony Lloyd
If the hon. Gentleman will forgive me, I will not; the debate is short and I know that the Minister will want some time to respond.
We have to look at the question of land availability in a determined way. Some of that is about the cost of land. One issue we all face is that if land is valued at the post-development price, the landowner is the institution or person who creams off all the excess profit, even though the work is not put in by the owner, but possibly by the developer or the commonweal. We have to find some way of transferring the capacity for that value added into provision for the commonweal, whether through the public sector or more generally. We also have to look at the fact that in many of our cities—London, Manchester and northern cities generally—a lot of our brownfield sites are in need of enormous investment to bring them up to a level that is fit for building. Remediation is not just a fancy word; it is something that has to be invested in to make land usable.
We need to recognise that we have a massive skills shortage. There may be an ambition to increase housing supply, but we have a crisis looming with the ageing workforce in construction. The Minister needs to work with other Departments to ensure that there is some rational planning for the future. Frankly, it is not obvious that there is any sense of rationality or planning. If the two could be joined together, we may be in with a chance. We urgently need to tackle that skills shortage. If we do not and we have any kind of housing boom, we will once again see the development of the cowboy builder or prices going through the roof.
If we are to provide starter homes, we must ensure that they are starter homes in perpetuity. The discount needs to stay with the property, because otherwise we will never be able to guarantee, in our overheated housing market, that people will continue to be able to get on the housing ladder as first-time buyers. We need to ensure that Help to Buy for first-time buyers is realistic. Some of the suggestions that the right hon. Member for Wokingham put forward are well worth considering. We have to have something that allows first-time buyers to get into the property market. As Members have said, often the problem is not the cost of funding the mortgage—the mortgage is sometimes considerably cheaper than the rental alternative—but the deposit. The accumulation of the deposit is virtually impossible for many people, and we need to do something about that.
Where I disagree with the right hon. Gentleman is on the concept of right to buy. We have to look at one-to-one replacement. We have to ensure a consistent supply of housing in the social sector or under council ownership. There is nothing immoral about different types of tenure. We need to be tenure-blind in how we plan our future, but if we are tenure-blind, we have to ensure that the resources are there for that tenure.
The last point I will make, simply because of time, is this: I appeal to the Minister to look carefully at the role of social landlords. Social landlords in my city region told me that if they are given the opportunity to develop tenure-blind, they can increase the supply of new homes that they put on the market. The significant increase that they could provide would make a material difference. The artificial restrictions on social landlords are simply not helpful.
I once again congratulate the right hon. Gentleman on securing an important debate. We have to continue the debate, because we are scratching at the surface. We have a long way to go if we are to move to that sense of having a long-term vision for housing. Without that long-term vision, we will fail this generation and we will continue to fail future generations. This is an important debate, but it must continue.
The Minister of State, Department for Communities and Local Government (Alok Sharma)
It is an absolute pleasure to serve under your chairmanship for the first time in this Parliament, Mr Bone. May I start by declaring an interest, in that my wife is the owner of a property that is rented out? I congratulate my right hon. Friend the Member for Wokingham (John Redwood) on securing this debate. I agree with other Members that we are debating an incredibly important subject. As ever, he made an incredibly thoughtful and intelligent speech, which has been the hallmark of his contributions since he entered this House in 1987. I would like to take some credit for helping him win that first election, because I was his bag carrier at the time.
I think the housing White Paper is a rather good piece of work. I was not involved in it, but it makes clear that there is no silver bullet, while acknowledging that for decades we have not built enough houses in the United Kingdom. I agree that every credible analysis says that we need to build between 225,000 and 275,000 homes a year to keep up with demand. There is a reason the White Paper is titled, “Fixing our broken housing market”. I hope colleagues will acknowledge that it is not just a question of individual Governments; successive Governments have tried but not succeeded in getting the house building market going. We have seen some progress: in 2015-16, some 190,000 homes were delivered, but I fully acknowledge that there is a lot more to do.
Whether housing is for sale or for rent, it is increasingly unaffordable, as we have heard from Members today. To give some statistics, to buy an average home in England costs almost eight times average earnings. Twenty years ago, it was three and a half times average earnings. I agree with my right hon. Friend that in this country people value owning their own home. A very large percentage of people want to do that. I also agree with the hon. Member for Linlithgow and East Falkirk (Martyn Day) that there is an element of social mobility to home ownership. The Conservative party commitment in our manifesto is absolutely clear: we want to deliver a million homes by the end of 2020 and half a million more by the end of 2022. We need to do better, and that means tackling the failures at every point in the system. I know that Members have talked about those failures, and I will try to address them in my speech.
As one or two colleagues have noted, I am new to this brief. I have heard many of the suggestions that have been made, and I will take an opportunity over the summer to think carefully about much of what has been said, but the start has to be building more houses. In October, we launched the home building fund, which will provide £1 billion of short-term loan funding for small builders, custom builders and innovators to help diversify the house building market. The fund is versatile. It provides £2 billion of long-term loan funding for infrastructure, which we all agree is incredibly important. Many communities are happy to take more homes, but want the infrastructure to go with them. Although it is too early to see homes completed through the fund, I am confident that, over time, it will unlock up to 200,000 homes, with an emphasis on brownfield developments. I would encourage Members to spread the word to businesses in their areas that may benefit from that fund.
We are supporting communities by ensuring that they can get involved in local planning through neighbourhood planning. I do not know whether the hon. Member for York Central (Rachael Maskell) has had an opportunity to talk with her local communities about neighbourhood planning in the context of the local plan, which she expressed some concerns about.
As we have seen with neighbourhood plans that have been adopted and made, local communities are willing to take more housing. In fact, in the areas where plans have been adopted, an average of 10% more housing has been accepted than was the case under the plans of the local authority. What people do worry about is infrastructure, so we have introduced a £2.3 billion housing infrastructure fund to make sure that infrastructure is put in first, which is vital. The prospectus was launched on 4 July and I would again encourage hon. Members to bring the fund to the attention of their local councils. If every local council put forward high-quality proposals, I believe we could make a real difference. As my right hon. Friend the Member for Wokingham mentioned, we are talking about more roads, healthcare facilities and schools. Getting local people to accept housing means giving them more infrastructure.
On public sector land, we are taking direct action to release public sector land for development. Since 2011, we have released land or identified land to be released with the capacity for almost a quarter of a million homes. That is incredibly important and I want to get to grips with it in my brief. The accelerated construction programme will ensure that those homes are built quickly on surplus public sector land. The programme will also encourage new entrants to the market to deliver more homes overall.
We also need councils to plan for the homes that people want to live in, where they actually want to live. As we set out in the White Paper, we intend to consult on a new standardised approach to provide a transparent and consistent basis for the preparation of local plans, which is more realistic about the current and future housing pressures in each place and is consistent with the modern industrial strategy that we have set out.
Many colleagues talked about support for home ownership. I want to make it clear that the Government are absolutely committed to supporting home ownership and we are taking action to help first-time buyers. We have helped more than 400,000 households buy property through schemes such as Help to Buy and right to buy, and 80% of those we have helped through Help to Buy have been first-time buyers. The number of first-time buyers is at a nine-year high. I agree that we need to be doing much better, but it is at a high. My right hon. Friend asked why the Help to Buy scheme applies only to new homes; the reason is that that helps to drive up supply.
Our shared ownership offers an important route in to full home ownership, by allowing purchasers to buy a minimum 25% share in a new-build home. We have also raised the income cap on shared ownership in England.
Siobhain McDonagh
What would the Minister say to my constituent, Jonathan, who earns £37,000 a year but cannot be part of a shared ownership scheme built by London and Quadrant Housing Trust, because the cheapest one-bedroom flat is half a million pounds? My constituency is one of the cheapest in London!
Alok Sharma
As I have acknowledged, we need to be building more homes—there is no doubt about that. I am happy to discuss with the hon. Lady that particular case. I am not here making excuses; I acknowledge the tone of this debate, which is that we need to be building more houses.
Tony Lloyd
Will the Minister reflect on the question of incentives to new home ownership? Restricting the scheme to new properties does a number of things. First, it restricts the supply. Secondly, it breaches the point that my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier) put forward about people wanting to stay in their communities. On top of that, older properties are often cheaper. The policy does not make a lot of sense.
Mr Peter Bone (in the Chair)
I remind the Minister that it is normal for the proposer to have a chance to reply.
Alok Sharma
I have noted the points that have been made and I am sure we will have individual discussions with colleagues.
Another issue noted was the rate of build-out and developers not building out on the planning permissions granted. As colleagues will know, we made proposals in the housing White Paper to ensure planning permissions are acted on much faster. I want to work with developers to help them, but they also need to help us to get homes built.
We had a discussion about social housing and affordable housing. Housing associations are responsible for about a third of all new housing supply every year. We are supporting them to build more affordable homes through our £7.1 billion affordable homes fund.
In the wake of the Grenfell Tower tragedy, it is more important than ever to reflect on our approach to existing social housing. That is why we are focusing on supporting housing associations and local authorities with their plans to regenerate existing housing estates. The estate regeneration national strategy and funding package was launched in December 2016 and more than 100 estates are already receiving funding.
It is clear that there is an enormous amount to do. Successive Governments have failed to provide the homes that we need. Although there has been some progress, it has not been good enough. I am determined to work with every organisation, business and colleague who has a role to play, to ensure that we build many more good-quality homes, which our country needs, to help more people achieve their dream of home ownership.
John Redwood
I thank the Minister for his reply, as well as all colleagues who have contributed to a wide-ranging and informative debate. As we have been reminded, some prices of flats and houses, particularly in London, are now excessively high for anyone on any kind of normal income. That is a reminder to those thinking of buying their first properties that the best reasons are that they like the place, can afford to live in it on the financial terms available and like the freedoms that home ownership produces, because what we have seen in the last 40 years of great price growth, where people make a lot of money, might not be repeated given the very high levels that some properties have reached. The main purpose of a home is somewhere for the family to live, not as an increasing store of value, although that has been an advantage for those generations who have bought in recent decades.
I urge the Minister to get into discussion with the Ministry of Defence. I mentioned in my opening remarks a particular problem with the provision of accommodation for people leaving the services, who are not well served by the arrangements for service quarters. There are things that could be done—some using public money and public assets, and some that could be done by the private sector harnessing private money to the housing needs—that would provide a much better answer and not leave people in danger of being homeless when they leave our service. It is quite wrong that some people are placed in that position and councils are unable to help them.
I also urge the Minister to be in regular contact, as I am sure he is, with the Treasury. As previous Housing Ministers have discovered, the Treasury is crucial in the housing equation. High interest rates, which made difficulties with mortgages, used to be the curse of Housing Ministers, but that is not his problem. Perhaps in a way we have had the reverse; with all the quantitative easing, asset prices, including property, have risen rather more than they otherwise would have done. But there are a lot of tax issues. I was pleased that the last Budget did something about stamp duty, but it is still very high for people buying their first home in the more extended markets. Anything that can be done to cut the costs that the Government impose on buying a home and owning it will be extremely welcome.
I hope the Minister will look again at how wide-ranging some schemes are. I think we can make a good case to say that the Help to Buy loan should be extended from new homes to second-hand homes. Surely we are interested in the prospects of every individual trying to buy a home. It is not primarily a scheme to increase the number of houses being built—there are many other ways of doing that—but is primarily to involve more people in the housing market. It seems very odd to ration that scheme only to people who are near a new development that would suit them when that might be only 1% of the properties on offer.
Motion lapsed (Standing Order No. 10(6)).
Organ Donation: Opt-out System
(6 years, 9 months ago)
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Dan Jarvis (Barnsley Central) (Lab)
I beg to move,
That this House has considered the matter of the introduction of an opt-out system for organ donation in England.
It is a pleasure to serve under your chairship, Ms Buck. I want to begin by sharing with the House my reasons for tabling my debate and by telling the stories of Max Johnson and Joe Dale. Yesterday, I had the privilege of meeting Emma and Harry Johnson—Max Johnson’s mother and brother. Max is nine years old and has cardiomyopathy—a condition that enlarges the heart and can be life-threatening if left untreated. Max is kept alive by a tiny metal pump in his chest, and has been waiting for a heart transplant for six months. He is one of 6,388 people in the UK waiting for an organ donation. Last year, 457 people died while still waiting.
Joe Dale was a constituent of mine. He died last month after a sudden asthma attack, which caused devastating brain damage. He was just 16 years old. After his death, his family made the selfless decision to donate some of his organs so others might have the chance to live. Because of their decision, Joe became one of the hundreds of deceased donors who save and improve lives every year in the UK. I know that right hon. and hon. Members will want to take the opportunity to join with me in passing our condolences to Joe’s family and giving our thanks for their brave determination to help others in spite of their personal tragedy.
The stories of Joe and Max, the work of my hon. Friend the Member for Newport West (Paul Flynn) and the very important Daily Mirror campaign have re-energised my long-held belief that as a country, as politicians and as a legislature we can do more to help those in need of organ transplants.
Mr Geoffrey Robinson (Coventry North West) (Lab)
I will be very brief. My hon. Friend mentioned the Daily Mirror campaign and the private Member’s Bill introduced by my hon. Friend the Member for Newport West (Paul Flynn) and other supporters, which failed due to the prorogation of Parliament and the general election. Luckily, I have position No. 6 in the ballot, and I want to inform my hon. Friend the Member for Barnsley Central (Dan Jarvis)—I compliment him most sincerely on conducting today’s debate—that I intend to reintroduce the Bill pretty much as it stands. I will be presenting it next Wednesday in the House of Commons, and I hope I can count on my hon. Friends’ support. That also applies to the hon. Member for Strangford (Jim Shannon).
Dan Jarvis
I join my hon. Friend in paying tribute to the Daily Mirror, which ran a very important campaign for some time, and thanking it for the work it has done. I also thank him for confirming, I think for the first time, that he intends to use his private Member’s Bill as an opportunity to introduce a legislative mechanism for the Government to change the law in England, should they wish to use it. I hope that will provide a forum where this matter can be further debated constructively in Parliament. I am very grateful to him for taking that decision, and I look forward to supporting his Bill and working with him and, I hope, the Government to make it a great success.
Four hundred and fifty seven unnecessary deaths a year is too many, and I believe it is our duty to reduce that number and save the lives of people such as Max. By changing the law to an opt-out rather than an opt-in system we in Parliament can do that.
The truth is that there is a common misconception about how organ donation works. Only a very small number of people die in a way that allows for organ donation. The vast majority of people on the organ donor register will never actually donate their organs. The figures are startling: about half a million people die every year in the UK, yet last year, out of that half a million, only 5,681 people died in circumstances that made donation possible—about 1%. Although there are hundreds of thousands of people across the country who are registered as potential donors, only a handful will ever be in a situation that allows donation to take place. The reality is that there are simply not enough registered organ donors. People in the UK—specifically in England—are dying as a result.
Accompanying those alarming facts are some more positive recent statistics, as reported in this week’s “Organ Donation and Transplantation Activity Report for 2016-17”. Last year, there was a 4% increase in the number of deceased donors to 1,413—the highest number ever in the UK. Coupled with more than 1,000 living donors, that has resulted in 4,753 life-transforming transplants this year—a 3% rise from last year. The number of patients whose lives were saved or improved by an organ transplant has increased by 3% to 4,753. All that means that more than 50,000 people are alive today thanks to a transplant.
The “Organ Donation and Transplantation Activity Report” is a good news story, but I believe we can make it an even better news story. Behind every statistic there are people, and, as Lorna Mason and Gary Masterson wrote this week in the annual transplant activity report:
“Every transplant is the result of a complex collaboration between donors and their families, a host of clinicians working in different parts of the NHS and finally in transplant recipients and their family.”
They went on to say that
“opportunities for donation continue to be missed...While we cannot quantify every missed opportunity precisely, we need to work collaboratively to make sure that these are as few as possible.”
Despite the excellent campaign run by the NHS to encourage organ donation—details of which can be found at www.organdonation.nhs.uk—the UK still has one of the lowest rates of consent in Europe for organ donation.
The “Taking Organ Transplantation to 2020” strategy, published in 2013, set the target of increasing the donation consent rate from 57% to 80% by 2020, in line with the better-performing countries in the world. That is the rate at which families who are approached by NHS Blood and Transplant actually go on to become donors afterwards. Although the consent rate has increased to 63%, it is still too far below this year’s target of 70% and the 2020 target of 80%. Now is the time for us to do something about that.
I believe that the best way for us to increase the number of lives saved through organ donation is to adopt the so-called opt-out system—sometimes known as a system of deemed consent. Under the current law in England there is an opt-in system of organ donation. In other words, people must proactively state that on their death they would like their organs to be donated to someone else. And yet surveys consistently show that there are many more people who would like their organs to be donated when they die, but they are not registered. Polling conducted by the British Medical Association supports this and has shown that 66% of people in England would donate their organs after death, but only 39% have signed the organ donor register. That means millions of people here in England are willing to donate their organs, but are not registered to do so.
I am sure we all understand that people lead busy lives and that organ donation is not something most people think about on a day-to-day basis, but the reliance of the opt-in system on our not only thinking about it but finding the time to sign up is reducing the number of organs available and the number of lives saved. That is why many other countries use a different system.
Wales has had an opt-out system since December 2015 and only last month the Scottish Government announced plans for a similar system of organ donation in Scotland. In a statement, the Scottish Health Minister said:
“Moving to an opt-out system of organ and tissue donation will be part of the long-term cultural change in attitudes to encourage people to support donation.”
That view is increasingly shared by countries around the world and by many of our European neighbours such as Austria, Belgium and Spain, which all use variations of the opt-out model. It is time that we in England joined them, modelling our system on that in Wales where they offer three clear options: first, to register someone’s wish to be a donor by opting in to the system; secondly, to register their wish not to be a donor by opting out; and thirdly, to have their consent to donation deemed by taking no action.
It was argued when the law was passed that the availability of the three options would increase the number of organs available for donation, and that that in turn would save lives. I am pleased to say that the evidence from Wales suggests that such assertions were correct and that the new law is working. Indeed, the potential pool of organ donors has almost trebled since 2014-15, and the opt-out system does not appear to have deterred individuals from proactively opting in. It is right, of course, that we strike a note of caution with that data, but the initial signs are encouraging.
I now want to address some of the concerns that people have about an opt-out system of donation. This is undoubtedly an emotive issue and there are strong feelings on both sides of the debate. I would not want to question anybody’s motives in deciding whether they wish to be a donor. It is, after all, a deeply personal matter. Under an opt-out system, people would not be required to give a reason for choosing not to be a donor, as the system is not about trying to shame people into becoming donors. Also, similar to what is happening in Wales, any new law would need to be accompanied by an active public awareness campaign: first, to ensure that people understand the new system; secondly, to encourage more people to make the positive decision to become an organ donor; and thirdly, to give people who may want to opt out the information they need to do so.
1 understand that some people have concerns that an opt-out process raises the risk that a person will have their organs taken against their will and against their families’ wishes, which in turn could cause unnecessary distress to the families of the deceased. I also understand that such concerns may be more prevalent within some ethnic and religious groups and that some members of our Muslim and Jewish communities have different interpretations of the religious legitimacy of deceased donation. I completely get that. I understand their views and have the utmost respect and sympathy for them. However, I firmly and wholeheartedly believe that not only do the benefits of an opt-out system far outweigh the risks, but that the risks can be mitigated through a public awareness campaign tailored to different ethnic and religious communities and through the use of in-hospital safeguarding measures. Any new system would have to ensure there were safeguards in place to ensure that no one’s organs were donated against their wishes; that the opt-out system applied only to those over the age of 18; and that for those under 18 it continued to be the case, as it was with my constituent Joe Dale, that the family have the final decision, because it is vital that nobody feels as though they are being coerced.
I also accept that changing the law is not the only change we need to make. It would need to be part of a wider package of measures to increase organ donation. We need to redouble our commitment to the “Taking Organ Transplantation to 2020” goal of increasing the consent rate to 80%, and to consider carefully whether the strategy needs strengthening in the light of the progress so far.
The evidence from Wales and from countries across Europe gives us the confidence to say that an opt-out system would be an important step forward. For that reason, I very much hope that we can proceed on a cross-party basis. I respect anyone who takes a different view on an issue of conscience such as this, but it is clear that the principle of deemed consent has support from Members of all parties across the House.
The Health Secretary recently told the House that an opt-out system has “a lot of merit”. Only yesterday at Prime Minister’s questions, the First Secretary of State told me that
“organ donation is clearly a hugely important part of our system, and the Department of Health is looking at the impact of those changes to see if those can give rise to further improvements in the number of available organs.”—[Official Report, 12 July 2017; Vol. 627, c. 290.]
I welcome such statements because I know that an opt-out system has merit. When the Parliamentary Under-Secretary of Health, the hon Member for Thurrock (Jackie Doyle-Price), winds up the debate, will she tell us what work is taking place in her Department and when it will report?
Before I conclude, I want to take a moment to say how much my hon. Friend the Member for Sunderland Central (Julie Elliott) wanted to be here today. About a year ago, her daughter, Rebecca, a fit young marathon-running mother of one, had blood tests that indicated kidney failure. Three weeks ago she had surgery at the Freeman Hospital in Newcastle to enable her to start dialysis. Today, she joins the 6,000 other people on a waiting list for an organ donation. The average wait for a kidney on the transplant list is two years. I know that all hon. Members will want to join me in wishing Julie, Rebecca and their entire family all the very best. Also, I want to take this opportunity to thank charities such as Kidney Care UK for their work. Because of these stories we should move forward as quickly as possible; children such as Max and mothers such as Rebecca do not have the luxury of time to wait. Anything that we can do to help them get a new organ is a step worth taking so that they can join the thousands of people in our country who have benefited from organ donation.
We have a duty of care to those in our society who need help, and that includes those who need transplants. We can and must do more to help them. We cannot save the 457 lives lost last year, but who knows how many we could save in future? As an old friend once told me, “The best time to plant a tree was 20 years ago. The second best time is now.” I very much hope that the Government will act.
Fiona Bruce (Congleton) (Con)
It is a pleasure to serve under your chairmanship, Ms Buck. I congratulate the hon. Member for Barnsley Central (Dan Jarvis) on securing the debate and on his sensitive and compassionate tone; I hope I can reciprocate. I agree with the hon. Gentleman that it is imperative to work to increase the number of organs available for donation, because every week people in this country die because there is a shortage of available organs. The critical question that we must ask today is whether presumed consent would help with that.
Presumed consent certainly seems an attractive proposition, but perhaps I may enter a note of caution, to aid our early deliberations on the matter. One of the key legal principles I was taught as a student lawyer was that silence is no reply, which means that, much as we might like to draw conclusions from silence, there are good reasons why it may be inappropriate to do so. Introducing the principle of presumed or deemed consent would involve a major change with respect to organ donation. It would effectively mean that even if someone did nothing at all—did not sign an organ donor register, or opt out or in—a consequence would be triggered. The person’s silence would trigger a quite major action. Their organs could later be taken and transplanted. Consent would be deemed, although they would have done nothing.
Of course, some people, on seeing the publicity that might surround the introduction of presumed consent, would deliberately and knowingly decide to do nothing, aware of the consequence; they would be comfortable with that. Those people would be aware that they had, in doing nothing, effectively chosen to donate. However, there would inevitably be a significant group of people who missed the publicity altogether. We need to be sensitive to that.
Informed consent is an important principle, undergirding the relationship between the citizen and the state, so it is right that the House should explore the issue carefully, which is why I welcome the debate. It is critical to explore whether, for example, it is right in this instance to undermine the principle of informed consent by introducing presumed consent. Is it possible that that could create a precedent that might be appealed to in future for less enlightened purposes?
Some practical concerns were highlighted during the debates in Wales that preceded the legislation there, some of which I did not feel were satisfactorily resolved at the time. When the Welsh Government made the case for introducing presumed consent, they based their case, at least in part, on a piece of research by two academics, Abadie and Gay:
“Evidence...suggests that introducing an opt-out type system could result in a 25 to 30 per cent increase in deceased organ donation rates which could equate to a further 15 donors each year in Wales, each of whom...on average might donate 3 organs. This means around 45 more organs could become available to the UK pool for transplantation.”
I understand that the research compared practices in other jurisdictions, and classified Spain, the country with the highest donation rate in the world, as a presumed consent country. Spain introduced presumed consent legislation in 1979, but the law has never been implemented; Spain is still in practice an informed consent jurisdiction like England. Indeed, rates of donation there started to increase only when, 10 years later, Spain made other changes, in particular investment in the organ donation infrastructure. It increased the capacity, training and availability of medical staff to talk to families about donating the organs of a loved one when a life has tragically been cut short.
A leading expert in the field, Professor John Fabre, unsuccessfully tried to point out to the Welsh Government their misconception. In an article entitled “Presumed consent for organ donation” in the journal Clinical Medicine, he referred to their explanatory memorandum, published in December 2012, to the Bill that became the Human Transplantation (Wales) Act 2013. It stated:
“For example, an opt-out system is operated in Spain and it has the highest donation rate in the world.”
As I have said, Spain, even today, does not operate an opt-out system, so I believe that that statement was incorrect, even though it was cited in official papers in Wales, underpinning the presumed consent legislation. The recognition that the country with the highest donation rate in the world does not in fact operate a presumed consent system is important in any assessment of the efficacy of presumed consent. It is also striking that some of the countries that are least successful with their organ donation rates, including Sweden, Greece and Bulgaria, operate presumed consent.
A second objection raised during the debate in Wales was the fact that in some countries the introduction of presumed consent has been associated with significant numbers of people withdrawing from donation. Some people interpret the introduction of presumed consent, despite its noble motivation, as the state seeking to claim their organs without proper consent. Rather than seeing it as a mechanism for donation, they see it as a mechanism for bypassing consent to donation. There has been some evidence of that in Wales. Giving oral evidence to the Health and Social Care Committee of the National Assembly for Wales, organ transplant specialist Dr Peter Matthews, who was based in Morriston Hospital in Swansea, said:
“My own experience is that the British psyche has a particular view that what it should do is donate organs as an altruistic gift, and if it is felt that the state is going to take over the organs, then there is the potential that people who may have been willing to become a donor will not do so. We have seen two cases in Morriston where patients who were on the organ donation register, on hearing about this, said to their families that if the state was going to take their organs, they were no longer willing to give them. We lost two donations”.
During the debate on the Bill in Wales, three Assembly Members relayed similar stories from constituents.
I want to comment on the impact of presumed consent in Wales. NHS Blood and Transplant records donations on a yearly basis, from April to April, and the first full year of results that we have from Wales is for 2016-17. The data tell us two important things: first, in 2016-17, 61 deceased donors facilitated 135 organ donations. Far from representing the anticipated increase of 15 donors and 45 organs, that apparently constituted a decline by three donors and 33 organ donations from the previous year’s figures. That might come as something of a surprise, because some people have suggested that the system was a great success. However, under informed consent a family can donate the organs of a deceased person if the deceased has signed neither the organ donation register nor the opt-out register, which means that, as we have heard, in Wales prior to December 2015 the families or living representatives of the deceased could—as they can here—decide to donate their loved one’s organs. But under presumed consent those informed consent donations would be reclassified as presumed consent donations. Critically, that does not mean that those donations would not have happened under the old system.
Secondly, and not surprisingly, bearing in mind what Dr Matthews told the Assembly, there has been a huge increase in the number of people in Wales opting out. In 2016-17, 174,886 people in Wales were on the opt-out register. That figure far outstrips comparable figures for other parts of the UK, where consent is not presumed. Only 27,559 individuals in England, 1,834 in Scotland and 204 in Northern Ireland have opted out. That means that a staggering 85.5% of individuals in the UK who have opted out live in Wales, despite the population of Wales representing only 4.8% of the UK population.
I have cited a lot of figures, but I do so to get them on the record and to aid our debate. To appreciate fully the cost of the change in Wales, we must remember that prior to the introduction of presumed consent, people who had signed neither the opt-out register nor the opt-in register were potential donors.
Paul Flynn (Newport West) (Lab)
Does the hon. Lady agree with the Welsh Government’s conclusion that 40 lives have been saved under the presumed consent scheme that would have been lost under the previous arrangement?
Fiona Bruce
My concern is to demonstrate that we have to look very carefully at some of the evidence that the Welsh Government used to come to their conclusions.
Where someone has signed the opt-out register, conversations cannot even begin. That means that more than 174,000 of the Welsh population have effectively been removed as potential donors. Previously, in the absence of express direction to do otherwise, those people’s families, as their living representatives, might have been happy to donate their loved ones’ organs at their death. When Wales embraced presumed consent, the other UK jurisdictions said that they would wait to review the results in Wales before deciding whether they wanted to go down that path. I ask the Minister to look at the evidence.
We have significantly increased donation levels in England since implementing the recommendations of the organ donation taskforce in 2008, which of course came down very much against presumed consent. Rather than seeking to emulate Wales, England should perhaps seek to emulate Spain and put its emphasis on lowering the family refusal rate by increasing the number of clinicians who are trained and available to discuss this issue with families when the need arises—often at short notice.
Professor Fabre concluded his seminal paper in Clinical Medicine in the following terms:
“Rather than legislating for the consent of donors, we should be addressing the misgivings and misunderstandings of families so that they decline donation much less frequently, as has been done so successfully in Spain. An acceptance rate of 85% is a realistic and achievable objective for the UK over a 5-year period. As previously, we have the Spanish model to guide us. It will not be easy. It will require…a detailed plan at the national level”.
I very much hope that the Minister will consider all those points and confirm that the Government will take into account every possible consideration and concern about this issue before any legislation is introduced. I look forward to her response.
Paul Flynn (Newport West) (Lab)
I warmly congratulate my hon. Friend the Member for Barnsley Central (Dan Jarvis) on securing this debate and on the clarity and comprehensiveness of his speech. He covered the ground in commendable fashion and hit the significant factors involved.
The hon. Member for Congleton (Fiona Bruce) rehashed the debate in Wales. She mainly addressed opinions and fears that were expressed before the change was made in Wales. I am sure that those fears were sincere, but they have not been realised in the way that she suggests. It is not important that the Welsh Government might not have had entirely accurate evidence; evidence rarely is entirely reliable, and there may have been misunderstandings. What is crucial is the outcome, which is impressive. At least 40 lives were saved—at least 40 people are alive today who would not have been had the presumed consent Bill not passed. As my hon. Friend said, the figure for lives lost in England is 457. That is an extraordinary number of people. If there were an accident today in which that number of lives was lost, that would be our main concern.
My interest in this issue began in 2012, when my 22-year-old constituent Matthew Lammas came here to lobby me and my hon. Friend the Member for Newport East (Jessica Morden). That young man was in need of a heart transplant. He had a heartbreaking story of so many false alarms. He would get a call at perhaps 2 o’clock in the morning to drive to Middlesbrough or Birmingham, but halfway up he would get another call to say, “Sorry; somebody else got the heart—someone got here before you.” Six months after he visited me here, I attended his funeral. A 22-year-old man’s life was lost. I am absolutely convinced that, had we taken the bold decision to introduce presumed consent in Wales six years ago, we would be in a far better position and Matthew Lammas’s life would not have been lost in that way. Those are the simple facts.
There have been extraordinary changes in Wales since the passage of the presumed consent Bill. No one in Wales has died for lack of an organ since that system came into effect. In 2015-16, 214 organ transplants were carried out and 192 patients were on the organ donation waiting list. There was a great deal of concern in Wales, and we all understand that; we all know the feeling of wanting to treat the bodies of our loved ones with reverence and care. There is something that upsets us profoundly about the idea of organ transplantation. There are also genuine religious objections, which were played out again and again in Wales. But I come back to my point: look at the outcome.
There has also been a huge change in public opinion in Wales. In 2014-15, 48.5% of the people of Wales had consented to donating their organs. The figure leapt to 64% in two years. Public opinion has come around to this. We must congratulate the Daily Mirror, which demonstrated tabloid journalism at its very best. I am not sure that this sells many papers, but it has, for all the best reasons, boldly sought to ensure that this life-saving measure is introduced. We can now have great optimism, because my hon. Friend the Member for Coventry North West (Mr Robinson), who came sixth in the private Member’s Bill ballot, announced that he will take this issue up, and there is every chance that the spirit of this Parliament will take it forward.
We rejoiced this week when a decision was taken about the long-standing injustice of contaminated blood. We have come to a consensus about that, and the Government have shown themselves willing to move forward and introduce valuable reform. When I introduced my Organ Donation (Deemed Consent) Bill in the last Parliament, my contact with the Government was entirely friendly. They were reasonable; they were cautious in reaching conclusions but made it clear that the door was open for reform soon. We can change that figure of 457 avoidable deaths. We must move rapidly and find consensus among all parties to take the clear and unambiguous lesson from Wales that presumed organ donation consent saves lives.
Jim Shannon (Strangford) (DUP)
It is a pleasure to speak in this debate. I congratulate the hon. Member for Barnsley Central (Dan Jarvis) on presenting what I thought was a passionate, honest and fair contribution. This is a matter I am also interested in and seriously believe in. I will say early on that I subscribe to the opinion put forward by the hon. Gentleman, because I feel that is the way things should be. That is a personal opinion. All of us here obviously agree that organ donation is important, but we might look at it in different ways.
I am not interested in this only because of my role as the DUP’s health spokesperson; I also have a personal interest relating to family members. The hon. Gentleman gave the example of one of his constituents. My nephew Peter was born with a kidney the size of a peanut, which is probably fairly hard for people to comprehend. From the day he was born to the day he had the transplant, he was on dialysis treatment, which, once someone has started, they cannot come off. I am very aware of the issue, and I will make an honest, personal contribution to the debate.
Someone in this world donated that kidney to Peter, who is alive today because of it. The alternatives were looked at by the family, and everyone looked at it in the way that they thought best. His mother was going to give her kidney, but then she became pregnant, so that opportunity fell away. In the meantime, someone else came forward with a kidney donation, which Peter had. Peter is the same age as my second boy, so I can quite honestly relate to the difference between the two boys as they grew up. I understand the importance of organ donation, and believe that people certainly should be on the register.
I was on the Organ Donation Northern Ireland website just before we came here, and the first sentence I read really impacted upon me:
“Most people would accept an organ if they needed one.”
That is not really surprising, is it? Yet only 40% of us in Northern Ireland have signed the NHS organ donor register. We would all want an organ donation if we needed it, but we have not all signed up. I have to ask the question honestly, sincerely and fairly to those here: if that is the issue, would they not donate their organ? I know that I would.
I carry a wee organ donation card, although it does not make any difference. It is long faded because it has been in my wallet—they say that the money in that wallet is like a prisoner, but that is by the by. I signed up for the card when I was 18, although that is no longer necessary, because when people sign up for their driving licence and tick that box, they are registered forever. That is how we do it in Northern Ireland. The card is very faded, but it says:
“I would like to help someone to live after my death”.
That is its purpose.
I was returned for Strangford with 42% of the vote in 2015, and this year—I thank the people of Strangford for this—I was returned with 62%. I have to tell hon. Members that it is a much better position to be in this time around than in 2015. It is a lot more safe and secure, but how much more so for those who need donations as a matter of life or death? Last year, 12 people died in Northern Ireland while waiting for an organ transplant. That may not seem a huge number, but speak to those 12 families and hear exactly what it means to them. Every one of us in the Chamber— those in the Gallery and hon. Members who are contributing—will know exactly what it means. It is a phenomenal loss.
The sad fact is that some people who passed away in that same year may well have wanted their lives to make a difference by donating their organs, but because their families did not know, it did not happen. It is about raising awareness, having the debate today and every one of us searching our souls and consciences for how to respond. It is really important that we do so; it is a conscious decision that everyone should consider. I completely believe that this is a matter of conscience. In fairness, the hon. Member for Barnsley Central said that in his contribution. He recognises that it is a matter of conscience, and I heard that in what others said as well.
I will look down on no one who feels that, due to a religious belief or some other belief, they cannot donate their organs. That is freedom of belief in action and the conscience clause is important, but what I cannot understand is someone who simply refuses to consider or discuss the possibility. I agree with the Welsh example: I believe that people should be on the list unless they opt out. We have to up the ante and move forward constructively.
I mentioned the case of my nephew. There is another case that I always remember. There was a gentleman in Newtownards whose son was injured in a car accident. Unfortunately, he was on life support and was going to die. His dad told me that his son, by his death and donation, was able to save six lives. In Newtownards we also have a very active group of people who are donation recipients. The council at that time—it was called Ards Council then; it is now Ards and North Down Borough Council—had made a remembrance garden, which we had an opening ceremony for. Many people in not only my constituency but across the whole of the United Kingdom of Great Britain and Northern Ireland understand exactly what this means.
The last time I spoke about organ donation in this Chamber, I said that 30% of people in the UK were registered to donate. That figure is now 36%. That is great, but it is still not enough. That is why we have to do something and look seriously and honestly at what is being proposed today. Registered donor numbers have increased every year since 2012 and are 20% higher than five years ago, yet three people a day are still dying needing a transplant. Is that right? No, it is not. We have to do something about that. The figure could be lower if people were prepared to think or talk to loved ones about it.
I see so many driving licence forms in my office. It is not for me to judge, and I will not—I never judge anybody on donation—but on too many of those driving licence forms people have not ticked the box to say that they want to be a donor. I do not know why they have not done it. It is up to them to make their own mind up, but when our time comes to pass on from this side of the world, we can help someone. If I can help someone with this old, fragile, diabetes 2 body standing here, why should I not? It is time that people understood the importance of this decision.
I am conscious that other Members want to speak, so I will not ramble on too much longer, but I want to make a wee comment about Wales. We are all aware that in Wales, where they have had so-called deemed consent since December 2015, only 6% of the population has chosen to opt out, which speaks volumes. More importantly, in that one year in Wales, as the hon. Member for Newport West (Paul Flynn) said, 39 organs were transplanted through deemed consent out of a total of 160 transplants. That 39 out of 160 was a significant contribution to saving lives. Why should we not do that? I cannot get my head around it at all.
I will finish with this, because you are giving me the eye, Ms Buck, so I need to be careful. I urge people to be aware of the decision and the impact that it can have on families. We must take more positive steps to see a better take-up of organ donation, while always ensuring that people can make the choice themselves. I am conscious of the conscience clause. The simple fact is this: we can save lives in our deaths. Let us encourage people to do this in a manner that is sensitive and yet makes clear the case that we would nearly all take an organ if we needed one—would we not?—and should therefore all be willing to give one.
Kerry McCarthy (Bristol East) (Lab)
It is a pleasure to see you in the Chair, Ms Buck. I want to start by congratulating my hon. Friend the Member for Barnsley Central (Dan Jarvis) on not just securing this debate but taking the opportunity to raise this incredibly important issue at Prime Minister’s questions yesterday.
I am pleased to hear that my hon. Friend the Member for Coventry North West (Mr Robinson) will be introducing his presumed consent private Member’s Bill when he gets his opportunity on a Friday. I hope we will not see a repeat of the usual filibustering, which means we cannot have a proper debate and do not get the opportunity to vote on the Bill. It is really important that the House finally gets the chance to express its view on this matter, and that will not happen if the Bill is simply talked out.
I want to reiterate the concern that has been expressed about our not being on target to achieve an 80% consent rate for donation after death by 2019-20. We have missed the strategy’s interim targets every single year. More needs to be done to make a difference and to save lives. We have a moral obligation to do something, which in this case means introducing presumed consent. It is neither perfect nor a panacea for all the issues surrounding organ donation but, as we heard from my hon. Friend the Member for Barnsley Central and others who spoke in the debate, it would make significant difference.
A constituent contacted me today about her severely disabled son. She is concerned that he lacks capacity to opt out and she is worried that in the medical profession’s view some lives may be worth less than others. It is important to give people such as my constituent the reassurance they need, and that is not just about the right to opt out. As we have seen in Wales, where there is a soft opt-out procedure, families still get consulted. It is important to put people’s minds at rest.
Across Bristol, there are more than 182,000 people on the register, with more than 38,000 in my constituency. In March, 27 people in the city were on the active transplant list, 13 of whom were in my constituency. Last year, there were 10 deceased donors and 22 deceased donor transplants. At the moment, we are not quite keeping up with demand.
Cystic fibrosis is a subject dear to my heart, not least because my 12-year-old niece, Maisie, has it. It is a life-limiting illness that affects 10,800 people in the UK and most of them will need a lung transplant to extend their life and improve their quality of life. I want to take the opportunity, slightly gratuitously, to pay tribute to Maisie’s 14-year-old brother, Isaac, and her 17-year-old sister, Lilli, who did a 65 km—40 mile—walk across the Peak district the weekend before last to raise a few thousand pounds for the Cystic Fibrosis Trust. It was quite a trek.
The trust does brilliant work to raise funds and to support the families of people with cystic fibrosis, most of whom will need a lung transplant at some point. About 50 cystic fibrosis patients receive a transplant each year. It is the third most common reason for lung transplantation. Such patients have the best outcome, with 60% of recipients living at least five years after donation.
At any time, about 60 people with cystic fibrosis are on the transplant waiting list. Patients on the list are generally not expected to live more than a couple of years if they do not receive a transplant. One in three will die before they can receive one, so you will understand, Ms Buck, why it is important to me that we up the donation rate and make sure that lungs are available whenever possible.
The Cystic Fibrosis Trust does not see opt out as the only answer. I am sure the Minister knows that it has been calling for a national allocation system so that there is less of a postcode lottery and it is not just people who are fortunate enough to be in a place where lungs are available for transplant who get them. Last month, NHS Blood and Transplant announced that it would move from a regional system to a fairer national allocation system for urgent cases. The Cystic Fibrosis Trust has, of course, welcomed that.
Organ donation is complicated. It is not just a case of finding available lungs and a donor who wants them. According to the Cystic Fibrosis Trust, 75% of clinically usable donor lungs are not used. It wants more training for doctors because only three doctors in the UK can downsize lungs to make them suitable for smaller patients. It is often teenagers and people in their early 20s who have poor lung capacity and need new, downsized lungs. Will the Minister consider training more people to ensure lungs can be used?
Repairing sub-optimal lungs to make them suitable for transplant is also an issue. Spain has the highest organ donation rate in the world not just because of its opt-out system but because it has medically trained transplant co-ordinators, uses intensive care beds better and more frequently, has different admission criteria for its intensive care units and uses more high-risk donors.
I appreciate that we are talking specifically about presumed consent, but I want to ensure the Minister is aware of all the wider issues. I hope she will work on those as well as supporting the opt-out Bill.
Ronnie Cowan (Inverclyde) (SNP)
I am delighted to be having this debate, and I congratulate the hon. Member for Barnsley Central (Dan Jarvis) on securing it. He told us the moving stories of Max and Joe, bringing a human aspect to the debate. He underlined that deaths are preventable, but that although 66% of people in England would donate, only 39% are on the donor register. Combined with the knowledge that only a small number of people on the register of donors will be able to donate, that highlights the fact that there is clearly a lot of work to be done.
The hon. Member for Congleton (Fiona Bruce) added a few notes of caution, with the view of aiding an informed debate. There are always at least two sides to a debate, and being informed does us no harm. Unfortunately, she is no longer in her seat to hear me say so; to me, hanging on for an entire debate is important.
The hon. Member for Newport West (Paul Flynn), speaking in his own inimitable style and even summing up the debate for me at one stage, told the story of Matthew, a 22-year-old man who unfortunately lost his life, and the feeling that had a system been in place back then, an operation could have been available and his life might have been saved. The hon. Gentleman also urged England to follow Wales’s lead by implementing a soft opt-out scheme.
The hon. Member for Strangford (Jim Shannon) spoke about his nephew Peter, who required a kidney and fortunately got one, and is alive today due to that donation. Not everyone in Northern Ireland has been as fortunate. He also highlighted that one donor can save multiple lives.
The hon. Member for Bristol East (Kerry McCarthy) spoke about missed targets, saying that no plan is perfect, which reminded me of the Churchill quote:
“Perfection is the enemy of progress.”
She also spoke passionately about the needs of those with cystic fibrosis.
There were a few false starts, but now that the Welsh Government’s soft opt-out is up and running, the Scottish Government have announced plans to do the same thing. An independent evaluation of the implementation of the Welsh opt-out system is due to be published in December 2017, and we believe that the numbers will be encouraging, but if even one donor has been identified, it must be worth it. The British Medical Association has stated that it believes that, over time, an opt-out scheme promotes more positive social attitudes to donations, so it may well be that we will not see the benefits for a few years to come.
I believe that the most important people in this debate are the many waiting for a donor—those whose lives are poorer or even on the line as they wait, and wait. This is not solely about saving lives; it is about improving them. One donation does not simply save or improve one life; it has a knock-on effect. My colleague Iain Fraser would not have been born if his father Sandy had not received a kidney many years ago. I thank Sandy Fraser for his ongoing commitment and work in his capacity as the chairman of the Scottish Kidney Federation.
I ask Members: if they had a loved one, as many of us do, whose life could be transformed by receiving an organ donation, would they not turn over every single stone and investigate every possibility in order to identify a donor? I hope that is what we are about to do. In my view, a soft opt-out scheme is the path to go down, but whatever comes of this debate, it must stimulate discussion. We should all make our wishes known to our friends and family. When my time comes, as it will, please take whatever you want.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
It is an honour to serve under your chairmanship, Ms Buck. I thank my hon. Friend the Member for Barnsley Central (Dan Jarvis) for securing this debate, his excellent contribution and all the work that he has done in recent weeks to raise awareness of the need for more people to become organ donors. I commend other hon. Members for their thoughtful contributions to this debate; the Daily Mirror for raising awareness of organ donation since the case of Max Johnson, a nine-year-old boy in need of a new heart; and the more than 9,000 people who signed the Change.org petition.
I also pay my respects to other hon. Members who have brought this issue to our attention over the last decade or so. They include my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh), who introduced a private Member’s Bill on this topic back in 2004, and my hon. Friend the Member for Newport West (Paul Flynn), who introduced a private Member’s Bill more recently and who spoke so well today.
I will quickly set the scene on organ donation in the wider sense and then move on to the situation in countries such as Wales and Spain, in which opt-out systems have been introduced. Finally, I will talk about three tests that Opposition Members would like the Government to look at, if such a system were implemented in England, to ensure that patients, NHS staff and community groups could have confidence in such a change in the law.
There is no doubt about the need for more organ donors in England. We have heard about that so clearly today. With so many people on the waiting list for new organs, it is important that we get more people signing up to donate their organs so that we can ensure that more people have the chance to live. That is why it is welcome that in a written answer last year, the then Public Health Minister, Nicola Blackwood, confirmed that since 2008 organ donation across the UK had increased by 68% and transplants by 47%, and that 2015-16 saw the highest ever deceased donor rate in the UK, with 1,364 deceased donors resulting in 3,529 transplants.
However, as we have heard, there is still a lot more to do because, tragically, 1,000 people every year die while waiting for a transplant. As we heard from my hon. Friend the Member for Barnsley Central, 6,388 people in Britain need a transplant. That includes 183 children. It also includes Rebecca, the adult daughter of my hon. Friend and constituency neighbour the Member for Sunderland Central (Julie Elliott). I send my hon. Friend, Rebecca and all her wider family my best wishes, as I am sure we all do.
Like the hon. Member for Strangford (Jim Shannon) and, I am sure, others here today, I am a card-carrying organ donor. As soon as I became old enough to carry a card, I did, and that was also because of a direct family experience of someone requiring organ donation. My Aunty Ella was one of the pioneers of organ donation when she received a kidney transplant at the fantastic Freeman Hospital in Newcastle. That was about 50 years ago. I have just looked this up: the first organ donations at the Freeman were in 1967, so my Aunty Ella was literally one of the first. She had a very young family at the time. I was born in ’66, but I can remember being told that all she wanted was to live long enough to see her children grow up. Well, she saw her children grow up, get married and go on to give her grandchildren. That is what organ donation is all about: it gives people a future.
There are issues, though, when it comes to black and minority ethnic communities. NHS Blood and Transplant reported that 66% of people from BME communities in the UK refuse to donate their organs, despite being more likely to need a new organ because of a predisposition to certain illnesses, such as diabetes and hypertension. I will cover that issue when I come to the three tests that we would need to set. It is why it is welcome that we have had an opportunity today to debate this issue and everything that comes with it and to think about how we go about improving organ donation, alongside considering what my hon. Friend the Member for Barnsley Central set out on the principle of an opt-out system.
Currently, we know of two countries in which opt-out organ donation systems work: Wales, which we heard quite a bit about today, and Spain. As we heard, Scotland is also considering how it can introduce an opt-out scheme. In Wales, the system was brought in via the Human Transplantation (Wales) Act 2013, which came into force in 2015. The new law sets out that those who live and die in Wales will be deemed to have given consent for their organs to be used unless they have explicitly said otherwise—that is the opt-out.
According to the Organ Donation Wales website, a public awareness campaign before the change in the law came into effect resulted in the numbers of organs transplanted increasing from 120 to 160. NHS organ donation statistics have shown an 11.8% increase between 2014-15 and 2016-17 in people in Wales opting in to donate their organs—the highest increase among England, Wales and Scotland. However, a written answer from the Minister present today, based on NHS Blood and Transplant figures, stated that
“there has been no notable change in Welsh deceased donation figures since the change in legislation”.
This is backed up by NHS organ donation statistics, which show that despite the opt-out system in Wales, there were more deceased organ donors in England and Scotland. That could be because the system is still in its early days; people who have not opted out are still alive and have not yet been able to donate their organs.
Further afield, our friends in Spain have had a soft opt-out system since 1979, in which consent is presumed in the absence of any known objection by the deceased, but family consent is still sought. The implementation of that system led to a small increase in organ donation and transplant, but there was a dramatic increase after 1989 when the Spanish Government made a big push to reorganise organ donation, as a result of which there was a medically trained transplant co-ordinator in every hospital by 1999. However, as a 2012 British Medical Association report stated, there are likely to be differences between the UK and Spain’s performance on organ donation because of their different approaches to resources and clinical practices. For example, Spain has a higher number of intensive care beds, different ICU admissions criteria and end-of-life practices, and the use of higher-risk donors in comparison with those used here.
Nevertheless, those two examples give us food for thought on the change in organ donation rules in England. They show that if we implement this policy, we need to get it right. It is important that we learn from what has already happened, adapting and using what we learn from other countries to get it right in this country. I hope the Minister and her officials will be busy doing that after the debate.
Labour will set three tests for the Government if any new organ donation system is introduced in England. First, they must obviously ensure full public awareness of any change in the organ donation rules. Secondly, they must ensure that medical and healthcare professionals are involved in designing any changes to the system and that they have the support to raise awareness among the public. Thirdly, they must promise to work closely with community groups to ensure that cultural and religious views are fully consulted on and taken into account before any change is introduced. Those three tests are based on work done in other countries, notably Spain and Wales, but also on the current situation across the UK, where there have been documented issues with engaging with BME communities on organ donation.
Organ donation and transplantation is a sensitive issue, as we have heard in this debate. Many people have strong and differing opinions on it, and it is crucial that the Government ensure that all voices are listened to so that we can come up with a solution. These real problems must be addressed. We know of many people who are on transplant waiting lists for far too long. Sometimes people die because they have been on the waiting list for years without a match to save their lives. We need considered action by the Minister and the Government. They must look at the issue carefully, consult with the public, ensure that solutions are found and bring about the improvements needed. I trust that the Minister will endeavour to do just that.
The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)
It is a pleasure to serve under your chairmanship, Ms Buck. I thank all Members who have participated in this debate. Organ donation has been such an established practice in the NHS for quite some years that we often forget about it. The way that everyone has brought the subject to life today, with references to their own stories and experiences, has reminded all of us how important it is. Perhaps it is time this subject had some renewed focus, if only to raise awareness and encourage people to opt in, whether or not we ultimately introduce an opt-out system.
I pay tribute to the hon. Member for Barnsley Central (Dan Jarvis). He could not have done a better service to his constituents Joe Dale and Max Johnson in the way he expressed his argument with considerable persuasion. Perhaps through him, I could send my good wishes to Joe Dale’s family. I hope they get some comfort from the fact that Joe lives on by giving life to others. As we know, one organ donor can save or transform up to nine lives. What better legacy can we have than for other people to live on? We, as Members of Parliament, could perhaps be more proactive in giving that message, as we breathe life into this much neglected subject.
I am told that we last considered organ donation on the Floor of the House in 2014. This opportunity to discuss it is very welcome, and we will have many more opportunities, given the confirmation from the hon. Member for Coventry North West (Mr Robinson) that he will use his private Member’s Bill to push this issue forward. I am sure it will get a good airing.
The hon. Member for Washington and Sunderland West (Mrs Hodgson) presented tests at the end of her speech for what we should bear in mind when deciding what to do in this space. I think we should do all those things, in any case, as we talk about kidney donation. The key has to be public awareness and ensuring that medical professionals do their bit to encourage people to participate in organ donation. We must also engage with community groups where there is a specific problem. That is my biggest priority.
I want to say a bit more about the context. Obviously, we want to encourage as many people as possible to make clear their intention to donate after death and to have that conversation with their families. That is often where the decision is made. Medical professionals need the requisite training to have these sensitive conversations.
As the hon. Member for Barnsley Central mentioned, not many people understand the system of organ donation. We can all sign up to be on the donor register, but not all of us will be in a position for our organs to be used. Quite often, organs can be used after an unexpected and traumatic death, and it is very difficult for any medical professional to have a conversation with the family about what should happen to the deceased’s organs. We need to have a lot more understanding and be a lot more willing to make it clear to our loved ones that we would want our organs to be donated if we were ever unfortunately in that position.
I must pay tribute to all those in the national health service who work in this area. Their determination and commitment makes donation and transplantation possible. Although we still need more transplants, we have seen a significant increase in donations in the UK. We saw 1,413 donors giving 3,712 transplants in the last year, which illustrates how many lives can be saved by one successful approach to donation.
It is incredible that, as NHS Blood and Transplant told us only this week, more than 50,000 people are now alive thanks to organ donation and transplantation. The first transplants took place in my lifetime, and they were seen as revolutionary. One reason we have not given this subject as much attention is that donations now tend to be seen as commonplace.
There is much to celebrate, but there is also much more to do, not least because 457 people died last year while on the active transplant waiting list. That ignores the 875 people who were removed from the list because they had become too ill to receive a transplant. Many of those will have died shortly afterwards. At any one time some 6,500 people are on the waiting list, and again, although waiting times are declining, we cannot be complacent. We need to make sure that those people have hope that, when they are on the list, they have a realistic chance of receiving a transplant.
Our biggest challenge is black, Asian and minority ethnic donors, for two reasons. First, black and Asian people are more at risk of illnesses that may require a transplant, such as high blood pressure and diabetes, and secondly, the consent rate for those communities is half that of the white population. The same is true for blood, so we need many more blood donors from the black community. There is a constant need for that because of the prevalence of sickle cell anaemia, but we know that only 1% of the nation’s blood donors are black. So we need to do much more not only in organ donation but in blood donation.
There is some encouraging news. Last year, more than 6.4% of all deceased donors were from black and Asian communities. That is a significant increase, so the direction of travel is positive, but we need to do much more. Average waiting times for kidney transplants have fallen for everyone, and that rise in donations from black and Asian communities has meant that the biggest fall in waiting times is for black and Asian patients—down from four years to two and a half over the past seven years. The direction of travel is good, but we need to do more, because people from black and Asian communities still wait at least six months longer than white patients. That problem needs to be tackled, because recipients are matched according to blood and tissue types, which differ across ethnic groups.
As we set out in our manifesto, we are determined to target that audience, and we welcome the involvement of all hon. Members in that. We are looking at other partner agencies, and we are working with the National Black, Asian and Minority Ethnic Transplant Alliance. However, many other groups need to be engaged, not least to tackle misplaced cultural concerns about donation. It is not incompatible with Christian beliefs to bequeath one’s organs, and we need to make sure that that message gets out loud and clear by engaging with all community leaders in this space.
We have heard some persuasive arguments on opt-outs and why we should move towards an opt-out system, and I certainly understand the thinking behind that proposal. To add my personal experience of this, my constituent Patricia Carroll regularly lobbies me on the subject. Her daughter Natalie suffered from anorexia and diabetes, and died awaiting a kidney and pancreas transplant. Patricia tried to donate her own kidney to Natalie but was not a match. Following Natalie’s death, she decided to become a live donor. Last year—I think it was around Christmas—she gave a kidney to a 22-year-old young man called Joe who had been on dialysis for three or four years.
What Patricia has done for that family—it is the family, not just the individual—has transformed their lives. I again pay tribute to all live donors. That is an incredibly altruistic thing to do when recognising the impact it can have on the donor’s own health. It is amazing, particularly when there are donors who have absolutely no personal relationship with the beneficiary of their organ. Patricia will be watching with interest to see what I have to say about this.
There are obvious attractions to opt-outs as a tool; anything that will increase the pool of available organs will obviously be attractive. However, opt-outs on their own are not a panacea, and the references to what we can learn from Spain are significant. The issue is about what is wrapped around that. Specifically, it is not just about public understanding and public awareness of why we need donation and what it means, but about how the medical profession deals with it.
The crucial point that affects donation is the conversation in the room between medical professionals and bereaved families. We have seen examples of families refusing consent because they are not convinced that their relatives wanted to donate and it feels safer to say no. Equally, we have seen that being overruled. We find that the highest rates of donation are achieved when we have specially trained nurses who have that conversation with the family in a sensitive way. When such conversations take place, rates of donation go up significantly. Those conversations are critical. If we look at the experience of Spain, we see that that injection of medical advice achieved the step change in donation rates, over and above having an opt-out system.
None the less, we are interested to see the experience in Wales. We are certainly prepared to consider that, and obviously we need to consider it sooner than we might have intended, given the private Member’s Bill, but opt-out will never be a silver bullet to achieve more donation. We are committed to ensuring that we do whatever we can to increase donation. Our strategy, “Taking Organ Transplantation to 2020”, contained the ambitious targets that the hon. Member for Barnsley Central mentioned. Although we have not actually achieved the 70% that we are aiming for, the direction of travel is positive. The fact that more than 23.5 million people have opted in to donate their organs is quite an achievement, although I am not complacent. To give credit where credit is due, the NHS and everybody involved have achieved a great deal in achieving those figures.
The key thing is the availability of specialist nurses. We must ensure that organ donation is embedded as a normal consideration of end-of-life care, where that is available. We have looked at developing a new organ donor register that makes it easier for people to opt in. We are trying to make available as many opportunities as possible for people to do that, for example when people sign up for a new driving licence. In any interaction with Government, we need to give people that option, because where it is a positive choice, it is more likely to be effective.
Jim Shannon
We all agree about the need to raise awareness on the mainland and across the whole United Kingdom of Great Britain and Northern Ireland. When it comes to raising awareness—I presume the Minister will do so imminently—will she engage with the Northern Ireland Assembly, provided that it is still going, and with Scotland and Wales to ensure that we have a UK-wide programme of awareness to get people on the register?
Jackie Doyle-Price
The hon. Gentleman makes an excellent point. He might have seen that I am wearing a pin, which is a nice pink heart that says, “Yes”. That campaign is being run by NHSBT to highlight the need for people to offer to be a donor. If people are prepared to do it, they should wear this nice pin. We need to use any number of the tools at our disposal, and we need to be a lot more imaginative about the ones we use. I look forward to seeing him with his nice pink heart.
I should conclude my remarks to allow the hon. Member for Barnsley Central an opportunity to respond to the debate. I think that we are all united in the outcome we are trying to achieve, which is to encourage more people to be willing to donate their organs to achieve more transplants. With regard to the tools we employ to achieve that, we will look at opt-out and consider whether that would do anything, but in the meantime we are prioritising engagement with black and minority ethnic communities. We will continue to invest in specialised nursing to have those very sensitive conversations, because they need to happen. We will look at what more we can do to encourage more families to be willing to give consent at the time it needs to be given. I thank everyone for contributing to the debate.
Dan Jarvis
This has been a constructive and useful debate, and I am grateful that we have had contributions from Northern Ireland, Wales, Scotland and England. The reality, as the Minister said, is that this is a serious, sensitive and complex subject, but ultimately it is about saving lives.
It was a great privilege to meet Max Johnson’s mother yesterday, and I pay tribute to the Johnson family for their stoicism and the fact that they are prepared to talk about their experiences. Speaking as a parent, I can only imagine how difficult it must be for them. Today, Max Johnson sits in hospital in Newcastle, waiting and urgently hoping that an organ donation will be made available to him.
As I said in my opening remarks, we all have a responsibility to do everything we can. We have a duty of care to people more generally, and that particularly includes those who require some form of donation. We can learn a lot from what is happening across Europe and in Wales. I am delighted that there are moves afoot to move to a similar system in Scotland.
I was obviously very pleased to hear that my hon. Friend the Member for Coventry North West (Mr Robinson) will be introducing a private Member’s Bill, which will have its First Reading next week and its Second Reading at some point in the autumn. That provides a valuable opportunity for us in this House to have a further discussion.
As the Minister again rightly said, there is no silver bullet solution. If the Government were to be persuaded that moving to an opt-out system was the right thing to do, that would have to be accompanied by a range of other measures, not least further publicity to raise awareness so that, collectively, we can all encourage people to sign up and be organ donors.
I am not prone to making predictions, but I will say, in conclusion, that I think that at some point we will move to an opt-out system in England. It is my strong belief and hope that we do that sooner rather than later, because I am confident that to do so would save countless lives.
Question put and agreed to.
Resolved,
That this House has considered the matter of the introduction of an opt-out system for organ donation in England.