All 46 Parliamentary debates on 5th Mar 2024

Tue 5th Mar 2024
Tue 5th Mar 2024
Tue 5th Mar 2024
Shared Parental Leave and Pay (Bereavement) Bill: Instruction
Commons Chamber

InstructionShared Parental Leave and Pay (Bereavement) Bill:
Tue 5th Mar 2024
British Citizenship (Northern Ireland) Bill: Instruction
Commons Chamber

InstructionBritish Citizenship (Northern Ireland) Bill:
Tue 5th Mar 2024
Tue 5th Mar 2024
Tue 5th Mar 2024
Tue 5th Mar 2024
Tue 5th Mar 2024
Tue 5th Mar 2024

House of Commons

Tuesday 5th March 2024

(3 months, 3 weeks ago)

Commons Chamber
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Tuesday 5 March 2024
The House met at half-past Eleven o’clock

Prayers

Tuesday 5th March 2024

(3 months, 3 weeks ago)

Commons Chamber
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Prayers mark the daily opening of Parliament. The occassion is used by MPs to reserve seats in the Commons Chamber with 'prayer cards'. Prayers are not televised on the official feed.

This information is provided by Parallel Parliament and does not comprise part of the offical record

[Mr Speaker in the Chair]

Oral Answers to Questions

Tuesday 5th March 2024

(3 months, 3 weeks ago)

Commons Chamber
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The Secretary of State was asked—
Alan Whitehead Portrait Dr Alan Whitehead (Southampton, Test) (Lab)
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1. What recent discussions she has had with the Secretary of State for Energy Security and Net Zero on tackling the health impacts of fuel poverty.

Victoria Atkins Portrait The Secretary of State for Health and Social Care (Victoria Atkins)
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The Government’s 2021 fuel poverty strategy recognised that warm homes can help to reduce health inequalities and pressure on the NHS. That is a key reason why we are delivering a package of cost support worth £3,700 per household on average from 2022 to 2025 and investing heavily in fuel efficiency.

Alan Whitehead Portrait Dr Whitehead
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The recent Institute of Health Equity Marmot report highlighted the negative effects of living in cold and uninsulated homes, including respiratory and circulatory diseases and hampered lung and brain development in children. Last year, the Energy Systems Catapult and a number of NHS providers ran a trial of warm homes prescriptions, with NHS practitioners identifying vulnerable patients and supporting them with their energy needs. I think that the Secretary of State has accepted the link between cold homes and health outcomes. If that is the case, are the Government considering expanding this approach, or looking for alternative ways in which the health system and fuel poverty prevention can go hand in hand?

Victoria Atkins Portrait Victoria Atkins
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The hon. Gentleman is right to say that a number of local warm homes prescription schemes have offered additional support to help people with health vulnerabilities to stay warm and well. Such schemes are excellent examples of local collaboration between the NHS, local government and other partners—tailored, of course, to the local needs of their areas—and I would be interested to see whether other parts of the NHS choose to take up these sorts of ideas in the future.

Mary Robinson Portrait Mary Robinson (Cheadle) (Con)
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2. What steps her Department is taking to improve urgent and emergency care.

Flick Drummond Portrait Mrs Flick Drummond (Meon Valley) (Con)
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9. What steps her Department is taking to improve urgent and emergency care.

Andrew Lewer Portrait Andrew Lewer (Northampton South) (Con)
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14. What steps her Department is taking to improve urgent and emergency care.

Helen Whately Portrait The Minister for Social Care (Helen Whately)
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A year ago we set out a plan to improve urgent and emergency care, and the plan is working. Performance this winter has been better, with ambulance waits down by nearly a third, and we are learning the lessons from this year to make further improvements in the year ahead.

Mary Robinson Portrait Mary Robinson
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It is welcome news that the brand-new £30 million A&E campus at Stepping Hill Hospital is nearing completion. However, other buildings on this ageing site are failing and urgently need replacing. Will my hon. Friend ensure that Stepping Hill remains at the heart of hospital facilities in Stockport with rebuilt units, and support new hospital investment and specialist diagnostic hubs across Stockport?

Helen Whately Portrait Helen Whately
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I am delighted that Stepping Hill Hospital will soon have a new emergency care campus, with all the benefits that that will bring to my hon. Friend’s constituents. I know that she is a great campaigner for her local NHS and has already met the Secretary of State about the concern she raises. As well as making her argument so clearly in Westminster, I would encourage her to continue discussions with her local NHS integrated care board, which is responsible for local decisions on capital investment.

Flick Drummond Portrait Mrs Drummond
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Up to £900 million for a brand-new acute hospital is coming to mid-Hampshire and health experts are making the case that it will make huge improvements in care, despite some politically inspired and misinformed opposition. Can my hon. Friend reassure my constituents that those running our local NHS should be listened to, and also that the doctor-led urgent treatment centre in Winchester will continue to provide for three quarters of urgent cases including X-rays, MRI scans and other tests after the new acute hospital is built, which we hope will be at junction 7?

Helen Whately Portrait Helen Whately
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I commend my hon. Friend for her hard work on supporting the new hospital, for the leadership she is providing and for her work on encouraging residents to have their say in the consultation. I cannot prejudge the outcome of the consultation but I agree with her that the new hospital will be great for patients, with its modern facilities. She is right to say that an urgent treatment centre can provide excellent emergency care for the majority of people who attend A&E.

Andrew Lewer Portrait Andrew Lewer
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Northampton has been the beneficiary of many welcome new or improved facilities in recent years, including a children’s A&E, a main A&E and the announcement of a community diagnostic centre. However, the missing piece of the jigsaw is an urgent treatment centre, for which I have been campaigning for many years now. Will the Minister inform me on the progress on that centre?

Helen Whately Portrait Helen Whately
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I congratulate my hon. Friend on his successful campaigning for healthcare in Northampton, which is, as he says, benefiting from upgrades to the children’s A&E and the main emergency department and will soon have one of our 160 new clinical diagnostic centres. He will know that his local NHS integrated care board will decide whether to fund a new urgent treatment centre, and I have every confidence in his ability to persuade it of doing so.

Chris Bryant Portrait Sir Chris Bryant (Rhondda) (Lab)
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It is one of the great successes of the past few years that we now save the lives of a lot more people with an acquired brain injury. Although we might save them in acute and emergency care, however, a national strategy for acquired brain injury is a really important part of ensuring that people have the proper care thereafter. The Government appointed me and the Minister for Health and Secondary Care, the right hon. Member for Pendle (Andrew Stephenson)—he is just passing the hon. Lady a note to inspire her on the subject—to try to publish one. When does she hope that there will be money available to ensure that that strategy is one worth having?

Helen Whately Portrait Helen Whately
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I know that the hon. Gentleman is a great campaigner on this issue; he has worked very hard on it with me in the past, and he now does so with my right hon. Friend the Minister for Health and Secondary Care. I assure him that we are in the process of revising the draft strategy, taking on board feedback from patients, their families, charities and the NHS, and we will publish the strategy in due course. I thank all stakeholders for their continued efforts.

Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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In January, the average category 2 response time for west midlands ambulance service was over 43 minutes. We know that the problems are worse in Shropshire, following stories such as that of a lady who waited 18 hours before seeing a doctor, having contracted an infection following radiation therapy for her cancer treatment. The situation in Shropshire does not seem to be improving as fast as we would like. What steps is the Minister taking to resolve the problem?

Helen Whately Portrait Helen Whately
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Across the country, ambulance response times have come down by a third. We have worked very hard, particularly with areas that face greater challenges, including Shropshire. I have spoken to leaders in the local health system about the ongoing challenges. We are learning lessons about what has worked over the past year, and from where we have not made so much progress, to ensure that we do better in areas such as the hon. Lady’s over the year ahead.

Jim Shannon Portrait Jim Shannon (Strangford) (DUP)
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I thank the Minister for her positive answers; they are really appreciated. Bearing in mind the pressure that GPs are under, which is leading to more pressure on emergency provision, what steps are being taken to provide greater incentives for medical students to take on positions in GP surgeries? That would make a big difference.

Helen Whately Portrait Helen Whately
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The hon. Gentleman is absolutely right to talk about the whole health system. One thing we are doing as part of our work on urgent and emergency care is preventing people from being admitted to hospital unnecessarily, or from being brought to A&E in the first place. Primary care is part of that. In our investment in expanding medical school places, we are particularly encouraging medical schools, such as the new Kent and Canterbury Medical School near me, to train students to work more outside hospitals, including in primary care.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Karin Smyth Portrait Karin Smyth (Bristol South) (Lab)
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Despite watering down the targets for ambulance response times and the A&E four-hour wait, the Government still cannot meet them. We have heard from Members across the House this morning how patients are waiting longer. The new targets say that there will be further improvements in 2024-25, and the Minister has said that again this morning. Can she let us in on what exactly they will be?

Helen Whately Portrait Helen Whately
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I am not going to pre-empt the publication of targets for the coming year, but, as I have said, we will continue to learn lessons from the progress that we have made this year, including on ambulance response times, which are down by over a third. Anyway, I will take no lessons from Labour, because we know the state of the NHS in Wales.

Peter Aldous Portrait Peter Aldous (Waveney) (Con)
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3. What progress her Department has made on reforming social care.

Helen Whately Portrait The Minister for Social Care (Helen Whately)
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We are making great progress on our 10-year vision for adult social care reform. We have introduced the first ever national career structure for care workers, and we have introduced new assessments by the Care Quality Commission, which will shine a light on how well councils are delivering their social care duties.

Peter Aldous Portrait Peter Aldous
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I am most grateful to my hon. Friend for that reply. In Suffolk, where the population is increasingly elderly, social care is under enormous pressure, and it is a significant challenge to recruit carers, pay them fairly and provide them with a proper career path. Therefore, I heard what my hon. Friend said, but will she consider commissioning a long-term workforce plan for adult social care equivalent to that for the NHS?

Helen Whately Portrait Helen Whately
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My hon. Friend is right about the importance of the social care workforce: social care is its workforce. I can assure him that we already have a plan for the care workforce, set out in the “People at the Heart of Care” White Paper, and now we are putting it into practice. Our care workforce pathway is already being implemented, our new accredited qualification for care workers will be launched later this year, and we are backing social care with up to £8.6 billion in extra available funding.

Sharon Hodgson Portrait Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
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I was concerned to hear that a constituent of mine was initially denied access to social care for his mother who suffers from Alzheimer’s despite her inability to administer her own medication. Will the Government look to broadening the criteria of the Care Act 2014 to include those requiring support with administering medication?

Helen Whately Portrait Helen Whately
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We very much want everybody who needs care to get it and everyone who is eligible for financial support should get it. That, of course, is assessed by local authorities. We are introducing Care Quality Commission assurance of social care commissioned by local authorities, to make sure people get the care they deserve and to shine a light on where local authorities are doing a really good job and where others could do better.

Tom Hunt Portrait Tom Hunt (Ipswich) (Con)
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The idea of a social care cost cap has dropped off the agenda slightly. I know it is incredibly expensive, but I continue to be contacted by constituents who face losing everything. When often their loved ones have dementia and it is already emotionally an incredibly traumatic time, they have the added anxiety of how they are going to pay for care. The only thing that should matter is what works and is best for their loved one, but there is a cloud of anxiety hanging over society, which we all worry about. Will the Minister confirm that this issue has not lost her attention and that we will continue to consider whether we can introduce a cap?

Helen Whately Portrait Helen Whately
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I thank my hon. Friend for his important question on concerns about the cost of care and how much it costs some people. As he may know—I remind him—the charging reforms were delayed in 2022 by the Chancellor after we listened to local authorities.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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A fifth of the social care roles in Westmorland and Furness are currently vacant and unfilled. Coincidentally that is the same proportion of beds in Morecambe Bay that are occupied by patients who are unable to get a care package and therefore leave hospital. The reasons for this are blindingly obvious: the pay and career structures are derisory for hard-working wonderful people and there is a complete absence of genuinely affordable homes for people in those sorts of roles to enable them to live locally. Does the Minister agree that fixing that crisis in my community and others should be the priority for the Chancellor tomorrow, not silly electoral gimmicks?

Helen Whately Portrait Helen Whately
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I recognise the challenges in the hon. Gentleman’s area, although nationally vacancies in social care have fallen by over 20,000. We are reforming adult social care careers to make care a career for the UK workforce. We are putting extra funding into social care—up to £8.6 billion over two years—and introducing CQC assurance to make sure local authorities are doing their best on social care. I would encourage the hon. Gentleman to talk to his local authority and make sure it is paying a fair rate for the care it commissions.

Peter Grant Portrait Peter Grant (Glenrothes) (SNP)
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4. What steps she is taking to help increase recruitment and retention in the adult social care sector.

Sarah Owen Portrait Sarah Owen (Luton North) (Lab)
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10. What steps she is taking to help increase recruitment and retention in the adult social care sector.

Joanna Cherry Portrait Joanna Cherry (Edinburgh South West) (SNP)
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19. What steps she is taking to help increase recruitment and retention in the adult social care sector.

Helen Whately Portrait The Minister for Social Care (Helen Whately)
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Care is a skilled profession and I want care workers to get the support and recognition they deserve. In January we took the next step in our ambitious care workforce reforms, launching the first ever national career structure for the care workforce alongside our new nationally recognised qualification.

Peter Grant Portrait Peter Grant
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I know the Minister will want to join me in thanking every single person who dedicates themselves to working in the social care sector, including perhaps particularly those who have come to the UK from overseas to do so, but it is not sustainable to rely on incoming workers forever. The Migration Advisory Committee has found that Scotland is now less reliant on migrant workers in the social care sector than England, through the simple expedient of paying a decent wage. That might, by the way, also be a good way to stop doctors in England going on strike; the Minister might want to look at that. Has the Minister asked the Chancellor to provide funding in the Budget so that social care workers in England can enjoy the same pay and conditions as their colleagues in Scotland, and if not, why not?

Helen Whately Portrait Helen Whately
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I agree with the hon. Gentleman that we are grateful to all who work in social care, including those who have come here from other countries to care for our loved ones. We also agree that international migration is not a long-term answer to our care workforce needs. That is why we are reforming social care to work as a career, and we are backing that with extra funding—up to £8.6 billion extra for social care over two years.

Sarah Owen Portrait Sarah Owen
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I am afraid the Minister’s warm words about the social care workforce do not meet the reality check for most people. The Government’s own statistics show that there are at least 152,000 vacancies in social care in England alone, leaving my constituents waiting up to 10 weeks to be discharged from hospital. The Government have been using international recruitment to plug the gaps and as a result have filled over 11,000 vacancies in the past few years, so can the Minister confirm whether recruitment and retention in social care will be better or worse due to Government plans to prevent overseas social care workers bringing family members to the UK?

Helen Whately Portrait Helen Whately
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As I said a moment ago, vacancies have fallen and the care workforce grew by more than 20,000 last year. We are seeing better retention of care workers as well, but we need to go further. That is why we are reforming social care careers, introducing the first ever national career structure for the care workforce and new qualifications and training.

Joanna Cherry Portrait Joanna Cherry
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Edinburgh Trade Union Council recently described changes to the healthcare worker visa route as cruel and inhumane. Many of my constituents who have relatives in care share its concerns, as do I. We know the valuable contribution that foreign care workers make to the sector. Ideologically driven change to visas could further exacerbate the recruitment and retention crisis that other Members have so eloquently described. Given that the Government skipped consultation on these changes, will the Minister commit to meeting trade unions and social care leaders in Scotland to understand the impact of these harmful changes?

Helen Whately Portrait Helen Whately
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I am grateful to international care workers who have come to the UK to look after loved ones. Their work has contributed to reducing vacancies and increasing the supply of social care, but we need to get the balance right between international recruitment and our homegrown workforce. We are carrying out ambitious reforms of our adult social care workforce, and therefore it is right, alongside that, to ensure that we have the right numbers of people coming here from overseas for social care. That is why we have worked with the Home Office on changes to visas.

Andrew Selous Portrait Andrew Selous (South West Bedfordshire) (Con)
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The managers of the wonderful care home I visited in Dunstable on Friday were annoyed by the number of job applicants for care places who were making the interview stage and then not arriving on the day. Can the Minister have a word with ministerial colleagues at the Department for Work and Pensions to ensure that job coaches are certain that jobseekers are not wasting the time of care homes? It is not fair, and those who work in care homes are busy people with a lot to do.

Helen Whately Portrait Helen Whately
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I work closely with colleagues in the Department for Work and Pensions on the recruitment of people looking for jobs in social care, and I will raise that point with my colleague in the Department.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Andrew Gwynne Portrait Andrew Gwynne (Denton and Reddish) (Lab)
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It was the Minister’s party that promised to fix the crisis in social care “once and for all”. With vacancy rates almost three times above the national average and turnover rates for new staff at more than 45%, it is clear that the Government failed. Labour’s plan for a national care service with clear standards for providers and a new deal for staff will give social care the fundamental reset it needs. The Government have done it with our workforce plan, and they have half-heartedly tried it with dentistry. Does the Minister want to copy our homework once again?

Helen Whately Portrait Helen Whately
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Let us be honest, Labour has no plan for social care. Whatever the shadow Minister says, it is unfunded. There is no funding committed to it and it is not meaningful. Those of us on the Conservative side of the House are reforming adult social care. We not only have a plan, but it is in progress.

Lindsay Hoyle Portrait Mr Speaker
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I call the SNP spokesperson.

Amy Callaghan Portrait Amy Callaghan (East Dunbartonshire) (SNP)
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I have asked the Secretary of State a number of times how she intends to recruit and retain social care staff, particularly with the visa changes coming into effect next Monday, stopping those from overseas coming to fill skills gaps from bringing their spouse or dependants with them. I ask again: how does the Secretary of State intend to improve the recruitment and retention of staff in the social care sector while her colleagues effectively work to undermine her?

Helen Whately Portrait Helen Whately
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We are grateful to international workers coming to support us in social care and improving supply, but we have to get the balance right between international recruitment and our domestic workforce. In England, we are reforming social care careers to make social care work a career for our homegrown workforce, and I encourage her to make sure the SNP does the same in Scotland.

Tulip Siddiq Portrait Tulip Siddiq (Hampstead and Kilburn) (Lab)
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5. What discussions she has had with the North Central London integrated care system on the potential closure of maternity services in north London.

Maria Caulfield Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
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Improving maternity care is a year 2 priority in our women’s health strategy for this year. Any decisions around maternity services need to be focusing on improving outcomes for mums and babies. However, decisions on the local reconfiguration of services are made by local integrated care boards and local trusts.

Tulip Siddiq Portrait Tulip Siddiq
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The maternity unit at the Royal Free Hospital in my constituency is facing closure. Last week, I met with doctors from the unit who told me that the Royal Free is uniquely placed to help mothers with diabetes, pregnant women with HIV, and mothers who require interventional radiology. The Royal Free is the only local provider that offers this life-changing treatment 24 hours a day, seven days a week. Does the Minister agree that the Royal Free maternity unit has to stay open for the sake of those vulnerable groups of women?

Maria Caulfield Portrait Maria Caulfield
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I thank the hon. Lady for raising her concerns, but as I said, this is a public consultation. It runs for 14 weeks and will close on 17 March. I urge her to raise her concerns as part of that consultation. It is absolutely crucial that we keep expertise in our maternity services, but I understand that the local proposals by the trust and the integrated care board outline plans for £40 million of significant additional investment into maternity services. Those decisions are for the local ICB and the local trust. The deadline is 17 March, and I urge the hon. Lady to ensure she takes part in that process.

Charles Walker Portrait Sir Charles Walker (Broxbourne) (Con)
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Remaining in north London, can I bring to those on the Treasury Bench my concern over the quality of nursing care at Barnet Hospital? An elderly constituent of mine, who is in her 80s, was admitted there recently. She asked to use the lavatory but was told no one could take her, and was handed a nappy; she waited three hours until someone could actually take her to the loo. She is a coeliac, but was not offered any food for coeliacs during her 10-day stay because nobody had read her notes. She was also moved around her bed by her arms despite having a broken shoulder, which nobody knew as nobody had read her notes.

Maria Caulfield Portrait Maria Caulfield
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I am very sorry to hear about the experience of my hon. Friend’s constituent. That level of care is absolutely unacceptable. I know he has raised this particular issue with the Patient Safety Commissioner, Henrietta Hughes, but I am very happy to meet with my hon. Friend and his constituent to discuss those complaints, because that care is not acceptable.

Sarah Green Portrait Sarah Green (Chesham and Amersham) (LD)
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6. What steps she is taking to reduce waiting times for gynaecology treatment.

Andrew Stephenson Portrait The Minister for Health and Secondary Care (Andrew Stephenson)
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At Buckinghamshire Healthcare NHS Trust, the number of gynaecology patients waiting more than 52 weeks reduced by over 30% between August and December, but I sympathise with the many women who are still waiting too long. NHS England has been doing targeted work to help trusts with the most long waiters to support gynaecology patients in the community where appropriate, and to find specialist services that can treat them as quickly as possible.

Sarah Green Portrait Sarah Green
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My local NHS trust recently stated that the average wait for a gynaecology appointment is 18 weeks, with patients starting treatment within 24 weeks, but that does not include those on cancer pathways. One of my constituents who had been identified as having abnormal cells in her cervix waited more than 60 weeks for a diagnostic assessment. She is one of many contacting me with tales of long delays for gynaecology appointments and paying to go private out of desperation. What steps is the Department taking to reduce waiting times for gynaecology assessments and treatment for those on cancer pathways?

Andrew Stephenson Portrait Andrew Stephenson
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Significant investment is going in to reduce both general wait times and cancer wait times. More patients on the cancer pathway have been seen than ever before; nearly 220,000 patients were seen last December following an urgent GP referral for suspected cancer, representing 117% of December 2019 levels. We continue to keep this under review and continue to strive to make the system go faster and reduce the elective backlog.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Abena Oppong-Asare Portrait Abena Oppong-Asare (Erith and Thamesmead) (Lab)
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NHS figures from December show that the number of women waiting for gynaecological treatment reached another record high of nearly 600,000. That number has tripled since 2012. A Labour Government will cut NHS waiting lists in England by funding 2 million more appointments a year. What can the Minister say to the women waiting urgently for treatment?

Andrew Stephenson Portrait Andrew Stephenson
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I would say that we are sticking to our plan to back the NHS to cut waiting lists and make our NHS fairer, simpler and faster. When there is no strike action, that plan is working. We already eliminated the longest waits, and, in November, we saw the biggest fall in waiting lists outside of the pandemic in more than a decade, alongside record investment in things like women’s health hubs. We are prioritising women’s health.

Julie Marson Portrait Julie Marson (Hertford and Stortford) (Con)
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7. What steps her Department is taking to improve access to primary care.

Greg Smith Portrait Greg Smith (Buckingham) (Con)
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8. What assessment she has made of the adequacy of primary care provision in rural communities.

Victoria Atkins Portrait The Secretary of State for Health and Social Care (Victoria Atkins)
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We have met our manifesto commitment to deliver a record extra 50 million GP appointments annually. Our primary care recovery plan addresses increased GP access and expands community pharmacy services nationwide with Pharmacy First. Our NHS dentist reform plan also allocates resources for 2.5 million appointments, targeting rural and coastal communities.

Julie Marson Portrait Julie Marson
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I thank the Secretary of State for her response, and I thank the Minister for Health and Secondary Care, my right hon. Friend the Member for Pendle (Andrew Stephenson), for visiting the community diagnostic centre and minor injuries unit at the Herts and Essex Hospital yesterday and all the fantastic staff there.

Frontier Estates committed to building a GP surgery as part of the wider Stortford Fields development. However, citing inflated build costs, it now questions the viability of the plans despite months of negotiations and efforts by the local NHS to find a solution. Will my right hon. Friend work with colleagues in the Department for Levelling Up, Housing and Communities, with whom I have already met on this issue, to ensure that Frontier really engages with the process and builds the surgery it promised my constituents?

Victoria Atkins Portrait Victoria Atkins
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I congratulate my hon. Friend on the enormous amount of work she has done in her constituency to secure that community diagnostic centre. We have rolled out some 160 or so of those centres across England —we want to do more—and they are supplying some 6 million tests and scans for patients across England.

On the important issue that my hon. Friend raised, my officials and Levelling Up officials are already considering how primary care infrastructure can be better supported in the planning process to ease the pressure on primary care estates, particularly in areas of housing growth. I know that she will continue to be as conscientious in her campaigning on that as she is on other matters.

Greg Smith Portrait Greg Smith
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Rural communities need local, easily accessible primary care. Since Long Crendon surgery closed during the pandemic, patients in that village and surrounding villages have been displaced, mainly to Brill and Thame, for GP appointments. For the vulnerable and those without private cars, the absence of regular bus services can mean an unaffordable £25 at least in taxis to see a GP. I have raised many times an innovative approach to building a new health centre in Long Crendon by the parish council, which has the land and the agreement by the ICB for the rent to put Unity Health in there—we just need the money to build it. Will my right hon. Friend break down every barrier to help us get that health centre built in Long Crendon?

Victoria Atkins Portrait Victoria Atkins
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Again, I very much admire the effort and determination that my hon. Friend is showing to stand up for his constituents. He will know that sadly I am constrained from commenting on individual cases, but what I do know is that the innovation he is showing alongside his parish council—and, indeed, I would hope, his local integrated care board—is the approach we want to adopt across our rural and coastal communities to ensure that they, too, have the access to primary care that we all expect.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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Equal access to primary care is so important, but the use of physician associates is downright dangerous. Does the Secretary of State agree that patients have the right to see a qualified GP and not be fobbed off with a two-tier primary care system?

Victoria Atkins Portrait Victoria Atkins
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I understand the concerns—we have seen them in the media—but, please, we in this House have a responsibility to our constituents and to professionals working in healthcare, including our clinicians and physician associates. In fact, physician associates have been working in the NHS for some two decades. They are there to work with doctors to assist them, freeing up doctors’ time to focus on the tasks that only they are qualified to do. We have been very careful to listen to the concerns raised, which is why we recently announced intentions to regulate them. But, please, we must all take that responsibility for ensuring that we are not spreading concern. Actually, these roles can have a very positive effect on healthcare system.

Alistair Strathern Portrait Alistair Strathern (Mid Bedfordshire) (Lab)
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My constituents are fed up with battling to see a GP. I have been working hard across party lines with local councillors and the ICB, but I was surprised to hear from the Prime Minister in response to a question last week that only £2 million was allocated to my ICB for primary care, and that it should raid its hospital refurbishment budget instead. Could the Secretary of State advise me which part of the much needed hospital investment should be overlooked to compensate for the failure to invest in primary care locally?

Victoria Atkins Portrait Victoria Atkins
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Again, it is for integrated care boards to assess the needs of their area. If there are concerns about access to primary care, we are keen to give them the autonomy to make decisions about how they spend their budget. We have set expectations of integrated care boards in a couple of respects—in particular, we expect them to use the money that we have provided for dental care and we have set clear expectations that integrated care boards will introduce at least one women’s health hub in their area this year.

Lindsay Hoyle Portrait Mr Speaker
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I call the Chair of the Health and Social Care Committee.

Steve Brine Portrait Steve Brine (Winchester) (Con)
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While we are talking about the recovery of primary care and the Secretary of State is at the Dispatch Box, the recovering access plan released last May talked about high-quality online consultation, text messaging services and online booking tools. They were due in July, but that became August and then December, and I understand that it has now been delayed indefinitely due to a claim made against NHS England in what is a £300 million project. That delay is hitting access to primary care. Will the Secretary of State update the House?

Victoria Atkins Portrait Victoria Atkins
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We are determined to bring not just primary care but the whole NHS up to speed with technology. We are firm advocates of the idea that technology can help free clinicians’ time and ensure that they are spending time looking at their patients rather than at computer screens. In primary care, we are working to ensure the digital telephony services that have played such a critical role in providing those 50 million additional appointments, as I described. I will take away my hon. Friend’s points, and look into them carefully.

Daisy Cooper Portrait Daisy Cooper (St Albans) (LD)
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I have been corresponding with the Primary Care Minister, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), and her predecessors about urgently needing to protect general practice locations in city centres from outdated Treasury rules that potentially force them to move to ring-road locations. The Minister’s latest reply suggested that the ICB could use capital funding to pay for new premises, but my ICB claims that that is against the rules. Would she and her officials please urgently meet me and my local ICB to bottom out what the rules are and urgently protect our city centre GP locations?

Victoria Atkins Portrait Victoria Atkins
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I will ask the relevant Minister to write to the hon. Lady.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Secretary of State.

Wes Streeting Portrait Wes Streeting (Ilford North) (Lab)
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The simple fact is that the Conservatives have been in power for 14 years, and general practice has never been in a worse state. Despite slogging their guts out, GPs are struggling because this Government have cut 2,000 GPs since 2015, making it even harder for patients to get an appointment. Given that, why has the Government decided that the NHS needs what the Institute for Fiscal Studies has described as the biggest funding cut since the 1970s?

Victoria Atkins Portrait Victoria Atkins
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It has been a very long time since Labour were in government, but even the hon. Gentleman knows that Ministers will never comment on fiscal events the day before they occur. Let me introduce some facts into his analysis. We have now delivered on our manifesto commitment for 50 million more general practice appointments per year, with 363.8 million booked in the last 12 months. That compares with 312 million deliveredin the 12 months to December 2019. [Interruption.] If the hon. Gentleman stopped shouting, perhaps he would be able to hear me. About 62,000 more appointments were delivered per working day last December, excluding covid vaccinations. We have our primary care recovery plan, and it is working. Of course there is more to do, but even the hon. Gentleman would not be so churlish as to deny those extra 50 million appointments.

Paul Girvan Portrait Paul Girvan (South Antrim) (DUP)
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11. When she plans to introduce a tobacco and vapes bill.

Andrea Leadsom Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
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The hon. Member will know that, shockingly, smoking kills 80,000 people across the UK every year, and costs society £17 billion in ill health and loss of productivity. The Government will introduce the tobacco and vapes Bill shortly. I am delighted to say that Northern Ireland Ministers announced just this morning that we will legislate for the whole of the United Kingdom.

Paul Girvan Portrait Paul Girvan
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I thank the Minister for that answer. I just want to say that the age-related Bill on the sale of tobacco products will create the first generation of smoke-free people in the United Kingdom. All politics is local, and it is vital that we have the same legislation in Northern Ireland. In Northern Ireland, smoking contributes to at least 1,300 smoking-related cancers per year. Some 13.9% of the people in my constituency continue to smoke, irrespective of the guidance given. I am glad to hear the Minister’s assurance on the legislation, but will the Government engage with the Northern Ireland Executive to ensure it is on their priority list?

Andrea Leadsom Portrait Dame Andrea Leadsom
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I can tell the hon. Gentleman that the Secretary of State met the Northern Ireland Health Minister just yesterday. I absolutely assure him that all parts of the United Kingdom will be included in the once-in-a-generation public health intervention that will save millions of lives.

Bob Blackman Portrait Bob Blackman (Harrow East) (Con)
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I urge my right hon. Friend to get on with introducing the Bill, because every single day we delay, more people die of cancer and other smoking-related diseases. Equally, in creating the first generation of people who will not be allowed to buy cigarettes or tobacco products—that is excellent—does she agree that one concern is that young people are now taking up vaping instead of smoking, and that vaping is clearly a path towards nicotine addiction?

Andrea Leadsom Portrait Dame Andrea Leadsom
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Yes. My hon. Friend raises an incredibly important point. There is no doubt that tobacco and vaping companies are now trying to recruit children, putting vapes, including many illegal vapes, next to the sweet counter with extraordinary flavours such as bubble gum and berry blast, which are clearly not designed, as was originally proposed, for adult smokers to be able to quit smoking by moving to vaping. He is absolutely right and we will bring forward this once-in-a-generation legislation shortly.

Neale Hanvey Portrait Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)
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12. What steps she plans to take to improve the recruitment and retention of community and district nurses.

Andrew Stephenson Portrait The Minister for Health and Secondary Care (Andrew Stephenson)
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We have delivered our manifesto commitment of 50,000 more nurses six months early. There are now almost 361,000 nurses working across the NHS. As part of that, community nursing has grown by over 9% since 2019.

Neale Hanvey Portrait Neale Hanvey
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There has been a crisis brewing in community-facing nursing over the past decade, with the number of district nurses down by 40% and health visitor numbers in England and Wales falling by almost a third. What guarantees will the Minister provide that this vital workforce will be supported, when health budgets in all the nations of the UK are under increasing strain and NHS funding faces a £2 billion black hole, and cuts to spending in England have a consequential impact on budgets in Scotland?

Andrew Stephenson Portrait Andrew Stephenson
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Record funding is going into our NHS. In addition to the 9% increase in community nursing since 2019, we are investing over £2.4 billion in education and training through the NHS long term workforce plan, which commits to increasing training places for district nurses by 41% by the end of the decade. Since 2010, we have delivered over 63,300 more nurses and midwives into our NHS.

Olivia Blake Portrait Olivia Blake (Sheffield, Hallam) (Lab)
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13. When she plans to respond to the Joint Committee on the Draft Mental Health Bill’s report entitled “Draft Mental Health Bill 2022”, published on 19 January 2023.

Maria Caulfield Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
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I put on record my thanks to the members of the pre-legislative scrutiny Committee, which scrutinised our draft Mental Health Bill. We are looking at the recommendations and will respond to the Committee’s report shortly.

Olivia Blake Portrait Olivia Blake
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It is now over a year since the Joint Committee report on the draft Mental Health Bill was published. Despite repeated promises of reform, the Government have failed to act. More than 50,000 people are held under the Mental Health Act 1983. It is an outrage to them and to campaigners that reform has been de-prioritised. Will the Minister confirm when the Government plan to bring a formal Bill to Parliament and what conversations they have had with the Chancellor in the run-up to the Budget to ensure the reforms are properly resourced?

Maria Caulfield Portrait Maria Caulfield
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As I have said, we have published our draft Bill, it has undergone pre-legislative scrutiny and I shall respond to the Committee’s recommendations shortly, but this is not just about legislative reform. As a result of the £143 million that we have invested in crisis support, we have already seen less use of the Mental Health Act 1983 because people are being seen earlier: our crisis cafés and crisis telephone services, for example, have led to a 15% reduction in the use of the Act.

Jackie Doyle-Price Portrait Dame Jackie Doyle-Price (Thurrock) (Con)
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It is a number of years since we promised to reform mental health legislation that reflects a time when people with severe mental ill health were viewed as problems to be managed rather than as individuals. I believe that we on these Benches, as Conservatives, should be doing everything we can to empower people and respect their liberties. It simply is not right that in the 21st century people’s health conditions are being managed through the forced administration of drugs, which pays no respect to their liberties. May I reiterate the urgency with which measures should be introduced, particularly as people with lived experience have relived their trauma to provide the benefit of their experiences?

Maria Caulfield Portrait Maria Caulfield
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I absolutely entirely agree. That is why the Government published the draft Bill in January last year, and why it underwent pre-legislative scrutiny. I gave evidence to the Committee, and we are working our way through its detailed recommendations and will publish our response shortly. However, that is in addition to our significant reform of mental health services, particularly earlier intervention and crisis cafés. We have seen the impact of that: 15% fewer detentions under the Mental Health Act, 8% fewer admissions to hospitals and 12% fewer admissions from our mental health crisis telephone centres, which are now available across England 24/7.

Lyn Brown Portrait Ms Lyn Brown (West Ham) (Lab)
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15. What steps she is taking to improve healthcare for women.

Victoria Atkins Portrait The Secretary of State for Health and Social Care (Victoria Atkins)
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Women’s health is one of my top priorities. As we approach International Women’s Day, we have already improved access to contraception and the treatment of urinary tract infections through Pharmacy First, announced £50 million of funding for research on maternity disparities and other health conditions affecting women, and set the expectation that each integrated care board area will have at least one women’s health hub operating this year.

Lyn Brown Portrait Ms Brown
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For more than a decade I have been raising the appalling, often agonising treatment of many women who need hysteroscopies in the NHS. They are being left with unnecessary trauma and are reluctant to engage further with doctors, which is quite simply life-threatening. However, the medical establishment continues to resist change and the Government shirk their leadership role. Earlier this year the Secretary of State set out her priorities for the women’s health strategy, and access to pain-free hysteroscopy was not included. Why?

Victoria Atkins Portrait Victoria Atkins
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I thank the hon. Lady for her work in this regard, and I absolutely acknowledge the issues that women are experiencing with this highly invasive procedure at what is often an extremely distressing time in their lives. We are waiting for the Royal College of Obstetricians and Gynaecologists to update its guidelines on best practice in hysteroscopies. Following consultation last year that is under peer review, and is due to published soon. However, as the hon. Lady knows, I am clear that it should not be the responsibility of women in those very distressing circumstances to ask for pain relief. Clinicians must assume that a woman wants it, and discuss that with her before the procedure.

Theo Clarke Portrait Theo Clarke (Stafford) (Con)
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I welcome the Government’s recent refresh of the women’s health strategy and the addition to it of birth trauma. However, I am currently chairing a national inquiry into birth trauma, and we are hearing from mothers throughout the United Kingdom about some of the severe mental health conditions that they are facing, including postpartum psychosis. I have been particularly concerned to hear about the risk of suicide among new mothers. What action are the Government taking to address this?

Victoria Atkins Portrait Victoria Atkins
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Let me put on record my admiration for my hon. Friend’s action in sharing her own experiences in order to improve healthcare for women across the country. She will know of yesterday’s important announcement about suicide prevention, elements of which addressed exactly the concerns that she has rightly raised. Thanks to her hard work, we have also announced that within eight weeks or so of giving birth mums will be asked by GPs whether they are okay, and we hope very much that that will open up the conversation with women who may be struggling.

Alison Thewliss Portrait Alison Thewliss (Glasgow Central) (SNP)
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Amma Birth Companions has just been recognised in the 2024 GSK IMPACT awards. The charity is doing really important work to support vulnerable asylum seekers and refugees who would otherwise face giving birth alone. Will the Secretary of State meet the charity to discuss its work and research, given the disparities that continue for this group of women?

Victoria Atkins Portrait Victoria Atkins
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The hon. Lady describes a very interesting piece of work. I will ask my ministerial colleague to meet the charity, as we want to support women. Indeed, part of our work across the women’s health strategy is ensuring that maternity services are not just safe, but trusted by mums-to-be.

Michael Ellis Portrait Sir Michael Ellis (Northampton North) (Con)
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With regard to healthcare for women, a gynaecologist who claimed that Hammersmith would be better if it were “Jew free” has been ruled as not racist, but merely

“comfortable with using discriminatory language”,

according to the Medical Practitioners Tribunal Service. He was merely suspended for three months and is due to start seeing patients again in a few weeks. I am concerned that this doctor may be a danger to Jewish patients. I am also concerned that the tribunal is defective and its decision is grossly unreasonable. Will the Secretary of State instruct Government lawyers to begin judicial review proceedings against the tribunal?

Victoria Atkins Portrait Victoria Atkins
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I sincerely thank my right hon. and learned Friend for raising this issue. As the Prime Minister set out on the steps of Downing Street last week, there are people whose ideology and dogma are in direct conflict with our country’s shared values. Just as we will not stand for that across the country, nor will I stand for it in our NHS. I have already written to NHS England and regulators, setting out their responsibilities and our expectations of them, and I can assure my right hon. and learned Friend that I will be looking into this issue with great urgency and great care.

John Penrose Portrait John Penrose (Weston-super-Mare) (Con)
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T1. If she will make a statement on her departmental responsibilities.

Victoria Atkins Portrait The Secretary of State for Health and Social Care (Victoria Atkins)
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I am committed to making our NHS faster, simpler and fairer for all, including families, which is why the Government have recently introduced baby loss certificates. Nothing can diminish the pain of losing a baby, but we hope that this formal recognition of a life lost can help families to live alongside their grief. Indeed, since we announced the launch some two weeks ago, more than 37,000 certificates have been requested by parents.

That same commitment to families is why we are rolling out Martha’s rule across England, giving patients and their families the automatic right to a rapid review of their case—24 hours a day, seven days a week. Families and carers know when something is not right or their loved one’s condition is deteriorating. Martha’s rule not only recognises this powerful instinct, but allows anyone concerned to act on it and to make sure that the NHS listens.

With your permission, Mr Speaker, for which I am very grateful, I would like to alert the House to a written ministerial statement and a detailed letter from NHS England that has been laid this morning. It addresses a historical issue whereby women who received radiotherapy above the waist to treat Hodgkin lymphoma, and who were therefore at a higher risk of breast cancer, were not given annual checks. Yesterday, the NHS wrote to the 1,487 women affected in order to inform them. We expect all women to be offered a scan within the next three months, and NHS England has established a helpline and briefed GPs and relevant charities. The vast majority of this group of women will already have been receiving screening on a three-yearly basis, but NHS England wants to ensure that they receive annual tests, in line with the clinical guidance.

I wanted to alert hon. Members to that because, with the letters having been sent out yesterday, it is perfectly possible—indeed, probable—that they will start to receive queries from their constituents. I will of course keep the House updated. I emphasise, however, that what I have given is a summary, and I would encourage hon. Members to look at the very detailed letter from NHS England in order to reassure their constituents that we are scooping up everybody we can to look after them at this very troubling time.

John Penrose Portrait John Penrose
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Like many people here, I was delighted by last month’s NHS dentistry recovery plan. How many new NHS dental appointments does the Secretary of State expect to be available in my constituency of Weston-super-Mare, and by when?

Victoria Atkins Portrait Victoria Atkins
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I thank my hon. Friend for supporting our dental recovery plan. Indeed, he is one of many colleagues who campaigned hard for it. I am pleased to inform him that dental activity, as measured by courses of treatment, has increased by 15% on the previous year in his local integrated care board area, and our plan will support further increases to dental access through some 2.5 million additional appointments across the country, including in his constituency. The first measure, namely new patient premiums, went live on Friday, and we hope to have the results very soon.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Secretary of State.

Wes Streeting Portrait Wes Streeting (Ilford North) (Lab)
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With a general election in the air, I welcome what the Secretary of State has said about baby loss certificates and Martha’s rule—there is genuine cross-party agreement on this. I also thank her for advance notice of today’s important written ministerial statement.

However, with a general election in the air and given the Secretary of State’s principled, vocal and consistent opposition to funding the NHS by abolishing the non-dom tax status, on a scale of one to 10—one being utterly shameless and 10 being highly embarrassed—how red-faced will she be when the Chancellor adopts Labour’s policy tomorrow?

Victoria Atkins Portrait Victoria Atkins
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One of the joys of being at the Government Dispatch Box is that not only do we have to deal with very serious matters, such as I have just set out, but we get to have a knockabout on the Labour party’s electioneering. The hon. Gentleman will know the Conservatives’ proud record on funding our NHS since 2010. I invite him to wait for tomorrow’s Budget to see what more this Conservative Government are doing to support our constituents, and to help our economy grow for a bright future.

Wes Streeting Portrait Wes Streeting
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The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), has said that the policy will be

“as much use as an ashtray on a motorbike.”—[Official Report, 28 February 2023; Vol. 728, c. 710.]

As she speeds down the A23 back to Lewes, to defend her constituency against the Liberal Democrats, how on earth will she feel with all those embers of the Conservatives’ 14-year record blowing in her face?

Is it not now clear that, with the Government having adopted Labour’s workforce plan, Labour’s dentistry recruitment plan and now Labour’s NHS funding plan, when it comes to a record to be proud of, and when it comes to finding the answers, only Labour can deliver an NHS that is fit for the future?

Victoria Atkins Portrait Victoria Atkins
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The Leader of the Opposition is a former barrister, and barristers like to rely on evidence, so let me give some evidence on what the Labour-run NHS in Wales looks like. People are almost twice as likely to be waiting for treatment under the Labour-run Welsh NHS—21.3% of people in Wales are waiting for hospital treatment after a consultant referral, compared with 12.8% in England. Patients in Labour-run Wales are, on average, waiting five weeks longer for NHS treatment than patients in England, and the number of patients in Wales who are escaping to seek treatment in England has increased by 40% in two years. But don’t worry, folks, according to the Leader of the Opposition this is the blueprint—

Lindsay Hoyle Portrait Mr Speaker
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Order. I remind everyone that these are topical questions. It is about the many Members I need to get in, rather than the ping-pong over the Dispatch Box. Let us move on to Andrew Jones as a good example.

Andrew Jones Portrait Andrew Jones (Harrogate and Knaresborough) (Con)
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T2. Thank you very much, Mr Speaker. I am talking to my local integrated care board about establishing the first centre of dental excellence in North Yorkshire, to be located in Harrogate, to build on the dental recovery plan. Does my right hon. Friend the Secretary of State agree that boosting capacity is critical to catching up from the pandemic, and that centres of dental excellence are a very good way to achieve it?

Andrea Leadsom Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
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I completely agree with my hon. Friend that we need more capacity in our dental workforce, and I know he will be a big advocate for his constituency. We set out in the first ever NHS long-term workforce plan that we will increase dentistry training places by 40% by 2031-32. Our dental recovery plan sets out many different measures to improve capacity.

Lindsay Hoyle Portrait Mr Speaker
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I call the SNP spokesperson.

Amy Callaghan Portrait Amy Callaghan (East Dunbartonshire) (SNP)
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Later this month I will be 10 years cancer free, having survived melanoma first as a teenager and again in my early 20s. Can the Secretary of State look me in the eye and guarantee that she is doing all she can to prevent others from getting the same diagnosis ?

Victoria Atkins Portrait Victoria Atkins
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Again, I thank the hon. Lady for sharing her experience, and of course we are doing all we can. I know that the SNP Scottish Government share our determination to ensure that cancer treatment continues to improve. England is diagnosing earlier and treating more. We have seen cancer survival rates improve by almost 10 percentage points since 2005, but we also know that four in 10 cancers could be prevented, which is exactly why we are bringing forward the smoke-free generation work. Of course, if the Scottish Government would like us to help with some of their waiting lists, we genuinely stand ready to do so.

Andrew Selous Portrait Andrew Selous (South West Bedfordshire) (Con)
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T3. The general practice estates and technology transformation fund supported projects in my constituency and was appreciated by my local integrated care board. What evaluation has been made of it, and will it be continued?

Andrea Leadsom Portrait Dame Andrea Leadsom
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I have had a number of meetings with my hon. Friend and know that he is determined to resolve some of these long-standing issues in his constituency. I have assured him that ICBs have the freedom to increase capital for primary care in their region, so long as their plans remain within their overall capital allocation. I will certainly be happy to meet him again to talk about what more measures we can take to support his constituents.

Rachael Maskell Portrait Rachael Maskell (York Central) (Lab/Co-op)
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T4. I held my first dental summit since the publication of the Government’s dental recovery plan, which I have to say was met with disappointment and frustration. The reason for that is that is not enough funding or flexibility, or the resolution to the contract. Will the Minister set out the timetable for when the dental contract will be resolved?

Andrea Leadsom Portrait Dame Andrea Leadsom
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I am very surprised and disappointed to hear the hon. Lady say that. We are delivering 2.5 million more appointments through the new patient premium, which started last Friday. We will have information within a month to see which dentists have taken up this generous new patient premium to ensure that many more people get access to dentistry. Not only that, but we have golden hellos to attract dentists to areas that are underserved, mobile dental vans and, importantly, a new focus on Smile4life. That is going to ensure that all babies and young children have that fabulous smile for life.

Nigel Mills Portrait Nigel  Mills (Amber Valley)  (Con)
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T5. The Pharmacy First service has proved popular in Amber Valley, but some pharmacists report confusion because the ear infection service applies only to under 18s and patients are being referred to pharmacies when they should not be. Will the Minister either extend the service to over-18s or ensure that NHS communications are clear that this service is only for children?

Andrea Leadsom Portrait Dame Andrea Leadsom
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My hon. Friend raises an important point. He will be aware that a decision was taken that ear wax removal services are better done in the community and that ear syringing can cause problems. That area is under review and I am happy to write to him to address the specific point he makes about over-18s and children.

Nia Griffith Portrait Dame  Nia  Griffith  (Llanelli)  (Lab)
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T7.   I absolutely agree that we should redouble our efforts to recruit and retain more home-grown carers, as the Welsh Government are doing by paying them all at least the real living wage, but in the short term we have to rely on foreign workers. From her earlier answers, it appears that the Social Care Minister is happy to deprive them of the enjoyment of their own family life, while we expect them to give our relatives loving care. Will she think again and speak to Home Office colleagues about dropping this totally inhumane ban?

Helen Whately Portrait The Minister for Social Care (Helen Whately)
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As the hon. Lady will have heard me say earlier, we are grateful to international care workers who come to care for our loved ones in this country. We need to get the balance right between international recruitment and our home-grown care workforce. On the question specifically on dependants, I say to her that every care worker who comes here to do work in the UK has a choice as to whether to come here or not.

Vicky Ford Portrait Vicky Ford (Chelmsford) (Con)
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T8. I thank the Health and Secondary Care Minister for visiting the new medical school in Chelmsford yesterday. This is the first time that students have ever been able to train as doctors in Essex in its history, and the results are phenomenal. This is living proof of the Government’s commitment to train the NHS staff of the future. What progress is he making to increase work placements for students so that we can train even more doctors, nurses and people for important roles such as physician associates?

Andrew Stephenson Portrait The Minister for Health and Secondary Care (Andrew Stephenson)
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I thank my right hon. Friend for her question and her kind invite to visit her constituency. I pay tribute to all the work she has done to secure investment in Anglia Ruskin University. She is right to highlight the importance of delivering clinical placements as part of the long-term workforce plan. I assure her that we are working closely with NHS England and partners in health and education to ensure that happens.

Alan Brown Portrait Alan Brown (Kilmarnock and Loudoun) (SNP)
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Medicine shortages have doubled in the UK in the last two years. There might be some global pressures, but two issues have particularly affected the UK: first, the post-Brexit regulatory framework; and secondly, the fact that the pound has tanked, making it more expensive to buy medicines. What are the Government doing to undo that Brexit dividend?

Andrew Stephenson Portrait Andrew Stephenson
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The hon. Gentleman sounds like a broken record, as usual. The Department has no evidence to suggest that EU exit is leading to sustained medicine shortages. Shortages occur for a wide range of reasons and are affecting countries all over the world.

George Freeman Portrait George Freeman (Mid Norfolk) (Con)
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Rural Norfolk is experiencing a dental crisis and a generation of children are in danger of going without dental care. I welcome the dental recovery plan, but I notice that it will be four or five years before we get more dentists. Last week, NHS Norfolk and Waveney integrated care board announced a £17 million underspend on dentistry. Will the Minister agree to meet with me and the ICB to work out how we get more money out now to help dentistry in Norfolk today?

Victoria Atkins Portrait Victoria Atkins
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One of the many ways we have tackled access to dental care is to ensure that those dentists who have a contract to conduct NHS work are using them to the top of their licence. We are encouraging dentists to do that through the new patient premium and a higher rate paid for units of dental activity. There is so much more to the plan. Labour keeps trying to claim credit for our plan, but the truth is that our plan promises 2.5 million appointments while its plan promises a miserly 700,000.

Rachel Hopkins Portrait Rachel Hopkins (Luton South) (Lab)
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It is imperative that we tackle the scourge of mental ill health in children and young people. Labour will ensure access to mental health support in every school and establish an open-access mental health hub in every community, paid for by charging VAT on private school fees. Why will the Government not adopt that plan?

Maria Caulfield Portrait Maria Caulfield
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I have a news flash for the hon. Lady: we are already doing all that work. Mental health support teams are being rolled out in schools—44% of pupils now have access to a mental health support team, rising to 50% shortly. Over 13,800 schools and colleges now have a trained senior mental health lead. Only last week we announced 24 early support hubs for 11 to 25-year-olds—they will not need a referral; they can drop in. There are 24/7 helplines available that can be accessed through 111. That is what we are doing.

Priti Patel Portrait Priti Patel (Witham) (Con)
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Mid and South Essex integrated care board is seeking to remove vital community health services from St Peter’s Hospital in Maldon. Will the Minister meet me and our right hon. Friend the Member for Maldon (Sir John Whittingdale) to discuss the proposals? They will affect both our constituencies and are causing a great deal of concern.

Helen Whately Portrait Helen Whately
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I would be very happy to meet my right hon. Friends to discuss those concerns.

Christine Jardine Portrait Christine Jardine (Edinburgh West) (LD)
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I thank the Secretary of State for her offer to help cut waiting lists in Scotland. I listened to the frankly delusional statements from the SNP Benches about the state of the NHS in Scotland. We are in dire straits and suffer the same problems, particularly about GPs and appointments disappearing. When are we going to see an improvement in appointment availability?

Andrea Leadsom Portrait Dame Andrea Leadsom
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The hon. Lady will no doubt be extremely envious of the fact that in England there are 50 million more GP appointments now every year, which is a fantastic achievement by this Government. She will want to look at what is happening in Scotland, which has some of the worst health outcomes in western Europe, and challenge SNP Ministers over drug and alcohol death rates and falls in life expectancy.

Jacob Rees-Mogg Portrait Sir Jacob Rees-Mogg (North East Somerset) (Con)
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Will my right hon. Friend explain an anomaly in the “Agenda for Change” pay deal as it affects non-NHS providers? People working in the NHS for non-NHS providers may be eligible for extra money if the organisation they work for is in financial difficulties, but not if it is not. So badly run organisations are being rewarded and well-run organisations are being penalised, which seems to me to be perverse.

Andrew Stephenson Portrait Andrew Stephenson
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I am happy to meet my right hon. Friend to discuss the matter. We have reached pay settlements with the “Agenda for Change” unions, and we continue to reach pay deals with other unions. We are also supporting non-NHS providers whose contracts are dynamically aligned. It is a complex area, so I am more than happy to meet my right hon. Friend to discuss his concerns.

Florence Eshalomi Portrait Florence Eshalomi (Vauxhall) (Lab/Co-op)
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The Secretary of State will know that NHS England is expected to announce the decision about the primary children’s centre for cancer treatment in south London and south-east London. Evelina London Children’s Hospital in my constituency is one of the only specialist centres in south London. Does she agree that the final decision should be made as soon as possible in order to benefit staff, patients and families? Will she join me in visiting Evelina London?

Victoria Atkins Portrait Victoria Atkins
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I thank the hon. Lady for her question. In fairness, colleagues from across the House have been raising this issue with me because it affects a large population of London and the surrounding areas. I must leave it to NHS England to finish its consultation process, but I would be very happy to visit not just the Evelina but our other wonderful hospitals that look after children.

Maggie Throup Portrait Maggie Throup (Erewash) (Con)
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Given the expansion of health services through Pharmacy First, what action is my right hon. Friend the Minister taking to ensure that communities such as Sandiacre in my constituency, whose branch of Boots is due to close at the end of the month, are not left without access to such vital services?

Andrea Leadsom Portrait Dame Andrea Leadsom
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I am very happy to discuss that matter with my hon. Friend, who is a huge advocate for her constituency. It is always disappointing when a community pharmacy closes, but she will know that the launch of Pharmacy First on 31 January expanded the value and contribution of all our community pharmacies. It has been met with a £645 million investment over this year and next.

Gregory Campbell Portrait Mr Gregory Campbell (East Londonderry) (DUP)
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On access to primary care provision, will the Secretary of State assure the House that she will liaise with Health Ministers in the devolved Departments to ensure that rural communities do not lose out because of their isolated locations?

Victoria Atkins Portrait Victoria Atkins
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I am very happy to give that assurance. I was delighted to meet Minister Swann yesterday to discuss his plans for Northern Ireland healthcare, including access to primary care.

Paul Bristow Portrait Paul Bristow (Peterborough) (Con)
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I remind Members of my entry in the Register of Members’ Financial Interests. The Medicines and Healthcare products Regulatory Agency’s international recognition procedure will ensure faster access to innovative treatments, but it will realise its full potential only if it is matched by the National Institute for Health and Care Excellence’s evaluation process. What is my right hon. Friend the Minister doing to ensure that the two processes are aligned?

Andrew Stephenson Portrait Andrew Stephenson
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My hon. Friend will be aware that there have been delays with approvals by the MHRA and NICE. We are keen to ensure that those delays are reduced, and I am delighted to tell the House that significant progress has been made in both organisations. I am happy to work with my hon. Friend and both organisations to ensure that progress continues to be made.

Sarah Dyke Portrait Sarah Dyke (Somerton and Frome) (LD)
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Figures obtained by the British Dental Association project that £8 million of the NHS budget in Somerset is going unspent. Will the Minister explain to my constituent, who is suffering in dental agony, why that is happening?

Andrea Leadsom Portrait Dame Andrea Leadsom
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I encourage the hon. Lady to hold her integrated care board to account. We invest more than £3 billion a year in dentistry, and our dental recovery plan means that significant money is available for NHS dentistry. It is for the integrated care board to commission those units of dental activity, which now offer more money—a minimum of £28 per UDA. I am happy to meet the hon. Lady if she finds she is not getting anywhere with her ICB.

Anna Firth Portrait Anna Firth (Southend West) (Con)
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I am currently working with a brilliant local pharmacist, Fizz, to open a new NHS dental practice in Belfairs in my constituency. Premises and dentists have been lined up, but we need the ICB to commission the service. Will the Minister meet me, my local ICB and Fizz to unlock that vital service as soon as possible?

Andrea Leadsom Portrait Dame Andrea Leadsom
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I am delighted to hear about that really good news for my hon. Friend’s constituents—I know she works tirelessly for them. Of course, I will be very happy to meet her.

Richard Foord Portrait Richard Foord (Tiverton and Honiton) (LD)
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Wendy Hart had a high white blood cell count when she was discharged from the Royal Devon and Exeter Hospital. Her husband, Terence, described a dreadful, pointless 60-mile round trip home and back to hospital before Wendy died of sepsis. Will the Minister consider distances between acute hospitals and rural communities when reviewing hospital discharge guidance?

Helen Whately Portrait Helen Whately
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I am very sorry to hear about what happened to the hon. Gentleman’s constituent. I send my condolences to her family and loved ones. Clearly, it is very important that discharge decisions are led by clinicians, who can make a clinical decision about whether somebody is medically ready to be discharged. I have no doubt that the family may well take up that decision with local NHS organisations.

Will Quince Portrait Will Quince (Colchester) (Con)
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No doctor wants to be on strike, so I welcome the new deal with the consultant unions. It shows that by being reasonable, pragmatic and acting in good faith, unions can deliver for their members. Does my right hon. Friend agree?

Victoria Atkins Portrait Victoria Atkins
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My hon. Friend knows only too well the importance of industrial action and the impact it can have on patients and on the NHS as a whole. I am pleased that the BMA has announced today, following the previous settlement that was narrowly rejected in its ballot, that it has been able to get back around the table with my officials and me. We have been able to find a fair and reasonable settlement that the BMA will advocate for and recommend to its members. We hope that that shows those who are choosing to strike that constructive negotiations, and trying to sort out some of the concerns that we know clinicians have, can be dealt with in a reasonable manner, which is of benefit not just to staff, but to patients.

Chris Bryant Portrait Sir Chris Bryant (Rhondda) (Lab)
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How many people were treated for acquired brain injury last year?

Andrew Stephenson Portrait Andrew Stephenson
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The hon. Gentleman has caught me off guard—I will write to him. I am keen to continue working with him on that issue. As he knows, we have already shared draft details of the acquired brain injury strategy with him and members of the all-party parliamentary group, and I am very keen to continue working collaboratively on that issue with him.

Point of Order

Tuesday 5th March 2024

(3 months, 3 weeks ago)

Commons Chamber
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12:45
Nick Smith Portrait Nick Smith (Blaenau Gwent) (Lab)
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On a point of order, Mr Speaker. I have spoken before in the House about my constituent, retired school caretaker Gary Godwin, who is fighting for redress after losing £2,000 of his hard-earned savings to the now defunct funeral plan firm Safe Hands. Gary and 47,000 others look to have been let down by a failed regulatory regime overseen by the Treasury and the Financial Conduct Authority, for a grand total of £60 million between them. After raising the issue in questions to the Leader of the House last July and at Treasury questions last October, I finally managed, at the start of the year, after several attempts, to get a meeting with the Economic Secretary, who said he would raise it with the Chancellor. Having not had a reply for two months, I informed the Economic Secretary that I would raise a point of order today. Within an hour, I received a reply, but there was no mention of discussing the matter with the Chancellor, or of a review of the correspondence, as was originally promised. Will you tell me, Mr Speaker, what more I can do to ensure that Gary and his fellow victims do not have a lengthy wait for justice?

Lindsay Hoyle Portrait Mr Speaker
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I thank the hon. Member for his point of order and for giving me notice of it. I understand that the Chancellor has replied to his letter in the last few minutes—is that correct? In any case, those on the Treasury Bench will have heard what he has had to say. He still has time to table a question for the Chancellor at Treasury questions on 19 March to follow up on this important matter. I am sure that the Table Office will be able to advise him on how to else he might pursue it.

Senior Civil Service (Accountability and Appointment)

A Ten Minute Rule Bill is a First Reading of a Private Members Bill, but with the sponsor permitted to make a ten minute speech outlining the reasons for the proposed legislation.

There is little chance of the Bill proceeding further unless there is unanimous consent for the Bill or the Government elects to support the Bill directly.

For more information see: Ten Minute Bills

This information is provided by Parallel Parliament and does not comprise part of the offical record

Motion for leave to bring in a Bill (Standing Order No. 23)
12:48
Giles Watling Portrait Giles Watling (Clacton) (Con)
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I beg to move,

That leave be given to bring in a Bill to make provision about the scrutiny and approval by Parliament of appointments to senior civil service roles; and for connected purposes.

In this nation, people rightly expect this elected and accountable Parliament to oversee an impartial civil service. The notion of distance and unaccountability has, however, grown among the populace like a spectre, caused by unnecessary tensions on both sides and casting aspersions on the majority. It is time something was done about it.

We need this reform because nothing is more fundamental to our democracy than the relationship between Parliament and the civil service. This is the mother of Parliaments, and our civil service is held to be the gold standard in the world of officialdom. When elected Members and the civil service row in the same direction, we can produce startling results, which have beaten fascists, built the NHS, and won the Olympic bid. When the conduct between us becomes strained, when confidence is undermined and when accountability, trust or respect are lacking, we get cast-iron assurances regarding matters such as weapons of mass destruction and sub-par personal protective equipment contracts. As a result, perfectly sound policies get stalled.

I am sure all colleagues will agree that our civil service is a great one, as is our Parliament—men and women dedicated to the public good—but has been plagued in recent years by increasing tensions that have a fundamental impact on the discharge of governance and policy. Let us consider the issues we have seen in recent years and how they tell of structural deficiencies, rather than being merely isolated accidents under a particular Administration.

The Sue Gray affair should alarm us all, whatever side of the House we sit on. To have a civil servant preside over an investigation into a Prime Minister, and then achieve escape velocity from the civil service to go and work immediately for the Opposition, has scarred the view of impartiality that the majority rightly accept and expect. The same could be said of the role of political appointees. In many ways, we can view certain Labour and Conservative spin doctors as essentially the same entity: unaccountable to the public, but very much imposed on the public, beyond the advisory role for which they were initially intended.

Both those issues could be addressed through updates to the Constitutional Reform and Governance Act 2010, which sought to better control apparatus such as special advisers, but if we wish to fix an issue, we need to amend the culture that goes with it. To do that, we need to start at the top. We need a culture that the majority of the service still respects.

Let us define that top and the route to it. The great mandarins who hold vast power are often faceless. That cannot be right in a democracy: if a person wants power, they must be subjected to the sunlight of this place. Permanent secretaries are appointed under a scheme in which the Prime Minister has the final say in the recruitment process—the Prime Minister alone chooses directly from a list created by the civil service commissioners. If any Member present can, without the aid of Google, name the commissioners who appoint people to hold power over their constituents’ lives, I would be amazed.

It is not just the permanent secretaries we must consider. The Transparency of Lobbying, Non-party Campaigning and Trades Union Administration Act 2014 explains that a permanent secretary is a person serving in a range of government posts. That definition needs massively expanding to ensure that it encompasses top officials within state entities such as the NHS—for instance, the CEO of the NHS is often seen as a godlike distant figure and not suitably accountable to this place. Let us be in no doubt: horrific things happen if a culture is enabled where officials feel they are above policy instructions from the elected. At the current time, advancement in the civil service comes from appeasing the established networks, such as the commission, and the Minister for the civil service. These people serve the nation, so their fortunes should lie with this institution, not an elite few within it.

I do not propose that we fix all the issues at once, nor do I propose a baby-out-with -the-bathwater approach, but a modest solution that resets the relationship to a more traditional and, may I say, British footing. By that, I mean a process that is less invested in smoke-filled rooms with those from the Executive, one that empowers this place. I propose that a cross-party Committee of both Houses be formed to fold those appointments into understood due process. Appointments would be fixed-term and renewable by this place, which will end at a stroke the concept of a job for life. This is hardly revolution: it is a mix of established democratic processes in Parliament and professional standards that industry outside this place would recognise. It would only impact a few dozen people at the top; it is hardly onerous. I imagine that 99.9% of the civil service would not be impacted, but the change to the culture at the top would cascade down. If the upper echelons knew they were better overseen by this place—this cross-party institution—they would ensure that those they manage are correctly supported, mentored and held to account.

Some siren voices claim that this work could be discharged by Select Committees holding more hearings, or that better training of Ministers could fix all the issues, but the bottom line is that if a person has vast power over the machinery of government but does not feel a sense of fealty to Parliament, such ideas are mere tinkering. What I have proposed can be done now, in a modest manner, to gently course-correct a few errors and modernise and empower this institution. If we do not do so, eventually we could well need more radical reform. The relief valve is simple and established: professional industry processes via this accountable House. Let us act now, because if a trend of unaccountability continues to make people question who is really running Britain, the gold standard I mentioned will soon be seen as fool’s gold.

Question put and agreed to.

Ordered,

That Giles Watling, Michael Fabricant, Andrew Rosindell and Mr Mark Francois present the Bill.

Giles Watling accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 17 May, and to be printed (Bill 171).

Second Reading
[Relevant documents: Seventh Report of the Transport Committee of Session 2022-23, Self-driving vehicles, HC 519, and the Government response, Session 2023-24, HC 264.]
12:56
Mark Harper Portrait The Secretary of State for Transport (Mr Mark Harper)
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I beg to move, That the Bill be now read a Second time.

As hon. Members know, most journeys take place on our roads. About 86% are made by cars, taxis and vans, but in the over 100 years since the invention of the car, despite our vehicles becoming better, safer and now cleaner, one aspect of driving has remained constant: the driver has always controlled the vehicle. In future, things may be different. For all or part of a driver’s journey, self-driving vehicles will free them from that responsibility, improving the lives of the millions of people who are unable to drive; boosting connectivity for rural communities across the country; transforming freight, be it long haul or last mile; and above all, making our roads safer.

Jonathan Edwards Portrait Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)
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As the Secretary of State knows, insurance premiums have been going through the roof recently—the costs are astronomical. What impact does he expect automated vehicles to have on insurance premiums?

Mark Harper Portrait Mr Harper
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If the hon. Gentleman will allow me to make a little progress, I will speak about how one centrepiece of the Bill and of our approach is the safety not just of the automated vehicle and its occupants but of other road users, particularly vulnerable road users. I will come on to that point; if the hon. Gentleman does not feel that I have covered it, he should feel free to intervene again.

We are on the cusp of a transport revolution, and Britain is very much at the wheel of that decision. British companies are developing the self-driving technology; British lawyers are developing the robust new legal frameworks that are being used; and British parliamentarians in this House and the other place can now agree regulation widely seen as among the most comprehensive in the world. The goal is clear: we want to make this country the natural home for the self-driving vehicle industry, and this Bill is the next stop on that journey.

Ben Everitt Portrait Ben Everitt (Milton Keynes North) (Con)
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It will not surprise my right hon. Friend that I am speaking up for Milton Keynes on this subject. This is a huge global opportunity for Britain, worth £350 billion, and Milton Keynes is often the testbed of this technology. It is a beautiful, vibrant city that is going places—except perhaps in the eyes of the producers of last night’s “EastEnders”—so does he agree that when we get this technology, we will be able to roll it out because we have tested it in places such as Milton Keynes?

Mark Harper Portrait Mr Harper
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I thank my hon. Friend for speaking powerfully for his constituency. He is right: those developing this technology will want to roll it out carefully and thoughtfully, and they will want to do that in specific places in the United Kingdom. He has just made a powerful bid for Milton Keynes to be at the centre of that.

Gearing Britain up for a self-driving future has been the work of years. In 2015, our world-leading code of practice enabled self-driving vehicle trials in the UK. We passed the Automated and Electric Vehicles Act 2018, which codified insurance in this area for the first time and recognised the importance of that, as the hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards) said earlier. In that same year, we kicked off a Law Commissions review on a legal and safety framework for self-driving vehicles—

Mark Harper Portrait Mr Harper
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Let me just set out what that review did, then I will take an intervention from the hon. Gentleman, who is an esteemed member of the Select Committee. It convened legal minds from across the country, launched three rounds of public consultation, sifted through hundreds of written responses and produced more than 70 recommendations, which now underpin this legislation.

Grahame Morris Portrait Grahame Morris
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I am grateful to the Secretary of State for giving way. These are really important points, as is the clarification sought by the hon. Member for Carmarthen East and Dinefwr on insurance liability. Can I ask the Secretary of State about the arrangements for the compensation of victims of any collisions that are caused by uninsured automated vehicles? He mentioned the Automated and Electric Vehicles Act 2018, but that legislation does not mention this point. This Bill represents an opportunity to address that. Will the Secretary of State set out how we are going to do that, or are we missing an opportunity?

Mark Harper Portrait Mr Harper
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The hon. Gentleman is right to raise that point. We have arrangements in place for vehicles with human drivers who are uninsured, and we are working with the Motor Insurers’ Bureau on the arrangements that will be in place. I would envisage analogous arrangements for self-driving vehicles that are uninsured, to make sure that if they are involved in accidents, any victims of those accidents are able to receive reimbursement in the same way as happens now for the victim of an uninsured driver. We already have arrangements, and I would envisage analogous arrangements. We are already having those conversations, but if the hon. Gentleman has more to say on that, either today or in Committee, I will be delighted to hear from him—

Mark Harper Portrait Mr Harper
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I am happy to hear from him again now.

Grahame Morris Portrait Grahame Morris
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I am grateful to the Secretary of State for that clarification, but this is a whole new world where we will be relying on AI, software and so on. How would an insurer prove that a vehicle was being driven autonomously rather than by a driver? Under the provisions of the Bill, would the insurer have access to the data so that they could analyse it and see whether an individual was in charge of a vehicle or whether it was being driven autonomously?

Mark Harper Portrait Mr Harper
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I will come on to that in my speech, but I will answer the hon. Gentleman’s specific questions. From the point of view of any person needing to make a claim, the insurer will be liable whether the vehicle is in self-driving mode or the user is in charge. What happens subsequently, regarding whether the manufacturer, the software provider or whoever has to pony up the money, is a matter for the insurer to argue about with them. That will not impact the victim, who will be paid by the insurer.

On the hon. Gentleman’s important point about data, we discussed this last week when I met a roundtable of those involved in the industry, including road safety campaigners and those in the insurance industry. The Bill will ensure that the data can be shared, and the insurance industry is keen for that to happen so that it can properly price the risk. I will say more about this when I talk about the safety framework, but there is a real opportunity here because most road traffic collisions are caused at least in part by human error. The track record of self-driving vehicles shows that this is an opportunity to improve road safety, which is important not just for those who use vehicles but for other road users. There is a balance to strike here. We need to capture that benefit but also ensure that we do not leave anyone exposed without protection, as the hon. Gentleman rightly set out.

Greg Knight Portrait Sir Greg Knight (East Yorkshire) (Con)
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On the point the Secretary of State has just been discussing, presumably the details of all journeys undertaken by automated vehicles will be recorded. Where will that data be stored, and who will have access to it? Could someone access that information for non-driving reasons—for example, someone involved in divorce proceedings or an employer in an employment tribunal?

Mark Harper Portrait Mr Harper
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My right hon. Friend should note that data for these purposes will be protected in the usual way. Data has to be used for the purposes for which it was gathered. There are legal processes for who has access to it, as well as those we will set out specifically for driving purposes. The other things he mentioned will be governed by the usual laws that govern the use of data. I do not want to dwell on those specifics, but they are already covered by existing data protection legislation for the devices that people have in vehicles to monitor their progress or for mobile phones.

I would like to start with safety. Anyone stepping into a self-driving vehicle will reasonably ask: “Can this car consistently drive safety? Will the law protect me if there is an accident? Is the manufacturer regulated and can they be held to account?” Under this legislation, the answer to each of those questions will be yes. The Bill has been built on a bedrock of safety, protecting not just the driver inside the car but road users outside the vehicle.

As I mentioned in answer to the hon. Member for Easington (Grahame Morris), I chaired a roundtable with road safety groups last week and explained how we are holding self-driving vehicles to a higher safety standard than the average human driver, guided by principles we will soon consult on; how these vehicles must meet rigorous technical requirements before rolling off production lines and being authorised for our roads; and how we will tackle misleading marketing, with new offences for companies that seek to blur the line between true self-driving and driver assistance.

Clive Efford Portrait Clive Efford (Eltham) (Lab)
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That gets to the nub of the point. Because these vehicles are going to be automated, they will be governed by an algorithm written by a human being somewhere remote from where an accident might occur. How do we determine whether the primary purpose of that algorithm is to protect the person in the car or someone outside the car, such as a pedestrian or a child crossing the road? How does the algorithm make a choice in those circumstances?

Mark Harper Portrait Mr Harper
- Hansard - - - Excerpts

We will consult on the statement of safety principles, which will set out the governing principles of the legislation. On the specifics, this will be about making sure that the manufacturers—those who create the software and those who put the cars together—have rigorous processes for testing and decision-making. Those systems will have to be authorised to be used in our cars, and it will be important to look at their data and their track records. As I say, in real-world situations where these vehicles are being used—for example, in California—the evidence suggests that they have a very good safety record that is much better than that of human drivers. There is a big opportunity here to have a safer road environment, not just for the users of the vehicles but for other road users.

I do not know whether the hon. Gentleman has had the opportunity to ride in a self-driving vehicle, but the data they collect of their surroundings is interesting. My personal observation is that the space they give when passing a cyclist, for example, is a lot more generous than that I have seen many human drivers give. Of course, those parameters are going to be set and regulated, and people will have to be assured that the vehicles are safe before they are on the road. Ultimately, the manufacturer will be legally responsible if they turn out not to be.

Clive Efford Portrait Clive Efford
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I am grateful to the Secretary of State for giving way a second time. I agree entirely that, overall, roads will be safer with automated vehicles, but there will still be accidents. My question was specifically about where there is an accident and there is a choice to be made about protecting the person inside the car and injuring someone outside the car. How do we determine what takes priority in those circumstances?

Mark Harper Portrait Mr Harper
- Hansard - - - Excerpts

We will consult on the safety principles, but with some of this stuff we have to look at the way the vehicles make decisions. We cannot possibly legislate for every single set of circumstances. In the same way, when there is a collision involving a vehicle with a human driver, the driver will make the best decision they can in the specific circumstances. Sometimes those situations lead to legal conflict and then people have to make a judgment. We cannot legislate for every single one of those circumstances in advance. What we can do is make sure there are robust systems that make good decisions based on the best data, and then look at the track record. We will also set up a regulatory system whereby any accident involving an automated vehicle will be properly investigated.

The hon. Gentleman raises an important point. It is essential with this legislation that we earn the public’s trust and win their confidence. That is one of the reasons why we have been so clear, and why we accepted the amendments in the other place, about putting safety at the forefront of the Bill. If people are not persuaded of that, this technology will not make much progress.

None Portrait Several hon. Members rose—
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Mark Harper Portrait Mr Harper
- Hansard - - - Excerpts

I will take an intervention from my hon. Friend the Member for North East Bedfordshire (Richard Fuller) and then make some progress before continuing to take interventions.

Richard Fuller Portrait Richard Fuller (North East Bedfordshire) (Con)
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The Secretary of State is taking a safety-first approach to this legislation, and that seems to be the will of the House. I have used a driverless vehicle operated by Waymo, a driverless Uber-style service in the United States. He will know that those vehicles have more cameras—more eyes—looking in more directions more of the time than it would be possible to achieve even with 100 drivers sitting in a single vehicle. My concern is whether, in his effort to put safety first, he is compromising the potential for economic growth. In America, most of the force for change with automated vehicles is being driven by the leading global technology companies. What discussions has he had with those companies in preparation for the Bill? How comfortable are they with the Government’s approach?

Mark Harper Portrait Mr Harper
- Hansard - - - Excerpts

I have discussed the legislation with a number of those companies—both UK companies and those in the US—and I am pleased to assure my hon. Friend and the House that they too recognise that safety is incredibly important. They all understand that they have to be able to operate within a legal framework set by legislators who are ultimately accountable to the public, and that they have to take the public with them. As ever with these things, whatever the track record of existing vehicles and drivers, because this is new technology, people will be sceptical about it, and anything that goes wrong will have a brighter light shone on it. The industry is very aware of that and, I think, very happy to work with us on those issues.

None Portrait Several hon. Members rose—
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Mark Harper Portrait Mr Harper
- Hansard - - - Excerpts

I will take one more intervention and then I will make some progress.

Jim Shannon Portrait Jim Shannon (Strangford) (DUP)
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I will be honest, Mr Deputy Speaker: I am not very technically minded. I like the idea of a manual car with five or six gears and reverse. In the rural community that I live in, I am very happy with that. I have a bit of hesitation about automated vehicles. Thinking about young drivers—this is really important, because the Secretary of State mentioned blurred lines—we have to make sure that everyone who learns to drive has full capacity to drive any vehicle, and does not think they can get into an automated vehicle and just sit there and do nothing. It is really important that everyone is subject to the same rules. Can he confirm for anyone who thinks that in future they will be able just to sit in the back of the car that that is not the case, and that they will have to learn to drive in the way that we all have over the years?

Mark Harper Portrait Mr Harper
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I will come to that in a second—it will become clear in the next section of my speech—but I can tell the hon. Gentleman that the Bill is about giving people choices. If people want, as many will, to carry on driving their existing vehicles in the traditional way, that is absolutely fine and no one is going to try to stop them. To be very clear, the hon. Gentleman can carry on driving for as long as he wants to and is safe to, and no one is going to try to stop him. Certainly, I am not going to try—I wouldn’t dare.

On the legal concerns—this will address the point about the driving test, too—the Bill redefines our legal relationship with road transport. As soon as someone turns on a self-driving feature, legal responsibility for how the car drives will transfer to an authorised self-driving entity, or ASDE—not a very catchy acronym, admittedly, but that is what they are called. That could be a manufacturer or a software developer but, crucially, it will not be the human driver, who will assume a new status. As a user in charge, they will still need to ensure that the car is roadworthy, and they will need to reassume control if necessary. That answers the hon. Gentleman’s question: someone will still need to be in possession of a full driving licence and able to reassume control of the vehicle if required, but they will be protected by law from any offences while the car is driving itself.

Some journeys, either in private cars or on self-driving transport, will be fully automated, and a human will never need to take control; they will be, in essence, a passenger. My hon. Friend the Member for North East Bedfordshire (Richard Fuller) mentioned the example of Waymo cars in the US. Those are operated as taxis, with no driver present, and the human is never expected to take control; it is classed as a “no user in charge” journey. In those circumstances, someone would not need a driving licence, because they would never be expected to drive the car, in the same way we are not expected to drive a taxi or private hire vehicle. Those legal concepts will have a seismic impact.

Wera Hobhouse Portrait Wera Hobhouse (Bath) (LD)
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This is the future, and it is both quite exciting and quite scary. We have to get our heads around it and make sure that we get this right. On what the Secretary of State has just been describing, is it basically the difference between someone taking a taxi and driving their own car? If there is an accident in a taxi, the taxi company is responsible, not the passenger.

Mark Harper Portrait Mr Harper
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If someone is using a vehicle for a “no user in charge” journey for which they are, in effect, the passenger and there is an accident, it will be totally the responsibility, in all circumstances, of the person operating the vehicle. Where someone who is driving the car for part of the time switches on the self-driving features and something happens while those features are activated, that will be not their responsibility but that of the manufacturer or the software developer. If someone is in control of the vehicle and the self-driving features are not activated, they retain responsibility.

One of the things that we will have to do is educate people about the difference, and we are being clear to manufacturers that there is a big difference between a self-driving feature and driver assistance. Under driver assistance, the driver is still fully legally responsible for the vehicle, but with some technological help; when the self-driving features are activated, they no longer have legal responsibility.

Wera Hobhouse Portrait Wera Hobhouse
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Is there not potential for a legal conflict between a driver who says, “I was in self-driving mode,” and a company that says, “No, it was switched off”? Does the Secretary of State see that it might be very difficult to establish what happened in such circumstances?

Mark Harper Portrait Mr Harper
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Potentially, but that is exactly why the earlier question about data is very important. These vehicles generate a huge amount of data and one part of the authorisation process will be making sure that that data is properly managed and there is proper access to it by the investigators of any potential accident and the insurance industry to establish exactly what has happened in such circumstances.

Mark Harper Portrait Mr Harper
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I give way to the Chairman of the Select Committee on Transport.

Iain Stewart Portrait Iain Stewart
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I want to build on the question from the hon. Member for Strangford (Jim Shannon) about the situation where a driver is in control of the car at some point and at other points the car is autonomous. That will presumably result in drivers becoming less experienced, as they will not accumulate as much knowledge and experience of driving. When the automated features switch off and the driver needs to take control, those will be potentially immediate and challenging circumstances. Is my right hon. Friend assured that the driving test and refresher courses will give drivers sufficient capacity to take over in those circumstances?

Mark Harper Portrait Mr Harper
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My hon. Friend raises a good point. I am very comfortable with the driving test; it continues to be updated to make sure drivers are familiar with features such as satnavs, and the new technology will be added. The wider question about how often drivers drive and how experienced they are of course arises now. Someone can take a driving test and not drive very much but occasionally hire a vehicle, and we hold them to the same standard as those who drive day in and day out; they are still responsible. There might in these circumstances be a question about whether it would be sensible for people to take refresher courses and do further training, and we will want to monitor that and determine whether we should legislate for it or issue guidance. It is an interesting point for us to keep an eye on.

As well as the legal issues, making driving more convenient in this way also makes it potentially much more accessible, by for example giving those who cannot drive at the moment, such as the 340,000 people registered blind or partially sighted, new options to travel independently, opening doors to economic and social opportunities that have thus far remained closed. Interestingly, in the United States, where this technology has been rolled out earliest, it is those groups who have been most vocal in arguing for the technology, because it changes their lives for the better and opens up their opportunities.

The third area is learning and enforcement. This technology will get stronger, smarter and safer over time. The safety data will be collected by the vehicle, monitored by its operator and scrutinised by a Government regulator, which means we can take enforcement action when things go wrong or through sanctions and suspensions if a company withholds data. The Bill also includes measures to investigate incidents independently and ensure that lessons are learned. I have spoken about the context behind the Bill and addressed some of the key components and will turn now to some of the benefits self-driving vehicles will bring.

Alexander Stafford Portrait Alexander Stafford (Rother Valley) (Con)
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This is an exciting Bill about an exciting future. I have listened carefully to what my right hon. Friend has said about who will ultimately be responsible if there is an accident. My understanding is it will always be the manufacturer and will never be the person who owns the car. In my constituency, as in many others, large numbers of people like modifying their cars and I am sure when autonomous vehicles are introduced people will want to modify those as well. They might change them in ways that ultimately slightly limit or diminish some of the safety features put in when the car was built, so who will be ultimately responsible in such circumstances? People may make modifications without knowing the implications, potentially, for diminishing the safety of the car. Will the manufacturer still be responsible when the car is modified, or will it be the owner?

Mark Harper Portrait Mr Harper
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My hon. Friend raises a very important point that we must make sure is covered. Clearly, if people make modifications that alter the functioning of the self-driving features of the vehicle, we would either have to say that that was not acceptable or they would have to accept that the vehicle was no longer self-driving. There would need to be rules. The vehicle will go through an authorisation process to go on the road, and there will be things that people will be allowed to change and things that they will not. I suspect that manufacturers will be very clear that they will no longer be responsible for a self-driving vehicle if someone has modified it. As long as that is clear, that is fine, but people will have to accept that, as cars become more technological with more technology built into them, the days of being able to tinker around with them under the bonnet and alter things will be long past if we want that technological stuff to kick in.

Alexander Stafford Portrait Alexander Stafford
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My question was not just about modification that may change the safety of the car but about any modification. If someone who owns an iPhone changes the screen, it is no longer under manufacturer warranty even though that does not affect how it works. If someone has modified their car and it does not affect a safety feature but there is then an accident, will the manufacturer be able to say that the car has been modified and that, even though the safety features are unchanged, it is therefore no longer its responsibility? Will the liability pass to the owner if the manufacturer decides it has nothing to do with it?

Mark Harper Portrait Mr Harper
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These cars will have to be authorised by the regulator to go on the road, but my hon. Friend makes the good point that, as part of that process, what the user of the vehicle can and cannot do needs to be clear. I suspect there will be very limited things that they could do without affecting the operation of the vehicle, but it is good to put on the record that in the information provided by both the manufacturer and the regulator we must be clear about what the user of the vehicle can and cannot do to ensure it can be driven safely.

Despite Britain having some of the safest roads in the world, the levels of serious injury and road deaths remain too high. That could soon change. If we can eliminate driver error, which is involved in 88% of road collisions, we could get to the point where self- driving vehicles are a game changer for road safety: they do not drink and drive, they do not get stressed or distracted, they do not speed, get tired, bend the rules of the road or push their luck.

Self-driving vehicles will save lives and we cannot ignore the economic impact either. According to industry estimates, 40% of new cars will by 2035 have some self-driving capability. This is a growing global market, Britain’s share of which could be worth £42 billion and generate 38,000 skilled jobs in areas ranging from cyber-security to AI, and thanks to Government support, our self-driving vehicle industry is not only thriving but recognised the world over.

Grahame Morris Portrait Grahame Morris
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I thank the Secretary of State for his reassurances about safety. I do not think it is all one-sided, because another aspect of safety is cyber-safety, which we do not need to worry about with a traditional car. Automated vehicles are extremely vulnerable to cyber-attacks from hackers and potentially from terrorists, especially as the software and technology age. What are the Government going to do? Are they going to commit to establishing the necessary regulations to ensure cyber-security for automated vehicles is robust and that protections continue over the lifetime of the vehicle?

Mark Harper Portrait Mr Harper
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The simple answer is, yes, we are going to do that. The hon. Gentleman is right to raise cyber-security as an issue, and it is of course an issue today, because many cars today have electronic features from keyless entry to navigation systems. Existing cars are vulnerable to being hacked. Cyber-security is important and we and the industry are working with the National Cyber Security Centre. I agree that cyber-security will be very important, but it already is important.

Clive Efford Portrait Clive Efford
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I agree with what the Secretary of State said about tinkering and that nullifying any insurance, but we have also just experienced the Horizon scandal, where the manufacturers themselves had access to the technology. What security do drivers have from the designers of the software governing these cars covering their own backs?

Mark Harper Portrait Mr Harper
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One of the things we will have in place is a duty of candour. We will also set up a regulatory process with investigations of every self-driving vehicle involved in an incident. Importantly, manufacturers will be legally obliged to have that duty of candour to disclose the information, so that these issues can be got to the bottom of. The hon. Member raises a specific case that I will not comment on, and there will no doubt be learnings from that case, but the regulatory approach we are setting up will deal with the issue he just raised.

Greg Knight Portrait Sir Greg Knight
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Will the Minister give way?

Mark Harper Portrait Mr Harper
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Let me make a bit of progress; I want to try to get to a conclusion, because others wish to speak, but I will try to get back to my right hon. Friend in a sec.

In 2019, Google’s Waymo made the UK its first European engineering hub for self-driving technologies. Bosch and ZF, among others, are investing in the UK, drawn by our highly skilled workforce. CAM Testbed UK, a unique cluster of five facilities between London and the west midlands, has received £200 million of Government and industry funding, and we have put £66 million into scaling up self-driving mobility ideas, from buses in Scotland to HGVs in Sunderland, with a further £150 million announced as part of our advanced manufacturing plan. We do not want to lose momentum, and we want to make sure that we push the industry to realise the full benefits of this technology. I hope that the Bill brings certainty to investors, clarity to manufacturers, confidence to the public and demonstrates Britain’s strongest commitment yet to a self-driving future. Before I conclude, I will take an intervention from my right hon. Friend.

Greg Knight Portrait Sir Greg Knight
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The Secretary of State has been generous in giving way. Just to clarify the point, there could be circumstances where a vehicle is in fully auto mode, but the owner bears some responsibility. For example, if an automated vehicle is on full auto and is involved in an accident, but it is then discovered that all the tyres are without tread, surely in those circumstances the owner would bear some blame.

Mark Harper Portrait Mr Harper
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I set out at the beginning that in circumstances where a user is in charge—where they are not purely a passenger with a company providing a taxi or private hire service—and the vehicle is in self-driving mode, the manufacturer or software provider is responsible for the conduct of the vehicle, but the user in charge is responsible for such things as the physical condition of the vehicle and the tyres, and they retain that responsibility. The balance of which of those things caused the accident will be determined in exactly the same way as currently.

In conclusion, as I think the hon. Member for Bath (Wera Hobhouse) set out, self-driving vehicles will provoke excitement from some and nerves from others, but for most of us, it is a combination of the two. Clearly it is an opportunity, but there are some risks. I know that first-hand, not only having visited California-based Waymo and ridden in one of its self-driving vehicles, but having done a journey from my departmental office to this House in a self-driving vehicle designed by the British company Wayve. It was interesting, as it went expertly through busy streets and responded quickly to things. It was a rainy day and a lot of people were darting in and out of the traffic—probably not sensibly—but the car responded safely. I realised the enormous potential of this technology, not just as a growing economic sector, but for a future where transport is safer, more convenient and more accessible. This Bill is a crucial step towards that future, and I take great pleasure in commending it to the House.

13:33
Louise Haigh Portrait Louise Haigh (Sheffield, Heeley) (Lab)
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Let me start by confirming Labour’s support for the legislation and the principle behind it. Automated vehicle technology, once the preserve of science fiction, is advancing at pace. Fully autonomous vehicles are already being tested on our roads by world-leading UK companies. The progress they have made is truly something to behold. Continuing that progress and getting this technology and the safety standards around it right are so important. It has huge implications for road safety, vehicle accessibility and our economy, so Labour agrees that it is vital we have a proper regulatory framework in place to ensure these technologies are introduced in a safe and accessible way that contributes positively to our economy.

On that basis, we welcome the Bill and its efforts to set safety principles for these vehicles and clear rules around marketing to stop consumers being misled about the autonomous capability of the vehicles being sold to them. However, there is still room to go further and to ensure that these vehicles’ introduction is a public good and not in any way a destructive force. A few months ago, I also visited Wayve in King’s Cross, a UK company doing pioneering work to develop autonomous technology for vehicles, which it is already testing on our roads. It is an experience, sitting in a vehicle with no driver, no controls and no clue which direction it will go in next, and I admit that I wondered, as I was being whisked about central London in all sorts of directions without any input or control from me, if that was not how the Secretary of State felt sitting around the Cabinet table most weeks.

Turning to the safety benefits of autonomous vehicles, it has been estimated that road collisions cost our economy as much as £43.2 billion in 2022 and that 85% of road crashes involve an element of human error. Automated vehicles can play a huge role in reducing human error, avoiding tragic accidents and helping to reduce the burden on the state in the process. The need to do more to tackle these deaths and injuries on our roads cannot be overstated. The last Labour Government cut road fatalities by almost 50% while in office, but there has been only an 8% reduction since 2010.

The Bill comes to us in a vastly improved state from the other place, thanks to pressure from my Labour colleagues there. As a result of their efforts, the Bill explicitly targets a safety standard for autonomous vehicles equivalent to or higher than a careful and competent human driver, as it rightly should. The statement of safety principles that the Secretary of State must make following the passage of the Bill will now also be subject to proper parliamentary scrutiny. That is important progress, and we are grateful for the Government accepting those important amendments.

Grahame Morris Portrait Grahame Morris
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We are addressing important safety and regulation issues, but does my hon. Friend share my concerns about potential job losses? Almost a million people are employed in the logistics sector, including drivers, delivery drivers and so on. I know the Bill is not concerned with alternative employment, but I see the effects of deindustrialisation in my area. Does she share my concerns about the potential job losses if this legislation is not done in a sensible way?

Louise Haigh Portrait Louise Haigh
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It is typical of my hon. Friend to raise such an important and pertinent point. I will come to it shortly in my speech.

It is a shame that much of the important work still to do on this safety regime will be set out further down the line, rather than being debated today in the Chamber. We will look closely at the detail when it comes to see how the standard is defined in practice, and I welcome any insight from the Government today to reassure colleagues on that. For instance, what level of fault will be allowed for an autonomous vehicle compared with a standard practical driving test, if any at all?

This technology does not just offer potential road safety benefits. It is estimated that disabled people in the UK take around 38% fewer trips than non-disabled people. Automated vehicles could help address that gap by unlocking a world of opportunity for those who cannot or struggle to drive and for those held back from that opportunity by the inaccessibility of too much of our public transport network. Securing those benefits will mean ensuring that access to these vehicles is not limited just to the extremely wealthy, and that the interests of disabled people, who are currently five times more likely to be injured by a vehicle than non-disabled pedestrians, are at the heart of the development of these technologies from the very start. I would welcome the Secretary of State setting out how he will ensure that disabled people and disability-led groups will be properly consulted as these vehicles are introduced to our roads.

Jim Shannon Portrait Jim Shannon
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I suppose, if I am being honest, that I am a bit of a sceptic in this matter. I am not a petrolhead, by the way, but many of my constituents love their cars, love their vehicles, and love the opportunity to work under the bonnet. I am always conscious that we may see a move towards automated vehicles all across the country, irrespective of what people think. Is it the shadow Minister’s intention to ensure that people will always have choice? If she does, that is the right way.

Louise Haigh Portrait Louise Haigh
- Hansard - - - Excerpts

I am grateful to the hon. Gentleman for his intervention and remain impressed that he has something to say on this issue, as on so many others. It will of course remain the case that should people wish to drive their cars, they will be free and able to do so. I think it will be a long time—indeed, the industry has predicted it will be several decades—before the number of automated vehicles outstrips the number of vehicles with drivers on our roads.

As my hon. Friend the Member for Easington (Grahame Morris) mentioned, there is one major area that the Bill does not address, and which we have not considered in any meaningful capacity, which is the potential impact on jobs from automated vehicles. As a South Yorkshire MP, I am all too familiar with the economic impacts of deindustrialisation. Far too many towns and cities across the north have already suffered enough from lost livelihoods, with the social fabric of their communities ripped apart as a new economic model left them behind. We simply cannot afford to make those same mistakes again.

That is why Labour has been clear that artificial intelligence and automation must be harnessed as a public good—one that delivers social benefits, grows the economy and supports jobs rather than destroying them. That is why, during its passage through the other place, my Labour colleagues attempted to amend the Bill to establish an advisory council that would ensure the Government consult on the introduction of these vehicles with not only industry representatives and road safety experts, but trade unions. The Government opposed that amendment. From the way this Government have politicised the ongoing industrial dispute on our railways and Ministers’ failure to even sit down with union representatives, we have already seen just how important it is to have proper engagement with workforce representatives, as well as just how far this Government will go to avoid doing it.

I would welcome an explanation from the Secretary of State as to why he is so opposed to the idea of speaking to experts and trade union representatives about the introduction of such sensitive and consequential technology. Will he also say what steps he will take to ensure this technology creates jobs, rather than destroying them, especially in the areas of the country where low-paid work dominates? It is in exactly those areas, which still feel the ravages of deindustrialisation, that jobs in driving, warehousing and logistics dominate—all jobs that face the highest risks from automation. Unless the Government are prepared to play an active role in how we transition our economy, it is exactly those areas, like my constituency in South Yorkshire, that will be hit all over again.

I have talked a lot about what the Bill is, Mr Deputy Speaker, but allow me a minute to talk about what it is not. As the Secretary of State well knows, his Government have promised us all sorts of transport legislation over the years that they have failed to make parliamentary time for. This Bill is not his long-promised rail reform. It is not legislation to properly regulate e-scooters, e-bikes or drones, to set minimum standards for taxis, to extend franchising for buses, or to strengthen the powers of the Civil Aviation Authority—legislation that has been promised time and again by this Government, without any intention of actually delivering it.

I will close by pointing out the irony that the one major piece of transport legislation in this parliamentary Session is a Bill on driverless cars brought forward by a driverless Government who are running out of road.

Roger Gale Portrait Mr Deputy Speaker (Sir Roger Gale)
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I call the Chairman of the Transport Committee.

13:43
Iain Stewart Portrait Iain Stewart (Milton Keynes South) (Con)
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It is a great pleasure to be able to contribute to this debate. I should flag that the Transport Committee conducted an extensive inquiry on self-driving vehicles and published our report on the subject last year. Our principal recommendation was to bring forward legislation to give the industry and investors the certainty to continue their work. We are very pleased indeed that the Government have taken on board our central recommendation and brought forward this Bill. We commend the Law Commission for the background work it did to provide the legal underpinning.

Hopefully there will be sufficient time for the Bill to reach the statute book before we get to the general election. Had it not been brought forward, there was a real danger of a missed opportunity. The UK has been a leading player in the development of this global technology, but there is no certainty that that would continue. One message we heard loud and clear from the sector was that it needs the regulatory framework and that certainty to allow further investment to take place, so we are, as I say, very pleased that that is happening. To give some idea of the scale, figures from the Society of Motor Manufacturers and Traders estimate that by 2040, the annual economic impact to the country will be £66 billion. My fellow Select Committee member, the hon. Member for Easington (Grahame Morris), raised legitimate concerns about the risk to jobs from this new technology, but there is an upside: 12,000 new direct jobs in automotive manufacturing, and more than 300,000 additional jobs in the wider economy, again using SMMT figures. There are economic opportunities —job opportunities—provided by this new technology.

It is always difficult to adjust to change in the economy. I often use the analogy that a few decades ago, lots of people were employed in manufacturing typewriters; now there is hardly anyone in that industry, but other job opportunities arose. That will also be the case in this sector. He is not in his place now, but I echo the points made by my hon. Friend the Member for Milton Keynes North (Ben Everitt) that the city of Milton Keynes has been at the forefront of the research and development and the testing of this technology in the UK, and long may that continue.

As other speakers have said, the advantages are not just economic; this technology also widens the accessibility of transport for many people who are, for various reasons, inhibited at the moment. That wider social value may be more difficult to quantify in monetary terms, but will be increasingly valuable. More generally, this technology will widen the transport choices available. Self-driving vehicles will replace some journeys made purely by car, but will also be part of an integral transport system where a self-driving vehicle may pick up people from a railway station, bus station or airport to complete their journeys. There are many, many upsides to this legislation.

I want to highlight a few other concerns we had during our inquiry, some of which the Government have already addressed. The first is on safety. We very much welcome the amendments put forward by the Government in the other place to introduce a more certain and wider definition of safety; we set out concerns in our report that the broad definition of a self-driving vehicle as being as safe as a

“competent and careful human driver”

was just a bit too vague and weak. The amendments that have been brought forward in the Lords to ensure proper consultation not just with the industry, but more widely with road safety stakeholders, are very welcome, while the change in the parliamentary procedure from a negative to an affirmative resolution will give it greater clarity. We very much welcome that.

I will raise two particular safety issues. One, which I mentioned in my intervention on the Secretary of State, is the need to ensure that drivers have the relevant level of skill and experience to intervene when the technology requires them to do so. As I said, those instances will obviously be immediate and often in challenging conditions, and will require skills over and above the general driving competencies and knowledge as to what a driver ought to do in those circumstances. I do not think it is necessarily something to include in the Bill, but, as the Government look at the consultation on safety, I strongly urge them to look at what changes to the driving test may be appropriate, and even at wider encouragement for everyone to have refresher courses. I think most drivers—me included—would be terrified at the prospect of resitting our driving test, as we have probably built up many bad habits over the years. There is, perhaps, a wider point about ensuring that drivers remain competent, but this new technology does introduce specific new circumstances that need to considered.

The second safety-related issue is about ensuring that MOT tests are up to date so that they properly capture all safety-critical technology. In the future, cameras, sensors, software and other technology will be as safety-critical as tyres, brakes and other mechanical parts that are currently assessed. Again, I urge the Government to look ahead and perhaps redefine what is encapsulated by the MOT.

Related to that is a concern raised with me by smaller garages about ensuring that they still have a fair chance of carrying out MOTs. As the technology becomes ever more sophisticated, there is a risk that the original equipment manufacturers will have a monopoly on maintaining software and related equipment and that only their garages will be able to carry out such work. There a wider point—this is not just about self-driving vehicles—about ensuring that the full spectrum of operators in the car repair and maintenance sector has fair access to doing that work.

I will also raise two points related to insurance. My friend and colleague from the Select Committee, the hon. Member for Easington—he is no longer in his place—mentioned data sharing. I welcome the fact that data sharing is referenced in the Bill and that its scope will be set out in secondary legislation. It is important for the insurance industry to be able to capture the full picture of driver behaviour and the behaviour of vehicles in this new world. That will not be limited to collisions, where the insurers will need to know what happened; there will be other injuries for which data must be available—say, a self-driving vehicle may brake suddenly, which results in a whiplash injury or related concerns. As a probing suggestion, is there a case for putting in the Bill a requirement for consultation with the insurance industry on the concept of data sharing, similar to the one that Government have set out for the setting of safety parameters? I will leave that with my hon. Friends on the Front Bench to consider.

The second insurance concern was raised by the Motor Insurers’ Bureau about where we have what might be called a “black swan” event, with a significant co-ordinated cyber-attack that instructs many vehicles simultaneously to behave in a way that could cause mass public injury. The instruction might be to drive at high speed and turn sharp right into a crowded pedestrian area. The concern is that, as things stand, the absence of a mutualisation of risk could lead to such a level of claims that it would bankrupt the car insurance sector.

In property, there is an equivalent backstop to cover the event of such terrorist activity. Some thought needs to be given to that. Again, it probably goes wider than purely self-driving vehicles, because, as the Secretary of State mentioned, the technology is often already embedded in cars and could be hacked by a malevolent actor. The insurance industry is concerned about that, and I urge the Government to consider that perhaps not necessarily in the Bill but as part of wider reform.

Notwithstanding those concerns and questions, this is a welcome Bill with huge upsides economically and socially. As the hon. Member for Bath (Wera Hobhouse) put it succinctly, it is an exciting new world, but for many people it is a scary new world, and we have a duty to bring the public with us.

There are many areas where transport is already automated and people accept it and are quite relaxed about it. They will get on a get on a docklands light railway train, which is automated, and aircraft flights are now 95% automated. In Milton Keynes, we have delivery robots going along the pavement and no one bats an eyelid about them. But as we see with smart motorways, if the public are not convinced about the safety of new technology, they will not accept it.

We all have a duty to make sure that the regulations ensure the safety of the drivers and the passengers as well as the wider roads-using and pavement-using public. The upsides are enormous, but we must bring people with us. I commend the Government for bringing forward the Bill, which is incredibly important, and I look forward to seeing it on the statute book.

Roger Gale Portrait Mr Deputy Speaker (Sir Roger Gale)
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I call the SNP spokesman.

13:55
Gavin Newlands Portrait Gavin Newlands (Paisley and Renfrewshire North) (SNP)
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It is a pleasure to follow the hon. Member for Milton Keynes South (Iain Stewart), the Chair of the Transport Committee, on which I serve alongside him. He made many good points and I agree with much of what he said. We still have good questions about the Bill on technical details and insurance among other things, which we will undoubtedly cover in great detail in Committee. His final point about bringing the public with us is key. During the Select Committee’s inquiry, which was referenced by the Chair, I brought that up several times with the witnesses. As the Chair said, we accept things like the DLR, but that is fixed transport; this is very different. Obviously, as we have seen with smart motorways, the public may not buy it unless we and the industry are robust in what we are selling them.

Before I start, I must be honest about my own thoughts and preconceptions about autonomous or automated vehicles, as we are calling them in the Bill. The kid and science fiction fan inside me looks forward to the transport of tomorrow, with futuristic cars like those in films such as “I, Robot”, “Minority Report” and “Blade Runner”—although it must to be said that with their current policies the Government are doing their level best to deliver the bleak and dystopian future from “Blade Runner”. “Back to the Future” told us that that we would have flying cars by 2015, but perhaps “The Jetsons” was more accurate with its version of 2062.

Growing up, my favourite had to be “Knight Rider”, where David Hasselhoff played—[Interruption.] Yes, I am showing my age. Well, “The Jetsons” is from 1962, so hopefully that was on repeat when I was watching it. In “Knight Rider”, Michael Knight very much played second fiddle to KITT the car.

In truth, I am not the best passenger in a car. I prefer being in control, no matter how suboptimal that might be for my passengers. I also like driving. As a family, we have been driving electric for three years to reduce our carbon footprint. I also use public transport and active travel a lot more than I used to, but I enjoy driving and would not want my car to drive itself, although I do enjoy the driver aids seen in most modern cars. I hope we never quite get to the point where automation becomes compulsory, but I suspect that will be a debate for MPs a couple of generations and more from now.

This issue and the Bill sound exciting, but the truth is that the Bill is technical and dry—it is less Michael Knight, more Michael Howard. Its Committee may not be a barn burner, but none the less it will be important. That is because the Bill is absolutely necessary—indeed, we could say it is long overdue—and will put in place much-needed regulation to focus and develop this technology and ultimately enable its full commercialisation and public roll-out.

As you might hear me saying from time to time, Mr Deputy Speaker, Scotland has been taking the lead on autonomous vehicles for some time now. The Forth bridge has been home to one of the main pilots of autonomous vehicles for passenger services, with the CAVForth project operating since last summer. Buses built just up the road by Alexander Dennis in Camelon are taking thousands of passengers a week over the bridge and into Edinburgh. It is a groundbreaking and world-leading trial, which could help revolutionise public transport in the long term. I cannot resist saying that it would not have been possible had the Scottish Government listened to the naysayers just over a decade ago and dropped construction of the Queensferry crossing. We now have the Forth bridge operational for public transport, with private vehicles transferred to the new crossing. Those trials can happen in the best possible environment, with the result that thousands of passengers are crossing the Forth every week on an autonomous bus.

Like Labour’s shadow Minister, I welcome the Bill, although with some reservations. Ultimately, it represents a chance to be ahead of the curve and get the appropriate legislative framework in place before problems arise. It allows that framework to change things when the future does not deliver what it is supposed to. Motoring is a highly regulated area of life, and rightly so, given that we are dealing with machines capable of wiping out multiple lives with barely a scratch on them.

It was mentioned earlier in the debate, although perhaps from a different viewpoint, that we have seen in the US that problems arise when there is a lack of regulation and proper legislative oversight of the industry. Since there is virtually no national oversight, those issues and the regulatory frameworks have been dealt with at state level. We saw the dangers of such lax regulation with the suspension and collapse of Cruise in four different states. Just weeks after getting approval for full operation of its autonomous taxi service in San Francisco, a slew of incidents and accidents led it to withdraw all its vehicles from service.

The day after the Transport Committee was treated to a trip around London in autonomous vehicles, with drivers in the driver’s seat ready to take over, a friend of mine posted clips of his journey in a Cruise taxi in San Francisco. I am not sure I would have been as willing at that point to do the same without a driver ready to take over, because later investigations showed that the cars had difficulty identifying children as pedestrians and risked hitting them. In a statement to The Intercept website, it said:

“its vehicles sometimes temporarily lost track of children on the side of the road.”

That is exactly the type of thing we need to stop here before it happens. We support the approach of legislating before those vehicles are on the road. We do not want to follow the United States into a wild west of autonomy, where it takes multiple incidents or corporate whistleblowers to ensure intervention from the state. That intervention must be built into the entire regulatory process from beginning to end.

I also want corporate responsibility to be built into the regulatory framework. As we have seen with the law on corporate manslaughter, although the legislation may talk a good game, the reality is that prosecutions are few and far between, and those who should be held accountable for actions carried out under their watch are instead allowed to walk away. I do not want that to happen to the operators of autonomous vehicles that are proven to be at fault, particularly in incidents where people are harmed or even killed. I would welcome some reassurance from the Minister that where negligence or fault is established, those ultimately responsible are held to account through the criminal law.

Like Labour’s shadow Minister, we welcome the changes made in the Lords to guarantee that autonomous vehicles achieve equivalent or higher safety standards than human drivers. That only seems right, and it would be a retrograde step if this much-vaunted technology delivered worse results and worse safety than we have now. I ought to be clear that, despite my personal misgivings, I have every confidence that, in the end, automated vehicles will prove to be safer.

This area crosses legal jurisdictions. As the Minister mentioned, much of the Bill results from joint working between the Law Commissions of England and Wales and of Scotland, which may at times have been a tricky needle to thread. Throughout, the Scottish Government have been keen to work alongside the UK Government to ensure that the Bill is fit for purpose not just for today’s environment, but to anticipate future developments.

I am happy that, for the most part—highly unusually, it has to be said—there has been constructive working and pragmatic engagement. I say “for the most part” because, unfortunately, the Scottish Government’s representations on clause 50 have so far been ignored. Clause 50 is hugely problematic because it gives the UK Government the power to amend Acts of the Scottish Parliament in areas that are fully devolved, with no recourse to this place or to Holyrood. As it stands, there will be nothing to stop the Secretary of State laying a statutory instrument containing regulations that are counter to Acts passed at Holyrood, where the UK Government regulations would override the Scottish Parliament’s Act.

That is simple disrespect for devolution and for the devolved institutions, and it has happened despite the Scottish Government engaging with the UK Government to find a way forward on clause 50 that respects Scotland’s Parliament as well as this place. There is no objection to having in place a provision to allow existing legislation to be updated to account for autonomous vehicles and the implications on traffic laws and the highway code, but it is simply not on for the Secretary of State to grab that power from the existing devolved powers that rest with Holyrood, rather than accept that Scotland has a different legal framework and work within that reality.

Like so many folk across Scotland, I am sick and tired of the arrogance of this Government when it comes to devolution. There is still time for the Secretary of State and his officials to sit down with their counterparts in Edinburgh and iron out a solution, particularly given the good working relationship on much of the Bill. I urge him to make that happen, and not have the UK turn this Bill into another constitutional punchbag.

We would also like a clear strategy from the Government on the societal and economic consequences of a move towards automation in the transport sector. As the Chair of Select Committee, the hon. Member for Milton Keynes South (Iain Stewart), said, these new technologies will create new and novel jobs, but there are 2.7 million jobs in the logistics sector in the UK, and not one of those positions will be unaffected; they will be either lost or changed as a result of this new technology. There are around 400,000 taxi and private hire drivers in the UK. If we end up with autonomous taxis, how many of those drivers will remain in jobs 50 years from now? What will their jobs be in 50 years’ time?

The UK has an unfortunate track record of managing technological change and its impact on the employment market. As the Labour shadow Minister said, deindustrialisation destroyed countless communities across these isles, particularly in Scotland and in swathes of the north of England, in part because there was no plan and no thought put into how to deal with and support that transition. The Tories caused untold long-term damage by essentially abandoning sectors such as manufacturing altogether, in favour of putting all the UK’s eggs in the services basket. We are seeing the same thing happen now with the move to green technology, although thankfully in Scotland we have a Government committed to a fair transition.

Automation is a much bigger issue than the matters we are talking about today. In many ways, it is time to have a public conversation about what this means for society as a whole. Change always comes with positives and trade-offs. An assumption that the public will simply consent and welcome automation without that conversation is potentially gravely misplaced. The Government must acknowledge those issues and be prepared to support sectors and communities if the changes that the Bill envisages come to pass.

It has taken longer than anticipated by many for automated vehicles to get to this point, but we cannot assume that the advances in technology will continue at the current pace. The pace may increase quickly, and the implications will be with us before we know it. Those implications of automation for our society more generally are serious and deep rooted, and they need a serious response.

We broadly welcome the Bill, but it is incumbent upon the Secretary of State and his Government to fix clause 50 and engage in real dialogue with the Scottish Government in order to help both parties. It is incumbent upon Ministers to explain their approach to the wider societal and economic implications of these measures. I look forward to positive responses on those issues as the Bill moves through its stages.

14:07
Matt Western Portrait Matt Western (Warwick and Leamington) (Lab)
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It is a pleasure to speak in this debate. One of the first things I did when I arrived in this place was to sit on the Bill Committee on the Automated and Electric Vehicles Act 2018. Here we are, all these years on, and the technology is making significant improvements. I would like to outline what I see as the important benefits of this legislation, and some of the safety and security issues. I will make the case for why these technologies should be developed further. But an advisory council is paramount, as my hon. Friend the Member for Sheffield, Heeley (Louise Haigh) mentioned, because a wide range of voices must be heard before this legislation is implemented.

The automotive sector is the jewel in the UK’s manufacturing crown. The Society of Motor Manufacturers and Traders estimates that its total turnover in the UK economy is £78 billion, with £16 billion of added value. The industry’s transition and development are all about the automated connected electric and shared vehicles—the ACES vehicles—which are the future. As has been said, what they bring is very exciting, but there are also concerns. They are a rapidly developing technology. We must ensure that the UK automotive industry has a prime role in its development. According to the SMMT, it is estimated that autonomous vehicles could create a market worth £42 billion by 2035 and potentially provide 38,000 new jobs.

Importantly, autonomous vehicles make roads safer—I believe that and I think most in the industry would say it; and we heard it, too, from the Secretary of State in his opening remarks—not just for occupants but for pedestrians and cyclists, provided the right sort of technologies are deployed. I have personally seen that they remove the opportunity for human error, which causes 88% of road traffic accidents. Indeed, research from the SMMT states that if automated vehicles were deployed in substantial numbers, some 4,000 lives could be saved and 60,000 serious accidents prevented between now and 2040. I will come to the benefits of that not just in terms of lives, but what that means for the economy.

Autonomous vehicles can improve connectivity in areas where our public transport is failing passengers. With the depopulation of rural areas, we can see how challenging that issue can be, including for older people and disabled people more generally. Other countries, including states in the EU, and most states in the United States, are all moving forward with their own autonomous vehicle frameworks, so the United Kingdom cannot afford to fall behind in an industry that could be worth £750 billion globally by 2035. That is why the legislation is so important. The UK automotive industry needs to be at the forefront of this rapidly developing technology and we need the legislation to provide the framework to support it.

Like the Secretary of State and the shadow Secretary of State, my hon. Friend the Member for Sheffield, Heeley, I have experienced driverless vehicles. I was fortunate enough to try it in the Jaguar I-Pace and the technology is incredibly impressive. Although we had a driver at the wheel for safety and security, just seeing the screens and all the information feeds determining the passage, speed and direction of the vehicle was extraordinary. This work is not just being done in silicon valley, but around the world by great organisations. I am particularly proud to have as a neighbour WMG, University of Warwick—the Warwick Manufacturing Group—developing these technologies, but we also have companies such as Oxa at the forefront of developing this work.

I said I wanted to talk about safety. As I articulated with the numbers I mentioned earlier, we will see a significant reduction in the number of accidents, and in the number of those killed and seriously injured. In 2018-19 I tried to introduce legislation called Rowan’s law. If you will forgive me, Mr Deputy Speaker, I will remind the House that seven-year-old Rowan Fitzgerald was killed on a bus in Coventry because the driver fell asleep at the wheel. He had been driving more than 70 hours a week for three weeks. Rowan and another passenger were killed in the incident. It is my belief that, with certain assistive technologies we are discussing, that would not have happened.

While the technology is being developed and rolled out, we must ensure that public safety is at the forefront of the Bill. The insurance giant Axa, based on 2022 data, calculated that accidents in the UK cost the UK economy £42 billion in lost productivity and wider loss. There was also a cost to the NHS of £2.4 billion. That is why I commend the work by my Labour colleagues in the other place in pushing the Government to concede on two key safety points. I welcome the Government’s concession to put the highest standard of safety on the face of the Bill.

To introduce automated vehicles successfully and safely in the UK, we need to bring all the public with us on the journey. Whether as drivers or as those sharing the roads with AVs, the public need accurate knowledge of any new transport technology so that they know how to engage with it safely. It cannot be acceptable for manufacturers to mislead or over-promise. Equally, manufacturers will benefit from being held to a fair standard. We therefore need strong, fair and enforceable standards. Improving and strengthening safety communication and messages on AVs should be the top priority before we fully deploy AVs on the roads. Communication and messages about AV safety must be written and delivered in a clear and accessible manner. Technical knowledge must be translated into language that everyone in society can understand. False and misleading AV advertising should be regulated to avoid miscommunication. For example, driver-assistance systems should not claim to be self-driving systems. We need an objective national safety threshold definition for the safe deployment of AVs. There is evidently still work to be done on the implementation of the legislation to ensure that safety remains at the forefront of the Bill.

The implementation of the Bill should be supported by an advisory council, which would advise on its implementation and on the roll-out of self-driving vehicles. It would include trade union representation, emergency vehicles, disabled groups, manufacturers, highway authorities and other road users, such as pedestrians and cyclists. It is a shame that the amendment that would establish such a group was voted down. I am pleased that we passed amendment 5, which would ensure representatives of road user groups are consulted when preparing the statement of safety principles. I would like that expanded to include the membership of the advisory group, and to put that on the face of the Bill.

On security, I have concerns, particularly on insurance, that have been aired across the House. Having listened to manufacturers in recent weeks about security challenges and the amount of vehicle theft across the country, I am satisfied they are doing their utmost to provide vehicle security. There are, however, many out there who are seeking to steal vehicles for export. The simple truth is that whatever technologies manufacturers come up with, they be overridden, especially by organised crime. That must be a real fear for the future. My hon. Friend the Member for Eltham (Clive Efford) mentioned the unfolding Horizon scandal, the role of the tech company and the cover-up it was alleged to have been involved in. What does that mean for the development of vehicle technology? More generally, we have seen the challenges that authorities face when trying to impose regulation on tech companies. Just this morning we read about Apple facing a fine from the EU of, I think, €1.6 billion. A central concern must be the extent of the control given to big tech, and the transparency that policymakers such as Governments, as well as other authorities, will be able to demand of it.

When the hon. Member for Milton Keynes South (Iain Stewart) mentioned MOTs, I was thinking precisely the same as him. At present many elements are not covered by MOTs, and I wonder how it can be ensured that a vehicle is valid, legitimate and roadworthy when so much of the brain power of that vehicle is driven by new technologies. All MOT centres will have to be geared to keep up with technological development to ensure that these vehicles are roadworthy and have fully up-to-date software.

As I said earlier, these developments will have a huge impact on the economy and jobs. Other Members have asked what they will mean for operators in the logistics sector and, for instance, taxi drivers. I urge the Government to adopt our proposal for the establishment of an advisory council to hear from trade union representatives and take on board their thoughts, and, indeed, I suggest that a requirement for trade union representation should be included in the Bill. Other Members have also mentioned the concerns raised by industry, such as who will be responsible for software updates. How will a victim of a crash involving an automated vehicle be able to prove whether the vehicle was driving autonomously? Perhaps the Minister could clarify those points, and confirm that insurers will have appropriate access to data to deal with claims of this kind.

Without doubt, the future lies in automated, connected, electric and shared vehicles, and it is important that the UK has the necessary legislative framework not only for manufacturers but for the development of these technologies. The automotive industry contributes an estimated £3 billion to UK research and development and is one of our greatest strengths, so we must ensure that we have the legislation to provide for that. In the short term, the benefits of the Bill will be largely in assistive technology—data and mapping technologies, for instance—to make vehicles much safer for their occupants and for others. I welcome those safety benefits and the potential opportunities for the UK automotive industry, but, as I have said, there are real concerns about future security.

14:23