Oral Answers to Questions
Debate between James Murray and Danny Beales(2Â weeks, 3Â days ago)
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James Murray
The hon. Gentleman is right to point to the fact that international events have an impact on prices here at home. We did not want to get involved in that conflict, unlike the Conservative party. None the less, we are impacted by it, and the right thing for us to do as a Government is to make sure we are providing breathing space for families as we weather international events.
Danny Beales (Uxbridge and South Ruislip) (Lab)
I welcome the Government’s commitment to the cut on fuel duty, although motorists are being not only squeezed at the pumps but ripped off by unfair monthly insurance charges. Does the Minister agree that insurance companies should not be charging unfair and unjustified additional costs for monthly insurance, when that is what most people can afford? Will he meet me to discuss the Which? research, which has found that people paying monthly for insurance are paying hundreds of pounds in additional costs?
James Murray
Although my hon. Friend is right that fuel duty is one cost that families face, they also face a number of other costs, including through insurance. He is a formidable campaigner on a range of issues, so I would be happy to meet him to discuss this issue, or to ask my colleague, my right hon. and learned Friend the Member for Northampton North (Lucy Rigby), to do so, if she is better placed to respond.
VAT on Medication: Compassionate Access Schemes
Debate between James Murray and Danny Beales(2Â weeks, 4Â days ago)
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The Financial Secretary to the Treasury and Paymaster General (James Murray)
It is a pleasure to respond to this debate. I thank my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) for securing it, and for all his engagement and campaigning on this important issue. I know from my conversations with my hon. Friend that he cares deeply, as do I, about ensuring that patients can access innovative medicines, particularly when there is unmet clinical need.
Free-of-charge arrangements play an important role in giving patients early access to medicines, as my hon. Friend so powerfully illustrated when he spoke about the patients and families who have shared their stories with him. I was moved to hear the experiences of those patients, and am grateful to my hon. Friend for sharing them this evening. My thoughts, as I am sure every Member’s thoughts will be, are with those patients and families, including the family of the young woman who my hon. Friend told us had tragically passed away. I am sure that everyone in this House agrees that we must find a solution that means that those patients, and others like them, can continue to access lifesaving medicines.
Before responding to the points made, I will first set out some of the context for the existing VAT treatment of donated medicines. This evening’s debate concerns the application of long-standing VAT rules to some medicines supplied free of charge. Under UK VAT law, some transactions where no money changes hands are treated as though a supply has been made, and these are known as deemed supplies. These rules help to keep the VAT system fair where a business has reclaimed VAT on its costs. These are not new rules introduced by this Government; they are long-standing features of the VAT system dating back to the early days of VAT, before the VAT Act 1994.
His Majesty’s Revenue and Customs wrote to the sector in 2023 as part of the process of ensuring that businesses pay the correct tax. However, the Government recognise concerns raised by pharmaceutical companies and patient groups about the potential impact of this treatment on free-of-charge access and, ultimately, on patients. That is why, as my hon. Friend mentioned, on 23 June, my predecessor announced that the Government would bring forward a new approach as soon as possible. As set out in the written ministerial statement on 2 July, the Government are considering either changes to the VAT rules or a reimbursement scheme. The new approach will be effective for donations made on or after 23 June 2026.
Officials in the Treasury, HMRC and the Department of Health and Social Care have been working closely together and engaging constructively with the pharmaceutical sector to develop the detail of both options. That work must ensure that any approach supports patients while being legally robust, operationally workable and sustainable. We recognise that free-of-charge medicines are supplied through a variety of arrangements. Those include early and expanded access, post-trial access and arrangements that operate after Medicines and Healthcare products Regulatory Agency authorisation.
My hon. Friend raised the question of which medicines would be in scope of the new approach, and the Government are considering this question carefully in collaboration with the sector. The solution must capture genuine patient access arrangements without creating unintended consequences elsewhere in the VAT or supply systems. It is important that we complete that work quickly, so that patients across the UK can benefit from innovative medicines as quickly and safely as possible. It is equally important that we get this right to avoid inadvertently omitting important avenues by which medicines are donated, or opening the door to abuse. That is why we are working closely with industry to craft the scope appropriately.
My hon. Friend asked which forms of donation would be in scope, and whether the solution would apply only to donations to the NHS. He will appreciate that I am not in a position to announce any final decisions today, while work remains ongoing with the firms. However, I can reassure him that I have no desire to artificially circumscribe the scope of the new approach and unduly leave out genuine donation practices.
My hon. Friend asked about timelines. I regret that as we are talking about a potential tax change, I cannot give further detail, beyond reassuring him that I have reiterated the urgency that we both feel, and the need to reach a swift resolution, and I have imparted that urgency to my officials. On historical liabilities, the new approach will apply to donations made on or after 23 June 2026, but I am happy to hear input from firms on that point as we go through the process. On co-ordination in the case of AstraZeneca, it would not be appropriate for me to comment on the tax affairs of an individual taxpayer, but I would certainly encourage firms in the round to share the detail of any specific concerns they have with my officials. On whether HMRC could publish a business brief to fix this issue, as a matter of existing law, firms must account for VAT on donated medicines. An HMRC brief can communicate a change in policy only when the law itself has changed, or following a judicial decision requiring a change in law. A Revenue and Customs brief cannot itself make the change in law.
Finally, I share my hon. Friend’s desire to see Bayer return to the early access scheme, so that patients can regain access to innovative medicines. We have committed to applying the new approach retrospectively to donations made on or after 23 June 2026, and I hope that Bayer takes confidence from that and rejoins the early access scheme as soon as possible.
Danny Beales
The Minister is being very generous in giving way, as ever, and I appreciate his response about the limitations of the business brief process. If amending the VAT Act 1994 is the right route, does the Minister know roughly how long that would take to find a resolution? I fully his support his point about Bayer re-engaging. The Government have moved in good faith, and I hope Bayer will, too.
Pathways Study: Puberty Suppression
Debate between James Murray and Danny Beales(3Â months ago)
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James Murray
I agree with the shadow Minister that most children and young people who are questioning their identity and gender are likely to resolve those questions on their own, and I think Dr Cass would agree with that. As I said in my opening remarks, for the majority of children who question their gender, we should let them be; they will resolve the matter through their friends and family and their own development. We are talking here about a small subset within a small group of children who need further support. I also agree with the shadow Minister that the situation before Dr Cass did her review—the situation that had developed in the last few years before the turn of the decade—was totally unacceptable, and we should be clear that that was wrong.
The shadow Minister asked about protecting the young people involved in the trial from harm. As I set out, there is intense scrutiny, and there are robust mechanisms to prevent the children involved from being harmed. She mentioned the MHRA recommendation for the lower age limit. Initially, there was no lower age limit, but a scientific dialogue between the MHRA and the trial sponsor led to publication last week of the updated protocol, which recommended the minimum ages of 11 and 12.
The gateways to younger people and children becoming involved in the trial are significant. There must be not just consent or assent from the children, and consent from their parents or guardians, but approval from the NHS care team, the national multidisciplinary team and others before anyone can be involved. As I set out, I feel uncomfortable and uneasy when considering this matter, but I think that the right way for us to move forward is to have the clinical evidence on which to base decisions. I have received reassurances about there being the highest possible level of scrutiny and protection from harm for young people involved in the trial, and that is the basis on which, on balance, I think it is right for it to proceed.
Danny Beales (Uxbridge and South Ruislip) (Lab)
I thank the Secretary of State for his statement. The Conservative party committed to and commissioned the Cass review, and today’s statement takes forward Dr Cass’s recommendations in full—guided not by ideology, but by evidence. Some Members who are critical of that approach have said in this place that these young people just need love. I agree that we should show trans people and trans young people more care and compassion—far too often, those things have not been demonstrated in public discourse in recent months and years—but trans people and trans young people also need and deserve high-quality, evidence-based and timely healthcare. I therefore welcome today’s statement and the Secretary of State’s commitment. Will he say that this Government are still committed to rolling out gender clinics in every region?
James Murray
As my hon. Friend will know, the recommendations in Dr Hilary Cass’s review set out how to establish better services for young people in the future. The focus of today’s statement, the clinical trial, is just one part of the wider work on how best to support young people who need extra support in this situation. It was welcome that there had been, at least until recently, a cross-party consensus that Dr Cass was finding the right way through this difficult matter.