The National Health Service

Matt Western Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Barry Gardiner]

I cannot give way because of time.

It is this legislation that now exposes our NHS to foreign competition and undermines our public healthcare system. It is Donald’s door into our NHS. Some 170,000 people already know this, and they have signed a parliamentary e-petition calling on this Government to introduce safeguards that will protect it from new trade deals. Trade agreements lock in privatisation, and open up access to foreign investors and speculators. That is why we need safeguards.

[Matt Western (Warwick and Leamington) (Lab)]

Does my hon. Friend agree with me that one of the great threats to our NHS is a trade deal with the US that, as happened in Australia 10 years ago, will drive up the price of medicines significantly?

[Barry Gardiner]

I agree with my hon. Friend.

In 2007, Slovakia wanted to move from a private health system, modelled on the USA’s, to a system more like ours. Slovakia was sued for millions of euros by a Dutch company that thought the move might affect its future profits. Trade deals often contain clauses that give foreign investors the right to sue Governments for decisions that might affect their profits. These investor-state dispute settlement—ISDS—clauses are common in modern free trade agreements.

Policy decisions such as legislating for the plain packaging of cigarettes have been subject to ISDS claims. Labour believes the UK should be free to make public health policy based on the health needs of the British people. We should not have to bend to some company that is profiting from keeping our people ill, whether from tobacco, polluted air or too much sugar.

More than 750 cases are known to have been brought under ISDS clauses in other countries, and more than half resulted in compensation for foreign investors or in financial settlements out of court. Labour will not sign up to any free trade agreement that uses these ISDS-style rules, which are wrong in principle and, even where they are not used, can lead to regulatory chill.

Incredibly, the right to sue the Government under these ISDS clauses does not extend to our own UK companies, only to foreign companies in separate private courts. Labour has confidence in our courts and thinks foreign companies should have no greater rights of redress than British companies.



Free trade agreements also typically include market access clauses and national treatment provisions. These would set out the extent to which overseas businesses can operate in our markets, and they would insist that we afford at least the same treatment to foreign businesses as we do to our own businesses. In the past that was done by listing all those services that had been agreed. If an NHS service was not on the list, it could not be the subject of foreign competition. Agreements used to set out only those services that we were prepared to open up to competition, but modern trade agreements do not work that way.

Instead, modern trade agreements adopt a negative list system that says every service is opened up to competition unless it is placed on the negative list. Anything missed off the list is automatically open to competition. Once missed, a service can never be put back on the list. Any new service that comes as a result of technological or scientific breakthrough, if it is not on the list, is automatically open to foreign competition.

Imagine if we had agreed a negative list before the age of the internet and before digital technology had changed how patients can be screened and tested. If we lose our capacity and skill to provide these services directly, we will become a captive market and vulnerable to the abuse of private monopoly and spiralling costs.

Governments cannot intervene where there has been a clear failure in the sector or where patient health has been compromised. We need legal guarantees that no such negative list trade agreement will be concluded. That is why Opposition Members sought to introduce measures into the Trade Bill to achieve this protection. Conservative Members voted down every single one.

When their lordships secured essential provisions for proper scrutiny of trade agreements and a defined parliamentary procedure for ratification, what did the Government do? They abandoned the Bill entirely. Now they want to bring back the same legislation, but without those safeguards.

A potential deal with the US is of major concern to those who care about our health service. The American model is renowned for its pursuit of profit and its indifference to the poor. The US ambassador told national TV that the NHS would be on the table and that the US had already looked at all the components of the deal. President Trump confirmed it, and the Office of the US Trade Representative has published its list of negotiating objectives for any such deal. One objective is to stop the NHS using its bulk purchasing power to negotiate lower drug prices. The US Secretary of Health and Human Services actually said that the US would “pressure” other countries in trade negotiations so that Americans pay less and we pay more.

The USA wants to stop the UK regulating the pharmaceutical industry unless the US industry has agreed. So much for taking back control. In one of their first acts after establishing the Department for International Trade, this Government opened three new offices in the US, in Raleigh, in Minneapolis and in San Diego—biopharma hubs where major healthcare providers, biotech, pharmaceutical manufacturers and health insurers are headquartered. What made those cities so attractive if it was not an attempt to attract players from those sectors into our NHS? The Labour party created the NHS. We will not allow this Government’s trade agreements to damage it. Under Labour, the NHS will remain a universal service, free at the point of use, and based on medical need, not ability to pay.

Health Infrastructure Plan

Matt Western Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

I am grateful to the hon. Gentleman. As I said to the hon. Members for Ogmore (Chris Elmore) and for Linlithgow and East Falkirk (Martyn Day), I am happy to write detailing the process, and I am happy to include the hon. Gentleman and his hon. and right hon. Friends in that.

[Matt Western (Warwick and Leamington) (Lab)]

I welcome the Minister to his new position and congratulate him. We have a mental health crisis, as everyone is well aware. I want to highlight the predicament in Warwickshire, where the suicide rate is significantly higher—25% higher —than the national average. St Michael’s Hospital in Warwick has a fantastic reputation but, despite that, it is losing all its acute mental health beds to Coventry. We need greater capacity, not reduced capacity. The Caludon Centre site in Coventry does not have the capacity and is not fit for purpose. Will the Minister meet me and visit St Michael’s Hospital, which is an excellent facility that needs investment?

[Edward Argar]

The hon. Gentleman rightly highlights the importance of mental health care and services for those with mental health needs. I go back to the point that this Government have placed those needs and that care front and centre of our approach and have put investment in place to back up that commitment. In respect of his specific request for a visit and a meeting, it may take a little time, given the number of colleagues who have asked to see me, but of course I am happy to do so.

University Hospital Coventry

Matt Western Excerpts

Thursday 13th June 2019 Commons Chamber

[Mr Jim Cunningham (Coventry South) (Lab)]

I am grateful to Mr Speaker for granting me the opportunity to raise this issue, which is very important to my constituents in Coventry South. I am sure it is also important to the constituents of colleagues from Warwickshire.

I thank my colleagues—my hon. Friends the Members for Coventry North East (Colleen Fletcher), for Coventry North West (Mr Robinson) and for Warwick and Leamington (Matt Western), and the hon. Members for Nuneaton (Mr Jones), for Rugby (Mark Pawsey) and for North Warwickshire (Craig Tracey)—for their support. Together, we sent a letter to the Secretary of State for Health and Social Care to request a meeting to discuss these issues, and I am keenly awaiting a response. Many of those colleagues also attended an informative meeting with two surgeons from the hepato-pancreato-biliary unit at University Hospital Coventry, Mr Khan and Mr Lam. The point of the letter was that we wished to discuss the transfer of the HPB unit, which provides pancreatic services at University Hospitals Coventry and Warwickshire, to hospitals in Birmingham and Worcester.

UHCW has been developing pancreatic cancer services since 1990. It has an excellent team of doctors, specialists, nurses, surgeons and other healthcare professionals, and has completed more than 1,000 major operations and thousands of other therapies. It deploys cutting-edge robotic, endoscopic and radiologic technology to treat patients in Coventry. It takes a patient-centred approach to its service, resulting in excellent feedback from those who have undergone treatment in its care. The success of the department cannot be denied. The outcomes of therapies are on a par with international standards in all spheres. Proposals to shut down this extremely successful department will be a great loss to the NHS.

[Matt Western (Warwick and Leamington) (Lab)]

I thank my hon. Friend for giving way. He is making a very important point. Does he agree that one of the key issues, as he was just alluding to, is that with any potential loss of service comes not just the potential loss of reputation but what haemorrhaging effect it may have on the rest of this great hospital?

[Mr Cunningham]

Yes, I fully agree with my hon. Friend. That was one of the points made by the surgeons whom I and the hon. Member for Nuneaton met a few weeks ago.

These proposals stem from the 2014 regional review of services. They are based on the fact that the UHCW was not providing care for enough people, according to the requirements of the Department of Health and Social Care and commissioning guidelines. There were serious capacity constraints at University Hospital Birmingham, leading to multiple cancellations of operations on the day and prolonged waiting times. The process of the review was in fact challenged by a legal notice. The initial proposal stated that UHB and UHCW services should be amalgamated, with the teams working together to develop a model that would provide more efficient services in the west midlands and maintain operating at both sites, with the joint service to be led by UHB.

--- Later in debate ---

[Mr Cunningham]

Although the 2015 review stated that the HPB unit did not reach the population requirements, thousands of lives are saved because of the outstanding service that the team at UHCW have developed. The most obvious problem that my constituents in Coventry South, and people in east Warwickshire, will be faced with is geographical, as the hon. Member for Nuneaton said. Many of them will have to travel about 16 miles for treatment, which will be very costly. They will have to take trains, and we all know the problems associated with that. The time it will take patients who currently use the service to travel to Birmingham is unfair. Patient access will no doubt be reduced, as the journey time, as my colleagues from Coventry will be well aware, is about an hour by car and over 80 minutes by public transport. The journey time for patients who currently use the service at UHCW and live outside Coventry, in rural areas out of the reach of public transport, will be considerably longer and the journey will be considerably more expensive. NHS England will directly increase the stress and physical discomfort that patients and family members will have to endure. In addition, once patients have made the hour-long, or hours-long, journey to UHB, there will be a good chance that their treatment will be cancelled or delayed.

University Hospital Birmingham specialises in liver transplants, and it has a success rate that the whole of the west midlands is immensely proud of. Understandably, those operations take priority because of the speed with which they need to take place. Patients at the hospital who have other, slightly less urgent, conditions find that their operations are routinely cancelled in place of a liver transplant. Moving pancreatic services to Birmingham will dramatically increase the number of patients at risk of having their vital operation cancelled. Any patient who suffers from pancreatic cancer, or people who have a family member who has died from this terrible disease, will know that the speed of detection and the speed of treatment are absolutely vital to survival. It is extremely hard to detect, and, as a result, doctors need to act quickly after a patient has been diagnosed. Any delay to operations decrease the chances of survival even further.

The closure of the HPB unit at UHCW also poses a risk to the overall status of the hospital. By closing a key unit, the hospital is at risk of losing its specialist status, and, as a result, being downgraded to a district hospital. That will have a domino effect on the rest of the hospital.

[Matt Western]

My hon. Friend is making some very powerful points. For me, one of the most staggering facts —I am sure he will agree—is the sheer scale of the number of such operations that are undertaken at Coventry—5,000 over the past two years, I believe. That does not seem a small figure to me. Does he agree that it is surprising that this is even being considered in the first place?

[Mr Cunningham]

Of course, I totally agree. As I have outlined, it is not about just the volume of operations but their quality, and the skill of the surgeons, the nurses and all the auxiliary staff who do the best that they can for the patients. UHCW will inevitably lose its most skilled doctors and staff, and see the disintegration of the team, service and leadership that the unit has spent so long building.

Finally, I understand that UHCW has written to NHS England outlining its opposition to these proposals—something that I fully support, as I am sure my colleagues here do. It is concerning that UHCW may face these proposals being forced upon it by NHS England, justified by guidelines that have little thought or respect for the quality of care already being provided and the concerns of local people. Not only do these guidelines ignore the quality of care, but NHS England has shown an incapacity to implement them fairly and equally across the country. There was a similar case in Stoke, but rather than close the unit, NHS England allowed it to carry on operating as normal, despite not meeting the population requirements. Will the Minister guarantee that NHS England will work with UHCW and support it by allowing it to continue to provide these outstanding services to the people of Coventry and Warwickshire?

Medical Cannabis under Prescription

Matt Western Excerpts

Monday 20th May 2019 Commons Chamber

[Charlie Elphicke (Dover) (Con)]

It is a pleasure to follow the hon. Member for Gower (Tonia Antoniazzi), who spoke so movingly and with such great sincerity on this important subject. I congratulate her and my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) on securing this debate, which is incredibly important to my constituents.

Teagan Appleby is just nine years old and lives in Aylesham. She is wheelchair-bound and can suffer up to 300 seizures a day. She was born with a rare condition, Isodicentric 15, a severe form of epilepsy. Last year, she required life-saving treatment five times in just eight days.

Teagan’s mum, Emma, who is in the Gallery this evening, has been a tireless fighter not just for little Teagan, but for the medicine that little Teagan needs. Emma has tried everything to ease Teagan’s pain. One thing she could not try was cannabis oil, despite NHS trials showing that it could dramatically reduce epileptic seizures. The alternative suggested by doctors was Teagan having risky procedures on her brain. Understandably, like any parent, Emma does not want the surgeons getting out the scalpel and starting to operate on her daughter when alternatives are available.

That is why, last year, I urged the Home Secretary to intervene in Teagan’s case, along with many others, including my right hon. Friend the Member for Hemel Hempstead, who fought on this and I welcome the fact that he did so. Last October, the Home Secretary announced that cannabis would be medically prescribed by specialist consultants, yet the reality was somewhat different. Teagan’s treatment was still delayed, first due to the restrictive guidelines drawn up by the NHS and then due to supply issues.

I have visited Emma and Teagan at their home in Aylesham. It is incredible: all of us who are parents fight for our kids, yet somehow when we see someone in Emma’s situation looking after little Teagan we cannot help but think that some people fight harder than others. No one could fight harder than Emma does for Teagan. Teagan is so charming, and it seemed to me that things had improved, but Teagan was still suffering seizures during her sleep. Emma started fighting to get the stronger, THC form of cannabis, which has been discussed this evening, approved to see if it could stop the seizures entirely. She went to mainland Europe to get it, because she could not get it here, and it was seized on her return.

The latest position is that Teagan is getting better. She now goes whole days without seizures, which was extremely rare before. She can now walk short distances. Her doctor is so pleased that he has issued a fresh prescription, yet she still cannot get it on the NHS. The fact that it is legal but unlicensed means that Emma has to submit an individual funding request to the local clinical commissioning group. It takes weeks for those panels to meet, and weeks for them to make a decision. That is why, in the meantime, Emma has to fork out thousands of pounds for bottles of cannabis oil. The price almost doubles when we add the import duties—that is, of course, when she does not have the extra hassle of having the oil seized at the border. That is also why Emma is having to consider going to Holland again to get this much-needed medicine for little Teagan. I ask the House this: should she not be supported and helped? Should she not be understood as having the compassion that every parent has for their child? Is it not wrong that she is effectively being declared by the law to be acting as some kind of drugs mule? How can that be right? I do not think that it is right. There has to be change.

All of us understand that we need to have evidence and clinical trials. We understand the need for proper processes, but none of us can understand why this is taking so long. We cannot understand why we are so bad at dealing with pain management in this country. We are just not good enough at it at all.

[Matt Western (Warwick and Leamington) (Lab)]

The hon. Gentleman is making an important and powerful speech. Is he not as frustrated as all of us here and, particularly, the families are at just how long it is taking for all this to go through and for medical cannabis to be legalised so that GPs will be allowed to prescribe it? Products such as oxycodone—OxyContin—and other opioids are totally addictive, yet they are available, at great cost. Surely the time has come for medical cannabis to be made legitimate.

[Charlie Elphicke]

The hon. Gentleman makes a powerful point, with which I wholly agree.

This is not just about speed; it is also about consistency. We can go to the local supermarket and buy ibuprofen, which people say is safe. We can buy as much as we like, yet we need a prescription for naproxen, a similar drug, because it is meant to be more dangerous. This is despite the fact that an article in the British Medical Journal in 2016 showed that, following experiments, the evidence concluded that the risk of heart problems was higher for people taking ibuprofen than for those taking naproxen, and that naproxen was less problematic and had fewer side effects than ibuprofen. Nothing has happened about this.

NHS 10-Year Plan

Matt Western Excerpts

Tuesday 19th February 2019 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

With five and a half minutes of speaking time per year of the plan, I suspect that we have not quite done it justice tonight. However, we did manage to hear from nine Back Benchers during the debate. While I cannot refer to everyone in the time I have, I want to draw particular attention to certain contributions.

My hon. Friend the Member for Hartlepool (Mike Hill) spoke about the importance of improving GP access—something we can all relate to—and the importance of mental health, a big driver of the 10-year plan. My hon. Friend the Member for Stroud (Dr Drew) made important points about threats to services in his constituency, and we heard such points across the Chamber. I was particularly pleased to hear from my hon. Friend the Member for Easington (Grahame Morris), who, of course, speaks about cancer treatment from personal experience. He rightly pointed out the deficiencies in the 10-year plan in relation to that. My hon. Friend the Member for Enfield, Southgate (Bambos Charalambous) was absolutely right to highlight the postcode lottery in palliative care. As with other areas such as neonatal care and IVF, it varies depending on where in the country someone lives. He also made a very important point about the cancer workforce.

I want to say a few words about the workforce. In recognising their invaluable work, which we thank them for, we also recognise—we on the Labour Benches do, at least—that without a fully staffed, respected and motivated workforce, the NHS would simply not be able to deliver the service that our constituents deserve. Last June, there was at last some Government recognition of the importance of the workforce, when the 10-year plan was announced. The then Health Secretary—now the Foreign Secretary—said:

“Alongside the 10-year plan, we will also publish a long-term workforce plan recognising that there can be no transformation without the right number of staff, in the right settings and with the right skills.”—[Official Report, 18 June 2018; Vol. 643, c. 52.]

We now know, however, that the workforce plan will not be with us until some time later this year, so is it not the case that without a workforce plan, we simply do not know how much of the 10-year plan is achievable?

As we know, the House of Lords Committee on the Long-term Sustainability of the NHS said that the lack of a workforce strategy

“represents the biggest internal threat to the sustainability of the NHS”.

Amazingly, the 10-year plan makes no reference to the actual numbers of staff expected to be employed during this period, so I put in a written question to the Minister about how many staff the NHS expects to employ by the end of the period covered by the 10-year plan. I was told in response:

“The Department does not hold the data requested.”

So there we have it in black and white: the Government do not have a clue.

[Matt Western (Warwick and Leamington) (Lab)]

Does that not just underline the fact this evening’s debate has been so ridiculously short on such an important subject? We need more time; we need another debate.

[Justin Madders]

I thank my hon. Friend for his contribution. Of course, we were not actually meant to be here at all this week, but it is absolutely right that this debate took place tonight. We need another one and we will very shortly need a debate on the social care Green Paper, when that is published. We also need a debate on what we are going to do about some of the legislative changes that the Government have promised, because all these things need to take place in the public eye.

Healthcare (International Arrangements) Bill (First sitting)

Matt Western Excerpts

Committee Debate: 1st sitting: House of Commons
Tuesday 27th November 2018 Public Bill Committees

[Maggie Throup (Erewash) (Con)]

Q Mr Jethwa, when you look at the current regulations, do you think the powers in the proposed legislation are proportionate?

Raj Jethwa: We would like to see much more emphasis on scrutiny of all the discussions in the arrangements going forward. There are some negative procedures—I think that is the term. Given the weight of the issue and the number of people that could be affected by it—I have mentioned the 190,000 UK pensioners who live abroad at the moment, but there are close to 3 million people from the European Union who access healthcare in this country, and there are many more than that who travel across the European Union at the moment—there probably needs to be greater scrutiny of any arrangements going forward.

[Matt Western (Warwick and Leamington) (Lab)]

Q Mr Henderson, I think you described the existing arrangements as pretty well universal. Could you explain a little more what the gaps are?

Mr Henderson: I am not actually sure I have all the detail. My understanding is that the European health insurance card and such arrangements work for all emergency situations, certainly, and most normal circumstances. I think, and Raj may know better than I, that there are some areas that are not covered particularly, but as I understand it, it is fairly universal. I am not an absolute expert in that, I am afraid.

Raj Jethwa: We can write to the Committee. My opinion is that it is pretty universal. There are probably niche areas that may not be covered. We can look into that and get back to the Committee if that would be helpful.

[Justin Madders]

Q I have one more question to both of you—I am not sure if either of you will know the answer. Some of the reciprocal arrangements we have at the moment are based on the actual cost expended and some are based on an average—Estonia, Denmark, Finland, Hungary, Malta and Norway. I am not clear why that is the case. Is there some sort of historical issue? If either of you can shed any light on that, that would be extremely helpful. One of you is shaking your head.

Raj Jethwa: I do not know that, but again we are happy to look into that and to come back to you if we find out that somebody back home does know the answer. I am not sure that I know.

Mr Henderson: It is probably lost in the mists of various previous agreements.

--- Later in debate ---

[Alberto Costa]

Q What I am trying to ask is whether it might be the case that, without this Bill and without reciprocal arrangements, the cost of travel health insurance is likely to go up? Those of us who take out these policies are not necessarily reliant on EHIC, because we would refer to the private claim, whereas others who perhaps do not have healthcare benefits under a travel insurance policy would be entirely reliant on EHIC. What I am trying to tease out is whether, without this Bill, the healthcare side of travel insurance—the premiums—would potentially go up?

Alisa Dolgova: The claims cost will definitely increase, which may lead to an increase in travel insurance costs as well.

[Matt Western]

Q Out of interest, can I ask you a really simple question? What happens currently, but also perhaps in future, when someone is abroad and has an injury, an accident or whatever for which some form of implant is required, and that implant subsequently fails when the person returns to the UK and it is not supported by the NHS? Where does the cost burden fall and how does that impact on insurance, and how may that work in future if we do not have regulatory alignment?

Alisa Dolgova: Sorry, your question is who would pick up the cost if treatment were provided overseas, but it fails?

[Matt Western]

Yes. If that implant failed, whatever it might be, and the cost to revise that implant were then borne by the NHS, who picks up the cost, and how does that work? How does it work currently, and how might it work in the future based on this?

Alisa Dolgova: I am not sure I have a detailed enough answer to give at the moment. I would be happy to come back to the Committee on that, but again, I think it would ultimately depend on exactly what travel insurance policy is in place. I would assume that the travel insurance policy is likely to cover a person for the treatment they receive overseas, and if they then need additional medical treatment back in the UK, they would be treated within the UK healthcare system in the same way as they are currently.

[The Chair]

Are there any more questions from members of the Committee? If not, I thank you very much for helping the Committee with its deliberations on this Bill, and I call the next witness.

Examination of Witness

Fiona Loud gave evidence.

 Orkambi and Cystic Fibrosis

Matt Western Excerpts

Monday 19th March 2018 Westminster Hall

[Paul Scully]

I thank the hon. Gentleman for that intervention. I will give way one more time and then conclude.

[Matt Western (Warwick and Leamington) (Lab)]

The hon. Gentleman has been very generous with his time. What struck me most—I am sure that this was the case for many people in the Chamber—was just how many countries, particularly in Europe, have agreed and licensed this product. Therefore the cost-benefit analysis has been done, and therefore it is now incumbent on the Government—the Secretary of State—and the NHS to sit around the table with Vertex and discuss how we can deliver it as soon as possible.

[Paul Scully]

I thank the hon. Gentleman for that intervention. Let me be the first to mention Brexit. This is not quite as random as it might seem, because I met someone last week who lives close to the Irish border. Of course, that means that his daughter cannot access Orkambi, but if they were only a few miles across the border, in the Republic of Ireland, she would have access to it. We have to address that inequality, and that will be done, as I keep repeating, by two things. If we can ensure that we use any of our good offices to get NHS England and Vertex to come to a sensible agreement quickly, we can get the portfolio process started now. But I also ask the Minister to see what more he can do to adapt the system long term, so that it is fit for purpose for those modern-style, portfolio-type deals that are done elsewhere.

I keep talking about the urgency of this issue. We were taken to the Cystic Fibrosis Trust by someone who works here, one of the parliamentary outreach team. Alasdair lost his partner. Her lung capacity had dropped to 20% before she died. Some of the people we met had seen their lung capacity drop from 90% to 15% within two or three months. That is why things such as infections are so dangerous. It does not take a lot. Something that we would just shake off can be, for these people, literally a matter of life or death, or it can be a matter of being able to get a lung transplant somewhere down the line or not. That is why there is this sense of urgency. They have been described as a limited number of people, but none the less they are crucial, important people who, if we give them the treatment that they deserve, can go beyond the 31 or 47 years and live a full life, as we would expect to do. With that, I will conclude and let others speak.

Deafness and Hearing Loss

Matt Western Excerpts

Thursday 30th November 2017 Westminster Hall

[Stephen Lloyd (Eastbourne) (LD)]

It is a privilege to serve under your chairmanship, Mr McCabe. I join other hon. Members in congratulating the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) on securing the debate. I was chair of the all-party parliamentary group on deafness, but was rudely interrupted in 2015 when something else happened. It is a pleasure to be back and to serve as vice-chair of the APPG under the hon. Gentleman’s excellent chairmanship.

I commend the previous speakers’ comments about cochlear implants. I remember 20 or 30 years ago, when they really began to take off. The difference between now and then is absolutely huge. That overlaps with what the hon. Member for Rochester and Strood (Kelly Tolhurst) described of her mother’s experience. I thank her for that moving speech. Her mum will be proud of her, I am absolutely sure of that. I can relate to a lot of the things that her mum went through. I have been deaf for about 50 years of my life.

Cochlear implants have made a huge difference and the improvement is absolutely massive. The Minister is from the Department of Health—he is an old colleague from coalition days; it is good to see him—and I ask him to explore how cochlear implants can be ever more available, because they do much more now and they do it much earlier. They are a game-changer. For many years after they first came out, a long, long time ago, they really did not make that much of a difference. There was vigorous opposition from a lot of the British Sign Language community, and I understand why. That has changed a great deal over the years and cochlear implants are now, in many ways, the future for transforming deafness. I never really believed it in the old days, but now I do, because of the advances.

I would like to cover a few areas, a couple from the UK Council on Deafness angle and a couple specifically because we have a Health Minister here. British Sign Language is a different language. I am hard of hearing and have been since having measles when I was six. Sometimes, people might say to me, “Stephen, are you a member of the deaf community?” and I would say, “No, I am a member of the hearing community. I just don’t hear very well.” That is an important point, because they are completely different. The deaf community is a community. The BSL community is a completely different community, with cultural norms and a different language. BSL is not even a direct translation of my speech; it is different. Sometimes people do not understand that. They would say to me, “Why don’t you learn BSL?” and I would say, “Because I am a member of the hearing community, I just don’t hear very well, and it is a different language.” I am very supportive of profoundly deaf people trying to get BSL as a recognised language, as has happened, I believe, in Holyrood in Scotland.

I remember just before 2015 having meetings with a number of people down from Scotland and we were watching that development with great interest. Once it happens in one legislative House, it is very hard for other legislative Houses not to follow, so I say good luck with that up in Scotland, because it is a game-changer. It will happen eventually in Westminster. When it does, it is not just a label. When a nation says that a language is a statutory language, it means it is accessible and that public bodies have to provide information in that language, and that will make a huge difference for a lot of profoundly deaf people. I will tell hon. Members why and give one very good example.

I have been involved for many years in politics around deafness as a trustee of this or a patron of that, or what have you. I knew a lot of people who are profoundly deaf working in that area, including from the British Deaf Association. I just came from a statement this morning in which the Secretary of State for the Department for Work and Pensions mentioned that about 50% of disabled people are out of work. I tell you what, Mr McCabe, it is a hell of a lot higher than that for the profoundly deaf. I do not have the figures because no one really finds them. The DWP—it used to drive me crazy when I was here before—will not slice the different disabilities up. It just says “problems with deafness and problems with visual impairment”, which completely denies the separateness of deafness. Off the bat, though, I would say that profoundly deaf people have an unemployment rate of around 70%, which is just ridiculous. How can we possibly have 100,000 people—if not more—of adult working age and have such barriers that 70% are unemployed? It is a blooming outrage! Now that I am back in the House, which is wonderful for the people of Eastbourne—I thank them—I am determined to lobby hard to make BSL an accepted language.

I am also keen to join the hon. Member for Poplar and Limehouse in lobbying on Access to Work. The Government have done a great thing with Access to Work—I think it was John Major’s Government that started it. Access to Work is a good thing which has made a huge difference to a lot of people, and I am a big supporter or it, but there is a challenge. It has made a great difference for people who are in work and acquire a disability through illness, a catastrophic incident or what have you—it has been fantastic in helping them to stay in work. I want it to be improved, particularly in the small and medium-sized enterprises sector, so that SMEs understand that they can employ people with disabilities. Access to Work provides a lot of the money that will buy an induction loop, put in a ramp, or do whatever is necessary to help an employer take on a disabled person. That is really important. Corporates kind of get it—they are huge, and they have massive human resources departments and pots of money, so they try to do their best. It is much harder for an SME employing three people. If I were the director of a plumber working seven days a week, and someone with disability came to see me, it would be so much easier to say, “No, no,” and find an excuse not to employ them. Access to Work often provides the money that allows the SME to take on that disabled person.

I will let the House into a vast secret. I say this with authority, because I used to be a consultant in this area for years. If a business employs disabled people, they get lower churn.

[Matt Western (Warwick and Leamington) (Lab)]

rose—

[Stephen Lloyd]

I have seen that in call centres, in businesses and in numerous other areas. I used to be very involved with the Federation of Small Businesses, and I am sure I will be again now I am back. Lower churn is really important for businesses if a lot of their spend goes on employing people. At a later date, I will explain why it leads to lower churn, but it does.

[Matt Western]

Will the hon. Gentleman give way?

[Stephen Lloyd]

Yes, certainly—sorry.

[Matt Western]

The hon. Gentleman is talking about the challenges that SMEs have in employing people with such impairments. Does he agree that it is difficult for many people who suffer from deafness or failing hearing to progress within organisations because of the cap? It is therefore almost self-enforcing that those people are pressed into part-time working.