NHS Long-Term Plan

Seema Malhotra Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right not to use the word “bung” in his question and to correct that very quickly indeed. He is also right to talk about productivity. The last Labour Government made important progress in bringing down waiting times. That required significant extra resources. When Alan Milburn had a 10-year plan, there was not a big productivity element to it. This time, when resources are much tighter, we have to make sure that productivity and efficiency gains are at the heart of the progress we make.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

The Secretary of State is right that more funding is urgently needed, because he knows better than anyone that the percentage of NHS trusts in deficit rose from 5% in 2010 to 44% last year. Today, he has talked repeatedly about prevention, but he has failed to say directly what will happen to public health. Will he therefore clarify whether any of the settlement he has announced today will go towards public health services, vital for prevention and tackling health inequalities, which are being cut by £800 million over five years?

[Mr Hunt]

Today’s settlement covers NHS frontline services. As I explained in the statement, it does not cover public health, but we fully recognise its importance. The hon. Lady talks about the increase in trust deficits. It is true that the number of hospitals in deficit has gone up, but that is because we deliberately decided to be very careful in the way that we performance-managed trusts with deficits. In Mid Staffs, getting rid of the deficit was one of the reasons why the number of nurses in wards was stripped down to totally inappropriate levels. We have to make sure that we handle this in an appropriate way.

Hospital Car Parking Charges

Seema Malhotra Excerpts

Thursday 1st February 2018 Commons Chamber

[Melanie Onn (Great Grimsby) (Lab)]

I am very grateful to be able to take part in this important debate. I congratulate the right hon. Member for Harlow (Robert Halfon), my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy), and my neighbour, the hon. Member for Cleethorpes (Martin Vickers), on securing it.

Diana, Princess of Wales Hospital in my constituency provides a range of helpful wellbeing services. The site has an A&E, a dialysis unit, a child development unit, a nursery, an eating disorder unit, and health education spaces. It covers a huge range of services that deliver to a very wide community. There are two main areas that I want to address: first, the difficulties and challenges for patients caused by ever-increasing parking tariffs; and, secondly, car parking issues for staff, which have been raised with me on a number of occasions when I have been at Grimsby’s hospital.

In Grimsby, I can go and park in the Iceland car park, in the centre of our town, for £1 an hour. If I need to park for more than two hours, I might go to the Abbey Walk multi-storey, again in the centre of town, and pay £3.50 for the privilege of four hours’ parking. Having worked in places like York, I know that I should be very grateful for the seemingly small amounts that it costs to park in the centre of our town, so I count my blessings. When those smaller amounts are set against what people are expected to pay in hospital parking charges, it feels very much to my constituents as though the NHS is over-inflating the expense and putting an unnecessary burden on patients and families.

The charge for an hour’s parking at Diana, Princess of Wales Hospital has recently increased to £2.10— £1.10 more than in the centre of our town. If I go to the hospital to pick up a prescription, it might take—on a good day, admittedly—just a few minutes to collect the prescription, but on top of the prescription cost, I am paying another £2.10 to do so. Last week, I went for a blood test. I walked in, got my ticket, checked on the screen, and saw that there was a wait of about 68 minutes. It took me a matter of minutes to get the blood test, but the sitting in the waiting room lasted about 68 minutes. The cost of that visit was therefore £3.50. I am not bemoaning the cost to my personal pocket. I can afford it, but many in my constituency cannot, and the cost is prohibitive.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

Does my hon. Friend agree that, as well as the issues that have been raised powerfully so far, the example she gives shows the opportunity for greater flexibility? In Hounslow, for example, free half-hour parking has been introduced to support local businesses. It is the same for leisure centres. We need to be proportionate as we consider the overall issue, and that is what was can do today.

[Melanie Onn]

My hon. Friend raises an important point. There is room for flexibility, and all trusts should be looking at what they can do to make parking less prohibitive so that people are not put off.

It is galling for my constituents to know that parking charges are much lower in other areas of the town. Local authority car parks, shops and private parking companies all have the same issues of maintenance, lighting and security, albeit to different degrees, but they are not charging that high rate. It feels very much like profiteering off the back of people who have no choice but to be at hospital, whether that is for themselves, their friends or their relatives. The trust offers concessions through lower costs for blue badge holders, although they are not exempt from charges, as well as for parents who are staying overnight with poorly children and those having cancer treatment. That is, of course, incredibly welcome. However, when the justification for the charges is that they pay for the maintenance of the site, it really does not stack up, given the costs of other paid parking sites in the town.

An automatic number plate recognition system was recently installed at the Diana, Princess of Wales Hospital, which led to even more frustration and concern for constituents. While that fantastic new automated system was supposed to make the process a lot quicker and easier for people, all it did was to cause additional delays and costs. After spending time in the waiting room, as I had to, people had to come out to try to pay for their parking with the new machines. It caused absolute havoc, and there were queues going around the block, and people ended up tripping over into the next pay band and paying even more. The process caused an extraordinary amount of frustration and reflected very poorly on the trust, which is a real shame.

The knock-on effect of the charges is that surrounding streets, such as Second Avenue, Edge Avenue and Limetree Avenue, which are all residential streets with limited on-street parking, get filled with the cars of patients, staff and people attending the hospital. I know that there is nothing illegal about that. There is nothing wrong with people parking in those residential streets, but it really irritates residents if a parked car crosses a dropped kerb or impinges on people’s driveways. That is not only incredibly frustrating, but it gives rise to increased concerns about road safety, especially in school hours.

The right hon. Member for Harlow addressed very well the broader point that people with disabilities or long-term illnesses are generally financially worse off than the rest of the population. The additional cost represents a significant inconvenience and potential hardship for people who can least afford it.

Hospital staff have increasingly been talking to me about this issue. There have been discussions with staff about increasing the amount that they already pay to go to work. An increase has been postponed for now, but the opportunity for it to be brought back next year is, I understand, very much on the table, and the increase will be significant. As the right hon. Gentleman indicated, the people affected will be not just consultants or senior executives who might be earning a very good wage. We are also talking about porters, healthcare assistants and medical secretaries—all the people behind the scenes who keep the hospital going—being expected to pay even more.

The frustrations for staff are immense. They say that they already struggle to get a parking space, not least because some shifts overrun. The likelihood that someone might do an eight-hour shift in the NHS at the moment is frankly negligible. Most people, through their own good will, are giving more to the NHS and working beyond their shift. They do not want to leave their patients in the middle of an incident. The number of parking spaces available is therefore reduced, and people are leaving home an awful lot earlier—an hour to an hour and a half earlier—than their shift starts, which increases their working day immensely.

Most of this is not just about travel time. I know that the roads are congested around the Diana, Princess of Wales Hospital, but that is not the only issue. There is also the problem that people are driving around car parks trying to find a space. It is incredibly frustrating that people are paying for a space at work and cannot get one, and sometimes that is even making them late for work.

Oral Answers to Questions

Seema Malhotra Excerpts

Tuesday 4th July 2017 Commons Chamber

[Mr Speaker]

It is always quite interesting to study the habits of colleagues. The hon. Member for Feltham and Heston (Seema Malhotra) has perambulated from one side of the Chamber to the other; nevertheless, she is here and I suppose we should hear her. No? The hon. Lady had a question on the Order Paper. Your opportunity is now—get in there!

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

During the election campaign, a lady in my constituency told me that she had had to wait nearly four hours for an ambulance to arrive at her home to help her off the floor. Does the Secretary of State have confidence in the ambulance service in London and other regions where targets have been consistently missed? Will he now look at extra resources for the ambulance service across the country, which is so urgently needed by all of our constituents?

[Mr Hunt]

If I may say so, that was a brilliant recovery. The hon. Lady is absolutely right to focus her attention on the performance of ambulance services. They are under pressure. They are hitting around 71% for their category A calls, and the target is to hit 75%. However, there are some bigger issues with the way those targets work, which we are looking at. Her ambulance service has just had a Care Quality Commission inspection.

Health and Social Care

Seema Malhotra Excerpts

Monday 27th February 2017 Commons Chamber

[Meg Hillier]

We have not looked at that directly, but we know that the biggest revenue cost for hospitals is staffing, which is followed, for some hospitals, by servicing a PFI deal. Early analysis suggests—I would not want the House to lay too much on this, because it comes from conversations I have had with auditors—that the challenge is that the cost of refinancing those PFI deals can swamp the potential savings. Perhaps Ministers could look into that further. A lot of technical work has been done to attempt it. The British Medical Association tells me that spreading the payback period over a longer time would reduce the day-to-day resource costs for hospitals, so that might be a way forward. However, I speak from work I have done outside the Committee Room, rather than strictly through the work of the Public Accounts Committee and the National Audit Office.

The supplementary estimate this year is worrying. The trend is going in the wrong direction for taking money out of the capital spend. As the hon. Member for North Herefordshire (Bill Wiggin) highlighted, a lot of the transformation in the NHS will require the reconfiguration of buildings and estate. Those sorts of capital expenditures are important to save money in the long term, so the estimate really is very short-sighted.

If we look at how NHS trusts are managing with their deficits, again we see a worrying trend. At the beginning of this financial year—2016-17—NHS Improvement committed to ensuring that the provider sector deficit did not exceed £580 million at the end of the year, which is now in a month’s time. However, NHS Improvement forecast a deficit of £644 million in quarter one. Its forecast declined further to a deficit of £873 million in quarter three. That pledge did not amount to very much, and it is moving very much in the wrong direction. NHS trusts have been overspending by approximately £300 million a quarter throughout this financial year. If that trend continues into the final quarter of the year, the overspend will be close to £1.2 billion. I have laid out the reality very starkly by picking out uncertain elements in the Department of Health’s consolidated accounts.

We hear a lot of discussion about how much money the Government are putting into the NHS. The Committee had an unedifying experience at a hearing on 11 January, in which the head of NHS England came before us on the very day that anonymous briefings in the national press from sources at No. 10 criticised him and NHS England. He defended his position in the Committee but, frankly, patients do not want anonymous briefings from people to save face when the Committee is actually looking at saving lives and treating patients. They do not want to see a ding-doing about the money. They need to know that the people running our health service, and the Government overseeing and channelling taxpayers’ money into it, are committed to long-term patient care and tackling future long-term challenges.

Let us be clear that protecting the NHS England budget is not the same as protecting the health budget. As the hon. Member for Totnes mentioned, Public Health England and Health Education England are being squeezed, and social care budgets—although not a direct national health cost—went down by 10% in the last Parliament. There are some clever measures by Ministers, saying, “Put up your council tax precept and it’ll all be fine.” That is still taxpayers’ money being found from somewhere to go some way towards solving the problem, but it will not solve it in the long term. Unless we tackle social care and health together, we will have an unsustainable future. There is too much robbing Paul to pay Paul—shifting money from one bit of the budget to another in a clever way that is not transparent to most people out there because it is buried in big numbers.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

My hon. Friend is making a thoughtful and evidence-rich speech, as always. One issue that is not often talked about, but that appeared in the media again today, is the rise in physical attacks on NHS staff. The budget of NHS Protect, which deals with a lot of security issues, is also being cut. That is part of creating the perfect storm, with evidence that a lot of perpetrators of such attacks are those with mental health issues. Unless we have the resources for an environment in which we keep NHS staff safe, the issue could get worse.

[Meg Hillier]

My hon. Friend makes her point well. It is important to protect staff. I echo the comments of the Chair of the Health Committee that staff cost more than anything else in the NHS and provide the direct patient care that is so important to its long-term sustainability. I will touch on workforce planning in a moment.

Mental Health and NHS Performance

Seema Malhotra Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

The hon. Lady is absolutely right. One example where that is particularly true is in addiction services. Highly vulnerable people whom we are trying to help kick a drugs habit may also have a housing problem, a debt problem or a work problem. Unless we solve those problems holistically, we are unlikely to be able to address the health problem that sits at the heart of those challenges. In essence, that is what the STP process is trying to address—I am talking about providing more joined-up integrated services. I am happy to have further discussions with her as to how we can make more progress in that area.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

In his statement, the Secretary of State promised a Green Paper on children and young people’s mental health before the end of the year. That could be 11 and a half months away. One in four people have a mental health disorder, and the Government’s own research says that young people are disproportionately affected. We have all heard stories—I certainly have in my constituency—of young people waiting more than a year for support, including those who have been victims of domestic violence. Schools and parents are picking up the pieces. Young people deserve better. Will he clarify the reasons for what appears to be quite a long delay and commit to bringing forward the Green Paper so that action can be taken more quickly and that this pressing issue is not kicked into the long grass?

[Mr Hunt]

May I reassure the hon. Lady that we will not be kicking the issue into the long grass? The Prime Minister has made a statement that we will have a Green Paper. There is a very specific reason why we need a bit of time: we want to ensure that the changes that we make—[Interruption.] We are getting a bit of chuntering from the Labour Front-Bench team. They might want to listen to the answer. The reason why we need to take some time is that a number of pilots concerning the improvement of mental health provision are taking place in schools at the moment, and we want to see them go through and evaluate them to inform what we do in the Green Paper. That will take a bit of time, but, at the end of it, we will get a better evidence base for the right way forward.

Oral Answers to Questions

Seema Malhotra Excerpts

Tuesday 20th December 2016 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

I thank my hon. Friend for that question and commend him for his work as a pharmacy champion. The Murray review was indeed published last week, and NHS England will respond to it in detail early in the new year. It is a very important document because it sets out in some detail how we intend to transform the community pharmacy network into a service-based profession along the lines that my hon. Friend likes.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

T3. Last week, a 76-year-old man with diabetes in my constituency took a fall and had to wait almost two hours for an ambulance. I then wrote to the Health Secretary after it emerged that not a single ambulance trust in England met its response time targets in October, including for the most critical of cases. Will he explain the reasons for these unacceptable ambulance delays and what he intends to do as we approach Christmas?

[The Minister of State, Department of Health (Mr Philip Dunne)]

I am aware of the case that the hon. Lady refers to. In the week of the incident, the London ambulance service received 40,433 emergency calls—an 8% increase on the previous week. We are trying to do something about this. We have recruited 2,200 more paramedics since 2010 and increased the number of paramedic training places by 60% in this year alone. The London ambulance service has recruited 107 more paramedics since September 2015 to help with this increased demand.

Young People’s Mental Health

Seema Malhotra Excerpts

Thursday 27th October 2016 Commons Chamber

[Lyn Brown (West Ham) (Lab)]

I congratulate my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) and the hon. Member for South Cambridgeshire (Heidi Allen) on securing this debate. I warmly congratulate, too, the clearly very talented Youth Select Committee on producing such an excellent report, which cogently highlights the need for additional and better mental health services for young people. It is a job very well done indeed.

For too long, those suffering from mental ill health have received far less care and attention than those suffering from physical ailments. Even though mental ill health accounts for 28% of the total burden of disease, it gets just 13% of the NHS budget. One in four adults is diagnosed with a mental illness at some point in their lives, but only about a quarter of those who need mental health services have access to them. Serious medical conditions are going untreated because of the disparity of esteem between physical and mental health that everybody—the Government, health professionals, patients, the voluntary sector—speaks of wishing to end. There is such a long way to go.

The consequences of our neglect of mental health services are devastating. Over a third of people with mild mental health problems and almost two thirds of those with more severe mental health problems are, in fact, unemployed—yet research shows that the vast majority of them wish to work.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I thank my hon. Friend for giving way and congratulate the Select Committee on this report. She makes an important point about the number of people with mental health issues who are unemployed. I have been struck by the message from schools; one in my constituency told me that it was referring 40% of its pupils for mental health support. Does she agree that early intervention, as highlighted in the report, is vital? Does she recognise the work of Members of the Youth Parliament, including Tafumi Omisore in Hounslow, who raised these important issues with us?

[Lyn Brown]

Absolutely. I totally agree with my hon. Friend, and as I go through my speech I am hoping to provide an example to show how intervention is particularly important for a very young child because of the impact on the rest of the family. Early intervention can do a lot to mitigate other events and difficulties occurring in the family that might include other family members, too.

Unfortunately, tragically and outrageously, young people’s mental health services often receive less attention than adult mental health services, so that young people’s mental health services have been called the “Cinderella of Cinderella services”. In November 2014, the Health Committee found that there were

“serious and deeply ingrained problems with the commissioning and provision of services for young people’s mental health.”

Many providers reported increased waiting times and increased referral thresholds for specialist services, where patients would have to show severer symptoms to receive treatment than they would have done in the past. GPs reported feeling ill-equipped and lacking in confidence when dealing with young people’s mental health issues. The Select Committee found that early intervention programmes were

“suffering from insecure or short term funding, or being cut altogether.”

There really is no excuse for this failing. Around half of people with lifetime mental health problems experience symptoms by the age of 14, and about 75% of them before the age of 18. Catching these problems early could well lessen the severity of adult problems, possibly saving the NHS money in the long term. More importantly, I would suggest, it would reduce unnecessary suffering and enable people to live better lives.

I want to be fair to the Government, who have recognised that there is a problem. In 2014 they set up a children and young people’s mental health and wellbeing taskforce, which made a number of recommendations in its 2015 “Future in mind” report. The taskforce identified a number of problems with young people’s mental health services. The right hon. Member for North Norfolk (Norman Lamb), who was then the responsible Minister, said that there needed to be a fundamental shift in culture, with a much greater focus on prevention and early intervention.

The taskforce rightly recognised that one of the challenges facing young people’s mental health services was—unsurprisingly—funding. I was pleased when the Government responded by announcing the provision of an additional £1.4 billion of transitional funding for youth mental health services, but that additional money needs to be considered in the context of the less encouraging overall picture of mental health services funding. NHS England’s planning guidance states that all clinical commissioning groups must increase their spending on mental health services by at least as much as their overall budget increases. However, there have been warnings from organisations including mental health trusts that mental health funding is not properly ring-fenced, and that NHS England’s target is being missed.

Let me again follow in the footsteps of my hon. Friend the Member for Dulwich and West Norwood. We know from the responses to a series of freedom of information requests from my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) that more than 50% of CCGs intend to spend a smaller proportion of their budgets on mental health in 2016-17. That clearly demonstrates that what the Government tried to do has failed, and that that target is being missed as well.

[Lyn Brown]

We need early identification and we need early intervention, but we also need the funds to ensure that there are services to which people can be referred. That is the rub of this whole debate. There does not seem to be the necessary funding at any point in the journey of young people who need help, whether in the form of awareness, intervention or services.

I have been looking into the good work done in my borough, the London borough of Newham. Even in these difficult times, it is increasing its mental health spending in both absolute and relative terms, and its children’s mental health services received an “outstanding” rating from the Care Quality Commission. I wanted to find out how we could improve young people’s mental health provision, and to learn about the challenges that an “outstanding” local provider continued to face in its fight for better services. Professionals in Newham recognise that a good young people’s mental health service does not just help those who have already developed severe and serious conditions, but provides early intervention and preventive programmes so that problems can be dealt with at source.

[Seema Malhotra]

Is it not important for young people’s mental health services to consider the needs of parents as well? I was struck by a recent case in which the parents did not understand where the issues had come from and could not identify what they were, and felt unable to understand how best to help their child.

[Lyn Brown]

My hon. Friend is right. The family is often key to the provision of the support that a young person needs, but a family may itself need intervention to gain the support that it needs to lead a mentally healthy life.

The national lottery funded a programme in Newham called HeadStart, which helps 10 to 16-year-olds, particularly in schools. It trains teachers in secondary schools to develop programmes that help to build resilience among their pupils. It also provides children directly with mentoring schemes so that they can learn from each other about how to manage mental health issues—it is peer-to-peer learning—and works directly with parents to show them how they can work through mental health issues with their children. Unfortunately, the scheme relies on lottery money rather than core funding, which means that its future as a core service cannot be guaranteed. It is often difficult to obtain the necessary proof that would persuade funders—including the Government—that core funding should continue, because the timescale is often not big enough to be persuasive.

Newham would love to run more services directly in the community, and more integrated services, because it knows that they make a real difference to people’s lives. M, aged two, and her baby brother T, just seven weeks old, were referred by a perinatal psychiatrist, who was helping their mother to deal with chronic mental ill health. M was still frequently breastfed, and showed a very insecure attachment to her mum. Her anxious, and therefore sometimes controlling, behaviour was making it difficult for her mum to wean her and to attend to the needs of the new baby, who was being bottle-fed. M’s speech was also delayed.

Following assessment, the family were offered parent-infant psychotherapy, which enabled them to reflect on the needs of both children, and gradually to help M to become more independent of her mum. At the same time, T was able to have more appropriate attention from his mum as the baby of the family. I am pleased to say that, following that intervention, M is more confident and her speech is developing. She sleeps in her own room, and has settled well into nursery. That is an example of our physical and mental health services working in tandem to improve real lives.

J was a 17-year-old who had been arrested and charged with possession of a weapon and affray. He had a history of violence and non-engagement with services. During the course of his referral to a youth offending team, the team became concerned about his mental health, and referred him directly to a child and adolescent mental health services specialist for an urgent examination. During that assessment, J was having suicidal thoughts, was highly anxious, and showed quite severe symptoms of obsessive-compulsive disorder as well as softer symptoms of attention deficit hyperactivity disorder.

The youth offending team nurse arranged for J to have urgent psychiatric treatment. He was put on medication for his anxiety, with an accompanying course of cognitive behavioural therapy for his obsessive-compulsive disorder. He will also be assessed for ADHD in the longer term once his more acute symptoms abate. I am pleased to report that J has not offended since he has engaged with the mental health services offered through the youth offenders team. That shows that integrated services are better for individuals, and better for the whole community.

Those are just a few of the stories that I have been told, but I believe that there are enormous challenges to the provision of community-based and fully integrated services. I am told that Newham would love to run services directly from general practices, but they cannot currently do so because they do not have the necessary resources. With the current staffing levels it would not be efficient, because staff would spend as much time travelling to and from general practices as they would spend helping patients.

Health professionals acknowledge that early intervention work often increases rather than reduces workload in the short term. Professionals in Newham worry that they simply will not be able to deliver the clinical hours that are necessary to help more patients. Over 50% of patients in Newham already have to wait for more than five weeks to see a specialist, and that figure can only increase when further cases are uncovered without corresponding additional resources.

Some well integrated and community-based mental health services are delivered in Newham and, I am sure, throughout the country, but if we want to preserve and expand those programmes, we must be aware that they need stable and long-term funding. A good place to start would be ensuring that money designed for mental health services actually finds its way to the front line.

Hormone Pregnancy Tests

Seema Malhotra Excerpts

Thursday 13th October 2016 Commons Chamber

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

Thank you, Madam Deputy Speaker, for the opportunity to speak in this debate on this devastatingly sad topic. I also thank the Backbench Business Committee and my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for securing the debate today. It is an honour to follow some passionate speeches today. I pay tribute to Marie Lyon and the hormone pregnancy test campaign for their powerful representations in telling their own stories and the story of Marie’s daughter in the media.

Much that we take for granted today, given the improvements in health care and the ease of pregnancy tests, sheds an important light on what happened 40 years ago. It is a matter of great sadness and shame that it happened in our country. Many of the tributes and stories that we have heard today show that many are still living with the consequences and that we must learn the lessons. This inquiry and our confidence in its findings is critical not only to close this chapter of our history but to ensure that lessons are learned and clear findings will be adhered to in the future when it comes to regulation and the description of how medications should be used.

When I first came to hear of this issue, I found it hard to comprehend why it seems to have taken so long for those who were prescribed Primodos to get clarity and answers about what happened to them, for the issue to be comprehensively researched, for an explanation to be given about why the drug continued to be used after concerns were raised and for families affected to be given an apology and justice. Studies in the UK and elsewhere from the late 1960s into the early 1970s suggested a link between the use of hormone pregnancy tests and a range of abnormalities including cleft lip, limb reduction and heart abnormalities.

Bethan Dickson from my constituency was affected after her mother took the drug. I want to thank her for having the courage to come and meet me about this issue and for giving me permission to share her story with the House. She says:

“My name is Bethan Dickson, I am 48 years old and work as an occupational therapist in West London. But I was born in 1968 in South Wales with heart and limb defects that have impacted on my entire life. My mother was given Primodos, an oral pregnancy test, by her doctor and I believe that this is the cause of these physical defects.

Along with members of the Association for Children Damaged by Hormone Pregnancy Tests I am supporting an inquiry into how this damaging drug could have been prescribed to mothers when there were already concerns raised about its safety.

I feel it is important that accountability is accepted by the drug company who put profit before patient safety, and for the government to acknowledge its responsibility for not ensuring that the citizens of this country were protected from harm.

I was born with a heart murmur and poorly formed bones in my feet. I experienced some shortness of breath as a child, slept poorly as a baby and was restricted in sporting activities. The heart murmur did not require a surgical intervention, but I had frequent and regular visits to cardiologists.

I suspect that many Association members can relate to waiting to see the doctor in hospital in the 1970s and '80s and knowing where you are in the queue because you can see the thickest medical record in the stack and knowing that it’s yours. Thankfully the introduction of electronic medical records means I don’t suffer that particular humiliation any more.

The defects in the bones of my toes became more obvious as I grew, and from my earliest memories (about six years old) I remember pain in both feet that prevented me from participating fully in activities in school.

When I was nine years old the orthopaedic surgeon in the local hospital recommended surgery to address the deformed joints. He felt that although I was still growing the pain I was experiencing needed to be addressed sooner. I had my first orthopaedic surgery in 1980, but the problems have persisted and I have required six further surgical interventions since then.

The pain today varies depending on the activity, but prolonged standing or walking is painful. I have been fortunate to have had excellent healthcare both in South Wales and in west London to address my physical impairments; and lucky enough to have had loving parents and a husband to give me the strength and support to deal with the emotional strain of dealing with the ongoing difficulties.

I have been able to live a full life, going to university, working full time and making a contribution to society in my capacity as an occupational therapist. Every day at work I meet people with disability and physical or cognitive impairments, but nothing prepared me for my first meeting with other Association members in June 2014.

The severity of impairments in some of my contemporaries both shocked and angered me. Some have profound disabilities that have prevented them from living a full life, and left them dependent on carers and family for care and support. This could have been avoided with responsible oversight of the drugs being given to expectant mothers, and more robust testing of drugs before they were brought to market across the world.

When I met other Association members I felt guilty that their suffering was so much worse than mine, and then felt guilty that I was relieved at that. My mother along with the mothers of many members feels guilty that she took a tablet that caused these lifelong problems to her child.

Of course logically I understand that the guilt does not lie with me or my mother, but in the absence of any form of apology or recognition of wrongdoing by the drug company or the government we do not have closure or the confidence this won’t happen again.”

[Hannah Bardell]

The hon. Lady makes the absolutely crucial point that, until the families have answers, they cannot deal with the trauma and they cannot get the proper counselling and support that they deserve.

[Seema Malhotra]

I thank the hon. Lady for her intervention. That is certainly the reason why Bethan Dickson has written to me. She said:

“That’s why I support an inquiry to establish the facts and explain to the country how this could have happened just a short while after the Thalidomide scandal.”

Bethan’s story highlights the impact of this drug and how it was prescribed and the effects that it still has to this day. I have been struck as well by the work of Marie and her campaign, their patience and their systematic and honest work. They have desired to work in partnership simply to find answers, for justice and to ensure everything is done so that this does not happen again, but I am concerned that they are not being met halfway by an inquiry that does not appear to have had effective governance while there are concerns about the constitution of the panel, the robustness of its procedures and the approach to the evidence collected and how it is analysed.

I want to close my contribution today with some questions to the Minister and some commitments that I would like to hear being made today. I believe that it is time to make sure that there is commitment today to respond to the issues raised and to do so formally in writing to my hon. Friend the Member for Bolton South East; to reconfirm the status of the inquiry, its terms of reference and its timetable for delivery; to say how quality will be ensured; to explain what action is being taken to address the concerns that have been raised by hon. Members today; and to state on the public record that Ministers will see through their commitment on this inquiry to a report and findings that will command the confidence of the House and, indeed, the families and victims who have waited so long for those answers and for justice.

Oral Answers to Questions

Seema Malhotra Excerpts

Tuesday 11th October 2016 Commons Chamber

[David Mowat]

I agree with my hon. Friend, and I will try to give a clear answer. NHS England is determined that all 44 areas will publish their plans shortly. For those that have not already done so, publication will take place after the formal checkpoint review at the end of October. Areas are working to different timescales, but the plans will all be published by the end of November. For the avoidance of doubt, that includes the STP for Buckinghamshire, Oxfordshire and Berkshire West.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

The NHS “Five Year Forward View” called for a radical upgrade in prevention and public health. How does the Minister square that with the Government’s subsequent cuts to public health, including £200 million in-year cuts and further cuts expected by 2020?

[David Mowat]

The STP process is an attempt to upgrade our public health and mental health provision and cancer outcomes. Every STP will be expected to provide an assessment of local public health priorities and the timetable for progress towards that.

Women Entrepreneurs

Seema Malhotra Excerpts

Wednesday 18th March 2015 Westminster Hall

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I am delighted to open this debate on the important topic of women and entrepreneurship. I grew up above my parents’ shop in Osterley, just half a mile from my constituency, and I have spent time self-employed and running my own business. I have visited women’s business centres in America and the UK and I passionately believe in the need for an ambitious strategy to support women-led enterprise. I would like to acknowledge the work Hounslow chamber of commerce does in my constituency and across Hounslow to support women-led enterprise. A number of women have set up and started their own businesses in the community, making a huge difference to the local economy.

Women’s entrepreneurship has great potential for growth, creating jobs and wealth while reducing gender inequality. Women-led small and medium-sized enterprises already add £70 billion to the UK economy, yet women are only half as likely as men to start their own business. According to the findings of the Women’s Business Council, chaired by Ruby McGregor-Smith, CEO of Mitie, it is estimated that if women were concentrated in entrepreneurial activity at the same rate as men, there could be an extra 1 million female entrepreneurs. Indeed, according to the most recent OECD data, there is a gender gap of almost 50% in entrepreneurship in the UK: total entrepreneurial activity, defined as the percentage of the working-age population either in the process of starting a business or running a new business, among working-age women was 7.5% in 2014, lagging behind the rate for men, which was 13.5%. In the US, the rate is 11.2% for women, compared with 16.5% for men.

There are real challenges, therefore, in realising the economic benefits that can come from women-led enterprise, but that should not be the case. Research published last week by the business software group Xero, for example, found that women-led start-ups tend on average to lose less money and to have more success in winning new contracts. Emerging findings from research being undertaken by the Centre for Entrepreneurs suggest that, although women have entrepreneurial and growth ambitions, men seem to be better than women at realising those ambitions. Continuing to understand and to deal with the barriers to women’s entrepreneurship needs to remain a core part of our economic policy.

A review of that policy area in the UK shows a growing focus on women entrepreneurs since 1997. The then Department of Trade and Industry formed a women’s enterprise policy team in its Small Business Service, and in 2003, the then Labour Government published “A Strategic Framework for Women’s Enterprise”, which was the first policy response of any kind from a UK Government on the potential for economic growth if women were encouraged to start their own businesses in a similar way to men. The report set out targets, and the women’s enterprise panel was formed to advise the Government.

[David Simpson (Upper Bann) (DUP)]

I congratulate the hon. Lady on bringing this debate to Westminster Hall. If I did not speak in it, my wife would be very angry, because she has been an entrepreneur for many years and has been very successful. Does the hon. Lady agree that to encourage young women to start up businesses or whatever, we need to start at the very root, in further education colleges, schools and universities, to encourage them to come out and use their skills?

[Seema Malhotra]

I thank the hon. Gentleman for his intervention. He is absolutely right. Although the Government have made some progress on increasing enterprise education, we have a long way to go. One finding from research that I undertook last summer was that women who were starting their businesses later in life wished that they had had that education earlier. Women never know at which stage in their life they will be starting a business. It is increasingly common for both very young women and those who may have taken time out of the workplace to have children to become returners to start enterprises and suddenly find that they do not have the support or knowledge they need. I therefore thank the hon. Gentleman for his wise comment.

The Women’s Enterprise Task Force, established in 2006, took forward some of the work. Although not a delivery body, the WETF provided input to Government on key policy areas that affected women’s entrepreneurial uptake. The WETF produced several recommendations and directed and implemented Aspire, a £12.5 million women’s co-investment fund to support high-growth, women-owned enterprises. In 2008, policy developments taken forward included Government provision of enterprise support focused on women through the regional development agencies and Business Link.

In recent years, there has been a slow-down in support for women-led enterprise. Although the Women’s Business Council, formed in 2010, has done very important work, Prowess, the UK advocacy network for women in enterprise, has been scaled back to, in effect, a newsletter service, and the regional women’s ambassador programmes have been disbanded. For the recently published Burt report, a survey was done of local enterprise partnerships. The author wrote to ask all 39 local enterprise partnerships about their current engagement with women entrepreneurs, but only seven responded; of those, none had more than one female director for every three male directors and none had a strategy for promoting women in enterprise.

I remain extremely concerned that activity is being scaled back instead of pushed forward in the way the Government have reallocated resources for development programmes across the regions. The Department for Business, Innovation and Skills small business survey in 2014 suggested that women-led businesses fare less well over time than equally led or entirely male-led businesses. In 2014, 24% of one-year-old businesses were female- led and 45% were male-led, but of four to five-year-old businesses, only 14% were female-led and 49% were male-led.

I mentioned research on women and entrepreneurship that I undertook some months ago. Through a series of seminars and public meetings, I looked at three dimensions of the gender gap in entrepreneurship in the UK: the rate of business start-up, the sustainability of enterprises, and the speed of growth of female-led versus male-led enterprise. Findings from our focus groups research suggest that there is greater support for starting up an enterprise, as well as perhaps at the top end, but a lack of support for established women entrepreneurs in the middle who are looking to grow their enterprise and are struggling to find support and advice on how to do so. Access to finance can be harder to come by, with investors and banks assessing some women’s businesses as more risky. Indeed, one woman I met, who had set up a child care business in Reading, was turned down for investment by her bank because it could not understand her business model—frankly, it did not understand the business of child care. She remortgaged her house to put her own finance into the business, and went on to increase her turnover and to employ about 20 people.

The needs of this group of women are not being met, so their economic potential is not being realised. The key question that emerges is what more needs to be done by the UK to bridge the gender gap not just in start-ups but in growth and sustainability. Closing the gap means understanding better the circumstances and gender differences in entrepreneurship, so I will spend a few minutes talking about motivations and barriers.

We know that although women have the ambition to set up businesses and grow them, different motivations make entrepreneurship attractive to them. They can include pursuing social goals, a personal passion or a niche in the market, or seeking a work-life balance, flexibility or more control over one’s life. It is positive that young mothers are leading an entrepreneurial surge in new business start-ups—the high cost of child care and the easy availability of technology that allows businesses to be started and run from home contribute to that surge—but if our current statistics are anything to go by, those businesses will need support to survive and grow. A new breed of business women, dubbed “the returners”, has made an excellent contribution to the increase in the proportion of small and medium-sized enterprises run by women from 14% a few years ago to 20% today. The number of women over the age of 30 seeking start-up finance and mentoring has increased by a third in recent years. In some measures, therefore, we see some positive trends, but the research suggests that women-led enterprises have less of a chance of surviving and growing.

Barriers to growth may be encountered by female and male entrepreneurs. According to emerging research by the Centre for Entrepreneurs, all groups express concerns about cash flow and about getting the right people and skills, but women are more likely than men to identify child care and supporting their partner’s career as barriers that affect their own enterprise. They were also more likely to want specific business education—a point made by the hon. Member for Upper Bann (David Simpson)—face-to-face contact, and good mentors, in contrast with men, who specified that they sought advice.

That may shed some light on another gender-specific barrier: lower self-belief, as identified in research by Xero. A third of women said that a lack of self-belief had been the biggest barrier standing in the way of launching their small business, and it was the single reason most often given. In my research, I found that access to support and advice remains a problem. Women want forms of business education that are better tailored to their needs, and they raised with me the need for enterprise education in schools, so that young people can build entrepreneurial skills. We do not know who will become the entrepreneurs of the future, and that door should be open to children from a very young age.

In Liverpool, I saw an excellent example of networking and advice tailored to reach women when I visited the outstanding Women’s Organisation. Simply by moving the sessions to more family-friendly times, the organisation ensured that the number of women who attended business support events increased. The classic timing of business events and drinks right after work at 5.30 pm clashes perfectly with the time when kids are at home, or at after-school clubs, and dinner needs to be made.

Confidence can also be a significant factor in personal risk levels that may guide or limit the decisions that women make. Women may calibrate risk and confidence differently in taking tough decisions; they may also be less likely to see themselves as entrepreneurs than as business owners or founders, which may affect how they perceive and respond to marketing campaigns.

The Government have introduced some strategies, but there is still a long way to go. The Government published the Burt report, “Inclusive Support for Women in Enterprise” in February. That was helpful, but it is unfortunate that when the role was established, it was aimed at promoting and supporting female entrepreneurs, focusing on raising awareness rather than producing sound, evidence-based policy recommendations. The report recognises some initiatives such as StartUp loans, the enterprise allowance and local growth hubs, but it also suggests that there have been deficiencies in the way support has reached women, because it has been extremely patchy, rather than universal.

The report recognises the need to change some of our language around support, so that it looks and sounds more accessible and relevant to women entrepreneurs, who may search for it online. I am often struck by the huge contrast between the US Small Business Administration website, which has mainstreamed women’s business support and which feels customer-centric and targeted towards small business, and the website of the Department for Business, Innovation and Skills, which I believes serves Ministers more than it does those who seek access to services.

I welcome the fact that the Government have recognised the need to give diverse businesses diverse support. They have extended the types of support that may need to be provided to businesses set up by different people—for example, young people and those from ethnic minority backgrounds—to ensure that there is access and guidance for mentoring, networking and sources of finance. However, women have told me that they feel the Government’s support is located in a range of places and those who are looking for support find it hard to join up; they also find it difficult to identify what is really relevant and where to get the quality help they need. A page for women-led enterprise is attached to the GREAT Business website, but it feels like an add-on and a collation of bits and pieces. It could be far more integrated. I would be interested to know why the Aspire fund, a £12.5 million fund that makes equity investments of between £100,000 and £1 million on a co-investment basis, has so far invested only £4.7 million in women-led enterprises. It is certain that problems remain. As David Prosser wrote in The Independent last week:

“There is certainly a problem to tackle here. Government statistics suggest that fewer than one in five smaller companies are led by women. That’s not enough—not just because social justice demands equality of opportunity, though of course it does, but also because there is every reason to expect women-led companies to outperform.”

I will close with a few questions for the Minister. First, what cross-Government work is going on to integrate support for women-led enterprises at start-up and growth stages, and which Departments are actively involved? Secondly, what consideration have the Government given to putting the Women’s Business Council, which has done some important work, on a statutory footing so that it remains part of our business and policy-making infrastructure? Thirdly, why has the Aspire fund, which is designed to invest in women-led enterprises, invested only a third of its intended funds? Fourthly, which Minister is accountable for closing the gender gap in entrepreneurship, and whose dashboard is it on?

[Dr Julian Huppert (Cambridge) (LD)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I am really pleased that this debate has been brought to Westminster Hall, and I congratulate the hon. Member for Feltham and Heston (Seema Malhotra) on securing it. It is a shame that there are so few hon. Members here from both sides of the House. We are discussing a really important subject, and it would be good to have more participants.

I know from my constituency what a key role women entrepreneurs can play, have played and will play in our communities and economy. I have some experience in the matter, because I set up a very small biotech company with two women entrepreneurs and two other colleagues. It was extremely successful in every respect other than having a product that actually worked; as it turned out, that was quite important. One of the women with whom I worked has continued in entrepreneurial roles, and I am delighted about that.

Too often, we do not hear about women entrepreneurs. They are not the stereotype; they are too often the unsung heroes, and we must do far more about that. There has been some progress in the past five years, as the hon. Member for Feltham and Heston has described, in support for women entrepreneurs, including the appointment of an ambassador for women in enterprise, my hon. Friend the Member for Solihull (Lorely Burt), who is upset that she cannot be here this morning. Far more needs to be done, however. No Government have yet got it right, and we need to go much further.

Let me pick up on some of the examples in my constituency. It being Cambridge, many of our successful women entrepreneurs are involved in the tech sector. One example is Lily Bacon, who co-founded the pioneering software company RealVNC. She worked incredibly hard to get that company up and running in perhaps one of the earliest attempts at crowdfunding. Remarkably, the initial money for the company came from selling merchandise bearing the company’s logo. It is quite impressive to be able to do that ahead of time, and that was entirely Lily’s idea. The company is now a world-leading provider of remote-access software, and it has won three Queen’s awards for enterprise in three years.

There are many others, such as Martina King, who is doing amazing work at Featurespace, Julie Barnes at Abcodia and Annie Brooking at Bactest. I particularly want to mention Emily Mackay, who is doing some nice work with Crowdsurfer. She started the company while she was having her first child, and she has turned it into something quite exceptional. Sherry Coutu is an angel investor who helps entrepreneurs in a whole range of things and who is really committed to evidence base. She produced the “Scale-Up” report for the Government, which was excellent work. Outside technology, to pick one example, we have Julie Deane, who co-founded the Cambridge Satchel Company in 2008 with her mother. Only a couple of years later, they were making at least 3,000 bags a week in the UK and selling to 86 countries. It is an amazing company that makes very nice bags, Mr Robertson, if you ever want a satchel.

To enable women entrepreneurs to thrive, we must set the right conditions across the piece. I will talk about finance later, but much of the issue is not directly about entrepreneurs. It is about our society’s attitudes: the explicit and implicit discrimination that holds women back. We have regressive attitudes in so many areas, and one of those attitudes implies that women cannot and should not be innovators in our economy, that women should not take risks and that women should go for a safer job. I come across that attitude all too often. It is not right, and it has no place in what we are doing.

Another issue is imposter syndrome, which has been highlighted by one of my former colleagues, Professor Athene Donald. Many people, disproportionately women according to Athene and others to whom I have spoken, feel that however they are doing, they should not really be there and that they have not really earned their position. Frankly, that feeling strikes all of us. Anyone who claims that they have never felt that they do not deserve to be where they are is probably either over-confident or not telling the truth, but the feeling is expressed disproportionately by women. I recommend some of Athene Donald’s writings and comments on the subject.

We must address, rebut and debunk all those issues to make more progress. There has been work done, and I particularly highlight the work of my hon. Friend the Member for East Dunbartonshire (Jo Swinson) in both her roles as Parliamentary Under-Secretary of State for Women and Equalities and for Business, Innovation and Skills in trying to send forceful messages about sexist dogma in the workplace and, more broadly, society. Similarly, we have seen the work of my hon. Friend the Member for Solihull.

We have made some progress. We still have a society in which it is expected that women will do a disproportionate share of child care. We need to break that apart, and we have introduced shared parental leave, which is important not only for women but for men; parental leave should be open to everyone. Having spoken to many female and budding entrepreneurs, I know that that is an important issue for them. We have also worked to encourage parity of pay for men and women. There is no reason why men and women should be paid differentially for the same job. We have seen the gender pay gap come down, and after some internal coalition disagreements, we are now introducing measures so that large companies will have to publish the average pay of men and women. There are a number of schemes for women entrepreneurs, some of which the hon. Member for Feltham and Heston has already mentioned. There is the women and broadband challenge fund, support for women in rural areas, the road show of mentoring events and much more, so we are making some progress but not enough.

I completely agree with the hon. Lady that we are not there, and so long as we do not have more women entrepreneurs, we and our economy are missing out on a pool of talented, able people who could contribute much more. Research by Enders Analysis shows that raising women’s employment to the same level as men’s could lift GDP by 10% by 2030, which we should all want. As she said, the Women’s Business Council has said that if women had the confidence and support to start businesses at the same rate as men, the UK would be home to an extra 1 million female entrepreneurs, which we would all welcome. We are missing out, and we are doing too badly. Women majority-own only about one business in five, and they are about a third less likely than men to start a business. There is a lot to do.

We need to ensure that education is far more gender-neutral and to encourage women to take subjects that are not seen as traditionally feminine. I recently looked at the application rates for different subjects at the university of Cambridge in my constituency, and there is huge discrepancy between the subjects for which women do not apply and the subjects for which they do. We have to change that. Computer science is at one end and education is at the other. There is no good reason for that, and we have to change it. One thing we would like to do is to change application rates in science, technology, engineering and maths. We support initiatives such as the STEM diversity programme to address gender stereotypes. We need to ensure that each school has access to a female science champion to encourage the idea that women can be successful in technology and science.

[Seema Malhotra]

The hon. Gentleman is making an excellent speech. He reminds me that my sister studied engineering at Cambridge and now works with racing cars in America. He makes an important point about how we can attract more women into subjects that have not been female-led. Does he have a view on how we can build a stronger connection between schools and women who are running businesses and who have been successful in science or technology? Those women can be great role models and can encourage more women to come forward.

[Dr Huppert]

The hon. Lady is right that we have to do far more. In fact, her sister could perhaps be doing some of that. Various studies have asked people to draw an engineer, and almost invariably the person they draw is a man. We have to break that stereotype. There have been some great examples and, rather embarrassingly, I have forgotten the name of the brilliant engineer who worked on the Shard project. She featured in some of the television programmes, and I have met her, but I do not remember her name. She has gone out to try to encourage people in schools, which is essential. We need to show that there is diversity and that people from all walks of life can do it, whatever their background. The hon. Lady is right to raise that issue.

Female entrepreneurs have a particular issue with obtaining finance. Even if they have the background, the idea and the confidence to go for it, access to finance can be very difficult. As the hon. Lady said, banks can be very unsupportive of women entrepreneurs. Studies in the US found that when banks changed their approach to female enterprise, there was growth in female entrepreneurship. I am not saying that we should necessarily copy exactly what was done in the US—it might not exactly work here—but we should try to change the banking culture. We should work with the British Bankers Association to find information on lending to female entrepreneurs in England so that we can see how we can change it.

There are also non-bank funding issues. At the initial stage of funding, women are apparently rather more concerned to seek the three f’s: friends, family and fools. It can be difficult to ask people for money at that stage. There are similar figures for angel and venture capital investment. Only 8% of angel and venture capital investment goes to companies that are run or co-founded by women, which is an astonishingly small fraction. One ray of light is that we are seeing crowdfunding and equity crowdfunding, and 41% of successful equity crowdfunding goes to companies that are run or co-founded by women—we are seeing much more.

Amanda Boyle, the chief executive officer of Bloom VC, has talked about how crowdfunding is opening access to women. I do not have the figures with me, but I understand that men are still more likely to ask for money but women are more likely actually to get the money, which is changing the dynamics. I support all the recommendations of the report by my hon. Friend the Member for Solihull on inclusive support for women in enterprise.

I have spoken at length on some issues, and far, far more could be covered. It is good that we are having this discussion, and it is good that we are trying to make a difference. Whoever forms the next Government, and whoever is in the next Parliament, I hope that women entrepreneurs will be prioritised. So long as we have a society that stereotypes and gives the impression that women should like pink things and should be doing feminine jobs—we have no truck with those attitudes here—we will be weakening our economy and making our society less fair, which is the exact opposite of what we want. We want opportunity for everyone.

--- Later in debate ---

[Seema Malhotra]

The hon. Gentleman is making a powerful point about older women coming into entrepreneurship. There is no age barrier and someone can start a business when younger or when circumstances are different, but then need to accelerate later. Does he support my call for a more integrated approach to supporting women’s entrepreneurship, which has the backing and support of a range of different Departments where they may have different ways of interfacing with women’s lives?

[Jim Shannon]

I could not have said it better myself. I thank the hon. Lady for that intervention. Clearly, we need all Government bodies to work together to encourage people at whatever age they decide to start a business, whatever the reasons for starting at the time they started, and whether they are caring for a disabled relative or have family responsibilities. Whatever time they start a business, let us encourage them.

The opportunities are endless and it is clear that help and support should be given by the Government to allow people to understand how best they can begin a new business. In Northern Ireland, Invest Northern Ireland, in partnership with the Department of Enterprise, Trade and Investment, has help available. Indeed, it has a mentor programme. Perhaps the Minister and shadow Minister will say whether there is a mentor programme here in the UK mainland. If not, may I suggest they look at what Invest NI and DETI are doing in Northern Ireland? New starts are helped. There is a Training for Women website that has useful courses and guidance, and a lot of other help available.

Women into Business is Northern Ireland’s premier business women’s programme aimed at encouraging and supporting the progression of women hoping to enter or re-enter the workplace through employment or self-employment. Women in Business NI—WIBNI—is Northern Ireland’s largest and fastest-growing network for business women and entrepreneurs. WIBNI has more than 1,000 members and offers events aimed at helping women develop both personally and professionally, and to make connections and ultimately grow their business. WIBNI also offers a variety of free marketing benefits to all members, including publication of their news articles in a quarterly and a monthly magazine.

DETI and Invest Northern Ireland have worked out a strategy to encourage women in business and entrepreneurs in Northern Ireland. My hon. Friend the Member for Upper Bann (David Simpson) mentioned the importance of further education colleges. We see lots of good students coming through and taking up courses. The South Eastern Regional College does tremendous work in Newtownards and in my constituency, Strangford. It encourages young people when it comes to business start-ups and ideas, and helps to move them along the way. There are as many young girls and young women as there are young men involved in that college and those courses, and it is good to underline that as well.

There is an onus on the Government to offer help; more help can and should be offered. Again, I congratulate the hon. Member for Feltham and Heston on raising this issue today and on highlighting the great work that has been done, and the fact that there is the potential for so much more to be done, if only more support were offered.

It must be remembered that the greater the success of new businesses, the greater the benefit to the local economy and to the country as a whole. So, whether a woman wishes to create her own business at home, or open a shop, or indeed five shops or 10 shops—whatever their potential dream or wish may be—the advice and support must exist to help them do so. And the onus is on those of us in this place and in Northern Ireland, where this matter is a devolved one, to ensure that that advice and support are provided.

--- Later in debate ---

[Stella Creasy]

I am pleased that the hon. Gentleman will be back, because it is good to see male MPs supporting the idea that there is a gender gap that needs to be addressed. However, may I venture to say that that is not necessarily a concern because of his wife but because when 51% of the population are not fully utilised it is a concern for us all that we are missing out on the contribution that they could make? Frankly, sorting this issue out would help a lot of men, because it would help our economy, and therefore it perhaps has less to do with his wife and more to do with his constituents. It is because of them that he should be concerned about why we have such a gender gap. In particular, my hon. Friend set out well the particular gender gap that we see in the UK, because the situation is not the same in other countries, which should be very telling about what we can do in this country to address these issues.

A number of Members have already pointed out that there would be many more businesses if women were starting up businesses at the same rate as men. However, it is worth considering the situation in other countries. It is not only America that has a higher level of female entrepreneurship than the UK but countries around the world. Therefore, there is something happening in the UK. It is also worth noting that we have a higher rate of churn in the UK, so even when women start up businesses here they are failing more often than in other countries. Women entrepreneurs here are also less likely than elsewhere to attribute the closure of their business to business failure and more likely to cite personal reasons as one of the reasons why their businesses were not successful.

Why does this issue matter to us all? It is because equalising the labour market participation rates of men and women would boost the UK economy by an average 0.5 percentage points every year, with a potential gain of 10% of GDP by 2030. Given the recession that we have just gone through and given the fact that our recovery appears to be beginning to slow, getting more women into business and into leading more businesses would clearly make a tremendous difference to us all and our future economic position. Indeed, the Royal Bank of Scotland has calculated that boosting female entrepreneurship could deliver an extra £60 billion to the UK economy.

[Seema Malhotra]

As always, the shadow Minister is making an excellent speech. She raised the issue of female participation in the labour force and the important contribution to the economy that could be made by boosting the number of women entrepreneurs. Does she also see this situation as an opportunity for us to see women not only as entrepreneurs but as the employers of the future, who employ others and make changes as their businesses start to grow?

[Stella Creasy]

My hon. Friend has pre-empted one of the points that I was going to make, namely that this issue is not just about women employing themselves. Indeed, all the evidence suggests that on the whole women’s businesses tend to be better at creating jobs than men’s businesses, because women’s businesses are generally more labour-intensive than men’s businesses. Again, I go back to my initial theme that it would do men, and not just women themselves, a big favour if we could get more women into business.

Therefore, it is worth asking ourselves why we are not seeing that kind of progression in the UK, given that we need it within our economy to make it more stable. My hon. Friend set out the admirable record of the previous Government in bringing forward this agenda and I am very proud of the previous Government for making women’s business a priority for all, and not just for women. However, as the hon. Member for Cambridge (Dr Huppert) rightly said, we have all seen that the progress on this issue has been too slow. Since 2008, the percentage of small and medium-sized enterprises run by women in this country has only gone from 14% of the total number of SMEs to 20%, which is a 6 percentage point increase in that time period. That is simply not good enough. As a result, women own only about one business in five in this country. When we compare that with America, where women are twice as likely to be entrepreneurially active as women in the UK, even though the rates of entrepreneurship for men are very similar for both countries, that tells us the problem that we face here.

In that same time—the period since 2008—it is also worth reflecting on just how quickly women’s employment in and of itself has changed. Not only have women been hit disproportionately hard by the Government cuts but in terms of unemployment. Therefore, it is not a surprise that in the boom in self-employment that we have seen in this country in the last five or six years, women have accounted for much of that growth. Women account for under a third of those who are in self-employment in our country, but more than half of the increase in self-employment since 2008 has been among women. In fact, between 2008 and 2011 women accounted for an unprecedented 80% of the new self-employed people within our economy, which means about 300,000 more women going into self-employment since the economic downturn.

What sort of businesses might those new businesses be? I am sorry to see that the Members from Northern Ireland in Westminster Hall have now shrunk down to one—the hon. Member for Strangford (Jim Shannon)—but I hope that it is a case of quality not quantity. The hon. Gentleman himself talked about online shopping and women using their interest in that to drive business. What we have certainly seen is a boom in the internet economy and the opportunity not so much to shop online as to sell online; we have certainly seen that women have been taking advantage of that opportunity. I would wager that that is not so much because of women’s interest in shopping but because of the reduction in barriers to entrepreneurship that online activity creates. The fact that now someone needs only a few hundred pounds to set up a business rather than several thousand pounds, because it is possible to sell online, changes our economy in substantial ways. Indeed, online businesses have accounted for almost a quarter of total UK growth in recent years, and much of that has been driven by new entrants into the market, including women benefiting from the fact that they can combine work around some of their other commitments to get into that online business.

[Seema Malhotra]

The shadow Minister is making an excellent point and I am reminded of the excellent phrase in the book, “A Woman’s Place is in the Boardroom”, by Peninah Thomson, in which she talked about the “customer being queen”, because of the fact that women are responsible for more than 80% of retail purchases, or decisions about them. Does my hon. Friend agree that that highlights even further the need to focus on women and what they can bring to our economy through setting up enterprises? The fact is that when women make decisions about what to purchase for themselves and their families, they understand the market so much more than men, and when they come forward and start businesses they are often filling niches and going on—just as Anita Roddick did with the Body Shop—to be hugely successful.

[Stella Creasy]

Again, my hon. Friend shows her experience in this area. What we are certainly seeing is that women who start businesses tend to bring forward new products, as opposed to men who start businesses, who tend to bring forward competitor products. So women are certainly driving innovation.

My point in referring to the online economy is to set on the record that Labour thinks this issue is less about women bringing their previous experience of purchasing to business so much as their ability to use the opportunity that online behaviour offers to open up markets to people. When someone is bringing a new creative product to the market, having a window that sells to millions of people rather than perhaps having a window just in their local high street opens up the potential for greater success, and it is important that we consider that and ask ourselves how, for example, we can support more women to learn skills, such as coding, to be able to sell online.

A number of Members today have obviously focused on women themselves and what might be stopping them from getting into business. Certainly, one of the issues that people have come up with is child care. So let us be very clear that there probably is an issue around child care and helping women to be able to juggle, which suggests men are holding women back, because, after all, it takes two to have a baby. One thing that I would be interested to hear the Minister’s view on is how we can make men hold up their part of the bargain in looking after children, so that their wives can be the successful entrepreneurs that they want to be.

Labour’s child care proposals will probably help a lot of women entrepreneurs. For example, there is our proposal to increase the number of hours of free child care that are available. With child care costs rising by up to 30%, there could be many parents—for example, the women who want to be the next Anita Roddick or Laura Tenison—who find their ability to be entrepreneurial being hampered as a result of this Government, because they find they cannot afford the child care necessary for them to spend the time setting up a business.

Today, therefore, I will set out four areas that I would like to hear the Government’s response about. They are less to do with women and more to do with the environment that we are asking women entrepreneurs to enter.













First, hon. Members talked about finance. Clearly, finance matters. The evidence shows us that women start businesses undercapitalised, and with not just less finance, but fewer human resources and less social capital. That puts them at a disadvantage by comparison with their male counterparts. Not having the same level of resource is a factor in respect of confidence and risk-aversion among female entrepreneurs. It is important to say that it is not always a bad thing that women are risk-averse, but we should recognise it when they do not have the same resources, and so cannot take the same risks, as their male counterparts. We must consider how to ensure that they have access to more resources, rather than encouraging them to take more risks, and we should recognise that their lack of confidence may not be misplaced and that they might not have the resources to succeed.

How much of a barrier is finance? Some 10% of female entrepreneurs say that access to finance is their only barrier to entrepreneurship, and that it is a particular challenge in respect of expanding in the way they would like to. Again, that appears to be a bigger problem in the UK than in other countries, particularly in Europe. Women in Europe are much more likely to be able to access finance to start and run their businesses than their UK counterparts. Some 20% of women in the UK have tried to get money to start a business but have been turned down, compared with only 11% of European female entrepreneurs.

My hon. Friend talked about the Aspire fund, which was set up in 2008 to try to deal with this challenge and ensure that there was a dedicated pot of money to support women in business. As she said, as of last year only £4.7 million of the £12 million had been invested. It is worth comparing that with other forms of start-up finance backed by the Government to see what the difference is. For example, in the same period, the enterprise finance guarantee scheme, set up to provide assistance to small businesses with an annual turnover of less than £41 million, has offered £2.6 billion, and £2.3 billion has been drawn down. The regional growth fund, which matches private finance with public assistance, has awarded £2.6 billion, of which £1.15 billion has been drawn down. There is a differential. It would be interesting to hear the Minister’s view on why the Aspire fund has not been as successful in promoting and supporting women’s businesses as some other start-up funds.

Research by Strathclyde university states that decisions regarding women and finance are based on the interaction between women, who may lack confidence—perhaps because they recognise that they do not have the same level of resource to start a business—and those offering them finance, who may have a certain attitude and approach. There is an interesting challenge for us: if we can change the attitudes of those offering finance—for example, through the Aspire fund—will more women go into business?

Secondly, we have to acknowledge the issue of confidence. I challenge slightly the vicious circle that the hon. Member for Strangford mentioned: he said that dedicated schemes for women could undermine their confidence. I assure the hon. Gentleman that the other way of looking at that is that it recognises that they are a priority. Dedicated schemes, with mentoring and support for women, recognising that there is a gap, and bringing other women forward are helpful and supportive.

Some 38% of women in the UK, compared with just 3% of women in Europe, take advice from Government business support projects. Women are more likely to use all forms of business support than men, whether public or private, and are more likely to access support from professional services. It is important that mentoring schemes exist. It matters that other women are in business, because you cannot be what you cannot see. It is a simple principle, but seeing other women being successful in business offers a road map for women, showing them how they could be successful.

I pay tribute, as other hon. Members have, to a women’s business forum in my constituency. I venture to say that that forum, run by the amazing Jo Sealy, is more successful than our general business forum.

--- Later in debate ---

[George Freeman]

The hon. Gentleman makes an important point. I was about to talk about the importance of small business in driving innovation if we want an innovation economy. Small businesses tend to be quicker to adopt innovation and to drive it. They are a force for insurgency in the economy. In tourism and crafts, we should not forget that small businesses are important in our theatre, media, digital and tourism sectors. A culture of empowering people and unleashing the talents of women in every walk of life is incredibly important if we are to build a diverse and strong economy and a strong and linked society.

That is why I am absolutely delighted that the UK is a truly great place to start a business. This year we have seen data confirming that 760,000 small businesses have been created in this Parliament since 2010. We are backing business every step of the way, making it easier to start, succeed and grow. We will hear about more such measures in the Budget later today, I have no doubt. I am delighted, too—but not complacent for a minute—that in 2013 there were more women-led businesses in the UK than ever before: 990,000 of our SMEs were run by women or a team that was more than 50% female, an increase of 140,000 since 2010. We know that more needs to be done, and we need to build on that positive momentum. I am also delighted that in the UK, women-led small businesses are contributing £82 billion to the gross value added of the UK economy.

Before the debate, I looked at the latest data, which are even more encouraging. The data from the Office for National Statistics for October to December 2014 show that there were 1.45 million self-employed women in the UK, which is 42,000 more than in the previous quarter and 281,000 more than in May to July 2010. Some 672,000 of those self-employed women were working full time and 778,000 were part time.

I pay tribute to the work of the Women’s Business Council and the important policy work that it has done and intends to follow up. It has rightly, as a number of Members have highlighted, pointed out that if we had women starting businesses at the same rate as men, we would have up to 1 million more entrepreneurs. That is a good reminder of the latent potential that we need to continue to drive at.

One or two Members asked about the Government’s commitment and which Minister is responsible for this. I am delighted to say that a number of Ministers are responsible. The Minister for Business and Enterprise leads on enterprise policy for the Government. The Secretary of State for Education is also the Minister for Women and Equalities. The Under-Secretary of State for Women and Equalities at the Department for Education is also an Under-Secretary of State for Business, Innovation and Skills. They are all working to develop joined-up policies with the Government Equalities Office. We take it seriously as part of our commitment to social justice and to the long-term economic plan.

Research by the Enterprise Research Centre has shown the challenges that confront women entrepreneurs, but in many ways they are similar to those facing men.

[Seema Malhotra]

The Minister has acknowledged the important work that the Government Equalities Office has been doing and the different Departments involved, but he has not been so clear on who is actually in charge of the policy area. Having many people involved is good, but who is in charge? Also, he has not mentioned what plans the Government might have for the Women’s Business Council and whether they think its role needs to be strengthened. Should it be looking at more diverse aspects of business? Should it be put on a statutory footing?

[George Freeman]

With eight days of this Parliament left, perhaps I could undertake to write formally to the hon. Lady to confirm the various initiatives that we have running. I assure her that if this Government are returned on 9 May, we will continue to keep our foot to the pedal and drive on this agenda. She would not expect me to commit now to what that might look like, given the uncertainties that we all face.

A number of colleagues mentioned access to finance, which is rightly regarded as a major obstacle preventing women from starting and growing a successful enterprise. It is worth pointing out that access to finance is an issue for all businesses, but although it is in many ways gender neutral, the truth is that women perceive higher financial barriers and the evidence shows that they are more likely to be discouraged, particularly by some forms of borrowing. Sources of finance for male and female-led businesses are similar, but studies show that women-owned businesses start with lower levels of overall capitalisation, use lower ratios of debt finance and are much less likely to use private equity or venture capital.

Encouraging women to start their own business is a key part of our long-term economic plan, which his why we have put in place a range of Government initiatives to support women. Through the GREAT website, we have brought together in one place all the relevant Government advice, guidance and support, but there is more to do. I am delighted that, this week, we in the Office for Life Sciences have redone our business support portal to make navigation easier for those outside the system. The Department for Business, Innovation and Skills has also launched a range of new measures, including a new web page specifically aimed at potential and existing female entrepreneurs.

The Government’s “Business is GREAT Britain” campaign has been highly effective at making small businesses aware of the range of support on offer to help them to grow. Specifically for women, we have committed additional funding to understand in communications terms the particular challenges that female entrepreneurs face, and we are making sure that existing activity is widely promoted among women. We have managed to match up experienced business women with those new to enterprise and invested £1.9 million in the “Get Mentoring” project—a number of colleagues mentioned mentoring. That project has recruited and trained more than 15,000 volunteer business mentors from the small business community, 42% of whom are women, I am delighted to say; that is more than 6,000 mentors trained specifically to support female entrepreneurs. Owing to the success of that project, the Government recently announced an extra £150,000 to host 12 “Meet a Mentor” roadshows throughout the UK for female entrepreneurs.

[Seema Malhotra]

The Minister mentioned the GREAT Business website, which I referred to, and said that it has been successful in raising awareness among small businesses. Has there been any formal evaluation of how successful it has been?

[George Freeman]

The process of evaluating the BIS portals has been taking place only in the past few months. Perhaps I could come back to the hon. Lady with the latest details of that assessment.