9.30 am

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

I beg to move,

That this House has considered the effect of maternity discrimination.

It is an honour to serve under your chairmanship, Mr Chope. I am very pleased to have secured this debate on an important topic for many women and a key campaigning area for the Labour party: maternity discrimination. I thank all hon. Members who have turned out this morning to contribute to it.

Maternity discrimination is an issue that cannot be ignored. It is only right that action be taken to ensure that this persistent issue in our society is ended once and for all. It is a welcome point of reflection for us all that this debate comes exactly a week after we celebrated International Women’s Day and just over a week before mothers’ day. I felt it was important to secure the debate between those two dates, to press the Government to do more, but also to raise awareness of the many women beyond these walls who are met with blatant and unnecessary discrimination.

Many people—some of whom may even be in this Chamber today, although I hope not—think that maternity discrimination is not a concern that we should focus on, possibly because it does not feature on their radar at all. But it is real, it is happening and it is becoming ever present in our society. Action is needed. That is clearly documented in the Women and Equalities Committee report from last August, which highlighted the fact that pregnant women and mothers are now reporting more discrimination and worse treatment in the workplace than 10 years ago. By some estimates, that discrimination is double what it used to be. According to the Government’s own figures, one in nine women—54,000 in total—are forced out of their jobs each year because of being a mother or becoming pregnant. If that statistic applied to the women elected to this place, it would mean 21 of our fellow female MPs being forced out of this House. If that happened, we would be up in arms and raising merry hell on the Floor of the House. Well, if it is not acceptable for women in this place, it is not acceptable for women in any workplace.

A hundred years ago, women got the vote for the very first time, as part of a campaign to see women become part of public life so that they did not have to abide by the whim of a man and could be fully integrated into society, taking their rightful place as both actors and influencers in how our country should look and act. However, a century on, women still face many hurdles, and all because of their gender.​

I will touch on three key themes in my speech. First, I want to set the scene by expanding on the ramifications, both economic and social, of maternity discrimination in our society. I will then move on to the work of the Equality and Human Rights Commission and the Women and Equalities Committee. Finally, I will look at what the Government are doing—or not doing—to end maternity discrimination.

As I said, this place would be a lot worse off if the statistics on maternity discrimination were replicated in this, the mother of Parliaments. However, maternity discrimination has a far broader impact on our society than some may first expect. The financial costs identified affect not only society, but businesses, the Government and the women themselves. A report last year by the EHRC found:

“The cost to employers of women being forced to leave their job as a result of…discrimination…was estimated to be around £278.8 million over the course of a year.”

Much of that cost was incurred owing to recruitment and training to replace the woman who was forced out of her job, lost productivity from being down a member of staff and statutory maternity payments if the woman was on leave when she left work. For the Government, maternity discrimination means not only lost tax revenue from women not working, but increased benefit payments when they seek support because they have been forced out of work. The cost to the Government is between £14 million and £16.7 million a year.

The financial losses that women themselves face have been estimated to range from between £28.9 million and £34.2 million. Some 20% of women reported significant financial losses as a result of failing to get a promotion, receiving lower pay increases or bonuses than they would have secured were they not pregnant, or even demotion for becoming pregnant. Pregnancy and children are costly—there is no doubt about it—but the costs incurred by women are unjust, unfair and discriminatory. The gift of pregnancy should never be a cost to a women’s potential or her economic worth.

It is not only the economic costs of women being forced out of the workplace or facing discrimination for becoming pregnant that are a problem, but the social and equality issues that arise. Women’s position in society has come on in leaps and bounds from the time when they were not able to vote, could not work once they were married, had to stay at home or had to defer to a man for every major decision made in their life—as late as the 1970s, women had to have a male guarantor for a mortgage. However, the specific issue of maternity discrimination highlights the fact that the position of women in our society is still tentative. There is still a long way to go.

Jessica Morden (Newport East) (Lab)

I congratulate my hon. Friend on securing this important debate and on her excellent speech. Does she agree that such discrimination also happens later on in life? We should recognise that women also face discrimination during the menopause. That point was very well made to me on Saturday by the Wales TUC women’s committee, which is doing a survey on that very subject.

Mrs Hodgson 

I am grateful to my hon. Friend for raising that period in women’s lives. I will not be able to touch on it in my speech, but it is very important. There ​is a real lack of knowledge about what women have to go through during the menopause. I am probably not long off that period myself. People have no idea what women may have to go through, but we hear all the horror stories. A little understanding from employers would make all the difference. I know that I would probably be a better employer after I have gone through it; unfortunately, men do not have that luxury, so they rely upon us to tell them. That is definitely an important aspect of the matter, and I am grateful to my hon. Friend for raising it.

Some may argue otherwise, but for me and many other women—especially on this side of the House, but across the House, too—equality is a cause worth fighting for, because it creates not only a fairer society, but a stronger and more resilient one. Maternity discrimination holds us back from achieving that goal of an equal society. We need renewed vigour to tackle the problem, so that we can fully realise our country’s potential, with everyone having a fair chance in life and not having to face discrimination for being who they are. It was therefore welcome that this time last year the EHRC and the Department for Business, Innovation and Skills published their findings on the prevalence and nature of maternity discrimination in our society, so that we could fully understand the scale of the problem, which was indeed damning. The research showed that, of the women surveyed,

“77%...had a negative or possibly discriminatory experience during pregnancy; maternity leave; and on their return from maternity leave.”

Such experiences included facing harassment or negative comments related to their pregnancy, struggling to secure flexible working from their employer to manage the demands of pregnancy and subsequent childcare, or, for 9% of women, feeling that they had to leave their job because they were being treated poorly or unfairly.

What women are documented as facing because of pregnancy and impending motherhood is worrying and deeply shocking. Even case studies from Maternity Action’s helpline have documented these shameful occurrences. One woman became so stressed with her working environment, where she was being singled out by her manager and treated appallingly, that she was signed off sick with stress before her maternity leave had even begun. As we all know, when someone is pregnant, stress is the last thing she needs. She is told to have a calm and radiant time, which was hardly the case for that mother. It goes without saying that no woman should face such hurdles in life or feel pressured into choosing between having children or having a career that progresses at the same rate as the careers of their male counterparts.

Following the forensic light shone on the issue by the EHRC, the Women and Equalities Committee, under the excellent leadership of the right hon. Member for Basingstoke (Mrs Miller), who I am thrilled to see in the Chamber today—I look forward to her contribution —undertook to investigate maternity discrimination further. In August last year, that inquiry produced some excellent recommendations for the Government to look at and act upon. Sadly, however, it took until January of this year for the Government to respond to the inquiry’s findings.​

Included in the recommendations in the Select Committee’s report were further calls for action around the health and safety of pregnant women in the workplace, such as placing a duty on employers to conduct an individual risk assessment for new and expectant mothers, all the way to identifying issues around casual, agency and zero-hours workers, who do not have the same pregnancy and maternity entitlements as women classed as employees.

Melanie Onn (Great Grimsby) (Lab)

In an economy that increasingly relies on temporary contracts, more and more women are unable to access any kind of statutory maternity leave, because they have no right to it. That is because they are classed as workers rather than employees. Does my hon. Friend agree that much more needs to be done to provide those women with better access to maternity rights?

Mrs Hodgson

I totally agree. On the issue of workers and employees, there is clearly a need to tidy up the law so that women who work in these areas of the labour market are protected and guaranteed the same rights as those women who are classed as employees, so I am very pleased that my hon. Friend has raised that issue. Indeed, Maternity Action has pushed for action on it and recently made a submission to the Matthew Taylor review, which aims to look at working practices in the modern economy, and to the Select Committee on Business, Energy and Industrial Strategy inquiry, “Future World of Work”. I hope that the Minister will be able to shed some light on progress on this issue.

It is safe to say that when the Government eventually responded to the Women and Equalities Committee report, the response was far from pleasing. Although the Government’s commitment to zero tolerance of discrimination against expectant or new mothers in the workplace is to be welcomed, as is the announcement of a consultation on protecting pregnant women against redundancy, sadly the wider response failed to see words leading to action. The Government’s response can easily be seen as a mixture of defending the unacceptable status quo and kicking the issue into the long grass, as if it was something that should be thought about on another day. The Government are failing to realise that this is happening right now.

I am not just making a party political point. The likes of Maternity Action have analysed the Government’s response and reaction to each of the recommendations and have come to the same conclusion: that the Government see this as an issue for another day. I have a lot of time and respect for the Minister who is responding to this debate—she knows that—but I find the Government’s response disappointing to say the least. That is why I hope she can offer me some reassurances when she responds to this debate.

I would like the Minister to consider two things ahead of her response. First, when will we see the details of the consultation on protecting pregnant women from redundancy? Two months on from the Government’s commitment to consult on this issue, we are yet to see publication of the scale or time frame. I hope that information will be forthcoming following this debate, and sooner rather than later. Even better, the Minister could announce further details in her speech today.​

My second ask is that the Government take another look at the excellent recommendations in the Select Committee’s report and heed the words of the right hon. Member for Basingstoke, who said that the Government’s response was

“a missed opportunity for the Government to demonstrate the urgency and bite on this issue that we found lacking”.

I could not have put it better myself. Therefore, I hope that the Minister will commit to re-evaluating the Government’s response to the Select Committee report and their own wider actions when it comes to maternity discrimination.

To conclude, we have come a long way in the march for women’s equality. I know that this point will not be lost on the Minister, but it bears reiterating: as the current standard bearers, we in this House have a duty to uphold the work done by the women who came before us. Failing to end maternity discrimination would betray our crusading predecessors, who campaigned to improve the position of women in society. As women here today, we have the power to make the changes possible for women who face discrimination in the workplace for being pregnant or being a new mother. However, we must also stand up for the women who will come after those facing these challenges now, and ensure that in the future no woman faces discrimination in the workplace for doing what is only natural—having a child.

I hope that the Minister will heed this call to arms and take it back to her officials, knowing that we in this House and many more women beyond this Chamber are willing her on to make the changes needed and improve the standing of women in the workplace. She alone has the power to do that. I hope she realises that and does not squander this incredible position she has to enact change.

5.32 pm

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

I want to focus on the need to boost skills and jobs in our country, especially in manufacturing, following last week’s Budget. That is especially pertinent as we begin the process of leaving the EU.

It is unsurprising that, in a constituency-wide Brexit listening exercise I conducted, Nissan, which is based in my constituency, dominated, especially in terms of trade, investment, jobs and skills. Last week’s Budget was the perfect opportunity for the Chancellor to lay the foundations for strong economic growth that is resilient to any storms we may weather during the EU negotiations, but, sadly, we were left wanting. The announcements we did get on skills did not go far enough, and they must be placed in the context of the Government’s wider approach to education and skills.

Since 2010, we have seen the further education budget cut by 14% in real terms. That is a cash reduction from £3.18 billion in 2010-11 to £2.94 billion in 2015-16. That is compounded by the fact that the non-apprenticeship adult skills budget has been depleted by 54%. However, that negligent approach by the Government has not scuppered the innovative work by great employers in my constituency. Only last Friday, I was honoured to open Unipres’s new training academy, which will help to boost the skills of our local workforce by offering much-needed apprenticeship opportunities in engineering and manufacturing. It goes without saying that manufacturing is symbiotic with the north-east. We are the country’s makers and builders—I am pleased that Stoke colleagues are not here to shout me down—due in part to the innate talents of the people in our region and the skills we inherently have within us to manufacture with high quality and high productivity.

I like to call my constituency the manufacturing hub of our region, perhaps the country, with the likes of Nissan, BAE Systems, Rolls-Royce, Unipres, Rayovac and Gestamp, to name but a few, all based there. The manufacturing presence in our region will only be strengthened with the creation of the IAMP—International Advanced Manufacturing Park—which will be based not only in my constituency but that of my neighbour, ​my hon. Friend the Member for Jarrow (Mr Hepburn). However, the success of the IAMP and manufacturers in my constituency—from the large, some of which I have mentioned, right down to small and medium-sized enterprises such as AdFab Ltd, Washington Components, and PFF Packaging—depend on the Government strengthening their approach to skills and jobs. This is especially important with Brexit on the horizon.

There is one way in which Ministers could easily help to bolster our manufacturing, not only in the north-east, but across the country—through catapults. I am not talking about the ancient war machines but instead “a network of world-leading centres designed to transform the UK’s capability for innovation in specific areas and help drive future economic growth.”

A number of catapults have been started across the country, yet there seem to be none for materials. This means there is no support for the innovation and development of materials such as steel, ceramics, glass and plastics, all of which are crucial to the dominant industry in Sunderland—the automotive sector. If we were to see a catapult for materials like the industry-supported proposal by the Materials Processing Institute in Redcar that received cross-party endorsement in January from the all-party parliamentary group on steel, this could have a positive impact on the whole of the manufacturing industry. However, it would especially help the Nissan supply chain, which Nissan has said needs re-powering.

Anna Turley

I appreciate my hon. Friend mentioning the fantastic institute in my constituency. Does she share my concern at a story on WalesOnline last week saying that Swansea is predicted to receive £80 million for a steel science centre that would almost directly duplicate the work that is happening at the MPI in Redcar and could then impact on the Nissan supply chain that she mentions?

Mrs Hodgson

I do not want to take anything away from Wales, especially with colleagues from Wales in the Chamber, but duplication does not make any sense, especially when there is so little funding around, and we definitely do not want to take any support away from Nissan. I am pleased that my hon. Friend made that point.

Currently, only a minority of parts used to build a Nissan car are made here in the UK, through a 38,000-strong supply chain workforce across the UK, with 27,000 of those jobs based in the north-east.

Graham Evans

What an exciting constituency the hon. Lady represents! My understanding is that one of the reasons Nissan decided to stay in her constituency is the cluster of battery technology companies. Is that true?

Mrs Hodgson

Yes—I am pleased that the hon. Gentleman makes that point. Electric battery technology is going from strength to strength. I was very pleased to see that there was an announcement on electric vehicles and battery technology in the Budget.

However, we see a predicament looming on the horizon as we begin to leave the EU—WTO tariffs. Ministers have given countless reassurances that we will strike a deal with the EU that does not mean we have to fall back on the 10% WTO tariffs. Yet only this weekend ​this was blown out of the water when a leaked document showed the Prime Minister’s willingness to fall back on those terms, regardless of the economic impact they may have. That was then reiterated by the Foreign Secretary on TV, also over the weekend. This would be catastrophic not only for the country but for my constituency and the businesses there. In the case of Nissan, falling back on to WTO tariffs and crashing out of the customs union would cause significant delays on products coming into the country that they rely on.

Another issue is that overseas parts currently used to build Nissan cars would have to be reduced significantly to meet the WTO rules of origin. The Society of Motor Manufacturers and Traders has said that cars need to have 50% local content to meet the rules of origin and be classed as British-made, and that could prove a major problem for Nissan. This is where the materials catapult comes into play. Not only would it reinvigorate the supply chain with innovation, especially in skills and jobs, but it could act as a way to mitigate the issues arising from the potential impact of WTO tariffs on manufacturing. I cannot make this point strongly enough the House: this catapult could also mean potential jobs growth. If we take the case of reducing overseas content in Nissan cars, it could significantly boost the UK supply chain and create tens of thousands of new UK jobs, which could seriously transform the manufacturing sector in the UK. Catapults could help in part to achieve the resilience I have talked about, and I hope the Government will listen and look again at the potential of a materials catapult.

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

9.59 am

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

I am very happy to serve under your chairmanship, Ms Dorries. I want to make a small contribution to this very important debate, because I passionately believe that nursery schools are a vital contributor to social mobility in this country. There is ample evidence to show that maintained nursery schools that offer high-quality early education can have profound impacts on the start of children’s lives. That is why it is not surprising that nursery schools have been described as the “jewel in the crown” of the education system. However, the current Government are allowing the crown to be tarnished by going down a route that will place all nursery schools under threat. That is especially true for children in some of the most deprived communities in the country.​

As was said at the last meeting of the all-party parliamentary group on nursery schools and nursery classes, which my hon. Friend the Member for Manchester Central (Lucy Powell) so excellently chairs, it was estimated in 2011 that 80% of three-year-olds from the most deprived areas attended a setting with a qualified early years professional compared with just 50% in more affluent areas. That was surely a good thing.

In my own constituency, Washington and Sunderland West, there are four maintained nurseries: Hylton Red House, Usworth Colliery, Oxclose and Pennywell Early Years Centre. I understand that I am lucky because there are four good maintained nursery schools in my constituency, but that also shows the demographics of my constituency. It must be pointed out that Sunderland has one of the highest numbers of these nurseries within our local authority area—a total of nine.

The Government have partially redeemed themselves with transitional arrangements. That is welcome, as it will help to mitigate any problems that nursery schools face due to the cuts in their funding. However, it must be said that funding will still be reduced and the transitional subsidy may not continue—the Minister may tell us otherwise this morning—after the two years are up.

In Sunderland, the baseline funding rate for three and four-year-olds for 2016-17 stood at £5.38 per hour, but through the early years national funding formula that will decrease to £5.11 per hour. That might not sound like much of a decrease, but it is per hour and it is the difference between survival and closure. As the Social Mobility Commission has stated:

“It would be a travesty if funding reforms mean that over time we lose more of the remaining high-quality, maintained nursery schools.”

I could not agree with that more, and I hope that the Minister agrees with it, too.

The concerns expressed have been echoed by staff and parents at my local nursery schools—they have all been in touch with me. Claire Nicholson, the local headteacher of Pennywell Early Years Centre, has told me that

“such a big percentage is going to be lost, that it won’t allow us to be viable”.

Also, nearly 100 parents at Pennywell Early Years Centre, in a letter they sent to me, have described their disbelief and dismay at the policy and the direction in which the Government are taking early years education.

These schools are a proven and vital part of our country’s strategy for improving social mobility, which is something we desperately need to be doing more of, not less. It is important that the Government do all they can to give children the best start in life. That is why many of us in this House, and specifically in this Chamber today, got into politics, and we will hold Ministers to account every step of the way on this matter. I urge the Minister not to squander the life chances of any of the children in this country, especially those in the most deprived communities. Our young constituents do not deserve this, and I hope that the Minister will reconsider for their sake.

3.17 pm

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

I thank my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) for securing this debate, following the very sad news that her friend Samantha Heath, who had been receiving this life-extending treatment, had heard from NICE that it was being taken away from her. I am pleased that she was able to secure this important debate through the Backbench Business Committee.

I also thank all colleagues who have attended the debate and made excellent speeches, sharing with us their experiences and thoughts, including the hon. Members for Milton Keynes South (Iain Stewart), for Portsmouth South (Mrs Drummond), for Louth and Horncastle (Victoria Atkins) and for Wycombe (Mr Baker), my hon. Friends the Members for Torfaen (Nick Thomas-Symonds) and for Wythenshawe and Sale East (Mike Kane) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who spoke for the SNP. I am sure that the Minister has been given lots to think about, and I look forward to her response shortly. I also thank Breast Cancer Now for its work campaigning on this matter, along with Breast Cancer Care for its continued dedication and its support and advocacy for individuals with secondary breast cancer.

In my contribution, I will first briefly establish the documented and perceived benefits of Kadcyla, and then, building on that, discuss the broader issues around the provision of off-patent drugs, before moving on to present the problems with determining the funding of a drug based principally on its cost-effectiveness as judged by NICE.

Kadcyla’s continued funding through the cancer drugs fund in 2015 was a great success for patients and patient advocates. At the time, the value of the drug was recognised and the concession was made that, despite its high cost, its positive impact was worth the funding it needed. Yet just over a year later, the alterations to the cancer drugs fund have prevented the future funding of this drug, along with, potentially, that of a number of other secondary breast cancer drugs such as palbociclib and Perjeta—I hope that I pronounced those correctly—as it moves towards becoming a funding mechanism for under-researched but innovative drugs with cost and value as a principal driver, and away from its original principle, which was to finance drugs that were too expensive to be recommended by NICE but proved effective in treating cancer patients.

We can all agree that patients have benefited significantly since the introduction of the cancer drugs fund, but the progress that has been made in recent years in improving access to cancer drugs is now at risk. That is unsurprising, given the cash-strapped state of the national health ​service—we have discussed that in the House recently in the past few weeks—which faces pressures to provide these costly drugs that are developed by large pharmaceutical companies, and is forced to consider costs rather than clinical need. I hope that the Minister will tell us whether those concerns have been assessed, and how she plans to address them. We have heard a number of good suggestions today about how funding may be redirected.

Mary Glindon (North Tyneside) (Lab)

Is not the situation made all the more poignant by the fact that since 2001, the incidence of breast cancer has been rising by 9% every year?

Mrs Hodgson

That is a very good point. It may be that more and more people are coming forward and being diagnosed, but, as my hon. Friend says, this will clearly become more of an issue, not less of an issue, in the years to come.

As we have heard today, it is estimated that Kadcyla benefits 1,200 women every year in England alone, and that on average it can increase the length of a woman’s life by six months, although reports suggest that in the case of some women that can stretch into years. Even if it is measured in months, however, the extra time is surely priceless to the women and families involved. I speak from personal experience, as I lost my mother-in-law to secondary breast cancer 20 years ago this year, when my children were very small. I know that she fought for every extra week and day in the end, and that she would have given anything for an extra six months to spend with her grandchildren. We all wanted that little bit longer for her. For all those 1,200 women, that extra time is time with their families. It means seeing their children reach perhaps one more milestone, starting school or university, getting married, or even giving them a grandchild. What is the cost of such moments, such memories, which are so precious and which help families so much with what, ultimately and inevitably, will follow?

Iain Stewart

The hon. Lady has made a powerful point. In the case of the most aggressive cancers, the period between diagnosis and death can be very short. As the hon. Lady says, any extension of life enabling women to celebrate family events, or anything else, is incredibly important, and we should not lose sight of that.

Mrs Hodgson

I agree. What price can be put on those precious months?

Thangam Debbonaire (Bristol West) (Lab)

I have some investment in this. My own experience of breast cancer treatment over the last two years has left me passionate about the issue of prevention and early diagnosis. Will my hon. Friend join me in not just thanking the breast cancer charities—as she has already done—but calling on all Members to spread the word among all the women they know that they must learn how to examine their breasts? I learnt how to do it from a comic sketch in a television programme: that is how I diagnosed my lump. I want everyone to learn how to do it, and also to learn what they can do to help prevent breast cancer, because, although there is no magic prevention method, there are ways of reducing the risk.

Mrs Hodgson

Although we have not so far touched on prevention or early diagnosis, they are vital issues. We have discussed them in the House on many occasions, but they can never be discussed too often, and I am grateful to my hon. Friend for raising them. Let me add that I am happy every day to see her back in this place, and doing so well.

What also stands out with Kadcyla is the reduced side effects, as we have heard, as opposed to alternative breast cancer treatments, the side effects of which can include the inducement of osteoporosis and an increased risk of blood clots. As some colleagues will, sadly, know first-hand or through experiences of family and friends or constituents, the side effects of some cancer treatments can be truly awful, and in some cases are daunting enough to prevent the acceptance of further treatment entirely. It is a common perception that women make the decision to end their treatment much earlier than planned, despite it prolonging their life sometimes. That is because they feel the suffering they are enduring as a result of the treatment is not worth the additional life it is providing to them, because it is all about the quality of that life.

Research conducted by Genentech in the United States on the side effects of Kadcyla found that less than 5% of women taking the treatment suffered any hair loss. Through my work as co-chair of the all-party group on breast cancer, I know that hair loss can be a highly traumatic experience for women undergoing cancer treatment and is one of the most discussed side effects of cancer treatment in general. Given that in this debate we are discussing the treatment of secondary breast cancer, which is ultimately a terminal disease, the best outcome we can offer through treatment is both the extension of life and the preservation of the quality of life enjoyed pre-diagnosis. Therefore, because Kadcyla causes fewer side effects, it represents a treatment that can effectively achieve not only an extension of life, but the preservation of some of that quality of life enjoyed by these women pre-diagnosis. So I look forward to hearing from the Minister about what she is doing to ensure women will benefit from this vital treatment in the future.

I will now move on to how we can better support off-patent drugs, especially for breast cancer. Drug patents typically last for 20 years—although sometimes only 10 years—and at the end of that patent there is very little incentive for the drugs to be licensed for use in another indication. These drugs are still clinically effective in many cases and can be a low-cost effective treatment, but currently the NHS has no method for making them routinely available.

Bisphosphonates are one such example of an off-patent drug that is not being made universally available to patients, despite evidence showing its effectiveness. It is estimated that, if given to the entire eligible population, this drug could prevent one in 10 breast cancer deaths. It is therefore concerning that research conducted by the UK Breast Cancer Group found that only 24% of breast cancer clinicians were offering bisphosphonates to patients. Solving this issue therefore provides an opportunity to improve breast cancer survival rates, and it is something that I hope the Minister will consider carefully.

I want to finish by discussing the cost-effectiveness of drugs. Currently NICE measures cost-effectiveness using quality-adjusted life years—QALY—and one QALY is ​equal to one year of life in perfect health. As I am sure colleagues will agree, it is almost impossible to objectively measure someone’s quality of life, and there are questions surrounding the morality of attempting to do so, as raised in NICE’s “Social value judgements” paper on the moral evaluation of drugs.

As is so often the case in these debates, a clear cause of the problem lies with how NICE approves drugs. At the last general election, Labour proposed a top-to-bottom reform of NICE, ensuring that drug acceptance and funding is determined solely by clinical need, not with cost or value considerations. This debate shows there is clearly a need to re-address these issues.

As I have already mentioned, Kadcyla patients tend to experience considerably fewer side effects, and this can potentially have a positive impact on their ability to enjoy a higher quality of life post-diagnosis. Because of practicality and cost implications, it is almost impossible for NICE to comprehensively and effectively measure this exact quality of life. However, what we can say, without a doubt, is that these individuals would suffer a lower quality of life without Kadcyla, and this, I believe, deserves more attention and value in the process of drug approval and funding.

The current funding of drugs is becoming based on the cost-effectiveness of a drug, rather than the clinical need, yet, as this debate has shown, it should not be the final deciding factor as it disregards very personal reasons for many people who rely upon drug treatments. Kadcyla has benefited many women during their time living with a terminal disease, and has now been pulled, devastatingly, out of their reach.

It is the Minister who has the levers of power to address the problems in the system which is letting these women down. Members from across this Chamber have eloquently made their case to the Minister. I hope she has listened—I am sure she has—and will give these women and their families some reassurances today.

10.36 am

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

It is an honour to serve under your chairmanship, Sir Alan. I thank my hon. Friend the Member for Dudley North (Ian Austin) for securing this important debate. I note that as he said, it is just over a year since he first brought to the House a debate on cystic fibrosis.

I appreciate all hon. Members who have attended and spoken in this debate to show their support for the cause; it is one that we must urgently get right. Members have shared many moving cases involving their constituents whose lives Orkambi could save and would certainly transform. My hon. Friend the Member for Dudley North mentioned Carly Jeavons and Sam and Rob, the parents of Daisy. The hon. Member for Strangford (Jim Shannon) spoke about Evie-May, and my hon. Friend the Member for Bristol East (Kerry McCarthy) mentioned her niece Maisie. My right hon. Friend the Member for Leigh (Andy Burnham) spoke about his office manager Karen Aspinall and her son, as well as Philip and his sister Melissa, who sadly died. Philip believes that Orkambi would have helped his sister and would certainly help him, as he also suffers from cystic fibrosis. Those people believe that their lives would be transformed by Orkambi. I believe that too, and the evidence supports it, as we have heard in detail.

I thank all hon. Members who have spoken in this debate, including the hon. Member for St Ives (Derek Thomas), the hon. Member for Bath (Ben Howlett) and ​my hon. Friend the Member for Cambridge (Daniel Zeichner), for their excellent contributions, as well as the many others who have made valuable interventions. I also thank the Cystic Fibrosis Trust for its dedicated campaigning on the issue, and the 20,000 people who have been involved in its survey, in the digital debate here in Parliament, and in petitions and e-action. The concerns and the need for action are clear, and it is up to the Minister to give all those people beyond this place the answers that they need.

In my contribution, I will set out why the Opposition want to see the Government do more on innovative drugs, through case studies involving Orkambi. I will touch on issues of access to Orkambi and other drugs for those living with cystic fibrosis and expand into the recommendations of the accelerated access review, which can do much to address many of the issues involving access to new drugs.

Although it is welcome that the prescription drug Kalydeco was given the go-ahead by NHS England last week for two to five-year-olds as part of re-prioritisation, Orkambi remains an issue. There is currently a deadlock in negotiations between the pharmaceutical company Vertex, the Government and NHS England for the drug to be accessible to the 2,700 people who stand to benefit from it. As we have heard in detail today, that is all down to rejection of the drug under NICE’s appraisal system because there is a lack of long-term data. Although it is welcome that NICE recognises the treatment as effective in managing cystic fibrosis, it is clear that we desperately need a new system under which drugs can be better accessed, especially those that show that they can benefit patients. We have also heard about new data that NICE did not take into account and that would have showed 42% effectiveness.

Orkambi has been shown to halve the amount of hospitalisation of cystic fibrosis sufferers, and 96-week data published recently showed that it can help to slow lung function decline by 42%. The data are also backed up by anecdotal evidence from people who have accessed Orkambi through the compassionate use programme and are beginning to report transformations in their health—some are reporting enough improvement to come off the lung transplant list. That information is all positive. It should be made better available for consideration as part of the appraisal process; it should also form part of the negotiations between Vertex, the Government and NHS England. However, when we see a deadlock, all of that information is for naught. Thousands of people are suffering irreversible lung damage that could be stopped if the current impasse between those around the negotiating table was broken. Those who will suffer the most are stuck in the middle.

It is up to the Government to facilitate the end of the deadlock so that people can access Orkambi and see their lives transformed. One way to do that is to begin the job of implementing the recommendations set out in the accelerated access review, which the Opposition welcome. The goal of speeding up access to drugs by cutting four years off the time needed to bring new medicines to patients is something that we should all welcome; we need to see whether it can be achieved. The review has the potential to change the philosophy of the NHS in line with the five-year forward view, but also to help to maintain our global lead in life sciences. The recommendations set out in its final report have the ​potential to transform how we provide drugs and treatments, ensuring that we see innovation in drugs, diagnostic tools and healthcare developments. However, there still remain issues around thresholds for new drugs, which NICE and NHS England are currently consulting on. I understand that some associations and charities have raised concerns about that, and I hope that the Minister will update us on some of those discussions.

Mark Durkan (Foyle) (SDLP)

My hon. Friend is right to be so positive about many aspects of the accelerated access review. However, as she has mentioned, there are concerns that new definitional ruts could be created by some of the terms of the review, which could lead to some patients and some promising drugs being trapped in exactly the sort of deadlock that she has described.

Mrs Hodgson

My hon. Friend is right to raise those concerns. We do not want to move into a new system that will create new unintended consequences. Perhaps the Minister will touch on that in his speech.

Although some are calling for interim solutions to help people who are stuck waiting for the accelerated access review’s recommendations to be implemented, it is also important that the Government get on with implementing those changes. The review was announced more than a year ago and was published two months ago now. It is important to remember that the transformation that we all want to see will not happen straight away, but it is still right that we keep up the pressure for the recommendations to be implemented. There are many such recommendations, and I hope that the Minister will be able to update us today on the progress on each of them. There are two in particular that illustrate what can be done to resolve the deadlock around Orkambi—the immediate establishment of an accelerated access partnership and the setting up of a new flexible strategic commercial unit.

The accelerated access partnership is one way in which, through co-ordination and collaboration across the system, we could see drugs brought on to the market more quickly to benefit patients who need access to them. I would be interested to hear from the Minister what progress has been made on its creation, especially in conjunction with the issues surrounding the deadlock on Orkambi.

It is clear that the strategic commercial unit could help to benefit those who wish to see Orkambi offered on the NHS. The unit could work with those involved in this dispute to end the current deadlock through facilitation of the flexibility and transformational change promised by the accelerated access review. That would go some way towards helping to access data on drugs such as Orkambi and getting them out to patients. There is a willingness out there for that flexibility to be brought into the system; for example, the Cystic Fibrosis Trust has offered to use the UK cystic fibrosis registry to help to provide essential data that can help to prove how effective drugs can be and what more needs to be done. We have already heard how substantial that registry is; it includes 99% of sufferers. I understand that the trust’s offer has been welcomed by all sides in the negotiations but is blocked due to the lack of progress in implementing the changes set out in the review. I hope that the Minister will give us some clarity on when the unit will ​be created and when we can see a culture shift within the system that will allow for flexibility to accept data and information that show how much effect these drugs have on people’s lives.

Dr Philippa Whitford

Does the hon. Lady share my concern about drugs for other conditions, such as sofosbuvir for hepatitis C? Even after they get NICE approval, those more expensive drugs are now being rationed at the NHS England stage. At the moment we are fighting to get through NICE, but it needs to be a smooth path all the way through.

Mrs Hodgson

The cost of drugs sometimes leads the NHS into the terrible and unfortunate situation in which rationing seems to become the norm. There can also be a postcode lottery, which is another element that we need to look at. The price of drugs really is the crux of the issue.

In conclusion, I hope that the Minister will offer some insight into the progress being made on the recommendations of the accelerated access review. The case of Orkambi can help to drive through these changes and to end this deadlock, which, as we have heard, is causing unnecessary suffering for those living with cystic fibrosis. The review has established a space for change and for patients to access new and innovative drugs and treatments. It is important that there is no stalling or delay in transforming the system, because people’s lives depend on the changes called for by the review. I am sure that the Minister will keep that in mind when he goes back to his officials.

 4.32 pm

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

The order does not change anything that is already on the statute book; it just updates enforcement provisions, following the passing of the Consumer Rights Act 2015. We therefore welcome it and will not divide on it.

Enforcing the regulations and legislation relating to the sale, packaging and marketing of tobacco is incredibly important, especially as we are continuing down the road to becoming a smoke-free society. Currently, one in five adults smokes, and although the number has halved since 1974 we still have a long way to go before we can cheer and pat ourselves on the back for achieving that vision of a healthier society.

Over the years, important work has been done to reduce the prevalence of smoking in our society, including the ban on smoking in public places introduced by the previous Labour Government and some important measures introduced under the coalition Government, such as the standardised packaging of tobacco products, which the hon. Member for Battersea (Jane Ellison) spearheaded so valiantly. I know it is peculiar for a shadow Minister to be bipartisan, but the hon. Lady deserves credit for her work on this matter, especially on the previous tobacco control plan.

That brings me nicely to my last point. I cannot miss the opportunity to remind the Minister that we remain concerned that our work to reduce tobacco consumption in our society could stall if the new tobacco control plan is not introduced sooner, rather than later. I want to use this opportunity to ensure that it is at the forefront of the Minister’s mind—I am sure it is—and that she does not forget it over the Christmas break.