Danny Beales MP: speeches

Speeches

• 15 Sept 2026 · Student Loans · Hansard source

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  I thank the Committee for its work and for the report. I completely agree with the Chair’s presentation of the level of mistrust among graduates and learners when it comes to the broken system. Does she agree with me that this is not simply a communications issue? It is not about telling people more clearly how bad a deal they have. Fundamentally, this is a broken system—a bad deal that is having massive intergenerational impacts. Does she agree that we need a full and thorough review of the student finance and loans system?

• 7 Sept 2026 · Health Bill · Hansard source

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  My hon. Friend might have read my speech, because I was about to turn to her amendment’s proposal of a report on integrating health and social care. It is an interesting idea that has a great deal of merit, and I hope that the Minister, in her response, will outline the Government’s approach to enabling more progress on integrating health and social care, particularly with the ongoing Casey review. Inequalities have already been mentioned in the debate. Obviously, one of the Government’s key ambitions is growth in every postcode; another is good health in every postcode. Time and again we see disproportionality and inequalities that are seemingly hardwired into our health system. To change that, we are going to have to do something differently, and I welcome new clauses 90 and 91, tabled by my hon. Friend the Member for Stoke-on-Trent South (Dr Gardner) which would definitely reinforce the Government’s 10-year plan commitment to halve the gap in healthy life expectancy between the richest regions and the poorest, and to raise the healthiest generation of children ever. Unfortunately, we have moved away from those goals over the past 10 years, and we will have to do something differently if we are to bridge that gap. In my own constituency, from north to south, there is a huge divide in the quality of health and outcomes based on postcode. That must change. Although the Government are not minded to accept those amendments, I know that the Minister is passionate about inequalities and that the Bill requires neighbourhood health plans to be developed. That will be an important new measure when responding to neighbourhood health needs, and in preparing those plans, “the responsible local authority and…partner integrated care boards must have regard to any guidance issued by the Secretary of State.” I hope that the Minister will explore using this guidance to ensure that as they are developed, neighbourhood health plans specifically address inequalities between neighbourhoods. Finally, I turn to the SEND system, which is another major challenge with which the Government are rightly grappling. I thank my hon. Friend the Member for Thurrock (Jen Craft), a fellow member of the Health and Social Care Committee, for new clause 85, which would address the chasm between the education system and the health system. While this is fundamentally a health Bill, it is right to ask what more the health system could and should be doing. As the Chair of the Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), has rightly said already, the “H” is far from present in EHCPs. Decision makers are not required to come round the table, and the specialists are not provided. I have been to specialist schools in my constituency where there is no nursing provision, so people miss school days, and where there is no specialist transport, so people cannot even get to school, because bus drivers do not have the proper health knowledge. We need to have an education and health response. I therefore hope that the Minister will address in her closing remarks how, if this Bill is not the right mechanism, future SEND reforms may pick this issue up and how the Department of Health and Social Care will contribute. There is a great deal to support in this Bill. It is a major step forward, particularly for digital healthcare, giving people control of their records and joined-up care. I hope that the Government will continue to drive forward reform of our health system.

• 7 Sept 2026 · VAT on Medication: Compassionate Access Schemes · Hansard source

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  I agree that we do need to find a permanent and comprehensive solution. Hopefully we can air those issues fully today. Fundamentally, the principle underlying this issue is very straightforward: if a pharmaceutical company is willing to provide a lifesaving medicine to a patient free of charge because that patient has a serious or life-threatening condition and has exhausted the available standard treatment options, the tax system should not make access to those lifesaving drugs more difficult. That reflects the points raised by the hon. Member and my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge). Pharmaceutical companies already operate these schemes at a loss. For example, over the last four years, AstraZeneca alone has given more than 2,500 patients access to innovative, lifesaving medicines free of charge, costing millions of pounds. This is clearly not a commercial transaction. It is a moral, compassionately motivated decision and programme, and in my view that means it should be supported, championed and facilitated by Government, not blocked, disincentivised, or made administratively more burdensome—but unfortunately that is exactly what has been happening since HMRC started charging VAT on those donations. This is not just a line on a tax return, impacting on the bottom line; the impact is also having real-world consequences on patient groups. The consequences of this delay are gut-wrenching and deeply frustrating for clinicians, patients and their families. Every day, every week and every month that we wait for a permanent solution to move forward, more severely ill patients are denied access to drugs that could save or extend their lives, at no cost to the NHS. It is also important to note that patients with rarer cancers are disproportionately affected by this issue, as they generally have fewer treatment options. In August, I was contacted by Emma and her husband Ian. Ian and Emma are currently watching this debate online from Ian’s hospital room at University College hospital, as they could not be here in person. Ian has an advanced, rare and aggressive bile duct cancer. Following his latest chemotherapy, his consultant Professor Bridgewater recommended regorafenib as Ian’s next treatment. Regorafenib was previously supplied free of charge by Bayer through a compassionate use programme. However, since Bayer became liable for VAT on the medicines it was donating, it withdrew from the programme, meaning that Ian lost free access to this potentially life-extending treatment. Ian and Emma are now urgently trying to find the money to pay privately for Ian’s treatment, and the cost is thousands of pounds per month. It goes without saying that many families cannot afford to pay thousands of pounds, each and every month, for treatment. Working with Sarcoma UK, I have also heard from Dr Robin Young, a consultant medical oncologist at Weston Park cancer centre. He reported that a 62-year-old patient with metastatic leiomyosarcoma, whose disease had progressed through all the standard chemotherapy options, was also denied this drug in January 2026 because of Bayer’s withdrawal. That patient subsequently self-funded an alternative treatment at a cost of £3,500 for one month, before deciding that he could not afford to continue with that treatment. These are heartbreaking decisions for patients and their families. I have also heard from Dr Alex Lee, a consultant medical oncologist at the Christie NHS foundation trust, who has reported that two patients with advanced osteosarcoma were refused access to the drug earlier this year, with Bayer citing the VAT position. Tragically, one of those patients has since died. She was just 20 years old. I hope these stories make clear the urgency of resolving this issue as soon as possible. This would not only enable Bayer to re-engage, but ensure that existing participants could continue to access their drugs through the programme and enable potential new drugs to enter early access and compassionate access schemes in the future. On paper, this might be a niche and complex part of tax policy, but in real life it is a desperately ill patient, it is a family and it is a clinician having to explain why a medicine that had previously been made available can no longer be provided. I shall turn now to the position of the pharmaceutical industry. Patients, clinicians and the Minister will be pleased to hear that the pharma companies are keen and willing to re-engage with compassionate, early access and other similar schemes once a suitable solution has been finalised with Government. However, I have heard concerns from the industry about the pace and scope of negotiations since the Government announced the pause. The first issue is about the breadth of the definition of the products that will be exempted from VAT liabilities. The definition used to determine any VAT exemption should include the full range of schemes that pharma companies engage in to provide these medicines free of charge. These include: compassionate use, where a clinician requests a specific medicine as a last resort once other options are exhausted, usually off-licence; early use, for new patients immediately after a trial; post-trial provision, for patients who responded well during a trial and need to continue; and bridging prescriptions, for patients where a drug has been approved but is not yet funded on the NHS. However, I have been told that the definition initially suggested by HMRC during negotiations has been too narrow to cover all those uses. I encourage the Minister to look again at this, given that compassionate use of off-licence drugs accounts for a substantial proportion of the patients who benefit from donations to the programme. I understand that the Government may be now moving to a better position on this point, and I would welcome confirmation of that from the Minister. The second issue I have heard is that HMRC is considering attaching two conditions to any VAT exemption: first, that the patient must be treated on the NHS rather than by a private clinician; and secondly, that medicines must be supplied directly by the company to the NHS. I am sceptical of the merits of both those points. First, patients should not potentially lose access to a lifesaving free treatment, which is at the cost of industry, just because the clinician recommending the treatment is a private doctor. On the second point, I would be grateful if the Minister would explain how such an arrangement would work on a practical level. We know that the NHS can refer to private clinics and that clinicians can, particularly for specialist issues, work regularly between NHS practices and private clinics. The fundamental question must surely be whether the medicine is clinically needed and whether it is free at the point of use for the patient. The third issue raised by pharma pertains to the question of historical liabilities. My understanding is that many pharma companies have already paid VAT for historical liabilities, and it is important to say that we do not expect that they will be able to recover that in full. However, given the upcoming changes, it would be helpful if the Government provided some clarity on the legal position on historical liabilities before the pause. I urge that settlements should be negotiated constructively and with understanding based on the nature of these liabilities. Closely related to the issue of historical liabilities is that of co-ordination between Departments on this issue. AstraZeneca has told me that, despite ongoing negotiations with HMRC and the pause announced in July, it is currently being pursued by His Majesty’s Treasury for accounts by the end of September, which it has been indicated should include VAT liability on compassionate access—a position AstraZeneca is not confident is consistent with what it is hearing from HMRC. Business needs certainty to prepare accounts. I encourage the Minister to ensure that HMRC and the Treasury are working from the same hymn sheet. On the method and pace of resolution, my understanding is that the Government are looking at creating an exemption for the compassionate donation of medicines through a legislative change to the Value Added Tax Act 1994. However, have the Government considered issuing a business brief from HMRC to clarify the new position, given that this could be a faster and more effective route? I would be grateful for the Minister’s perspective on that. As well as the patient benefits, there is also a key strategic opportunity for us as a country to be a global industry leader in life sciences research. Many other countries have complex schemes in place, and sometimes charge VAT or the equivalent on such things. However, I understand that although liabilities technically exist in the Netherlands, they are not enforced in practice. If the UK were to fully resolve this issue and put it beyond doubt, this would be a genuine point of competitive advantage in attracting life sciences investment, research and clinical trials to this country, at a time when our overall competitiveness in the sector is under pressure from other directions and policies. It would also encourage the participation of innovative new drugs and potential wider patient applications of them, driving forward potential research opportunities and improving healthcare practice. To sum up, my questions to the Minister are as follows. First, can he confirm that a permanent solution will define eligible products as widely as possible, to include the full range of schemes that are currently used? Will he reconsider the proposal to restrict eligibility to NHS-treated patients only? Secondly, the Government have said that they will act as soon as possible, but for a patient with a life-threatening disease, that phrase can feel like a very long time. Will the Minister set out a clearer timetable about actions and next steps, and when the consultation with industry is likely to conclude? Will the Government decide to bring forward a reimbursement mechanism? Can the Minister explain why a business brief route has not been preferred, or whether one can be explored? When is detailed guidance likely to be published and operational? Finally, what is being done to repair the relationships with industry, which have been damaged as a result of this policy? Where a company such as Bayer has withdrawn, I hope that it will be strongly encouraged to re-engage as soon as possible, so that the patients we have heard about today can gain access quickly. Will the Treasury work with the Department of Health and Social Care to engage industry and be in direct communication with clinicians to help to identify which patient groups have been most affected, so they can be notified as soon as possible that the treatments may become available again? This is, on paper, a narrow, technical issue of tax policy—not always the thing that makes the front pages of newspapers or the most engaging social media videos—but in practice, a clear and quick resolution to this issue is a life-and-death issue for many thousands of people. It is the difference between a patient like Ian fighting to save thousands of pounds a month—just to be able to focus on his health and his loved ones— or not. It is the difference between a clinician having to explain why a medicine that was available last year is not available now, and being able to provide that innovative and lifesaving drug to them and many more patients besides. It is the difference between a pharmaceutical company that wants to do the right thing, providing drugs to patients for free or at a low cost, and it withdrawing its drugs completely because the costs become significant. Once again, I strongly welcome the ministerial statement and the pause from June. I thank the Minister and his predecessor considerably for their work to date, which has made a difference. I know that he is committed to engagement on this issue and to finding a way forward.

• 3 Sept 2026 · Vaccination Rates: England · Hansard source

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  I agree. Those issues are clearly intertwined and cannot be separated. Every contact should count. Shared digital records should identify, at the next GP appointment, pharmacy check-in, health visit or hospital appointment, where vaccines are missing. The system should be enabled, encouraged and paid to act, but this is currently not the case. The hesitancy argument focuses on the growing prevalence of misinformation around vaccines and falling trust in vaccines and health institutions more broadly. Polling shows that these are not the most important factors numerically, but for the 15% of parents who have concerns, they matter. Evidence from the University of Manchester shows that this is especially important for certain population groups. As my hon. Friend the Member for Thurrock (Jen Craft) just said, the barriers are multifaceted: poor trust and poor access go hand in hand, because the best way to build trust is through regular contact with known, trusted professionals. To maximise vaccine coverage, we need a system that can reliably identify and locate every child or patient missing their vaccination, repeatedly invite them for appointments and make attending appointments as easy as possible, with clear lines of responsibility when targets are missed. To do that effectively, the vaccination system needs adequate resourcing, accurate data and explicit accountability for meeting targets. Currently, we have none of that. The Government have been acting. We are piloting health visits and community pharmacy delivery, although roll-out has been slow and it is unclear when national roll-out will be possible. Parents are now given access to their child’s records through the NHS app, work is under way to improve the consent process for vaccinating children in school. More is being done, and all of that is positive, but the Select Committee is not convinced that that will be enough to restore our vaccination levels to WHO standards, and neither are officials, who are unable to say whether and when levels will be restored. Moving forward, what do we need? We need resourcing. Data I have obtained through parliamentary questions shows that in 2023-24 NHS England spent 0.51% of its total budget, or £852 million, on vaccination, down from 0.65%, or £989 million, in 2022-23. The very year the strategy released, funding was cut. We also need to be honest about what improvement will cost. Vaccinating the last 10% or 15% of any population is not the same task as vaccinating the first 80%, because of deprivation, language barriers and housing instability. All families affected by those factors need more contact with clinicians, and GPs simply do not have the resources to do the necessary outreach. We need to fund not just new medicines and drugs, but their roll-out. We should be using lifetime parental consent to increase uptake of school-age vaccinations, and developing efficient, convenient and ongoing catch-up opportunities in schools, shopping centres, nurseries and family hubs. The school-age immunisation service should be operating a check-and-offer approach at every contact. For the last 15%, we should be willing to fund what actually works: explicit payments to GPs for outreach programmes for underserved communities, including funding for multiple contact attempts, data cleaning, and non-responder tracking, with incentives linked to real outcomes. We should be training healthcare professionals and community groups to have difficult conversations with confidence and making far better use of our community pharmacy network, which is rooted in local areas. We also need clear accountability; the buck has to stop somewhere locally and nationally, with clear vaccination leads at both levels. Since the Lansley reforms in 2012 and the subsequent austerity cuts, lines of accountability have become blurred. From April 2027, integrated care boards will have greater responsibility for commissioning vaccination programmes locally, but who is overseeing the national strategy? That remains unclear. Who will require corrective action when that is deemed to be necessary? That is not clear. The removal of national targets was clearly a step backward for the system. Health officials and clinicians tell us that it is not always clear who is responsible when vaccination rates fall at delivery level in a given neighbourhood. We need a new national action plan that sets out concrete steps that will be taken to return coverage to our WHO targets. We do not have all the systems in place to tell us reliably who has and has not been vaccinated. Data challenges run right through the system. Vaccines given in maternity settings, community pharmacy settings or school often fail to make their way back to the child’s GP surgery because the systems do not talk to each other. How can we expect call-and-recall strategies to work if clinicians do not reliably know which children need to be called? Lastly, on hesitancy, we need to tackle misinformation, regulate it online and hold the peddlers of harmful and potentially deadly misinformation to account. Social media companies must step up their game in bringing down anti-vax information and providing clear, evidence-based health information instead. I know much of this is not easy, but that is why it requires genuine commitment and prioritisation. I thank the Minister for listening; will she outline whether the Government accept that the situation is unacceptable and that urgent action is needed, and whether a clear timeline for meeting the WHO targets can and should be agreed by the NHS? If we are to set a timeline, will a clear action plan be outlined to set us on the path back to 95% of all children being vaccinated, so that we can all see a welcome and vital return of our measles elimination status? We must ensure that every child is safe, that people of all ages get the vaccines they need, and that the UK is once again a global leader in vaccinations.

• 3 Sept 2026 · Vaccination Rates: England · Hansard source

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  I beg to move, That this House has considered vaccination rates in England. It is an honour to serve under your chairship today, Mrs Barker. I am pleased to co-sponsor this debate alongside colleagues from the Health and Social Care Committee who are also here today. It is very easy, from the vantage point of the 21st century, to forget that about half of children used to die before the age of 15 from infection and disease. Thankfully, we now have vaccines and our routine vaccination schedule providing protection against 15 preventable infections across our lifetimes. For decades, our system was one of the best in the world. The childhood diseases that used to cause so much suffering—measles, polio and others—sound like things from history books. I am sure we all have memories of our early school-based vaccinations and flu jabs in the winter period, and the joy of the discovery of the covid-19 vaccine and the hope it brought of a return to normality. So why have this debate today? Because, despite a seemingly continued record of progress and innovation since 2012, our vaccination system has been sleepwalking into a crisis. The percentage of eligible people getting the major vaccines has been falling year on year, dropping below the 95% coverage recommended by the World Health Organisation to prevent onward transmission. We have now undoubtedly hit a crisis point. Across England as a whole, the 95% target is not being met for any routine childhood vaccination programme and many adult programmes. For example, in 2024-25, only 83.7% of five-year-olds in England had both doses of the measles, mumps and rubella vaccine. In my own constituency, the figure is even lower, at 74%. We are now seeing measles outbreaks in our cities and, shockingly, we have lost our measles elimination status nationally. Tragically, three children died this year from measles—a totally preventable illness. When questioned about these issues at the Health and Social Care Committee, officials assured us that actions were under way and the tide was turning, but the most recent vaccine stats, released at the end of August, unfortunately show a continued downward trend. The 6-in-1 vaccine dose three coverage is down, the meningitis B dose three coverage is down, and the rotavirus dose two coverage is also down. This is also a serious equalities issue. Children who grow up unprotected are disproportionately those living in poverty and from ethnic minority communities, and the gap in vaccination status is growing across the country. How has that been allowed to happen in modern Britain? The 2023 vaccination strategy under the last Government was intended to halt the decline, but it is clearly failing, with vaccination rates continuing to fall in the three years since. The WHO target of 95% coverage for all routine vaccination programmes was removed from NHS planning guidance in 2025-26, with the Secretary of State at the time saying, “If everything is a priority, then nothing is”, but the choice not to explicitly prioritise vaccinations is incredibly short-sighted. My colleagues and I on the Health and Social Care Committee held a short inquiry into vaccination rates earlier this year, and we were, to be frank, shocked by the apparent complacency of leading NHS officials. There was no understanding of when it is hoped rates will return to WHO levels, or of whether and when our elimination status will be reached again. There is no target. This debate must be a call to arms to prioritise rebuilding our vaccination system as a matter of utmost urgency and to restore vaccination rates to 95% as soon as possible. Developing an effective vaccination system is not rocket science. Much of the existing strategy is relevant and positive, but we must acknowledge that we are off track. The debate about what is wrong tends to focus on two key issues: access versus hesitancy. The access argument focuses on systemic, practical barriers that make it harder for people to get vaccinated, such as poor appointment availability, ineffective call and recall systems, lack of data linkage and fragmented health systems. On that argument, recent coverage decline is the sign of a system under strain, rather than a loss of confidence. Most patients and parents do trust vaccines: 85% of people polled by Ipsos in 2025 said that vaccines were safe. But people are busy—moving home, switching GPs—and they do not have endless time to navigate a confusing and increasingly fragmented NHS system. The gap between MMR 1 and MMR 2 uptake is stark evidence of this failure, with MMR 1 coverage at five years at 91% and MMR 2 coverage at only 83%. The loss of contact is a system failure. Missed appointments should be chased, and families should retain close contact with trusted health professionals to guide them through the childhood vaccination schedule.