Jim Shannon MP: speeches

Speeches

• 13 Feb 2025 · Cardiovascular Disease: Prevention · Hansard source

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  I beg to move, That this House has considered the prevention of cardiovascular disease. I do not know where my functionality comes into it, Mr Mundell, but we are doing two debates in a row and it is lovely to serve under your chairship. As I explained in the last debate, I am my party’s health spokesperson. I have a lot of interest in this subject; I also declare an interest as chair of the all-party parliamentary group on respiratory health. Cardiovascular disease is one of the things that the group focuses on. Back in 2019, the NHS long-term plan defined cardiovascular disease as the single biggest area where the NHS can save lives over the next 10 years. Six years on, that statement still rings true, but I am not sure whether we any closer to arriving at a conclusion. Over 7.6 million people are living with heart and circulatory diseases in the United Kingdom, and CVD is responsible for a quarter of all deaths here every year. It is one of the biggest killers. I am very pleased to see the hon. Members here, and I thank them for coming. The Parliamentary Private Secretary, the hon. Member for Glasgow South West (Dr Ahmed), is here for the Minister, and I look forward to the Minister’s contribution. I am pleased to see the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans); he and I seem to regularly share debates. I am also pleased to see the Liberal Democrat spokesperson, the hon. Member for Mid Sussex (Alison Bennett). According to predictions from the British Heart Foundation, by 2030 the prevalence of heart and circulatory conditions in the United Kingdom will have increased by 1 million. By 2040, it will rise by 2 million, due to a growing elderly population, the high prevalence of CVD risk factors and improved survival from major CVD events. Cardiovascular disease care in the United Kingdom is most certainly at a critical juncture. That was starkly illustrated by Lord Darzi’s recent independent investigation into the state of the NHS; I know that we are all aware of some of the key points of that. The investigation set out how nearly 50 years of progress to improve CVD outcomes has begun to reverse in recent years. That must not happen. I seek reassurance from the Minister that we are out to stop that reversal. The number of people dying before the age of 75 with CVD has risen to its highest level since 2010, while the association between poor CVD outcomes and health inequalities has also increased, with people living in the most deprived parts of the country being twice as likely to die from CVD as those in the least deprived. Something is seriously wrong when those who just happen to live in a deprived area have a bigger risk of dying than those who do not. The slowing of progress is creating an enormous cost for the NHS and society as a whole, including £12 billion in total healthcare costs and £28 billion across the wider economy due to premature death, long-term care, disability and other informal costs. A key challenge relates to the high prevalence of CVD risk factors such as high blood pressure, obesity, diabetes, limited physical activity, air pollution and smoking. I declare an interest as I have had type 2 diabetes for almost 20 years. Mine is controlled by medication and I thank God for that, but I understand the impact on others much worse off than I am. Raised cholesterol is another significant risk factor, associated with one in five deaths from CVD. Just over half of all UK adults are living with raised cholesterol, significantly increasing their risk of heart attack and stroke. However, due to the lack of immediately obvious symptoms, high cholesterol levels often go undetected. There are concerns that without immediate action there could be a further tidal wave of CVD deaths due to the thousands of “missing patients” living with undetected and unmanaged heart and circulatory conditions. There are similar challenges in Northern Ireland. I always give a Northern Ireland perspective, which I think replicates what happens here on the mainland; that is why I do it. An estimated 225,000 people are living with heart and circulatory diseases in Northern Ireland—remember that we have a population of 1.9 million; that gives you an idea of the proportions. Since the 1960s, significant progress has been made, with CVD death rates falling by three quarters. But that improvement has plateaued in recent years: some 4,227 people died from CVD in Northern Ireland last year, including 1,133 people under age 75. It is not just an elderly person’s disease. That has to be put on the record. Annual NHS expenditure on CVD in Northern Ireland is some £290 million—a colossal amount—and CVD’s overall cost to the Northern Ireland economy equates to some £740 million each year. Those are massive figures. I know that we should not look at health from a purely financial point of view, but those figures tell us that if we were working better to combat CVD the impact on the economy and health service would be greatly reduced. Northern Ireland faces similar problems when it comes to identification and management of CVD risk factors, with around 400,000 people living with high blood pressure, including 110,000 who are undiagnosed. Some 45% of adults in Northern Ireland are not performing enough daily physical activity. In my constituency of Strangford, the prevalence of hypertension, coronary heart disease and stroke is significantly higher than in the rest of Northern Ireland. The reason for that could well be that our population is elderly: people tend to retire to my constituency. Despite the dire figures, there are real opportunities, both in Northern Ireland and the United Kingdom as a whole, to reverse the trends and help the UK become a world leader in CVD, as at one stage it was clearly trying to do. To get there, however, we clearly have to start doing things rather differently. Recent years have seen a number of policy commitments from successive Governments, but those have not shifted the needle, focus or direction. Today’s debate is about highlighting that and seeking help to address the situation. There was the NHS long-term plan of 2019, which set out ambitions to prevent 150,000 heart attacks, strokes and dementia cases over the following 10 years. Unfortunately, in my constituency and elsewhere there are high levels of dementia cases, strokes and heart attacks. In Northern Ireland the figures are unfortunately incredibly high. Successive versions of the NHS annual planning guidance have encouraged local systems to prioritise CVD and address the significant inequalities associated with it. Although the previous Government’s major conditions strategy was not fully implemented, it set out a series of robust principles to improve CVD care, including personalised prevention, early diagnosis, effective management of multiple conditions, integration of physical and mental health services, and services tailored to individual needs. The previous Government’s strategy was clear. I think this Government’s strategy is equally clear, but we need to address some of the issues that I will come to as I go through my speech. We are lacking a deeply embedded, system-wide approach to CVD prevention that moves care upstream, is backed by sustainable, long-term funding and deploys the latest technologies and innovations. The National Audit Office’s recent report, “Progress in preventing cardiovascular disease”, provided stark evidence that such an approach has been lacking. It focused on the delivery of the NHS health check, which is one of our main tools for enabling early intervention on heart disease. It concluded: “there is currently no effective system for commissioning Health Checks, despite it being a statutory responsibility on local authorities. DHSC and local government have weak levers to encourage primary care or other services to deliver Health Checks.” That will be one of my asks of the Minister, who I am pleased to see in his place. I wish him well, and I know I will not be disappointed by his response to our requests. In 2023-24, only half of the eligible population attended a health check, and only 3% of local authorities covered their entire eligible populations. We have to change that, so my request is that local authorities, which have statutory responsibility, primary care and other services that deliver health checks increase the number of people who get checked. We need an action plan. The NAO report said: “This is not a satisfactory basis for delivering an important and potentially life-saving and money-saving contribution to population health.” Major improvements are needed, and the Government must embed them in a policy environment that promotes prevention rather than treatment. I have always been a believer in prevention rather than treatment. We must diagnose early and prevent disease at an early stage to stop the whole thing going further. The current approaches do not sufficiently take account of genetics and the role of inherited familial conditions such as familial hypercholesterolaemia and cardiomyopathy in increasing CVD risk. Children are not routinely screened, GPs often fail to take account of people’s family history, and many patients report difficulties in accessing genetic screening. Patients and doctors need to be empowered to access genetic testing, secure diagnosis and take preventive measures, which will ensure better health for the future and save money in the NHS. I am pleased that the Government have committed an extra £26 billion to the NHS, because right across this great United Kingdom of Great Britain and Northern Ireland, we will all benefit from that. Up to 80% of premature deaths from CVD are preventable—we cannot ignore that figure. Preventing those deaths must be our goal, so the importance of this issue cannot be overstated. The evidence shows that CVD prevention pays. Analysis from HEART UK estimates that merely improving the management of cholesterol, triglycerides and other lipids through increased uptake of NHS health checks and, by extension, increasing the number of patients on lipid-lowering therapies, could deliver more than £2 billion in annual savings for the NHS and wider society. I will focus on lipid-lowering therapies, because that is a solution that I am keen to see the Government take on board. Although prevention spending is often deprioritised in favour of meeting short-term measures, that is the kind of investment that we need if we are to deliver on the Government’s pledge to shift from sickness to prevention. I welcome the Government’s commitment to do that; that is what my party and I want. In recent discussions I have had with stakeholders on this area, they have agreed a number of key themes that will be crucial to delivering progress on CVD prevention. Those include securing dedicated and ringfenced funding for CVD prevention, to enable targeted prioritisation of preventive approaches; identifying at-risk patients through early detection and risk assessment strategies, including testing from birth and family cascade testing; developing comprehensive public awareness campaigns that empower patients to self-monitor—if we can have patients’ participation in this as we go forward, that will be much welcomed; increasing access to prevention services by moving them closer to home, including by delivering more community-based diagnostic services; and ensuring timely implementation and consistent application of evidence-based clinical guidelines. There is growing recognition of the potentially transformative opportunity that can be realised through wider awareness and recognition of another key CVD risk factor: lipoprotein(a), or Lp(a), which is a large lipoprotein made by the liver. Lipoproteins are parcels made of fat and protein. Their job is to carry fats around the body in the blood. Elevated levels of Lp(a) in the blood are an independent, inherited and causal risk factor for CVD, due to its pro-atherogenic, pro-inflammatory and pro-thrombotic effects. One in five people are estimated to have raised levels of Lp(a) in their blood. That equates to some 13,400,000 people in the United Kingdom—equivalent to filling every seat in Wembley stadium about 150 times. Lp(a) is associated with an increased risk of several life-threatening events and conditions, such as myocardial infarction, heart attack, stroke, coronary artery disease, peripheral arterial disease and heart failure. Sadly, those events are often premature, so we need a way of diagnosing, doing early prevention and doing things better. My ultimate request to the Minister will be that that happens. In severe cases, which applies to about 12% of the population, raised Lp(a) contributes to a two to four times higher risk of heart attack, stroke and heart disease. The prevalence of raised Lp(a) is typically greater among African and south Asian populations—a trend that is likely exacerbating existing health inequalities even further. Despite the huge numbers at risk, few people know that they have a raised level of Lp(a). If they did, preventive measures might be taken: they could get a diagnosis, and we could ensure that their lives were better and longer, as well as reducing the cost to the NHS. The awareness of the role of Lp(a) in contributing to CVD risk is low among the general public and healthcare professionals, so there is a need to raise awareness. With that significant burden comes a huge opportunity to improve outcomes for a so far largely untreated and unserved patient population. I want to mention my constituent, Dr Paul Hamilton, and also Gary Roulston. They are consultant chemical pathologists at Queen’s University Belfast and Belfast health and social care trust. They are leading pioneering work to proactively measure Lp(a) levels in patients who are at risk of CVD. I am always amazed—I always like to say this about Queen’s University, and it is right to do so—that when it comes to research and development, it is at the forefront, including on Lp(a). I encourage the Minister to interact with Queen’s University. The recent audit of its testing programme has revealed that early measuring of Lp(a) levels leads to a change in CVD management for a large number of patients. That demonstrates that Lp(a) testing and management can be implemented to improve population health and reduce the risk of CVD. When we look at those things, we see something that can be done even better. Although there are currently no specific therapies for lowering Lp(a) levels, the taskforce believes that there is a clear and growing case for taking action now to incorporate Lp(a) testing and management within mainstream CVD prevention strategies. Several new therapies to lower Lp(a) are currently undergoing late-stage clinical trials, and could well be available in the near future, pending the outcome of those trials. That is a really exciting way forward, and an exciting way to save and improve lives. It is therefore vital that steps are taken to enable system readiness for those therapies and to ensure that the NHS is in the best possible position to maximise their anticipated benefits. In the interim, there is a growing clinical consensus about the value of identifying patients with elevated Lp(a). In particular, knowing an individual’s Lp(a) can inform more intensive management of other cardiovascular risk factors, including blood pressure, lipids and glucose, and empower people to make a lifestyle change to reduce their overall CVD risk. It can also support cascade screening of family and close relatives—again, a positive way forward —given the genetic status of Lp(a). There is clearly a way to use technology and innovation to test more and to do more good for people. Tangible progress in that area could play a key role in supporting many of the key principles that have been identified as crucial to guaranteeing the future sustainability of the NHS, such as reducing pressure in the acute sector, delivering more personalised care and precision medicine, and capitalising on the pioneering innovation led by the UK’s life science sector. More broadly, Lp(a) testing can support the Government’s ambitions right here in Westminster to get people back into work, by reducing the incidence of major CVD events, which can prevent people from participating in the labour market. Diagnosis and prevention can support people. To be fair, most people want to work; they want to have a normal life. The ones I speak to are not seeking benefits for any reason other than that they are unable to work. Without formal recognition of Lp(a) in national policy, the only Lp(a) testing that takes place will be reliant on the work of proactive local clinicians. We need to make it the norm; we need to make it acceptable and the way forward. The regional variations are also not acceptable, and local systems need clear direction from the centre to encourage them to start thinking proactively about how Lp(a) testing and management could be incorporated into their local CVD prevention pathways. What are we seeking? We are looking for a review of current CVD prevention and treatment pathways, for an assessment of where Lp(a) testing could be incorporated to deliver tangible benefits now—not later, but now—and to maximise the benefits of therapies that lower Lp(a), when those become available. We are also looking for engagement with local specialist lipid clinics and clinical laboratories to assess current levels of Lp(a) testing and whether it aligns with agreed best practice and to consider what will be needed to upscale activity in the coming years. We want to encourage local CVD champions to start thinking about the role of Lp(a) in contributing to CVD risk and to disseminate information about Lp(a) within their local networks. In the taskforce’s call to action, it identified several system barriers that are holding back progress in this area; these are also applicable to the success of other health prevention strategies. They include National Institute for Health and Care Excellence procedures and methodology. NICE’s guideline methodology needs to take account of wider evidence criteria beyond the ones that apply to a specific treatment. In the case of Lp(a), although specific therapies to lower Lp(a) are not currently available, the taskforce believes that there is none the less a strong case for taking action now to proactively incorporate recommendations on Lp(a) testing and management in NICE guidance. If replicated across other disease areas, that more proactive and anticipatory approach from NICE would help to improve NHS system readiness for new innovations and treatments, encourage healthcare professionals to think more proactively about how a specific risk factor may be contributing to overall risk, and embed a more preventive mindset across the health system, reflecting the significant role of NICE in driving clinical behaviour. If it is possible to make those improvements—it is cost-effective, and early diagnosis will make things preventable—we really need to look at that. Barriers also include the accuracy of health risk assessments. Risk assessment tools, particularly in CVD, play a crucial role in supporting health prevention strategies. An accurate assessment of an individual’s risk of experiencing a major CVD event can inform the most appropriate action to proactively manage and reduce that risk through a combination of treatment interventions and lifestyle changes—each of, us individually, has to play a part. Going forward, it is vital that existing CVD risk assessment tools are updated to take account of Lp(a) and its known association with a range of life-threatening or life-changing cardiovascular events and conditions. That recognition will be essential to delivering a truly holistic assessment of an individual’s cardiovascular risk profile. It is important to look at the standardisation of testing and reporting. The success of health prevention strategies also depends on the accuracy and consistency of diagnostic processes. In the case of Lp(a), testing should be conducted according to the best practice principles set out by HEART UK. Has the Minister had a chance to talk to HEART UK, which has some great ideas and positive ways forward? It is important to work in partnership to deliver therapies, diagnoses and prevention. On emerging therapies, in particular, it is vital that there is a focus on encouraging greater diagnostic standardisation from the outset. Clinicians often get used to the numbers they first use, and it is important that they do not become entrenched in using the wrong, or indeed superseded, units. Without action in these areas, Lp(a) testing and management risks becoming another promising area of health innovation where the UK falls behind comparative systems. We need to look further afield and to work with other countries; I met the shadow Minister, the hon. Member for Hinckley and Bosworth, this morning and said the same thing to him. Prominent European and American guidelines, such as those from the American Heart Association, the National Lipid Association and the European Atherosclerosis Society, have set out the importance of considering Lp(a) screening as part of CVD prevention approaches. Some countries are even thinking practically about how universal Lp(a) screening could be introduced. The present approach therefore puts us at risk of missing a rare opportunity to save lives that may be cut short by CVD, and will be increasingly out of line with the Government’s focus on transforming prevention across the NHS. The Lp(a) taskforce is a coalition of experts from across the cardiovascular, lipid and laboratory community, with members from all four nations of the United Kingdom. They have come together to help tackle the lack of awareness and to set out the value of testing for Lp(a) in routine clinical practice to improve CVD management. Chaired by HEART UK, the group published its calls for action in August 2023, and it has since been working with key stakeholders to set out the potentially transformative role that Lp(a) could play in the future and, more broadly, to help renew the UK’s status as a world leader. We can be the world leader in CVD prevention and care. I have some questions for the Minister. Is there a willingness to meet me and representatives from the Lp(a) taskforce, as well as other Members here with an interest in the subject, to discuss the essential steps that need to be taken to ensure that the UK is in the best possible position to integrate Lp(a) testing and management as a core part of CVD prevention strategies? Further, will he commit to engaging with key system partners such as NICE, NHS England and the devolved Administrations to address policy barriers that could hold back progress? I am ever mindful that the Lp(a) taskforce already comprises the four nations of the United Kingdom. The Government must take wider action through their forthcoming 10-year health plan to secure renewed focus on CVD prevention, underpinned by ringfenced funding, enhanced early detection, expanding community diagnostic capacity, the timely implementation of evidence-based guidelines, and comprehensive public awareness and patient empowerment programmes. Will the Minister explore the scope to develop a dedicated national strategy for cardiovascular disease? We had that in 2019; I believe we need it in 2025. Reversing these worrying trends in CVD is one of the great healthcare challenges that we face in this Parliament, and it must be approached with the necessary focus and attention. The UK must be able to capitalise on new and emerging areas such as Lp(a), which will be crucial if it is to renew its status as a world leader in CVD prevention and care. Just as with cancer, one in two people in this Chamber today are likely to develop heart and circulatory conditions in their lifetime. Just like the cancer community, the CVD community would welcome a commitment from the Minister to publish a dedicated national CVD strategy. At the end of the day, that is what I am asking for.

• 13 Feb 2025 · Infected Blood Compensation Scheme · Hansard source

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  I thank the Minister most sincerely for his statement. Nobody in the House is not reassured by what he has said. He also referred to the regional Administrations and how this will affect them, and he has had those discussions with them. There are reports today that only 0.2% of eligible family members have been contacted about the scheme, and there are concerns that the scheme does not have the capacity to cope with the numbers of potential applicants. Can the Minister outline how he will ensure that there is capacity for all those families to have a sense of recognition and to be definite about a form of restitution?

• 13 Feb 2025 · Business of the House · Hansard source

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  I chair the all-party parliamentary group for international freedom of religion or belief. We have started the Prisoner of Conscience scheme, in collaboration with ADF International. I wish to highlight the case of Yahaya Sharif-Aminu, a musician and follower of Sufi Islamic beliefs who was arrested and sentenced to death for blasphemy in 2022. In January 2021, a higher court in Kano state overturned Sharif-Aminu’s conviction. Despite that, he remains in prison and faces a retrial under laws that violate both the Nigerian constitution and international human rights standards. Nigeria is Africa’s largest economy and a key UK trade partner, so will the right hon. Lady raise with her Cabinet colleagues the potential economic and business implications for international companies operating in northern Nigeria if the Supreme Court there upholds the constitutionality of blasphemy laws, and the impact that might have on investor confidence, corporate social responsibility commitments and long-term business stability?

• 13 Feb 2025 · HIV Testing Week · Hansard source

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  I congratulate the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) on leading today’s debate. I am my party’s health spokesperson, so I make it my business to come to health debates. Indeed, I think I have missed only one debate on HIV in the 14 years that I have been here. Health is a devolved issue, so there may be different guidelines surrounding access to testing and to testing itself, but we all have the same goal wherever we are in this great United Kingdom of Great Britain and Northern Ireland. England could be the first country in the world to reach the goal, but we are currently not on track, so perhaps the Minister will tell us what action will be taken to ensure that happens. In Northern Ireland, there has been a significant increase in testing in recent years. Efforts have been made to promote early intervention and treatment. The Public Health Agency in Northern Ireland revealed that in 2023, a record 92,635 tests were conducted. Given that the population is 1.9 million, I think that is very significant. That is a 5% rise on 2022, and it is the result of a massive commitment by us—health is devolved to us—to ensure early detection. On the other hand, the number of new HIV cases has also risen. In 2023, there were 101 cases—67 men and 34 women—which was a 41% increase on 2021. I know the numbers are small, but the percentage is quite worrying. It is alarming that some of those cases were linked to injecting drugs, so will the Minister give us some idea of how we will address that issue? It is not just about physical exchange; it is also about the use of drugs, so what can be done to stop that? Sharing a needle is a cause of HIV for some drug users, and that concerns me. The right hon. Gentleman referred to the ’70s and ’80s—I am of an age that I can remember them very well. Historically, HIV was a stigma, and it was Princess Diana who helped to take away some of that. I always remember that she met people with HIV, sat alongside them, shook hands with them and drank out of the same teacup, and that dispelled some of the concerns that people had, so we are thankful for that. Testing for HIV of course must be discreet. There are numerous sexual health clinics across Northern Ireland, and indeed across the United Kingdom, that offer sexual health advice and testing. In addition, more discreet, self-testing kits are available, so we should be looking at some of those things. Early diagnosis is key to ensuring that treatment can be started quicker. Treatment can reduce the viral load, which means that the disease becomes untransmissible. The hon. Member for Vauxhall and Camberwell Green (Florence Eshalomi) and the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale mentioned HIV in third-world countries, and I agree with their sentiments entirely. The Elim church in my constituency of Strangford deals with people with HIV in Swaziland in Africa, and a choir comes over every year to do some fundraising. Every one of those young children with lovely voices received HIV from their parents when they were young, but the good thing is that they are now HIV-free as long as they have the drugs, so there is a way of going forward. Charities, agencies and church organisations do their best to provide support. I have seen and understand what they can do. I very much look forward to hearing from the Minister. I hope she can work in parallel with her counterparts in the devolved nations to ensure that we tackle HIV together and meet our 2030 goals.

• 13 Feb 2025 · Electric Vehicles · Hansard source

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  I thank the Minister for her answers. I am not a petrolhead, but I do love my diesel vehicle. Those of us who live in the countryside understand that having a diesel vehicle is incredibly important, and there are no electric charging points across the rural countryside. There need to be more of those charging points on the high street and in the shopping centres, and there definitely need to be more of them in the countryside, since those of us who live there are being disadvantaged by the electric car process as it goes forward. What is being done to help the rural community—those of us who live in the countryside and those of us who represent them—take advantage of electric cars as well? The charging points are not there; the system does not work.

• 13 Feb 2025 · Ukraine · Hansard source

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  Thank you, Mr Speaker —I am surprised to be called so early.

• 13 Feb 2025 · Ukraine · Hansard source

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  No, no—I will grab the chance. I thank the Minister for her answers. It is obvious to me and other Members of this House that she has a heart that wants to help those in Ukraine, and we appreciate that, especially since it comes from Government. I welcome the potential peace that might come, but of course it has to be a peace of justice; it has to be fair to the Ukrainians, and we hope a way can be found. Does she agree that any signs of negotiation are to be welcomed, but that there can be no doubt that Ukraine retains the support of this House? She has said that, and everyone has said it. What role will the UK have in ensuring that the people of Ukraine have security from further Russian aggression when Putin recalibrates his forces a year or two from now?

• 12 Feb 2025 · Energy Infrastructure: Chinese Companies · Hansard source

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  The Minister will be aware that the costly environmental obligations that the Government impose on home-manufactured goods are not adhered to by many other nations, which often prevents UK manufacturers from being able to compete. Does the Minister agree that those considerations, as well as the routine human rights breaches of Chinese business against the Uyghurs, Falun Gong, Christians and other ethnic minorities, should be equally weighted with costs? Human rights and Chinese production will never add up; that must inform any contract offered by this nation of ours.

• 12 Feb 2025 · Knife Crime in London · Hansard source

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  To my mind, the upward trend is worrying. There must be a zero-tolerance policy, so that if someone leaves the house with a knife in their pocket or coat, a custodial sentence is necessary. Does the hon. Gentleman not agree that that has to be part of the strategy?

• 12 Feb 2025 · Support for the Scotch Whisky Industry · Hansard source

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  I thank the hon. Member for securing this debate. He is right to highlight the importance of Scotch whisky in his constituency. In my constituency, the Hinch distillery is becoming a globally recognised, award-winning whiskey brand. These home distilleries provide for each and every person’s constituency, including the hon. Gentleman’s, mine and others. They grow the local economy and should receive support to further their success from the Government here at Westminster.

• 12 Feb 2025 · Israel and the Occupied Palestinian Territories · Hansard source

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  I thank the hon. Member for Alloa and Grangemouth (Brian Leishman) for setting the scene. I have a different opinion from other hon. Members, but I respect their point of view and I hope that they will respect mine. I am, and always have been, a steadfast friend of Israel. My commitment to the state of Israel is rooted in its right to exist as a secure and democratic homeland for the Jewish people. For me, that principle is non-negotiable. I hope that my remarks will reflect both my empathy and my unwavering belief in Israel’s right to defend itself. The ICJ measures, initiated by South Africa, reflect a deeply flawed and one-sided interpretation of international law. Israel has a sovereign right, indeed a duty, to protect its citizens from the barbaric terrorist organisation Hamas. The petitioners in this case conveniently ignore Hamas’s atrocities: their deliberate targeting of civilians; the massacre of innocent men, women and children; and the use of Palestinian civilians as human shields. I support the principle of a two-state solution, but let us be clear that peace cannot co-exist with Hamas’s continued aggression. Every time Israel has made significant concessions, whether during the Oslo accords or the unilateral withdrawal from Gaza in 2005, it has been met with an escalation in violence and not with peace. If Hamas retains power, Palestine will be a failed state from the outset—one that continues to launch rockets into Israel’s towns and incite hatred against Jews worldwide. Peace will be possible only when the Palestinian leadership prioritises economic stability and co-existence over terrorism and destruction. A weakened Israel emboldens its adversaries, most notably Iran, Hezbollah and radical Islamist movements. Those entities do not simply wish for an end to Israel’s military operations; they desire Israel’s total annihilation. The ICJ may issue opinions, but it is not infallible. We must challenge rulings that fail to acknowledge Israel’s security needs, excuse Hamas’s barbarism and seek to delegitimise a nation’s right to exist. The UK must continue to stand shoulder to shoulder with Israel, not just in words but in actions. That is my point of view, and I hope other Members will respect it, as I will respect theirs.

• 12 Feb 2025 · Support for Pensioners · Hansard source

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  Yes, it is disappointing, and I cannot ignore that fact. I always like to think that good people come together, reach out and try to address those issues, but the hon. Gentleman is right that they should not have to. In September 2023, NEA undertook a Northern Ireland-wide representative survey to assess the impact of energy prices on households. The survey found that 41% of households in Northern Ireland were spending at least 10% of their total household expenditure on energy costs, and were therefore in fuel poverty. The continued pressure on household budgets has led to a rise in detrimental coping mechanisms. Those systems that should be in place to help are clearly unable to. For example, 19% of households told the survey that they had gone without heating oil, gas or electricity in the past 24 months because they were unable to afford energy. One in 10 households admitted to skipping meals to ensure they had enough money to pay for energy. Others have referred to that. The pensioners I speak to are vulnerable, have complex health needs and have disability issues. Sometimes they have no family. As others have said, they have to look after themselves, but they are unable to. That dismays me greatly. Data shows that close to one in five households over over-60s are now in such severe fuel poverty that their homes are being kept in a condition that “endangers the health” of the inhabitants. What happens when someone cannot heat their house? The house deteriorates, the mould grows and the damp grows. It is a fact: people have to have a level of heat in their houses; otherwise, they will deteriorate. That is an impact that is perhaps not often seen. The hon. Member for Aberdeenshire North and Moray East will remember the debate this morning in which a constituent was mentioned: an elderly person, over 70, who was living in a house with a leak in the roof. He did not have the ability to fix it, had no family to fall back on and did not qualify for any grants for it. The deterioration of houses cannot be ignored. Fuel poverty among pensioners is dangerous and must be addressed. I recently went to the home of a lady who was applying for attendance allowance. I am no better than anybody else, but I know how to fill in forms—I know how to do all the benefit forms, and I have done them for umpteen years; I know how they work, and I know the right words to say on behalf of a deserving constituent. When I was on the election trail in July, going round the doors, I acquired between 80 and 90 attendance allowance forms. Those constituents did not qualify for pension credit, but we were able to get them on to attendance allowance, as I will explain with one of my examples. Those forms take at least an hour to fill in, and I have a staff member who does nothing but fill in forms five days a week—sometimes six. Let us be honest: I am no spring chicken any more. I am a pensioner and I will be reaching quite a significant figure shortly, but I am pretty strong. I think I am strapping, although I am not sure whether my wife agrees—she is the one who really matters. I know that the hon. Member for Aberdeenshire North and Moray East has a great interest in shooting; I could probably stand shooting for the best part of the day in cold weather, as long as the pheasants and the pigeons kept coming over my head.

• 12 Feb 2025 · Support for Pensioners · Hansard source

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  Will the hon. Gentleman give way?

• 12 Feb 2025 · Support for Pensioners · Hansard source

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  It is a pleasure to serve under your chairship, Dame Siobhain. I thank the hon. Member for Mid Bedfordshire (Blake Stephenson) for setting the scene incredibly well. I hate to say this, and apologise for doing so, but I am disappointed that no Labour Back Benchers are present because, as the Minister will know, my allegiance lies to the left of politics. That is who I am, but the party that I expected to be the party of conscience is no longer that party. I spoke to my friend, the hon. Member for Aberdeenshire North and Moray East (Seamus Logan), before I rose to speak. I am very conscious that it is not Opposition Members that put it into law that the winter fuel allowance would be withdrawn from pensioners; it is Government Members. That is incredibly disappointing for me. The party of conscience, as I saw it, is no longer the party of conscience. I say that with deep regret, but I say it honestly, because that is how I feel, and I have to put it on the record. Although the previous Government did it, we will take the credit for it. Remember that the DUP was in partnership with the Conservative party. As part of that deal, we secured the triple lock on pensions for our people. Everybody gains from that. To be fair to the Labour party, it is committed to it, and I do not see any changes coming in that regard—at least I hope to goodness that no changes are coming. For a certain period of time, that helped to keep pensioners out of poverty due to cost of living increases, not least the ever-escalating fuel bills. Even the triple lock cannot keep up with prices. Poverty among older people is the highest it has been since the 2008 recession. Northern Ireland, where oil instead of gas is more often used to warm houses, has seen sharp price rises. Indeed, I understand that 68% of houses in Northern Ireland depend on oil. Over the past three years, National Energy Action has experienced a significant rise in the number of households seeking emergency support because high energy prices and wider cost of living pressures mean they can no longer afford to keep their homes warm and safe. That is something to which I can testify. Many people get food bank vouchers from my office in Newtownards. My constituency had the first food bank in all of Northern Ireland. A good thing about the food bank is that it brings together the churches, individuals and organisations that wish to help. Sometimes we can focus on the dire need, but we should also focus on the fact that it brings good people together to help. There is a goodness out of it, and one that I am pleased to support. My office is the biggest referrer for food bank vouchers in the whole of the constituency. The food bank does wonderful things and helps people in their hour of need.

• 12 Feb 2025 · Support for Pensioners · Hansard source

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  The right hon. Gentleman was doing so well that I felt like leaving him in full flow. He is absolutely right that we need to focus on that issue. I was successful with that lady’s attendance allowance form, and I am pleased that the benefits system justified her claim given her complex health needs, including mobility issues. In that lady’s case, it enables her to get £436 per month, or £5,130 a year, which fills the gap from not getting the pension credit. However, not everyone qualifies for that allowance, which is what the right hon. Member referred to. The lady’s home was on the brink of freezing, and she very openly said that she was hopeful of getting the attendance allowance to fill the tank with oil, which she did. She justified her claim and she deserved it, but she should have got it years ago. She did not apply because she did not know about the allowance, so perhaps the Minister could look into contacting pensioners directly. I find the pensioners who I deal with regularly to be very independent, and they are nearly apologetic for applying for a benefit. They say, “Oh no, I don’t think I’d qualify for that,” but when we ask them questions, we suddenly find out that they do. My office staff were able to secure a Bryson energy grant to put some oil in that lady’s tank in the short term. When people say that pensioners are getting more than ever, I can only think of that wee lady in her cold home, who quite clearly was not. That lady is not the only one. Local churches, such as the House Church and Christian Fellowship Church, make their facilities available to people for food and meals, as well as to come and read—or “sit and knit”, as they call it—in their warm facilities in Newtownards town. I am greatly encouraged by people’s goodness, so I am thankful for the churches and the voluntary sector that step up when the Government fail. I want to clarify one final issue, although I am very conscious that somebody else wants to speak and I do not want to take up their time. A further issue of concern for pensioners are the letters that come from His Majesty’s Revenue and Customs, with no explanation, and ask women in their 80s to go online, fill out a tax application and pay back taxes. I have one lady whose husband’s pension is £50 per month and that puts her over the threshold. Honestly, I get so frustrated, and I know that wee lady was even more frustrated than me. She had to pay back a tax bill of £280, and of course, she said, “Look, take my husband’s pension. I don’t want it any more. It’s only giving me bother. I don’t know how to fill the forms in.” So there is an issue about pursuing that, and we have to reach out and help people who get those sudden letters. I conclude with this: my party has sought to divert some of the block grant as a small help for pensioners in fuel poverty, recognising that they need that help. I understand that the Government cannot pay all of the fuel bills, but I believe that we can do better, and help more, and I look to the Minister to do just that.

• 12 Feb 2025 · Support for Pensioners · Hansard source

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  In my contribution I hinted that attendance allowance might be another method of giving benefit entitlements to qualifying pensioners. Not every pensioner would qualify, but many would. I suggest a concerted campaign by the Government to make every pensioner aware of all the benefits. As the right hon. Member for Aldridge-Brownhills (Wendy Morton) said, sometimes they are shy, sometimes they are independent, and sometimes they do not know they are entitled to things.

• 12 Feb 2025 · Fuel Poverty: England · Hansard source

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  I will certainly do the best I can, Mr Efford. The issue, no matter what, starts in Westminster—it is a fuel poverty debate on England that affects everybody in this great United Kingdom of Great Britain and Northern Ireland—and decisions are made, right here, in this House. With that in mind, I ask the Minister again, will she speak to the relevant Minister on how we can do better?

• 12 Feb 2025 · Fuel Poverty: England · Hansard source

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  In questions, urgent questions and statements in the Chamber, I have been keen to ensure that every part of this United Kingdom of Great Britain and Northern Ireland can benefit from strategies in this House and that the ripples go out to everywhere. In my contribution, I asked the Minister again whether there would be an opportunity to discuss the matter with the relevant Minister back home. I know the Minister is committed to that. Will she please update me on where those talks and discussions have gone, so that we can all benefit?

• 12 Feb 2025 · Fuel Poverty: England · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Normanton and Hemsworth (Jon Trickett) for leading the debate. Fuel poverty is huge and has no doubt been emphasised further through the loss of the winter fuel payment for elderly people. I commend the hon. Gentleman for Normanton and Hemsworth; I admire courage, and I admire his, because he had the guts—I could use another word, but it would not be parliamentary—to stand up and vote against that decision by his Government. Well done! We admire him for his courage and for the stand he took. I wish to give a quick Northern Ireland perspective to back up the hon. Gentleman and the stand that he and others in the Chamber have taken. The Department for Communities back home defines a household as being in fuel poverty if it spends 10% of its income on energy costs. We are talking about a substantial section of the population. Others have outlined clearly that fuel poverty rates have fluctuated, and that is the case in Northern Ireland too, with rates of 44% in 2009 and 24% in 2021. Yesterday, I was fortunate to have the opportunity to speak in the energy debate led by the hon. Member for Bath (Wera Hobhouse), which highlighted the correlation between the cost of energy and fuel poverty, and this debate is an opportunity to highlight that issue again. The increase in prices has meant that many are on the breadline, and that is not to mention the devastating impact that the loss of the winter fuel payment has had on our elderly generations. I have never had as many elderly people, pensioners, vulnerable people and people with complex health needs battling—I use that word on purpose, because it is the right word—the loss of the winter fuel allowance. I say this with respect to my colleagues on the Government Benches, but not supporting the winter fuel allowance for pensioners was wrong. I wish the Minister well in her job, which she does to the best of her ability, and we welcome that. Has she had an opportunity to speak to the Department for Communities back home, which has responsibility for this issue? In his intervention, the hon. Member for Aberdeenshire North and Moray East (Seamus Logan) said that this theme starts here at Westminster, but has she had an opportunity to discuss it with the relevant Minister? Back home, we have just—

• 12 Feb 2025 · Fuel Poverty: England · Hansard source

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  I certainly do. One of things we can do here on the mainland is look at the issue of poor insulation and heating systems that need updating. I know the Minister will look at that and ultimately decrease the amount of energy a particular household has to use, but those are some of the things that we can do to help our constituents. Fuel poverty is still a massive issue across the board and there are few signs of it mellowing. We must do more to support our constituents around energy prices and fuel poverty, especially given that there is a huge section of the population struggling with energy bills. I genuinely and kindly look to the Minister for direction and support, because I am an MP from Strangford in Northern Ireland, representing my people in this Chamber on an issue that affects us all across this United Kingdom of Great Britain and Northern Ireland. Know something? I want answers as well.

• 12 Feb 2025 · Improving Access to Public Services · Hansard source

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  When it comes to public services, one thing that bugs me, and bugs our constituents, is the difficulty of accessing GP appointments, let alone having to call at half-past 8 in the morning. What progress is being made in allowing patients to book GP appointments online, so that they are not forced to wait on the phone every morning to see a doctor when they need an appointment right away?

• 12 Feb 2025 · SEND Provision: Derbyshire · Hansard source

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  I commend the hon. Lady on bringing this debate forward. I spoke to her beforehand. It is heartbreaking to hear what she is saying about her constituency, and I understand that, but the situation is replicated across this whole great United Kingdom. The number of Members who are here to speak is an indication of how many want to voice their concerns. She is right to talk about those who are waiting. Does she agree that early diagnosis and early intervention are all that really matters? If we can get that done early, we can save a child. It can give a child a future and an opportunity, and it can take the pressure off the parents as well.

• 12 Feb 2025 · Prevent: Learning Review · Hansard source

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  I thank the Minister very much for his words. None of us who were privileged to know Sir David Amess are not mindful of both his goodness and his faith—he and I shared the same faith. As a nation blighted by terrorism and action by evil people who believe that they have the right to take life, it is clear that the powers to address those people must be accessible by intelligence services and that funding to suit must follow appropriately. The actions that resulted in the death of Sir David and those three precious little girls were shocking. It is clear that there was not enough support for the Prevent programme. Indeed, it failed and we all acknowledge that. We do not say that in an objectionable way, but in a way that is factual and evidential, and it is a point that we want to make. I hope that things will change—I think that is what we are all looking for—so that UK citizens are safe from known suspects. How can the Government ensure that public officials and MPs’ staff, who we have a responsibility to look after, are safe in our places of business, while always remembering that we must be and will be accessible to our constituents who elected us to this place?

• 11 Feb 2025 · US Global Public Health Policy · Hansard source

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  I commend the hon. Gentleman for securing this debate. I cannot imagine that any Member on either side of this Chamber will not be concerned about the prospect that we face, but we have to live with the reality. Given the withdrawal of the US from the World Health Organisation, it is essential that lines of communication on global health issues remain open and consistent. Does he agree that we must be proactive in establishing a new method of co-operation and information sharing as a matter of urgency? I think that is what he is looking for. If we can meet somewhere in between, that might be the way forward.

• 11 Feb 2025 · US Global Public Health Policy · Hansard source

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  I thank the Minister for her comprehensive response to the hon. Member for Winchester (Dr Chambers), who set the scene very well. In my constituency of Strangford, I think of the Church groups, and in particular of the Elim Missions, which has a very constructive and positive strategy for Zimbabwe and Swaziland. In Swaziland, the number of people who have AIDS is at almost epidemic levels, but one of the things the west—the USA, the UK and others—can do is provide medications that can preserve life and help people to live longer than they ever have. That happens because of what the Government do but also because of what the Churches do. The Minister is always very helpful in her responses. Could the Government look at working more closely with the churches to make lives better?