Luke Evans MP: speeches

Speeches

• 15 Jan 2025 · Non-Domestic Rating (Multipliers and Private Schools) Bill · Hansard source

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  We have heard categorically from Labour that private schools are businesses. They see themselves as part of the community and as charities. Now that they are seen as businesses, they will act as businesses and will have to look to raise revenue from all their sports facilities and anything else that they willingly gave away to the state system. Private schools work with the state system and ensure that there is support for the state system—that is the community basis of what schooling is about. Does my hon. Friend share my concern that defining them as businesses will be a big problem?

• 15 Jan 2025 · Non-Domestic Rating (Multipliers and Private Schools) Bill · Hansard source

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  Talking of basic principles, does the hon. Gentleman therefore believe it is right to tax education—yes or no?

• 15 Jan 2025 · Non-Domestic Rating (Multipliers and Private Schools) Bill · Hansard source

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  One issue that the hon. Lady has not yet mentioned is the impact of the Employment Rights Bill, which will create further red tape for our high street businesses when it comes into play. Do the Liberal Democrats think that the Government should consider that? Changing taxes and rates is one thing, but creating red tape at the very same time, constraining business growth, is another.

• 14 Jan 2025 · UK-China Economic and Financial Dialogue · Hansard source

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  As the Chancellor flew east, the pound plummeted south and Government debt rocketed north. Why? The markets do not believe her plan for growth; that is the fundamental issue. To pick up the question from my right hon. Friend the Member for Stone, Great Wyrley and Penkridge (Sir Gavin Williamson), what is she going to say to the markets to make them believe she really does understand how to deliver growth in the UK?

• 13 Jan 2025 · Hospice and Palliative Care · Hansard source

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  I thank the hon. Member for Wimbledon (Mr Kohler) for securing this debate. I was going to test the patience of the House by reading out all the hospices that have been named, but we got to 45 and I realise that time is short, so I will not do so. It is, however, a testament to those hospices’ services that so many Members have spoken so fondly about them. On behalf of His Majesty’s Opposition, I would like to discuss three areas: the conversation about death; palliative services and the ecosystem; and some specific technical questions. It is rare in this House that we debate a topic that impacts literally everyone, and it is an honour to play my part in highlighting something I have long argued is not talked about nearly enough—that is, death and dying. We all know that the only certainty is death, but there is a variable, which is the quality of death. That has been the focus of today’s debate. After all, it was Woody Allen who said: “I’m not afraid of death, I just don’t want to be there when it happens.” Palliative care services dedicate their lives to making sure that people who will die do so with dignity. Many people think of hospitals or hospices in relation to death, and their staff do fantastic work, but we must not forget the pivotal role played by the likes of district nurses and GPs in ensuring there is palliative care in our nation. In my constituency, I am blessed with hospice care from Loros for adults and Rainbows for children, both of which are much loved by the public and, most importantly, supported by armies of volunteers. Those people deserve this House’s and the public’s recognition and respect for what they contribute to our society. Dying can be a difficult subject to talk about, as I know from my clinical days, but that does not make it any less important. I pay tribute to this House for the way in which it handled and discussed the assisted dying debate. Whatever position people take, it is fantastic to see a national debate now taking place across dinner tables up and down this country. So my first question to the Government is: what is being done to ensure that people look to plan their deaths better? When we talk about the wider ecosystem, we have to consider the roles of hospices, hospitals and primary care providers such as district nurses, who are all key stakeholders, and the nature of how they have ended up being involved in palliative care and the different journeys they have made to do so. That is beyond the scope of this debate, but it is important because it informs the make-up and patchwork of palliation across this country. As we have heard, there is a balance between charitable funding and NHS funding, and even this House is divided on what that formula should look like and whether it should be solely state funded or charitable. My second question to the Government is: will they consider consulting on a long-term funding model that allows this debate to take place, so that we have a better balance between the two? Building on that, looking at it from the clinical point of view, part of the issue at play is what the provision should even look like. My third question to the Government is: will they commit to establishing agreed basic standard criteria for service-level provision, and to getting a national agreement on the provision of palliative care services and what they look like for whatever a person should choose? On the record of the last Government, we legislated in the Health and Social Care Act 2022 to ensure that commissioning was taking place. As part of the NHS response to covid, £350 million was given to support hospices in those difficult times. NHS England also put in grant funding for a 24/7 single point of access for palliative care support. As we have heard, the last Government also increased the funding for the children’s hospice grant from £15 million in 2020-21 to £25 million, and I am pleased to see the Government continue that trajectory. To help manage staff, the last Government brought forward the first ever NHS workforce plan, and I commend this Government for continuing to commit to that. With the debate about assisted dying and the concerns expressed by the Health Secretary about provision, however, my fourth question to the Government is: what assessment have they made of the impact of assisted dying on provision? I believe the Secretary of State was commissioning work on this, so when will the results be released? On assisted dying and the ability to provide the services, this is not the right place to suggest whether they are right or wrong, but whether or not the Bill passes, I hope we will not let it distract us from the mission of continuing to improve palliative care and end of life services, for which there is momentum in the House and among the general public. On the specific questions from the sector, it would be remiss of me not to raise the concerns about Labour’s Budget and its impact on the palliative care sector. The employer national insurance contribution increases are a tax on charities—fact. Charities are not covered by the NHS exemption. Hospices are charities, so they are being taxed—fact. GPs provide palliative care and support. They are not covered by the NHS exemption, so they are being taxed—fact. Hospice UK has estimated that an additional £30 million will need to be found. This means that charities and non-profit organisations such as Sue Ryder, Macmillan and Marie Curie are being hit with additional wage bills, requiring more money just to provide the same level of care. The Government have said that they will give £100 million to hospices, but it has been made abundantly clear in this debate that it is for capital expenditure only, unless the Minister would like to correct me. What assessment have the Government made of what the spending review will look like when it comes to palliation? It is hard not to see this as a Labour Government giving with one hand while taking with the other—taxing GPs and hospices in order to give them money back in a way that they do not want. On staffing and contracts, some staff are employed by the NHS, while others are directly employed by the hospices. Have the Government made an assessment of the impact that will have on recruitment? For example, palliative care consultants face a postcode lottery of terms. Will the Government consider looking at that? Palliative care consultants’ contractual arrangements throw up another oddity in the sector: some NHS palliative care consultants have Crown indemnity, while others employed by hospices do not, costing them thousands of pounds. Will the Government consider looking at that? On the allocation of funding process, Together for Short Lives has called on the Government to confirm whether the £26 million will be ringfenced for children’s hospices and distributed centrally to avoid delays. Previously, the decision was made to give it to ICBs to better help local decision making. Although well meaning, that has resulted in delays. Are the Government aware of this issue and, if so, will the Minister commit to working to smooth it out? There is much more that I could say on the topic, and I sure that the same is true for many others. The UK has an ageing population, and demand for palliative care will continue to rise in decades to come. In this House, we have the opportunity to make a difference for all who come after us. At the heart of looking after the dying is compassion. True compassion means not only feeling another’s pain, but being moved to help relieve it. This Government have the power to do that, and I hope they will.

• 8 Jan 2025 · Draft Combined Authorities (Borrowing) and East Midlands Combined County Authority (Borrowing and Functions) (Amendment) Regulations 2025 · Hansard source

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  I declare an interest as a Leicestershire MP. Leicestershire looked at joining the East Midlands combined county authority but decided not to. Given what the Minister said about this Friday, if Leicestershire decided that it wanted to go into D2N2, would we need further legislation to change the borrowing that is set again, and a further SI to add that in, or is there a mechanism lined up so that county authorities can join mayoralties without the matter having to come back to Parliament?

• 7 Jan 2025 · Access to Primary Care · Hansard source

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  To improve access, the Government have announced a planned expansion of advice and guidance, and GPs will be paid £20 per advice and guidance request they make for further expert advice from consultants. How do the Government expect this expansion to take place? Will they be mandating it given that the current position of the British Medical Association, under its collective action, is that GPs should “Stop engaging with the e-Referral Advice & Guidance pathway”?

• 7 Jan 2025 · Access to Primary Care · Hansard source

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  Going back to advice and guidance, GPs use advice and guidance when they have come to the summit of their knowledge and need specialist input. For example, as a GP, I may see a rheumatology patient and ask for advice from a rheumatologist, who may advise specialist blood tests. The problem is that, as the inquiry clinician, I am legally responsible for those blood tests and have to pay for them out of the primary care budget. Do the Government propose that the £20 will cover subsequent follow-ups and the cost of suggested tests? Given the expansion of advice and guidance, will the Government be looking at a legal framework change in accountability for clinicians making requests?

• 18 Dec 2024 · Engagements · Hansard source

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  As it is Christmas, will the Prime Minister join me in congratulating Chris Middleton, who wrote a charity song to support Age UK that has already raised £10,000? What is even better is that it is likely to beat the leader of the Lib Dems’ single to No. 1 this year, proving yet again that the Lib Dems cannot win—something that I hope we can both agree on.

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  The hon. Lady has always been an advocate for childcare. One way the previous Government tried to address the issue was to try to stop the cliff edge for childcare by looking at households rather than individual parents. In the last Budget, the Government were looking at the proposal to consider households as one unit. Does that mean the hon. Lady has changed her mind and would support that mechanism being looked at again? It would solve a lot of the problems caused by, for example, a single parent having to pay for childcare because they are exempt, whereas a household containing a couple who earn under £45,000 are not eligible.

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  Is the hon. Lady aware that the National Pharmacy Association has agreed to collective action for the first time in its history, directly as a result of this Government’s Budget? Does she have any comment on that?

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  I am grateful to my fellow Leicestershire MP for giving way. One of the ways that we can judge the market is by looking at vacancies. James Reed, who runs the Reed recruitment agency, has seen a 13% drop in advertisements on the company’s website. He has sounded the alarm that that could be a sign of recession, and that is the implication of what we are voting on today. How will the measure support young people if there are no jobs out there for them?

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  Will the Minister give way?

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  I am enjoying the hon. Member’s exposition of his thinking on this matter. Will he set out how this works for national insurance contributions, which is what we are talking about? Those on the frontline—the likes of GPs and care homes—are private, but they are commissioned only by the NHS. Is he aware of where the funding will come from? Will it come from the £22.6 billion? That would make sense, but if so, the Government need to clarify where that money is going. Part of the problem is that it does not add up for the Government to say that they want to support the NHS yet tax those very people—the doctors, the hospices and the care homes—to fund it. Will he elaborate on how that will work?

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  The hon. Member has hit the nail on the head. The Labour Government say that they want to deal with this situation, and that they effectively protected secondary care, but the NI applies to GPs at the front end and care homes at the back end. That means that it will be the hospitals who hold the responsibility—the acute places that we need to keep clear if we are to help the backlog move through. Without getting an answer now, we risk recruitment decisions being kept on hold over the next three or four months and cutbacks being made. Does the hon. Member agree that, on top of the difficulties of an already hard winter, that will cripple the NHS?

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  When it comes to social care and GPs, there is a situation that has been described to me as Schrödinger’s care. Providers are seen by the state as being private, yet their services are commissioned solely by the NHS, which means that they are caught both dead and alive when it comes to NICs. This has happened either by design in the Treasury, or by accident. The answer from the Chancellor, the Prime Minister and the Health Secretary—I expect the Minister to say this—is that funding will be allocated in the usual way. The problem is that that will happen in April, four months away, while decisions are being made now. There are potential closures, and certainly redundancies, or decisions not to employ. How will that be addressed? Does my right hon. Friend agree that the Minister needs to address that, because these institutions are listening now, and need to know that answer?

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  Will the hon. Lady give way?

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  On a point of order, Ms Nokes. We are debating the National Insurance Contributions (Secondary Class 1 Contributions) Bill, in which I am not sure that Brexit is mentioned. I look to your leadership to decide whether the hon. Gentleman is in order.

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  My hon. Friend has hit the nail on the head, and the Treasury really needs to answer this question. Did it knowingly implement these tax rises on these industries, which would be a travesty in itself, or did it do so by mistake because it does not understand these issues? If that is the case, will the Government look to rectify the matter so that hospices, GPs and childcare providers are protected?

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  I am very grateful. The hon. Lady makes a fantastic point about wanting to set out the tax base. The difficulty is that the Government are also spending on the NHS. Fundamentally, GPs are private contractors to the NHS. Care providers are private contractors. Therefore, the Government have to make a choice: are they going to exempt them or will those private contractors have to pay? At the moment, the Government have done neither thing. That is the fundamental argument we are having on these amendments in trying to protect those contractors, because the Government have not made a choice. They have said that at some point there may be some payments along the way. That is the concern on the Opposition Benches. What is her answer to that?

• 17 Dec 2024 · National Insurance Contributions (Secondary Class 1 Contributions) Bill · Hansard source

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  My hon. Friend is an astute man, and he has picked up on something that I fear. According to S&P Global’s purchasing managers’ index, this has been the third consecutive month of job losses; December has seen the highest number since 2021, in the pandemic. It has said: “Barring the pandemic, the survey has not seen job losses on this scale since the global financial crisis in 2009.” That is a direct impact of the choices in the Budget and this NIC increase. Does my hon. Friend agree that this is something the Government really need to think about?

• 17 Dec 2024 · Community Pharmacies: Devon and the South-west · Hansard source

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  The Minister is espousing brilliantly what community pharmacies do. That all comes under a contractual framework, and one of the key things that pharmacies are asking for is when the negotiations will start and what the terms of reference will be. Will the Minister address that point?

• 17 Dec 2024 · Community Pharmacies: Devon and the South-west · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Betts, and to speak across the Chamber from the Minister for the first time. As a GP, I am grateful for the fact that 38 million GP appointments are saved each year. Although the temptation is to try to thank everyone—it can feel like doing a set of prescriptions again—I pay particular tribute to the pharmacists, because whenever I used to get a call from a pharmacist, I always knew that they were right and that I should listen carefully to what they said. As of January 2024, there were more than 10,000 pharmacies providing NHS services, with 80% of the population living within 20 minutes’ walking distance of a pharmacy. We know that the number of registered pharmacists also grew consistently under the last Government, up 61% in 2024 compared with 2010. I am pleased to hear that the Government are still committing to the NHS workforce plan. As we have heard today, there are still difficulties in meeting recruitment needs. I congratulate the hon. Member for Tiverton and Minehead (Rachel Gilmour) on securing her first debate. As she rightly pointed out, there are many difficulties in the sector. I would like to take a quick canter through them. With five minutes, I have five questions to the Minister. The first and most obvious issue is the community pharmacy contractual framework, which is so important to the financial agreement for 2024-25. This was a deal struck in July 2019 to provide £2.59 billion in annual funding to NHS pharmacy services. Under the last Government, in 2023, the NHS published a delivery plan for improving access to primary care, which included a £645 million investment over two years to expand community pharmacies. However, the delays in the negotiations are having an impact on pharmacies across the country. In a recent letter, Community Pharmacy England wrote that “there will not be a community pharmacy sector left to deliver the Contractual Framework, let alone the future ambitions of the Government and the NHS.” Question No. 1 is: can the Minister provide an update on the negotiations? When will it start, and will there be published terms of reference? My next question relates to the impact of the increases in national insurance contributions and the national living wage—the Government’s choice to place a burden of about £50 million on the sector, as has been set out. The Government have exempted secondary care, but made no such commitment to community pharmacies. Question No. 2 is: was the Health Department aware of the Treasury’s decision, and did it raise concerns about pharmacies and the impact the changes would have? After all, it has led the National Pharmacy Association to vote in favour of collective action for the first time in their history, saying: “The sense of anger among pharmacy owners has been intensified exponentially by the Budget, with its hike in national insurance employers’ contributions and the unfunded national living wage increase, which has tipped even more pharmacies to the brink.” Question No. 3 is: what mitigations are planned and when for? As we have heard from the Prime Minister, the Chancellor and the Health Secretary, it will be done in the usual way. Decisions are being made now, so could they please set that out? Let me turn to the evolving model of Pharmacy First. The programme has shown just how capable pharmacies are, and it has been welcomed. There is great potential for the service to benefit patients, yet recent data from NHS England identifies that GP referrals to Pharmacy First in England can vary quite significantly across integrated care boards. For example, in Greater Manchester, there were 11,683 referrals, whereas in Cornwall and Isles of Scilly, there were 612. There could be obvious reasons for that, such as demographics or locations, but question No. 4 is: can the Minister clarify what the Government are doing to promote Pharmacy First services, and share that data? I was pleased to hear the hon. Member for Mid Dorset and North Poole (Vikki Slade) discuss the issue of dispensing GPs. There are 948 dispensing GPs, and they account for 7% of prescriptions, covering almost 9 million people, many of whom are in rural areas. Not much is mentioned about what they do, so I am keen to understand the Government’s position on dispensing GPs. Question No. 5 is: will the Minister set out how he perceives the landscape? Given the time constraints of this debate, perhaps he can write and give me an idea of what it would look like. Finally, the pharmacies stepped up during the pandemic. They were the lightning rod not only for getting medications out but for providing the much-needed vaccinations that allowed us to relieve lockdown. Christmas is one of their busiest times—I have seen that at first hand. I would like to put on record our thanks, from both sides of the House, for the fantastic job that they do.

• 11 Dec 2024 · Finance Bill · Hansard source

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  rose —

• 11 Dec 2024 · Finance Bill · Hansard source

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  My hon. Friend talks about choices, and one of the choices that independent schools are now going to have to make is how to use their own resources, such as their sports pitches, bursaries and scholarships. The kinds of things that benefited the wider local community may now have to be turned into fundraising and revenue-making machines to be able to deal with this change, which in turn means that other schools will not be able to use their community facilities, such as their football pitches. Those may all have to be charged more for, or indeed cut completely, as the independent schools have to make those difficult choices. That is not good for community cohesion at all.