Luke Evans MP: speeches

Speeches

• 11 Dec 2024 · Finance Bill · Hansard source

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  One of the schools in my area has posed a question on VAT. It has combined fees, within which things like meals are included. It is not clear from Treasury guidance whether the school would have to separate those fees out, creating another accounting problem—in order to have separate VAT and travel, for example, as part of the fees—when currently it is all one unit. Could the Minister provide clarity on that? When I met the Schools Minister, he was unable to give me an answer, and was going to go away and speak to the Treasury about what that looks like. This will have real impacts for this school, which will have to decide how to set out its accounting, and whether it has to include the fees or separate them out into several different blocks.

• 11 Dec 2024 · Finance Bill · Hansard source

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  The point is valid. The Government are trying to get more properties for people to buy, but at the same time they are changing back the threshold for first-time buyers. Those first-time buyers will be stifled when they want to buy a house because they will have to pay more tax. Introducing both measures simultaneously seems to cause a rub. Does my hon. Friend agree?

• 11 Dec 2024 · Finance Bill · Hansard source

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  I am grateful for the Minister’s clarification on that point; I think he is hitting towards it. The school itself has everything grouped into one fee, which includes the transport, schooling and food. Its contention, therefore, is that it will have to break that all out, which means it will have to deal with all the accounting issues on top of this. It is just another burden to think about. I wonder whether the Treasury has thought about that and whether there will be further guidance—there is literally just one line in a piece of written guidance put out by the Treasury. Is there anywhere the school can raise this issue to work through the exact advice it needs? I appreciate that the Minister cannot give that advice directly to the school from the Dispatch Box.

• 11 Dec 2024 · Finance Bill · Hansard source

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  It is important to have transparency. It is not controversial to say that we need more houses—Members on both sides of the House agree—but take Leicester, where new housing targets have been reduced by 31%. We will now have an exodus of people offering rental residences. Will that not compound the problem acutely? We will not have the number of homes. The target has dropped in Leicester, but we will have more people needing to rent. The homelessness rate could go up, because people are leaving the market. The Government need to think carefully about that. The new clauses would give transparency on whether there is a problem.

• 11 Dec 2024 · Finance Bill · Hansard source

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  The Minister mentions first-time buyers. However, the change to stamp duty is likely to affect them, because they are now being brought into paying stamp duty. How does that help first-time buyers to realise their aspiration of getting into the housing market?

• 11 Dec 2024 · Finance Bill · Hansard source

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  Does my hon. Friend agree that the veterans’ commissioner that will be introduced by the new Government will be perfectly primed to look at this kind of problem to ensure that both Departments—the Ministry of Defence and the Department for Education—get the best? Is that not the purpose of the commissioner?

• 10 Dec 2024 · Rare Autoimmune Rheumatic Diseases · Hansard source

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  It is a pleasure to serve under your leadership, Dr Huq, and thank you for the introduction. I thank the hon. Member for Strangford (Jim Shannon) for his detailed canter through a subject that needs to be highlighted. He hit the nail on the head in relation to improving clinical pathways. We, as a House, need to think about the best way to do that, and to help the NHS to do that. He exemplified that by telling Zoi’s story. As the hon. Member for Bootle (Peter Dowd) rightly highlighted, the impact on patients is the crux of the matter, which was also personified by the hon. Member for Mid Sussex (Alison Bennett) with her story about Carrie—what she and her mother have to go through, and the difficulties they are living and breathing every single day. The co-ordination of care is so important. The hon. Member for East Londonderry (Mr Campbell), who is no longer in his place, made a timely and pointed intervention about clinicians, awareness and training. Being a clinician, and bringing that experience to the House, I believe it is difficult to identify the issues because they are often masked by other conditions. A random screening test may conclude rheumatoid factor, anti-CCP antibodies, ESR, CRP, ANA, ANCA, and even anti-ro and anti-la. All those may be positive or negative, and can be indicative of, but not definitive about, some of those conditions. That is part of the problem we have with those rare diseases. With 170,000 people affected, they are uncommon but common enough for us to see them. I certainly have treated several patients with conditions such as systemic lupus erythematosus, Sjögren’s or Raynaud’s. When we think about these conditions, we need to break them into two distinct groups: the connective tissue disorders, such as lupus, scleroderma, myositis and Sjögren’s, and vasculitis disorders, such as ANCA-associated vasculitis, giant cell arteritis and Behçet’s. By their nature, because they are rare, they are hard to diagnose. I hope that in the future, we may well have artificial intelligence to help clinicians to identify, or at least to think about, the differential diagnosis when it comes to dealing with those patients. It is a broad and difficult topic to break down, so it will be helpful to look in turn at the framework to address rare diseases, the research behind it, the diagnosis, the workforce, and, finally, the treatment. A framework to help the approach is important, so under the previous Government, the UK rare diseases framework was published in 2021 to set out a vision to improve the care for people with rare diseases. It set out four priorities: delivering early diagnosis, increasing awareness among health professionals, improving access to a specialist team and providing co-ordinated care. In essence, that is the care pathway. The framework was designed to improve the speed of diagnosis, the co-ordination of care and the access to treatment. As RAIRDA said: “The UK rare disease framework (2021) has been a significant step in securing equity of treatment for rare diseases, and going forwards, it is crucial that the Government does not lose sight of the work done to date to drive changes for people living with rare conditions.” Therefore, I ask the Minister my first question: how do the Government intend to build on the UK rare diseases framework to ensure that it remains adequately funded and relevant? Next, we need the research, and that is the hardest part. As I mentioned, some of the tests cannot even diagnose conditions such as Behçet’s syndrome; it is often a clinical diagnosis. The establishment of the Genomics England project, further mapping the genetic codes of individuals with rare conditions, was a move hailed by researchers worldwide. The programme, although ostensibly broad, directly benefits patients with rare autoimmune rheumatic diseases by identifying genetic markers and enabling targeted treatments. My second question to the Minister is: what progress has been made in expanding genetic research to uncover new treatment options for such diseases? Earlier this year, the Government published an action plan that includes significant new commitments against each of those four framework priorities, including the health inequalities that we have heard so expertly talked about today. The action plan highlighted the significant investment in driving research on the diseases, including £14 million to the Rare Disease Research UK platform. That facilitates greater collaboration between academics, clinical and industry research, as well as people living with rare diseases, research charities and other stakeholders to try to accelerate the understanding, diagnosis and therapy of these diseases. I was pleased to stand on a manifesto commitment to take forward the rare disease action plan. I fully accept that more needs to be done, and the new Government must work closely with their delivery partners on the matter. I was pleased that in a recent written response, the Government reiterated their support for research into rare diseases. They further highlighted that the Department for Health and Social Care has invested £2.2 million to enable the National Institute of Health and Care Research to carry out research programmes related to rare genetic diseases, and of course the £340 million to Genomics England. I did my medical training at the University of Birmingham medical school, which has the University of Birmingham Centre for Rare Disease Studies, a collaboration to try to pull together all the academic research. That is translational research. As we keep saying, these diseases are rare so, by definition, to do the trials, we need to have a wide pool to pull people together to try to work things out. I hope the hon. Member for Strangford will be interested in the fact that that university has joined with the Queen’s University Belfast to research and collaborate across the four nations, including with Newcastle University. In 2015, I had the privilege of visiting that centre, and this is a note for him to look into that. Will the Government continue to increase funding specifically for rare autoimmune rheumatic diseases, especially within the Medical Research Council’s care for rare disease programme? Then we need to look at workforce and testing capacity. Over the last few years, the Government have allocated £2.3 billion to community diagnostic centres, of which there are almost 170 across the country. Those are really important for doing blood tests, ultrasounds, MRI scans and CT scans. In my constituency, I am lucky enough to have had £24 million invested; one is being built as we speak. That is revolutionary for our area, because for too long people had to travel to the likes of the George Eliot Medical Centre or to Leicester. Now they can have these tests in their community, providing swifter access. I hope that that will help people like Zoi, about whom we have heard, by making sure that she is one of the lucky ones who gets swift access. Within that, we also need the people who can do the tests and understand the specialisms, so will the Minister tell us whether the Government will be expanding the network of CDCs any further? On staffing, the last Government brought forward the NHS workforce plan. How are this Government looking at addressing rheumatology and radiology in that plan to make sure there are no gaps? Treatment is the one thing we are looking for. We have the diagnosis, but we need the treatment. Innovative drugs are coming, including immunotherapies, but they often come with high price tags. NICE is looking at how to speed things up, but will the Government commit to accelerating the processes so that we can make sure people get these innovative drugs as quickly as possible? We should not forget that standard drugs are used as well, including methotrexate. They can be quite dangerous, so I ask the Government what they are doing to ensure safe use of such drugs. Disease-modifying medications are important, but they can have high toxicity if not used properly, so they can cause harm. Safety is really important. The previous Government’s legacy is one of frameworks being established, investment being made and a road to improve lives. For the 2024 general election, RAIRDA published a manifesto that called on the Government to ensure that rare diseases remain a priority, to develop a quality standard for rare diseases and to develop better support for specialist networks. How will the Government work to consider and address those points? I hope this debate has highlighted exactly those calls, because we unanimously agree that this is what we need: research, networks, support and treatments for the individuals who are suffering.

• 10 Dec 2024 · Rare Autoimmune Rheumatic Diseases · Hansard source

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  I am grateful to the Minister for acknowledging the workforce, and for looking at the workforce plan. I was aware of the Health Secretary’s plan to revisit this, and the Minister talks about it being done next year. Does he have a timescale for how long the review will take? The danger, especially in healthcare, is that modernisation happens so quickly that, by the time we review something, it is already out of date and needs another review. This is always a chicken-and-egg situation. I would be grateful for a timescale.

• 10 Dec 2024 · Rare Autoimmune Rheumatic Diseases · Hansard source

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  No!

• 10 Dec 2024 · Lobular Breast Cancer · Hansard source

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  It is a pleasure and an honour to serve under your stewardship, Ms Vaz, and even more of an honour to be part of this debate. I pay tribute to the hon. Member for Dulwich and West Norwood (Helen Hayes). Not only was her speech emotional, but it was powerful. Cressida, I am sure, is incredibly proud and Heather would be even more proud. That is because the hon. Lady has really done the subject justice today, not only by securing this debate but by bringing the whole room together and highlighting the most salient points. Often in these debates, there is a lot to cover, and the hon. Lady has done it with aplomb. I also thank my hon. Friend the Member for Maidstone and Malling (Helen Grant) and the hon. Member for City of Durham (Mary Kelly Foy) for speaking up about their personal experiences. That is tough to do, and it is a testament to their constituents that they have put on record, in public, the trials and tribulations they have been through. It is important that people feel they can advocate in this space and lead by example in doing so. That leads me on to the hon. Member for Bexleyheath and Crayford (Daniel Francis), who talked about his wife. He is an example of how important it is to have a powerful advocate. Partners and families do exactly that: they advocate for patients who are going through treatment. The fact that he is doing that here as well is incredibly powerful. The hon. Member for Strangford (Jim Shannon) and I are starting to have regular conversations about health in Westminster Hall debates, with an hour and a half this morning and another hour and a half this afternoon. His passion for health topics is probably only superseded by the volumes of Hansard content he accounts for. He talked about networks, and in research it is important to make sure that we are bringing together the best brains from across the field for the biggest possible research pools. That is much needed. I congratulate the hon. Member for Horsham (John Milne) on highlighting hope. The danger is that we spend too much time talking about difficulties, when over the past couple of decades, breast cancer actually provides a good story of how far advances have been made and survival rates improved. It is important that we point that out, so that not all is doom and gloom. There are fantastic survival rates for breast cancer, for example. The hon. Gentleman paid tribute to Dr Susan Michaelis, as did the hon. Member for Wokingham (Clive Jones). As MPs, we are lobbied a lot, so to have got so many MPs signed up and to have secured debates here repeatedly, month on month and year on year, is an incredible testament to the character of Dr Michaelis. The Lib Dem spokesperson, the hon. Member for North Shropshire (Helen Morgan), rightly highlighted access. When it comes to making sure we get diagnoses, access is key. The last Government rolled out community diagnostic centres—almost 170 of them. When it comes to diseases such as breast cancer, I hope that new MRI and CT scanners will become available, allowing us to have better screening pathways, because that is what often limits a screening programme. That access is now being widened so dramatically, with the Government confirming this morning that they are continuing with it, is a sign of great cross-party working, which we all know the NHS needs. Much has been said about lobular breast cancer in this debate, and for me it matters because of the way it presents. One can take the doctor out of medicine but not the medicine out of the doctor, so I will use this opportunity to ensure that people are aware that they should regularly check their breasts. They should look for lumps but also for skin changes, or what we call peau d’orange—it looks a little like orange peel—on the breast. They should also look for slight changes, a little bit of discharge or blood. Lumps, bumps and discharge do not mean an individual has cancer; it simply means they need to be assessed. One of the great things about the set-up in this country is that it is quick and accessible—a good success story—but we need to ensure that people feel comfortable and able to come forward. Cases have been highlighted where clinicians did not seem to trust women. It is important that clinicians trust women’s instincts. Women know their own breasts, and when they are aware of changes, they must be taken seriously. We have a chance through clinical pathways to do that, which is important. We heard that 22 women a day in the UK are diagnosed with lobular breast cancer. As someone who has given that diagnosis, my next piece of advice for anyone unfortunate enough to receive a diagnosis of breast cancer is to ask whether it is lobular or ductal. That is often forgotten. As a clinician, I have never been asked that question, but it would help to change the narrative of expectations about what treatments may be available, and promote understanding. If a patient speaks to someone else with breast cancer, they might wonder why their treatment is different. It is important to educate people, not in a condescending way, but to appreciate the general difference. Treatments are becoming so specialised and nuanced that all will not be the same, and that can be quite disconcerting. I pay tribute to those who are battling lobular cancer, the cancer survivors and the campaigners from Lobular Breast Cancer UK for their tireless work in raising the issue. Of course, the ultimate goal is to have a cure for lobular breast cancer. Advances in medical research and treatment options are moving us closer to that goal. In 2022, the Government invested £29 million into the Institute for Cancer Research and the Royal Marsden biomedical research centre to support research into cancer, including lobular breast cancer. That included a £1.3 million project to determine whether abbreviated forms of breast MRI can detect breast cancers missed in screening. That links to the point about having more MRI scanners, which might well enable better research to determine the way to pick these things up and improve the ability to deliver. I am pleased the previous Government supported, through the National Institute for Health and Care Research clinical research network, 10 further lobular breast cancer-related studies. I am also reassured by the Lobular Moon Shot Project, which we have heard a lot about. I pay tribute to the former Member for Horsham, Sir Jeremy Quin, who did a lot to raise that issue. I am pleased to see the new hon. Member for Horsham standing in his shoes to raise it now. It would be useful to know if the £20 million for the five-year study is being looked at by the Government. It was raised several times with the previous Government, but an election got in the way and power changed hands. It would be interesting to see if the proposals have been reviewed and merit the Government taking them forward. A key measure that has been missed to some extent is guidelines. Lobular Breast Cancer UK is to launch a campaign calling for national breast cancer guidelines to be updated to recognise lobular breast cancer. Will the Minister commit to reviewing and updating the guidelines with the National Institute for Health and Care Excellence? We have also heard about devolved powers. Scotland, for instance, has the Scottish Intercollegiate Guidelines Network. It would be useful to know whether the Minister will raise this issue with the devolved nations to ensure we have a joined-up approach, without any cross-boundary difficulties. I do not want to turn this into a political battle because this is not the place, but I put it gently to the Minister that we have heard about the need for support, a lot of which comes from charities. The changes in national insurance contributions for employers have hit charities, including the likes of Breast Cancer Now, Macmillan and Marie Curie. They are not shielded from the rises. I will be grateful if the Minister considers raising with Treasury what can be done to help support those crucial nurses, advice lines and workers, so as to make sure that when people are going through these difficulties—we have heard how complex the scene can be, particularly in breast cancer—advice is accessible to all. I thank all those who took part in this debate, and I remind people to regularly examine their breasts. If there is a change, seek help. If a diagnosis of cancer is given, ask if it is lobular or ductal. Finally, remember that no one is alone. As we have heard today, many people suffer from cancer and there is support out there—from the NHS, charities, family and friends—so do not be fearful. Speak out and get that support.

• 10 Dec 2024 · Lobular Breast Cancer · Hansard source

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  I want to draw the Minister’s attention to the point about guidelines. Will she consider speaking to the devolved nations and, in England, to NICE, about guidance on lobular breast cancer?

• 10 Dec 2024 · Legislation on Funerals · Hansard source

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  5. What assessment she has made of the adequacy of legislation on funerals.

• 10 Dec 2024 · Legislation on Funerals · Hansard source

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  As the Minister knows, we have been in correspondence about that sector. She kindly wrote back to me to say that the Fuller inquiry’s phase 2 interim report has been released. My constituent Joseph Barsby runs G. Seller, one the biggest independent funeral directors. He is passionate about how we can bring forward a compassionate way of looking at people who have died, while ensuring that standards are kept high. Will the Minister consider meeting me and him to further discuss ways that we can bring the sector into the 21st century?

• 9 Dec 2024 · Terrorism (Protection of Premises) Bill · Hansard source

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  I was fortunate enough to listen to the hon. Gentleman’s Westminster Hall debate on the Edinburgh fringe and its success around the world. That is a prime example of where the Bill might be helpful. Has the hon. Gentleman given any thought to how those small venues can work together? If they share best practice, that can create an environment of security. I wonder whether the fringe organisations themselves have thought about this, given that they are, by their very nature, likely to be a target. Sharing best practice may help to strengthen the entire environment when people visit it.

• 9 Dec 2024 · Terrorism (Protection of Premises) Bill · Hansard source

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  For me, when we think about creating the regulator, it is about ensuring that it is effective. It needs to be staffed and funded appropriately, and we need to ensure that it does the job that the House expects it to do. The idea of having a system to report back is important when we make these provisions. When my hon. Friend was shadow Minister, did he give any thought to how many businesses come within scope, and whether there are resources in the regulator to even provide those assessments, so that we can make sure that it is held accountable and that this is effective legislation?

• 9 Dec 2024 · Terrorism (Protection of Premises) Bill · Hansard source

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  I think that the volunteer side in particular is concerning a lot of people. One thing that strikes me about new clause 2 is that, given that these are often volunteer organisations, who would fund the training? Has there been thought about who would pay for it and how much it would cost? Small venues like my village halls may struggle to make a couple of hundred pounds a year, let alone be able to afford further training. I wonder if the hon. Member would enlighten me on how that may work.

• 9 Dec 2024 · Terrorism (Protection of Premises) Bill · Hansard source

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  Without the regulations and guidelines being set out clearly, there is a risk that businesses will worry about being fined quite heavily just because they do not quite know what they should be doing. Does my hon. Friend agree that this amendment and new clause 1 will help cement that clarity in place?

• 9 Dec 2024 · Terrorism (Protection of Premises) Bill · Hansard source

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  I too have lots of churches in my constituency, and while I fully support the legislation, I do worry about some of the rural churches. There is a risk of a fine, if they are not compliant. Does that mean that there is a risk that those venues, which are already under stress, would not be able to open? I hope that is not the case, and that the Minister can allay some of my fears, but given how the legislation is written, that could be a prospect. That would be very damaging for many of the rural churches in the hon. Gentleman’s constituency.

• 9 Dec 2024 · Terrorism (Protection of Premises) Bill · Hansard source

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  Will the hon. Member give way?

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

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  Is the hon. Member aware that the Royal College of General Practitioners said that it will cost 2.2 million appointments just to service the NIC payments that must be made? How does that resolve our service provision in primary care?

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

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  Absolutely. Does the hon. Member realise that we had to deal with that because the amount that we had to borrow in 2010 was £158 billion? For the pandemic, it was £400 billion. That is the kind of thing that the Conservatives have had to deal with that led to the difficult decisions. We were on track to have the fastest growing economy, which has now been trashed by decisions taken by Labour.

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

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  We have heard a number of times from the Prime Minister and the Chancellor, and even from the Exchequer Secretary to the Treasury today, that allocations will be made in the usual way, but we are six weeks on from the Budget and health services are trying to decide what to do now. They cannot wait.

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

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  Part of the biggest problem that I have with the way this is being done, looking at the NHS as a whole, is that while at the front door of primary care the raising of national insurance contributions means that GPs do not want to recruit, at the back door social care is also being hit by the increase. It is all very well protecting the centre—the hospitals—but the biggest problem is system-wide, in that both the back door and the front door are jammed shut. How will the Bill resolve that? This is the practicality that the Labour party must explain to the health services, because they are asking the same question and it is going unanswered.

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

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  The Minister talks about protecting businesses or charities, but hospices, for example, employ many more than four people. I cannot think of one hospice that does not employ more than four people. How will they be protected?

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

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  Is it not the biggest slap in the face for people listening to this that when Labour uses “working people”, it cannot define that term? Pub landlords and people working in charities are by definition working people—they are of working age and earn a living—and they will now be hit by this tax, which will have such a detrimental impact on their livelihoods. Is that not a disgrace?