“If the final agreement includes ISDS, we would wish to see very strong safeguards built in so that this mechanism cannot be used to frustrate the public policy intentions of elected member state governments.”

It also states:

“There is a need to be vigilant that the TTIP wording does not lower standards for the approval of pharmaceuticals”,

in the same way as we have talked about for food standards.

I urge the Minister to make certain that the UK is fully involved in those negotiations, and that we do not leave any i undotted or t uncrossed, and we make sure that we safeguard our NHS, our food standards and our environmental standards.

4.19 pm

Jeremy Corbyn (Islington North) (Lab): I commend my hon. Friend the Member for Swansea West (Geraint Davies) for securing this debate. It is long overdue, so

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well done to him for pressing for it. I also want to thank all the campaigning groups that have done so much work on this subject, including War on Want, the Global Justice Movement and the TUC. To the irritation of Conservative Members, I also want to thank 38 Degrees. There is no harm in members of the public e-mailing us. There is no harm in them getting together and asking MPs what they think, what they are doing and, above all, what they intend to do about a particular issue. That is what an interactive democracy is about, and modern technology gives us the opportunity to do these things. We should not be afraid of that; we should welcome it, even if it means replying to 300 or 400 e-mails at a time. That is not complicated, and I am sure that Members will eventually get used to the idea that there is going to be a lot more interaction in the future.

The Government have sent—perhaps only to Conservative Members, I do not know—a very unhelpful document called “Transatlantic Trade and Investment Partnership: separating myth from fact”. It actually raises far more questions than it answers. It states rhetorically that it is being suggested that

“TTIP is being agreed by a European institution which was not democratically elected”.

Its response is:

“The UK Parliament will have an opportunity to scrutinise the final agreement through debates in both Houses.”

However, it goes on to say that the eventual deal will be agreed by the EU Council and the European Parliament—which is of course not the same as a national Parliament—and prays in aid the fact that

“TTIP is also the subject of a House of Lords enquiry and an All-Party Parliamentary Group.”

That is hardly a wholehearted endorsement of the democratic scrutiny of an arrangement that will be crucial to the work and ordinary lives of the people of this country.

What is the objective of TTIP? It is to increase trade between Europe and north America, but that trade is not without a cost. It benefits the companies that undertake it and, yes, that could be beneficial if it means more jobs. But let us look at other trade agreements that claimed in advance that they would offer the same great advantages. An example is the North American Free Trade Agreement between Canada, the United States and Mexico. Severally, companies in those countries were all told that free trade would increase trade and opportunities and help to eliminate poverty. Who have been the losers? Those who have been de-industrialised in what is now, unfortunately, known as the rust belt in the USA; those who have seen their working conditions damaged in Canada; and those working for companies that have been set up in Mexico in a virtual tax haven zone on the border, who are paid disgracefully low wages and have appalling working conditions. Has NAFTA actually benefited any of the people it was claimed it would benefit, or has it in fact enriched those who were already doing very nicely, thank you very much? There are some serious questions to be answered there.

There are seven areas of concern: food, climate change, small businesses, policy making, medicines, jobs, and public services. All of them would be affected by TTIP, and all are examples of areas in which private businesses would become empowered to prosecute Governments if they took decisions that were seen to be damaging to

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private interests. Do we think that this is a cri de coeur? Well, yes it is. It is a cri de coeur for democracy and for the right of people to elect a Government who can decide what goes on in their country. Let us examine the power of global corporations to attack the Government of South Africa for trying to buy generic anti-retroviral drugs, the Government of Ecuador for trying to protect the environment, or the Government of Argentina when the vulture funds bought up debts and are now penalising the people of that country. There are many other places where similar things are happening.

I conclude by asking why there is secrecy surrounding the negotiations. Is it because there are ante-rooms on either side of the Atlantic stuffed full of highly effective corporate lobbyists doing their best to develop their own interests? Should we not instead be demanding a free trade agreement that narrows the gap between the rich and the poor, that protects the advance of public services such as the national health service, that fundamentally protects food production, and that ensures that the best standards become the universal standards, rather than engaging in a race to the bottom that results in the worst standards becoming the norm on both sides of the Atlantic? I hope that the House will reject TTIP.

4.24 pm

John McDonnell (Hayes and Harlington) (Lab): In my traditional role as the last Back-Bench speaker, I thank my hon. Friend the Member for Swansea West (Geraint Davies), as others have done, for bringing the subject before us.

These Back-Bench debates enable us to come to a view on a particular matter. It does not look as though there will be a vote today, apart from a shouted vote, in favour of my hon. Friend’s proposal, which aims for some element of democratic involvement in the process. For the record and for my constituents, if there were a vote today with regard to TTIP, I would vote against it. I think the majority of Members would vote against it because it is a pig in a poke. We do not know what it is.

I agree with my right hon. Friend the Member for Warley (Mr Spellar). It is a good job that he is not here, as he would probably have a heart attack hearing that. He described TTIP as the establishment of the biggest institutional trade agreement since we joined the Common Market. That is true. If one considers the scale of this agreement, the population that it covers and the immensity of the world trade that it covers, it is bigger than the Common Market agreement. I cannot understand why we are not going through the same process. When we entered the Common Market, we went through a lengthy process. There were Green Papers and White Papers. There were consultation papers that went to every household, and there was eventually a referendum because we thought it had such significance for the sovereignty of the people of this country.

The TTIP agreement passes over economic sovereignty on a scale that is equivalent to the establishment of the Common Market and the European Union, so I cannot understand why the Government are allowing that to happen without the full involvement of the people. Well, I think I can understand it, because most people have guessed it by now. This is about the corporate capture of policy making in this country and in parts of Europe. The only direct response MPs have had from

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the Government dates back to last September, when our constituents started contacting us. Eventually we got a letter from the Secretary of State for Business, Innovation and Skills trying to assuage the anxieties expressed to us by our constituents. He went through a series of points.

We need to start having a real debate with our constituents on the points that the Secretary of State made. He argued that there would be immense economic benefits. We heard that today—at least £10 billion of increased trade as a benefit to this country, and a significant number of jobs. The bizarre thing about it is that the work commissioned by the Government and the Centre for Economic Policy Research states that there is a risk of a million jobs being lost in this country overall.

Each point the Secretary of State made is now contested. On small businesses, he argued in his letter that the trade agreement would be good for small business in this country. That is contested by the small business lobby in this country and right across Europe in every sector, particularly agriculture. On deregulation, the Secretary of State tried to allay fears about deregulation and said that there would be a levelling up rather than a levelling down. We heard today from a range of speakers. I commend my hon. Friend the Member for Heywood and Middleton (Liz McInnes) and the hon. Member for Richmond Park (Zac Goldsmith), who went through a series of areas where there is a risk to the standards we have set in this country across the provision of services.

With regard to the NHS being under attack and the assurances that we have been given, the person who said that TTIP would cover the NHS was not on the Opposition Benches. It was the right hon. and learned Member for Rushcliffe (Mr Clarke). He was asked whether the NHS would come within the ambit of the agreement and he confirmed that it would. We have had assurances since then, but the hon. Member for Banff and Buchan (Dr Whiteford) pointed out that if we look at the detail of the paperwork provided to us at last, it demonstrates that there is a series of caveats. That means that the NHS is still at risk.

We come to the main issue at stake, the ISDS process. This is a transfer of power and decision making from democratically elected sovereign bodies to a group of corporate lawyers sitting in private and in secret. This country might not have lost cases, but in countries where this process has operated and where sovereign Governments have made decisions about the provision of public services, the countries have lost out, and it has cost them billions. In some instances, it has impoverished whole countries and whole sectors of a particular industry.

TTIP presents a huge risk. I hope that if we pass the motion today unopposed, the Government will recognise that there needs to be a democratic process in place, not just for this House to scrutinise at each stage, but for the people of this country to be involved in the process. That is why I commend all those who pressurised us to have this debate today.

4.29 pm

Ian Murray (Edinburgh South) (Lab): It is always a great pleasure to follow my hon. Friend the Member for Hayes and Harlington (John McDonnell)—indeed, I always follow him because he always seems to be called last in these debates. I do not know what he has done

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to upset someone in this House, but I am sure Santa delivered him some presents last month. He rightly pointed out the concerns about TTIP, and the Minister might wish to reflect that my hon. Friend and my right hon. Friend the Member for Warley (Mr Spellar) are agreeing on something, which shows there must be significant problems with the TTIP negotiations. I hope that the Minister realises that people have significant concerns across the House, and those have been expressed today.

I pay tribute to my hon. Friend the Member for Swansea West (Geraint Davies) for bringing this important debate to the House. Everything he said in his opening remarks has been reflected across all the contributions made this afternoon, and I am glad he stated at the end of his contribution that his aspiration was for a gold standard in trade deals to properly regulate trade from the EU and across the Atlantic. That is the way we want this to go, and the proper debate in this House is about ensuring that we can get the information, the scrutiny and the transparency we need to make those proper decisions on behalf of our constituents.

TTIP does command considerable public interest, and I was slightly disappointed that the hon. Member for Worcester (Mr Walker) railed against 38 Degrees. I appreciate that there have been some problems on this issue but, as my hon. Friend the Member for Islington North (Jeremy Corbyn) rightly says, if constituents are e-mailing us with concerns and the information they are getting is inaccurate, that gives us an opportunity. I am glad they e-mailed me in their thousands, because that gives me an opportunity to put the record straight and give them further information.

Mr Robin Walker: Let me reassure the hon. Gentleman that I agree with him completely; I am always glad of the opportunity to put the correct facts to my constituents. The problem occurs where a group is misleading its own members, and I do think it is legitimate to raise concerns about that, especially where a Select Committee has been misled on a number of occasions.

Ian Murray: I agree with the hon. Gentleman to a certain degree, but as for the way the campaign has been run by a number of organisations, let me say that they are rightly raising concerns. That is a symptom of the transparency and the debate in this House, and the fact that Members have not been given the information that their constituents are seeking. It is incredibly disappointing that this is the third debate we have had in this House but each has been brought by Back-Bench Opposition Members. We really need the Government to debate this properly and in a much more transparent fashion.

The truth is that this place lacks proper ways to hold Ministers to account for what they do or decide in Europe on these trade deals. This is not just a criticism of this place and the Government, because the EU has also had to be persuaded to be more transparent. Although it has improved transparency to a certain extent on TTIP, the EU has an incredibly long way to go to give the public confidence that it is actually responding to their concerns.

Mark Tami (Alyn and Deeside) (Lab): In what has been termed a “zombie Parliament”, the Government can hardly argue that we do not have time to spare to talk about very important issues such as TTIP.

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Ian Murray: My hon. Friend is absolutely right; we often talk about the zombie Parliament. We seem to have done very little in this House for the past year to 18 months, and we could have used some of that Government time to explore these issues. Perhaps if we had done so, we would not have had some of the misinformation that is perceived to be around, and we would have been able to address some of the concerns of the constituents who have e-mailed us in great numbers. That was rightly emphasised by my hon. Friend the Member for Heywood and Middleton (Liz McInnes), who stressed that a lack of scrutiny and transparency had led to widespread suspicions about TTIP, and those have to be addressed.

The economic impact of TTIP is debated, but it is important to bear it in mind that it will entirely depend on the final scope of the deal. To a certain extent I agree with the hon. Member for Skipton and Ripon (Julian Smith); we have to analyse this on the basis of benefits and we have to make sure that they are actually tangible benefits to our constituents. We know from recent history that balanced trade deals have a positive impact on economic activity and job creation, but people’s concerns mean that we are here to debate them and whether or not those positive impacts are actually real. Until we address those, we cannot get on to what the positive impacts might be—and there should be such impacts, because Europe and the US are our most important markets today.

Indeed, the US is the UK’s biggest export market and TTIP could be transformative, but only if it is allowed to be and only if the deal is good for the UK. It does provide a real opportunity to regulate global trade, and it could benefit the UK. We should not shy away from that, because unregulated trade creates a race to the bottom. Many Members have stated in this debate that it is the race to the bottom that concerns them, and it is this process that is creating that race to the bottom, especially when it comes to standards and the way that the negotiations are perceived to be progressing.

As many Members have mentioned, including my hon. Friend the Member for Sedgefield (Phil Wilson), Labour Governments, going back to the Attlee Administration, have engaged positively in attempting to regulate global trade, making trade agreements to ensure that everyone benefits, and that is an important point to make.

Labour lends its support to the principle of TTIP and trade, but not unqualified support. We should not accept any deal that is not beneficial to the British people, and the benefits from any deal must filter down to consumers and small businesses. That point was made by the Federation of Small Businesses in the submission that it sent to all Members. We are not prepared to accept a deal that does not protect our public services and the NHS, and which does not satisfy the concerns that we have heard this afternoon on safety, food and environmental and labour standards. That was a point that was made quite forcefully by my right hon. Friend the Member for Warley (Mr Spellar). We must have a deal that has transparency and accountability at its heart.

There is widespread interest in these negotiations. Organisations such as Global Justice Now deserve tremendous credit for ensuring that TTIP is in the consciousness of both the public and politicians. It is the topic on which I have received the most correspondence

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as a Member of Parliament, which shows the thirst that the public has for gaining more information on what this trade deal means for them personally.

What is clear is that this cannot be a backroom trade deal done between Brussels and Washington. In a debate last February, my right hon. Friend the Member for Wentworth and Dearne (John Healey) said:

“Like justice, good trade policy must not only be done but must now be seen to be done.” —[Official Report, 25 February 2014; Vol. 576, c. 189.]

Any legitimate agreement must command broad-based confidence that it will deliver on the benefits that it has claimed.

Pressure from interested politicians and the public through some of the campaigns has led to advancements in the deal. Let me start by mentioning the NHS and public services. We have said all along that unless the NHS and public services are fully protected we cannot and will not support any TTIP deal. It was Labour and my right hon. Friend the Member for Wentworth and Dearne who were the first to insist on full protection for the NHS. With Labour colleagues in the UK and European Parliaments, we have been campaigning hard for this guarantee, and it is that campaigning that has secured the commitment from the EU chief negotiator that the NHS can and will be fully protected. He said that

“full policy space has been reserved for publicly funded health services”

and, further, that any provision will have

“no impact on the UK’s sovereign right to make changes to the NHS.”

However, Labour will not support a deal unless that commitment is totally honoured. It will take a strong UK Government in the EU to ensure that that is delivered, but Government Ministers have done nothing to secure that commitment at EU level. What is clear is that the biggest threat to the NHS and public services in the UK—this has been said by many of my hon. Friends—is not this or any trade agreement, but the re-election of a Conservative Government in May. Of course EU negotiators need the agreement of member state Governments to be able to take these things forward. Will the Minister confirm that the Government will not support any TTIP treaty that includes the NHS and public services? He can give that commitment at the Dispatch Box this afternoon and take the matter off the table.

As my hon. Friend the Member for Edinburgh East (Sheila Gilmore) said, if the Government are so convinced that the NHS and other public services are not to be included in the deal, why do they not take a belt and braces approach and put it into the negative list to give everyone the comfort that they seek? This is important not just for the NHS and public services but because Labour will repeal the Health and Social Care Act 2012 in May 2015 without impediment. The failure to put public services, including the NHS, on the negative list might, as my hon. Friend the Member for Sedgefield said, undermine the assurances we have been given. So it would be very good to get the Minister’s response to that.

The second area that many Members have focused on is ISDS. There is a case for saying that private arbitration mechanisms are best used among partners with uneven levels of protection and where a due process of law

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cannot be guaranteed, but that is not the case in either the US or the EU, and many Members have said that in those particular advanced jurisdictions, contract law should suffice. There are huge concerns that ISDS would prevent Governments from legislating for the benefit of the country. TTIP must not challenge the ability of this House, and of elected Members, to adopt and implement laws and regulations as we see fit and as we are elected to do.

Zac Goldsmith: If the Labour party were given an opportunity and were in charge of these negotiations at any point in the near future, would they insist on the removal of ISDS from TTIP? Is that a red line for them?

Ian Murray: We have said clearly that ISDS in its current form is not desirable in this trade deal, and the Government have said they do not think that ISDS will ever be used in the context of an EU-US trade deal, so my question would be, if it will not be used, why have it in that deal? We very much welcome the European Commission’s consultation. We very much welcome yesterday’s announcement that ISDS has been suspended, but we are unconvinced at this stage that ISDS in its current form is either necessary or desirable in the agreement, and we would have to see what its pausing would do.

On the basis of that intervention, my question to the Minister would be: how will he respond to the pausing and suspension of the ISDS negotiations in the trade deal yesterday, and what will the UK Government be doing to express the serious concerns on those issues expressed in the House today?

I shall mention some of the views expressed by my hon. Friends. My hon. Friend the Member for Blaydon (Mr Anderson) emphasised that we want free trade but that it is important to engage to ensure that it is fair and regulated. He was right to talk about the power of trade agreements to drive up standards, and to say that that should be the goal, and that we should not support the dilution of standards. He gave personal examples of where that has happened. I absolutely agree with the hon. Member for Banff and Buchan (Dr Whiteford), who highlighted the potential benefits for the Scottish agricultural industry, but spoke about what the impact would be, in that particular economy, on food standards.

I was slightly confused by the hon. Member for Totnes (Dr Wollaston), who seemed to say that the NHS was completely and utterly secure, but then argued that the tobacco industry should be removed from the deal in case it could use ISDS provisions to sue the UK Government for acting on public health grounds. That was a slightly contradictory response. That highlights the fact that ISDS is a real problem as regards what TTIP is intended to deliver.

As time is running out, I shall pose some questions to the Minister, who may be able to answer them in his reply. What plans do the Government have to ensure that this House is kept fully informed as to the content of those negotiations and the Government’s response to them? Will he keep the public informed and engaged, because it is clear from this afternoon’s debate that the public are not engaged in this process directly by the Government but by other organisations? Will he outline

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how the business community will stay engaged in this debate and how he will respond to what looks as though it will be the unanimous passing of the motion moved by my hon. Friend from Cardiff West?

Geraint Davies: Swansea West.

Ian Murray: I am sorry. That is a slip that should never be made in this House, but never mind. Cardiff West is probably the best place to be. I have often been called the Member for Glasgow South, and been very happy to be so.

We need more engagement on TTIP in this House and at EU level, and I hope the Government will respond positively to this debate so that everyone can benefit from a robust and effective treaty, and so that the concerns that were exposed this afternoon can be dealt with properly.

4.44 pm

The Minister for Business and Enterprise (Matthew Hancock): It is a pleasure to respond to this crucial debate on TTIP. We must set the debate in the context of Britain’s great trading history, from the wool trade of the middle ages and the spice routes of the 17th century to the Pax Britannica in Victorian times, which saw the Navy deployed to keep the lanes of trade open around the world. As a nation, we are deeply committed to free and fair exchange, and with remarkably few exceptions that was the consensus in today’s debate. With the abolition of the corn laws by a Conservative Prime Minister, we were the first country in the world to open ourselves up to foreign competition. Peel knew that one tackles the cost of living not by fixing markets but by setting them free, and that is a lesson that holds true today.

Mark Reckless (Rochester and Strood) (UKIP): Is—[Interruption.] Is TTIP really about setting markets free, or is it about having a single regulatory system across the Atlantic whereby people will be forbidden from selling things unless they comply with those regulations?

Madam Deputy Speaker (Mrs Eleanor Laing): Order. Before the Minister replies, if the hon. Gentleman has not been in the Chamber for the debate, and I judge by the mood of the House that that might well be the case, he should think carefully before intervening on the Minister and taking up time.

Matthew Hancock: TTIP is about fair and free trade and since 1970 the percentage of people worldwide who live on less than $1 a day has fallen by 80% when adjusted for inflation, not because of public works or central planning but because of the dawn of market liberalism in countries that once embraced state control. That point was made by Members on both sides of the House. Indeed, the hon. Member for Swansea West (Geraint Davies), whom I congratulate on obtaining the debate, set out how TTIP can demonstrate trade liberalisation and, alongside the trans-Pacific trade partnership, or TPP, which is proposed between the US and countries around the Pacific, and the EU-Canada deal, can form the basis of a global free trade area with global standards to which others could aspire. I very much agree with him on that point.

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Geraint Davies: Does the Minister agree that there is a strong case for a trade relationship with Africa, particularly north Africa, given that a lot of the pressure for migration comes from inequality? We should be sharing the fruits of global trade rather than hoarding it for the rich nations.

Matthew Hancock: Yes, I agree wholeheartedly, not just about Africa but about progress on the India trade deal. This raising from grinding poverty of billions of people has come about because they have been able to access the world market economy. That is a vital way of fighting poverty around the world.

Caroline Lucas: Will the Minister explain why the Government’s leaflet on “TTIP myths” claims that a family of four would benefit by £400 a year yet makes no mention of the peer-reviewed paper from Tufts university that predicts that over 10 years the average working Briton will be more than £3,000 worse off as a result of the lower wages that TTIP will fuel? Why is that not included in his myths?

Matthew Hancock: The conclusion that trade raises wages and prosperity is borne out not only in the theory but in the evidence. The evidence of my lifetime has been that enhancing trade increases prosperity. That has happened in the decades for which I have been on this earth in a greater way than in any other time in history. About £1.5 billion in goods and services is traded between the US and Europe every day and 13 million jobs are linked to that. This ambitious agreement has the target, which it could meet, of adding as much as £10 billion to the UK. What does that figure mean? It is almost meaningless to all but the very largest companies.

This is what it means. Let us picture a small business owner who, five years ago, might nearly have gone under through no fault of his own thanks, in part, to the economic circumstances. Like so many smaller business owners, he did not give up and recently things have got better. The recovery might have delivered for him here, but he might want to expand and take on more staff and he might find people in America who want to be customers. He wants to sell his product to more people, but if margins are tight the prohibitive extra cost of the trade barriers means that that simply is not an option. Now, let us picture a post-TTIP world in which those costs do not exist. We have not only increased the UK’s GDP but managed to ensure that someone can trade, creating an apprenticeship or a job to fulfil those orders, and in America somebody can get a product that they could not get before. That reciprocity—that “something for something”—explains why free and fair exchange makes us all better off.

So how do we make that a reality? First, we must significantly reduce cost differences in regulations by promoting greater compatibility while maintaining high standards of health and safety and environmental protection, especially for cars, pharmaceuticals, food—which was mentioned by Members in all parts of the House—and financial services. Secondly, while tariffs are low on many goods, we must tackle the high remaining tariffs on, for instance, food, clothing and other goods that impede exports and hurt consumers. Thirdly, we must push for better market access for service companies, which make up almost three quarters of the UK economy. Where possible, we will seek a guarantee that our service

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companies are treated in exactly the same way as US providers and do not face any additional regulatory requirements beyond those that US businesses face. Fourthly, we must have more open and transparent public procurement opportunities. Why, for instance, should US rules require that only US steel is used in certain projects? Fifthly, we will target trade facilitation, removing some of the red tape and bureaucracy at borders, and cut unnecessary costs while speeding up the movement of goods.

This is a historic deal. I want to tackle some of the challenges and objections head on. Several Members raised concerns about regulation. In fact, TTIP provides an opportunity to take stock of existing rules on both sides of the Atlantic and to remove unnecessary duplication while ultimately making sure that we support a well-regulated market. This will be done without lowering environmental, labour or consumer safety standards. Nor will the inclusion of the ISDS provisions affect the ability of Governments to regulate. As many Members mentioned—my hon. Friend the Member for North Dorset (Mr Walter) brought it up first—we already have 90 such agreements in place and there has never been a successful claim brought against the UK.

Others expressed concern about the impact on jobs, yet time and experience show that trade creates jobs and supports higher wages. This is backed up by independent assessment. The overall impact on labour markets will be positive in the EU and the US, as real wages, whether of unskilled or skilled workers, will be able to increase.

Mark Durkan: The Minister relies on history in saying that the UK has never lost an ISDS case. With regard to the way in which the ISDS regime will operate under this treaty, whether or not one can be confident that the UK will not lose a case, if a case is lost by another member state, or a firm in another member state, what would be the implications for the UK?

Matthew Hancock: If a case is lost in another member state on its domestic regulation, I would not expect that to have any implications for the UK.

As on regulation, so on the NHS, which has been brought up many times. We are quite clear that there is no threat to the NHS from TTIP. Public services and publicly funded health services are not included in any of the EU trade commitments. I will go further and read what the former Trade Commissioner said to the BBC:

“Public services are always exempted—there is no problem about exemption. The argument is abused in your country for political reasons but it has no grounds.”

My hon. Friend the Member for Totnes (Dr Wollaston), the Chair of the Health Committee, gave a very clear enunciation of the exemption of the NHS set out by not only the EU but the US side in these negotiations. I would say this to anybody who continues to campaign against the inclusion of the NHS in TTIP: you have already achieved your aim, and continuing to campaign is continuing actively to mislead, because public services and publicly funded health services are not included in this negotiation.

Bob Stewart (Beckenham) (Con): May I clarify one thing? It is probably not as important as the whole thrust of this debate, but when I was badly hurt in the Army and the NHS took responsibility for helping me

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get better, we used an American system to put me back on my feet. I hope, and assume, that use of American techniques and systems by the NHS is still allowed.

Matthew Hancock: Of course that will be allowed, but the point is that we would still have control over our public health policy. I can give that reassurance, which was sought by the hon. Member for Edinburgh South (Ian Murray) on the Labour Front Bench, so I hope he will now remove that objection. I do not want to conclude that some Opposition Members do not want to be reassured, but increasingly that is the only view I can reasonably come to.

Ian Murray: That was not the question I posed to the Minister. The question I asked was: if there is any threat whatsoever to the NHS and the UK’s wider public services, will the Minister and the Government sign a TTIP trade deal?

Matthew Hancock: The Health Secretary has already made it clear that if a trade deal threatened the NHS, he would not support it. However, as the former Trade Commissioner has said:

“Public services are always exempted”.

I am glad that we can finally put that issue to bed. I doubt that Labour Front Benchers will raise it again, because they now know that they would be misleading the nation if they did so.

Geraint Davies: Would the Minister sign a deal without ISDS? Does he think that ISDS is a necessary part of TTIP?

Matthew Hancock: The reason for the inclusion of ISDS is to make sure that people who want to make investments have the confidence do so because they know that recourse is available.

In the couple of minutes remaining, I want to address the issue of scrutiny. As my hon. Friend the Member for Skipton and Ripon (Julian Smith) has said, there has been huge scrutiny and engagement, including four debates in both Houses; four Select Committee inquiries; regular updates to the Chair of the European Scrutiny Committee and the chair of the all-party group on TTIP, the right hon. Member for Wentworth and Dearne (John Healey); regular stakeholder meetings; endless piles of letters that I and the Minister for Trade and Investment have signed; constant consultation with the European Parliament; four online public consultations by the Commission; and we even have a TTIP roadshow.

Let no one be in any doubt: enormous consultation is taking place both inside and outside this House. The commissioners have come to this Palace. Last week, 150 pages of text, eight proposals for legal text and 15 position papers were published. Following the passage of this motion, we will ensure that I and other Ministers continue to engage with this House.

Let us once more assume our historic role as the pioneers of free trade, not only for the sake of the British people, but for the sake of all people around the world for whom liberty and prosperity go hand in hand.

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4.57 pm

Geraint Davies: I briefly thank Members for the massive attendance at this very important debate. We have heard a series of excellent speeches focusing on the benefits of trade, particularly if it is done on the right terms. On ISDS, however, no argument has been made as to why it is a good idea, other than that it has not been used against us, which sounds like the argument that there should be no gun control because we have not been shot.

This has been an informative debate and we should now unite as one to demand more scrutiny and to determine a future without multinationals breathing down our necks while we make democratic decisions on behalf of our constituents. Yes, we should trade, but we should not trade our democracy, public services or the rights that we have enjoyed and should bequeath to our sons and daughters across Europe. We want more trade, which is good for everyone as long as it is done on the right terms. We are elected here by our constituents to ensure that fair trade is delivered in the future.

Question put and agreed to.


That this House believes that the Transatlantic Trade and Investment Partnership and any associated investor-state dispute settlement provisions should be subject to scrutiny in the European Parliament and the UK Parliament.


Sale of Land at Parklands School in Swansea

4.59 pm

Geraint Davies (Swansea West) (Lab/Co-op): I rise to present a petition opposing the sale of land at Parklands school in Sketty, Swansea, following a similar petition of 254 local petitioners.

The petition states:

The Petitioners therefore request that the House of Commons urges the Government to encourage the City and County of Swansea Council to reconsider plans to sell the land at Parklands School in Sketty.

Following is the full text of the petition:

[The Petition of residents of the UK,

Declares that there are plans to sell land at Parklands School in Sketty, Swansea; further that Parklands School is oversubscribed and faces increasing demand; further that it is the only school land sale that proposes to dissect a school site; further that the proposal under-estimates the school roll as consisting of 420 pupil places when it is currently 480 plus nursery places; further that the planned sale would disproportionately affect pupils with disabilities; further that the proposal has not yet been consulted upon; and further that a local petition on this matter has been signed by 2054 residents of the Swansea West constituency.

The Petitioners therefore request that the House of Commons urges the Government to encourage the City and County of Swansea Council to reconsider plans to sell the land at Parklands School in Sketty.

And the Petitioners remain, etc.]


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Pancreatic Cancer

Motion made, and Question proposed, That this House do now adjourn—(Mark Lancaster.)

5 pm

Nic Dakin (Scunthorpe) (Lab): There have been several parliamentary debates on pancreatic cancer over the past year, not least the one in Westminster Hall in September in response to the e-petition launched by my constituent, Maggie Watts, which gained more than 100,000 signatures. The petition called for more to be done to improve public awareness and early diagnosis of, and increased research into, pancreatic cancer. It was a positive, constructive debate, with many Members from across the House showing their passion and commitment to upping our game on tackling pancreatic cancer.

The Minister and hon. Members in the Chamber are well aware of the issues, but it is important to put on the record again the seriousness of this disease. Pancreatic cancer is the fifth largest cause of cancer deaths in the UK today, and is set to overtake breast cancer as the fourth biggest cancer killer by 2030. Some 8,800 people are diagnosed with the disease each year, and 8,700 people die from it each year. Five-year survival rates are less than 4%—the worst rate for any of the 21 most common cancers—and have barely changed during the past 40 years. While mortality rates have fallen for most forms of cancer, sadly, those for pancreatic cancer are rising. That is largely due to late diagnosis, with half of all diagnoses made via emergency admissions, which means that less than 20% of patients are diagnosed at a stage when curative surgery remains an option.

Thankfully, these days a majority of cancer patients survive for 10 years. Sadly, that is not the case for pancreatic cancer patients, of whom fewer than 1% survive 10 years. That is why future medical support for pancreatic cancer—greater awareness, early diagnosis, new treatments and faster access to treatments—is so important.

The debate this week is fortuitous as it follows Monday’s announcement that the cancer drugs fund has removed 25 drugs from its approved list. As the Minister will know, there was real anxiety about the pancreatic cancer drug Abraxane being removed. That drug has been shown to extend patients’ lives by an average of about two months, and in some cases by significantly more. It is routinely used around the world as a basic standard of care for pancreatic cancer patients. If it is removed from the CDF, there is a real danger that English patients will be hugely disadvantaged. It was positive news that Abraxane has not been removed from the CDF list.

However, from reading the small print of the CDF decision, it appears that the drug is still under threat of removal. The CDF panel has merely granted a stay of execution while more evidence on Abraxane is gathered. Do not get me wrong: the extra time is welcome—I hope, once more evidence has been provided, that the CDF panel will agree to keep Abraxane for the longer term—but at the moment we are in a state of limbo.

Will the Minister clarify just how much time will be allowed for the drug manufacturer to provide additional evidence to the CDF panel? What specifically needs to be provided for a positive decision? Importantly, will clinicians dealing with pancreatic cancer day to day and

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patient organisations be allowed to feed into the process and submit their observable evidence to the CDF? I hope that the Minister will agree that an appropriate period should be allowed for sufficient evidence to be collated, presented and analysed. Ideally, gathering evidence over a period from clinicians, using the drug at the coal face, would be the best way to trial commissioning through evaluation. Does the Minister support that approach?

The truth is that the CDF’s decision not immediately to delist Abraxane on Monday is more important than ever because over the Christmas break NICE announced that it would not fund Abraxane routinely on the NHS. Consequently, if Abraxane were no longer on the CDF list, patients in England would not be able to access the drug for free. Its place on the CDF list is now, literally, the last lifeline for some patients.

NICE rejected the drug on cost grounds, yet it costs only £8,000 per patient—much less than some other specialist drugs, which run to tens of thousands of pounds. The issue is the way that NICE calculates cost benefit through its system of quality adjusted life years, which in reality works against cancer drugs, especially for those cancers with poor prognoses such as pancreatic cancer. In this instance I understand that the drug was not even assessed or considered under NICE’s less prescriptive end-of-life criteria. That seems rather strange when the disease we are talking about has the worst survival rate of any common cancer, with the average survival time for metastatic pancreatic cancer patients just two to six months.

Questions have been raised about the effectiveness of the NICE drug appraisal system, with 60% of cancer drugs rejected by NICE in 2012—an increase on figures for 2010. Despite the excellent work that NICE and the CDF have done, there is a strong argument for reform, and I know that a number of models have been considered in the last few years. I urge the Minister to bring together NICE, the CDF, the NHS, charities, the industry, and others to thrash out as soon as possible a new, workable drug appraisal model that everybody has confidence in.

Important as they are in extending life, chemotherapy drugs are not the be-all and end-all. In fact, for pancreatic cancer survival rates to increase substantially we need earlier diagnosis of the disease, and new types of treatment made available to patients as a matter of priority. Will the Minister prioritise a public awareness campaign? Campaigners such as my constituent, Maggie Watts, and fantastic pancreatic cancer charities such as Pancreatic Cancer Action and Pancreatic Cancer UK would, I am sure, be keen to work with the Department, and others, to promote a public awareness campaign that leads to earlier diagnosis.

Some of the trial measures for early diagnosis announced by NHS England last weekend, including direct GP access to CT scans, direct patient referral to specialists, and multi-disciplinary diagnostic centres, are welcome. Measures that are designed to speed referral pathways and stop patients being “ping-ponged” backwards and forwards between GPs and different specialists were raised in the Westminster Hall e-petition debate.

Self-referral may end the tragic cases of patients who get so fed up with being ignored by their GP or hospital that they end up paying for a private scan to confirm one way or another whether they have cancer, and I am

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optimistic that progress can be made. Perhaps the Minister can provide us with more details about the trials, which I know are being implemented jointly with Cancer Research UK and Macmillan Cancer Support. How many trial areas will be selected? Where will they be? How can patients take part? Perhaps importantly for this debate, will access to tests for pancreatic cancer, such as CT scans, be included in the pilots?

One issue raised in the September debate was the need to prioritise promising new technologies for treating cancers of unmet need—such as pancreatic cancer—as soon as possible. It was welcome when the Minister said in response to that debate that a new NHS England and Cancer Research UK trial into stereotactic ablative radiotherapy—treatments such as CyberKnife—would include pancreatic cancer. That, and other treatments such as NanoKnife, can precisely target tumours, potentially making them very important in the fight against pancreatic cancer where the location of the tumour sometimes makes curative surgery impossible—for instance, when the tumour has grown very close to an artery. Those new technologies could therefore help to reduce the size of the tumour on so-called borderline resectable patients, subsequently making them eligible for full curative surgery. The confirmation over the weekend that NHS England will be carrying out the SABR trial is most welcome. Will the Minister confirm that the trial will include pancreatic cancer? Will she confirm how many patients will be recruited and which centres will carry out the trial? When will it start recruiting?

One of the ways we might gain more rapid data on the efficacy of technologies such as CyberKnife and NanoKnife and benefit patients at the same time is through the commissioning through evaluation programme. The Minister will be aware that the all-party group on pancreatic cancer produced a report in October that made a number of recommendations about how to boost research into pancreatic cancer. I am grateful to the Minister for copying me in to her response to the hon. Member for Lancaster and Fleetwood (Eric Ollerenshaw), who is in his place. He has done an outstanding job of chairing the all-party group and raising issues both in this House and outside relating to this difficult matter. One recommendation suggested including both NanoKnife and CyberKnife in the NHS England commissioning through evaluation programme as a matter of priority. Will the Minister update us on the current funding status for commissioning through evaluation? What consideration will be given to the all-party group’s recommendation to include those technologies in the scheme as a priority?

On a similar subject, and referring to another recommendation from the recent all-party group’s research report, the Minister will know that Genomics England is funding a huge project to sequence the genomes of people with rare diseases and cancer. As things stand, I believe only six types of cancer are included in that project and that pancreatic cancer is not one of them. I therefore ask the Minister to include pancreatic cancer as a priority area as part of that project. Failing that, will she confirm that, under their service specifications with Genomics England, individual centres have the flexibility to add to the types of disease from which they collect and sequence samples? If individual centres were

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agreeable, they could themselves decide to add pancreatic cancer to their work areas above and beyond the six cancer types agreed nationally.

I note that a new independent cancer taskforce has been established to produce a new national cancer strategy for the next five years. That is truly welcome news. I understand it will look at areas such as early diagnosis, access to treatment, improvements to care, and, vitally, research and innovation. As part of that development, will the Minister consider making sure that the new strategy has a particular focus on prioritising cancers of unmet need? If we are to make real inroads into improving overall cancer survival rates, we must prioritise building research and innovation to better tackle the most difficult-to-treat cancers—those with the lowest survival rates such as lung cancer, brain tumours, oesophageal cancer and, of course, pancreatic cancer.

In conclusion, hopefully in the coming months we will receive confirmation that Abraxane stays on the cancer drugs fund list for the longer term. This is a short-term, but important, step. I hope we will see new treatments, such as CyberKnife and NanoKnife, made quickly available to pancreatic cancer patients, perhaps through the commissioning through evaluation process. I hope clinical trials and research projects, such as the Genomics England project, will prioritise pancreatic cancer for research, and that a new national cancer strategy might prioritise research and innovation into tackling the cancers with the worst survival outcomes. Lastly, I hope the Government will work with all interested parties to introduce a public awareness campaign to maximise early presentation, followed by early diagnosis, leading to earlier action and transforming outcomes for patients with pancreatic cancer.

5.14 pm

Eric Ollerenshaw (Lancaster and Fleetwood) (Con): I am grateful for the opportunity to speak in this Adjournment debate and to my friend the hon. Member for Scunthorpe (Nic Dakin), the deputy chair of the all-party group, for his constant work. He introduced the Westminster Hall debate and it seems that we merry three—the Minister, the hon. Member for Scunthorpe and myself—meet frequently in these debates. But we make no excuses for that.

With the permission of the hon. Member for Scunthorpe, I will let the Minister into a secret; we deliberately went for this debate not knowing the outcome of the cancer drugs fund decision. We must thank everyone involved in the decision to keep Abraxane. Those include the people who signed the petition, and my hon. Friends the Members for Romford (Andrew Rosindell) and for Milton Keynes South (Iain Stewart), the right hon. Member for Hazel Grove (Sir Andrew Stunell) and my hon. Friend the Member for Mid Derbyshire (Pauline Latham), who accompanied me to No. 10 to hand in the petition. I thank also Pancreatic Cancer UK, Pancreatic Cancer Action—as mentioned by the hon. Member for Scunthorpe—Pancreatic Research UK and Maggie Blanks. I thank everybody who put so much effort into this. But as the hon. Gentleman said, it is temporary and we expect something more.

Reference has been made to the period of two months but in terms of the average, that could double the survival rates of most people with pancreatic cancer.

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I will not repeat the figures but, on average, 24 people today will be diagnosed with pancreatic cancer. Of those 24, 23 will die within a year. That is the situation.

I also thank the Minister and, as the hon. Member for Scunthorpe mentioned—he seemed to mention everything—there is the five-year action plan. We talked about unmet need and the Americans have talked about recalcitrant cancer strategy, but I add my support to the hon. Gentleman that that becomes part of the responsibilities of the taskforce.

I welcome the announcement last month by NHS England that one-year survival rates from cancer would become a measurement for the new clinical commissioning groups from 2015. I believe that that will make a huge difference; not just with pancreatic cancer but with every cancer. Given that that is the only disease that will be measured in those terms, I thank the Minister and her colleagues for getting that through. I also commend the work of the all-party group on cancer led by my hon. Friend the Member for Basildon and Billericay (Mr Baron), which has worked constantly on early diagnosis. That will be a fundamental key in the revolution that is happening in cancer, and we would like to see it happen for pancreatic cancer.

I also thank the Minister for her detailed reply to the all-party group’s report on pancreatic research, “A Roadmap to Change.” We are grateful for that and the group will try to come back on it. But I have one last request; when I met the Minister, we were promised that the chief medical officer would at some point come to the all-party group and discuss the findings. I would be grateful if she used her good offices to ensure that that happens.

5.18 pm

The Parliamentary Under-Secretary of State for Health (Jane Ellison): I return to the Dispatch Box very rapidly after the debate earlier this afternoon, and on an important topic; one of the most important in my portfolio. I congratulate once again the hon. Member for Scunthorpe (Nic Dakin) on securing the debate. As ever, he is ably assisted by my hon. Friend the Member for Lancaster and Fleetwood (Eric Ollerenshaw). They and their colleagues in the all-party group have achieved much in this Parliament in highlighting the needs associated with this dreadful disease and in raising awareness of it.

I have said many times before at the Dispatch Box that improving cancer outcomes is a major priority for the Government and as the annual report on our cancer outcomes strategy in December showed, we are on track to save an extra 12,000 lives by 2015. Sadly too few of them are those suffering from pancreatic cancer, so while we want to see the best possible results for all cancer patients, I appreciate—as we have discussed before—that outcomes are particularly poor for patients with pancreatic cancer. We need to do a lot better.

I was delighted that on Sunday 11 January NHS England announced a new independent cancer task force to develop a five-year action plan for cancer services that will build on the existing work to improve survival rates and save thousands more lives. The taskforce has been set up to produce a new cross-system, national cancer strategy to take us through the next five years to 2020, building on NHS England’s vision for improving outcomes as set out in the NHS five-year forward view.

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The taskforce will be set up in partnership with the cancer charities and the health system leaders, and chaired by Dr Harpal Kumar, the chief executive of Cancer Research UK. The all-party group might like to consider how it, too, can participate in, and contribute to, the taskforce.

The new strategy will set a clear direction covering the following areas: prevention; early and faster diagnosis; better treatment and care for all; recovery, re-ablement and living with and beyond cancer; research and innovation; end-of-life care; data and metrics; and work force. The taskforce will produce a statement of intent by March this year, with the new strategy published in the summer.

Tackling late diagnosis is, as we have often said, a very important element in achieving our ambition to improve all cancer outcomes. As the hon. Member for Scunthorpe said, however, there is currently no easy way of detecting pancreatic cancer and it can be particularly difficult for GPs to detect and diagnose, especially in its early stages. Symptoms can be complicated by the fact that they are shared with a wide range of benign conditions.

My ears pricked up when, as part of the taskforce announcement last weekend, NHS England launched a major early diagnosis programme, working with Cancer Research UK and Macmillan Cancer Support, to test new approaches to identifying cancer more quickly. These include offering patients the option to self-refer for diagnostic tests, as the hon. Gentleman said; lowering the threshold for GP referrals; creating a diagnostic pathway for vague symptoms like tiredness, which is particularly important for hard-to-spot cancers such as pancreatic cancer; and setting up multidisciplinary diagnostic centres so patients can have several tests done on the same day at the same place—not the ping-ponging around, which can be so debilitating for someone already feeling very poorly. NHS England’s aim is to evaluate these innovative initiatives across more than 60 centres around England, collecting evidence on approaches with a view to implementation from 2016-17.

Turning to the awareness campaign, we have debated the possibility of pancreatic cancer being part of the “Be Clear on Cancer” campaign set before. Since 2010-11, the Department has undertaken a series of local, regional and national campaigns. Public Health England now leads on this work with the Department, NHS England, charities and relevant stakeholder groups.

It has always been difficult to give a positive response with regard to pancreatic cancer to date, because the focus has so far been on those cancers with the largest number of avoidable deaths. As colleagues know, these campaigns are under constant review, and we work with the relevant experts to see what more can be done. All the time, there are small trials going on to see where we can tackle other cancers. Pancreatic is obviously one that experts will keep under review.

The group that makes decisions about the campaigns, the public awareness and primary care steering group, chaired by our national cancer director, Sean Duffy, has considered pancreatic cancer for a possible campaign. To date, it has been unable to recommend it owing to the problems we mentioned about symptoms, but members would be very happy to look at it again if there were new evidence. I sense from all the things going on—particularly some recent announcements—that that point might not be too far in the future.

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Nic Dakin: I thank the Minister for everything she has said to date. On the issue of a public awareness campaign on pancreatic cancer, is there a way in which those with pancreatic cancers could engage with that body to see if there is a way forward?

Jane Ellison: If I recall my diary correctly, I have a meeting with Sean Duffy coming up, and I would be happy to raise that issue with him, along with any other points arising from this debate. It will certainly be on my agenda for discussions with him. I have touched on the matter briefly with him before, but I will pick it up again.

The problems with late diagnosis have been explored before, and it is critical that we get people the most appropriate treatment early. We have discussed radiotherapy before. It can be a very helpful treatment for some patients. As part of its recent announcement, NHS England committed a further £15 million over three years to evaluate and treat patients with a modern, more precise type of radiotherapy— stereotactic ablative radiotherapy or SABR, as the hon. Gentleman mentioned. That evaluation programme will mean a significant increase in the number of cancer patients eligible to access this treatment by around 750 a year, and the programme will widen the number of cancers being treated by SABR, including cancer that has spread to another part of the body.

The new investment is in addition to NHS England’s pledge to provide up to £6 million over the next five years to cover NHS treatment costs of SABR clinical trials, most of which are being led by Cancer Research UK and one of which—as the hon. Gentleman knows from our debate last September—relates to pancreatic cancer. As for the hon. Gentleman’s suggestion regarding commissioning through evaluation, I shall raise it with NHS England. I am afraid that we do not yet know which centres or how many patients will take part in the trials to assess the effectiveness of SABR in comparison with conventional radiotherapy or surgery, but I understand that we are likely to have that information in the coming weeks. I will certainly make the decision-makers involved aware of the debate, and of the interest in the outcome of their deliberations.

NHS England’s chemotherapy clinical reference group has set out service specifications defining what NHS England expects to be in place to enable providers to offer evidence-based, safe and effective chemotherapy services. NICE has issued technology appraisal guidance which recommends Gemzar as an option for treating patients with advanced or metastatic adenocarcinoma of the pancreas who meet certain clinical criteria. NICE is also appraising a number of new drugs for pancreatic cancer. NHS commissioners are legally required to fund treatments recommended by NICE in its technology appraisal guidance.

Understandably, the cancer drugs fund has been mentioned this evening. The Government’s reasons for establishing the fund are well documented. At the end of August 2014 it received an additional £160 million, and I welcome the announcement on 12 January by NHS England, which is now responsible for the fund’s operational management, that it too would provide extra money. The CDF panel has decided that further

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consideration of Abraxane for the treatment of pancreatic cancer is needed, and it will remain on the national CDF list until that has been concluded. I am not yet sure about the timings, but I will undertake to update the all-party group, including the hon. Members for Scunthorpe and my hon. Friend the Member for Lancaster and Fleetwood, in due course.

Let me now say something about NICE appraisals. Representatives of the Department, NICE, 10 key cancer charities and the pharmaceutical industry met in December to discuss the future of cancer drugs commissioning. They committed themselves to establishing a working group to develop a robust process to support the sustainable, long-term commissioning of cancer drugs. The group will meet for the first time, opportunely, on Monday 19 January.

I am glad that the hon. Member for Scunthorpe found the letter about research useful. He and I, along with my hon. Friend the Member for Lancaster and Fleetwood, had a very good meeting with the chief medical officer, and we have followed that up with a response to the all-party group’s excellent report, which was published last October. At our meeting, the chief medical officer said that she would be happy to attend a meeting of the all-party group. I will remind her of that, but I suggest that the hon. Gentleman and my hon. Friend get in touch with her. We would respond positively to that.

The Government are investing a record £800 million over the five years to 2017 in a series of biomedical research centres and units, including £6.5 million of funding for the Liverpool pancreas biomedical research unit. The unit is working in partnership with industry and leading research institutions to develop new treatments and diagnostic strategies for pancreatic cancer. The National Cancer Research Institute brings together clinicians, scientists, statisticians and lay representatives. Its upper gastro-intestinal cancer clinical studies group has a pancreas sub-group, which plays a vital role in the development of trials.

Late in 2012, the Prime Minister launched the 100,000 genomes project, which will sequence 100,000 whole genomes from NHS patients by 2017. It focuses on patients with rare diseases and their families, as well as on patients with some types of cancer. We believe that the six cancers that will be covered will give us knowledge and understanding that can be applied to all cancers. Although pancreatic cancer is not one of the six, we expect the project to make a useful contribution in that regard.

I thank both Members who have spoken this evening, I thank the all-party group, and I thank all those who campaign tirelessly for progress on pancreatic cancer. We know that achieving improved outcomes for people with the disease is a huge challenge, but I believe that the change that we all desperately want to see will come. I welcome the new cancer taskforce, which will be leading the way, and I undertake to write to its independent chairman, drawing his attention to this evening’s important debate and the work of the all-party group.

Question put and agreed to.

5.29 pm

House adjourned.