Like my right hon. Friend, I have a constituent who suffers from Duchenne muscular dystrophy. Jagger Curtis is a pupil at Romsey Abbey primary school and is just eight years old. I have highlighted Jagger’s case in this Chamber before and I have raised it twice at Prime Minister’s questions, but, like Archie, Jagger is still waiting for an answer on whether he will be allowed to have Translarna. I will focus briefly on the issue of treatment, but mainly I want to echo my right hon.

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Friend’s calls, asking when families such as Jagger’s can expect to be notified of guidance from the National Institute for Health and Care Excellence on access to Translarna.

I know the Minister is aware of the time sensitivities of access to this drug—it has to be prescribed while the patient is still mobile—so I ask him to consider meeting me and my constituents, Jules Geary and James Curtis, who are Jagger’s parents, to discuss how the process might be accelerated. It might not necessarily be accelerated now, for their son, but it should be for the other hundred boys who will be diagnosed with Duchenne muscular dystrophy every single year. We have been waiting many months for a decision on Translarna, and every deadline appears to result in a decision to prolong matters further. There are concerns about the clinical trial capacity for drugs developed to assist neuromuscular conditions; will the Minister please assure me that he is actively promoting the network of specialist muscle centres as a means to overcome that problem?

Other issues associated with Jagger’s care have also raised huge concerns. He has had to wait far too long for his specialist wheelchair, and there seems to be little understanding that the chair is a lifeline for Jagger and his parents. Last week he went on holiday to Tenerife, and his wheelchair arrived literally just in time—the very day before he went on holiday—despite the fact that it was ordered back in May. The hon. Member for York Central (Rachael Maskell) referred to the fact that children grow and change, and their needs change. It seems to be an absolute tragedy that a child can wait all those months, and then by the time the chair arrives the danger is that it will no longer be correct for their condition.

Jagger still has his mobility, but his parents have done an arguably very difficult thing in making sure that he has that chair. Inevitably, as a child with a condition in which his muscles deteriorate, he tires really easily, so that chair is his lifeline and his access to continued mobility now and in future. He is still suitable for treatment with Translarna—he is one of the boys who has the nonsense mutation—but his family feels as though the clock is ticking very quickly.

Muscular Dystrophy UK has highlighted the problems with wheelchair provision throughout the country. Clinical commissioning groups are now responsible for commissioning wheelchair services. I am really conscious that in west Hampshire there have been delays for many people, not just Jagger. For those with neuromuscular conditions, as the hon. Member for York Central said, it is all about getting the right chair at the right time. It can be particularly devastating for children to have to wait for a chair that enhances their freedom.

I recently saw that Jagger’s mother had posted on Facebook a picture of him proudly showing off his new chair. However, it also said that the family had launched a GoFundMe page to buy a powered sitting and standing chair to enable Jagger to live his life as fully and actively as possible. It is heartbreaking that they are trying to fund that through GoFundMe because they do not have the confidence that the CCG is going to provide that sort of facility for them.

In the south-east we lag behind the rest of the country in the provision of neuromuscular care and adviser support. As we have heard, there are two specialist treatment centres in London and one in Oxford. That is

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a two-hour journey for a child in a wheelchair, coming via Waterloo, and his parents tell me that it is incredibly difficult for them to do that whenever Jagger needs to come to London for treatment. There is also a problem with specialist guidance. These families are looking for support—they need support, advice and information.

We are lucky that in Romsey we have brilliant GPs, but Jules Geary told me the tale of trying to get Jagger diagnosed. As a first-time mum, she was often dismissed as a worried mother, when in fact she was the one who knew her son best and knew that there was a problem. I do not blame the GPs at all, because if 100 boys are diagnosed every year, one would not expect a GP in Romsey to see it very often. It was not until James read an article in the Daily Mail about Duchenne muscular dystrophy that he pointed his finger and said, “Those are the same symptoms that Jagger has.” They took that article to the GP, and it was only then that the specialist tests were done on Jagger.

I know that we keep returning to this subject, but that is because it is important. It is right that we keep returning to it. Quality of life, especially for children, is crucial. I hope the Minister will look round this Chamber this afternoon and hear the cross-party and apolitical calls for help for those with such conditions, and I hope he will address some of the points that we raise.

3.10 pm

Ms Margaret Ritchie (South Down) (SDLP): It is a pleasure to serve under your chairmanship, Mr Brady. I congratulate the right hon. Member for Chesham and Amersham (Mrs Gillan) on securing this debate on a vital issue that affects many young people throughout the UK.

As the right hon. Lady said, neuromuscular diseases come in many different forms. In fact, there are about 60 different types of muscular dystrophy and related neuromuscular conditions, which makes it difficult for the NHS to provide clear-cut statistics on the number of people affected by such diseases. However, research undertaken by Muscular Dystrophy UK suggests that out of every 1 million of the UK’s population, approximately 1,000 children and adults are affected by such muscle-wasting conditions. On that basis, we can estimate that some 70,000 of our constituents, of whom approximately 2,000 live in Northern Ireland, are affected by those conditions.

Another way of totalling the scale of the issue is to look at the admission rates of those with neuromuscular diseases to accident and emergency departments. Muscular Dystrophy UK undertook work on that issue and found that in Northern Ireland in 2011, 787 people with a neuromuscular condition were admitted to A&E departments requiring emergency treatment, at an estimated cost of £2.2 million. Those figures are broadly in line with the GB average. There were 28,000 emergency admissions in the UK, at a cost of £81 million. Relying on the emergency services to fill the gaps in treatment for people with such conditions robs people of their independence and costs the NHS much more than a well-designed system that helps people to manage their conditions and avoids emergencies.

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I am sure everyone in this Chamber is in agreement on this issue and wants the best possible treatment and care to be provided to people living with the effects of this cruel disease. Unfortunately, we are not there yet. There is still much work to do—in particular, on an issue that the right hon. Lady already referred to: Duchenne muscular dystrophy and the need for Translarna to be commissioned by NICE and approved by its guidelines. It is important that that happens, because Translarna is already in use in France, Germany, Italy and Spain. Families in those countries can use it, but families here are waiting for it.

Will Quince (Colchester) (Con): One of my constituents has two sons with Duchenne. Does the hon. Lady agree that it is deeply regrettable that they are considering moving to France and commuting back to work so that their sons have the vital access to those drugs?

Ms Ritchie: I thank the hon. Gentleman for his intervention. I agree. His point illustrates that we urgently need a decision from the Minister. I hope the Minister provides us with some welcome information on that issue. It is deeply regrettable that families will go through Christmas not knowing for sure whether the drug will be approved. In the new year, NICE’s decision must not be delayed further. We must end the difficult wait of those families and children.

In Northern Ireland, there has been a commitment for more adult neuromuscular nurse specialists and adult neuromuscular consultants. I share the hope that, when combined with increased care adviser support, the new specialists will begin to improve our currently overstretched services, although there are still valid concerns about how that can be carried out effectively in the context of broader reorganisation and funding scarcity. If we are to achieve the standard of care we all want, much more must be done to co-ordinate better and join up services to ensure patients with muscle-wasting conditions get the help they need efficiently and effectively.

Before I conclude, I want to mention one of my constituents, a lady called Michaela Hollywood, who is wheelchair-bound and was born with spinal muscular atrophy. She was born without ears and is permanently in a wheelchair. She is now 25 years old. She received a Points of Light award, and on Thursday last week she was with the Prime Minister when the Christmas tree lights were turned on in Downing Street. She is on the BBC’s list of the 100 most inspirational women. She received her undergraduate and master’s degrees from Ulster University, and she hopes to go back to do her PhD. She is a lady of immense capacity. She is a campaigner for young people like her with muscle-wasting conditions and, although she spends every day of her life in a wheelchair, she very much enjoys every one of those days because she is a constant campaigner with enormous zeal for life.

Michaela gave evidence to the all-party group on muscular dystrophy in the Northern Ireland Assembly for its report on specialist neuromuscular care. What she said is most important, because it highlights the need for joined-up Government thinking, whether here at Westminster and in the Department for Health or in the devolved Administrations. She said:

“There’s physiotherapy and hydrotherapy, trying just to cover everything. I do receive physiotherapy but it’s a tricky issue because when you’re under 18, with a neuromuscular condition,

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you have respiratory physio in the community; when you’re over 18 and in the community, with a neuromuscular condition, you’re with disability physios, even though you’re deemed as having a respiratory problem. So that I think is something that is a prime example of the disjointed care that we’re receiving. If we have one specialist multidisciplinary team…that would make things so much easier. If we had a physio that concentrated on neuromuscular diseases but also had experience within respiratory areas, that would make things easier. Also, if we had a cardiologist who pretty much had a good knowledge all round, that would help too.”

Michaela’s words make the case for a joined-up service better than any of us could, so I will end by simply reiterating her appeal for specialist multidisciplinary teams for the treatment of muscular dystrophy to be established. I call on NICE to make its decision on Translarna with the utmost urgency. I hope the Minister will give us some favourable answers to alleviate the distress that is felt by many people throughout the UK.

3.18 pm

Jim Shannon (Strangford) (DUP): It is a pleasure to speak in this debate. It is always a pleasure to follow the hon. Member for South Down (Ms Ritchie), who made an impassioned plea on behalf of her constituent. Every one of us has constituents who suffer from Duchenne muscular dystrophy and other diseases and problems, so it is always good to make a plea on behalf of them in this Chamber. As always, it is good to see the Minister and the shadow Minister here.

I congratulate the right hon. Member for Chesham and Amersham (Mrs Gillan) on setting the scene for us all. She clearly outlined the issues, and asked questions of the Minister that we all endorse and support. I thank all other Members who have spoken. I am my party’s spokesperson on health, and I hope to find out about promising developments on the mainland that can be taken back to Northern Ireland, and that thoughts from Northern Ireland can be explained to the Minister. Perhaps the combination of the two can help us to look forward together, in ways that are to our advantage.

As other hon. Members have said, there are some 60 different types of neuromuscular condition, and it is estimated that around 60,000 to 70,000 people in the UK live with neurological conditions that affect their muscle function. Duchenne muscular dystrophy has been mentioned in particular. A couple of my constituents have that condition, and I am aware of the issues. At an event at the Methodist central hall across the way, people with the condition from across the United Kingdom of Great Britain and Northern Ireland clearly explained their needs, the issues—such as the massive advances in medical technology—and the best approaches. There are different levels of Duchenne, and what is medicine for one may not be medicine for another; that is the point I am trying to make.

In Northern Ireland, an estimated 1,600 people in the Southern Health and Social Care Trust area alone are diagnosed with neurological illnesses each year. That is equivalent to the number diagnosed with a major cancer; the conditions we are debating are of as great a relevance as some better-known ones. An estimated 34,000 people in Northern Ireland suffer from a disabling long-term neurological or neuromuscular condition such as epilepsy, multiple sclerosis, Parkinson’s disease, or one of the rare disorders such as motor neurone disease or muscular dystrophy, including Duchenne muscular dystrophy.

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Neurological symptoms such as headaches are one of the most common reasons for seeing a general practitioner, and they account for up to 8% of emergency department visits.

Last year, a new dedicated out-patient centre for neurology, with some responsibility for neuromuscular issues, was opened in Northern Ireland. That has been a positive development in the Province, helping with the nationwide momentum for access to treatment, and better treatment, for those living with neurological conditions. The new facility helps us to move towards meeting some of the latest standards in caring for people with long-term neurological and neuromuscular conditions. Since it opened, feedback has been very positive. Improved access to a modernised facility makes life much easier for patients and greatly improves their overall experience of their care.

I understand that the proposed multidisciplinary team will include neuromuscular consultants, neuromuscular physiotherapists and speech and language therapists, along with other care professionals. One of the key service outcomes, which I welcome, is that all patients with long-term neurological conditions have an individual care plan. The hon. Member for Romsey and Southampton North (Caroline Nokes) commented on access to wheelchairs; it is important for each individual to have a wheelchair that suits them. That might seem a small thing to some people, but to the patients, it is massive. With 60,000 to 70,000 people in the UK living with neurological conditions, we must take those conditions seriously and prioritise our responsibility to those living with them.

A landmark decision could end the agonising wait for the delivery of the treatment that we are talking about to all those eligible to benefit in England, Wales and Northern Ireland. For those in Northern Ireland who benefited from the dedicated out-patient service I mentioned, I am sure this would be an additional boost. Nationwide, the momentum is now in favour of those living with neurological conditions. That may not always be how it feels, but there is a step forward, and we have to look at that, and at how to deliver that better. Although the move is very well intentioned and welcome overall, concerns have been raised and reservations expressed.

I know that the Minister will respond to what has been said about the NICE conditions. Lately he seems regularly to make particular reference to NICE in responding to debates in Westminster Hall and the main Chamber, and I think that is what Members are interested in. There is a need for a specific NICE response. It has asked for further clarification from PTC Therapeutics of the degree of benefit that its drug Translarna provides in the treatment of a type of Duchenne muscular dystrophy. DMD is one of a group of muscular dystrophies, which are inherited genetic conditions that cause the body to produce too little dystrophin, a substance crucial for muscle functioning. Seeing some of the young patients who have the condition focuses one’s attention quickly on how critical the availability of the medicine is. The condition leads to changes in the muscle fibres, which gradually weaken the muscles, resulting in an increasing level of disability. The decline in physical functioning in DMD leads to respiratory and cardiac failure and eventual death, usually before the age of 30.

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Ataluren is the first licensed treatment for DMD that addresses the loss of dystrophin, the underlying cause of the condition. It has a conditional marketing authorisation in the UK for the treatment of DMD. The families of children affected, and Muscular Dystrophy UK, have campaigned for NHS England to make the drug available, since it became the first EU-approved drug for tackling Duchenne muscular dystrophy last August. The condition affects 2,500 people in the UK, causing increasingly severe disability and cutting lives short. It would be useful if the Minister and his Department could address NICE’s concerns, as it has asked questions. The right hon. Member for Chesham and Amersham referred to NICE and outlined four or five questions. I think that the focus that will emerge from the debate will be on how to improve the NICE guidelines and improve access to drugs throughout the United Kingdom of Great Britain and Northern Ireland.

Whenever I attend health debates in Westminster Hall, I ask whether we can have not just a regional strategy but a UK-wide one, bringing Northern Ireland, Scotland and Wales together. Will the Minister consider that? The four regions can benefit from each other’s knowledge. Collectively, we can do better.

3.26 pm

Mrs Madeleine Moon (Bridgend) (Lab): I want to speak not so much about Duchenne muscular dystrophy as about Parkinson’s disease and motor neurone disease—particularly the latter, which is also a neuromuscular condition. I will consider the problem of getting appropriate diagnosis and in-care support from neurologists. That is critical. We have already heard about the difficulty that those living in the wrong part of the country have in obtaining a quick diagnosis and the right support as they progress through the condition.

Neurological disorders account for up to 20% of acute medical admissions, and there are more than 60 different neuromuscular conditions. I was helped to understand the patchwork problem that people experience in getting access to neurological advice, support and guidance by a report commissioned in 2014 by the Association of British Neurologists. With 60,000 to 70,000 people in the UK living with a neuromuscular condition, there is considerable pressure on neurologists, and on specialist diagnosis and support. In 2011, a joint report of the ABN and the Royal College of Physicians, “Local adult neurology services for the next decade”, recommended that all relevant patients be admitted to hospitals that had an acute neurological service led by consultant neurologists. We are nowhere near that position now.

In 2014 a survey by the ABN found that the likelihood of a patient with a neurological problem being seen by a neurologist varies dramatically depending on where they live. The availability of a neurological review varied according to the type of hospital the patient was admitted to—whether it was a neuroscience centre, a neurology centre or a district general hospital, with or without neurological support. It was significantly better to be seen at a neuroscience centre, where there was support on 91% of days. Those who went to a neurological centre got support from a neurologist on only 80% of days. District general hospitals with a neurologist based

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at them had access to a neurologist on only 58% of working days. In contrast, access for patients at district general hospitals with no resident neurologist was available on only 32% of days. That is totally unacceptable, when we know that access to such neurological support dramatically changes the impact on a patient; there is an effect on their capacity to continue their life, and on their prospects of being discharged from hospital with a good quality of life.

I am concerned about the fact that access to CT and MRI imaging varies between hospitals. MRI was available 24/7 at only 30% of sites in the UK. The 2014 study identified a wide variation in access to specialist services for patients presenting with acute neurological disorders. As liaison neurology services change the diagnosis and management of a high proportion of patients, improving outcomes and reducing length of stay, there is an opportunity to improve both patient care and cost-effectiveness.

The all-party parliamentary group on motor neurone disease recently heard emotional and dramatic evidence from Mark and Katy Styles. Mark worked in local government and Katy was a secondary school teacher before she gave up work to become Mark’s full-time carer. Mark has a form of motor neurone disease called Kennedy’s disease, which is slowly progressive and genetic, passed from mothers to sons. He lives in Canterbury, and they have to travel to University College hospital in London to see a neurologist. That is nonsensical. Support should exist locally, because his condition may soon deteriorate to the extent that he cannot access the neurological support that he and his wife need. When Katy was working, she earned £150 a day. She now gets £67 a week to provide the on-duty, 24/7 care that her husband needs. We must recognise the invaluable work of carers and ensure that they get the necessary support.

Some 30% of people with motor neurone disease will die within one year of diagnosis. It is absolutely critical that they get rapid access to help and support for their condition. I will not repeat all the words that have been said about access to wheelchairs, but I stress that if someone with MND has the wrong wheelchair, they may not be able to communicate that. An ill-fitting wheelchair causes acute pain, but MND sufferers rapidly lose their speech and the ability to move their hands and upper limbs. They cannot communicate that they are in pain or distress, so the provision of wheelchairs is critical.

The APPG commissioned a report last year called “Condemned to Silence” about access to communication support. The issue is not money, because the Government have put money in place for communication support; it is poor roll-out, and something must be done to improve it. I look forward to hearing from the Minister what steps are being taken to ensure that people are not condemned to die without access to communication support, which they need to talk to their loved ones and carers about their needs, and to avoid suffering the indignity of being unable to communicate if they are admitted to hospital.

I have two final points. First, access to care support is critical as conditions deteriorate. People cannot wait for further assessments, or be put on waiting lists for care support, when they often need double-handling care support. If people are not to be condemned to lie in beds, support must be available immediately. Access to hoists and high-low hospital beds is often delayed.

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We must get faster at providing them. Secondly, access to finance to research such conditions is vital if we are to give families hope, and a sense that time and research will give them—and perhaps family members, who may inherit a condition—a better life in the future.

3.33 pm

Richard Arkless (Dumfries and Galloway) (SNP): I thank the right hon. Member for Chesham and Amersham (Mrs Gillan) for securing a debate on a subject that clearly touches many people for various reasons. It is also of course a pleasure to serve under your chairmanship, Mr Brady. Those Members who know my background as a lawyer and a businessman may be forgiven for asking, “Why are you here to speak about neuromuscular diseases?” I am not a member of the SNP health team, which is lucky to have the profound experience of my hon. Friends the Members for Central Ayrshire (Dr Whitford) and for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), but I am developing something perhaps even more important and certainly more profound: I am living with motor neurone disease within my family.

If I can declare an interest of sorts, Mr Brady, my mother has motor neurone disease and, if Members will allow me, I will restrict my comments to that experience. I do not mean to sideline the 59 other important neuromuscular diseases; I want to ensure that what I say comes from a real place, not just a bunch of briefing notes. That notwithstanding, I want to add my voice to the calls to the Minister to persuade him to get Translarna approved as quickly as is humanly possible. I know that he looks sympathetically on that cause, and we have heard many vivid stories today about how it would affect people quickly.

Like everybody, I would lay claim to my mother—and indeed my wife—being the best that there is. She is the most selfless, dedicated mother in the world. She has literally lived her life for me, my brother, Nicholas, and my baby sister, Poppy—a baby who is now in her twenties. We have been her life. She has lived her life exclusively for us. My brother and sister and I will always be grateful for that. My mother was diagnosed 20 months ago. She kept it a secret with my dad for 16 of those months—thank goodness that she has my dad, with whom she has an unbreakable bond—so I have only been living with it for a few months. It is difficult and, as may become obvious during this speech, extremely raw.

During those 16 months, we witnessed the deterioration of my mother’s speech and joints. She explained the speech by way of fictional dentures that she had apparently had implanted. She explained the hands with reference to a historical arthritis problem in our family. Both were plausible and not really questioned up until the point that she decided to tell us. She did not tell me, my brother or sister or our extended family until after I was lucky enough to be in this place and make my maiden speech. She was determined that I should pursue my dream, and of course her dream, of making Scotland a better nation. I suspect that what she really wants now is a second referendum before it is too late, but I suppose that you get the point.

I will return to my mother later, but I want to pick up on some points made by other Members in this enlightening

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and touching debate. The right hon. Member for Chesham and Amersham is right to say that there are 60 different types of neurological disease, and I hope that she will forgive me for indulging myself with only one of them today. She talked about the Hill family, particularly Archie. I have this vivid image in my mind of Archie running up to 10 Downing Street and giving the Prime Minister what for—if only all of us could get that opportunity.

The speech of the hon. Member for York Central (Rachael Maskell) was touching indeed. She brings a wealth of practical experience, to which the Minister ought to listen carefully. I was particularly captured by her assertion that equipment needs to be made available when needed. It needs to be the right equipment in the right place at the right time, because time moves too quickly with such diseases. I hope that the Minister will pay careful heed to the hon. Lady’s practical experience, which has substantially benefited the debate.

I was particularly touched by the story of Jagger from the hon. Member for Romsey and Southampton North (Caroline Nokes). I hope that he enjoys his break in Tenerife and that the Minister will listen to calls for Translarna to be approved as soon as possible.

The debate has been consensual so far, and I want to take the politics out of what I am going to say. I want to touch on some things that Scotland is doing well on motor neurone disease, but I do not mean that to be a criticism of the UK Government. I hope that everybody’s ears are open. If we are doing things right, I sincerely hope that the UK can learn. If the UK is doing things right, my ears are open and Scotland can certainly learn. There is no politics in this whatsoever. As an aside, as new Member I have been frankly dismayed at how health services are politicised by both sides of the House. I have become increasingly amenable to the suggestion that perhaps the health service should not be run by politicians at all, but by people who have at heart the interests of the people whom we are here to serve.

Motor neurone disease is a neurological degenerative disease. In simple terms, the mind is fine and continues to operate with full function, but the body gradually gives up. The signals do not go from the mind to the body to make it work: that is how I think of it. Patients are affected differently. My brother-in-law died from it a couple of years ago, and his limbs were affected first. His legs started to give way for no apparent reason. However, my mother’s speech was the first thing to go—this was a lady who liked to talk, who seriously liked to talk! To have that stripped away from her must be incredibly difficult—and I know it is.

Scotland is doing many things well on motor neurone disease. Over the past year we have announced that we will double the number of motor neurone nurses. We are very much in the early stages, but the Scottish Government have provided funding to local authorities to ensure that things happen. At the moment local authorities are recruiting and assessing the need, and I hope that process will be speeded up as we go on.

That funding is a recognition of the difference that specialist nursing can make to motor neurone disease. My mother has to rely on a motor neurone nurse who comes from another region and who can only come on a part-time basis. A very proud woman, she was initially most reluctant to consider any form of help, but she has since come to realise what a benefit the nurse is. She has

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asked me to take up the cause of getting more motor neurone nurses throughout not only Scotland, but the rest of the UK—we are all human beings, despite our political views.

The change in Scotland has been praised in all quarters. Huge thanks are due to people such as Archie and Jagger. In Scotland a gentleman called Gordon Aikman, Christina McKelvie MSP, and all the staff at MND Scotland have done an incredible job of persuading the Government of the immediate need for those services. We have committed to giving a free voice box on the NHS and to paying families directly for support, not as a patronising gesture to pay people to look after their relatives, but to ensure that support is available if needed. We have also increased investment in palliative care.

I live in a town called Stranraer. The UK average is two people with motor neurone disease per 100,000; the Stranraer average is 13 per 10,000—an astronomical figure. I have asked the chief executive of our local health board to figure out exactly why—

Mr Graham Brady (in the Chair): Order. I am sorry, the hon. Gentleman must resume his seat. I am loth to interrupt a very personal story, but we need to leave time for both the official Opposition spokesperson and the Minister to wind up. I have allowed more than eight minutes, and I am keen to allow the same to the official Opposition.

3.42 pm

Barbara Keeley (Worsley and Eccles South) (Lab): It is a pleasure to speak in the debate with you in the Chair, Mr Brady.

As others have done, I congratulate the right hon. Member for Chesham and Amersham (Mrs Gillan) on securing the debate. She gave a moving account of the Hill family in the light of Archie’s diagnosis and of the impact on Archie and his family of Duchenne. We have also heard excellent speeches from my hon. Friends the Members for York Central (Rachael Maskell) and for Bridgend (Mrs Moon) and the hon. Members for Romsey and Southampton North (Caroline Nokes), for South Down (Ms Ritchie), for Strangford (Jim Shannon) and for Dumfries and Galloway (Richard Arkless).

The all-party group for muscular dystrophy has carried out essential work to raise awareness and understanding of the needs of people living with muscular dystrophy and other neuromuscular conditions. I congratulate the APG on the quality of its inquiries and reports. The right hon. Member for Chesham and Amersham also paid tribute to the work of Muscular Dystrophy UK, and I join her in that tribute.

Providing access to treatment for people with muscular dystrophy is complex, because it is a rare condition. There are challenges in delivering localised, specialised care to people who have multiple, complex needs, but that cannot be an excuse for poor-quality care. As we have heard, some 70,000 people are affected by a neuromuscular condition in the UK. We must ensure that the NHS delivers equal treatment for equal need and that those with complex needs may have access to the treatment and support necessary to help them achieve the best quality of life possible.

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In 2009 the APG’s Walton report showed clear deficiencies in the provision and planning of, and access to, care for people living with neuromuscular conditions. It found cases where care was “inadequate and not acceptable”. Although the report offered many sensible recommendations to improve the quality of care, the potential for progress was limited by the coalition Government’s reforms of the NHS under the Health and Social Care Act 2012.

Given those reforms, the APG undertook a six-month inquiry that considered their impact, releasing another report in March this year. Sadly, the reorganisation of the NHS and other reforms had done little to improve access to and availability of treatment for patients with neuromuscular conditions. Sadly, in fact, the reforms had made it even harder for patients to access support as a result of significant regional variations in the commissioning and funding of services. That is the nub of what I want to say.

There is a failure to join up services, and confusion about responsibilities and processes is a common theme. The hon. Member for South Down gave us an excellent quote on that lack of joined-up services. At the national strategic level there has been no specific mention of neuromuscular conditions in the five-year forward view, nor anything in the consultation document on the draft NHS mandate, which suggests a failure to recognise the specific needs of such patients at the strategic level. In fact, the five-year forward view groups together rare diseases and cancers, but there is a great deal of difference between all the conditions that we have discussed today and rare cancers.

There is a lack of clear guidance on which bodies in the NHS fund certain services and, as we have heard, sometimes people are not even receiving crucial respiratory support. Locally, there were examples of clinical commissioning groups failing to fund sessions of specialist neuromuscular physiotherapy or to provide sufficient funding for people to receive the right wheelchair at the right time. That is clearly so important and was mentioned by my hon. Friend the Member for York Central and the hon. Member for Romsey and Southampton North. It must be right for a child to have a comfortable chair while growing up.

The coalition Government’s reforms have also contributed to a delay in decisions on the availability of drug treatment for Duchenne muscular dystrophy, a life-limiting illness that affects about 2,500 boys and adults. The right hon. Member for Chesham and Amersham talked about that so well. To have to wait with a condition such as Duchenne for a decision on the drug Translarna is clearly agonising. It is a shame that the issue has been caused by NHS England halting its assessments to review its processes. I was not present at a Westminster Hall debate last week in which I understand that the Minister present said that he was “hopeful” that access to the drug would become available:

“I am hopeful about Translarna…NICE has been consulting on the process, and I believe the company has been engaging with NICE on pricing. I am hopeful that there will be a decision in the next few months”.—[Official Report, 8 December 2015; Vol. 603, c. 274WH.]

As he went on to say, however, the decision is not in his gift.

I hope that the Minister’s optimism is well founded, because as we have heard today it must be recognised that time is an important factor. The decision is different

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from some others, because the timing can affect the benefit that the boys will receive. I wish to ask, as everyone else has done, about that decision, and what he is doing to ensure that delays do not happen again. We must ensure that system of wider support is available for patients and their families and carers. In some cases people need 24-hour support and care; homes must be adapted; physiotherapy, speech and language therapy, and occupational therapy need to be available; and carers need access to the right advice and support, as has been said.

I am concerned, like others, that the Government’s failure to protect social care funding and other non-NHS health funding, such as training budgets, will mean that that wider network of support is not available when needed. The Walton report highlighted issues with social care back in 2009, but since then the number of people with access to publicly funded social care has fallen by 25%. The availability of the right support for people with specialist care needs is unlikely unless we have a sustainable funding settlement for both the NHS and social care. The difficulty with recent funding announcements, if the Minister intends to refer to them, is that the 2% social care precept and the better care fund are back-loaded funding mechanisms, with nothing this year and little next year.

We have heard about the regional differences in access to care. The Walton report highlighted that there were only 13 neuromuscular care co-ordinators when 60 were felt to be needed. My hon. Friend the Member for York Central said that there was only a single neuromuscular care adviser in North Yorkshire; in fact, no neuromuscular care adviser support is available for adults living with such conditions in Greater Manchester or the surrounding areas of the north-west. That is in spite of the fact that an estimated 8,100 people with a muscle-wasting condition live in the north-west. There is a need to ensure that clinical commissioning groups and other regional health organisations are aware of their responsibilities. Sadly, the findings of the 2015 APG report suggest little progress in the issue of unequal access.

Given the devolution deals on health and social care in certain parts of the country, will the Minister assure us that the inequalities in specialised services that we have heard about will be addressed and that the relevant bodies will be made aware of their responsibilities, which they do not seem to be at the moment? The debate has highlighted the fact that we have ingrained problems in our health and social care system. The lack of a sustainable funding settlement for social care and other recent reforms have led to fragmentation and instability in services. That means that inequalities in care sadly will continue. I urge the Minister to consider in full the most recent report and recommendations from the APG. We must ensure that people with neuromuscular conditions receive the care that they need, and that those inequalities in care are addressed.

3.49 pm

The Parliamentary Under-Secretary of State for Life Sciences (George Freeman): It is a pleasure to serve under your chairmanship, Mr Brady. I am left with 10 minutes in which to try to deliver my speech and the answers that I have carefully prepared while listening to colleagues’ comments. If I run short of time, I will undertake to write to everyone in the Chamber with answers to the points raised.

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I start by paying tribute to my right hon. Friend the Member for Chesham and Amersham (Mrs Gillan) for securing the debate. She is a tenacious advocate on this issue, as on others. I join her in paying tribute to Archie and his family. I have met patients who suffer from these diseases and their families, and one’s heart goes out to them. One wants to pay tribute to the bravery with which they deal with their conditions. As is so often the case in the history of medical progress, the families, patients and carers are those who advocate and, in the end, win through to make their point heard, with the help of colleagues from across the House. My right hon. Friend eloquently paid tribute to the families of children with these disorders and diseases who, in many ways, suffer every bit as much as the patients who show such incredible fortitude. She asked me last week whether I would give her an A grade for effort and persistence. I will happily give her an A-plus in this end-of-term summary, but the people to whom we really want to give an A-plus are NICE and NHS England.

I want to touch on some of the excellent points that were raised. My right hon. Friend raised Vimizim and Translarna, so I will say something in detail about the timing of those decisions in a minute. She also made an important point about standards of care across the NHS in clinical trials, which was mentioned by numerous colleagues, and the importance of NICE giving more prominence to the time aspect of these conditions, which are unusual because they can deteriorate with every week’s delay in getting treatment.

The hon. Member for York Central (Rachael Maskell) gave us the benefit of her front-line clinical expertise. In case I run short of time, I shall say now that I will happily convene a meeting at the Department of Health with officials from my Department and NHS England, to which I invite colleagues from all parties who want to discuss the issues she and others raised about front-line care, because a range of practical issues about such care has been raised, in addition to access to drugs, and giving colleagues the chance to raise such points on behalf of their constituents would represent a powerful opportunity. The hon. Lady talked in particular about training and the interface of paediatric and specialist services, which I come across in connection with numerous different specialist conditions.

My hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) spoke passionately about James, Jules and Jagger Curtis, and the importance of expediting those particular decisions and quicker assessment, as well as adoption in general. That is a passion of mine, which was why I launched the accelerated access review to look systemically at what we can do to expedite getting new medicines into the service. She also touched on the importance of wheelchair access.

The hon. Member for South Down (Ms Ritchie) talked eloquently about Michaela and the importance of specialist, multidisciplinary teams. The hon. Member for Strangford (Jim Shannon), who gets the prize for appearing in more debates with me than any other Member of the House, which is a tribute to his activism as the Democratic Unionist party’s spokesman on these issues, highlighted the importance of Belfast as a hub of research and regional strategies in Northern Ireland and spoke about his constituents. This is a devolved matter, and while I pay tribute to the work of researchers and medics in Northern Ireland, it is important that the

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devolved Administration in Northern Ireland put in place a similarly enlightened commissioning process.

The hon. Member for Bridgend (Mrs Moon) raised the broader issues of Parkinson’s and neurological disorders, while the hon. Member for Dumfries and Galloway (Richard Arkless) spoke passionately about his mother’s suffering. Before I came to Parliament, I worked in Scotland and, as he highlighted, in this area, as in several others, Scotland pioneers some of the clinical commissioning work. The supreme irony of the debate was brought to light by his request that we depoliticise the NHS. For me, one of the greatest steps following the Health and Social Care Act 2012 was the separation of the NHS from the Department of Health. NHS England now operates under its own arm’s length management, subject to a mandate from Ministers

We do not control the NHS—believe me that if, for one afternoon, I could do that, I wish it was now. I would love nothing more than to pull the lever and give all these children the drugs that we all want them to get before Christmas, but that is not in my gift, and I suggest that it is in all our interests that it is not. It is right that such decisions are taken by NHS England and clinical professionals, advised by the very best people at NICE.

Barbara Keeley: It is important that the NHS mandate covers these conditions because at the moment it does not. Something must be done to make sure that they are covered.

George Freeman: In the few minutes I have available, let me say a few things about the main issues raised. I pay tribute to Muscular Dystrophy UK, Robert Meadowcroft, Emily Crossley, the Duchenne Children’s Trust, Action Duchenne and all the other organisations that work so hard in this area, and specifically on the two or three key drugs.

I remind the House that the decision from NICE on Vimizim is due before the end of the year. Without breaching due process, I have asked that, if that decision is in the pipeline, it can be made as quickly as possible, ideally before we all break up for the Christmas holidays. That is not in my gift, but I made that request. Similarly, I have requested that the Translarna decision, which I believe is due in February, is similarly expedited. However, again, that is not in my gift, and while during the year the Prime Minister and I have urged NICE and NHS England to do everything they can to expedite their decision making on those drugs, we do not have the power—rightly, in my view—to step in and breach process. It is fair to all patients in the NHS that decisions are taken properly.

Mrs Gillan: The Minister has given us a sympathetic hearing and I know that he has done everything in his power to try to bring forward that decision. Quite rightly, it is not his decision to make, but, through him, may I appeal to the men and women who are making that decision? If they have any humanity about them, they ought to make a positive announcement before Christmas.

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George Freeman: My right hon. Friend made the point more powerfully that I could. On Vimizim, I am delighted that BioMarin, the company concerned, has, following exhortation from me and others, sat down with NHS England and gone through pricing flexibilities. I have been able to grant an access agreement. The drugs are incredibly expensive, which is what makes NICE’s work difficult, so if anyone from PTC Therapeutics, the company responsible for making Translarna, is watching, I urge them to sit down with NHS England and adopt a similar approach.

On specialist commissioning, we lived through and focused on difficult decisions, and this summer NHS England agreed to 23 new treatments, including Duodopa, which controls the symptoms of patients with Parkinson’s disease, wider access to proton beam therapy, and extending treatment with ivacaftor for cystic fibrosis involving G551D mutations.

We live in an age of extraordinary biomedical progress, but budgets struggle to keep up with the rate of progress that our scientists and researchers make. I know that this of little comfort to my right hon. Friend and to Archie and his family, but I hope that hon. Members agree that, in deciding which treatments should be procured on behalf of us all, due process must apply. However, I share their frustration, which was why I launched the accelerated access review, which will report independently to me in the spring. That substantial piece of work is examining whether we can do more to embrace breakthroughs in genomics and informatics to give NICE and NHS England new flexibilities to speed up how innovations for patients are assessed, as well as to explore new pathways and flexibilities for different models of reimbursement to get innovation through quicker.

I want to pick up the point that was made about specialist neuromuscular care. The truth is that there are few curative treatments for most of these diseases, so we are talking about the importance of routine care for people that is provided by local primary and secondary care services via local CCGs. However, a number of specialist services have been designated among the 146 that NHS England is responsible for commissioning nationally, which are set out in legislation and commissioned directly by NHS England through 10 area teams. Twenty-five specialised neurological treatment centres across England ensure that patients can access high-quality neurological care where they live.

As I said, I will be happy to convene a meeting in the Department with officials and NHS England to talk about how we can address some of the practical issues raised when providing front-line, integrated services. I fear that the clock is against my being able to go through the 22 questions for which I had answers prepared, so I close by saying that while we all would want to pull a lever to make this happen quickly, the truth is that we need a system that is rigorous, robust and evidence-based, but quicker, in recognition of the effects on these patients.

Motion lapsed (Standing Order No. 10(6)).

4 pm

Sitting suspended for a Division in the House.

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Weymouth to Waterloo Rail Line

[Mrs Madeleine Moon in the Chair]

4.11 pm

Richard Drax (South Dorset) (Con): I beg to move,

That this House has considered the Weymouth to Waterloo rail line.

It is a pleasure to serve under your chairmanship, Mrs Moon, and a great pleasure to see the Minister here, whom I regaled, for half an hour of her precious time, only about two hours ago, so I thank her for that. It is very nice to see her in her place.

Welcome to a number of colleagues, and to a right hon. colleague, my right hon. Friend the Member for West Dorset (Mr Letwin); it is a particular pleasure to see him here. I will talk for about 10 minutes, then another colleague would like to say something, and I think others want to intervene. After that, the Minister will obviously respond.

I start by saying that Dorset is one of the most beautiful and unspoiled counties in the country, with a Jurassic and world heritage coastline that is the envy of the world. That combination of sea, coast and countryside attracts millions of visitors and tourists. At the height of the summer, the road system struggles to cope and frequently does not. That is not to say that we are all crying out for a motorway—indeed, the lack of one is part of the attraction. However, we simply cannot sit back and depend on seasonal jobs, which do not provide a secure enough career and future prospects for many of our constituents. We need to attract investment into the area, and rail connectivity is key. The lack of it already makes things very hard for those who live and work in Dorset, thwarting many ambitious plans.

Take Portland port, which is a growing port: commercial road traffic there is expected to treble in the years ahead, and the number of visiting cruise ships continues to rise, dropping off countless thousands of customers, who then go into all our constituencies. In the centre of my constituency, a newly announced enterprise zone on the outskirts of Wool is expected to generate thousands of jobs—so too, hopefully, are our expanding marine and engineering industries, new museums and tourist attractions.

For all those to work, we need to improve our infrastructure, and with little scope for more roads, for reasons I have explained, rail is the only option. There has been a railway line to Weymouth for 148 years. The terminus, originally designed by one of Brunel’s assistants, sits only yards from the resort’s golden beaches. The line was decisive in opening up the town, which was first made fashionable by George III and his followers in 1789, hence the façade. It is not hard to imagine the scene as the early tourists enjoyed the waters from their wheeled bathing huts. The same train continued to the Channel Islands ferry terminal at the mouth of Weymouth harbour, winding its way through the town, led by a man waving a red flag to clear the way. Times have changed, but the significance of rail travel has not, and if we are to ensure that both Weymouth and Portland can thrive today as they did back in the 19th century, some imaginative thinking is required.

Two trains an hour serve Weymouth from Waterloo. Typically, they take three hours to travel only 130 miles, so the time is considerable. There is an infrequent and

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sporadic service to Yeovil and Bristol. With the aim of speeding up trains to Weymouth, I began to investigate the various possibilities with South West Trains. We came up with three options. The first was to run a faster, third train in each direction on the current route via Bournemouth and Southampton, but that would require substantially more power, platforms and rolling stock, making it expensive and, due to the bottleneck in the New Forest, essentially unworkable. Even if multimillions of pounds were spent on new electricity substations, the increasing number of passengers from projected new housing developments would give any franchisee little flexibility to drop a station in order to generate faster journey times on a line that is already run to capacity.

The second option is to make one of the two hourly London trains “fast” and the other “slow.” However, the negative impact on intermediate stations effectively rules that out. The third option is via Yeovil, and I and many others—not least the colleagues sitting around these tables—believe that that is a goer. With much of the infrastructure in place, it is more affordable and has major advantages. It would: reduce the journey time from Weymouth to London to two hours and 25 minutes; provide more room for passengers on the existing line through Bournemouth and Southampton; expand capacity and business opportunities across a number of south-western constituencies; connect Dorset to Heathrow—I sorely hope that the planned expansion there eventually gets the go-ahead—and take up some of the ample capacity on the Weymouth-to-Bristol line.

The proposal would mean an additional service to Waterloo via Yeovil and Salisbury, with reduced stops, calling at Weymouth, Dorchester West, Yeovil Junction, Salisbury and London.

Michael Tomlinson (Mid Dorset and North Poole) (Con): I am very grateful to my hon. Friend for giving way and for securing this important debate. Does he agree that if the new route via Yeovil goes ahead, it still has the potential to benefit my constituents, who neighbour his, by increasing capacity on the trains, hopefully thereby increasing rail use and relieving a great deal of pressure on our roads, particularly in and around Wareham?

Richard Drax: I entirely agree. As my hon. Friend well knows, the charity railway, which will be linked from Swanage to the main line through Wareham, will also play its part, which is very good news. And yes, that will relieve pressure greatly on the line through his constituency. I have also heard today that he and others are looking at a new metro service running between Christchurch and Wareham, or something of that nature. In itself, that will take up more capacity on the line, which makes my plan less workable, although his constituents will be able to travel backwards and forwards more efficiently and more ably, which is very good for him and others.

The work needed for the third proposal would be relatively minimal—certainly less than would be required on the Bournemouth-to-Southampton line. That work includes some short stretches of new track, enhancements to platforms at Weymouth, Yeovil and Salisbury, an increase in the speed limit on parts of the line, and the extension of a footbridge. I—or we, I should say—believe that none of those is impossible.

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John Glen (Salisbury) (Con): Does my hon. Friend not recognise the absolute imperative, however, of having clarity about the infrastructure costs required, and particularly the cost of dualling the track between Yeovil and Salisbury, which would be key to unlocking a secure future for his plans?

Richard Drax: My hon. Friend makes a very good point. In fact, it is key, as the Minister well knows, because this is a point that we raised with her only an hour or two ago. I say to her gently and humbly that if Network Rail could possibly do the study and come back with some sort of affordability plan, that would help us. We went away from the meeting that the Minister kindly held feeling very positive. At the moment, the local enterprise partnerships all down that line—this is the plan—would be very keen to draw up some sort of business plan and come back to her. What we do not want—my hon. Friend the Member for Salisbury (John Glen) mentioned this—is to do all the work, and for Network Rail to come back and say, “That’s not how we did it,” or “They have missed out this or that,” or “They haven’t put this into the equation.” That would be unfortunate, particularly if a great deal of money was spent on the report that the LEPs are considering drawing up. Some clarity from the Minister at the end of the debate would be most helpful.

It is estimated that the plan for a service via Yeovil would take between three and five years to complete; as with all these things, it would not happen immediately, but it chimes with the Dorset local master plan to reconnect the south and north of the county by train for the first time in almost 30 years, and to link Dorchester and Weymouth to Exeter in the west. As the Minister knows, the Members to my west, east and immediate north are all involved in this potential project and would benefit equally. We are all in this together.

I and many others believe that the proposal would have a dramatically beneficial effect on Weymouth and Portland and, as discussed earlier with the Minister, the whole region. Weymouth and Portland would be connected to a vital east-west arterial route, and that would promise better access for businesses, visitors and tourists, and hopefully generate more investment in the resort.

It is lovely to see my right hon. Friend the Member for West Dorset here. Dorchester would play a key role because it is in a key location. With the housing on the Prince of Wales’s land—this was discussed with the Minister earlier—and other developments across that part of the world in the years ahead, we must have an updated, modern railway system; otherwise, we will simply not cope.

Mr Oliver Letwin (West Dorset) (Con): It is absolutely true that my constituents in Dorchester and Sherborne, and indeed those between them, would hugely welcome the plan that my hon. Friend is describing. Does he agree that if we could get the LEPs to co-ordinate with Network Rail on the specifications of the report, we should be able to establish a very strong business case?

Richard Drax: I entirely agree with my right hon. Friend. It would be useful to have some clarity from the Minister. We are very willing to help out and to do our part, but some guidance from Network Rail would be hugely helpful, so that it does not say that all the work

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that we have done does not come up to scratch. Some negotiation between the two parties would be hugely beneficial.

The knock-on effect—all good—would be dramatic for train times. Pending a study, it is estimated that Weymouth to Waterloo would take two hours, 25 minutes; the typical time now is three hours. If there was a direct service from Salisbury to London, that time could be reduced by a further 10 to 15 minutes. That would have a knock-on effect for the rest of the region. Yeovil to Waterloo would take two hours; Honiton to Waterloo would take two hours, 30 minutes; Exeter to Waterloo would take two hours, 50 minutes; and north Devon—a crucial area that is growing and has very little rail network—to Waterloo would take three hours, 55 minutes. If the non-stop Salisbury to London service introduced a third service in the hour, it would greatly reduce the time—by another 10 to 15 minutes. My hon. Friend the Member for Salisbury is very keen on that.

I have done the train journey to Weymouth in my constituency; three hours is a long time for visitors and businesses, and is beyond daily commuting. What we need, as I am sure the Minister knows, because she has been to my part of the world many times, is to break away from the seasonal hole. It is important to my constituents; they can have longer-term careers and prospects only if we attract investment. I have said, and will say again, that because of the inability to improve our roads dramatically—we can tinker at the edges—rail connectivity really is the key, just as it was for George III and his team. If it was good enough for him, it is good enough for my constituents.

As the Minister knows, the Yeovil option has the support of the local chamber of commerce and the local enterprise partnerships up and down the line. I know of two that are behind it, and further work has been done. I cannot see them not being involved. Weymouth and Portland Borough Council, North Dorset District Council, bordering LEPs and councils, my right hon. and hon. Friends who are sitting around me, and many others who are not here would benefit. I am sure that those who are not here would have been here, if they could.

Bringing these huge benefits to so many for a relatively modest investment in railway terms—the Minister said how amazing it was that even a little work costs a lot of money, but in railway terms, this would be a fairly modest investment—and an achievement that we could all be proud of. Dare I say that as Conservatives—I am proud that we have a Conservative Government—we always go on about jobs, prosperity, wealth and the northern powerhouse, which I totally accept and am totally behind, as I am sure are my colleagues, but how about the south and south-west powerhouse? It depends so much on rural activities, and we need all the help we can get.

I have requests for the Minister. First, will she consider commissioning Network Rail, with the LEPs, if indeed that is the way we go, to undertake a study to look at this idea? Secondly, will she instruct the Department to include the scheme in the south-western refranchising specification, if indeed that is possible? I believe this project is innovative, affordable and doable, and has far-reaching benefits for my constituents and those represented by MPs who are here, and those who are not here. Let us not forget that one of them—the right

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hon. Member for Exeter (Mr Bradshaw)—is a Labour MP; I am sure that if he knew this debate was taking place, or could attend, he would be just as keen on the project. I hope that the Government will play their part in making it happen.

Mrs Madeleine Moon(in the Chair): Before calling Mr Fysh, I alert him to the fact that he has an allowance of four minutes before the Minister needs to sum up.

4.27 pm

Marcus Fysh (Yeovil) (Con): Thank you, Mrs Moon. It is a great pleasure to follow my hon. Friend the Member for South Dorset (Richard Drax). Delivering jobs and opportunities to the south-west is at the centre of my mission as an MP and a major focus of our Government. Somerset is a key gateway to the south-west and presents substantial economic opportunities, including in Dorset, as we have heard.

The Government are spending a massive amount on dualling the A303 and A358 corridor, and this scheme would be a perfect complement to that. It would enhance the prospects for jobs as well as networking our centres of economic growth to allow them to grow more rapidly together than would otherwise be the case. Double tracking the line between Templecombe and Salisbury is essential for that and could unlock substantial further growth. Importantly, it would help a great deal while the A303 work is being carried out because that will probably cause serious congestion that might otherwise present a substantial challenge to the area.

It is important that the analysis of the potential upgrade is carried out in a joined-up way with, and at the same time as, the current analysis on double tracking west of Yeovil. Network Rail is undertaking that analysis as part of its investigation into increasing the resilience of the south-west peninsula. It is hard to think about how trains will be scheduled and what enhancements are necessary without looking at capacity over the whole route at the same time.

South Somerset, of which Yeovil is the key town, has ambitious plans for growth in housing and industry, and would be greatly enhanced by the plan for better rail connectivity, which could bring Yeovil closer to London by up to 40 minutes. That would represent a real step change with knock-on benefits for the whole of the south-west, including Devon and the rest of the south-west peninsula. I cannot emphasise the idea of networking enough. Whenever I have looked professionally at economic projects around the world, the element of new public infrastructure to connect places and reduce journey times, thus raising economic potential, has been a major feature. This is a major plan for jobs and opportunities in the south-west, so we must grab it with both hands.

4.30 pm

The Parliamentary Under-Secretary of State for Transport (Claire Perry): It is a pleasure to serve under your chairmanship, Mrs Moon. I congratulate my hon. Friend the Member for South Dorset (Richard Drax) on securing this debate on the important issue of rail services between Weymouth to Waterloo. As he mentioned, we had a very fulfilling and useful working session earlier this afternoon, which was attended by some of our other hon. Friends in the Chamber. It is telling that so many

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right hon. and hon. Members are here today, including my hon. Friend the Member for Woking (Jonathan Lord), who represents an important constituency on this line. In all such debates, we hear a lot of joined-up support from MPs representing people living in towns, villages and cities right the way along the relevant routes, and I shall go on to address why that is so important.

Jonathan Lord (Woking) (Con): I join my hon. Friend the Minister in congratulating our hon. Friend the Member for South Dorset (Richard Drax) on securing this debate and everything that he said, but will the Minister indulge me and reiterate that she supports the large improvements that will be required over the years to come at my station in Woking, which is on the line?

Claire Perry: Indeed; I would be happy to support that. I was going to come on to say that the Weymouth and Waterloo termini are at either end of the south west main line. That line has the third-rail system, which is rather old electrified technology, and we know that that is one reason why its trains run more slowly than on lines with overhead technology. My hon. Friend raises an important point. Ultimately, the aspiration is to bring all electrified track up to the state-of-the-art level, which would include the investments that he references.

As we heard, journey times on the line are anywhere from two hours 40 minutes to three hours. My hon. Friend the Member for South Dorset came to see me well before the general election to discuss the idea of upgrading the electrical supply along the line to provide a power boost. Some work has been done and, as he rightly said, it is difficult to see the cost-effectiveness—the business case—of those specific investments. As he is a person who does not give up easily, he therefore turned to option 2, which is the idea of connecting that line with the one running through Yeovil, thereby allowing a diversionary route that, of course, would benefit stations in Yeovil and Salisbury, which are represented by hon. Friends in the Chamber. That proposal is interesting, and we had an excellent session this afternoon to run through what would actually need to be done to deliver the journey time improvements that we want. We want to deliver the increased frequency and decreased journey times that would deliver the economic benefits about which we have heard a great deal.

As we know, this is a vital franchise area for the country. Waterloo is the busiest station in the UK. This franchise carries millions of people every year, which was why we announced this year that we would have a franchise competition with a view to getting a new operator in place for 2017. This is a fortuitous time to be discussing infrastructure, because the franchising opportunity gives us a chance to look at what we really want to achieve for the whole of the south-west network. There are proposals to introduce faster trains, and perhaps diesel or bimodal trains, which might be something that bidders come back with to deliver improvements to journey times overall.

There is also the question of how to get investment for infrastructure. My hon. Friend spoke about this, and I am always amazed by how expensive it is to do things on the railway. However, we are talking about a small set of projects—this is not something of the scale of the Great Western electrification. We have clearly signalled our desire not to route all railway investment

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through Network Rail, but to use the train operating companies as the commissioners, as well as the operators running on the network. We have an example of that, because FirstGroup is already taking the lead role in the Selby to Hull electrification project.

While we are going through the franchise process, there is an opportunity to engage with the bidders and determine their appetite is to deliver improvements. Of course, the question is: what is the cost to them? My hon. Friend is right that one cannot set out the business case without knowing the cost. In all honesty, I do not want to burden Network Rail with any more projects at the moment, given its enormous challenge of delivering the projects that we have already set out, but I will discuss with my officials a way of trying to get a better analysis of at least what the range of costs might be for these improvements. We can then start to build a case that takes account of those costs and examines the benefits that improvements to journey times and greater connectivity could deliver.

What was so refreshing in today’s meeting—I pay tribute to my hon. Friend, as well as others who attended—was that we had the local enterprise partnerships and local councils present, as well as MPs assiduously representing their constituents. All were thinking about how this network might look for the region, and that is the way to crack the investment conundrum. I have become aware that it is often surprisingly difficult to generate a business case for transport investment. The Jubilee Line extension, High Speed 1 and the M25 were all things whose benefits people in my position many years ago had to struggle to get recognised.

If we start to bring in the broader benefits, such as the housing that these transport improvements could underpin, the businesses that would move to the area and the local growth that could be unlocked, we could really start to capture the value that transport investment can bring. The right way to do that is to engage from the bottom up with the local enterprise partnerships and

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the council, which can then pull through investment for the benefit of their towns, cities and region.

I therefore urge my hon. Friends, working with their LEP and local council colleagues, to get this issue into the consultation for the franchise, which will run until 9 February. I know that my hon. Friend the Member for South Dorset is not going to come up with a wish list. Any proposal will be targeted, but we could look at that as something that could be put into the franchise competition for the bidders. Then, by the way, we would be starting to get some competition around the bidding process, which could only be to the good.

In the longer term, as I said, there is an aspiration to improve the electrification right along the line, but we need to be in the business of the delivery of infrastructure. For too long, many Governments have been in a “jam tomorrow” place. Now, we have a fully funded list of improvements and projects that Network Rail will deliver over the next four years, after which we can start to bring together the investment horizon for the future.

What is so refreshing about this debate and the amount of work that went into preparing all the documents that my hon. Friend brought to our meeting is that we are not only spending a record amount on the railways—it is the biggest investment programme since Victorian times—but spending it in the way that most benefits local communities. The investment is being not pushed out by the Department for Transport, but pulled out by those in the regions, because without good transport investment, it is not possible to grow a local, regional or national economy.

I commend hon. Members for attending the debate and speaking so passionately for their railways, and I commend my hon. Friend the Member for South Dorset for all his work. I undertake to consider whether we can come up with a way of getting the numerical range to which I referred so that we can at least start to have a more detailed conversation as the franchise period progresses.

Question put and agreed to.

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Access to Justice: Wales

4.38 pm

Carolyn Harris (Swansea East) (Lab): I beg to move,

That this House has considered access to justice in Wales.

It is a pleasure to serve under your excellent chairmanship, Mrs Moon. Access to justice is not a special privilege, but a fundamental right. No one should be denied access to justice because of who they are, where they live or how much they earn. Everyone is equal before the law. The two-nation system is something on which the Secretary of State for Justice and I would possibly agree. When he was appointed, he said:

“There are two nations in our justice system at present. On the one hand, the wealthy, international class...And then everyone else, who has to put up with a creaking, outdated system to see justice done in their own lives.”

What he did not say was that his policies, and those of his Government, have created much of the injustice that we see today. Cuts to legal aid, tribunal fees and court charges have all put a price on justice, and ordinary people across Wales have suffered as a consequence.

The cuts to legal aid implemented by the Conservative and Lib Dem coalition have had a dramatic effect on access to justice in Wales. The number of cases granted funding has dropped by two thirds. Solicitors in my constituency say that cases have “decreased significantly”, and the number of debt cases supported by legal aid fell from 81,000 to just 2,500 over a one-year period. Every one of those cases involves real people, who are being denied the help that they need when they are at their most vulnerable. It is the most vulnerable people in Wales who are being hurt by the changes.

Jessica Morden (Newport East) (Lab): Earlier this year, the Select Committee on Justice and the Public Accounts Committee criticised the Government’s civil legal aid changes, saying that they limited access to justice for some of those who need legal aid the most and that, in some cases, they resulted in cases becoming more difficult and therefore costing the taxpayer more. Does my hon. Friend agree that that very much echoes the cases that we see, week on week, in our constituencies?

Carolyn Harris: It certainly does. I agree with my hon. Friend, and I will come on to discuss that further. When we put a price on justice, those with the means to pay sky-high legal fees will be fine, but people who are in debt, women experiencing domestic violence and parents seeking custody of their children will not be. Ten law centres have already closed in England and Wales, and many more are unable to cope. We are talking not about legal aid lawyers supposedly raking in millions of pounds in fees, but about centres, staffed by volunteers, that can no longer offer fundamental support to those who need it most. Solicitors’ firms in my constituency have told me of the obstacles facing their clients:

“The evidential requirements are stringent. There are occasionally cost implications for clients in seeking evidence to support their application for public funding which is difficult for them if they are on benefits.”

They say that

“everything the Legal Aid Agency is doing is making it harder for both clients and lawyers to get legal aid.”

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The cuts have removed legal aid from nearly all family law cases and led to a sharp increase in the number of litigants in person. In the first quarter of this year, 76% of private family cases involved at least one party who was not represented. The Personal Support Unit, which has an office at Cardiff Crown court and which offers advice to litigants in person, has seen the number of people accessing its services more than double from 20,000 in 2013-14 to an estimated 50,000 this year. The idea that someone who has had their children taken away from them and who may be fighting allegations of domestic abuse is able to defend himself or herself as well as a lawyer could is ridiculous, but that is the reality of the two-nation justice system.

Ian C. Lucas (Wrexham) (Lab): I am grateful to my hon. Friend for raising the important subject of litigants in person. I have spoken to court staff and judges who are deeply concerned about the impossible position that they are placed in when they have to make a decision on cases involving, but at the same time end up giving advice to, litigants in person who are desperately unable to cope with the complexities of the legal system in which they have to operate.

Carolyn Harris: My hon. Friend refers to the reality that the two-nation justice system has created. Cuts to legal aid are having a significant impact on advice services for those experiencing housing, debt and welfare problems. A report commissioned by the Welsh Government shortly after the first changes were introduced found that cuts had “severely affected advice services” and resulted in

“specialist welfare benefits advice being significantly reduced by Legal Aid funding.”

The Welsh Government have done what they can to mitigate those cuts, investing an extra £1 million a year to support front-line advice services, in addition to the top-up of £2.2 million a year to Citizens Advice Cymru to help it to provide a specialist advice service for those who need it. The reality is that thousands of people in need of support will still lose out because of the Ministry of Justice cuts. In Wales, the number of free, face-to-face welfare law advice sessions provided by the not-for-profit sector is estimated to have fallen from nearly 20,000 to barely 3,000 in just one year.

Last month, in the Chancellor’s autumn statement, the Government snuck in an increase in the small claims court limit, which means that the majority of people injured in road accidents, regardless of how severely they were injured, will lose their access to legal representation. Whether for people injured in accidents, families facing debt proceedings or those of limited means who want legal advice before a court hearing, the Government’s changes have had a profound effect on access to justice in Wales.

Few people are more in need of support than women who are experiencing domestic abuse. I am talking about women who have suffered years and years of physical and sexual violence, who turn to the family court to seek help for themselves and their children. Women who may need legal aid to divorce an abusive partner, or even to apply for a child arrangements order to protect their child from an abuser, now have to convince the Government that they have been abused before they can get any help. Worse, the narrow set of criteria proposed by the Government means that many women are unable to prove that they have been abused.

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Charities such as Women’s Aid expressed serious concerns about the evidence criteria before the law was changed. Women’s Aid now says that 54% of women who access services as survivors of domestic violence would not meet the evidence criteria initially proposed. The cuts were railroaded through, however, and in one year the same charities found that 43% of women who had experienced domestic violence did not have the prescribed forms of evidence required to access family law legal aid. The Government have let those women down and, more importantly, let their children down.

In the light of that, it came as no surprise when the Justice Committee concluded last year that the reforms had failed three of the Government’s four tests. The reforms have not discouraged unnecessary litigation or targeted help at those who need it the most. On the Government’s claim that the changes were necessary to cut costs, the Committee said that the Ministry of Justice

“has failed to prove that it has delivered better overall value for money for the taxpayer because it has no idea at all of the knock-on costs of the legal aid changes to the public purse”.

The changes have not delivered value for money. Instead, they have forced vulnerable people to represent themselves in court and taken vital support away from abuse survivors.

The Government are charging ahead with changes to criminal legal aid, and we will face the same problems. From next year, the number of contracts issued to solicitors’ firms for criminal legal aid will fall from 1,600 to just over 500. Solicitors’ firms in parts of Wales, especially in rural areas, have warned that there simply will not be enough firms left to do all the work.

Mr Mark Williams (Ceredigion) (LD): I congratulate the hon. Lady on securing this important debate. She will be aware that in the area that the Ministry of Justice names Dyfed Powys 2, which consists of all of Ceredigion, Pembrokeshire and all of Powys—the Opposition Members present will be aware of the geography of the terrain—it is suggested that only four solicitors’ practices will offer the reduced legal aid. Does she agree that that is the worst kind of access to justice imaginable?

Carolyn Harris: I would go as far as to say that it is almost zero access to justice.

The tendering process has been shown to be a complete shambles—the implementation date has slipped from January to April of next year and possibly into 2017. The president of the Law Society of England and Wales has spoken of a

“serious risk of a knock-on effect on access to justice for clients.”

That warning comes just weeks after the Government were forced to drop their criminal courts charges, which led to some 50 magistrates resigning from the profession in protest. In the words of the Justice Committee, the changes were

“having effects which are inimical to the interests of justice”,

including the creation of “perverse incentives” for innocent defendants to plead guilty. I am glad that the Government have finally realised that the court charges were not fit for purpose, but it was not before countless people potentially changed their pleas because they could not afford to say that they were not guilty.

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Mr David Hanson (Delyn) (Lab): Before my hon. Friend leaves the point of criminal courts charges, I am a member of the Justice Committee and we have just agreed that it was right to change the system. However, of the £5 million that was levied, only around £300,000 has been raised, leaving a debt on a large number of people who should not have had that charge imposed on them in the first place. Through my hon. Friend, I ask the Minister to tell us what will happen to those who have been levied the charge and who have not yet paid.

Carolyn Harris: It is clear that, alongside access to justice, the Government’s reforms to the criminal courts system have risked another fundamental British principle—the right to a fair trial. One of the most basic attributes that we expect of any justice system is that it is fair. Those who have committed crimes must be punished quickly and effectively, but everyone has the right for their case to be heard and nobody should have to decide how to plead based on whether they can afford to pay the fees—not least because victims of crime deserve better.

Will the Minister agree to an urgent review into how legal aid costs are affecting access to justice in Wales? As court charges—one of the flagship policies—have now been dumped, what confidence does he have that the other changes are not having a similar perverse effect on justice and the right to a fair trial?

Members across the Chamber have serious concerns about the proposal of the Ministry of Justice to close 11 courts and tribunals in Wales. In large parts of the country, it is already hard enough for those attending trials to reach their nearest court in the allotted time, and the decision to close those courts will make that harder still.

The Law Society has found that many people will find it impossible to get to their nearest court within an hour when travelling by public transport. If the Government go ahead with their plan to close, for example, two courts in Carmarthen, just 32% of people taking public transport to my constituency of Swansea for family law cases would be able to get there within 60 minutes. For criminal cases, the figure is 31%. Across Wales, in areas where there is limited or infrequent public transport, it is a very real possibility that defendants and witnesses could end up on the same bus to the court hearing. Members can imagine the distress and legal complications that that will cause.

Wayne David (Caerphilly) (Lab): Does my hon. Friend agree that it is quite ridiculous that, at the last Justice questions, the Minister suggested that people could access justice by telephone?

Carolyn Harris: I think I referred to it as sentencing by text, if I am not mistaken. It is an absolutely absurd idea.

Huw Irranca-Davies (Ogmore) (Lab): The Minister did indeed say that mobile phones would be the way forward for my constituents. We are facing closures in Pontypridd and Bridgend, which are difficult enough to get to at the moment. To tell those constituents to come down the valley and change transport to get to Cardiff will add another impediment to access to justice. Through my hon. Friend, I would say that the Minister really

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needs to think this through again and to think about the geography of Wales. We are not flatlands with a huge transport hub; we are valleys. I know that your constituency is affected by the issue as well, Mrs Moon.

Carolyn Harris: I thank my hon. Friend for his intervention. The Law Society has expressed “grave concerns” that the proposal to close courts—I agree with this point—could “erode access to justice”. Its worries are shared by many people across the region.

Whether it is closing courts, slashing legal aid or any other reforms that I have not had an opportunity to address—such as employment tribunal fees, changes to judicial review or the plan to scrap the Human Rights Act—Government policies are having a severe impact on access to justice in Wales. It is the responsibility of any Government to ensure that our justice system does not become the preserve of the wealthy and unresponsive to the needs of those who need to use it most. It is vital that the justice system is accessible when we need it and accessible to all. I seriously fear that after another five years of this Government, neither of those opportunities will be open for Wales.

Several hon. Members rose—

Mrs Madeleine Moon (in the Chair): Order. I have only two names of Members who have asked to speak before me. At 5.20 pm, I intend to call the Front-Bench spokesmen for the Labour party and the Scottish National party, who will have five minutes each, and then the Minister, who will have 10 minutes. I will first call Albert Owen, and if other Members wish to speak, they will have to rely on the generosity of the hon. Gentleman and the next Member to be called if they are to get in before 5.20 pm.

4.56 pm

Albert Owen (Ynys Môn) (Lab): It is a pleasure to serve under your chairmanship, I think for the first time, Mrs Moon. I congratulate my hon. Friend the Member for Swansea East (Carolyn Harris) on an excellent speech that covered most of the points that need to be considered.

I will actually start by agreeing with the Minister and the Ministry of Justice that access to justice for all is a fundamental aspect of our society. That is what it says in the consultation document on proposals for the provision of the court estate in England and Wales. I totally agree that we all want access to justice for all. Indeed, I would say that local justice and democracy are the pillars of a modern society, but we are moving away from that—I shall develop that argument a little later.

I welcome the Minister to the Chamber, because he was kind enough to acknowledge my submission to the consultation and to meet a delegation that included Citizens Advice and a local solicitor. We were able to outline many of my concerns for my area and, indeed, the periphery area of north-west Wales, including Dwyfor Meirionnydd, because the representative from the solicitor represented the whole old county of Gwynedd. However, it is Christmas, and I am going to subject the Minister to my concerns once more because it is important that they are on record.

People know the importance of direct access to justice. The Ministry of Justice wants to close the two remaining courts in my area in Llangefni and Holyhead. Llangefni

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is the principal and municipal town of Anglesey. Holyhead is the largest town on the island, but also the furthest from Cardiff and London—it is on the periphery area. It is the hub to the Republic of Ireland and has a large transit population, as well as local residents. The proposal to transfer to Caernarfon court is therefore fundamentally flawed. What is more, the alternative that the Minister has talked about—the virtual courts and the digital fines—are equally flawed. Frankly, the one-size-fits-all proposal of the Ministry of Justice does not fit Wales; each part of Wales should be looked at on its merits. I understand, as I think does every Member in the Chamber, the need to modernise the justice system, but denying access is not modernisation. It is a backwards step and the proposal does not take into account people’s distances from court.

The Government talk about courts being 30 miles away and taking about an hour to reach. The journey from Holyhead to Caernarfon is 30 miles, but it can take an hour and a half. It can involve train journeys, two buses and changing. As has been said, many of those who have to travel will be witnesses, not just those who are up in court.

I believe that the proposal is flawed because it is driven by the Treasury. One of the main reasons why the exercise is being carried out now and in such a way is to save money on the estate. Yes, we need to get value for money, but the process is driven by the Treasury, rather than the Ministry of Justice. It is important to put that point on record and I will be interested to hear the Minister’s response to it.

Access to local justice has to be practical, and people have to be able to have such access. The Minister talks about virtual courts, but they will be virtually impossible to implement. There are very few buildings in my constituency that could accommodate a virtual court. He talks about access via the digital age, but the digital age has not arrived in many rural or peripheral parts of Wales. That is an important point because the superfast broadband roll-out is happening at the exchanges, but not going to many towns and areas that need it. It would be difficult to have a virtual court in north-west Wales, for example, because the information and communications technology systems simply are not there—they are intermittent. I am pleased that the Government have done a U-turn with regard to universal coverage, but that will not come in until 2020, at the earliest, and these proposals are going through now. When will the Minister respond to the consultation exercise and make his recommendations and proposals? I believe that he should wait until we have proper infrastructure if he wants to experiment with the digital age for accessing justice.

I am conscious that other Members wish to speak, so I will not go over most of the issues that I discussed with the Minister. However, I highlight the fact that in the 21st century we still need a court system that individuals can access. The public want individuals to be tried in their area, as has happened historically. If we are to move forward into the digital age, we need the necessary infrastructure in place, and the Ministry of Justice needs joined-up thinking with other Departments.

Wayne David: Does my hon. Friend agree that it is particularly important that digitalisation is done properly in Wales because we are a bilingual country and people

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must have access to justice in the language of their birth? If that language is Welsh, they must have access in Welsh.

Albert Owen: My hon. Friend is absolutely right. I was going to make that point in my closing remarks, because when we talk about “local”, we are talking about local culture and local languages as well as the basic principle of access to local courts.

The Government talk about putting in place devolution and decentralisation, yet their record is one of the complete opposite. They are centralising tax offices, for example. If the Government’s proposals go through, the nearest tax office to Anglesey will be in Liverpool, which is nearer to my constituents than Cardiff. We are now talking about courts moving 30 or 40 miles away from their population, which is nothing but centralisation. I urge the Minister to look again at these proposals, to put them on hold, to talk to local communities and to listen to the consultation. He should not rush through the proposals because while I agree with him, ultimately, that we need free and fair access for all, that will not happen if these proposals go through.

5.2 pm

Mr Mark Williams (Ceredigion) (LD): It is a pleasure to serve under your chairmanship for the first time, Mrs Moon, and I will be brief. I congratulate the hon. Member for Swansea East (Carolyn Harris) on raising this issue. She talks about the emergence of a two-tier system, and there will be a very strong divide between rural and urban communities.

Mercifully, there is one courthouse left in my constituency, in Aberystwyth. That is the only one, as our courthouse in Cardigan was shut down five years ago. I reiterate what the hon. Lady said about the challenges of geography and distance. In the debate that I secured when we tried to stop the closure of Cardigan courthouse, we heard that as Cardigan was only 38 miles from Aberystwyth, all would be well, because there would be ease of access to our court in Aberystwyth, but that is not so. It might be quick and easy to travel 38 miles down the A55 or the M4—or perhaps not—but the situation is a different kettle of fish for people living in rural communities. As she said, the problem is compounded by my constituents’ experience of trying to access public transport in rural areas where no such system exists.

Access to our courts is a very real issue. If I were being parochial, I might say that my underused courthouse in Aberystwyth will gain more work when the courthouse in Dolgellau is shut, but I do not say that because, from experience, I believe that the situation goes to the heart of access to justice for many of our constituents.

Let me talk specifically about the point regarding which I intervened on the hon. Lady. She alluded to the limitations of legal aid, and I want to talk about the number of practitioners out there in the country. When the right hon. Member for Epsom and Ewell (Chris Grayling), who is now Leader of the House, was Secretary of State for Justice, he proposed a two-tier system for delivering criminal legal aid. That proposal has continued under the current Secretary of State. The scheme involves a bidding process for the limited number of contracts within each bid zone, and I repeat what I said in my intervention. My vast constituency of Ceredigion falls

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into the Dyfed Powys 2 zone, which includes Ceredigion, Pembrokeshire and the whole of Powys, including the towns of Brecon, Llandrindod Wells, Newtown, Welshpool, Machynlleth, Aberystwyth and Cardigan. Incredibly, the Ministry of Justice decided that only four contracts would be made available in that vast area, which is dangerous nonsense.

When I talked to solicitors’ practices about the prospect of bidding, the reality soon emerged that no single firm in Dyfed-Powys would be able to service such a contract because the volume of legal aid work in mid and west Wales is so low that it could not sustain a business undertaking such an endeavour. The characteristic of our model for delivering criminal legal aid in Ceredigion, which is not dissimilar to that in other places in rural Wales, is of one or two solicitors within a high street mixed practice effectively subsidising legal aid work. When the Government made their proposal, the fact that there was no plan B suggested that it was doomed to fail. As of July 2015, there are only five firms undertaking legal aid work in Ceredigion, which suggests that many firms have already decided that such work is not profitable. None of the firms in my constituency felt able to bid for the duty contracts, either on their own or collaboratively. The Government suggested at the time of the announcement that small practices would come together, but that was not going to happen. Such an arrangement is fraught with difficulties.

We are where we are, but I am not quite sure where that is. The hon. Member for Swansea East said that we were led to believe that the bidding process would be concluded in January 2016, but it is now suggested that it will be concluded in April. There are contingency contracts around, which suggests that the situation might not be resolved until 2017. That is causing great concern among solicitors’ practices and a lot of uncertainty. When can we expect a resolution? The spectacle of there being only three or four providers across mid and west Wales makes one shudder, which is why a renewed number of legal aid concerns have been raised in all our surgeries. It is also why there is huge pressure on the very limited citizens advice bureaux across our constituencies, to which I pay tribute.

The other thing that needs to be mentioned is the Welsh language, which is spoken by more than half my constituency’s population. I am concerned about whether the providers, especially if they come from outside my area, or outside the broad expanse of mid and west Wales, will still be able to present their services through the medium of Welsh. That remains a great worry, whatever the Legal Aid Agency suggests, because when these services were being delivered by small solicitors’ practices in high streets throughout the country, we had a guarantee. As those practices were based in Welsh-speaking communities, their services could be provided in the mother tongue, whatever that mother tongue may be. Again, I sadly reflect that the situation illustrates how the Ministry of Justice has scant knowledge of and regard for rurality and, I believe, scant regard for the Welsh language, too.

Several hon. Members rose—

Mrs Madeleine Moon (in the Chair): Order. I have received a number of notes from Members advising me that they notified the Speaker’s Office of their wish to speak. I have not been advised that those requests were

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received by the Speaker’s Office, but in an attempt to get in everyone who has approached me, I shall set a three-minute time limit on speeches.

5.9 pm

Nick Thomas-Symonds (Torfaen) (Lab): It is a pleasure to serve under your chairmanship, Mrs Moon, and I congratulate my hon. Friend the Member for Swansea East (Carolyn Harris) on securing this important debate on such a crucial issue at such a crucial time. Access to justice in Wales is under threat. In employment tribunals, for example, there were 16,456 single-claim cases in 2014-15, which represented a 52% fall on the number in 2013-14. That fall was due to the introduction of the fees system that has levied up to £1,200 on people who have lost their jobs and are not in a position to spend that amount of cash.

I practised in the Welsh courts as a barrister for 11 years before entering this place, and while I remain a door tenant at Civitas in Cardiff, I no longer practise. I am fully aware of what has been going on, especially in relation to employment matters. The changes mean that literally thousands of people are no longer able to enforce their legal rights before an employment tribunal.

There are 11 scheduled court closures. My hon. Friend the Member for Caerphilly (Wayne David) pointed out that the Minister has talked about telephone hearings already happening in court, but let me make the distinction clear. Interlocutory hearings, especially those in the civil courts that last for less than an hour, have for some years been done on the telephone—that is absolutely true. It is also true that in certain trials and certain specific circumstances, witnesses have given evidence by video link. However, extreme care has always been taken with trials, when it is best that the veracity of witnesses is judged face to face. Their demeanour has to be judged; it is not simply as case of what they happen to say through a particular visual medium. It is crucial to realise that there has to be a limit to what is done through the so-called digital revolution in the court system. Certain trials simply cannot be done on the telephone or via such a visual medium, so the Ministry of Justice must take that into account.

Local justice is crucial, because it is important that we do not see justice as distant. Justice should reflect the culture of the area, and I fear that the closure of 11 courts will put that at risk.

I urge the Ministry of Justice to be wary of false economies on civil legal aid. It is one thing to take down the legal aid bill, but it is quite another if one ends up with far more litigants in person in the court system. There is nothing wrong with people representing themselves, but they should not do so simply because they cannot afford to access a lawyer. If that does happen, I am afraid that the court system will be slowed by having so many litigants in person, and the Minister will find that the cuts in civil legal aid are simply counter-productive.

5.13 pm

Jonathan Edwards (Carmarthen East and Dinefwr) (PC): One of my first contributions after being elected to the House of Commons in 2010 was to fight in this Chamber on behalf of the two magistrates courts that remained in my constituency: Ammanford and Llandovery. The Government proposed closing those courts on the

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basis that services would be provided in Carmarthen magistrates court, yet here we are debating the future of that court and the state-of-the-art family, tribunal and probate hearing centre that was opened in Carmarthen by the Lord Chief Justice in 2012. That goes to show, to use a famous Welsh political phrase, that centralisation is a process, not an event. I wonder how long it will be, with services being centralised in Llanelli, before we are arguing about the centralisation of services to Swansea, which is only a dozen miles to the east. It is easy for Ministers and their civil servants to sit here in London and draw lines on a map and crosses through budget lines without understanding the full effect of the changes on the communities we represent.

I oppose the proposals for the west of my country for five primary reasons. First, Carmarthen is the legal capital of the west of my country. It was afforded that status by James I in 1604, when he made it a county corporate by charter. I am struggling to understand why the Minister thinks he knows better than James I. Carmarthen is one of only two towns in Wales that still has a town sheriff, and that gives a clear indication of the importance of the role that Carmarthen has played in the legal system in the west of Wales.

Secondly, the Ministry of Justice has spent £1.7 million on the two courts in Carmarthen in the past seven years, so it would be a colossal waste of money to close those courts following such investment. When the family court was opened in 2012 by the Lord Chief Justice, it was seen as a pathfinder for the future of legal services in Wales and England because of all its video-conferencing technology. The Minister says that such technology is the way forward, but I am informed by magistrates that none of that equipment has actually been installed. I therefore find it difficult to understand how the Minister can make the case for closing that court in Carmarthen—it has just been opened—on the basis of a lack of operational capacity. He will argue that the way forward is remote justice but, as the hon. Member for Ynys Môn (Albert Owen) said, we are talking about areas that are known to have broadband “not spots” and to lack fast mobile provision. It will be difficult to deliver such a legal system in the areas we represent.

Thirdly, Carmarthen is the natural travel hub for the west, north and east of Carmarthenshire. It could take five hours by public transport for someone from Newcastle Emlyn or Llandovery to make it to Llanelli to attend court. The natural transport hub for Carmarthenshire is the county town, so it does not make any sense to close the courts in Carmarthen. Fourthly, as has been mentioned—

Mrs Madeleine Moon (in the Chair): Order. To get all hon. Members in, we will need to move on. I call Liz Saville Roberts.

5.16 pm

Liz Saville Roberts (Dwyfor Meirionnydd) (PC): Diolch yn fawr, Gadeirydd. I congratulate the hon. Member for Swansea East (Carolyn Harris) on securing the debate. It is an important topic, and it is particularly important to my rural constituency of Dwyfor Meirionnydd. Fifteen courts were closed across Wales during the last Parliament, and since the 2015 election, a further 14 have either closed or are being earmarked for closure by the UK Government. The proposed closure of Dolgellau

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magistrates court in my constituency, for example, means cases will need to be transferred to either Caernarfon or Aberystwyth, which, incidentally, is outside the North Wales police region. The issue of inadequate public transport in Wales is well documented, but Members will understand that a journey from Dolgellau to Aberystwyth or Carmarthen is not simply a matter of getting on a tube with an Oyster card. For my constituents in Dwyfor Meirionnydd, and indeed for many people across Wales, it is simply impossible for public transport to get them to a magistrates court for a 9.30 am start.

The Ministry of Justice claims its programme of cuts is necessary to save money, but what will effectively happen is that the cost of providing justice will be passed from the state to the citizen. The cost will still be borne, but by the individual regardless of ability to pay, while the state washes its hands.

I have left out a number of things due to time pressures, which is unfortunate, but I return to the issue of courts. I have a background in teaching through video conferencing, so I welcome the Minister’s commitment last month to undertake a Welsh language impact assessment before coming to conclusions about the future of courts in Wales. On the other hand, I am also interested in efforts to increase access to justice through the use of technology, particularly video technology.

Given the swathes of court closures and the particular problems they will cause in rural parts of Wales, allowing hearings to take place remotely may be welcome. I note however the eight conditions set out by Lord Leveson’s review of efficiency in criminal proceedings in January 2015. He considered those conditions to be prerequisites for remote hearings. The first of them seems obvious, but is in fact crucial: the equipment used and the audio and visual quality should be of a high standard. Given what fellow Members have said, I wonder what consideration has been given to the quality and reliability of digital infrastructure in those areas where courts are to be closed. I particularly urge that consideration is given to Lord Leveson’s recommendation that a committee of criminal justice professionals be charged with identifying best practice for hearings conducted via video link, not only to maintain the gravitas of the court environment, but, more importantly, to ensure that justice outcomes via communications technology are consistent with justice outcomes in a conventional environment.

I also urge the Minister to consider alternative public buildings if a court building—this is understandable—is no longer deemed suitable for 21st-century justice. In the case of Dolgellau, the Meirionnydd council chamber would require little adaptation, and offers such facilities as parking and translation equipment. As an aside, it is also nearer the cells and the police station than the present court—

Mrs Madeleine Moon (in the Chair): Order. We need to move on. I call Richard Arkless.

5.19 pm

Richard Arkless (Dumfries and Galloway) (SNP): It is a privilege to serve under your chairpersonship this afternoon, Mrs Moon. I thank the hon. Member for Swansea East (Carolyn Harris) for securing a very important debate. It has been amplified by the number

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of Welsh Members who have attended this afternoon to put their point across very passionately. It is further amplified by the lack of the 11 Tory MPs who occupy certain sections of Wales. The only thing more surprising is that Wales still has 11 Tory MPs; I hope the people of Wales will deal with that at the next general election.

Scotland is fortunate; we have had a separate legal system since the Act of Union. It was enshrined in the Act, so during the last 300-odd years we have been able to design certain elements of our justice system differently to suit the needs of the people of Scotland. Many of the complaints raised this afternoon would be fixed to a great extent by devolution of justice to Wales. I urge Welsh Members to think about that as a serious concept. Justice decisions made closer to the people that they affect would inevitably be better decisions.

The Government have created several bars to access to justice over the past few years. We have seen criminal court charges, which, thankfully, they have agreed to end. We do not have them in Scotland. Employment tribunal fees have been imposed on employment tribunal cases, as we have heard. We have committed to abolish those in Scotland as soon as the matter is devolved. The slashing of the legal aid budget has impacted on access to justice. We are not immune from such cuts in Scotland, but we feel we have been able to manage resources better so that they do not have the impact that they have had in Wales.

I have been very impressed by some of the submissions that we have heard, particularly from the hon. Member for Swansea East. She gave a passionate speech about the real effects on ordinary people. That is always the story with austerity, which impacts on the most vulnerable in our society first. The Government’s austerity agenda impacts on access to justice in Wales. That is undeniable.

The hon. Member for Ynys Môn (Albert Owen) made another fantastically passionate speech and coined the phrase “one size fits all”. It goes back to the whole devolution prospect. I do not believe as a matter of principle that a one-size-fits-all approach across the UK is sensible for all the Celtic nations. He is absolutely correct when he says that access to justice is driven by the Treasury. The Ministry of Justice has not come up with a grand plan to increase justice provision, yet reduce costs. The Justice Secretary has rolled over in negotiations with the Treasury, whereas other Departments have not done so.

Given the pressure on time, I will conclude my remarks. I support the proposal that Wales should have more decisions taken by the Welsh Parliament, closer to the Welsh people, to make better decisions for the people of Wales.

5.23 pm

Susan Elan Jones (Clwyd South) (Lab): It is a great pleasure to serve under your chairmanship, Mrs Moon. I am conscious of something that George Bernard Shaw once said. He apologised for writing a long note because he had not had time to write a short note. I fear I have written rather a long note, but I know you will keep me to delivering a short speech.

I congratulate my hon. Friend the Member for Swansea East (Carolyn Harris) on securing today’s debate and on such a wide-ranging, passionate and practical speech that highlighted some of the real problems with access

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to justice in Wales. I really hope the Minister will take these matters on board and make some changes. The debate has been phenomenal. We have had contributions from 10 Back Benchers and a visitor from Scotland, the hon. Member for Dumfries and Galloway (Richard Arkless). We have had contributions from my hon. Friends the Members for Caerphilly (Wayne David) and for Newport East (Jessica Morden), and from my right hon. Friend the Member for Delyn (Mr Hanson), who made a very important point about the Justice Committee and we look forward to a response from the Minister on that.

My hon. Friend the Member for Wrexham (Ian C. Lucas) talked about the issue of litigants in person. We heard from my hon. Friends the Members for Ogmore (Huw Irranca-Davies), and for Ynys Môn (Albert Owen). The latter referred to many issues relating to his constituency, but he also referred to an issue that really needs highlighting: the prospect of the accused and the defendant travelling on the same bus. Imagine a victim of domestic violence and the perpetrator on the same rural bus. That is a really important point that shows many of the flaws in the current proposals.

We heard a speech from the hon. Member for Ceredigion (Mr Williams) on rural communities, especially in mid and west Wales. My hon. Friend the Member for Torfaen (Nick Thomas-Symonds) showed his extensive practical experience of legal representation and some of the flaws in the current proposals. The hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards) rightly complained about centralisation, and the hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts) raised, among other issues, remote hearings. Labour Members often talk about the importance of being tough on crime and tough on the causes of crime, but for this Government and their proposals it is tough if you happen to be a victim of crime, which is very different indeed. It is extraordinary that no Conservative Members are here. They had an increase in numbers at the general election and they are still not here representing the interests of the people of Wales.

There are many problems, but I want to focus on two issues. The first relates to the impact on the Welsh language, which several Members mentioned. Few of us ever have to testify in court, and even fewer will testify against an attacker or an abuser, but, for the people who do, being able to communicate effectively and to hear and understand everything that is said is essential. For many first-language Welsh speakers, that means being able to engage with the court in Welsh. That right goes back nearly 70 years to the Welsh Courts Act 1942, which overturned the ban on Welsh in courts that had been in place since the 16th century.

Everyone can surely speak English, but I refer Members to the words of the Labour peer, Viscount Sankey, during the passage of the Welsh Courts Act:

“No doubt many members of this House read French easily and speak it well; many speak it perfectly; yet how should we like to be examined and cross-examined in French? Should we not be rather nervous and embarrassed witnesses and fail to do ourselves justice?”—[Official Report, House of Lords, 20 October 1942; Vol. 124, c. 662-8.]

I am not sure Members are quite as proficient in French as they probably were in the 1940s, but the point remains that being able to communicate in one’s own language before a court is essential. It is not a nicety. The Ministry

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of Justice’s own Welsh language scheme admits that the Department has failed to evaluate the linguistic consequences of its policies. Securing the rights of Welsh speakers and promoting the equality of Welsh and English are not optional niceties; they are statutory requirements, and the disregard is positively shameful.

The Welsh Language Commissioner has criticised the way in which the closures have been proposed. As she points out, a

“decision to change the court estate, should aim to promote and facilitate the use of Welsh in Wales.”

We want an answer.

Let us look at the case of Anglesey, or Ynys Môn, as my hon. Friend the Member for Ynys Môn calls it. Some 70% of people on the island have knowledge of Welsh, with 56% describing themselves as Welsh speakers. If I am allowed, I will refer to the Human Rights Act—

Mrs Madeleine Moon (in the Chair): No.

Susan Elan Jones: But I am sure the Minister will speak of the grave omissions in his Government’s policy.

5.28 pm

The Parliamentary Under-Secretary of State for Justice (Mr Shailesh Vara): It is a pleasure to serve under your chairmanship this afternoon, Mrs Moon. I commend you on having managed to get through so many speakers in such a short time. I congratulate the hon. Member for Swansea East (Carolyn Harris) on securing this important debate. I also thank the many colleagues who have turned out for this debate; that demonstrates its importance. Individuals have spoken with passion, both on constituency matters and more generally. Several points have been raised, and I intend to address as many as I can. I ask Members to be patient if I do not instantly respond to their issue in the first minute or two. I will make one thing absolutely clear at the outset: the Government share the hon. Lady’s passion for a justice system that works for everyone.

The hon. Lady referred to my right hon. Friend the Lord Chancellor’s eloquent comment that the Government’s commitment to one nation justice was fundamental to the rule of law. At the heart of one nation justice is equality, and a justice system that safeguards and protects the vulnerable and works better for victims and witnesses. Our justice system does not always do that, despite the fantastic efforts of those who work in it. That is why the Ministry of Justice is leading a major reform programme. As the hon. Member for Swansea East will know, the MOJ has secured more than £700 million in funding to invest in courts and tribunals in England and Wales. We are working closely with the senior judiciary to deliver a justice system for everyone, at a lower cost for all those who need to access the courts.

There is much agreement that our courts and tribunals need urgent reform, and a high degree of consensus that the current system is not only too slow, but unsustainable. Despite the best efforts of front-line staff, the infrastructure supporting the administration of the service is inefficient and disjointed, and based on technology that is, in some cases, decades old. I hope Members agree that that has to change. That means using up-to-date technology, which I will discuss later in my speech, and modernised working practices, and having a more appropriate and efficient estate. It will also mean victims and witnesses being able to attend some hearings remotely, and not

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having to experience the stress and strain of a personal visit to a court, or, indeed, having to take a day off work.

Mention has been made of victims and witnesses travelling together. Clearly, that is a situation that none of us would want. The beauty of a remote system is that there is no danger of meeting people on the bus to court. The victims will not be travelling with the witnesses and the defendants. They may well be in a local civic building of some kind, in a video-conferencing suite to which people go by appointment at a specific time. They will be far more comfortable there, and will not have the stress and strain of going to court, which would be a strenuous and stressful experience for most people.

We are replacing paper forms, automating much of the administrative process, and allowing defendants to indicate their plea online. The use of telephones was mentioned. Let me make it clear that we are piloting a scheme in Manchester in which pleas can be made online, using either computers or smartphones. That is happening right now, as we speak.

Nick Thomas-Symonds: Will the Minister give way?

Mr Vara: If the hon. Gentleman will forgive me, I will not, but I will address his point. He rightly said earlier that there will be some cases where digitalisation is clearly not appropriate; that is why we will maintain courts. Nevertheless, for many cases, court will not be necessary. The majesty of the court will remain for appropriate cases that deserve to go to court, but it is important to remember that access to justice does not always mean access to a court, with all the time and expense that that entails. Nor does it mean that people should always turn to taxpayer-funded lawyers. Where suitable alternatives are available, we want to see more cases diverted from the courts.

There is no doubt that in many cases court should be the last resort, not the first. Encouraging greater use of mediation has been a key part of our wider reforms to the justice system. Mediation can be quicker, cheaper and certainly less stressful than protracted litigation. For the taxpayer, who would otherwise be paying solicitors, barristers and for time in court, there will be a saving. For the parties involved, it is far better to sit around a table and have constructive engagement than to be in a court scenario, where there is often—I speak as a former solicitor—a destructive environment, rather than one of constructive engagement.

Susan Elan Jones: There might be some validity in that, but how does the Minister square it with the rise of litigants in person? We may well see the well-heeled being able to get the best legal advice in the world, while those on the other side of the dock have to represent themselves in person. Surely that is not fair.

Mr Vara: I plead with the hon. Lady to be patient; I will turn to litigants in person shortly.

From April last year, the Children and Families Act 2014 made it a legal requirement that anyone considering applying to court for an order about their children or finances should first attend a mediation information

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and assessment meeting, which we call a MIAM, unless exemptions such as domestic abuse apply. The requirement was introduced so that parties could consider the benefits of mediation before the start of court proceedings, which can be long, arduous and expensive. From November last year, we have funded the first single session of mediation in cases where one of the parties is already legally aided. In such circumstances, both parties will be funded for the MIAM and the first session of mediation.

I hope Members appreciate that legal aid is only one part of a balanced access-to-justice provision, although of course we recognise that in some cases it can be a vital part. We also recognise that those in greatest hardship at times of real need should have the resources to secure access to justice. When the programme to reform legal aid commenced in 2010, the scale of the financial challenge facing the Government was unprecedented. We had to find significant savings, which meant making difficult choices. Despite that, we have made sure that legal aid remains available when it is most needed: where people’s life or liberty is at stake; where they face the loss of their home; in cases of domestic violence; or where their children may be taken into care.

In the case of domestic violence, evidence is required to ensure that the correct cases attract funding, but we have listened and made changes to the amount of evidence required. One of the first things I did when I was appointed Minister in October 2013 was meet certain stakeholders, who told me that the conditions were too stringent. As a consequence, I made the appropriate changes. We will, of course, continue to listen and to make changes where necessary.

The fact remains that even after all the reforms, our legal aid system remains one of the most generous in the world. Last year we spent more than £1.6 billion on legal aid, which is around a quarter of the Department’s expenditure. We have also made sure that funding is available through the exceptional funding scheme, where that is required under the European convention on human rights or by European law. We believe that the reforms to the legal aid scheme are sustainable, but we have provided that there will be a review within three to five years of the implementation of part 1 of the Legal Aid, Sentencing and Punishment of Offenders Act 2012.

As far as the Welsh language is concerned, let me make it absolutely clear that Welsh-speaking users can call the Civil Legal Advice Welsh-language operator service, or request an immediate call back from a Welsh-speaking operator. The bilingual site architecture has been designed to ensure that the same service is available in the Welsh language as in English, and that the content can be easily kept up to date. We continue to work with the advice sector to develop sustainable and collaborative ways of working to ensure that people can obtain advice when they need it.

On litigants in person, we have provided £2 million for a strategy led by the advice, voluntary and pro bono sector. It maximises the provision of support to litigants in person, and there is an increase in the provision of face-to-face, phone and online support.

In the few moments I have left, let me address a few of the points raised. The hon. Member for Swansea East said that there has been a reduction in the number of criminal contracts, but there is a far higher number of contracts for own-client work, which means that

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people can continue to work for the clients that they already have. The right hon. Member for Delyn (Mr Hanson), who has a distinguished record in government, asked about the criminal court charge. He will know from his time in government that laws change. Until 24 December—the date that the Lord Chancellor gave—the law will apply. I have already touched on the issue of telephone access, but I emphasise that the digitalisation process that we envisage will clearly not apply to all cases. The physical presence of courts, which people will need to go to when appropriate, will always remain.

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I congratulate the hon. Member for Swansea East on securing this debate, and I thank all Members for taking the trouble to attend. I hope I have been able to give some comfort to Members, and assure them that we are very keen to ensure that access to justice remains.

Question put and agreed to.

Resolved,

That this House has considered access to justice in Wales.

5.41 pm

Sitting adjourned.