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  • Marion Fellows – 2022 Speech on Eye Health

    Marion Fellows – 2022 Speech on Eye Health

    The speech made by Marion Fellows, the SNP MP for Motherwell and Wishaw, in Westminster Hall, the House of Commons, on 15 December 2022.

    It is a pleasure to serve under your chairmanship, Mr Sharma. I thank the hon. Member for Strangford (Jim Shannon) for the nice things he said about me and congratulate him on securing this important debate. He is right: people would have been present if it had been possible, but weather, transport and other emergencies intervened.

    Eye problems can affect anyone at any age. It is important that people get their eyes tested regularly. In Scotland, we feel that that should be by having a free NHS-funded eye examination. It is easy for us to neglect our eyes, because often they do not hurt when there is a problem. Having our eyes examined regularly can help to detect early signs of sight-threating conditions and other serious health conditions such as diabetes, cardiovascular disease and high blood pressure, in addition to the conditions that the hon. Member for Strangford told us about a moment ago.

    In Scotland, community optometrists are the first contact point for any eye problems. They can diagnose and treat a number of conditions without the patient requiring an appointment with their GP or an ophthalmologist. An increasing number of community optometrists are registered independent prescribers and can issue patients with an NHS prescription to treat their eye problem.

    The Scottish Government intend to expand further the range of eye care services delivered in the community by investing in a shared electronic patient record and in accredited practitioner training. That will include the management of stable glaucoma and treated ocular hypertension patients, and a national low vision service for visually impaired people. The Minister should probably have a look at that.

    The Scottish Government also have a national ophthalmology workstream on hospital eye services, which sets out how they manage the delivery of hospital eye care services to provide timely care for patients. Patients with ophthalmic conditions are often vulnerable and must be supported by a responsive health service. Their care should primarily be safe and timely.

    In Scotland, the Government are committed to improving services for sensory impaired people through their See Hear strategy. Adults and children with a sensory impairment should expect seamless provision of assessment, care and support, and the same access to employment, education, leisure, healthcare and social care as anyone else. In 2017, NHS Education for Scotland carried out an independent review of low vision service provision across Scotland.

    In contrast to England and Wales, the Scottish Government provide free, universal, NHS-funded eye examinations, which is really important, especially given the cost of living. Universal access to healthcare is one of the Scottish Government’s key priorities, which is why free eye examinations for all were introduced in Scotland in 2006. Anyone, from any background, is able to access free eye care to help reduce the risk of sight loss. That includes all people in Scotland who are UK resident, refugees, asylum seekers and some eligible overseas visitors. Appointments are available every two years, and people are able to attend an optometrist for an NHS-funded examination of any eye problem that arises between times, including emergencies.

    I was a beneficiary of that system. My eye started to fail and I found it very difficult to carry on my work, especially here in Westminster Hall, when I could not read the screens properly unless I was sitting very close to them. I went to my local optometrist. She checked my eyes and discovered cataracts, and immediately put me on a path for treatment, which really helped. When the same thing happened in my other eye, I was able to go back between appointments and say, “Look, I think there’s a problem. Can you help?” Again, I was put on a treatment path. I now have two artificial lenses—one in each eye, as my late father would have said. I have really benefited from that system, as have many people in Scotland.

    If someone is unable to travel unaccompanied because of a physical or mental illness or disability, they can arrange to have a home visit quite easily. In fact, I walk from my house to my son’s house every week, and there are posters on railings across the roundabout that I have to go by, telling people that they can have that service. That is hugely important because, often, it is as people get older and more vulnerable—I put myself in that category some days—that they benefit from free eye care.

    Those on benefits such as employment and support allowance, jobseeker’s allowance, pension credit, universal credit, working tax credit or child tax credit, and children under 16 years old, are entitled to help with the cost of glasses or contact lenses, and the repair or replacement of glasses or contact lenses, in the form of an NHS optical voucher.

    In Scotland, before a child starts primary school, they will be offered a vision screening appointment as part of the See4School programme. That helps children begin school with the best possible vision and helps provide for any long-term visual problems. My daughter only discovered she had eye issues when she was learning to play a musical instrument and could not read the music from where she had to stand. If she had been screened earlier, it is possible that she would not have needed glasses for her whole life, as she does now.

    In Scotland, we believe that socioeconomic inequalities drive health inequalities. That is why the Scottish Government are acting to mitigate the impact of austerity and reduce inequality. Where we have public health issues, Scottish Government public health efforts are complemented by wide-ranging cross-Government action. That is where Scotland benefits from being a small country. It is much easier to work in partnership and get cross-governmental things done.

    We know that the worst health outcomes are driven to a significant extent by deprivation. That is why the Scottish Government are committed to addressing the underlying causes of health inequalities and to ending poverty; increasing access to fair employment, education and training; and improving our physical and social environments. That whole-systems approach and cross-Government action is needed to improve equity for Scotland’s people and communities. I believe that is true right across the four nations of the United Kingdom. That will be achieved by focusing efforts on the determinants of health inequalities and working more effectively in partnership. Reducing poverty and inequality sits at the heart of the SNP Scottish Government’s investment across all portfolios, and is a key driver of their development of a wellbeing economy that will have the needs of each individual at its core. The wellbeing economy is now becoming a recognised way of improving not just health, but everything around health and the lives of a nation’s people.

    We believe that prescription charges are a tax on ill health and a barrier to better health for many. Charging for prescriptions would mean that many people with chronic conditions, or even those receiving treatment for cancer, could be liable. The Scottish Government continue to demonstrate their commitment to the provision of free healthcare advice and treatment when needed, with the introduction of the NHS Pharmacy First service, which is available in all community pharmacies to everyone registered with a GP or ordinarily resident in Scotland.

    The Scottish Government are keen to support people to make healthier lifestyle choices that help take care of their eyes. I do not think many people realise that giving up smoking helps, because smokers are much more likely to develop age-related macular degeneration— the most common cause of sight loss in the UK—and cataracts than non-smokers. Given that smoking is more prevalent in the most deprived communities, the Scottish Government have set specific targets for cessation services focused on those communities. They provide £9.1 million a year to health boards to fund smoking cessation services targeted at achieving successful 12-week quits for 1.5% of the adult population in the most deprived areas. Through all of that, the Scottish Government will ensure a “done by communities, for communities” approach, making sure that lived experience is central to their work.

    The Scottish Government are also keen that people drink within the recommended limits, because heavy alcohol consumption may increase the risk of developing early age-related macular degeneration. The alcohol framework sets out the priorities for preventing alcohol-related harm. We consulted on potential restrictions on alcohol advertising and promotion in 2022 to protect children and young people. The Scottish Government have twice run their “count 14” campaign work to raise awareness of the UK chief medical officer’s lower-risk drinking guidelines of 14 units per week. It was run for four weeks in March 2019 and over six weeks in January to March 2020. They are exploring the evidence around managed alcohol programmes and are delighted to be able to contribute to the running of the model being piloted in Glasgow by Simon Community Scotland and its evaluation. Of course, making alcohol more expensive in Scotland, especially the kinds of drinks that young people in particular used to drink, has also helped. In the end, it will help their eye health as well.

    Will the Minister look at what we are doing in Scotland? I am sure he has a very good idea. It is really important. Will he tell us what he hopes will happen in England?

    In conclusion, it is really important that there is a blueprint, as the hon. Member for Strangford said. In Scotland we do things differently, but we want everyone to benefit from our experiences and to have the same chance of good eye health. Will the Minister support a national eye health strategy? As has previously been mentioned, the hon. Member for Battersea (Marsha De Cordova) cannot be here today, but she recently introduced the National Eye Health Strategy Bill. Will the Minister support the Bill on Second Reading on Friday 3 March? Everyone here wants the best for people in their communities. The best way forward—and I would say this—is to look at the Scottish example and put aside the barriers that prevent people from having their eyes tested regularly.

  • Jim Shannon – 2022 Speech on Eye Health

    Jim Shannon – 2022 Speech on Eye Health

    The speech made by Jim Shannon, the DUP MP for Strangford, in the House of Commons on 15 December 2022.

    I beg to move,

    That this House has considered a blueprint for eye health in England and the devolved nations.

    I thank the Backbench Business Committee for scheduling this debate. The hon. Member for Battersea (Marsha De Cordova) was going to be here, but she has a funeral to attend. As she is the chair of the all-party parliamentary group on eye health and visual impairment, her contribution would be significant. The funeral was at half-past twelve, so it is probably ending about now, and she said she would try to get here. Her contribution to this debate would be of significance to all of us here, particularly the Minister.

    I also thank the Eyes Have It partnership, which includes the Royal College of Ophthalmologists, the Macular Society, the Royal National Institute of Blind People, the Association of Optometrists, Fight for Sight and Roche, for its support. The name of the group is my favourite of all the names. The work that the group does is incredible. What could be better for a Westminster Hall debate in the House of Commons than the Eyes Have It? When the ayes have it, that means we are on the right road. I am pleased to see the Minister in his place. My staff have been in touch with him, so he will have a fair idea of what we are trying to achieve.

    I am also pleased to see the Labour spokesperson, the hon. Member for Tooting (Dr Allin-Khan), who brings much knowledge from her own personal job to the debate. I look forward to her contribution. I also welcome the hon. Member for Motherwell and Wishaw (Marion Fellows) from the Scots Nats. We speak in all these debates, and it is hard to find a margin of difference between the two of us when it comes to our proposals—indeed, between the three of us.

    I thank the Minister for his presence. I know the issues raised will be heard and acted on, which is what we want in these debates—a responsive Minster with a good ear to listen and to grasp the issues, which I know he does, and build on what we say. I am ever mindful that health is a devolved matter, so my contribution to a blueprint for eye health in England and the devolved nations will be from a Northern Ireland perspective. I know the Minister will respond specifically to what we have here on the mainland. The spokesperson for the Scots Nats will add her knowledge from Scotland. I like to hear the contributions from our Scottish colleagues because they have a health system and an eye care system that might be the envy of many of us.

    Today’s debate seeks to build on the previous debate, held in January 2022, on eye health and macular disease. It was a Tuesday morning debate, so probably more amenable to those who wanted to attend. Sometimes on a Thursday afternoon, when there are difficulties with trains and suchlike, the people who could be here are not. Since the debate in January 2022, some good things have happened. NHS England has appointed its first national clinical director for eye care. At the same time, England has established integrated care systems, which empower local areas to increasingly shape their healthcare provision. What has been done therefore has a local, community impact.

    At present, every nation of the United Kingdom except England has some form of eye care plan, whether it is self-contained or part of a wider strategy. I am sure that the Minister will give us his thoughts on that. However, the content and focus of the plans vary significantly, as I am sure we will hear from the shadow Minister, the hon. Member for Tooting. Additionally, policy progress has often been fragmented, and what planning guidance there is for services in England does not contain longer-term ambitions or measures for improvement. I hope that the debate will perhaps outline another, stronger direction. If we can do that, the debate will have highlighted what we want it to highlight.

    A plan for England would empower the NCD by providing a framework that enables effective oversight of ICSs without undermining local autonomy. It would create a shared long-term vision that encompasses primary, secondary and community care, and that future-proofs services. If we can achieve that, we will have done well. At the same time, it could provide a basis for increased alignment between nations, and I hope that the Minister will give us some pointers on how to address this issue better together. The fact that I always make this point does not weaken it: we can learn how to do better from all the regions. By doing better for one—England, for example—we can improve the situation for Northern Ireland, Scotland and Wales. If we can do that, that would be good news.

    Over 2 million people in the United Kingdom are living with a condition that can cause sight loss, such as glaucoma, cataracts, macular disease or diabetic retinopathy. Some 340,000 people in the United Kingdom are registered as blind or partially sighted, and 50% of UK sight loss is thought to be preventable. I say this honestly and with deep respect to everyone here, including the Minister: if we can prevent sight loss by doing early checks in opticians and GPs’ surgeries, that would be good. If we cannot, we will leave people with sight loss for the rest of their lives.

    I often think that, of all our senses, eyesight would be the hardest to lose. If I did not have the ability to hear, at least I would have vision, which colours everyday life as it goes by; losing eyesight becomes more and more difficult to handle. If 50% of UK sight loss is thought to be preventable, what is being done to prevent it? Members will know that sight loss affects people in many ways, but it is clear to everyone here that the impact of sight loss is profound for individuals, as well as their friends and families.

    The Royal National Institute of Blind People once asked me to do a walk around Holywood with guide dogs, which I was more than glad to do. That gave me a better understanding of what it means to have sight loss. I put a black mask over my eyes; I could see no light whatsoever. I had a guide dog that I had never met, and the guide dog did not know me. That guide dog stayed at my right knee, and guided me up the Holywood street, which was full of shoppers, and I got a perspective on having sight loss. The dog took me where it wanted me. It stopped on the footpath before crossing the road. That left an indelible impression of what it means to be blind and what we must do to help. I thank Guide Dogs for all that it does. We all respond to the adverts on TV, and many of us in this debate, and outside of this House, probably contribute to the charity, so that someone else can have a dog as their companion and guide.

    Choices made about the provision of eye care can change the trajectory of a person’s life. The experience of sight loss can often be similar to bereavement, inspiring feelings of denial, anger and fear. The impact of sight loss is also felt beyond individuals and their families. In England, the data is most readily available; it is always good to have the data, because it gives us the possibility of establishing a strategy and a way forward. In England, ophthalmology is the single biggest out-patient speciality, with over 7.5 million attendances at ophthalmology out-patient services in 2021.

    Recent calculations show that eye conditions cost the UK economy some £25.2 billion per year, a figure expected to rise to £33.5 billion per year by 2050, and 84% of the economic costs of sight loss lie outside the health and social care system. Again, Minister, how best can we draw sight loss within the health and social care system, to ensure that the delivery of treatment for people with sight loss is achieved in a positive fashion?

    A range of pressures contribute to what is now a capacity crisis in eye care. Over recent years, demand for eye care services has increased, driven by an ageing population, with people rightly concerned about losing their sight; if we can prevent that, then we will have achieved much. However, such concern can lead to unnecessary referrals, increasing pressure on services. A recent Moorfields study found that 52% of patients referred for specialist assessment did not need specialist treatment.

    There are also significant workforce pressures. In 2018, the Royal College of Ophthalmologists identified a shortfall of 230 consultants and 204 staff and associate specialist ophthalmologists. That situation is predicted to get worse, so again I ask the Minister: what can be done to retain the number of staff, and indeed increase their number?

    These structural factors have been combined with severe disruption to services due to the pandemic, making it harder for services to implement innovations that could mitigate growing demand. As a result, there are significant ophthalmology backlogs across the United Kingdom and indeed in Northern Ireland as well. Some patients are now waiting six months or longer to access eye care services. With great respect, I believe that situation really needs to improve. Eyesight can be saved if waiting times for appointments are shortened. Back home, I am aware of some people whose appointments were delayed and unfortunately in that short time they lost their sight.

    In England, 641,000 people were waiting for specialist eye treatment as of October 2022, accounting for some 9.2% of the NHS waiting list and 1.1% of the entire population of England. In Scotland, ophthalmology accounts for 12.2% of waiting lists; in Wales, the figure is 11.9%; and in Northern Ireland it is 9.9%.

    In my constituency of Strangford, the local health and social care trust is the South Eastern Health and Social Care Trust. As of 30 June 2022, 49% of patients waiting for ophthalmology out-patient treatment in the South Eastern HSCT have been waiting longer than 18 weeks. We need to shorten that and I have been in touch with the Minister back home—Robin Swann, who by the way is a very responsive Minister—to see how we can cut down that waiting period of 18 weeks.

    According to figures for Northern Ireland from the Office for National Statistics, almost 18,000 patients were waiting for ophthalmology services. Of those, over 9,000 ophthalmology patients—about 55%—were waiting more than 52 weeks for a first consultant-led out-patient appointment. That situation is the reason why people have lost their sight and it really has to be improved. In total, 82% were waiting over nine weeks. Again, it is very clear that something has to be done. It is not the Minister’s responsibility—I know that—but I am just putting the facts on the record in Hansard because I think that there are many issues for us to address, including back home.

    Evidence suggests that the mega-clinics are making some progress on cataract surgery waiting times. My own mother is 91 and she has had one of her cataracts done. She was treated on Tuesday and she made the appointment for the second cataract. This treatment will definitely improve my mum’s vision greatly, as well as her participation in life. She may be 91, but she is still a formidable lady. She has a deep interest in all that happens in the world, including in the political things that happen here; no doubt, she will want to watch this debate as well to find out what has been said.

    The figures for cataract surgery waiting times are deeply troubling, and the impact on patients’ lives, including their physical, psychological and emotional wellbeing, continues to be significant. It is my belief that the next Assembly or Executive should prioritise addressing waiting times for treatment in Northern Ireland by investing in and expanding the use of timely, targeted interventions, such as mega-clinics and community-based care and support. A greater use should be made of accessible patient communication to address waiting times and treatment delays.

    Treatment delays can have a significant impact. Up to 22 people per month experience severe or permanent sight loss due to delays to follow-up care. A national plan for eye care is needed to address the capacity crisis and ensure everybody can access the care they need at the right time and in the right place. Ultimately, that would prevent avoidable sight loss, which would be a massive step forward.

    Scotland, Wales and Northern Ireland have some form of eye care plan, but they vary in scope, focus and content. The Eyes Have It identified four key areas that the national plan should address. The workforce should be expanded to ensure the NHS has the skills it needs now and in the future. Ophthalmology training should be expanded, and optometrists and multi-disciplinary eye care teams should be enabled to work at the top of their licences. In other words, there should be a focus on them.

    New technologies, such as digital remote monitoring and remote triage, should be used to ensure the care delivered is efficient, prioritises those with the greatest needs and fits around patients’ lives. If we can do that, we will have achieved much.

    There should be research into the future of treatment to better understand sight loss, and that should be translated into innovative treatments that enable more people to keep their sight. That has to be a central goal of what we are trying to achieve. The uptake of innovative treatments will improve patient outcomes, prevent the deterioration of sight and reduce the burden of care on the families impacted. We need to address them, too.

    The national plan can support systems to ensure that patients access the right care at the right time. That would reduce unnecessary referrals and, ultimately, the pressure on NHS eye care services. A national plan would also help to improve the integration of all levels of community and hospital eye services. It is important that community and hospital eye services are married as one so they can do better. That would enable new integrated care systems to deliver care that is joined up, works for patients and local communities, and supports national oversight. In other words, the strategy starts here and works its way down to communities, councils and all the other systems.

    It is of course right that the nations of the United Kingdom of Great Britain and Northern Ireland can develop healthcare services that meet the needs of their own populations. I understand that, but a well-designed plan for one nation can provide a valuable blueprint for others, supporting all nations to improve their eye care services and prevent more avoidable sight loss.

    I am my party’s health spokesperson, which is why I am involved in all health debates and why I secured this debate, along with the hon. Member for Battersea. The cancer strategy in England provides a helpful guide for the structure of a well-built, potentially successful national plan. NHS England’s national cancer transformation board publishes an implementation plan for the strategy, and there is a commitment to a £200 million cancer transformation fund.

    There are yearly progress updates from NHS England. Alongside its principles, the strategy for cancer details the current landscape in cancer care and sets out ambitions and performance metrics, rather than measuring progress. At the end, it sets out practical recommendations for transformation: improving the experiences of care, treatment and support, improving the efficiency of delivery, and driving implementation and cost savings. Costs are a part of no matter what we do nowadays, and we should make cost savings as long as there is no detriment to the service. Those will be key components of a national eye care plan that tackles the big issues while proposing specific metrics and making recommendations for policymakers.

    As highlighted by Professor Kathryn Saunders, the division head of optometry in Ulster University back home, a blueprint for each nation would need to address eye health inequalities, and not just those of a geographical nature. We must ensure that there is more equitable access to eye care among the different communities and populations that are at a significantly increased risk of having a sight problem but may not be accessing NHS sight tests, such as people who are homeless, people with dementia—I make a special plea for them—and children and adults with learning disabilities.

    The charity SeeAbility has highlighted the wonderful work of Professor Saunders and the issue of eye care inequality. Some people in the Gallery today are directly involved, and I am pleased to see them here. I am also very pleased that they passed information through to us. Professor Saunders has said:

    “I’m sorry to say that not enough action on these inequalities is happening. I’m even sorrier to say that even a service currently offered in special schools appears under threat.”

    We need to marry things up better. She continued:

    “NHS England will not say what happens after 31 March 2023 to the NHS Special Schools Eye Care Service. It started last year and has reached 83 special schools so far supporting over 9000 children.”

    I commend the pilot scheme promoted by the Government and the NHS. It has done much—it is a success story—but I seek assurance that the special schools eye care service will continue beyond March 2023. That evidence-based, inclusive service was celebrated globally last year on World Sight Day, and it was a first for the UK, with Northern Ireland, Wales and Scotland watching closely. It was established by the NHS on the premise that children with learning disabilities are 28 times more likely to have a sight problem but struggle to access sight tests or glasses.

    The evidence is compelling. Half of children in special schools have a sight problem, yet only four in 10 have ever had a sight test. What can we do to improve that? I would be pleased if the Minister gave us some indication of what could be done, ever mindful that two Departments probably need to be approached to ensure that it takes place. I am pleased that research from Ulster University has provided evidence to support the benefits of in-school eye care for this vulnerable group. We are moving towards that strategy for Northern Ireland, which is positive, demonstrating that that model of eye care has educational benefits as well as positive impacts on vision.

    If the service is to be scaled back or abandoned, what will happen to the 9,000 children in a few months’ time? I do not think that we can ignore the good work that has been achieved. Surely the intention is not for them to return to overstretched hospital clinics. We must do better. If there was ever an example of the need for joined-up strategic thinking on eye care, surely this is it. I ask the Minister the question that Professor Saunders asked me to pose: will he take action to ensure that NHS England does not close the service without proper consultation? There is real good here, and it is important that we have the opportunity to see it continue.

    This is a slightly different point, but it is related to eye care in England and the devolved nations. The Older Drivers Task Force sent me some information and was keen to feed into the process, so it is important that we record that. Only the UK uses the ability to read a vehicle number plate at a set distance—20 metres—to assess someone’s visual fitness to drive at their first licence application, with no further requirement for visual assessments. The UK’s reliance on the number plate test has been widely criticised as not fit for purpose. Not only is it a crude measure of visual acuity, but, according to the Driver and Vehicle Licensing Agency in 2021, many motorists are unaware of that requirement for driving.

    There have been recent calls for vision checks, such as evidence of a recent sight test, to be introduced at licence application and renewal every 10 years. Those calls are in accordance with the Department for Transport’s “Road Safety Statement 2019”, which stated that consideration was being given to having a mandatory sight test at age 70 and at three-year intervals thereafter, to coincide with licence renewal. The covid pandemic has slowed things up, and we have lost two or three years of progress in the NHS and many spheres of life, but I am keen to hear the Minister’s thoughts on this issue. There is evidence of strong support from older drivers—those aged 60 and over—for compulsory eyesight testing when renewing a licence. The over-60s are entitled to free sight tests, so such a requirement would be at no cost to those drivers. If there is no cost, it seems to be a win-win, so let us do that.

    The Older Drivers Task Force recommended the introduction of mandatory eyesight testing, with an optometrist or an ophthalmic or medical practitioner providing an “MOT” of a driver’s eyesight at licence renewal at the age of 70, and at subsequent renewals. Should that be implemented, the NHS contract for free eyesight tests would need to be amended so that drivers aged 70 and above could have a more detailed “MOT” sight test. That is the request of the Older Drivers Task Force, and I believe it would benefit those in that age group who drive and everyone on the road.

    The covid pandemic has had a very negative effect on the visual health of the nation. In September 2020, the Eyecare Trust announced that an estimated 5 million routine eye tests had been missed. With subsequent lockdowns and restrictions, the situation has since worsened, which raises serious concerns for road safety, as the UK licensing system relies on drivers being responsible for ensuring that they meet the visual standards for driving. The pandemic has led to long waiting times for patients referred for assessment and treatment of DVLA-notifiable sight conditions. While they wait, they may continue to drive even though their condition may be deteriorating, jeopardising both their safety and that of other road users, so there is a practical reason for this request.

    Delays to cataract surgery—my mum, who has been on the waiting list for three years, had her first cataract surgery some three months ago, with the second to come shortly—have been identified as a particular concern. It is difficult to quantify the crash risk of visually impaired drivers, as data is not routinely collected. However, according to the College of Optometrists, a recent analysis of contributing factors recorded in STATS19 showed an association between visual impairment and injury collisions for drivers aged 60 and over. An earlier study by the Road Safety Authority estimated that some 2,000 drivers in the UK were involved in accidents in 2013 due to poor vision, causing nearly 3,000 casualties.

    The recommendations made by the Older Drivers Task Force are quite simple, but I believe that they are very practical and helpful. It calls for a change in the way that visual standards for fitness to drive are assessed and monitored for all drivers, but particularly for those aged 60 and over. It recommends that the number plate test should be replaced with a standardised measure of visual acuity plus an assessment of visual fields, contrast sensitivity and twilight vision. In other words, we should test both night and day driving; I think that is important for licence renewals. The Older Drivers Task Force also repeats its recommendation to introduce mandatory eyesight testing and to provide an “MOT” of driver eyesight at licence renewal at the age of 70, and at subsequent renewals.

    I will conclude by giving a couple of examples of the importance of people visiting their optician regularly. I know of two people in my constituency who have been affected by this issue. One lady was having headaches and went to see her optician, who checked her and found a growth, which turned out to be a tumour. He sent her to the Ulster Hospital, which is just up the road from Newtownards in my constituency. Ultimately, the lady was hospitalised and had an operation. Opticians, and regular attendance, can save people’s lives.

    A good friend of mine had not been feeling well for some time. He came in on a Monday to see me in the office before I came over here for work. He said, “I haven’t been well.” I looked at him and said, “You look very pale and have lost a bit of weight.” He replied, “Jim, I’ve had sore heads for almost three weeks.” He was going to see his optician that day. As a result of the eye test, the optician diagnosed a tumour or growth. My friend was told to go to the Ulster Hospital immediately and, within two days, he had an operation to remove a tumour the size of a tennis ball. It is hard to comprehend such things. I tell those two stories because they are examples of how regular check-ups with opticians save people’s lives.

    In conclusion—I have said that already, but I really will conclude with this—eye care services across the whole United Kingdom of Great Britain and Northern Ireland are facing significant pressures, with implications for individuals, the NHS and the wider economy. Developing a national plan for eye care will help tackle the capacity crisis in eye care in England and provide a blueprint to share good practice across the United Kingdom, including Scotland, Wales and Northern Ireland.

    I thank you, Mr Sharma, and I thank the Minister for his time. I also thank the two shadow Ministers, who will speak shortly. I have not read their speeches, but I suspect that we will all be on the same page, asking for the same thing. We look to the Minister to respond in a positive fashion.

  • Tom Pursglove – 2022 Statement on the UN Committee on the Rights of Persons with Disabilities

    Tom Pursglove – 2022 Statement on the UN Committee on the Rights of Persons with Disabilities

    The statement made by Tom Pursglove, the Minister for Disabled People, in the House of Commons on 15 December 2022.

    Today, I will place in the Library of the House a copy of the UK’s 2022 follow-up report to the UN Committee on the Rights of Persons with Disabilities, following the 2016 inquiry.

    This Government are committed to eliminating barriers faced by disabled people, in order to realise their full participation and inclusion in society. The follow-up report demonstrates how we are implementing the UN Convention on the Rights of Persons with Disabilities and showcases positive action taking place across the UK to support disabled people.

    The UK Government have implemented numerous policies and programmes to tackle the barriers faced by disabled people relevant to the articles examined by the inquiry, as highlighted in our latest report to the UN Committee for the Rights of Persons with Disabilities.

    We have seen 1.3 million more disabled people in work than in 2017—delivering a Government commitment five years early. We are investing £1.3 billion over three years in employment support for disabled people and people with health conditions.

    The Government are providing households with cost of living support totalling over £37 billion this year. This includes a £650 cost of living payment for people on means-tested benefits. In addition to this, six million eligible disabled people have received a one-off, disability cost of living payment of £150 to help with additional costs.

    We are reforming social care support to improve disabled people’s access to care services and ensure integrated health and care support. Increased funding for adult social care will also ensure a fairer cost of care for both carers and patients. Improvements in the accessibility of homes and transport are helping disabled people to live independently and have a better standard of living.

    We supported the passage of the British Sign Language (BSL) Act (2022) which recognises BSL as a language of England, Wales and Scotland in its own right. A BSL advisory board is being established to guide implementation of the Act from the perspective of people who use BSL.

    Recognising the need for wider societal change across all industries, our 19 disability and access ambassadors are using their expertise and influence in business to help drive and support changes in access for disabled consumers and employees.

    Alongside this, we recognise the importance of co-ordinated action across Government, reflecting the full range of services and opportunities that deliver full participation. Our ministerial disability champions have been supporting and driving forward work on disability in their respective departments.

    We continue to engage with disabled people and stake-holders through disabled people’s organisations, networks and relevant organisations. This is to ensure that lived experience underpins regular and co-ordinated action across Government. We remain committed to improving the lives of disabled people and making our society a more inclusive and accessible place for all disabled people.

  • Tom Pursglove – 2022 Statement on Personal Independence Payments

    Tom Pursglove – 2022 Statement on Personal Independence Payments

    The statement made by Tom Pursglove, the Minister for Disabled People, in the House of Commons on 15 December 2022.

    Today the Department will publish the latest update on progress on making backdated payments to personal independence payment claimants who are affected by the MH and RJ decisions of the Upper Tribunal (UT). The release will be published at: https://www.gov.uk/government/collections/pip-administrative-exercise-progress-on-cases-cleared.

    The MH decision changed how overwhelming psychological distress is considered when assessing someone’s ability to plan and follow a journey. The RJ decision changed how we decide whether someone can carry out an activity safely and if they need supervision.

    As at the end of November 2022, we have reviewed around 990,000 cases against the MH decision. This includes cases where claimants have previously been assessed as having “overwhelming psychological distress” or who have a “psychiatric disorder” as one of their health conditions. We have also reviewed around 1,100,000 cases against the RJ decision. This includes cases where claimants have a “neurological disease” as one of their health conditions. All reviews will have been carried out by a case manager within the Department.

    Around 8,400 arrears payments, totalling around £44 million, have been made. No one should have seen their PIP reduced because of this exercise.

    In addition, we will continue to review any case for any claimant who asks us to.

    This has been a complex and substantial exercise, involving over 2,090,000 reviews against two UT decisions. Our approach demonstrates that we have prioritised claimants who are most likely to benefit, to make backdated payments as quickly as possible.

    We have set out further background to this release in an updated “Frequently Asked Questions”. I will deposit a copy of this document and the statistical release in the Library of the House.

  • Dominic Raab – 2022 Statement on the Rape Review Action Plan

    Dominic Raab – 2022 Statement on the Rape Review Action Plan

    The statement made by Dominic Raab, the Secretary of State for Justice, in the House of Commons on 15 December 2022.

    The Government are today publishing a progress report 18 months on from the publication of the end-to-end rape review action plan. This is the third six-monthly progress report on implementation of the rape review action plan and demonstrates the Government’s ongoing commitment to be transparent and accountable to the public on our progress in delivering the ambitions of the rape review.

    The latest progress report sets out that we are on track to meet our ambitions in the review to more than double the number of adult rape cases reaching court by the end of this Parliament. In Q2 2022, compared with the 2019 quarterly average, adult rape police referrals to the Crown Prosecution Service were up 95%, CPS adult rape charges were up 65% and the number of adult rape cases reaching Crown Court were up 91%.

    The Government have also today published an independently authored report on the policing aspects of Operation Soteria, a policing and CPS programme to develop new operating models for the investigation and prosecution of rape in England and Wales by June 2023. The report outlines the key findings from research in five police forces and provides an initial draft of the national operating model for the investigation of rape which will be available to all police forces from June 2023.

    The rape review progress report sets out that:

    We are also publishing today a series of user-friendly guides on gov.uk for victims of rape and sexual assault, to enable victims to better understand what they can expect as their case progresses through the criminal justice system.

    We have launched the 24/7 rape and sexual abuse support line which will provide all victims and survivors access to dedicated support whenever and wherever they need it.

    We have also completed the expansion of Operation Soteria to a further 14 police forces and three further CPS areas. The aims of this ambitious joint police and CPS programme of work include:

    Improve relationships between police and CPS and prioritise early collaboration so strong cases can be built as early as possible;

    Improve victim communication including a pledge for more frequent contact and a clear guide to explain the justice process;

    Strengthen the partnership between independent sexual violence advisers, CPS and police to better co-ordinate support for victims.

    We successfully rolled out pre-recorded cross-examination for victims of sexual offences, a vital measure now available in all Crown Courts across England and Wales. This will spare survivors and victims the trauma of giving evidence in the glare of a courtroom.

    We introduced new powers through the Police, Crime, Sentencing and Courts (PCSC) Act to stop unnecessary and intrusive requests for victims’ phones and we are continuing to work with police forces to ensure they have the capability to return victims devices within 24 hours.

    These actions form part of the Government’s ambition to create meaningful cross-system change, improve the experience of victims and bring more perpetrators to justice.

  • Maria Caulfield – 2022 Statement on Ian Paterson, Patient Safety and Government Implementation Plan

    Maria Caulfield – 2022 Statement on Ian Paterson, Patient Safety and Government Implementation Plan

    The statement made by Maria Caulfield, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 15 December 2022.

    On 16 December 2021, the Government published their response to the findings of the inquiry into the issues raised by disgraced surgeon, Ian Paterson. We reiterated the apologies of the Government to the patients affected and those close to them and committed to ensuring we did more to protect patients in the future.

    In line with this commitment, the Government accepted the overwhelming majority of the recommendations made by the inquiry and set out an implementation plan of 40 actions to put those recommendations into effect. Finally, we committed to providing a further update on the progress of this implementation plan in 12-months’ time. I am happy to be able to publish this report fulfilling that commitment today.

    All the relevant bodies within the health sector have been united in understanding that these changes are essential. We all agree that patients cannot be failed in the same way again. On behalf of the Government, I want to thank every organisation that has engaged in this process for their commitment to making improvements. I would especially like to thank the representatives of patient groups impacted by Ian Paterson, who have campaigned tirelessly to ensure their experiences do not go unheeded. They have continued to be a source of inspiration and expertise throughout the implementation period.

    I am pleased to report that good progress has been made across the implementation plan which we set out in December 2021. The report published today provides full details of this progress against the four themes of the Government’s response as laid out in the implementation plan. In this statement, I will highlight some of the most important developments under each of these themes.

    Patient-centred information

    Patients now have more access to information relevant to their treatment than they did during Ian Paterson’s time practising. This includes access to information about the performance of consultants working for independent sector healthcare providers, and specialties in the NHS. These continue to be added to, so patients will have more, and better, access to independent information before choosing a consultant. NHS England (NHSE) will work with the professions so that meaningful consultant-level information on the numbers and types of procedures performed should be made publicly available. If patients choose to be treated in the independent sector, there is now more information about what to expect, with further information to be made available over the coming year.

    Patients now have the right to access their treatment records and clinicians are aware of the need to write to patients directly following a consultation or treatment, rather than only writing to their GP. This information gives patients a record of their condition, and test results to reflect on, or to seek a second opinion if required. This is reinforced by ensuring patients gets the time they need to consider treatment options and have access to a range of new resources to help them consider their options; options that patients will also be able to discuss with medical professionals who are equipped to handle these conversations.

    Making challenge heard

    Doctors across more specialties now have independent data on their practice available and will be required to use this as part of their appraisal and revalidation processes. This will help to identify issues and fix them. Staff in the health system also have more opportunities to make their voices heard about a patient’s care, including through clarified guidance and assessment of multidisciplinary team use as a forum.

    Care Quality Commission (CQC) updated its guidance on complaints processes in early 2022. It is now easier for patients to raise concerns about treatment they receive and access independent resolution of their complaint if they are unsatisfied with the provider’s handling. As part of the implementation of the NHS patient safety strategy, NHSE has introduced measures to advance safety and the response to harm. The Government have appointed the first ever patient safety commissioner for England, Dr Henrietta Hughes OBE.

    Ensuring accountability

    CQC published the new single assessment framework in July 2022, which sets out what good care looks like, and National Quality Board published national guidance on system quality groups, setting out the requirements for quality governance in integrated care systems.

    Alongside this, we have seen significant culture change in the independent sector, now leaving no doubt that independent providers must take responsibility for maintaining high standards of care in their facilities, irrespective of how the medical professionals involved are engaged by them (through employment or practising privileges). This has been supported by Independent Healthcare Providers Network’s refresh of the medical practitioners assurance framework in September 2022. NHS Resolution launched new exclusion guidance in April 2022.

    Putting things right

    Patients who are impacted by potential issues with their care will be reviewed through recall processes which are now better informed of how to put patients at the centre of their focus. The new national recall framework was published in June 2022 to facilitate this.

    Patients will continue to receive apologies from healthcare professionals and providers for potential issues with their care when appropriate. Enhanced training and resources are now available to clinicians to ensure these apologies are delivered effectively and meaningfully.

    The Government are working to ensure that any future changes to indemnity and insurance arrangements will be made using the best evidence base available. This includes a thorough assessment of the impact on patients, healthcare professionals, providers, and the wider market; with the aim of improving the position for patients when receiving treatment from any regulated healthcare professional, regardless of the setting. The Government’s ambition is that when this work concludes, patients have confidence that they can access appropriate compensation if harmed while receiving care, including when harm arises from criminal/intentional acts or omissions. The summary of responses to the consultation on appropriate clinical negligence cover for regulated healthcare professionals will be published alongside this implementation update on 15 December 2022.

    The Government will be continuing to ensure this work is built upon, as part of our wider commitment to ensuring patient safety and high standards of care across the health system. We understand that there is no room for complacency when it comes to patient safety and, together with the patient safety commissioner, will make sure this is one building block towards a health system in which patients and those close to them can have the maximum possible confidence.

  • Andrew Griffith – 2022 Statement on Life Insurance Taxation

    Andrew Griffith – 2022 Statement on Life Insurance Taxation

    The statement made by Andrew Griffith, the Economic Secretary to the Treasury, in the House of Commons on 15 December 2022.

    The Government are announcing the following measure— of which there are two components—which will take immediate effect from today.

    The first part of the measure applies to re-insurers of a specific type of long-term insurance business known as basic life assurance and general annuity business (BLAGAB). It addresses a possible tax mismatch in the life insurance rules where re-insurance precedes a transfer of BLAGAB. In this situation the measure eliminates the possibility of a mismatch by classifying the re-insured business as BLAGAB in the hands of the re-insurer. This will protect Exchequer revenues needed to fund vital public services.

    The second part of the measure addresses an industry concern that the current scope of section 92 of the Finance Act 2012 may be unnecessarily wide and is blocking commercial transactions. It amends that section so that it does not apply where substantially all the insurance risks of a book of BLAGAB are assumed by a re-insurer.

    The draft legislation will be published today on gov.uk: https://www.gov.uk/government/publications/re-insurance-in-the-course-of-transfers-of-long-term-business. It will be accompanied by a tax information and impact note and an explanatory note. A copy of the legislation will also be deposited in the Libraries of both Houses.

  • Alex Burghart – 2022 Statement on Government Transparency and Accountability

    Alex Burghart – 2022 Statement on Government Transparency and Accountability

    The statement made by Alex Burghart, the Parliamentary Secretary at the Cabinet Office, in the House of Commons on 15 December 2022.

    My noble Friend the Minister of State (Baroness Neville-Rolfe) has today made the following written statement:

    Since 2010, the Government have been at the forefront of opening up data to allow Parliament, the public and the media to hold public bodies to account. Such online transparency is crucial to delivering value for money, cutting waste and inefficiency, and ensuring every pound of taxpayers’ money is spent in the best possible way.

    The Government will continue to look at how the range of information published by the Government can be improved and made as useful as possible to the public, press and Parliament. The following subject areas include documents and information that the Government are due to publish.

    Routine transparency data on Ministers, special advisers and senior officials

    Departments will today be publishing routine transparency data on Ministers’, special advisers’ and senior officials’ gifts, hospitality, travel and external meetings, for the period of July to September 2022. This data covers the returns for the Prime Minister, Government Chief Whip and Leaders of the House of Commons and the Lords, as well as the Cabinet Office.

    Departments will also be publishing the business appointment rules advice summary for the same period.

    List of ministerial responsibilities

    The Government will today be publishing the list of ministerial responsibilities on gov.uk. Copies will also be deposited in the Libraries of both Houses. The list includes details of ministerial Departments, the Ministers within each Department, their portfolio responsibilities and private offices and the executive agencies within each Department.

    Salaries of Members of His Majesty’s Government

    The Government will today be updating the salaries of Members of His Majesty’s Government with information for the financial year 2022-2023 on gov.uk. This indicates the salaries to which Ministers are entitled and the actual salaries that they claim, along with supplementary information on ministerial salaries, allowances and payments on leaving office.

    Cabinet Office annual report and accounts 2021-22

    This annual report and accounts will also be laid before Parliament today. The publication includes the Cabinet Office’s audited financial statements for the year ended 31 March 2022 and a review of performance and governance arrangements. The annual report will be published on gov.uk.

    Cabinet Office accounting officer system statement 2022

    This publication is a single statement setting out all of the accountability relationships and processes within the Department. This update takes into account change since the previous version was published in 2020.1 have requested that a copy of the accounting officer system statement be deposited in the Libraries of both Houses. The publication will also be published on gov.uk.

    Cabinet Office: Spend control data for July to September 2022

    Along with all Government Departments, in 2010 the Cabinet Office committed to publish quarterly data on its planned spending that has been subject to the Cabinet Office spend controls. The spend controls covered are digital and technology, commercial, property, advertising, marketing and communications, and contingent labour (as for equivalent figures published by other Departments). For the quarter covered, 12 separate items of the Cabinet Office’s own spending (with a total value of £734 million) were approved under the cross-Government Cabinet Office spending control.

    Monthly workforce management information (September and October 2022)

    As standard, the Government are today publishing our monthly breakdown of workforce headcount and pay costs. This is a routine publication and will be published on gov.uk.

    Public procurement review service—progress report 2021-22

    The Government will today publish their annual progress report, detailing trends in issues raised to the public procurement review service. In this publication, we look to consider such trends and make recommendations on how to improve the service moving forwards. The report will be published, as usual, on gov.uk.

  • Grant Shapps – 2022 Statement Confirming Closure of Help to Grow Digital Scheme

    Grant Shapps – 2022 Statement Confirming Closure of Help to Grow Digital Scheme

    The statement made by Grant Shapps, the Secretary of State for Business, Energy and Industrial Strategy, in the House of Commons on 15 December 2022.

    This statement concerns the Government’s decision to close the Help to Grow: Digital programme. Help to Grow: Digital will close to new business applications for discounts on 2 February 2023. Discounts issued for eligible software must be redeemed within 30 days from issue date.

    The scheme has supported businesses to grow, but with take-up lower than expected, the Government cannot justify the continued cost of the schemes to the taxpayer. The decision has been taken to refocus efforts towards other support mechanisms for small businesses, ensuring businesses get the backing they need in the most efficient and productive way possible. The Help to Grow: Management scheme remains in place.

    The Government continue to support small businesses, such as through the Government-backed British Business Bank’s start-up loans, which are available to help aspiring entrepreneurs start and grow their businesses. The Government have taken action to protect all eligible UK businesses, including small businesses, from rising energy costs through the energy bill relief scheme.

  • Paul Scully – 2022 Speech on the Cyber-Attack on South Staffs Water

    Paul Scully – 2022 Speech on the Cyber-Attack on South Staffs Water

    The speech made by Paul Scully, the Parliamentary Under-Secretary of State for Digital, Culture, Media and Sport, in the House of Commons on 14 December 2022.

    I thank my hon. Friend the Member for Dudley North (Marco Longhi) for securing the debate and bringing attention to an important, serious issue that has been worrying a number of his constituents as well as constituents of those hon. Members who made contributions: my right hon. Friend the Member for Aldridge-Brownhills (Wendy Morton), my hon. Friend the Member for Burton (Kate Kniveton) and the hon. Member for Cambridge (Daniel Zeichner). Although my hon. Friend the Member for Dudley South (Mike Wood) cannot speak as he is a Government Whip, I know that he has also been active in contacting his affected constituents.

    While cyber-resilience in the water sector is the responsibility of the Secretary of State for Environment, Food and Rural Affairs, I am responding as the Department for Digital, Culture, Media and Sport has responsibility for data protection and cyber-resilience for the wider economy—I know that you were wondering, Mr Deputy Speaker, why I was here once again. The threat to the UK from cyber-attacks is on the increase as evidenced by the sharp rise in ransomware attacks that British companies have suffered in the last few years. Cyber-criminals are increasingly seeing ransomware as a profitable business. The Government are committed to addressing that issue, as evidenced by the national cyber strategy that was published in December 2021.

    As my hon. Friend the Member for Dudley North highlighted, in August, South Staffordshire plc—the parent company of South Staffs Water and Cambridge Water—was hit by a cyber-attack that resulted in data extortion and ransom. The criminals also exfiltrated information from the company and attempted to extort it for their own financial gains. The National Cyber Security Centre, which is a part of GCHQ, alongside UK law enforcement and the Department for Environment, Food and Rural Affairs, offered support to South Staffs Water and its incident response provider. In particular, the NCSC’s technical experts offered tactical and strategic guidance on how to effectively respond to and recover from the incident. DEFRA, which is responsible for the security and resilience of the water sector, also responded quickly and worked with South Staffs Water to understand the potential impact, provide business continuity advice and help it with notification requirements.

    It is important to note that at no time was the water supply to residents affected. This was an attack on the organisation’s corporate IT system, which resulted in the theft of some customers’ personal data. I extend my sympathies to the customers who were affected and thank my hon. Friend the Member for Dudley North again for taking up this issue with the company on their behalf. As we heard, the company has contacted the affected customers and offered them advice and support, including a free 12-month credit monitoring and fraud alert service.

    South Staffs Water made the Information Commissioner’s Office aware of the incident, and the ICO is making the necessary inquiries. Under the UK’s data protection legislation, organisations must take appropriate security measures to ensure the protection of the personal data they hold. That includes the personal and financial details of customers. If there is a breach of personal data that presents a risk to the affected individuals, organisations must notify the ICO within 72 hours of becoming aware of the breach. Breaches of the legislation are liable to enforcement action by the ICO, including fines of up to £17 million or 4% of the organisation’s global turnover for the most serious breaches.

    Firms that deliver essential services like the supply of drinking water, transport or electricity are subject to regulations to ensure that their protections are appropriate to the risk. The Network and Information Systems Regulations 2018, or NIS regulations, which the Department for Digital, Culture, Media and Sport brought into effect, are the relevant regulations in this case. The regulations require companies, including South Staffs Water, to take steps to ensure the security, resilience and continuity of their services.

    The NIS competent authorities are responsible for ensuring that organisations adhere to the regulations. The competent authority for the water supply sector is the Secretary of State for Environment, Food and Rural Affairs, and implementation is overseen by the Drinking Water Inspectorate. They responded to this incident, alongside the National Cyber Security Centre, to ensure that water remained safe and that the company was supported in its response. The NCSC worked with South Staffs Water by providing guidance on messaging, helping it to understand the potential impact and advising it on business continuity.

    Only two weeks ago, the Government announced that following a public consultation, DCMS would strengthen the NIS regulations to boost security standards and increase the reporting of serious cyber-incidents. We will ensure that more services and organisations, including outsourced IT services, come within the scope of the NIS legislation. Those changes will reduce the risk of cyber-attacks causing damage and disruption. The changes to the law will be made as soon as parliamentary time allows.

    However, legislation is not a silver bullet to address all cyber-threats. While it is important, it is only one of a broad range of activities, initiatives, programmes, and policies that are in place as part of the UK’s broader national cyber strategy, which was published in December 2021. If we are to limit the likelihood of such attacks being successful in the future, we have to raise the collective security and resilience of the whole country, and make everyone better equipped to resist and respond to those who would do us harm. The security and safety of our country is a top priority of the Government. Our national cyber strategy, backed with investment of £2.6 billion, sets out how the Government are taking action to ensure our people, businesses and essential services are secure and resilient to cyber-attacks. The National Cyber Security Centre is the Government’s technical authority on cyber-security. The NCSC is providing the expertise, advice, tools and support to ensure that government, industry and the public are secure online.

    Those in law enforcement, including the National Crime Agency and our specialist cyber-trained officers in police forces across the country, are apprehending cyber-criminals and providing advice on how businesses can protect themselves. My Department is also working to improve levels of cyber-resilience right across the wider economy. That includes ensuring we have the skilled professionals we need, supported by a growing and innovative cyber-security sector that provides the products and services to keep organisations secure. We are also working to ensure organisations are operated and governed in a way that tackles the cyber threat appropriately, for example, by training board members and including digital risks in company annual reports. The Department for Digital, Culture, Media and Sport is also taking action to improve the security of the technology being used by businesses, organisations and consumers.

    Given what we have heard today, I again commend my hon. Friend the Member for Dudley North for the way he engaged with the company about the correspondence, which, as I said, has to balance being simple to understand and including the complexities of the case. He was right to address that and I am glad that the company responded to his intervention. He talked about CIFAS. The fact is that that £25 subscription is an additional option. Again, I am glad that, thanks to his encouragement, the company clarified that for people who would, understandably, already be worried about loss and risk. Worrying about having to pay £25 to get support would have been an extra concern, but it is important to emphasise that that is not the case; they get all the support from the water company, but the £25 is an additional option, should they wish to take it up.

    Despite your encouragement, Mr Deputy Speaker, I will not go on long today. I am pleased to have had the opportunity to reassure Members that the Government continue to take significant action to ensure the security and resilience of our country’s essential services and the wider digital economy. However, the cyber threat continues to evolve and remains very real, despite the good progress we have made in recent years. In the past 12 months, 39% of businesses and 30% of charities suffered a cyber-breach or attack. Many of them lost money and data, as well as suffering from disruption and having to invest staff time to fix the problems. Cyber-security threats posed by criminals and nation states continue to be acute, particularly from low-sophistication cyber-crime. Ransomware attacks are also on the rise, and their use as a service is becoming more and more prevalent. For that reason, organisations across the economy must ensure they continue to manage their risks appropriately and put in place the measures needed to protect their money, data and operations.