20 NOV 2018

Road Safety and the Legal Framework

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Inactivity is far more dangerous to people's health than cycling or walking. We need to get the message out loud and clear that cycling and walking are great for our health, and we need to get Britain moving. One of the greatest deterrents, however, particularly for parents, is fear of the danger of our roads.

I will add to points made by other hon. Members by speaking about those drivers who escape all consequences. I suggest to the Ministerthat we need to get across the immediacy and certainty of consequences. The line between careless and dangerous driving is a very blurred one; today's careless driver is tomorrow's dangerous driver. We need to ensure that people do not entirely escape consequences and that they know what will follow. I agree that we need to close the exceptional hardship loophole. Merely inconveniencing and fining those who are at the beginning of their journey to becoming dangerous drivers is not enough.

I also ask the Minister to consider the role of restorative justice. To give an example, I got the phone call that no parent wants to get, telling me that my daughter was unconscious in the back of an ambulance. While wearing hi-vis in a cycle lane, she had been knocked off her bicycle by a careless or even dangerous driver who was in a hurry and was turning into a side road. If my daughter had not been wearing a cycle helmet, she would undoubtedly have been killed or very seriously injured. I was shocked that she was interviewed in the casualty department while she was still concussed.

There were no consequences whatever for the driver. My daughter is not a vindictive person and nor am I, but at the very least I would have expected someone to investigate the incident. Witnesses came forward and were happy to testify, but nothing happened. When someone has been very seriously injured in such a collision, restorative justice could play a role. I hope the Minister will consider how we can ensure that drivers meet the person whom they have injured. Until that takes place, they should face some immediate consequences—a ban, at least.

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20 NOV 2018

Health and Social Care Committee

The Health and Social Care Committee met today to discuss the implications of the Budget for health and social care.

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19 NOV 2018

Second Homes

Thank you to Cllr Ian Bramble and Lisa from South Hams District Council for coming to Parliament to meet Rishi Sunak MP, Minister for Local Government to discuss fair contribution from second home owners and the business rates 'loophole' which could be costing councils millions in lost Council Tax. Currently, second-home owners pay Council Tax on their properties including when the property is available to rent infrequently during the year.

Properties are valued for business rates when owners declare their property is available to let as 'holiday accommodation' for 140 days or more in a year. Any property registered for business rates, rather than Council Tax, is likely to qualify for small business rate relief. This provides 100% relief from business rates, so no tax is due on properties with a rateable value of £12,000 or less. Around 47,000 holiday lets in England are liable for business rates, of which circa 96% have rateable values of £12,000 or less. Currently there is no requirement for evidence to be produced that a property has actually been commercially let.

Genuine businesses can claim the relief to which they are entitled. However, there are concerns that owners of second homes which do not fall into this category, could exploit the system by not paying Council Tax, whilst still using local services.

A consultation is seeking views on whether to strengthen the checks that are already in place to ensure second-home owners have to pay Council Tax, while ensuring genuine holiday let businesses are able to demonstrate they are eligible for business rates relief. The consultation closes on 16th January 2019

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19 NOV 2018

Finance (No. 3) Bill: Carbon Emissions Tax

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Does the hon. Gentleman agree that this issue relates not just to future forecasting? The Health and Social Care Committee has been hearing that hundreds of millions of pounds are already being spent by pharmaceutical companies on no deal contingency planning—money that would be far better invested in our NHS.

Chuka Umunna Labour, Streatham

I could not agree more with the hon. Lady.

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15 NOV 2018

EU Exit Negotiations

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

It will be blindingly obvious to the entire country that the Prime Minister's deal cannot pass this House. People will find it unforgivable that we are running out of road and that in 134 days we will be crashing out of the European Union with no deal and no transition, with catastrophic consequences for all the communities that we represent in this House. May I urge her to think again about whether at this stage we should go back to the people and present them with the options, rather than just stumbling on regardless into something that will have such profound implications for all of our lives?

Theresa May The Prime Minister, Leader of the Conservative Party

The nature of Brexit and our future relationship with the European Union will be a matter that will come before this House in the vote that the House will take. Members of the House will have various issues to consider when they take that vote. I say to my hon. Friend, as I have said to other hon. and right hon. Members, that I firmly believe that, having given the choice as to whether we should leave the EU to the British people, it is right and proper, and indeed our duty as a Parliament and a Government, to deliver on that vote.

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14 NOV 2018

Healthcare (International Arrangements) Bill

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Does my hon. Friend accept, though, that the majority of the difference is due to the disproportionate number of British pensioners living abroad compared to the number of EEA foreign nationals living here as pensioners?

......

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I will be supporting the Bill today. I am only sorry it is necessary. There is no version of Brexit that will benefit people who rely on the NHS, social care, scientific research or public health; there are only varying degrees of harm. The Bill seeks to address one of those harms, and that is around our reciprocal healthcare arrangements, which have made such a difference to people's lives both here and across the EU. As Martyn Day pointed out, 190,000 UK expats live in the EU and 27 million people hold an active European health insurance card, which covers about a quarter of a million treatments every year, but we are also talking about British citizens who travel or live in the EU to work and the 1,300 people who benefit from planned medical treatments in the EU under the S2route.

I will turn first to the 190,000 British expatriates, mostly pensioners, living in the EU. Incidentally, 90% of them live in Ireland, Spain, France and Cyprus. They face a desperately worrying future. In the event of a deal, they will be covered by transitional arrangements until 2020, but in the event of a chaotic exit, with no deal and no transition, in just 135 days, they could be left stranded, many of them with access only to very basic medical care. Some of them will be uninsurable and many will have no easy path to return to the UK.

The Minister will know that, as I mentioned to my hon. Friend Sir Robert Syms, 75%—£468 million of the total £630 million in 2016-17—of the cost of our reciprocal healthcare arrangement relates to pensioners. When he sums up, will the Minister please respond to the updated estimated cost of those pensioners having to return to the UK and the net effect on the NHS? The Health and Social Care Select Committee heard that the current average cost of treating a UK pensioner in Spain was €3,500, but the average cost of treating pensioners in the UK was £4,500, and again the discrepancy between the pounds and euros makes that even greater.

In the future, the costs associated with EHIC— £156 million—and the S2 route for planned medical treatments will be borne directly by the 50 million UK nationals who visit the EU every year, but those costs will not be distributed evenly. The costs will fall disproportionately on those with pre-existing medical conditions. They will be exceptionally hard hit. As we heard from Justin Madders, many individuals will be effectively uninsurable and unable to travel. Will the Minister tell us what clear advice the Government are giving to people with pre-existing medical conditions who are thinking of making travel arrangements after 29 March? Is he being explicit with them, and telling them that they need to check now whether they may find themselves left stranded without medical insurance in the event of our crashing out in a chaotic exit with no deal whatsoever?

I recognise and welcome the fact that the Bill gives the Minister power to put in place an equivalent scheme, but that scheme will have to involve a dispute resolution process. In the deal that is about to be published, has the Minister seen what that process would be? Another thing that he needs to be very clear about when he sums up the debate is that if we crash out with no deal and no transition, we will not be making these reciprocal arrangements with a single body; we will be making them with 27 different European states, three European economic area states, and Switzerland. Is it even conceivable that we could complete negotiations on that scale with 135 days to go? We need to be really clear with Members throughout the House, and to the public, about what that means, so that people can make plans accordingly. May I also ask whether the Minister is setting aside, within the contingency fund, a sum of money that we could use to assist British nationals who find themselves in difficulties on the wrong side of the channel in the event of no deal and no transition? Those are all important points about which we must be very clear with people.

Does the Minister agree that during the referendum campaign there were very many different versions of Brexit? The Brexit reality with which we are about to be presented is very different from the fantasy version that was presented during the campaign. People will remember the "easiest deal in history" and the "financial bonanza" for the NHS, but the Brexit reality is that there will be a significant Brexit penalty, from the most damaging form of Brexit in particular. We are looking at effects across the entire health, care and research system. Yesterday I met representatives of the Royal College of Nursing to discuss their grave concern about the future workforce. While the overall number of registrants has increased, there has been a very worrying decrease in the number of joiners in the past year. The number of joiners from EEA countries has dropped by nearly 20%.

......

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

That is, indeed, a question that I have been addressing. What will happen to expats in Europe? What we absolutely must focus on, however, is what will happen 135 days from now if we do not have a deal and people are left high and dry. It is a very worrying situation.

The issue of the workforce does not just affect nursing staff. We should bear in mind that 5% of members of the regulated nursing profession, 16% of dentists, 5% of allied health professionals and 9% of doctors are EEA nationals. We cannot afford to lose any more of that workforce, or to demoralise them further. I think it shames us all that the Health and Social Care Committee heard from nursing staff from across the European Union some of whom were in tears when reporting that they no longer felt welcome here. That is a terrible Brexit penalty, and no one voted for it when they went to the polls.

This does not just affect the workforce either. The Brexit penalty applies to the entire supply chain of medicines and medical devices, from research and development to clinical trials, to the safety testing of batches of medicines, and right through to the pharmacy shelf and the hospital. There are many unanswered questions about the issue of stockpiling, and about contingency plans for products that may require refrigeration, or products with very short shelf lives that cannot be stockpiled. There may also be brand-switching issues: for people who suffer from conditions such as epilepsy, switching brands is not easy.

I am sorry, Madam Deputy Speaker. I will bring my remarks to a close shortly. [Interruption.] I understand that you were merely coughing, Madam Deputy Speaker, so I will continue.

Refrigerated warehousing and special air freight do not come cheap. The companies whom we met, represented by the Association of the British Pharmaceutical Industry, made it clear that they were already having to spend hundreds of millions of pounds on contingency planning. The Government have said that they intend to reimburse companies, but the smaller companies need to know how quickly they will be reimbursed, because they may have cash-flow issues. They need to know the details of how the scheme will work, but they simply do not have the information that would enable them to make plans for the future. I hope that the Minister will be very mindful of that.

As I said earlier, the simple truth is that the many versions of Brexit have very different implications for the NHS, for social care, for public health and for research. Once this deal is published, we will have an opportunity to set out what this means, but, most important, to set all the risks and benefits of the deal that is on offer for the NHS and social care. The Minister will be aware of the important principle of informed consent in healthcare. No one would dream of going into an operating theatre and having an operation without someone telling them what is involved and setting out the risks and benefits so that they could weigh them up for themselves. That is called informed consent, and without informed consent, there is no valid consent.

Let me say to the Minister that we are all being wheeled into the operating theatre for major constitutional, economic and social surgery without informed consent, and let me ask him please to consider how things will be 136 days from now, after we crash out with no deal and when the serious consequences of that start to unfold and unravel and hit real people's lives. What will he be saying to his constituents and the House if we have proceeded without informed consent?

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12 NOV 2018

UK Statistics Authority

Always a pleasure to catch up with Ed Humpherson of UK Statistics Authority, to discuss the importance of Government publishing accurate data, presented in a timely and meaningful way.

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12 NOV 2018

Epilepsy

Thank you to the Daisy Garland, SUDEP Action and the Epilepsy Society for coming to Parliament today to meet with Sarah Marsh, Deputy Head of Clinical Policy NHS England, Professor Adrian Williams, Consultant Neurologist and Charlie Fairhurst, Consultant in Children's Neurodisability to discuss service review for epilepsy, and the research and implications of Brexit

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06 NOV 2018

National Guardian

I met today with Dr Henrietta Hughes, the National Guardian and we spoke about how the work of the National Guardian Office and how Freedom to Speak Up Guardians are supporting NHS workers to speak up.

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06 NOV 2018

Assessment and Treatment Units: Vulnerable People

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Does the Minister accept that, fundamentally, far too many people are ending up in terrible conditions in secure settings because of the inadequacy of social care? Will she commit to include in the Green Paper, which is to be brought forward before Christmas, the Green Paper for young adults as well as for older people? Will she absolutely commit to that coming forward before Christmas?

Caroline Dinenage Minister of State (Department of Health and Social Care)

My hon. Friend is absolutely right to recognise that the cases in which people end up in a long-term residential setting often reveal a failure of joint working—of the wraparound services that people need to keep them in the community. We are looking at working-age adults as part of the social care Green Paper, and it will be published before Christmas.

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05 NOV 2018

Road Safety

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I am really glad to hear the Minister talk about close passing, but it is also about the speed of passing, which he has not mentioned. Will he also look closely at 20-mph limits and how they can be enforced?


Jesse Norman Parliamentary Under-Secretary (Department for Transport)

I am happy to let my hon. Friend know—or she may know—that we already have a consultation out on this, and we expect to report on that later this year.

Many factors go into making our roads safer, including the road environment, the vehicles we drive and behaviour, but so does enforcement. Last October, the Ministry of Justice published its response to a consultation on the penalties for the most dangerous drivers, and Ministers announced that they will introduce life sentences for killer drivers—an increase on the current 14 years. The Government have said that they will create a new offence of causing serious injury by careless driving, and that Ministers will introduce new legislation as soon as parliamentary time allows.

I welcome this debate. As the House will see, the Government remain energetic, focused and determined in their efforts to improve road safety.

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05 NOV 2018

Bullying and Harassment: Cox Report

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Dame Laura Cox refers in her report to the Parliamentary Health and Wellbeing Service helping staff who have been subject to bullying and harassment, and she comments that the service is

"overworked, under resourced, under promoted and undervalued by the senior administration."

Will my right hon. Friend meet Dr Madan, who heads up the service as the leading occupational physician? She has a unique insight into the culture and sees staff who might not feel confident to come forward.

Andrea Leadsom Lord President of the Council and Leader of the House of Commons

I would be delighted to meet the head of the Parliamentary Health and Wellbeing Service. My hon. Friend is right to point out that the service has been overworked. As part of the new complaints and grievance procedure, resources will be made available, but nevertheless I would be very happy to meet the lady she mentions.

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05 NOV 2018

Universal Credit: Prevention of Ill Health: Government Vision

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

In the Secretary of State's vision for prevention he rightly points out that £14 of social benefit accrues from every £1 spent in public health. Therefore it is going to be much more challenging for him to deliver on his objectives if there is a further transfer from the public health budgets into NHS England budgets. However, I recognise that this requires action across all Departments, so will he set out what he is going to do to encourage cross-government action on physical activity, because we all know that that is a vital part of public health and prevention?

Matthew Hancock Secretary of State for Health and Social Care

I agree with my hon. Friend the Chair of the Select Committee on that. Of course, the public health budgets for local authorities and Public Health England will be settled as part of the spending review, and there was no change to them in the Budget last week. There are also much wider responsibilities on activity—on cycling and walking—on which I am working with the Department for Transport. The document is all about the cross-government action, and the NHS will come forward with its long-term plan for the NHS-specific action. If there are aspects of cross-departmental working that she suggests we have not yet taken up, I will be looking forward to listening to her on that.

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01 NOV 2018

Fixed Odds Betting Terminals

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

In his Budget statement, the Chancellor referred specifically to wanting to reduce the tragedy of lives being lost to suicide. This is clearly a measure that could be taken; the industry has had ample time to prepare for it. May I urge the Secretary of State to reconsider and to bring forward the date on which remote gambling duty is brought in, so that it can cover the costs that he has mentioned in relation to protecting public services? The tragedy of lives being lost to suicide has to be our absolute priority here, and there is good evidence for this measure. I urge him to think again and to bring it in.

Jeremy Wright The Secretary of State for Digital, Culture, Media and Sport

I have huge respect for my hon. Friend's passion on this subject, and for the approach that she takes to issues such as this. I hope she will accept that there is no lack of enthusiasm on my part for countering the harms that she has described. The reason that we are making this decision is not because we believe it is important to pacify the betting lobby. Had that been the case, we would not have made this change at all. We have made this change because we believe that it is necessary to make it, but it is also necessary to make this decision in the most rational way that we can and to balance out a number of factors that we have no choice but to properly consider in order to achieve the objective that she and I share.

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01 NOV 2018

Shipping: Exhaust Emissions

Written Answers

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Transport, what discussions he has had with the (a) Secretary of State for Environment, Food and Rural Affairs, (b) Marine Management Organisation and (c) Maritime and Coastguard Agency on assessing and mitigating the risks that scrubber technology poses to UK waters and coastlines.

Nusrat Ghani Parliamentary Under-Secretary (Department for Transport), Assistant Whip (HM Treasury)

Exhaust Gas Cleaning Systems (EGCS), or 'scrubbers' as they are commonly known, are an internationally recognised technology which ships can use to comply with sulphur limits, providing an alternative to using low sulphur marine fuel. The systems are subject to controls at an international level through the adopted International Maritime Organization (IMO) Guidelines, which are mandatory.

The Guidelines ensure sulphur dioxide emissions from scrubbers are equivalent or better than would be obtained from using compliant fuel. They also address water quality and environmental impacts, in order to mitigate risks to the marine environment.

The Department and the Maritime and Coastguard Agency, played an active role in the development of the Guidelines at both European and international level with input from the Marine Management Organisation, the Department for Environment, Food and Rural Affairs, system manufacturers, as well as approval organisations and industry stakeholders.

Ships' installed scrubbers must be approved in accordance with the Guidelines before operating in UK waters.

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01 NOV 2018

Health and Social Care Committee

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I thank the hon. Lady for making that point. We did not look at devolved issues, because the remit of the Health and Social Care Committee is England only, but the hon. Lady makes a very important point. As the Justice Committee has an ongoing interest in this issue, there might be an opportunity for that Committee to take the matter up more quickly than we would be able to, but I would be very interested if the hon. Lady wanted to write to me about it.

I again thank all those who contributed to the inquiry, and I look forward to hearing the ongoing thoughts of the Justice Committee.

Jackie Doyle-Price The Parliamentary Under-Secretary for Health and Social Care

I really welcome the report. My hon. Friend Dr Wollastonalluded to the fact that this issue lies within the bailiwicks of both the Department of Health and Social Care and the Ministry of Justice; I am glad that the Under-Secretary of State for Justice, my hon. Friend Edward Argar, is here beside me. We are seized of the importance of this issue and recognise that silo culture is often the enemy of good policy making. Rest assured that we will take away the report and reflect on it. We are very grateful for the interest that the Health and Social Care Committee has shown in this very important subject, because we do need to do a whole lot better.

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01 NOV 2018

Prison Health

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I would like to present a report on "Prison health" by the Select Committee on Health and Social Care. I start by thanking my fellow Committee members and the Committee staff, particularly Huw Yardley and Lewis Pickett. I also particularly thank all those who gave evidence to our inquiry, both in person and in writing. We visited HMP Isis, HMP Belmarsh and HMP Thameside, and I thank the staff, healthcare staff and all the people in prison who spoke to us about their experiences.

A prison sentence is a deprivation of liberty, not a sentence to poorer health or healthcare, yet sadly that was the picture that we found in our inquiry. Too many prisoners are still in overcrowded, unsanitary prisons with overstretched workforces. Those poor conditions contribute to even worse outcomes and health for those who arrive in prison, who are often from very deprived backgrounds and suffering from serious health inequalities. Violence and self-harm are at record highs, and most prisons exceed their certified normal accommodation level, with a quarter of prisoners living in overcrowded cells over the last two years. Staffing shortages have led to restricted regimes that severely limit prisoner activity, as well as their access to health and care services, both in and outside our prisons.

Too many prisoners still die in custody or shortly after their release. Although deaths in custody have fallen slightly since peaking in 2016 as a result of increased suicides, so-called natural-cause deaths are the highest cause of mortality in prisons and, I am afraid, reflect serious lapses in care. Every suicide should be regarded as preventable. It is simply unacceptable that those known to be at risk face unacceptable delays while awaiting transfer to more appropriate settings. We see that happen time and again, without appropriate action being taken.

Our report refers to the impact of the increasingly widespread use of novel psychoactive substances, not just on prisoners but on prison staff; dealing with violent incidents takes time away from the work that we would otherwise expect prison staff to do. We heard time and again from people in prison who we met of not being able to attend appointments, either within or outside the prison, because there simply were not the staff there, because they had been diverted to other cases.

We have made recommendations for the National Prison Healthcare Board. We would like it to agree a definition of equivalent care, and to tackle the health inequalities that we know prisoners face. It also needs to take a more comprehensive and robust approach to identifying and dealing with the healthcare needs of people in prison. However, many of our recommendations will not be met until sufficient prison officers are in post. That is an overriding issue, because the cut in prison officer numbers—I know the Government are starting to address that—lies at the root of so many problems in our jails.

Health, wellbeing, care and recovery need to be a core part of the Government's plans for prison reform. It is in all our interests to care about the health and wellbeing of prisoners, because they will later be back in our communities. If more of them become dependent on drugs during their time in prison, and these problems worsen, they will come back into our communities with even worse health issues, health inequalities and mental health problems. I know it is difficult, because it sometimes seems that the public do not care about our prisoners, but it is absolutely in everybody's interest to care about the health and wellbeing of our prison population.

I am afraid that our report highlights a system in which, time and again, reports from Her Majesty's inspectorate of prisons are not acted on. We need those reports to have real teeth, and for people to be able to take action, or to be held accountable for not taking action. We heard time and again of governors not having the levers—even if they had the financial powers—to take the necessary action.

We call on the Government to regard the health of our prison population as a serious public health crisis requiring a whole-systems approach that takes root in sentencing and release, making sure that people are only in prison if absolutely necessary, that those with serious mental health problems are transferred in a timely manner and that sees time in prison as an opportunity to act and to address serious health inequalities. That is not only in their interest but in all our interests.

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31 OCT 2018

Shipping: Exhaust Emissions

Written Answers

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Transport, what assessment he has made of the potential effects of the use of scrubber technology and marine sulphur dumping on UK coastlines.

To ask the Secretary of State for Transport, what assessment he has made on the potential effects of the use of scrubber technology and marine sulphur dumping on the English channel.

To ask the Secretary of State for Transport, what assessment he has made of the potential effects of the use of scrubber technology and marine sulphur dumping on marine life and biodiversity in UK waters.

To ask the Secretary of State for Transport, what assessment he has made of the potential effects of the use of scrubber technology and marine nitrate dumping on algae build up on UK coastlines.

Nusrat Ghani Parliamentary Under-Secretary (Department for Transport), Assistant Whip (HM Treasury)

The Government has not seen any evidence that the use of scrubbing technology would have any significant effect on marine environment.

All scrubbers must comply with mandatory Guidelines, which were developed by the International Maritime Organization, before they are allowed to become operational. The potential effects of the use of scrubber technologies on the marine environment was taken into consideration when developing the Guidelines. To be compliant, the systems collect and store any sulphur residue and solid particulate matter on-board the vessel, to be deposited at a port waste reception facility.

Some scrubbers discharge treated wash water back into the sea – which is also controlled under the IMO Guidelines. There are ongoing studies which are looking at the impact of wash water discharges within European waters, which we are monitoring. At this stage, we are not aware of any significant issues which have been found. However, we will respond appropriately at international level, if these or any other studies, conclude that further controls are needed.

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30 OCT 2018

DEFRA Fisheries

Written Answer

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Environment, Food and Rural Affairs, what assessment his Department has made of the (a) location and (b) scale of bycatch in inshore fisheries; and when he plans to publish that assessment.

George Eustice The Minister of State, Department for Environment, Food and Rural Affairs

The Government funds the UK bycatch monitoring programme which provides essential observer data on incidents of bycatch. Bycatch levels are broken down by gear type and area. We do not have information on the exact numbers of bycaught individuals in inshore fisheries but estimates derived from observer data can be found here

The Sea Mammal Research Unit has undertaken work to identify potential marine mammal bycatch hotspots in the UK and the viability of the deployment of acoustic deterrent devices in the southwest of England. This report will be published following peer review.

We are currently working with stakeholders to develop a UK Cetacean Bycatch Strategy to address the issue of unintentional capture of dolphins, whales and porpoises. The Strategy will focus on implementing practical solutions in areas where there are high levels of bycatch, initially focussing on the southwest of England.

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30 OCT 2018

Budget Resolutions - Income Tax (Charge)

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

May I start by apologising for being absent for much of this debate because I was chairing the Health and Social Care Committee? I also declare a personal interest, as three members of my immediate family are employed as NHS doctors.

We need to take a whole-system approach to health— to think of it not just as the NHS, but as a system including social care, public health, the prevention arm and training budgets. I return to a point that I made in an intervention: I wholly welcome the uplift in the NHS budget, but the increase in the NHS England budget that will take place between 2018-19 and 2019-20 is £7.2 billion, whereas the uplift in the wider health budget in the Red Book is only £6.3 billion. It concerns me that this might indicate that some of the uplift in the NHS England budget will come by way of being taken out of other aspects of the health budget, particularly the Public Health Englandbudget, as we have seen in previous years. I hope that the Ministerwill touch on that in his response.

Jon Ashworth Shadow Secretary of State for Health

I think that the hon. Lady may have left the debate to attend her Committee when I re-emphasised her point directly to the Secretary of State, who told us that we would have to wait for the spending review. Would she share my disappointment if the Government tried to pull the same trick that they pulled three years ago, and actually misled us or gave us bogus figures for NHS spending that did not include public health expenditure, capital and training?

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

We need absolute transparency around health spending, and to take not only a whole-system approach but a long-term view.

Public health is the prevention arm of the system, and taking money out of public health has a serious impact on future spending and our ability to tackle health inequalities. It would be very troubling indeed if much of this uplift came directly from a public health cut. We need to be specific about that, and it is not sufficient to wait for the spending review to clarify that point; I hope that the Minister will be able to tell us further about what it means. People need to plan for the future, so if £900 million is going to be taken out of public health grants, we need to know that now.

When we ask the public which parts of the system they prioritise, public health tends to be at the bottom of the list. It is up to the Government to look at the evidence, and they must be clear that the evidence shows that we must focus unrelentingly on the prevention arm of healthcare. That is the right thing to do, and it is where we have the greatest chance of tackling the burning injustices of health inequality, so it is an important point to address.

The other aspect I want to touch on is social care. The Health and Social Care Committee has just had a sitting with the Care Quality Commission on its excellent "State of Care" report. The report comments on "fragility," and the report of a couple of years ago talked about "a tipping point." The CQC told us that that tipping point has been passed for many people in social care. The interaction between social care and the health service is so close that, if we do not focus on social care, we are simply tipping more costs on to the health service.

Of course it is welcome that there will be an in-year increase for adult social care of £240 million this year and £650 million next year, but it is widely recognised that, because of the extraordinary increase in demand and pressure—driven not just by the welcome fact that we are living longer but by the great increase in the number of people with multiple long-term conditions living to an older age and by younger, working-age adults living with multiple complex needs—social care needs more than £1 billion a year just to stand still, so we need to go further.

I recognise that much of this will come alongside next year's social care Green Paper, which we are all looking forward to, but the system is under considerable challenge. I hope the Minister will recognise in his closing remarks that we are not there yet on social care. He needs to say what we are going to do in the long term to address our social care needs. As I have said before, we will require an approach that involves the Labour Front Benchers, too. We need to see political consensus, otherwise the politically difficult decisions on funding will not get through the House.

If there are to be cuts to public health, the Government will have an even greater responsibility to provide other levers in their public health policy to reduce demand in the system. The Chancellorspecifically referred to wanting to reduce the tragedy of lives lost to suicide. Unfortunately, at the same time, the delay in the reduction of the maximum stake for fixed odds betting terminals means that we have passed up on an important opportunity to address the misery of gambling addiction. That is a hugely wasted opportunity. Likewise, there is a missed opportunity to look at what has happened in Scotland on minimum unit pricing to make sure we are addressing some of the key drivers of public health problems. The Government cannot duck that if we are to see cuts to the public health grant.

Finally, there is the impact of Brexit. The Chancellor has said that there will be £4.2 billion for preparations for a no-deal Brexit. I am afraid that the costs will be far higher. The Health and Social Care Committee recently heard from the pharmaceutical industry that it is having to plough hundreds of millions of pounds into preparing for no deal. That is phenomenal and inexcusable waste; it is money down the drain. I hope the Government will rethink their policy, because no version of Brexit will provide more money for the NHS. There is a Brexit penalty, not a Brexit dividend, and I hope both Front-Bench teams will come together and agree that, ultimately, we need the informed consent of the British people for whatever version of Brexit we come up with, with the option to remain and properly use the money instead for tackling austerity and improving the lives and the health of our nation.

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26 OCT 2018

DEFRA Fisheries

Written Answer

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Environment, Food and Rural Affairs, what discussions the Marine Management Organisation has had with Wildlife Trusts on the use of pingers on vessels in inshore fisheries.

George Eustice The Minister of State, Department for Environment, Food and Rural Affairs

The Marine Management Organisation recently held very constructive discussions with Cornwall Wildlife Trust on the use of pingers in the South West of England and the requirements of wildlife licences for activities that may harm marine species protected under EU and UK legislation.

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25 OCT 2018

Immigration: DNA Tests

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Mandatory DNA testing is not only illegal but unethical, and it can put lives at risk. I therefore welcome the statement, but does my right hon. Friend agree that in building a fair and humane system, we must also recognise the importance of the confidentiality of medical records? Will he look at a letter that I received from NHS Digital on 22 October, in my capacity as Chair of the Health and Social Care Committee, expressing concern about revised guidance that followed assurances given in the House about the importance of confidentiality earlier this year?

Sajid Javid The Secretary of State for the Home Department

My hon. Friend speaks with experience of these issues, and I strongly agree with her that mandatory DNA testing is not only unlawful but unethical. She raised the issue of confidentiality and mentioned a letter that she was sent as Chair of the Health and Social Care Committee. I should be happy to look at that and to respond to her fully.

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24 OCT 2018

Northern Ireland (Executive Formation and Exercise of Functions) Bill

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

My hon. Friend appears to be arguing for the continuation of a human rights border down the Irish sea.

 

Fiona Bruce Conservative, Congleton

What I am arguing—reluctantly, I need to repeat many of the points I made in the Chamber yesterday—is that this key issue does merit reconsideration, but reconsideration in the right legislative chamber, namely the Northern Ireland Assembly. Elected officials there should be making such decisions while accountable to the people they represent.

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23 OCT 2018

Health and Social Care: NHS Innovation

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Digital health tools, including decision-support software, have a great potential to increase the quality, safety and cost-effectiveness of care for patients, and nowhere is that more important than in reducing antimicrobial resistance. Will my right hon. Friend respond to the points that we on the Health and Social Care Committee make in our report about the variation in roll-out, which is wholly unacceptable, and what measures will he take to make sure that it is clear where the responsibility for this lies?

Matthew Hancock Secretary of State for Health and Social Care

I pay tribute to the Select Committee for the report on AMR that was published yesterday. Of course, digital tools such as the one that my hon. Friend mentions are important in making sure that we make the best use of antibiotics and counter antimicrobial resistance as much as possible.

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22 OCT 2018

Nick Hurd

I met today with Policing Minister, Nick Hurd to discuss police funding.

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18 OCT 2018

Scallops: Fisheries

Written Answers

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Environment, Food and Rural Affairs, whether he has had discussions with his French counterpart on ensuring that information resulting from the toxicity testing of scallop fishing areas in the English Channel is made available to British fishermen in a timely manner or at the same time as to French fishermen; and if he will make a statement.

George EusticeThe Minister of State, Department for Environment, Food and Rural Affairs

As the responsible UK body, the Food Standards Agency has reiterated to the French Authorities the importance of ensuring that communications about the opening of fisheries, where raised toxin levels in scallops have resulted in their closure, are made to all of those affected at the same time.

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17 OCT 2018

Social Care Funding

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

The very troubling case that the hon. Lady has described illustrates why we, as a House, must get this right. Does she accept that there has been political failure to resolve the issue of how we fund social care, and will she commit herself to taking a constructive, cross-party approach to getting it right?

Barbara Keeley Shadow Minister (Mental Health and Social Care)

The hon. Lady has asked me that question a number of times, and I always find it difficult to answer. She will know that my party really tried, but when we produced that White Paper in 2010—when we had a way forward and a set of funding proposals—all that we heard was "death tax". In last year's Budget, the Chancellor raised the issue of the "death tax" again: he said that it was not an option. I wonder how the hon. Lady thinks that Labour Members can talk to a party whose Chancellor has ruled out one of the options right at the start, before anyone sits down and discusses anything. I think that that is impossible. I valued the hon. Lady's role as Chair of the Health Committee, of which I used to be a member. Perhaps she will write to the Chancellor, and ask him to stop doing that.

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

As the hon. Lady will know, this is a pattern that has pinged backwards and forwards with successive Administrations. I repeat that we must get it right. We cannot continue these cycles of political failure. We will only solve the problem—particularly in a hung Parliament—with a constructive, cross-party approach.

Barbara Keeley Shadow Minister (Mental Health and Social Care)

I am constantly astonished when Conservative Members talk about a cross-party approach. It is up to their party to come up with some proposals. When it has some proposals, there will be something to talk about. All that we have seen the Conservatives do is abandon all the proposals that they have previously had. We legislated, in the Care Act 2014, for a cap on care costs and a lifting of the ceiling—the asset threshold—but the Conservatives have abandoned that now. They had a set of policies at the time of the election last year, but they have abandoned that. The hon. Lady needs to speak to her own Secretary of State, and I hope that she can have a constructive conversation with the Chancellor as well.

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17 OCT 2018

Universal Credit

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Totnes has a vibrant arts sector. My hon. Friend will know that many self-employed artists take longer to establish themselves as a business, and there may be great variation, month to month, in what they are paid. In the light of her detailed work, does my hon. Friend have any suggestions about how we can improve the situation for self-employed artists?

Heidi Allen Conservative, South Cambridgeshire

My hon. Friend is absolutely right: it is a fact that universal credit was not built for self-employed people, and it shows. The monthly assessments do not work and the minimum income floor needs to be looked at again because it typically takes more than a year for people's businesses to settle down.

To make the existing system really fly, I suspect that we need a boost to IT and admin man and womanpower behind the scenes, because let us make no mistake: universal credit is not yet fully automated. Claiming for childcare costs is a prime example of the manual work that is still being done. That brings me on to how we move legacy claimants across and the regulations that we have still to vote for—in November, I suspect. I am pleased that migration will start a lot later than originally planned, but I and many others still have concerns about the regulations. As a Government, we are choosing, for all the right reasons, to move people—that is people—across to a new system. I fail to see why that should be the complete and utter responsibility of those claimants. I have led on IT transformation projects in business and it would be unheard of for there not to be some kind of automated population of data from the old system to the new. We need to look really seriously into doing that, because it would save us hardship in the long run. Let us not forget that a third of migrated claimants are on ESA—the most vulnerable in society who have some kind of illness or disability—and we should look after them and not let them drop off the system. The population of data should be automatic and there should be no break in those people's payments at all.

Finally, when people arrive safe and sound on universal credit, the work allowances need to be what they should have been prior to 2015. How in this fair Great Britain that we call home can we have two families in identical circumstances living next to each other, but one has been protected across through migration and their next-door neighbours are £2,500 worse off a year? That is not Great Britain.

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15 OCT 2018

EU Exit Negotiations

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Here is some Brexit reality: AstraZeneca has announced just this afternoon that it is stopping investing in the United Kingdom. We have just 165 days to go until we leave the EU and we still have no deal, with disastrous consequences. The Prime Minister says that we cannot have a people's vote, but is not the truth here that the people were not able to see—there is no consensus about this—which of the many versions of Brexit we will be heading towards? Once we know that final deal, would it not be reasonable to go back to the British people, present them with what is involved and what the consequences are—both positive and negative—and then allow them to give their informed consent to moving forward?

Theresa May The Prime Minister, Leader of the Conservative Party

I have answered this question on a number of occasions before this afternoon in relation to the fact that I believe it is imperative for Members of Parliament across the House to deliver on the decision that we freely gave to the people of the United Kingdom and to deliver on the vote that they took in relation to leaving the EU. My hon. Friend references the fact that there is no deal yet, but we are continuing to work for that deal. We continue in those negotiations and look forward to continuing to work with the member states of the EU and the European Commission towards that end.

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10 OCT 2018

Agriculture Bill

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

The chief medical officer, Dame Sally Davies, has described antimicrobial resistance as a "catastrophic threat", and the Secretary of State will know that it is not only in human healthcare but sometimes in farming that we see inappropriate use of antimicrobials, thus increasing the risk that we will lose their benefit to human health. Will he use the Bill as a vehicle to drive down further inappropriate antimicrobial prescribing in agriculture and to incentivise farmers who do the right thing? Will he also make sure that we are not exposed to products from places around the world where antimicrobials are used wholly inappropriately, including with environmental contamination?

Michael Gove The Secretary of State for Environment, Food and Rural Affairs

The Chair of the Select Committee on Health and Social Care makes an absolutely important point. I have had the opportunity to talk to Dame Sally Davies, who has written a brilliant short book about the vital importance of dealing with antimicrobial resistance. I should also pay tribute to Lord O'Neill, who led work under Prime MinisterDavid Cameron on this. My hon. Friend is absolutely right to say that the Bill contains provisions to provide support and payments to farmers who take the appropriate animal health and welfare measures to ensure that we can fight the overuse of antibiotics, which is both a threat to human and animal health, and an environmental danger.

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09 OCT 2018

Government Overseas Aid Commitment: Private Investment: EU Exit Negotiations

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

The Secretary of State will have heard the clear intention of many colleagues on our Benches to vote down the Prime Minister's pragmatic deal. Meanwhile, the clock ticks down to 29 March and there is a serious risk that we could crash out with no deal and no transition. The consequences of that would be disastrous and very different from the dodgy prospectus that was set out in the referendum. Particularly if that is the case, will the Secretary of State commit to giving the British people the opportunity to give their informed consent to that final deal? It is not about obstructing the referendum; it is checking that we have informed consent, and no decent surgeon would proceed without it. 

Dominic Raab The Secretary of State for Exiting the European Union

I certainly agree with my hon. Friend about the need to pursue a good deal with the EU, and all our efforts are focused on achieving that. I do not accept the premise of her suggestion of a second referendum. I think it would inevitably be aimed at trying to reverse Brexit, and that would create democratic outrage and a huge amount of mistrust in the establishment and the political system.

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09 OCT 2018

Dangerous Waste and Body Parts Disposal

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I thank the Minister for the prompt action that he has taken since being notified of this situation. Will he reassure people in the community and in community settings that this issue will not affect their safety?

 

 

Stephen Barclay Minister of State (Department of Health and Social Care)

The Chair of the Health Committee raises an important point regarding residents in the areas where the sites are located, and I see Yvette Cooper in her place. The Environment Agency has confirmed that the waste is being stored safely; it is the amount of waste that is the issue. Many of our constituents are waiting for operations on these sites and will want reassurance that those operations can continue in a timely fashion. That has been a key focus of the Department, and I pay tribute to the work of officials in the NHS, the Department of Health, DEFRA and the Environment Agency, who have ensured that that strategic objective has been maintained.

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13 SEP 2018

Scallop Fishing: Bay of Seine

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

UK vessels have no access to scallops anywhere within French waters inside the 12-mile limit, which is very much in contrast to the position of French vessels that have access to waters within the six to 12-mile limit in the UK. Will the Minister reiterate—there has been some misunderstanding about this—that our vessels were fishing absolutely legally at the time of these disgraceful attacks? I welcome his assurance and talks with his opposite number, as well as his offer of assistance, but Brixham fishermen would like further reassurance that, when they fish in those waters, perfectly legally, measures will be in place to ensure their safety.

George Eustice The Minister of State, Department for Environment, Food and Rural Affairs

I entirely agree with and understand my hon. Friend's point. Much of the scallop fishing industry is based in Brixham in her constituency. She is right to say that the contested grounds are outside the 12-nautical mile limit—they are approximately 20 miles off the French coast and therefore not in French territorial waters. She is also right to say that in some areas the French fishing industry is able to fish in the UK's six to 12-mile zone. She will be aware that the Government have already given notice, under the terms of the London fisheries convention, to withdraw from that agreement and negotiate access arrangements afresh.

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11 SEP 2018

Home Care Services: Living Wage

Written Answers

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Business, Energy and Industrial Strategy, with reference to the Court of Appeal judgment on Royal Mencap Society v Tomlinson-Blake and Shannon v Rampersad made on 13 July 2018, what plans the Government has to bring forward proposals to ensure that overnight care is subject to the National Living Wage.

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Business, Energy and Industrial Strategy, what the (a) status and (b) liability for care providers that enrolled in HMRC's Social Care Compliance Scheme.

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Business, Energy and Industrial Strategy, what steps he is taking to issue guidance on rates for sleep-in shifts; and what discussions he has had with Cabinet colleagues on the adequacy of funding for local authorities to meet those rates.

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Business, Energy and Industrial Strategy, with reference to the Court of Appeal judgment on Royal Mencap Society v Tomlinson-Blake and Shannon v Rampersad made on 13 July 2018, what guidance the Government has issued on rates of pay for sleep in shifts to (a) local authorities and (b) care commissioners.

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Business, Energy and Industrial Strategy, with reference to the Court of Appeal judgment on Royal Mencap Society v Tomlinson-Blake and Shannon v Rampersad made on 13 July 2018, what plans the Government has to bring forward legislative proposals of the pay rates for care workers on sleep-in shifts.

Kelly Tolhurst Parliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)

The Court of Appeal judgment overturns the previous interpretation of the law and means that "sleep-in" shifts, as defined by the Court of Appeal, no longer attract the National Minimum Wage. The Court of Appeal judgment applies both retrospectively and going forward. Government guidance on when "sleep-in" shifts should attract the National Minimum Wage has been updated to confirm that the Government has noted the judgment. That guidance will be updated shortly once Ministers have fully considered the implications the Court of Appeal judgment.

Over the past year Ministers from across the Government have been working closely on how "sleep-in" shifts are remunerated and will continue to do so.

Ministers from BEIS and the Department of Health and Social Care are liaising with local authorities and care commissioners to ensure that they have clarity on the legal position and on their responsibilities when commissioning care services.

HMRC's voluntary Social Care Compliance Scheme remains open. Employers participating on the scheme should take note of the Court of Appeal judgment and review their pay practices accordingly. HMRC officers have been in contact directly with all employers enrolled on the scheme to set out next steps.

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10 SEP 2018

Ministry of Justice: Prisons: Staff

Written Answers

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Justice, what steps his Department and HM Prison and Probation Service are taking to speed up security clearance for health and social care staff commencing employment in prisons.

Rory Stewart The Minister of State, Ministry of Justice

The last year has seen a significant increase in the level of recruitment with a target of deploying an additional 2,500 prison officers in post by the end of 2018. This has impacted the overall volume of cases handled by our shared services provider, due to significant increases in the number of applications handled. This has resulted in backlogs in processing across all of the business.

The right balance needs to be struck between having staff appropriately security cleared and the speed at which they can begin employment with HMPPS. Steps have been taken to review the whole recruitment end-to-end procedure to look at the points in which delays have or can take place. Action has been taken to address these and the backlog of cases has been reduced significantly from last year. This in turn, has also resulted in speedier processing times in security vetting for all staff.

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Justice, what the average number of days taken was to gain security clearance for health and social care professionals seeking to commence employment in prisons in each of the last five financial years.

Rory Stewart The Minister of State, Ministry of Justice

The average number of days taken to complete security clearance for health and social care professionals seeking employment within HMPPS from 2016 has been provided in the table below.

We are unable to provide this information for cases prior to 2016, as a different operating system was used and to which the now service provider to HMPPS does not have access.

Financial Year
Average days
 2016-2017  56
 2017-2018  71
 April 2018 to present
 37

Please note - that the information in the table for health and social care professionals has been collated based on the job title of the campaign and may be subject to slight variations.

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06 SEP 2018

Integrated Care

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I beg to move, That this House has considered the Seventh Report of the Health and Social Care Committee, Integrated care: organisations, partnerships and systems, HC 650, and the Government Response, Cm 9695.

It is a pleasure to serve under your chairmanship, Dame Cheryl. I thank all those who contributed to our inquiry in writing and in person, my fellow Select Committee members, and the Select Committee team, which was ably led by our Clerk, Huw Yardley, with special input from Lewis Pickett. I also thank our special advisers, Professor Sir Chris Ham, Dr Anna Charles and Professor Pauline Allen.

We are all immensely grateful to the South Yorkshire and Bassetlaw sustainability and transformation partnership, the Doncaster Royal Infirmary and the Larwood practice, not only for allowing us to meet them and their teams, but for facilitating the Committee's meetings with local and national leaders from across the healthcare system, the third sector and many other providers to hear evidence during our inquiry. Without them, the report would not have been possible.

I will start by setting out what we are talking about, and why it matters. It is one of the greatest triumphs of our age that we are living longer but, as that happens, many more of us are living with complex, long-term conditions that require support and input not only from dedicated family and formal carer networks, but from across the health and social care system. If those systems do not join up, if they do not share information, or if they are poorly co-ordinated or inaccessible, patients' care is poorer and everyone has a worse experience. Don Redding from National Voices, said that patients and the public "want to feel that their care is co-ordinated, that the professionals and services they meet join up around them, that they are known where they go, that they do not have to explain themselves every single time, and...that their records are available and visible." That is essentially what we mean by integrated care.

Integrated care can happen at three levels. It can happen directly, in the teams around the patient who deliver care in the patient's home—for example, through joint assessments. It can happen at the service level—for example, with services brought together in a one-stop clinic. It can happen at an organisational level—for example, in commissioning or the pooling of budgets. We should all be clear, however, that none of that matters unless we keep the patient at the front and centre of those discussions. If the result is not delivering better care for patients and their families, it is not worth doing.

Integration does not save money in the short term or, sometimes, in the medium term, which acts as a key barrier to putting in place integrated systems for the long-term benefit of patients. Unfortunately, particularly with the current financial pressures, we have a system that is sometimes dictated and hampered by short-term pressures to deliver financial savings—I will come on to that later. In essence, we have to keep sight of the fact that integration is about people and families. Although our report focuses on organisations, partnerships and systems, we have tried to relate it back at every stage to why it matters to patients, rather than it being a dry discussion about systems.

.......

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I thank the hon. Lady, my fellow Committee member, for her input. We on the Committee heard that there is a complex spaghetti of acronyms—STPs, ICPs, ACOs—and nobody knows what they mean. Even those working in the system struggle to keep pace with them and with the changes. We have to keep bringing it back to plain English and why it matters to people and hold our attention there.

The integration of health and social care has been a long-term goal for successive Governments for decades, so we might ask why it is not happening everywhere if we have been striving for it for so long. We saw and heard about many fantastic examples of good integrated care, but they sometimes felt like oases in a desert of inactivity. It is also possible to have an area that does some things very well but others not so well.

.......

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I will respond further to the hon. Lady's remarks when I comment on legislative change and how we can get legislative change through a hung Parliament. I will also comment on the importance of engaging with the service and why that needs to come bottom-up from the service, and the importance of politicians from across the House listening to the service and being focusing on its message and the message from patients and patient representative groups. I thank her for her constructive input. The Committee has been successful in building consensus about how this should go forward. I hope the Minister has heard that intervention and that he will respond specifically to that point in his closing remarks.

........

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Coming back to why integrated care does not happen, there are many deeply ingrained structural divides. Since the inception of the NHS 70 years ago, we have had a system that is free at the point of use for the NHS, but means-tested for social care. That presents an extraordinary hurdle when systems are trying to join up. It is not just that; it is different contractual arrangements and working practices. Good integration comes down to individuals and teams being prepared to work together, but it often feels like they are working together to achieve integration despite the systems around them, not because of them.

We need a system where everybody is focused on helping the right kind of integration to take place, and we need to go back and look at that fundamental structural divide between the systems. I ask the Minister to look again at the joint report, "Long-term funding of adult social care", because that is an important issue that goes to the heart of the barriers to joining up services. It is about contractual differences, different legal accountabilities and payment systems that work against the pooling of budgets, and financial pressures within the NHS.

A certain amount of financial pressure can encourage systems to come together to pool their arrangements and provide a more efficient service, but as the Minister will know, when the elastic is stretched too tight and the financial strain becomes critical, we see the opposite—systems are forced apart. I have seen that happen in my area, where people suddenly feel that they have to retreat to their organisational silos to fulfil their legal obligations. There is no doubt that, for the process to work effectively, we need the right amount of funding—and sufficient funding—and tweaks to the legislative arrangements to allow people to come together, so it does not feel as if they are working together despite the system.

.........

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I thank the hon. Member for that intervention and for her own service to the Committee previously—she is very much missed. Her remarks are typical of the constructive input that she has always made to the health debate in emphasising the need to take the long view. Financial pressures so often force us into short-term solutions, not only in the way she set out but through the salami-slicing of services.

One of the points that our Committee feels strongly about and that I was going to make to the Minister is the need to ring-fence transformation funding, because it is so easy for that funding to get lost. I welcome the uplift in funding—a 3.4% increase will be very helpful—alongside a 10-year plan. However, we have to be realistic about what that uplift can achieve, because there are very many demands on that budget, as the Minister will know and as we have seen in the past. We saw it with the sustainability and transformation fund, which tended to get sucked into sustainability and not into transformation. That has been the pattern of recent decades. There is good intention to ring-fence money for transformation, but that money disappears because of other priorities around deficits and, as I have said, the many other calls on the funds available.

That is why we feel that, in order to prevent the continuation of that cycle of past mistakes, it is important that the pattern is recognised and that funding is earmarked for transformation—not only for capital projects but for things such as double-running.

I will give an example from my area. There will be a complete destruction of public trust in new models of care if money is not set aside for double-running. The community was prepared to accept that there would be a new facility—nobody wanted the closure of the local community hospital in Dartmouth, but there was an assurance that there would be a new facility. Unfortunately, despite many of us opposing the closure of the old facility, what happened was that it was closed and then there was a breakdown in the arrangements for the new facility. The community was left with nothing and there has been a huge destruction of public trust in the process, which unfortunately will have ripple effects across other communities. Had we received the money to keep the existing service while the new service was built and got up and running, it would have left us in an entirely different situation. I am afraid that we see that too often across health and social care. There is good intention, but without double-running, which is part of having a ring-fenced transformation fund, I am afraid that the system has broken down too often in the past. I would like the Minister to focus on that when he makes his remarks.

The Committee is also looking forward to the 10-year plan—we look forward to working alongside both NHS England and the Department of Health and Social Care to examine how that plan emerges—but is important to draw attention to legislative changes. Our Committee made a recommendation that legislative proposals should come from the service itself rather top-down from the Department, which would immediately run into difficulties. However, as a Committee we also offered to subject such proposals from the service to pre-legislative scrutiny.

As Diana Johnson pointed out in her intervention, we need to build cross-party consensus at every point. As it has not been covered in the formal response to the Committee's report, will the Minister say in his closing marks whether the Government would support the Committee conducting pre-legislative scrutiny?

I am pleased to have had a conversation with Simon Stevens, the chief executive of NHS England, who has confirmed that, as it emerges, the NHS assembly will consider that within its remit—NHS England hopes to produce proposals in draft form before Easter 2019. Nevertheless, as I have said, it would be helpful to receive the Minister's assurance that proposals will come to our Committee for pre-legislative scrutiny as part of the process of building consensus.
............

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Hon. Members know that a lack of proper pre-legislative scrutiny that responded to concerns expressed led to many of the barriers. We have to go back and address them when they could have been addressed in a more collaborative process during the passage of the Health and Social Care Act 2012. I am thinking of the need to reconsider the legal basis for merging NHS England and NHS Improvement, and how we establish a better statutory basis for the process so that provider partnerships do not always have to go back to separate boards to gain their approval. It is about considering how we address issues such as geographical arrangements so that they make more sense to local communities. The Committee could play a constructive role in a host of areas but—I say this to the Minister—unless proposals are subjected to pre-legislative scrutiny and unless a cross-party consensus is established, proposals are likely to fail.

My final point—other Committee colleagues will probably want to develop it further—is this: what will happen around establishing a legal basis for integrated care providers? For two reasons, the Committee welcomes the change of name from "accountable care organisations" to "integrated care partnerships". First, the original name confused the debate about Americanisation. The "accountable care organisations" proposed were not the same as those organisations in the States, and the original name caused a great deal of unnecessary anxiety. We do not see the process as Americanisation.

A concern raised with the Committee was that the process will be a vehicle for privatisation. We did not agree. In fact, we thought the opposite: we agreed with the witnesses who told us that the process provided an opportunity to row back from the internal market and away from endless contracting rounds, and move towards much more collaborative working. We would like that change to be properly reinforced within the legal status of health bodies, and are disappointed that the Government have not agreed to say categorically that these bodies would be classed as NHS bodies. When the Minister sums up the debate, I would like him to reflect on whether any form of wording can put the matter beyond doubt and ensure that these health bodies will not be taken over by large, too-big-to-fail private sector organisations.

It is not a concern that groups of GPs might want a leading role in the bodies. The Minister will know that the public concern is more about them being taken over by very large too-big-to-fail private sector organisations. It should be possible to come up with a solution. The Committee heard—the Minister knows this—that those working in the service have the view that that the bodies are not likely in practice to be taken over by private sector providers. However, that public concern exists and is a barrier to change. If we can put this matter beyond doubt, we should try to do so.

........

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I thank the hon. Lady for her helpful clarification. I was trying to distinguish GPs, who are private contractors to the NHS. Sometimes that status is used as a reason why integration cannot be done. I do not think there is concern about that level of leadership involvement but, as she rightly points out, there is concern about other aspects of the private sector. It is acting as an unhelpful distraction when there should be a consensual approach to ensure, as I said at the beginning, that we keep focused on the purpose, which is to provide better services for patients. Anything we can do to facilitate making it easier for that to happen—rather than feeling like we are wading through treacle—will be a positive way forward.

I thank my colleagues and all who helped with the inquiry.

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06 SEP 2018

Cystic Fibrosis

I met today with Matt Hancock and the Cystic Fibrosis Trust to discuss the deadlock on CFTR modulators on behalf of those living with the devastating consequences of Cystic Fibrosis and for whom delay increases disability and costs lives.

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04 SEP 2018

Prisons: Health Services

Written Answer

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect of the time taken to obtain security clearance for health and social care staff on the delivery of healthcare in prisons.

Jackie Doyle-Price The Parliamentary Under-Secretary for Health and Social Care

The Department has not made a formal assessment of the effect of the time taken to obtain security clearance for health and social care staff on the delivery of healthcare in prisons.

All staff and non-directly employed personnel are subject to a series of pre-appointment security checks to determine their suitability to work in a prison. The unique nature of such work means that checks may need to be more comprehensive than other locations and can take time.

NHS England continues to work with Her Majesty's Prison and Probation Service and the Ministry of Justice to expedite clearance on a case by case basis where concerns are raised by providers.

The end-to-end recruitment procedure has been reviewed by the Ministry of Justice to identify the points at which delays have or can take place. Action has been taken to address these and the backlog of cases has been reduced significantly from last year. This in turn, should also result in reduced processing times in security vetting for all staff.

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24 JUL 2018

Health and Social Care: NHS Services: Online Access

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I welcome the Secretary of State to his post. He will know that no regulator is prospectively examining the safety and effectiveness of diagnostic apps in use in the NHS. I wrote to his predecessor recently following concerns that were raised with me about Babylon's apps, which could be missing symptoms of meningitis and heart attack, for example. What steps will the Secretary of Statetake to ensure that, as these technologies are rolled out, patients have can have absolute confidence that they have been properly evaluated for safety and effectiveness? Will he set out how he will take that forward?

Matthew Hancock Secretary of State for Health and Social Care

The Chair of the Health and Social Care Committee makes a really important point. There is no greater enthusiast for technology than me—as you well know, Mr Speaker—but the thing about new technology is that the rules sometimes need to be updated to take changes in technology into account. The response when there are challenges such as the one my hon. Friend raises is not to reject the technology, but the opposite: to keep improving the technology so that it gets better and better, and to make sure that the rules keep up to pace. I spoke to Simon Stevens at NHS England about this only this morning—we have had a series of conversations in the past couple of weeks since I have been in post—and he is reviewing this exact question. I am absolutely sure that we will get to the right answer.

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20 JUL 2018

Fracking: Health Hazards

Written Answers

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Health and Social Care, whether the Government has commissioned a review of research relating to the health implications of shale gas extraction by any organisation since the 2015 general election.

Steve Brine The Parliamentary Under-Secretary for Health and Social Care

Public Health England continues to review the evidence on the potential public health impacts of emissions associated with shale gas extraction and has not currently identified any significant evidence that would make it change its views stated in its 2014 Review.

Hansard

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19 JUL 2018

Exiting the European Union: Contingency Plans

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Crashing out with no deal looks increasingly likely, particularly as former members of the Government have stated that they intend to undermine a deal. What is needed now is a plain English guide to the consequences of no deal for individuals, families, communities and businesses. Will the Minister commit himself to publishing such a guide so that people can see the consequences and step away from the edge of the cliff?

Chris Heaton-Harris The Parliamentary Under-Secretary of State for Exiting the European Union

As my—right hon. Friend? [Interruption.] It is only a matter of time; everything comes to those who wait.

As my hon. Friend knows, because she chairs the Liaison Committee, the Prime Minister said yesterday that a whole bunch of technical notices would be produced for exactly that purpose.

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18 JUL 2018

Liaison Committee

The Prime Minister, Theresa May, was today questioned by the Liaison Committee.

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17 JUL 2018

Trade Bill: Transfer Schemes

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

Evidence to the Health and Social Care Committee overwhelmingly showed the importance to patients of our maintaining close regulatory alignment not only here, but across the EU. Does my hon. Friend agree with the Committee that we must do more to publish the contingency planning and the consequences of not maintaining alignment so that the public can see this?

Phillip Lee Conservative, Bracknell

I will be as brief as possible, Mr Speaker.

Yes, I do agree with my hon. Friend's comments. Every month 45 million patient-packs of medicine go to the EU from the UK and 37 million packs move the other way. It is hard to think of a single other product that illustrates so well the importance of frictionless trade.

This amendment supports the Government's intentions as explained in the Prime Minister's Mansion House speech and their White Paper, but we must go further and enshrine them in law because of the very real impact on people's lives, on the NHS's ability to operate, on the industry, and on investment in the UK. That is why I will press this new clause to a vote.

I will also support new clause 18 this evening. Yesterday was the worst experience in politics I have had in eight years, and I am sorry that it has changed the dynamic. I started the week intending to support our Prime Minister in her deal and the White Paper. Yesterday changed that, and that is why I will be supporting other colleagues on these Benches when we come to new clause 18 this evening.

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17 JUL 2018

Electoral Commission Investigation: Vote Leave

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

The reality is that punishments are not following. We are talking about deliberate cheating and this money going to a firm that used highly sophisticated targeted Facebook advertising. In a quote since removed from the Aggregate IQ website, Vote Leavecampaign director Dominic Cummings said:

"We couldn't have done it without them."

That is Dominic Cummings, who will not appear before Select Committees, having claimed during the campaign that he wanted to restore the sovereignty of Parliament. He runs away from accountably himself. Consequences must follow. We cannot have confidence that the referendum was secure, and it should be rerun.

Chloe Smith The Parliamentary Secretary, Cabinet Office, Assistant Whip

The report is clear that consequences do follow. The Electoral Commission has issued fines and referred both Vote Leave and the BeLeave founder to the police. That is what I refer to when I say that consequences and punishments are following.

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12 JUL 2018

Eu: Future Relationship White Paper

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I thank you for your comments, Mr Speaker. I welcome the Secretary of State to his post, but I do not think it possible for Members to question him about the White Paper without having had a chance to read it. He said that he will step up planning for a no-deal scenario. Will he commit to publishing the consequences of no deal for individuals, communities and the economy, so that we can all assess what its impact will be?

Dominic Raab Minister of State (Housing, Communities and Local Government)

I respect my hon. Friend's views, and I know she takes a close interest in these matters. I seem to remember that under previous Administrations statements and hard-copy documents were received very late, but I have apologised for what happened today, and I will endeavour to ensure that it is not repeated. On her broader point, we have tough choices to make, and the White Paper seeks to reconcile the challenge of ensuring that we leave the customs union, with all the benefits of that and opportunities to be grasped, while also minimising any potential disruption to trade. I will release more details to the House about our no-deal planning in due course.

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11 JUL 2018

The Treasury

Thank you to Robert Jenrick,the Exchequer Secretary to the Treasury for meeting SW Conservative MPs to discuss budget priorities and the Spending Review. There was a long list of issues to discuss including transport infrastructure , funding pay rises for schools, water bill rebates and urgency to settle back pay for sleep-in shifts in social care

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10 JUL 2018

Grammar Schools: Transport

Written Answer

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Education, with reference to the Chancellor's announcement in the 2017 Budget , what the timetable is for the extension of free school transport for children in receipt of free school meals to those travelling to selective schools.

Nick Gibb Minister of State (Education)

The Department is committed to ensuring every child is able to access a good school place, regardless of background. The new Selective Schools Expansion Fund will create more good school places where there is local demand by supporting the expansion of existing good or outstanding selective schools. Those schools that are successful in their application will be expected to undertake activity to encourage more pupils from low-income families to attend and be committed to improving access for disadvantaged pupils.

Children will be eligible for free transport to a selective school if they meet the existing eligibility criteria.

The Department expects more children to become eligible for free home to school transport as a result of new rules on eligibility for free school meals, and will be providing local authorities with additional funding to help them provide this.

The Department is not, however, taking forward proposals to open new selective schools and, not taking forward plans for free transport specifically for children who are eligible for free school meals who attend their nearest selective school.

Where disadvantaged pupils are not eligible for free transport, schools may wish to consider whether it is appropriate to use pupil premium funding to support transport costs for these pupils.

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09 JUL 2018

Stalking Protection Bill

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

It is a pleasure to serve under your chairmanship, Mr Gray. I will start by thanking the many people who have come forward to talk openly about their own harrowing personal experiences at the hands of stalkers—including those who have been bereaved as a result of stalking—and the many organisations that have provided support and expertise: the Suzy Lamplugh Trust, the Gloucestershire stalking support service, Paladin, the Alice Ruggles Trust, Protection Against Stalking and, of course, many members of the police and the police and crime commissioner lead. I am very grateful to all of them for sharing their expertise. I am also grateful to the Minister's Bill team, who have been extraordinarily helpful in providing support.

Clause 1 creates a new civil protective order to protect victims of stalking, called a stalking protection order. I am delighted that the Bill has received such strong cross-party support. I really welcome this consensus, on behalf of those who have been victims of stalking in the past and, more importantly, those whom we can protect in the future. It is worth reiterating why we are here to create the new orders. Responses to a public consultation launched in December 2015 stressed the need for earlier intervention in stalking cases to protect victims and to address emerging patterns of behaviour in perpetrators before they become entrenched or escalate in severity, as well as for putting in place vital extra protections. They identified a clear gap in the existing protective order regime, particularly in cases of so-called stranger stalking, where the stalking occurs outside a domestic abuse context or where the perpetrator is not a current or former intimate partner of the victim.

The Bill is therefore intended to provide the police with an additional tool with which to protect victims and deter perpetrators at the earliest possible opportunity, and to fill the gap in the protective order regime. Stalking protection orders will be available on application to a magistrates court by the police, ensuring, importantly, that the onus to take action is not placed on the victim and that the police have end-to-end sight of the entire process, from application to enforcement of the orders, and if there is reasonable cause to believe that the proposed order is necessary to protect another person from the risk of stalking.

I should inform the Committee at this point that I am exploring the possibility of the British Transport police and the Ministry of Defence police also being able to apply for these orders. I hope to provide an update on Report.

Crucially, the orders will be available in cases of stranger stalking because, unlike with existing protective orders, clause 1 contains no requirement for stalking to have occurred in a domestic abuse context or for there to be a current or former intimate partner relationship between victim and perpetrator. The clause also contains no requirement for the orders to be made on conviction. Again, that is unlike what happens with existing protective orders.

Alex Chalk Conservative, Cheltenham

I congratulate my hon. Friend on her vision and stamina in promoting the Bill, which have been a lesson to us all. The fact that there is no requirement for a conviction is the strength of the provision. However, I am interested in the burden and standard of proof to be established before an order can be made. One can well imagine that they would be contested; and they should be imposed only where it is fair to do so, given that breach of such an order could result in a custodial penalty.

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I thank my hon. Friend for the extraordinary work that he has undertaken on behalf of victims of stalking. He is right to draw attention to that matter. Orders could be made on the balance of probability, but breach of an order would be a criminal offence. That is the important distinction, and I know that he welcomes those arrangements.

As I mentioned, clause 1 includes no requirement for orders to be made on conviction—an important distinction —or for the behaviour giving grounds for the application to have met the criminal threshold. That is what my hon. Friend the Member for Cheltenham was pointing out, and it is because stalking protection orders are designed specifically to permit early intervention when the criminal threshold has not yet been met but where it is known that there is a serious risk of harm as a result of stalking. If the police are gathering evidence and preparing a criminal case for court—for example if they are pursuing a stalking conviction—that takes time. The orders are not intended to replace such prosecutions. They can protect victims at the earliest possible opportunity and also are a way of stepping in to address the perpetrator's behaviour before it progresses into an obsessive campaign. Breaking the cycle is much more difficult if the behaviour is allowed to continue for longer.

To address the behaviour in question effectively, orders would make it possible to impose prohibitions and positive requirements on the perpetrator. Clause 1 would allow the police to propose to the court a bespoke intervention to protect the victim from harm but also, crucially, address the perpetrator's behaviour. Requirements to be imposed on a perpetrator by orders include notification requirements similar to those for registered sex offenders. Those are provided for in clause 9 and would help ensure that the police had the right information at the right time to manage the risk posed by perpetrators effectively. A perpetrator who did not comply with the conditions of a stalking protection order would face a criminal penalty for breach under clause 8, with a maximum sentence of five years' imprisonment.

Finally, clause 12 makes provision for the Government to issue statutory guidance to the police on the use of the orders. That will be developed in collaboration with criminal justice partners and sector experts and will help ensure that the police have the knowledge, understanding and confidence to use stalking protection orders to their full potential. It is only right to acknowledge that a new stalking protection order will not in itself deliver a better response to stalking; that will require an improved awareness of stalking on the part of all professionals working in that space, and a continued focus on improving the criminal justice response through the provision of high-quality training, guidance and professional development.

Other measures, beyond the scope of the Bill, were suggested on Second Reading. One was a stalking register. I know that the Government are committed to looking at wider options to improve the response to stalking, and to linking those considerations to wider work on supporting vulnerable victims. However, it is important to note that the notification requirements that could be imposed on a perpetrator under clause 9 are similar to those that can be imposed on registered sex offenders. I look forward to hearing the Minister's thoughts on that point.

I am sure that Committee members will agree that any further changes with respect to stalking should be introduced following rigorous and comprehensive consultation. That brings me to the reason I tabled an amendment to change the long title of the Bill: to ensure that it better reflects its content, which is limited to stalking protection orders and related matters. It is a minor, technical amendment that I hope provides neatness and clarity and will smooth the Bill's passage through Parliament.

I hope that I have made clear how the Bill provides the police with a welcome additional tool, the purpose of which is to protect victims of stalking and deter perpetrators at the earliest possible opportunity, even before the stage is reached at which a prosecution could commence, or to put in place protection while evidence for a prosecution is being gathered. It is imperative that we are able to provide effective support for victims of this devastating crime.

Emma Reynolds Labour, Wolverhampton North East

I congratulate the hon. Lady on introducing the legislation. Will she explain in more detail the provision for interim stalking protection orders in the Bill?

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I thank the hon. Lady for asking about that. It can take time to bring together all the evidence needed for a full stalking protection order, but we all recognise that time is of the essence—I am sure we have all heard compelling evidence of serious harm ensuing. The point is to bring forward an interim order at the earliest possible opportunity, not to replace either a full stalking protection order or the pursuit of a stalking conviction where possible, but to ensure that we recognise that time is of the essence. In the most serious cases we would expect the police to use their existing powers regarding pre-charge bail conditions. I hope that answers the hon. Lady's question.

I hope that Members will give their full support to the Bill and I welcome the cross-party support and constructive debate.

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons)

I thank everybody who has taken part in the debate. We had a contribution from the hon. Member for Huddersfield, who has been talking about this issue for a very long time, and I pay tribute to him for his long-standing commitment. We also had contributions from my hon. Friend the Member for Cheltenham, the hon. Members for Rotherham and for Enfield, Southgate, my hon. Friend the Member for Gloucester, the hon. Member for Birmingham, Yardley, my hon. Friend the Member for Taunton Deane, the hon. Member for Wolverhampton North East, and my hon. Friends the Members for Eddisbury and for Torbay. The right hon. Member for Exeter also provided vital support, as did the hon. Member for Liverpool, Wavertree and my hon. Friends the Members for Redditch and for Harborough.

Mr Gray, thank you for your excellent chairmanship. Finally, I warmly thank the Minister for her ongoing dedication to this cause. I also thank the Home Office team, Christian Papaleontiou and Emily Stewart.

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05 JUL 2018

NHS 70

It was such an honour to be in Westminster Abbey today for the wonderful and moving service to celebrate NHS70 and to thank Nurse Alison Cull for her years of service to the community in Totnes (and for making it today despite her broken leg)

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Public Whip


 

If you would like to view my voting record it can be seen on the Public Whip's website, but you need to see how this information is compiled as it can sometimes be misleading.

What is on in Parliament

If you would like to see full details of what's on in Parliament this week, you can do so via the Parliament website.

Hansard

This will take you to all of my written and spoken material by date