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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04 JUL 2018

Sustainable Fisheries

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

As an independent coastal state, we will be able to decide who can access our waters after 2020 and on what terms, but that will be subject to negotiation. Will the Secretary of State reassure the fishing community in my constituency that its interests will not be traded away after the transition period? In considering the environmental aspects of this, can he say whether those terms will also include a ban on electric pulse fishing?

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

I absolutely share the concern about pulse fishing, which has been articulated by my hon. Friends the Members for Totnes (Dr Wollaston) and for Waveney (Peter Aldous). Yes, absolutely. She and I may differ on one or two aspects of politics, but one of the many things that we are united on is our belief that we need to ensure that, as an independent coastal state, we control access to our waters, and that, separately, we secure the deepest and friendliest trade, economic and other relationship with the EU.

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02 JUL 2018

Health and Social Care Committee

 

Today the Health and Social Care Committee met to discuss NHS Funding

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02 JUL 2018

Ministry of Justice: Department of Health and Social Care and Ministry of Housing, Communities and Local Government

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

It is an honour to speak in this estimates day debate on the 70th anniversary of the NHS. I am privileged and proud to have worked in the NHS for 24 years before coming to this place, and I would like to start by saying thank you to all those who work in the NHS. The principle behind it is as strong now as it was on the day it first opened its doors: it should be free at the point of delivery, available to all, and based on need, not the ability to pay. That is as important now as it ever was; it is truly the thing that makes us most proud to be British. This is not just the anniversary of the NHS, however; it is also the 70th anniversary of the National Assistance Act 1948, which swept away the poor laws and introduced our system of social care, so it is absolutely right that we should be having this joint estimates day debate.

I absolutely welcome the uplift in funding announced by the Prime Minister, but I would like to talk about how we will get the most from those funds, and also how we will pay for this. One of the key challenges that we have long faced is that although the NHS is free at the point of delivery, social care has been means-tested from the outset. That has created a huge challenge in bringing the systems together and providing the integration that patients expect but often find, to their surprise, is not there. Moving towards more integration would have great benefits for patients, and would create savings and a much more logical, patient-centred approach for both systems. I urge the Minister to look closely at the report of both Committees into social care, in which we touched on that issue and made recommendations, which I will talk more about later.

Kevin Foster Conservative, Torbay

My hon. Friend is providing an excellent introduction to this debate. Does she agree that both Front-Bench teams could look at the example of Torbay Council—the local authority we share—which now has an integrated care organisation that brings together adult social care and the NHS for the benefit of our local residents?

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

Indeed; Torbay has led the way. When the Health and Social Care Committee visited Norway and Denmark, we were shown slides from Torbay, because its approach, referring to a Mrs Smith and actually trying to envisage how everything would work around the patient, has been hugely influential abroad as well as at home.

Chris Green Conservative, Bolton West

Health and social care within Greater Manchester has been devolved to the Mayor. Does my hon. Friend agree that Greater Manchester will hopefully lead the way in demonstrating the opportunities presented by combining health and social care?

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

Yes, and I am going to say more about that, because Manchester has benefited from transformation funding. I want to talk about not only the benefits of integration, but how we can ring fence transformation funding. I welcome my hon. Friend's comments.

Returning to the recent announcement, a £20.5 billion a year uplift by 2023-24 for NHS England is welcome and represents a 3.4% average increase over five years. Importantly, it is front loaded, with 3.6% in the first two years, and comes on top of £800 million that has already been promised to fund the Agenda for Change pay rises. However, the announcement should not be the end of the story, because it refers only to NHS England and does not include social care, public health, capital or, importantly, training budgets—staffing is crucial to making all this work.

Of course, the Prime Minister acknowledged that and promised to come forward with a settlement for social care and public health in the autumn. However, we need to be clear right from the outset that we must have a social care settlement that reflects demographic changes, because we will need an increase of 3.9% in funding just to stand still. If we want to do something to address quality and to allow social care to do more, we need to go substantially further. That will be essential if we want to get the most out of the settlement that has already been announced for NHS England.

Diana R. Johnson Labour, Kingston upon Hull North

Returning to the hon. Lady's point about public health not being part of the recent announcement, has she seen the 2017 review that highlighted that there is a return of over £14 for every pound spent on local and national public health policies? It therefore makes economic sense to invest in public health, not to cut it in any future announcement.

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

I absolutely agree. This is about not just funding for public health, but the policy levers. We do not need lots of talk about the "nanny state" that denigrates important national public policy drivers, because although we need funding for local services, as the hon. Lady says, this is also about the policy environment that is necessary to make important changes. Investing in public health makes a huge difference for people.

One of the problems here is that when the public are asked where they would like the priorities to fall, we often hear, understandably, about the importance of cancer outcomes, mental health and emergency waiting times. Public health is often bottom of the list because nobody necessarily knows when their life has been saved by a public health policy. The reality is that the major changes and achievements relating to life expectancy have arisen largely thanks to public health policy, but we rarely turn on the television and see a programme called "24 Hours in Public Health", which is a shame.

Philippa Whitford Shadow SNP Spokesperson (Health)

In the air quality debate last Thursday, I touched on the need for health in all policies. From active transport to quality of housing, is that not where we need to drive public health?

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

The hon. Lady is absolutely right. Health in all policies means using every opportunity to maximise public health. When Departments work together, such as on the childhood obesity strategy, we need maximum engagement across the whole of Government to make that effective. The way it was put to us when the Committee visited Amsterdam was that it should be viewed as a sandbag wall, and if any part of it is missing, we are not going to achieve what we want. That applies to all of public health.

Luciana Berger Labour/Co-operative, Liverpool, Wavertree

To echo the point that has just been made, the hon. Lady will be aware that I presented a ten-minute rule Bill in April about having health in all policies. Does she agree that the Government should reinstate the Cabinet Office Sub-Committee on public health so that the entire machinery of government can come together to ensure that we do everything possible to keep people well, rather than having a service that treats people when they are sick?

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

Absolutely. It is essential that we use every mechanism at our disposal to ensure that Departments work together. Public health is mostly delivered in the community, so we need that to happen at the local level, too. Councils should be reaching out into their communities and ensuring that they use every opportunity to deliver health in all areas when it comes to prevention.

One of the most welcome aspects of the funding settlement is that it is long term. For too long we have limped from one short-term sticking plaster to another, so I particularly welcome the fact that we now have certainty over five years combined with a 10-year long-term plan. In the Minister's response, I ask her to reflect on the recommendation from the House of Lords Select Committee on the Long-Term Sustainability of the NHS for an office of health and care sustainability to do long-term horizon scanning. That means not just future demographic challenges, but long-term workforce planning, which has always been a huge challenge within the health service. Brexit, for example, has implications for not just the workforce, and there are many other challenges ahead, so it would be helpful to have an independent body that could consider such things and help to work out the necessary long-term funding.

My final points are about how we fund the new system. I would be delighted if there was a Brexit dividend, but I am afraid that I do not believe that there will be. I think there will be a Brexit penalty. The difficulty with people thinking that everything might be solved by a mythical future fund means that we are not levelling with them right at the outset that we are all going to have to pay for it. The challenge should be about how to distribute the cost fairly. That is the key point here.

I want to stop here to thank the citizens' assembly that worked with my Committee and the Housing, Communities and Local Government Committee. I also thank the Chair of that Committee, Mr Betts, for the Committee's diligent work on this issue.

Going back to fairness, when I was in practice, it always came as a huge shock to my patients when they realised that if they had what might be really quite modest assets, they would have to fund all their social care. That shock was striking when the citizens' assembly considered the matter. If we are to move to a properly funded system, it must look at the quality of social care, which is precarious in nature, and at the provider challenge. We must be realistic, and we have to make it clear that somebody has to pay. We cannot just put it off to future generations; we have to think about it and explain to the public what that means.

That is why, unusually, our Select Committee makes recommendations to both Front-Bench teams, because the failure to address this has been a political failure. On the one hand, measures suggested by the Labour party have been denounced by my party as a "death tax" and, on the other, my party's suggestions have been denounced as a "dementia tax", and that means we get nowhere.

If we are to avoid having the same discussion in five years' time, we need to be clear about how we will get this across the line. That will require, particularly in a hung Parliament, the co-operation of both sides of the House. I therefore urge both Front-Bench spokespeople to commit to working together.

Members on both sides of the House have repeatedly said that we are prepared to form a parliamentary commission to go out and engage with the public, rather as Adair Turner did on the difficult issue of pensions, regarding what fairness means. We cannot offload this entire cost on to a relatively shrinking pool of working-age employed adults. We need to have a conversation that reaches out to everybody and asks, "What is the fair payment?", and in return we must make sure those extra payments are earmarked for the NHS and do not just disappear into wider Government funding.

How we do that will mean conversations about national insurance with the self-employed, and it will mean conversations with people in retirement about their own contributions. We cannot put the cost entirely on to young people, many of whom are already, in effect, paying a graduate tax of 9% on everything they earn over £25,000. That would not pass the fairness test.

I am afraid that least fair thing of all would be for us to duck this challenge and leave even more people without the care they need, with disastrous consequences for them, for their loved ones and for their carers, because it falls into the "too difficult" box. This is difficult, but we need to grasp it, explain it to people and come to a decision.

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28 JUN 2018

Backbench Business - Improving Air Quality

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

Does my hon. Friend agree that such a fund could also be used to build infrastructure for those who walk or cycle—for active transport?

 

Neil Parish Chair, Environment, Food and Rural Affairs Committee

My hon. Friend, who chairs the Health and Social Care Committee, makes a good point. Once we have the money, there are limitless things we can do with it. The unfortunate fact is that we do not have the money at the moment. I think the Government have felt that. Walking, cycling and altering the way we go about our daily lives is all good. It is good for our health, and it gets us out of our cars.

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28 JUN 2018

Exiting the European Union

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

I thank the Chair and members of the Exiting the EU Committee for today's statement and their excellent report. The Committee I chair, the Health and Social Care Committee, has been very concerned about what could happen, in the event of no deal, to the future supply of medicines and devices because of the challenges to the supply chain. Will the Chair of the Committee set out in what other areas he is seeing concerns about the lack of contingency planning being published so that we can scrutinise what is happening and prepare for the future?

Hilary Benn Chair, Committee on Exiting the European Union

Ministers have said to us that work is going on to prepare for the possibility of no deal. The Committee has previously expressed its view that a no deal outcome would be very damaging to the British economy and create a great deal of uncertainty. That is why we say in the report that we do not accept that a rejection of the deal will then automatically lead to us leaving with no deal, because it would be for Parliament, in the end, to decide whether it was prepared to leave the European Union with no deal. That would be a matter for every single one of us as Members.

I think the nearer we get to March 2019, the more there will be concern if the possibility of no deal being agreed becomes greater than it is at present. I still hope and believe that agreement will be reached because, frankly, neither side in this negotiation should contemplate with any equanimity the prospect of leaving with no deal. The consequences would be exceedingly serious, as we learned from the evidence we heard from the Port of Dover when we visited it, in terms of practical things like keeping the lorries flowing, never mind the medicines, never mind aircraft, never mind broadcasting rights, never mind data transfer. There is a very long list of questions on which people know how the system works today and they want to know how it will work once we have left, but they are very worried about what would happen if there were no deal, and my own personal view—I have expressed it in the House before—is that that is not something we should contemplate at all.

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28 JUN 2018

Housing, Communities and Local Government Committee

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

I thank my co-Chair for the dedicated work that he has put into this joint report, as well as all members of both Committees and our wonderful supporting Committee teams. Like him, I thank not only all those who took part in the citizens' assembly and those who advised and supported them, but the very many people, and their loved ones, who depend on social care, who wrote to us and whom we visited on our Committee visit. They told us moving stories about the level of unmet need and the consequences, both for themselves and their families.

The situation could not be more stark. As we approach the 70th anniversary of the NHS next week, would my hon. Friend say more about the impact on the NHS if we fail to address the unmet need in social care?

Clive Betts Chair, Housing, Communities and Local Government Committee

I thank the hon. Lady, the Chair of the Health Committee—I think on this occasion, my hon. Friend, because we have worked on a friendly basis on this inquiry. She is absolutely right. One of the important recommendations is about trying to extend the scope of care provision to include those with moderate needs. If we provide care for them, it is quite likely that we will stop them from getting into the substantial and critical phase and ending up in hospital in the first place. In terms of the NHS, it is about stopping people getting into hospital by getting them proper care and having care available for people in hospital, so that they do not have delayed discharges. In those two ways, that can be beneficial. Of course, we can also join up services. Can the NHS district nurse who goes into someone's home and looks at their needs not assess their care needs at the same time? Can we not get that sort of joined-up approach?

It was remiss of me not to thank the staff, as the hon. Lady did, and I will name Laura and Tamsin. The work they did on this was exceptional. To produce a report of this quality in the time available was absolutely first-class, and we should congratulate them on it.

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19 JUN 2018

Health and Social Care: Life Sciences and Medical Research

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

Further to the point made by Ian Austin, we know that the UK is a world leader in research into rare conditions, but that does not always translate into timely access to those treatments. The Secretary of State will know that there are many CFTR—cystic fibrosis transmembrane conductance regulator—treatments in the pipeline that could benefit people who are living with cystic fibrosis. Will he meet me to see how we can ensure that those are available in a timely manner for the people who desperately need them?

Jeremy Hunt Secretary of State for Health and Social Care

Of course I am happy to meet my hon. Friend. I recognise that this is one of the things that we are not good at at the moment. We have fantastic research, with amazing new drugs developed in this country, but our uptake can be painfully slow, and that is of course something that we want to put right.

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18 JUN 2018

NHS Long-Term Plan

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

I recognise and thank the Secretary of State for his tireless efforts in making the case for this funding uplift and for a long-term plan. Will he now go further and set out whether, as a result of the extra funding, we will see an end to capital-to-revenue transfers? Will he also set out the role of transformation funding, because we all know that that is essential to get the best from the resources that we are going to add?

Jeremy Hunt Secretary of State for Health and Social Care

My hon. Friend asks two important questions. As she knows, we have committed to phase out capital-to-revenue funding, because if we are to make the NHS sustainable in the long run, we urgently need to make capital investment in estates, technology and a whole range of new machinery, including cancer-diagnostic machinery and so on, and we will not be able to do that if we continually have to raid capital funds for day-to-day running costs. That was one of the main reasons why we decided that we had to put revenue funding on a more sustainable footing. My hon. Friend is absolutely right about that.

Transformation funding is also important, because when the five year forward view was published, pressures in secondary care and the acute sector meant that a lot of transformation funding was sucked into the hospital sector and we were not able to focus on the really important prevention work that can transform services in the long run. I am very sympathetic to the idea that we need, if not a formal ring fence, a pretty strong ring fence for transformation funding, so that the really exciting progress that we see in some parts of the country can start to spread everywhere.

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13 JUN 2018

European Union (Withdrawal) Bill:

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

I thank my hon. and learned Friend for giving way. Does he accept that disrupting complex supply chains in the motor industry can lead to economic disaster, but when we disrupt complex supply chains in medicines, I am afraid it means that people will turn up at their pharmacy and the drug they need might not be available on the shelves? The public will never forgive us for that. I am really sick and tired of hearing some colleagues say that that those who "lost" the referendum have no right to have any say in the type of Brexit we have.

Robert Buckland The Solicitor-General

As my hon. Friend knows, I was one of the 48%, and I do not forget that. That means that I do listen to the voices of concern about the supply of important goods and life-saving medicines. That is the Government's position. That is why we are striving to make sure that we achieve trade that is as frictionless as possible.

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12 JUN 2018

European Union (Withdrawal) Bill: Repeal of the European Communities Act 1972

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

I congratulate my hon. Friend on his courageous decision. Does he agree that there is no majority in this House or in the country for a destructive, cliff-edge, no-deal Brexit?


Phillip Lee The Parliamentary Under-Secretary of State for Justice

I agree with my hon. Friend on that and would add that I am not convinced there is a majority for such a Brexit in my constituency. It is fundamentally important that Parliament should have a voice so that it can influence the final outcome, in the interests of the people it serves. A fake choice between a potentially bad deal and a cliff-edge no deal—a vote between bad and worse—is not a meaningful choice. It would breach such fundamental principles of human rights and parliamentary sovereignty that we would not recognise it as being valid in other countries, and it is not one that our Parliament should accept. In all conscience, I cannot bring myself to vote for it in this bastion of liberty, freedom and human rights.

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11 JUN 2018

G7

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

I congratulate the Prime Minister on her resolve at the G7 in standing up for women's rights, the environment, free trade and the international rules-based order, but given events there, what appraisal has she made of President Trump's likely approach to trade deals with the United Kingdom after Britain leaves the European Union?

Theresa May The Prime Minister, Leader of the Conservative Party

The President of the United States has always made it clear that he is keen to be able to sit down and talk with the UK about a future trade deal. We are also clear that we want to ensure that we have a trade deal that works for the United Kingdom, but let us not forget that we already have a good trading and investment relationship with the US. Every working day, 1 million people in the United Kingdom wake up and go to work for an American company, and 1 million people in the United States wake up and go to work for a British company.

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07 JUN 2018

Tuberculosis

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

I thank my right hon. Friend for his very powerful speech. Further to his points about the importance of public health, would he urge the Government, in their future strategy, to make sure that we look at NHS public health and social care as part of a single system?

 

Nick Herbert Conservative, Arundel and South Downs

Yes. My hon. Friend is probably aware that there is a collaborative TB strategy that was introduced by the Government, urged by the all-party parliamentary group on global TB, which the hon. Member for Ealing, Southall and I co-chair. That strategy shows very promising signs. It represents exactly the kind of partnership that we need between Public Health England and NHS England. I commend the Government for having introduced that partnership.

Most people do not realise that there is no vaccine for tuberculosis. There is a child vaccine, BCG, that some of us had when we were young, but there is no adult vaccine that works for tuberculosis—and no epidemic in human history has been beaten without a vaccine. The reason there is no vaccine is that there is market failure. Unlike HIV/AIDS, this is primarily a disease of the poor. With HIV/AIDS, there were people dying in western countries as well. The pharmaceutical companies do not have a commercial incentive to invest in the new tools that we need—better drugs, better diagnostics and a vaccine. Without partnership funding that comes from the Government, and Governments around the world who can afford it, we will not develop these new tools and we will not beat TB in the requisite timeframe.

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07 JUN 2018

Bill Presented: Privilege

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

There is a danger that people will increasingly come under pressure to make the judgment that, by not appearing at all, the reputational damage will be less, so the hon. Gentleman makes a very important point. However, we have now come to a point where having the final backstop of a penalty—

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

I thank my right hon. Friend for that point. Yes, the point has been made before that someone may want to call for powers to be restored to Parliament, but actually not when it comes to themselves.

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

I thank my right hon. Friend for her point. Even in other jurisdictions where people can be compelled to appear, they are not compelled necessarily to answer a question. For Mr Cummings to have behaved in the way that he has is a grave contempt not only of this House but, more importantly, of the British people.

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

 I thank my hon. Friend for that point.

In closing, I pay tribute again to all those who do appear before our Committees and take the opportunity to thank all members of Select Committees for the work that they put in and all of our staff who do a magnificent job in supporting us. Thank you.

 

 

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07 JUN 2018

Leaving the EU: Fishing Industry

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

Given that unfortunately fishermen's rights have been traded away during the transition period, is not the best way to guarantee that we regain full control of the exclusive economic zone after Brexit to rejoin the European economic area and the European Free Trade Association?


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

Fishing has not been traded away in the transition agreement. We have made it clear in that agreement that nothing will change for the time-limited period until the end of December 2020, but we will negotiate as an independent coastal state in that year, 2020, for fishing opportunities in 2021.

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05 JUN 2018

Offences Against the Person Act 1861

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

I should like to start by paying tribute to Stella Creasy for all the work that she has undertaken in this area, and for bringing this debate to the House. The result of the referendum in the Republic of Ireland has been a great victory for women's rights to make decisions about their own bodies, but it has also thrown a stark spotlight on the situation of women in Northern Ireland. To my mind, it cannot be acceptable that in six counties of our United Kingdom, women are forced to make long, lonely journeys across the water or forced into the hands of the unscrupulous, or that they face criminal prosecution for making decisions that should be theirs by right. I believe that it is time for this House to act to protect their rights, as well as the rights of those everywhere else in the United Kingdom.

Jo Swinson Deputy Leader, Liberal Democrats, Liberal Democrat Spokesperson (Foreign Affairs)

We heard earlier from Sir Jeffrey M. Donaldson about the devolution of policing issues to Northern Ireland. Does the hon. Lady agree that the fact that we are talking about policing women's bodies is part of the whole problem? That is not the right context for this debate. Supporting women to take these decisions is a health matter and a medical matter, and no woman takes this decision lightly.

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

Indeed. I could not agree more with the hon. Lady.

It is time for us to review the way in which we treat this issue and to move to a medical model. Since the 1967 Act, things have changed considerably, not only in social attitudes but in the availability of medical terminations of pregnancy. They were not available at the time of the Act. We have also moved on from the paternalistic attitudes that dictated that two doctors were the only ones who could be trusted to help a woman to take this decision. That completely negates the role of specialist nurse practitioners, who often undertake the role of counsellor in the clinics. It is an anachronism that we should still insist on two medical signatures.

Hannah Bardell Shadow SNP Spokesperson (Digital, Culture, Media and Sport)

On the matter of paternalism, does the hon. Lady agree that comments about women having abortions as a matter of convenience are deeply offensive, and that this debate must be characterised by decency and by respect for the views being expressed across the House? I have supported friends who have had an abortion, and I know that nothing about what they have chosen to do has been about convenience.

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

I thank the hon. Lady for making those points. If the House will forgive me, I am mindful that many Members wish to speak, so I will not take further interventions.

There is a further point about the impact of medical terminations of pregnancy using two medicines. Because of the restrictions of the Act, the second of those medicines currently has to be administered in the clinic, which means that women sometimes have to face the extreme indignity of travelling home with heavy bleeding and in considerable pain. It is time for the House to review the whole way in which this operates, and to shift to a medical model. We know that there is an opportunity to put this right with an amendment to the domestic violence Bill, and I say to Ministers that now is the time to plan ahead for that, rather than looking the other way and saying that this is purely a devolved matter. We know that a cross-party amendment will be tabled, and now is the time to be planning ahead and making the thoughtful, careful preparations that we need to make about the kind of medical regulations we wish to see in place.

Of course, there are those who say that repealing sections 58 and 59 of the Offences Against the Person Act 1861 will lead to us being thrown into some kind of vacuum, but that is not the case. The hon. Member for Walthamstow pointed out that the term limit of 24 weeks would remain in place, and there are other protections. For example, it is already an offence to supply abortion pills under the Human Medicines Regulations 2012, and individuals can face up to two years in prison and a considerable fine for supplying such medications illegally. Equally, some say that there might be a free for all in people turning to back-street abortionists, with unqualified people carrying out surgical procedures—it has happened in the past—but that is not the case. That would still constitute actual bodily harm or grievous bodily harm, and unqualified people would not be able to rely on the victim's consent to the procedure as a defence under sections 47 and 20 of the 1861 Act, which would remain in place. Such offences would carry a penalty of up to five years in a prison and a fine.

The point here is that it is highly unlikely that anyone would want to visit a back-street abortionist if free, safe, confidential and non-stigmatising help was available free of charge on the NHS. As many colleagues have pointed out, we do not stop abortions happening by criminalising them and making an abortion difficult to access; we just make them happen in a less safe context.

I ask Ministers to start preparing for the inevitable cross-party amendments. I hope that the Minister in summing up will be clear that there will be no delay in the domestic violence Bill for fear of a controversial amendment, because an amendment will be tabled, and now is the time to ensure that all the regulations we need are carefully and thoughtfully consulted upon. As someone mentioned earlier, this process would allow the devolved Assemblies to decide what is right for their areas. The time is right for us to move from a situation in which women are criminalised to one where women are treated with respect and dignity.

I will take one further intervention from the Chair of the Home Affairs Committee.

Yvette Cooper Chair, Home Affairs Committee

I welcome the speech that the Chair of the Health Committee is making and her point that this is an opportunity to prepare and to consider such things in detail in anticipation of future legislation. Does she agree that the moving thing about the "Home to Vote" movement in the Republic of Ireland's referendum campaign was that so many women said that they were returning home to vote so that other women did not have to travel in future? They were making journeys so that other women would not have to do so.

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

I absolutely agree. We were all deeply moved by the "Home to Vote" campaign.

Although the change happened in the Republic of Ireland, there are implications across the entire United Kingdom, because it has given us the opportunity to review what is wrong with the existing legislation. It is now time for the Government to plan ahead and to have a thoughtful process of ensuring that the regulations are right. I hope that this House will decide collectively to protect and respect the rights of women, wherever they live in this United Kingdom.

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04 JUN 2018

Home Department: Topical Questions

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

Further to the comments on the tier 2 application route and the effect on the NHS—it is working against the best interests of patients—will the Home Secretary consider the impact on areas outside London, the costs to NHS staff of making applications and the cost of their failure, in monetary terms and for patients? Will he also look at the effect on scientists and researchers?

Sajid Javid The Secretary of State for the Home Department

My hon. Friend makes a good point. I thank her for the letter that she sent on behalf of the Health Committee, in which she made some other excellent points, and I assure her that I am looking at it carefully.

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24 MAY 2018

Porton Down

Thank you to Public Health England for showing me around Porton Down today. World class expertise and research, keeping us safe and highlighting the vital importance of health protection public health.

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23 MAY 2018

Social Services: Minimum Wage

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, pursuant to the Answer of 11 May 2018 to Question 141873, what progress has been made on evaluating the potential impact to the sector of sleep-in back-pay liabilities; and which care sector representatives have been consulted with respect to that evaluation.

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

The Government commissioned market analysis in order to understand the scale of the national minimum wage back-pay liabilities across the social care sector, which was open to all providers across the social care sector. This work is currently subject to further analysis and refinement.

Due to the sensitive nature of this work, no data that could be used to identify providers or local authorities has been shared with any Government department.

Officials meet regularly with various sector representatives including members of Learning Disability Voices, Voluntary Organisations Disability Group, Care England, the Local Government Association, the Association of Directors of Adult Social Services, and others – to better understand the impact this issue is having on the sector.

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

To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 26 March 2018 to Question 133443, on Social Services: Minimum Wage, what timescale he has for discussions with the European Commission.

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

Officials opened discussions with representatives from the European Commission on 6 December 2017. These discussions are ongoing.

The Government will continue to engage with the European Commission to determine how any support that may be offered would comply with State aid rules.

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22 MAY 2018

Transport Emissions: Urban Areas

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

The clean air strategy rightly sets out the compelling case for action to reduce public exposure to air pollution in order to save lives and improve the quality of life for many. We also know that there is a compelling case to get Britain moving and get us out of our cars, and that cycling and walking, even where there is a lot of traffic, exposes people to less air pollution than driving. Does the Secretary of State share my disappointment that there is only a single paragraph in the strategy on active travel? I urge him to go further by strengthening measures to get people out of their cars and, where possible, on to their bikes and walking for their benefit.

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

My hon. Friend makes a vital point. Today's strategy deals with a number of sources of air pollution, and I commend my right hon. Friend the Secretary of State for Transport for showing leadership on precisely the area that she draws attention to. We have spent £1.2 billion on a cycling and walking investment strategy. When my colleague Boris Johnson was Mayor of London, he introduced a cycle lane network across the capital, which has contributed hugely to an increase in the number of people cycling across the capital. I absolutely believe that we need to have a switch away from an over-reliance on traditional internal combustion engines, towards new modes of transport, and part of that is making sure that we can cycle and walk wherever possible.

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21 MAY 2018

Miles Briggs

I met this morning with Miles Briggs MSP to discuss NHS cross-border health issues and patient access to health care and new technologies.

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21 MAY 2018

NHS Clinical Commissioners

Thank you to Julie Wood the Chief Executive of the NHS Clinical Commissioners for coming to Parliament today to discuss NHS clinical commissioning, funding challenges and getting this right for patients

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21 MAY 2018

Care Quality Commissioner

It was lovely to meet today with the Care Quality Commissioner's Chief Inspector of hospitals, Prof Ted Baker to discuss protecting patient safety and the importance of tackling blame culture. It was also an opportunity to raise key local issue of rural ambulance services and response times

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21 MAY 2018

Community Buses

Thank you to Jesse Norman for meeting to discuss community transport and for listening to concerns raised by Bob the Bus Totnes and Coleridge Bus which are vital for communities across South Hams

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19 MAY 2018

Citizens' Assembly

Thank you so much to all those who have given up 2 long weekends to be part of the Citizens' Assembly on the future of social care. Really enjoyed joining you in Birmingham today

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17 MAY 2018

Gaming Machines

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

I warmly congratulate the Minister on her personal commitment to this and all those who have campaigned so hard. This is a great day. I know that the Minister recognises the devastating mental health consequences of gambling addiction. This also has to be about protecting those who are struggling with their mental health at the moment and in the future, so will she meet me to discuss the next stages of the review?

Tracey CrouchThe Parliamentary Under-Secretary of State for Digital, Culture, Media and Sport

I am always happy to meet my hon. Friend, the Chair of the Health and Social Care Committee. I was struck by the Committee's report on suicide, because in previous work on that really sad subject, gambling addiction has not really been highlighted as a potential concern. I am happy to meet and discuss that further.

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13 MAY 2018

Amsterdam

Today the Commons Health Committee visited Amsterdam to see how this great city is making a positive difference for young people by working together to tackle childhood obesity and narrow the health inequality gap. It was inspirational to hear people sharing stories about improving children's wellbeing and turning around childhood obesity.

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09 MAY 2018

Education (Student Support)

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

I thank the Minister for meeting me to discuss the concerns raised by the Health Committee in our nursing workforce inquiry. As he has stated, applicants for learning disability and mental health nursing tend to be older, and those applicants are more likely to stay. They are particularly affected, so I am grateful to the Minister for listening to our concerns. Putting the needs of patients first by allowing for these targeted extra packages is very welcome.

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

I am grateful for that support from the Chair of the Health Committee. Having spent four years on the Committee myself, I know the value that members of Select Committees bring to the House. The Health Committee, particularly under her chairmanship, is hugely valued in the Department. The mitigation package that has been put before the House tonight reflects the constructive engagement that we have had with the Committee. We realise the importance of having consistency between undergraduates and postgraduates, and of expanding the supply of places, but it is also important to recognise that there might be specific areas in which there are recruitment challenges, and that targeted action to mitigate those challenges is appropriate.

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09 MAY 2018

Data Protection Bill [Lords]: Information Orders

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

I rise to speak to new clause 12, which was tabled in my name, that of my colleague, Dr Williams, and those of other Members of the Health and Social Care Committee of and Members from all parties.

I wish to speak about the importance of medical confidentiality, because it lies at the heart of the trust between clinicians and their patients, and we mess with that at our peril. If people do not have that trust, they are less likely to come forward and seek the care that they need. There were many unintended consequences as a result of the decision enshrined in a memorandum of understanding between the Home Office, the Department of Health and NHS Digital, which allowed the sharing of addresses at a much lower crime threshold than serious crime. That was permitted under the terms of the Health and Social Care Act 2012, but patients were always protected, in effect, because the terms of the NHS constitution, the guidance from the General Medical Counciland a raft of guidance from across the NHS and voluntary agencies protected the sharing of data in practice.

This shift was therefore particularly worrying. There were many unintended consequences for the individuals concerned. The Health and Social Care Committee was also deeply concerned about the wider implications that this might represent a shift to data sharing much more widely across Government Departments. There was a risk, for example, that the Department for Work and Pensions might take an interest in patients' addresses to see whether people were co-habiting for the purpose of investigating benefit fraud. There was a really serious risk of that.

I am afraid that the letter that we received from the Department of Health and Social Care and the Home Office declining to withdraw from the memorandum of understanding made the risk quite explicit. I would just like to quote from the letter, because it is very important. I also seek further clarification from the Minister on this. The letter states that

"it is also important to consider the expectations of anybody using the NHS—a state provided national resource. We do not consider that a person using the NHS can have a reasonable expectation when using this taxpayer-funded service that their non-medical data, which lies at the lower end of the privacy spectrum, will not be shared securely between other officers within government in the exercise of their lawful powers in cases such as these."

I profoundly object to that statement. There was no such contract in the founding principles of the NHS. As I have said, it is vital that we preserve that fundamental principle of confidentiality, including for address data. I was delighted to hear the Minister's words at the Dispatch Box, but can she just confirm for me absolutely that that statement has now been superseded?

Margot James The Minister of State, Department for Culture, Media and Sport

Yes, I can confirm absolutely that the statement that my hon. Friend quoted from the letter of 23 February has been superseded by today's announcements.

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

I thank the Minister for that reassurance. There is much more that I could say, but I know that there are very many other colleagues who wish to speak. With that reassurance, I am happy not to press my amendment to a vote.

I would like to make one further comment on protecting patients. At a time when confidence in data sharing is so important, especially around issues such as research, we all rely on the role of NHS Digital. Set up under the Health and Social Care Act 2012 as a non-departmental public body at arm's length from Government, NHS Digital has the specific duty robustly to stand up for the interests of patients and for the principles of confidentiality. As a Committee, we were deeply disappointed that, despite the clear concern set out from a range of bodies, including Public Health England, all the medical royal colleges, very many voluntary agencies, the National Data Guardian and others, the organisation seemed to have just the dimmest grasp of the principles of underpinning confidentiality. I wish to put it on the record that we expect the leadership of NHS Digital to take its responsibilities seriously, to understand the ethical underpinnings and to stand up for patients. With that, I will close my remarks. I thank the Minister for the time that she has taken to listen to our concerns and for her response.

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08 MAY 2018

Learning Disabilities Mortality Review

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

The learning disabilities mortality review programme sets out the stark and unacceptable health inequalities faced by those with learning disability, and I welcome the steps the Minister has set out today. May I press her further, however, on the point about workforce shortfall? What is she going to do not only about recruitment, but about retention of the vital workforce in both health and social care?

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

My hon. Friend is absolutely right that the workforce in our health and social care system is absolutely fundamental to the way we look after people in our country. We must be able to attract, recruit, retain and bring back into the system people who have left it. We are currently compiling a workforce strategy jointly between Skills for Care and Health Education England, and it will be reporting later in the year.

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08 MAY 2018

Health and Social Care: Topical Questions

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

Thank you, Mr Speaker. Will the Secretary of State commit to publishing the progress report on sugar reduction and the next steps strategy on the reformulation programme, so that the Health Committee can examine that when Public Health England appears before us on 22 May?

Jeremy Hunt Secretary of State for Health and Social Care

I had a conversation with Public Health England before questions this afternoon, and it committed to publishing that before that hearing.

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08 MAY 2018

Health and Social Care: Access to Social Care

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

One of the most pressing issues for those who depend on social care is resolution of the back-pay issue for sleep-in shifts. Will the Secretary of State update the House with his own estimate of the liability? The independent sector puts this liability collectively at around £400 million. Will he also update us on the progress being made, because he will know that many sectors are handing back their contracts and withdrawing?

Jeremy Hunt Secretary of State for Health and Social Care

I thank my hon. Friend for raising this serious issue, and I can reassure her that a lot of work has been going on inside the Government to work out how to resolve the issue. A court case is due that may have a material impact on those numbers, but we are continuing to work very hard and fully understand the fragility of the current market situation.

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02 MAY 2018

Breast Cancer Screening

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

I thank the Secretary of State for the commitments and actions he has set out. Colleagues across the House will be thinking of the hundreds of thousands of women not called for their final screening test. They now need consistent, high-quality, evidence-based guidance so that they can make an informed choice about whether to take up the offer of screening. There is much material available setting out pictorially and clearly how they can weigh up the risks and benefits. Will he assure the House not only that a helpline will be in place but that it will be backed up with high-quality material available directly to patients and their GPs, many of whom will be directly counselling women following this news?

Jeremy Hunt Secretary of State for Health and Social Care

Yes, and I can reassure my hon. Friend that GPs will be briefed and that people will be referred for additional support to clinically trained staff at Macmillan Cancer Support and Breast Cancer Care. We have to be transparent with patients, however, about the absence of a clear clinical consensus on the efficacy of scanning for women in their 70s. The fairest thing is to explain that different people have different views and allow them to come to an individual choice, and that is what we are doing. It will of course cause considerable distress to those given that dilemma, but if anyone wants a scan, we will do that scan.

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01 MAY 2018

Health Select Committee

Today the Health Select Committee discussed childhood obesity.

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30 APR 2018

Windrush

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

Will the Home Secretary assure the House that he will do everything in his power to make sure that nobody faces unnecessary delays or costs for NHS treatment in the future, as we saw in the case of Albert Thompson? Will he meet me to discuss the wider policy so that other people do not face unnecessary delays in the NHS as a result of our policy on visas for NHS staff?

Sajid Javid

My hon. Friend is right to raise this issue and I very much agree with what she says. What happened to Albert Thompson was completely unacceptable. We do not want anyone else to be in that situation, and I will very happily meet her.

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26 APR 2018

Customs and Borders

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

Outside an effective customs union there is no such thing as a frictionless border. There is no escape from border checks, rules of origin and expensive infrastructure, and that means costs, delays and red tape. There will be implications for future investment, for people's jobs and livelihoods, and for the stability of peace in Northern Ireland. But there is one area that has not been touched on: the implications for patient safety.

I am privileged to chair the Health and Social Care Committee, and we have been hearing detailed evidence about the implications of leaving the customs union on patient safety. These consequences go far beyond the economic consequences for individual pharmaceutical companies, about which my right hon. and learned Friend Mr Grieve and my right hon. Friend Anna Soubry have spoken compellingly. In fact, these are consequences that directly affect patient safety.

The Committee heard clear and compelling evidence about the extent to which NHS care is dependent on a network of highly integrated, complex and time-sensitive supply chains for the delivery of medicines. For years, we have taken it for granted that when a prescription is issued, it will be available on the pharmacy shelf. I am afraid that we will not be able to take that for granted in the future, because the complex supply chain—from the research lab right through to the pharmacy shelf—will be disrupted by delays at the border, and that will affect costs.

Delays at the border will also directly affect the delivery of patient care. For example, every year in this country, about 700,000 diagnostic tests take place that rely on the availability of medical radioisotopes, which are very time-sensitive. Very many other products would be affected, such as blood plasma derivatives. There are products and devices that are not manufactured in the UK but which we know from past experience have very fragile supply chains, such as dialysis equipment. We have had problems with this before and it could happen again.

Ben Bradshaw Labour, Exeter

Speaking as a member of the hon. Lady's Committee, can I ask her to confirm that every single witness who provided written and oral evidence to our recent inquiry said that their preference was for us to stay in the customs union and the single market?

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

I thank the right hon. Gentleman; I can confirm that.

There are other very worrying examples. After the Manchester Arena attack, a very rapid supply of 500 highly specialised trauma-related items was flown in at very short notice from a Belgian-based company. There are very many serious patient safety issues.

There is also an issue of cost. A report today from the King's Fund highlights the increasing cost of drugs to the NHS. The cost of medicines has grown from £13 billion in 2010-11 to £17.4 billion in 2016-17. However, that cost has been held down by the impact of the supply of generics and the way that primary care has actively switched to these products. Generics are pharmacologically equivalent products that become available when a medicine comes off patent. The British Generic Manufacturers Association told us in evidence that once a medicine comes off patent, a dozen to 20 companies will pick it up. The risk is that as costs and other non-tariff barriers go up, some companies will relinquish their licences and their marketing authorisations. Why would they bother with all the red tape and extra costs? That immediately means that the number of manufacturers goes down, and the likelihood of the cost of generics to the NHS increasing goes up.

I am afraid that the fast and unhindered free movement of medical equipment, medicines, devices, organs and blood products between the UK and the EU that has evolved over decades is at risk if we leave the single market and the customs union. I think there will be a huge crunch moment of reality. The public will never forgive us if, after we leave the European Union, people's drugs and life-saving equipment are not available. This is where we are starting to run into Brexit reality, as opposed to the overly optimistic, unrealistic prospectus that has until now been sold to the British public. It is time for the Government to respond to our request in the Committee to hear when the Ernst and Young-commissioned report on the supply chain will be available. We need far greater contingency planning and a great dose of reality.

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25 APR 2018

School Funding: Social Care

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

Does the hon. Gentleman agree that, given that some funding decisions and challenges are very difficult, and given the amount of money that is needed, we should adopt a cross-party approach, looking at all the options, building consensus, explaining the position to the public and ensuring that this arrangement is delivered?

Kelvin Hopkins Labour, Luton North

In fact, the royal commission did cover funding. Over the last 20 years and more, I have spoken to many audiences, and have asked them, "What would you prefer—to have your house taken away from you, or Granny's house taken away, or to pay slightly more tax?" The unanimous view was in favour of a slightly increased level of taxation to pay for long-term care. Everyone is going to get old. I am easily the oldest person in the Chamber. I am not planning to go into long-term care any time soon, but on the other hand I am closer to it than the other Members who are present. However, I will not speak about myself.

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24 APR 2018

Energy and Industrial Strategy: Fracking: Methane

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 Implementation Unit Report on Shale Gas, what estimate the Government has made of the amount of unintended methane emissions at the projected (a) 17 sites by 2020, (b) 30 to 35 sites by 2022 and (c) 155 sites by 2025.

Claire Perry The Minister of State, Department for Business, Energy and Industrial Strategy, Minister of State (Business, Energy and Industrial Strategy) (Energy and Clean Growth)

Both the 2013 report, 'Potential Greenhouse Gas Emissions Associated with Shale Gas Extraction and Use'[1] (Mackay/Stone) and the Committee on Climate Change's (CCC) 2016 report 'Onshore Petroleum: The compatibility of UK onshore petroleum with meeting the UK's carbon budgets'[2] provided analysis on the potential implications of greenhouse gas emissions from extracting shale gas in the UK.

The Mackay/Stone report concluded that the carbon footprint of UK shale gas would likely be much less than coal and comparable to imported Liquefied Natural Gas.

The CCC report concluded that shale gas production is compatible with carbon budgets if three conditions are met:

Methane emissions from shale gas production minimised and monitored.

Gas consumption remains within carbon budget limits

Any additional shale gas emissions offset by reductions elsewhere in order to meet carbon budgets

We believe that our robust regulatory regime and determination to meet our carbon budgets mean those tests can and will be met.

The Government is grant funding an environmental monitoring programme led by the British Geological Survey in the Fylde (Lancashire) and Kirby Misperton (North Yorkshire), where applications for shale gas wells have been made. This programme includes the measurement of methane emissions, and would continue after the start of shale gas extraction. The evidence gathered from this programme will inform our future estimates of unintended methane emissions from potential shale gas extraction.

During any shale gas operations the operator will be required to undertake environmental monitoring, including emissions monitoring, to demonstrate compliance with their environmental permits.

Clauses in the Infrastructure Act make it clear that any hydraulic fracturing activity cannot take place unless appropriate arrangements have been made for monitoring emissions of methane into the air. Operators will also be required to publish the results of their methane emissions reporting.

[1] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/237330/MacKay_Stone_shale_study_report_09092013.pdf

[2] https://www.gov.uk/government/news/committee-on-climate-change-report-and-government-response-on-the-compatibility-of-uk-onshore-petroleum-with-meeting-the-uks-carbon-budgets

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23 APR 2018

Rating (Property in Common Occupation) and Council Tax (Empty Dwellings) Bill

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

I welcome the Bill and the measures to give councils the tools they need to ensure that we drive down the number of empty properties. Will the Minister also use this opportunity to ensure that those who own second homes are contributing their fair share through council tax, and that they are not able to sidestep that by opting to pay business rates and then claiming eligibility for small business rate relief? If we are to achieve our goals on decent, affordable homes, it is important that everybody should pay their fair share.

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

My hon. Friend makes a powerful point. The situation to which she refers is slightly different from that of vacant homes, but I would say that we need to balance the economic impact of any measures in that area with the underlying public policy imperative that she has rightly referred to. We have also made changes on holiday homes in the context of council tax and stamp duty. We will keep the point she raises under due consideration and I have also discussed it with the Minister for Local Government.

In addition, our new homes bonus scheme provides a financial reward for councils that bring empty homes back into use, so this involves a carrot as well as a stick. This has generated £7 billion in new homes bonus payments to local authorities since 2011. Since these measures took effect, the number of properties left empty in England for six months or longer has fallen by a third since 2010, from 300,000 to just over 200,000. So these measures can work and they can deliver changes in behaviour.

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19 APR 2018

Surgical Mesh

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

I pay tribute to the many women, including those in my constituency, who have come forward to discuss deeply personal and painful accounts of serious complications following mesh surgery, sometimes with life-changing and lifelong consequences for them and their families. I also thank Emma Hardy who, as always, has set out the background to the issue so eloquently. She has been such a campaigner on behalf of victims, and I really thank her for what she is doing. I will not repeat much of the background that she set out, but I will highlight a few points to which I hope the Minister will respond in her closing remarks. As we have heard, NHS Digital has published a review of patients who have undergone urogynaecological procedures for prolapse or stress urinary incontinence, including those where mesh, tape or equivalents were used. However, as the hon. Lady pointed out, the review does not cover all procedures, nor does it include the men who have been affected. We know that 100,516 women underwent these procedures between 2008 and 2016, of which 27,016 cases involved mesh for prolapse. Although the numbers are falling, I am afraid that this is just a snapshot.

.....

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

I was about to come to that very point. Crucially, many of the women I have met have been treated in the private sector. In this House, we should be concerned about all our constituents, not only those who are treated in the NHS. Of course, it is the NHS that often then bears the burden of managing complications, but we must have a much more accurate picture. I support the call from the Royal College of Obstetricians and Gynaecologists and from the British Society of Urogynaecology for mandatory prospective data collection, using the BSU’s database. That is a well-established method of collecting outcome data. Retrospective snapshots are no substitute for collecting data as we go forward or, most importantly, for being able to track it in the long term. Although the majority of complications that happen after 30 days happen in the first year, many of the women I have met developed complications far later than that. I particularly want to emphasise to the Minister how important it is that we have access to shared databases not just here in the UK, but across Europe. Will the Minister tell us whether the Government will be seeking for us to remain part of the European Database on Medical Devices—EUDAMED—so that we not only get an accurate picture of what is happening here in the UK, where our population is smaller, but can compare our data with the whole European Union? That brings me to the wider point about Brexit that is highlighted in the report of the Select Committee on Health on the implications of Brexit on medicines, devices and substances of human origin: the issue of access to clinical trials. It is encouraging that the Government have stated that they wish to remain a part of the European Medicines Agency or to have associate membership, but there are all sorts of aspects to forward clinical research on which it is essential that the Government campaign. They must campaign not just to maintain regulatory alignment and harmonisation, but to ensure that we can remain part of all research mechanisms and mechanisms for ensuring that we have the earliest possible awareness of any complications—not just from drugs but, as this situation has shown, from medical devices. I hope that the Minister will further outline the Government’s intention in that regard.

......

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

My right hon. and learned Friend is absolutely right, and his point applies not only to medical devices. When it comes to relatively rare conditions, we need to look at the widest possible population base in order to detect any complications. It is also important to use the widest possible population base when detecting rare complications. I thank him for highlighting that. If we are to have informed consent for women, it has to be based on high-quality, balanced and evidence-based information, and that has been lacking. We also need to be clear that if a medical device is altered in any way, it must be part of a clinical trial. That was entirely lacking in this situation. The types of device, including the size and thickness, were changed without anyone properly recording or following up on those changes. That has to be the key lesson for the future.

.....

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

I absolutely agree. It strikes me that there has been a kind of wild west out there, with representatives saying, “Why don’t you try this one? This is probably going to be better”, without organisations setting up clinical trials from the start so that we could compare different devices, and without women giving properly informed consent that a different kind of device would be used. Lessons have to be learned not just for mesh surgery, but for other medical devices. Just because something sounds like it might be better, it does not mean to say that there will not be serious complications. Those complications may also happen at a late stage. We need databases such as EUDAMED so that we have access to the widest possible population base and clear device tracking.

.....

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

I do agree. As I say, informed consent is essential, and that was lacking in very many cases. There are cavalier attitudes and assumptions that medical devices are somehow safer than medicines, but we know that that is simply not the case. We have to rigorously make sure that devices are all part of clinical trials, with long-term follow-up and tracking. Perhaps the Minister could update us on how we are getting on with the barcoding of devices, which clearly makes them over time. One of the tragedies is that many women are completely unaware that they have even had mesh inserted at all. That, again, has to be a lesson that we learn for the future about accurate documentation. I hope that the Minister will comment on whether there are plans to introduce compensation for victims. As I said, many of the women I have met have had profound, life-changing injuries, and many are entitled to compensation.

......

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

I thank the hon. Lady for making that point. Yes, absolutely: the scars have been profound not only in physical terms but in the impact on how people feel about themselves. There is a great impact not only on them but on their families and their relationships. On access to services, while we all welcome a tertiary service being set up for victims of urogynaecological mesh, there is concern about current waiting times for those who wish to have a referral to a tertiary centre, and about access to investigations, which need to be timely. When women come forward to report deeply personal and distressing experiences, it is important that they can be seen as rapidly as possible. I hope that the Minister will comment on that.

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16 APR 2018

Syria

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

In her powerful opening speech, Alison McGovern rightly pointed out that chemical weapons were not the only method of vile killing in Syria. However, there is a reason why their use is such a heinous crime under international law. I would like to address that, and also to make some remarks about those who fail to accept the role of Russia in attacks—not only in Syria, but here on the streets of the UK.

My right hon. Friend Mr Francois spoke immensely powerfully about the effect of chlorine gas, and I would like to add some comments about nerve agents—or cholinesterase inhibitors, as those chemicals are known. They are also indiscriminate. They can affect anyone who comes into contact with them—not only the women and children who are their intended victims in Syria, but those who come to their aid. They are particularly dangerous because they persist in the environment and because their victims require intensive care facilities that are simply not available in countries such as Syria.

It is only because of the availability of that intensive care here that the three individuals affected in Britain have survived, but their injuries will be persistent. These are hideous chemicals. They attack both the peripheral and the central nervous system, leaving people's lungs filling up with fluid while paralysing the muscles that would allow them to clear their lungs. They cause painful blurring of vision, terrible abdominal pain, muscle twitching and incontinence of bowels and urine. Nerve agents are a particularly cruel way for people to die, which is why it is absolutely right that the Prime Minister took decisive and timely action on the behalf of this House.

The lesson of 2013—I regret my vote at that time—is that inaction also has consequences. Of course, Iraq hung heavily over the debate then, and we can never know what might have been. As the hon. Member for Wirral South said, we should not constantly be looking in the rear view mirror, but we must learn from the past as we look forward. The lesson from the past is that if we do not act, we will see the increasing use with impunity of these truly hideous weapons of mass destruction. To those who say that this is not our fight, I say that it absolutely is. It is our fight in Salisbury, and it is a grave threat to humanity all around the world. To those who deny Russia's involvement, I say look at the findings that have already been presented to the United Nations. There is incontrovertible evidence of the use of sarin gas and chlorine gas.

Proportionate and limited action has been taken to degrade the storage and production of truly horrific weapons, and I think we will all come to feel that the action that has been taken jointly with our allies will save lives in the future. It was humanitarian action. I fully support the Prime Minister, and I hope that the whole House will at some point have the opportunity to vote to show that this was the right thing to do.

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16 APR 2018

Syria

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

Russia and Syria have lied and lied again about the use of these vile weapons for the mass murder of civilians in Syria, but this is not just a distant conflict; we have also seen these vile weapons used in Salisbury, where they would have resulted in the deaths of three people had it not been for the intervention of intensive care and the expert medical help we have access to here. Does the Prime Minister agree that it is time for people to stop acting as the useful idiots of the Russian regime by appearing on networks such as Russia Today and to look at the facts and bear their own responsibility?

Theresa May The Prime Minister, Leader of the Conservative Party

I absolutely agree with my hon. Friend. Nobody should be in any doubt about the actions of Russia, and nobody should be supporting them. We should all recognise the role that Russia has played in backing the Syrian regime and in failing to guarantee that it was dismantling all its chemical weapons, and that it continues to play in vetoing action on the UN Security Council and in not encouraging the Syrian regime to come to a resolution of this conflict.

They Work For You

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29 MAR 2018

Autism

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

I thank the hon. Lady and my colleague on the Health and Social Care Committee, who always brings such expertise and experience to these debates and to the Committee. Does she agree that it is not just the variation around autism, but the scale of that variation that is so striking? Children cannot access any of the other services that might be available without the initial diagnosis.

Lisa Cameron Shadow SNP Spokesperson (Mental Health)

That is an apt intervention, and I agree entirely. It is not just the postcode lottery, but the widespread variation right across the United Kingdom. Through the all-party group, we hear that people from different parts of the UK feel that they have to battle the system repeatedly at every stage. This is very important. In Health questions, I have asked the Secretary of State whether the Department might consider putting individuals who can diagnose autism into every child and adolescent mental health services team. I know that the Department is looking at data and waiting times. That is so important to getting some degree of stability in the services provided and to ensure that everyone has adequate access moving forward. Knowing where we are to start with can only be a good thing when we look at the progress being made.

As has been mentioned, autism spectrum disorder affects people across their lifespan, so it has to be at the core of policy across many Departments, including those responsible for education and community. This is also about our surgeries. I have taken on the excellent points made by Thangam Debbonaire and I will start my own such surgery in the near future. We have discussed it since our last debate on this subject and it is an excellent idea. I recommend that, as MPs, we all move forward in the same manner, walking the walk, not just talking the talk.

The management of our local shopping centres have been positive about having autism-friendly opening hours so that families can come at particular times. The setting will be made appropriate and people will feel included and relaxed when they go about their daily life. There is so much more to be done. On employment, the autism employment gap is so much higher than the disability employment gap. We must take that forward.

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