04 NOV 2019

Department of Health and Social Care: HIV Infection: Drugs

Written Answers

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

  • To ask the Secretary of State for Health and Social Care, how many local authorities do not have a PrEP impact trial site.
  • To ask the Secretary of State for Health and Social Care, what steps he is taking to support local authorities that do not have a PrEP impact trial prepare for routine commissioning.
  • To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that sufficient places are available in each clinic for the duration of the PreP trial.

Jo Churchill The Parliamentary Under-Secretary for Health and Social Care

Holding answer received on 04 November 2019

It has not proved possible to respond to the hon. Member in the time available before Dissolution.

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31 OCT 2019

Home Office: Immigration: EU Nationals

Written Answer

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

To ask the Secretary of State for the Home Department, what support is available for EU citizens with (a) dementia and (b) other similar health conditions when applying for settled status given the possibility that they may have lost the necessary paperwork.

Brandon Lewis The Minister of State, Home Department

The EU Settlement Scheme is designed to make it simple and straightforward for EU citizens and their family members to apply to stay in the UK after we leave the EU. We are looking for reasons to grant status, not reasons to refuse, and the scheme is performing well.

The Home Office has put in place a comprehensive vulnerability strategy to ensure that the EU Settlement Scheme is accessible for all, including those requiring someone to make an application on their behalf. We are also engaging with relevant stakeholders, such as the Department for Health and Social Care, the Local Government Association, the Association of Directors of Adult Social Services and the Devolved Administrations, to assess the needs of vulnerable groups and ensure they are met.

The Home Office has introduced a range of support for applicants, including assisted digital support at around 300 locations across the UK and the EU Settlement Scheme Resolution Centre, open seven days a week, to provide help and information by telephone and e-mail. We have also provided up to £9 million of grant funding to 57 voluntary and community organisations across the UK to enable them to mobilise services targeted at vulnerable EU citizens.

Regarding specific support for (a) those with dementia and (b) other similar health conditions, such as those without mental capacity, the Home Office has designed a scheme that allows applicants to consent to an appropriate third party to apply on their behalf. This means that care givers, family members and friends can provide the necessary assistance to those who need it.

The Home Office is aware that a range of vulnerable applicants may face significant challenges in securing evidence to support their application. For this reason, we will in such circumstances accept a range of evidence of identity and residence on behalf of an applicant, working with the person making the application to establish the applicant's eligibility based on all the evidence available. Caseworkers are trained to exercise discretion in the applicant's favour where appropriate.

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30 OCT 2019

Health and Social Care: Topical Questions

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

May I thank you, Mr Speaker, for all the support you have given to Select Committees during your time in the Chair?

After a long period of engagement with patients, staff and partner organisations, the NHS has come up with a clear set of recommendations to the Government and Parliament for the legislative reforms it needs. I hope all political parties are listening to that. Will the Secretary of State confirm that he will accept all its recommendations, including the one that recommends scrapping section 75 of the Health and Social Care Act 2012 and other provisions, which would end wasteful contracting rounds in the NHS?

Matthew Hancock Secretary of State for Health and Social Care

I want to pay tribute to the hon. Lady for the work that she, her Health Committee and all its members have done on this legislation. I think that the legislation proposed by the NHS—with the support of the Select Committee, which will of course scrutinise it further—is an important step forward. I am delighted that Her Majesty committed in the Queen's Speech to legislation on the NHS, of which these proposals will be the basis.

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24 OCT 2019

Ministry of Defence: Red Arrows

Written Answers

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

To ask the Secretary of State for Defence, whether the Red Arrows will go on tour to foreign countries in the next three years; and what recent assessment he has made of the effect on UK based air shows of future Red Arrows international tours.

Mark Lancaster The Minister of State, Ministry of Defence

The Red Arrows have a long history of overseas tours showcasing Britain at its best and will continue to undertake them. However, at this stage future overseas tours have not been confirmed.

The RAF fully considers the overall benefits of Red Arrows tours around the UK and weighs this against the benefits of displaying overseas.

Whilst overseas tours may limit the number of displays the Red Arrows can give in the UK during the summer display season, considerable effort is made to maximise the Red Arrows appearances in the UK. The RAF's other display assets including Typhoon, the Battle of Britain Memorial Flight and the Falcons Parachute Team will continue to be available for airshows.

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23 OCT 2019

Speaker's Statement

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

On a point of order, Mr Deputy Speaker. Frankly, I am astonished that at such short notice the Prime Minister has sent a note to the Liaison Committee refusing to appear before us in the morning. This is the only Committee that can call the Prime Minister to account, and it allows us to ask detailed questions with follow up on behalf of the public. This is now the third occasion on which the Prime Minister has cancelled. May I seek your guidance, Mr Deputy Speaker, because this is entirely unacceptable?

Lindsay Hoyle Deputy Speaker and Chairman of Ways and Means, Chair, Panel of Chairs, Chair, Standing Orders Committee

I recognise that three times is very difficult, and quite rightly we have to hold all officers, even the Prime Minister, to account. However, I also recognise that these are very difficult times at the moment, and I would hope that the point of order has been listened to by Ministers and that we can come forward with a date for the Prime Minister to appear, but, more importantly, that the Liaison Committee can get that meeting in—and, as Chair, I recognise the need to do so. So, both ways, there is a need to try to make sure we can make this happen.

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23 OCT 2019

Speaker's Statement: The National Health Service

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

It is a pleasure to follow James Brokenshire, who spoke so powerfully about his experience of the NHS and the importance of early diagnosis of cancer. He said in his opening remarks that we should have been discussing Brexit. I say to him and his colleagues that there is no version of Brexit that would benefit the NHS, social care, science and research or public health, so I urge him to look again at the way he has voted over recent days. That is something we heard compellingly and repeatedly—

Lucy Allan Conservative, Telford

Will the hon. Lady give way?

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

I will not give way, simply because of Madam Deputy Speaker's comments about time pressures.

We heard those views on Brexit powerfully and consistently from all those who gave evidence to the Health and Social Care Committee, so I again urge the right hon. Gentleman to reconsider.

No debate about the NHS can take place without considering alongside it social care and public health. I start by thanking all those who work in all those sectors, who are working under pressure as never before. I reiterate the powerful points raised by the shadow Secretary of State for Health and Social Care. I will not repeat his points about the pressures, including the financial pressures, because I agree with him. However, as parties write, structure and frame their manifestos, I urge all colleagues to look at the evidence and at the asks of the NHS's workforce and leaders.

I welcome an NHS Bill in the Queen's Speech—I was going to ask the Secretary of State this, but unfortunately he has left his place, so I hope it will be addressed in the summing up—but have the Government looked carefully at the work that was done by the NHS, alongside the Select Committee, to frame those asks? People in the NHS were clear that they did not want another top-down administrative disorganisation of the NHS; they wanted something targeted. As was set out by my former colleague on the Select Committee, Dr Whitford, they want the scrapping of section 75. They want a common-sense approach to getting rid of the endless and wasteful procurement rounds. They want an approach that allows all parts of the NHS and partner organisations to work together more closely. I want to hear from the Minister in his summing up that the Government have heard that loud and clear, and that it will all be adopted, because it has cross-party support in the Select Committee and a very clear evidence base. That would help us to implement the long-term plan much more quickly.

I would also like the Minister to say more about when we will hear the Government's proposals for social care, because the knock-on pressures from social care on the NHS are enormous. Far too many people end up in far more expensive settings, where they do not want to be and where they are put at greater risk, for the want of good social care in our communities. This is a political failure. Two Select Committees—the Health and Social Care Committee and the Housing, Communities and Local Government Committee—worked alongside a citizens' assembly to come up with a consensus approach. We have to get away from the back and forth of, "Is it a death tax?", "Is it a dementia tax?" The fact is that we already have a dementia tax in the NHS and social care. The result of the failure to grasp this issue and come up with a long-term solution is that 1.4 million people are going without the care they need. It is a failure on the part of all of us to grasp this problem and come up with something long term and sustainable.

We need to take a far more evidence-based approach to public health and prevention. To give an example of that, today the Health and Social Care Committee published our "Drugs policy" report. Last year, 2,670 people died as a direct result of drug use. That is an increase of 16% on the year before. That figure can be doubled if we include all the causes of preventable early death among people who use drugs. Again, we know what works. I urge the Government to look at the international evidence, to be bold and to consider making this a health responsibility—to say that we will help addicts and that we will radically improve treatment facilities.

There has been a 27% cut in resources for drug treatments, and as a result people are dying unnecessarily. I am afraid that we are not being bold enough in saying that we can save these lives and benefit people's wider communities if we are just prepared to take the step of destigmatising drugs and seeing drug use as an illness rather than something for which, for personal possession, people should be banged up in jail. We should allow our police forces to continue to go after the dealers—the Mr Bigs—rather than criminalise people, especially given that, frankly, we saw competitive drug-taking stories during the Conservative leadership election. I would ask whether any of those people would have been in the position they were had they had a criminal record.

The point is that people are dying completely unnecessarily because of our current policies. Our drug policies are failing, and they are particularly failing those who are dying, their families and all the wider communities that are being subjected to the harms of unnecessary acquisitive crime, discarded dirty needles and so forth. Let us look at the evidence, and let us be bold—not just on drugs policy, but on so many of the other things that are leading to serious health inequalities, such as childhood obesity. Let us be evidence-led in our policy and let us try to get away from the party divisions.

In closing, I would just like to express again my sincere thanks to all those who are helping us out there in our emergency services.

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21 OCT 2019

Preparations for Leaving the European Union

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

Very serious concerns have been raised by shellfisheries about no-deal preparations for their sector. The Secretary of State will know that they have to have an aquatic animal health certificate alongside a raft of other red tape for each consignment. Mussel fishermen in my constituency are very concerned about that, because they have been told that they will need to give five days' notice, but their customers do not order with five days' notice. Will he ensure that officials from the Department for Environment, Food and Rural Affairs will meet me and my constituents to ensure that the problems that are arising will be addressed?

Michael Gove Chancellor of the Duchy of Lancaster

Absolutely, yes.

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21 OCT 2019

Speaker's Statement

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

Further to that point of order, Mr Speaker. May I make a helpful suggestion, which is that you send a photocopy of "Erskine May" to members of the Government? On a more serious note, the Government keep insisting that Members of this House should have the opportunity to change their minds. Is it not time that they extended the same courtesy to the British people?

John Bercow Speaker of the House of Commons, Chair, Speaker's Committee on the Electoral Commission, Chair, Speaker's Committee for the Independent Parliamentary Standards Authority, Chair, Commons Reference Group on Representation and Inclusion Committee

I note what the hon. Lady has said. The second point is a political one, to which I will not respond. In relation to "Erskine May", it is available free online. In relation to the same question convention, I simply make the point that when I pronounced on the same question convention on 18 March, one of the early responses came from an hon. Member who said:

"may I say how delighted I am that you have decided to follow precedent, which is something I am greatly in favour of?"—[Official Report, 18 March 2019;
Vol. 656, c. 778.]

He went on to make other supporting points. The person who responded in that way was none other than the Leader of the House, Mr Rees-Mogg. The Leader of the House was very much with me at that time on the same question convention. I take the same view seven months later, and it is for him to explain whether he does.

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19 OCT 2019

Prime Minister's Statement

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

Evidence matters, Prime Minister. How can he possibly assure our constituents that this is a good deal if he has not carried out an economic impact assessment of what it will cost them? If he has carried that out, why on earth are we not able to see it as we debate this today?

Boris Johnson The Prime Minister, Leader of the Conservative Party

I am grateful to the hon. Lady, but I direct her to the answers I have already given on that point. Many business groups have already come out in support of the deal because it gives certainty and stability and allows the country to move on. I think it will, as my right hon. Friend Stephen Crabb just said, unleash a great deal of investment in the UK.

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17 OCT 2019

Business of the House

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

Could the Leader of the House please let us have an urgent debate on the serious issues facing shellfisheries? They are highly dependent on EU markets, and I am afraid that no-deal planning has been woefully inadequate. Mussel fishermen in my constituency still do not have guidance on how to export in the event of no deal after 31 October. Likewise, many crab fisheries have many—in some cases, all—of their pots in EU waters. Could we hear when we can debate this?

Jacob Rees-Mogg Lord President of the Council and Leader of the House of Commons

The debate on the economy on Tuesday would be an opportunity to discuss the economy of the sea as well as the economy more narrowly.

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16 OCT 2019

Northern Ireland (Executive Formation etc) Act 2019

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

As the Minister knows, Northern Ireland is the only part of the United Kingdom where women do not have access to safe abortion in the place where they live, and they are really looking forward to a change in the law. The Government have set out that they are talking to Church groups; can the Minister set out which women's organisations the Government have been talking to in advance of this very important and much longed-for change in the law?

Robin Walker Parliamentary Under-Secretary (Scotland Office) (jointly with the Northern Ireland Office)

The hon. Lady makes an important point. I can assure her that we have been engaging with a range of organisations, including human rights organisations, women's organisations and campaigns—[Interruption.] I would perhaps have to write to her with more detail.

Turning to the issue of abortion, one has only to look at the passionate and sincere demonstrations in recent weeks on both sides of this issue to appreciate that it remains a highly sensitive matter in Northern Ireland. I understand that there are many people in Northern Ireland who may, as the hon. Lady says, welcome the change. There are also many who would not. I would prefer, as would the Government, that the Northern Ireland Assembly was considering reforms of Northern Ireland's abortion law. This is, as I have noted, a highly sensitive devolved issue and as such it would be best addressed by Northern Ireland's locally elected and locally accountable political representatives.

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14 OCT 2019

Debate on the Address: [1st Day]

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

Does my right hon. Friend agree that this is also a desperately anxious time for British citizens living elsewhere in the European Union who face not knowing whether they will be able have healthcare or what will happen to their pensions six months from now? This is intolerable, and entirely avoidable.

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

My hon. Friend is quite right. In this place, we often have the debates, the braying and the back-and-forth across the Dispatch Box, and it can feel like the pantomime or theatre, but this is people's lives that we are talking about, and some of them are sitting in the Gallery today. I was going to ask the Prime Minister, but he is no longer here, so I hope that the Ministers will have the courage to look Kristin, Margot, Bina and Jennifer in the eye and apologise for the anxiety that they have caused to them and to the 3 million other citizens from the EU27. Our country is better than this. We do not turn our back on those who have come over to be our doctors and nurses, teachers and carers. We do not turn our back on our family, friends and loved ones, and we do not turn our back on those who, like the rest of us, only want to make our country a better place. That is not who we are.

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08 OCT 2019

Department for Digital, Culture, Media and Sport: 5G

Written Answers

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

To ask the Secretary of State for Digital, Culture, Media and Sport, what steps she is taking to introduce safety tests on the proposed 5G pilot projects.

Matt Warman The Parliamentary Under-Secretary of State for Digital, Culture, Media and Sport

Safety must always be paramount in technological developments and there is no credible evidence 5G is harmful to human health. All proposed 5G Testbeds and Trials (5GTT) projects have to comply with the guidelines published by the International Commission on Non-Ionizing Radiation Protection. ICNIRP is formally recognised by the World Health Organization. Public Health England's Centre for Radiation, Chemical and Environmental Hazards takes the lead on public health matters associated with radiofrequency electromagnetic fields, or radio waves.

The 5GTT has strict expectations that all grant funded projects will adhere to ICNIRP guidelines. A considerable amount of research has been carried out on radio waves and per PHE's advice we anticipate no negative effects on public health.

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08 OCT 2019

Department of Health and Social Care: NHS: Drugs

Written Answers

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

To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the availability of medicines in the event that the UK leaves the EU without a deal.

Edward Argar Minister of State (Department of Health and Social Care)

The Department is doing everything appropriate to prepare for leaving the European Union. We want to reassure patients that our plans should ensure the uninterrupted supply of medicines and medical products once we have left the EU.

The Department, as part of our EU exit preparations, is implementing a multi-layered approach to mitigate potential disruption to supply, which consists of stockpiling where possible, securing freight capacity, changing or clarifying regulatory requirements, procuring additional warehousing, working closely with industry to improve trader readiness and putting in place the National Supply Disruption Response to manage potential shortages. Further details can be found at the following link:

https://www.gov.uk/government/news/medicines-and-medical-products-supply-government-updates-no-deal-brexit-plans

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

To ask the Secretary of State for Health and Social Care, if he will publish the Government's worst case contingency plans related to his remit on the UK's withdrawal from the EU.

Edward Argar Minister of State (Department of Health and Social Care)

Operation Yellowhammer is a cross-Government programme of work to ensure that the United Kingdom is prepared to deal with the potential reasonable worst-case scenario impacts of leaving the European Union without a deal.

On 11 September, the Government published planning assumptions for exiting the European Union without a deal at the following link:

https://www.gov.uk/government/publications/government-response-to-humble-address-motion

An updated version will be published in due course.

These include the Department's planning assumptions relating to the continuity of medicines and medicine supplies, the provision of healthcare to UK nationals within EU Member States, and the provision of adult social care after we have left the EU. The Department maintains robust operational plans to ensure the continuity of services from the National Health Service and wider health and social care system, regardless of circumstances, and will continue to do so.

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08 OCT 2019

Government Plan for Net Zero Emissions

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

We have some of that information already, such as that last year we spent £26 billion on transport, but only £400 million of that was spent on active walking and cycling. Does the hon. Lady think that we need a shift of priorities so we are investing in green forms of transport that will also improve health?

Sarah Newton Conservative, Truro and Falmouth

The hon. Lady is absolutely right about the need to invest in cycling and walking infrastructure. Both of us, with many colleagues, participated in a debate in this Chamber on that very subject. The Government asked the Committee on Climate Change to consider what plans they need to put in place to enable us to reach that target; they are actively considering those plans and the Treasury is looking at the cost.

I have every confidence that the Government will produce detailed plans on how we are to reach the 2050 target, but I want them to set out clear milestones for the intervening period. Judging by conversations this morning with protestors, people think we will wait until 2050 to take any action, but we have already taken significant action, and the ambition is there to go further and faster. To give people hope and clarity, we need to set out the plans and milestones in detail so that people can see what is going on.

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03 OCT 2019

Ministry of Justice: Marriage: Humanism

Written Answers

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

To ask the Secretary of State for Justice, what plans he has to bring forward legislative proposals to amend section 14 of the Marriage (Same Sex Couples) Act 2013 to give legal recognition to humanist marriages before waiting for the outcome of the Law Commission's review.

Wendy Morton The Parliamentary Under-Secretary of State for Justice

The Law Commission review that the Government announced this June is a fundamental review of the law on how and where people can legally marry in England and Wales. As part of that review, the Government invited the Law Commission to make recommendations about how marriage by humanist and other non-religious belief organisations could be incorporated into a revised or new scheme for all marriages that is simple, fair and consistent.

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

To ask the Secretary of State for Justice, for what reasons the Law Commission is undertaking a review into humanist marriages.

Wendy Morton The Parliamentary Under-Secretary of State for Justice

The Law Commission review that the Government announced this June is a fundamental review of the law on how and where people can legally marry in England and Wales. The law has been added to over several centuries without any systematic reform.

As part of that review, the Government invited the Law Commission to make recommendations about how marriage by humanist and other non-religious belief organisations could be incorporated into a revised or new scheme for all marriages that is simple, fair and consistent.

The Law Commission has published the terms of reference for the review at https://www.lawcom.gov.uk/project/weddings/.

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

To ask the Secretary of State for Justice, what funding has been allocated to the Law Commission review of the law on marriage.

Wendy Morton The Parliamentary Under-Secretary of State for Justice

The Law Commission will review the law on how and where people can marry in England and Wales, and will provide recommendations for a simple, fair and consistent system which gives couples choice in to marry in a way that is meaningful to them. The cost of this project will be approximately £400,000.

This cost is for the resource for two years of a project team made up of one full-time lawyer, one full-time research assistant, a proportion of the time of a team manager and some travel, publication and translation costs (totalling approximately £150,000 per year) plus the cost of engaging a specialist academic (£50,000 per year).

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03 OCT 2019

Brexit Negotiations

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

The principle of consent requires people to be able to weigh up the risks and benefits of the actual deal, as opposed to the promises that were made during the referendum. I am afraid that there are many detailed questions arising out of the Prime Minister's statement, and they cannot be answered in this format, so may I ask him when he will keep the clear commitment he gave to appear before the Select Committee Chairs in the Liaison Committee, and will he do so before Parliament prorogues?

Boris Johnson The Prime Minister, Leader of the Conservative Party

I am absolutely committed to appearing before the hon. Lady's Committee, and she will have an answer within an hour of my departure from the Chamber this afternoon.

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02 OCT 2019

Department of Health and Social Care: 5G: Health Hazards

Written Answers

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

To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the level of risk to health posed by 5G connectivity.

Jo Churchill The Parliamentary Under-Secretary for Health and Social Care

Public Health England (PHE) has published a webpage about exposure to the radio waves from mobile phone base stations, including those for 5G networks, at the following link:

https://www.gov.uk/government/publications/mobile-phone-base-stations-radio-waves-and-health/mobile-phone-base-stations-radio-waves-and-health

This explains the health-related reviews and assessments have been performed, as well as the practical measures that are in place to protect public health.

PHE continues to monitor the health-related evidence applicable to radio waves, including in relation to base stations, and is committed to updating its advice as required.

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02 OCT 2019

Foreign and Commonwealth Office: Abd a-Rahman a-Shteiwi

Written Answer

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

To ask the Secretary of State for Foreign and Commonwealth Affairs, what representations he has made to the Israeli Government on the alleged shooting by the Israeli Defence Force of a 9 year old Palestinian boy, Abd a-Rahman a-Shteiwi on 12 July 2019; and if he will make a statement.

Andrew Murrison Minister of State (Foreign and Commonwealth Office) (Joint with the Department for International Development)

​Our Embassy in Tel Aviv has raised the death of Abd a-Rahman with the Israeli authorities, stressing the importance of protecting civilians, especially children. The Government is very concerned at the high numbers of Palestinian children killed and injured by Israel Defense Forces in the West Bank and Gaza. We have raised the issue of excessive use of force, including use of live ammunition with both the Office of the Coordinator of Government Activities in the Territories and the Israeli Ministry of Defense.

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02 OCT 2019

Domestic Abuse Bill

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

The Secretary of State may know that I took the Stalking Protection Act 2019 through the House and it received Royal Assent in March. Can he update the House on when it will come into force?

Robert Buckland The Lord Chancellor and Secretary of State for Justice

I pay tribute to the hon. Lady for her work on this important issue and on getting that legislation through Parliament. I will make sure that that information is furnished to her in the course of the debate. Of course, we are brilliantly served by the Under-Secretary of State for the Home Department, my hon. Friend Victoria Atkins, and she will respond to the debate.

We have talked about the moral case for pursuing this issue, but there is also an economic case—a case of financial responsibility. Research has established that the cost of domestic abuse was approximately £66 billion for victims in England and Wales in the year ending March 2017. The biggest component of that cost is the physical and emotional harm incurred by them, but the cost to our economy and our health service is also considerable. Domestic abuse makes up one third of all violent crime reported to the police. The case for removal is clear, but the challenge is not easy. The dynamics are complex and mean that much domestic abuse is hidden. Victims face significant barriers in seeking help and difficulties in escaping from an abusive relationship. That is why we need a cross-Government, multi-pronged approach to tackling it. The Bill is not only part of that approach but demonstrates the breadth of our ambition in showing strong leadership and taking decisive action to help to end the suffering and harm.

......

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

In my time as a GP and also as a forensic medical examiner, I learnt very quickly never to make assumptions about who are the victims of domestic abuse, or about how much courage it takes to come forward because of the extent to which such abuse isolates and terrorises its victims.

I pay particular tribute, as others have done already, to the hon. Members for Canterbury (Rosie Duffield) and for Bradford West (Naz Shah) for sharing their deeply moving personal stories. They will have done so much to encourage others to come forward and take that first step to safety—and this is about safety. Two women a week are killed at the hands of their current or former partners. We also need to do something about the under-reporting of the number of women who take their own lives as a result of being in abusive domestic relationships. We must ensure that there is proper reporting, and also better reporting of the gendered nature of this crime.

It is the job of this House to do all those victims justice and to make sure that the services are there to meet them when they come forward. Likewise, we must ensure that the criminal justice system responds rapidly and sensitively, and that services are also there for perpetrators and we do more on prevention and early intervention, because this crime goes through cycles of generations. Those who have witnessed terrible abuse may be more likely to become abusers themselves.

I will touch briefly on protection orders, on tackling variation, and on alcohol and services. I welcome the change in the Bill to domestic abuse protection orders rather than orders for domestic violence prevention. Those provisions will take us a lot further. It is encouraging that the Bill gets rid of the 28-day limit and that there will be an increased number of settings in which people can apply for the orders and more individuals who can do so.

There is much to welcome but, as the Minister has set out, that takes time. The Stalking Protection Act 2019 received Royal Assent in March, but sadly it will not come into force until the new year. However much we welcome the legislation, we know that there will be a delay. When the Minister responds to the debate, will she explain how we tackle variation in the existing orders? She will know from Home Office data that there is huge variation. For example, three orders were applied for in one assessment period in Cambridge, as opposed to more than 250 in Essex. There can be no reason for that kind of variation. Some data from Her Majesty's Inspectorate of Constabulary show that the use of the orders had gone down. Will the Minister set out what we are going to do to encourage the uptake of existing orders while we are waiting for the improved version to come into force?

I would particularly like to touch on the role of alcohol, because I do not think it has come up in the debate so far. Of course, alcohol is never an excuse for violent crime, but typically 25% to 50% of perpetrators have been using alcohol at the time of the offence. In particular, we know that there is a link with the very violent forms of domestic abuse—in those cases, alcohol is twice as likely to be involved. Will the Minister look at how we can take an evidence-based approach to alcohol in our policy? Will she set out what she is going to do to review alcohol policy so that we can make a difference to domestic abuse, as it is a significant factor?

Services must also be available for perpetrators. We are going to introduce protection orders, and it is welcome that there will positive as well as negative requirements. If people are referred, those services need to be in place so that they can respond. I am out of time, so I shall conclude.

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01 OCT 2019

Irish Border: Customs Arrangements

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

Will the Minister accept that customs clearance sites would involve physical infrastructure, and that it would not matter whether they were at the border or some miles distant from it?

James Duddridge Chair, High Speed Rail (West Midlands - Crewe) Bill Select Committee (Commons) , The Parliamentary Under-Secretary of State for Exiting the European Union

I have been very clear that there will be no infrastructure on the border. I have also been clear that the proposals are currently under negotiation, and I will not go into the detail of those proposals in the House.

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01 OCT 2019

Social Care Funding

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

Does my right hon. Friend accept that this could be done in a step- wise fashion? We could probably start immediately by introducing free personal social care for people at the end of their life, and we could then move forward to try to bring more people within that sphere. There is certainly a strong economic and moral case for introducing such care at the end of life.

Vincent Cable Liberal Democrat Spokesperson (Health and Social Care)

That is a helpful and humane suggestion, and if we approach this whole question in terms of its practicality, rather than with abstract ideology, we might make some headway. What my hon. Friend suggests seems an eminently sensible way to start that process.

The last and most difficult issue is the one in which successive Governments have got hopelessly bogged down: the so-called catastrophe risk for the small number of people who are caught with prolonged expenses as a result of residential care. When I was in government the Dilnot report attempted to address that issue, but I think we have moved beyond that now. This is a classic problem of insurance, and it is now recognised in a way that it was not before—I think the current Prime Minister said this publicly—that the private insurance market cannot, and will not, deal with this problem. If there is to be insurance it must be social insurance, and large numbers of people will have to make a contribution to prevent the burden falling on a small number of unfortunates who contract long-term conditions, with all the costs involved.

That could be done in a variety of ways. One idea is a supplement to national insurance. Another idea from 10 years ago, which I had no problem with, is that if we are to solve the problem of people losing their inheritance, everyone who pays inheritance tax should pay a small supplement. That struck me as a good social insurance principle. Whether or not that formula was right, we have now got to a point of accepting that this is a social insurance problem, and there are different mechanisms for dealing with it. If we are reasonably grown up politically, we should find a way of closing that gap.

.......

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

I begin by paying tribute to all the family carers and the care workforce, including those who looked after my mother-in-law Mary. It was only with their support that she was able to die where she wished: at home, surrounded by her loved ones. That support is not available to everybody, but it should be. For the want of good social care, far too many people unnecessarily end up in far more expensive hospital settings. We must act quickly, and I hope that the Minister will update us on when the Government will come forward with their consultative social care Green Paper, because it was promised two and a half years ago. Five publication deadlines have been missed, so when will we see that Green Paper?

I also hope that the Minister will confirm that she has looked at the Joint Select Committee inquiry by the Health and Social Care Committee and the Housing, Communities and Local Government Committee, because the proposals provide a blueprint for how to move things forward. It contains practical suggestions that have been road-tested for their acceptability through a citizens assembly. I hope that she will also confirm that the principles set out in the document will form part of the Green Paper.

I am afraid that I am going to disappoint my right hon. Friend Sir Vince Cable, who said that this debate provided an opportunity not to talk about Brexit, because Brexit poses a grave threat to a fragile sector. The Yellowhammer documents make it clear that smaller providers face going to the wall within two to three months and larger providers within four to six months. I hope that the Minister will be able to comment on what action will be taken to mitigate that.

The effects include not only the impact of an increase in inflation on a fragile sector, but the impact on the workforce. As the Minister knows, the vacancy rate is already at 8%, which amounts to around 110,000 positions across social care. Some 8% of the workforce come from our partner EU27 nations, and many workers are deciding that it is no longer economically viable for them to remain in the UK due to changes in the exchange rate. Several careworkers have told me in tears that they no longer feel welcome in this country, which is horrific and should make us all feel a sense of great shame, but that is the reality. People face racist remarks in our country today despite decades of service to the most vulnerable in society. We cannot afford to lose them. We need to set out what will happen to ensure that the people in this workforce, many of whom will not meet the income thresholds, will be able to come here, share their skills with us and be welcomed.

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26 SEP 2019

Compliance with the European Union (Withdrawal) (No. 2) Act 2019

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

The terms of the Benn Act are very clear, but so too is its intended purpose and spirit. The Minister has not been asked today whether the Government and the Prime Minister want to comply with the terms of the Act. He has been asked a very specific question: if, by 19 October, the House has not agreed to a deal or no deal, will the Prime Minister write the letter asking for an extension, as set out in the Benn Act? Can he answer yes or no, because I am afraid we have no clarity at all on that specific question today?

James Duddridge Chair, High Speed Rail (West Midlands - Crewe) Bill Select Committee (Commons) , The Parliamentary Under-Secretary of State for Exiting the European Union

We will obey the law.

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25 SEP 2019

Legal Advice: Prorogation

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

What message does the Attorney-General have for his colleagues in government who have been smearing and undermining the Supreme Court judges? Some of this is not done in the heat of the moment: we have been hearing from one journalist that he has been sent copies of articles about Iranian judges, comparing Supreme Court judges to them. Is he going to give an unequivocal message to his colleagues that they should resign if they undermine the Supreme Court's independence?

Geoffrey Cox The Attorney-General

The judges do not exist immune from criticism. There is nothing wrong at all in any member of the public, be it a Member of Parliament or otherwise, criticising a court judgment, but what is wrong is that motives of an improper kind should be imputed to any judge in this country. We are defenders of the entire democratic constitution and we must be sure, in everything we say—I agree with the hon. Lady if this is what she means—that we do not impute improper motives. With the judgments, we can be robustly critical; with the motives, we cannot.

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09 SEP 2019

Points of Order

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

On a point of order, Mr Speaker. Thank you for being one of the great reforming Speakers; it is you who is trying to take back control for this Parliament, and others should learn from your example. You have also been a great champion of Select Committees, and, as Chair of the Liaison Committee, I would like to thank you for that. You have also been a champion of allowing Back Benchers to hold the powerful to account. That is what my point of order is about now, and it is further to a previous point of order. Not only are NHS staff entitled to raise genuinely held concerns about patient safety, but they have a duty to do so, and they must be able to do this without fear of intimidation or bullying from people in positions of power, including Members of this House. Last week, the Leader of the House made highly offensive comments about Dr David Nicholl. I reiterate: unless the Leader of the House comes to this place to make an apology from the Floor of the House, what message does that send to NHS whistleblowers and what does it mean for patient safety?

John Bercow Speaker of the House of Commons, Chair, Speaker's Committee on the Electoral Commission, Chair, Speaker's Committee for the Independent Parliamentary Standards Authority, Chair, Commons Reference Group on Representation and Inclusion Committee

I thank the hon. Lady for what she has said. She is an extremely distinguished denizen of the House, both in respect of her constituency work and of her chairing of very important Committees—the Health and Social Care Committee and the Liaison Committee. She speaks with considerable authority and gravitas by virtue of those roles and the reputation she has garnered. I do not want to pick an argument with the Leader of the House—he and I get on extremely well—but points have been made and the hon. Lady has underlined them. If she is dissatisfied, my advice to her is the advice I regularly give to Members wanting to know how they can take a matter forward—the word begins with "p" and ends in "t. My advice is: persist, persist, persist. There is nothing to prevent her from returning to the matter when we come back after the conference recess. On the Conservative Benches, Dr Lewis, who is not in this place—I believe he is chairing various Committees this afternoon or attending Committee meetings—taught me decades ago that in politics quantity, persistence and, above all, repetition are at least as important as the quality of your argument. It is not good enough to have a good point and make it once—you have to keep going. If I may say so, at the risk of causing some disquiet on grounds of courtesies, I would suggest to the hon. Lady that she should follow the Churchill adage in pursuit of her cause: KBO—keep buggering on—at all times.

................

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

On a point of order, Mr Speaker, on behalf of the Liaison Committee. The Prime Minister gave an undertaking that he would appear before the Committee this Wednesday at 3.30 pm. The Committee met today, and we have written to the Prime Minister asking whether he will still appear, because—

John Bercow Speaker of the House of Commons, Chair, Speaker's Committee on the Electoral Commission, Chair, Speaker's Committee for the Independent Parliamentary Standards Authority, Chair, Commons Reference Group on Representation and Inclusion Committee

Order. I recognise the hon. Lady's sincerity and the strength of her conviction. If she wishes to contribute to the debate in an orderly way, on her feet, in a speech, because she has caught my eye, she can do so, but she should not use the device of a bogus point of order.

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05 SEP 2019

Department for Environment, Food and Rural Affairs: Agriculture: Subsidies

Written Answer

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

To ask the Secretary of State for Environment, Food and Rural Affairs, what steps the Government has taken to reduce the complexity of environmental schemes for land holders.

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

The Rural Payments Agency (RPA) took on responsibility for Environmental Stewardship and Countryside Stewardship schemes in October 2018, and has introduced a number of measures on agri-environment schemes to make it easier for farmers and land managers to apply and make it simpler for them to administer.

The RPA has made improvements to the online service, including making more offers available to apply for online and allowing applicants to download application packs. It has simplified both the rules regarding the evidence we require and the guidance manuals. In addition the RPA has made changes to the processing cycle which has reduced completion times for applications, agreements, claims and payments.

Looking forward we are considering ways to drive further online uptake, make improvements to the information on GOV.UK, and whether there are further simplifications we can make to the scheme to support the transition to a new Environmental Land Management Scheme, subject to exit negotiations and funding.

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04 SEP 2019

European Union (Withdrawal) (No. 6) Bill

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

Three independent and highly respected bodies—the Health Foundation, the Nuffield Trust and the King's Fund—have written an open letter to all MPs setting out in stark terms how there would be significant damage to health and care services from a no-deal Brexit and, more importantly, to the people who depend on them—the people we are supposed to be in the House to protect.

Hilary Benn Chair, Committee on Exiting the European Union

I agree with the hon. Lady. Other Members will have lots of other experience of the potential consequences. These are not risks that we should take with our economy, businesses, jobs, livelihoods and health. I hope these risks remind everyone in the House that, for all the focus on process, motions and procedure, this debate is about the impact that a no-deal Brexit would have on the lives of the people we represent.

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04 SEP 2019

Spending Round 2019

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

This morning I met with NHS trust leaders from around the country; they painted an absolutely shocking picture of infrastructure that is crumbling, unsafe and broken. They welcome the unfreezing of £1 billion so that they can get on and fix some of that, but it does not go far enough; there is a £6 billion backlog, and they are asking for us to reach the levels of comparable countries in spending on NHS infrastructure. Will the Chancellor meet me to discuss their serious concerns and the measures that we need to take to move this forward?

 

Sajid Javid The Chancellor of the Exchequer

I thank the hon. Lady for welcoming one of the changes I made a few weeks ago, which was to unlock or bring forward £1 billion of new capital investment in our hospitals and an additional fresh £850 million on top of that to upgrade 20 hospitals. She makes an important point, but today's announcement is about day-to-day resource spending whereas she is talking about another important area, which is capital. I will make sure she gets the meeting with Ministers she wants.

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03 SEP 2019

Food and Rural Affairs: Agriculture: Subsidies

Written Answers

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

To ask the Secretary of State for Environment, Food and Rural Affairs, with reference to the statement entitled Health and harmony: the future for food, farming and the environment in a green Brexit, published in September 2018, what steps his Department is taking to limit the costs for small land owners of the future environmental land management scheme.

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

The Agriculture Bill constitutes the first major agricultural reform in the UK for almost 50 years. It will allow us to break from the rules of the EU's Common Agricultural Policy and presents a unique opportunity to devise a new Environmental Land Management system where the Government will work with farmers, land managers, environmental experts and stakeholders to test and trial new approaches and investigate innovative mechanisms for delivery of environmental outcomes.

Small farmers and land owners will be well placed to benefit from any future scheme.

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03 SEP 2019

Sheep Farming: No-deal EU Exit

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

This will certainly devastate the hill farmers in my constituency, but we must also consider the impact that it would have on the landscape. Many people do not realise that our landscapes are the way they are because of grazing.

Jenny Chapman Shadow Minister (Exiting the European Union)

The hon. Lady makes an excellent point, and that is why even my constituents in urban Darlington care about what happens to our national flock and to the livelihoods of the tens of thousands of people who work so hard to keep our landscape the way that it is.

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25 JUL 2019

Priorities for Government

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

I warmly welcome the inclusion of social care in the Prime Minister's list of priorities for his Government. As he will know, there is the thorny issue of how we should pay for it. Two Select Committees of this House have worked together with a citizens' assembly to reach consensus on how we should fund this fairly. Will the Prime Minister meet me and Mr Betts to discuss how we reach a consensus and get it done

Boris Johnson The Prime Minister, Leader of the Conservative Party

I thank the hon. Lady, and I will of course make sure that I study the suggestions she has made in her reports. They will of course be taken into account as we come forward with a solution—a plan—for social care.

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24 JUL 2019

Point of Order

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

On a point of order, Madam Deputy Speaker. It is very rare for this House to find a named individual in contempt of Parliament, and to agree unanimously to admonish them. It would surely be a disgrace for Dominic Cummings to be rewarded, despite being found in contempt, with a post as senior adviser to the incoming Prime Minister. In opening the debate on the motion to admonish on 2 April, the Government stated that they had

"full respect for the privileges of the House of Commons and will continue to uphold them. They are crucial to the independence of Parliament and the strength of our democracy."—[Official Report, 2 April 2019;
Vol. 657, c. 942.]

Together with the Chair of the Committee of Privileges, Kate Green, who unfortunately had to leave for another engagement, I seek your advice, Madam Deputy Speaker, on whether the appointment of Mr Cummings would undermine that commitment to respect the House.

Eleanor Laing Deputy Speaker (First Deputy Chairman of Ways and Means)

I thank the hon. Lady for her point of order, and for her courtesy in giving me notice of it. She will know very well that the appointment of persons to official positions at Downing Street or elsewhere is not a matter that can be addressed by the Chair, but resolutions of this House are a matter of concern to the Chair. I can confirm that the House passed a resolution on 2 April that said, in terms, that Mr Cummings

"committed a contempt both by his refusal to obey" a

"Committee's order to attend it and by his subsequent refusal to obey the House's Order of 7 June 2018"—[Official Report, 2 April 2019;
Vol. 657, c. 941.]

and the House therefore formally admonished him for his conduct.

The hon. Lady has drawn this important matter to the attention of the House and, indeed, the Government, and although I can give her no further help at this moment, I am quite sure that she will find a way of pursuing her concerns. Not least, the matter is in her own hands when she chairs the Liaison Committee. I am quite sure that she will find a way of taking this matter forward, which would be quite proper.

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22 JUL 2019

Housing: Electricity

Written Answers

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

To ask the Secretary of State for Business, Energy and Industrial Strategy, what assessment he has made on the cost effectiveness of installing three-phase electricity supplies in (a) new and (b) existing homes.

Chris Skidmore Vice-Chair, Conservative Party, Minister of State (Department for Business, Energy and Industrial Strategy) (Universities and Science) (Joint with the Department for Education)

Department for Business, Energy and Industrial Strategy indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

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

To ask the Secretary of State for Business, Energy and Industrial Strategy, what assessment he has made on the feasibility on subsidising the cost of upgrading single-phase electricity suppliers to three-phase electricity suppliers to support people to make their homes carbon neutral.

Chris Skidmore Vice-Chair, Conservative Party, Minister of State (Department for Business, Energy and Industrial Strategy) (Universities and Science) (Joint with the Department for Education)

Department for Business, Energy and Industrial Strategy indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

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15 JUL 2019

Health Select Committee

This week, I visited Frankfurt with the Health and Social Care Committee to hear how they saved lives through a public health approach to drugs policy including drug consumption rooms and how they focused on prevention and harm reduction for both users and the wider community.

 

 

We then visited Portugal where we heard from drug users, community projects, clinicians, academics and politicians on how a health and harm reduction approach to drugs policy has saved thousands of lives and reduced stigma and other problems across criminal justice system.

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10 JUL 2019

Disability: Children

Written Answers

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

To ask the Chancellor of the Exchequer, what plans he has to increase support for parents who care for disabled children at home.

Elizabeth Truss The Chief Secretary to the Treasury

Child Disability Living Allowance (DLA) is a benefit for children under the age of 16 who, due to a disability or health condition, have mobility issues and/or require substantially more care, attention and supervision than children their age normally would. If a parent or carer is claiming Child Tax Credits (CTC) and their child is in receipt of DLA, they are also eligible for additional premiums on their award and for childcare support. Parents of disabled children may be also able to claim Carer's Allowance.

Universal Credit is designed to ensure that work pays and the most vulnerable in society are protected, making the system fair for claimants and those who are able to support themselves solely through work. The increased work allowance in Universal Credit from April 2019 is assisting 2.4 million working families, with children or with a disability, to become better off by £635 per year.

The government is committed to protecting and supporting the most vulnerable in society. It is for that reason the government has continued to uprate disability and carer benefits by inflation, including the disability elements of tax credits.

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10 JUL 2019

Climate Change, the Environment and Global Development

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

Has the hon. Lady's Committee looked at the issue of three-phase electricity supply to homes? One of my constituents is keen to invest in solar and Tesla-style wall plugs so that they can recharge vehicles and so on, but the cost of installing the necessary three-phase electricity supply is a problem. Does she feel that that would be a better area for the Government to invest in and allow us to expand renewables?

 

Rachel Reeves Chair, Business, Energy and Industrial Strategy Committee

Electric vehicles have been discussed quite a bit already today, and much more could be done to encourage people to buy them and to make it easier for people to charge them, as well as to get the charging infrastructure in all communities, including more rural ones.

Our Committee has produced several reports over the last few years on practical things that the Government could do. It has been disappointing at times that our recommendations and suggestions are often rejected by Ministers, when if they had accepted them, we might be a little closer to meeting some of our objectives. On electric vehicles, our Committee recommended that the target of 2040 be brought forward to 2032, and that was before the Government committed to net zero.

The Committee on Climate Change today said:

"The 'Road to Zero' ambition"— which the Minister is obviously proud of—

"for a phase-out of petrol and diesel cars by 2040 is too late and plans to deliver it are too vague. A date closer to 2030 would save motorists money, cut air and noise pollution and align to the net-zero challenge."

I urge the Minister to look at the evidence from the Committee on Climate Change, and the evidence that our Committee took, which points resolutely to the need to bring forward the date for phasing out the internal combustion engine.

While we welcome decisions by companies such as Jaguar Land Rover to invest in a new fleet of electric vehicles, we need to do more to work with our car manufacturing industry to turn the Faraday Institution's ideas and research into practical applications that can revive our British car industry and keep more jobs here, while not polluting the planet in the way that the car industry has in the past.

Everybody who gave evidence to our Committee said that there is no way that we would meet even our previous targets without the roll-out of carbon capture and storage. But we are still waiting for Government decisions on investment in that industry, so that we are not just doing the research and development in labs, but are trialling it and piloting it in some of our communities. That goes back to the point that Derek Thomas made earlier about communities all over the country. The communities that stand to benefit most from carbon capture and storage are in the north-east, Humber, Merseyside, south Wales and Fife, for example—all areas that desperately need jobs and investment. If the Government unlocked the funding, which they have previously cut, they could ensure more good-quality jobs all over the country while contributing to reducing our carbon emissions.

Our Committee has also just concluded a report on energy efficiency, which we will publish soon. Without giving away the findings—my Clerk might be watching—we heard a lot of evidence that the homes we are building today will need to be retrofitted in years to come because they are not of a high enough energy efficiency standard. It seems nonsensical that we know we are building homes today that will have to be retrofitted in future. Those who got planning permission on a development five or 10 years ago only have to meet the energy efficiency rules and regulations from when they got that planning permission, not those in place today. If we just fixed those things, we would be building homes that do not contribute to global warming in the way that they do today.

The Committee also heard evidence that since the Government scrapped the green new deal, improvements to existing housing stock are just not happening. They are not happening in social housing, the private rented sector or the owner-occupied sector. Unless that happens, we have no chance of meeting the net zero commitments. I urge the Government to look at that when our report is published, and not reject our conclusions and recommendations, which happens far too often, but engage with them, adopt them and put them in place. Only by doing that do we have any chance of meeting the targets that we all say we want to achieve.

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09 JUL 2019

Devon Police and Fire Rescue

I met today with the Devon Police and Fire Rescue operational experts to hear how Devon and Cornwall are leading the way in blue light innovation with community responders, tri service officers and Police and Fire Community Support Officers.

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09 JUL 2019

Smoking

Written Answers

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

To ask the Secretary of State for Health and Social Care, with reference to the July 2017 tobacco control plan for England, when the Government plans to announce a date for achieving its smokefree generation target of smoking prevalence at 5 per cent or below.

 

Seema Kennedy The Parliamentary Under-Secretary for Health and Social Care

The Government's vision, as set out in the Tobacco Control Plan for England published in 2017, is to create a smokefree generation by reducing adult smoking prevalence to 5% or below. The current smoking rates for England are 14.4%, the lowest on record. The Government has not yet committed to a date by which to achieve a smokefree generation but continues to keep progress on reducing prevalence under close review.

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

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that tobacco companies have no involvement in (a) smoking cessation services and (b) public health campaigns.

Seema Kennedy The Parliamentary Under-Secretary for Health and Social Care

The United Kingdom is a signatory to the World Health Organization's Framework Convention on Tobacco Control (FCTC). The Government takes very seriously its treaty obligations, including the commitment under Article 5.3 to protect public health policies with respect to tobacco control from commercial and other vested interests of the tobacco industry. It expects all public bodies to follow comply with the FCTC Secretariat's guidance on this Article.

To remind the National Health Service of this commitment, NHS England issued a note to clinical commissioning groups (CCGs) in the CCG bulletin dated 26 July 2018. Public Health England (PHE) has also written to local authorities and Directors of Public Health advising against such partnerships, a message reiterated in the PHE blog. The blog is available to view at the following link:

https://publichealthmatters.blog.gov.uk/2018/01/05/duncan-selbies-friday-message-5-january-2018/

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09 JUL 2019

Active Travel

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

We have heard the environmental, health and economic cases for cycling. I fell in love on a tandem and I am still cycling 40 years later, so perhaps I should add that there is a case to be made for cycling's benefit to your love life, and for the sheer joy of cycling.

We need to focus on how to make cycling happen. We should look across the water to see how it is done elsewhere. There is a formula to it: it requires consistent, long-term political support both locally and nationally, and the right funding. We spend £7.50 per person on it, but other countries, where this works and cycling has been transformed, spend between £10 and £35 per person. Will the Minister therefore continue his predecessor's commitment to the ambition of doubling per-person investment in cycling? That is what we need.

When we have that level of spend, we can go to the next stage: ensuring that councils can employ people to develop expertise in the long term to put these schemes in place. We need consistent rather than stop-start funding. One of the problems with competitive bids for funding is that some areas do very well, but others, such as mine, lose out altogether. We need much more consistency, so that we do not focus, as others have said, just on cities or even towns, but look at rural areas.

We need to spend not just on infrastructure, but on services and maintenance for our network, and to join up the network. Disgracefully, in my area there is still a gap in national cycle route 2, partly because of the prejudice cyclists sometimes face. For example, a bridge, half of which was paid for with public money, is still blocked to cyclists unreasonably by its owner, South Devon Railway. That prevents a critical join-up. I would like councils to have the power to sweep some of this nonsense out of the way, because this has been going on for more than nine years.

We need to fix those problems and join the network up, and look at links with other infrastructure, such as the rail network. We must also look at traffic calming. There are 20 mph speed restrictions on 75% of the network in urban areas, and they work. We should look at that, and at introducing traffic calming in rural areas where we have quieter routes for cyclists.

We know what works. Will the Minister look at the evidence base and assure us that we will implement what we need if we are really to have a revolution and get people to enjoy the benefits of cycling?

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09 JUL 2019

Justice

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

What assessment has the Minister made of the delays and errors at the Cardiff probate office, because what used to take a matter of 10 working days for my constituents is now taking months? Can he set out exactly what is causing the delays and, more importantly, what can be done to reduce them?

 

Paul Maynard The Parliamentary Under-Secretary of State for Justice

As I said at the start of Question Time, it is wrong that people in a state of bereavement are having to wait so long for these matters to be addressed. In May the average waiting time was eight weeks, and it has now decreased to six or seven weeks. I intend to keep working with Her Majesty's Courts and Tribunals Service to keep that downward trend and bring waiting times back to the traditional two to three weeks.

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09 JUL 2019

Ministry of Justice: Probate

Written Answer

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

What recent assessment he has made of the effectiveness of the probate system.

 

Paul Maynard The Parliamentary Under-Secretary of State for Justice

Waiting times in the probate service have recently increased. However, following urgent action by the courts service, they are now starting to improve.

The temporary delays were the result of more work coming into the system and the impact of the initial move to a new IT system for managing probate work.

Now that move is complete, and the unusually high workload has been dealt with, we expect waiting times to continue to improve – and be back to normal levels in the coming weeks.

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08 JUL 2019

NHS Pensions: Taxation

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

This matters first and foremost because of the impact on patient care, not only through increased waiting times in hospitals but in patient's ability to see a general practitioner out of hours. May I stress the urgency of the situation, as others have? Patients cannot afford to wait for the extended process of finding a new leader of the Conservative party.

May I briefly flag up another issue? One of my constituents, who wrote to me recently to say that he had requested an update on his pension, was told that it would take three months. He was then informed that Primary Care Support England had not updated his pension records for three years and that he would have to wait a further three months once they had been updated. Will the Minister also look at the delays facing doctors trying to get an update on their situation?

Elizabeth Truss The Chief Secretary to the Treasury

I thank the hon. Lady for her question. I will raise that matter with the Health Secretary. It is for the NHS to make sure that its pensions are properly administrated. As I have said, we are dealing with this issue urgently. We are not waiting for the election of a new Conservative Prime Minister to do that. My point about a new Prime Minister was that general tax and pension reforms are not likely to be happening in the next two weeks.

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04 JUL 2019

GP Trainers Group

Thank you to the GP Trainers Group for meeting today to discuss Primary Care, GP networks, continuity of care and access, workforce pressures, NHS long term plan, IT, pensions and so much more. It is always helpful to catch up with expertise from the front line

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04 JUL 2019

Brixham Harbour and Fisheries

Written Answer

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

To ask the Secretary of State for Environment, Food and Rural Affairs, whether he has plans to direct the £10 million funding allocated to the South West announced in the 2018 Budget to (a) the fishing industry and (b) the redevelopment of Brixham harbour.

Robert Goodwill The Minister of State, Department for Environment, Food and Rural Affairs

As announced in the 2018 Budget, the Government is investing £10 million from BEIS's allocation of the National Productivity Investment Fund for Research and Development to enhance the productivity and sustainability of fisheries and seafood industries across the whole of the UK. The Seafood Innovation Fund will disburse this money and help transform the industry to ensure the UK is a world leader in safe, sustainable and productive fishing. BEIS has asked Defra and Cefas to deliver this funding on behalf of UK Research and Innovation, given the specialist knowledge and understanding required to make the most of this opportunity. Details of the design of the fund are currently being finalised to ensure value for money and we expect the fund to launch shortly.

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02 JUL 2019

Air Pollution

Written Answers

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

To ask the Secretary of State for Environment, Food and Rural Affairs, what steps his Department is taking to ensure co-operation with the EU on tackling air pollution after the UK leaves the EU.

Therese Coffey The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs

The UK remains a signatory to the 1979 United Nations Economic Commission for Europe Convention on Long-Range Transboundary Air Pollution, and will continue to be at the forefront of international action and cooperation to tackle transboundary air pollution alongside the EU.

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

To ask the Secretary of State for Environment,Food and Rural Affairs what steps he is taking to promote cross-departmental collaboration on adopting World Health Organisation standards for fine particulate matter.

Therese Coffey The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs

The Clean Air Strategy sets out our commitments to take bold action across all parts of Government to achieve reductions in air pollution. We are committed to the setting of an ambitious long term target to reduce population exposure to PM2.5. Defra continues to work closely with other Government departments and agencies to deliver the Strategy.

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02 JUL 2019

Business Premises

Written Answers

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

To ask the Secretary of State for Housing, Communities and Local Government, what assessment he has made of the effect of disregarding restrictive covenants or planning conditions intended to prevent a domestic residence from operating a business from that premises when taking a decision to transfer a domestic dwelling from council tax to Uniform Business Rate.

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

To ask the Secretary of State for Housing, Communities and Local Government, what guidance his Department has provided to the Valuation Office Agency on dealing with restrictive covenants or planning conditions which apply to domestic dwellings and are intended to prevent any business from operating from such a domestic dwelling when making decisions regarding the transfer of a domestic dwelling from council tax to Uniform Business Rate lists.

Rishi Sunak Parliamentary Under-Secretary (Housing, Communities and Local Government)

The Valuation Office Agency decides whether a property should be subject to council tax or non-domestic rates. The Agency is an executive agency of HMRC and operates independently of Ministers. In reaching a view on the most appropriate listing, the Agency has regard to the relevant provisions of the Local Government Finance Act 1988. I understand that the Agency would not normally take account of whether the use is consistent with planning or other restrictions, rather it would be guided by the facts pertaining to the occupation of the property.

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01 JUL 2019

Royal College of Pyschiatrists

Today I spoke at the International Congress of the Royal College of Psychiatrists. There has never been a time where we are more in need of experts. We must never underestimate the importance of face to face contact.

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27 JUN 2019

Electric Scooters

Written Answer

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

To ask the Secretary of State for Transport, what assessment the Government has made of the increase in use of electric scooters on roads.

Andrew Jones Parliamentary Under-Secretary (Department for Transport), Vice-Chair, Conservative Party

In the UK, powered transporters, also known as micromobility devices, are treated like any other motor vehicle under the Road Traffic Act. This includes e-scooters, and means they are subject to laws requiring them to be built and used safely, including requirements for users to have insurance, driving licences, number plates, and helmets.

It is therefore, illegal to use a powered transporter on a public road without it complying with these legal requirements. At present, it will be difficult for electric scooters to meet these requirements. It is also illegal to use a powered transporter in spaces which are set aside for use by pedestrians, cyclists, and horse-riders. This includes on the pavement and in cycle lanes.

We are currently exploring how new technologies, such as e-scooters, could help the UK benefit from changes in how people, goods and services move around and possible barriers to securing those benefits.

The Future of Mobility Urban Strategy, published on 19 March 2019 includes a Regulatory Review to address the challenges of ensuring our transport infrastructure and regulation are fit for the future.

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26 JUN 2019

Climate Change Rally

Thank you to everyone who came to London today from across the Totnes constituency to lobby for urgent action on the climate and environmental emergency

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25 JUN 2019

Environment Protection

Written Answer

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

To ask the Secretary of State for Environment, Food and Rural Affairs, what assessment his Department has made of the effectiveness of the role of Natural England in helping farmers to improve their environment.

Therese Coffey The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs

The Department regularly reviews Natural England's performance including via formal Ministerial review. Natural England is required to report progress to Defra's supervisory board and the Secretary of State.

Natural England plays an important role in delivering the 25 Year Environment Plan, providing advice to help farmers to improve their environment. Natural England advisers provide valuable advice on how to effectively manage wildlife and habitats, promoting nature conservation and protecting biodiversity. This includes advice to help landowners set up agri-environment agreements and aftercare advice during the lifetime of the agreements, as well as for other projects that such as the 'Back to the Brink' species recovery project, supported by the Heritage Lottery Fund and other charitable organisations.

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24 JUN 2019

Sense

I recently met with representatives from the disability charity, Sense. One of their ongoing campaigns- 'When I'm gone', focuses on the families of those living with disabilities. Sense estimate that there are 1.7 million disabled adults being cared for by family or friends. It is also true that there are currently 2 million carers in England and Wales who are aged 50-64 and 1.3 million carers aged 60 and over. I know how important it is to families to have plans in place for the future and Sense found that this is also something that disabled adults are seriously concerned about.

81 per cent of disabled adults said that they worried about how they would manage their day-to-day life without the support of family and friends.

I am deeply concerned about the future of social care provision and will continue to do everything I can in Parliament to highlight the importance of this and to call on government to get on with their promise to find a sustainable long term settlement.

We need to provide the peace of mind families need, but also to help make it easier for disabled people with complex needs and their families to have timely arrangements for their future care in place.

To read more about this campaign or to download the very helpful toolkit, please click here.

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24 JUN 2019

Social Rented Housing: Regulation

Written Answers

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

To ask the Secretary of State for Housing, Communities and Local Government, what assessment he has made of the implications for his policies of recommendations for a new Social Housing regulator in the report entitled A Vision for Social Housing published by Shelter.

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

To ask the Secretary of State for Housing, Communities and Local Government, what assessment his Department has made of the potential merits of the recommendation in the Shelter report entitle of, A vision for social housing, to establish a consumer protection regulator for social renters alongside an economic regulator of social housing.

Kit Malthouse Minister of State (Housing, Communities and Local Government)

Nothing is more important than ensuring people are safe in their homes. Residents' voices need to be heard to ensure proper standards are maintained and that where things are going wrong they are picked up and addressed. We want to ensure that there is a coherent and consistent approach to regulation to deliver these objectives, and achieve the best deal for tenants and landlords. Our review of social housing regulation is exploring the most appropriate way of doing so, and we will publish the results of that review in due course.

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24 JUN 2019

Climate Change

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

I would really welcome an earlier shift towards electric cars and electric bikes, but is it not the case that, where possible, we really need to be getting people out of their cars altogether and encouraging greater use of cycling and walking? Will the Minister assure me that there will be increased investment in cycling and walking?

 

 

Chris Skidmore Vice-Chair, Conservative Party, Minister of State (Department for Business, Energy and Industrial Strategy) (Universities and Science) (Joint with the Department for Education)

I will get back to my speech in a moment. It is important that the Government are able to set out a pathway for considering the range of responsibilities across society, and that will encourage a range of individual actions. The Committee on Climate Change is the lead independent committee whose advice the Government have taken in order to legislate today. It has set out a range of future possibilities to reach net zero, many of which include individual actions for reaching the final 4%, but this is about system change and decarbonising our energy and heating systems, both domestically and industrially. There are a large number of areas where we will need to take action across society, and we need to be able to take that action now.

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24 JUN 2019

European Council

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

Anybody listening to the Prime Minister's statement will be struck by the importance of the issues raised at the Council, and also by the loss that we will have as a nation by not having a seat around the table in future. In her reply to Chris Bryant, she said that it is a matter for her successor whether he takes up to seven weeks before he comes to this House. Is it not the case that the Government could reset the recess dates that are on today's Order Paper to make sure this House has an opportunity to question her successor on his policies, which have a huge bearing on the issues in her statement?

Theresa May The Prime Minister, Leader of the Conservative Party

The hon. Lady will have an opportunity to consider this matter in the debate on the motion on the recess dates that is coming before the House later today.

........

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

On a point of order, Mr Speaker. The Prime Minister has just clarified that there will be no opportunity to debate the motion on the summer Adjournment dates. This is an extremely grave matter. About 0.25% of the population will be selecting the next Prime Minister at a crucial time in our history. Is there anything you can do to make sure that the House has an opportunity, when other Members are here, to properly debate this issue and make sure that the next Prime Minister can be held to account by this House without there being an extended period of summer recess in the way?

John Bercow Speaker of the House of Commons, Chair, Speaker's Committee on the Electoral Commission, Chair, Speaker's Committee for the Independent Parliamentary Standards Authority, Chair, Commons Reference Group on Representation and Inclusion Committee

I am grateful to the hon. Lady and most certainly understand her concern. I want to offer her two responses. First, it is perfectly open to Members if they disapprove of the motion to vote against it. They are not obliged to accept it; they can oppose it. Secondly, although I do not myself know at this stage what is in the minds of Ministers today, or what was in their minds at the time of the tabling of the motion, since I am not psychic and it was not something they discussed with me or would ordinarily have been expected to discuss with me, I can tell her something that may be of interest to her.

I have been assured that there is no intention on the part of the Government to prevent the new Prime Minister from appearing before the House before it rises for the summer recess. The Leader of the House had his first outing relatively recently on a Thursday morning at business questions, and as he addressed the House the Government Chief Whip approached me, unsolicited but on the back of a number of queries about Prorogation and the timescale for the announcement of the new Prime Minister, specifically to tell me—as I say, unsolicited—that the Government had no intention of doing that.

The Government Chief Whip told me that he judged it most important that that not be the case. I am merely faithfully reporting what he told me on that occasion. If there has been some change in thinking, I am sure the Government would wish to communicate that to the House. I think it very important that there be some clarity about the Government's intentions beyond simply the motion, which is a procedural motion, sooner rather than later, not because that is a matter of procedural necessity but because it is a matter of parliamentary courtesy.

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19 JUN 2019

Social Rented Housing

Written Answers

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

To ask the Secretary of State for Housing, Communities and Local Government, what assessment he has made of the potential merits of the establishment of a new regulator for social housing.

Kit Malthouse Minister of State (Housing, Communities and Local Government)

The Ministry of Housing, Communities and Local Government has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

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

To ask the Secretary of State for Housing, Communities and Local Government, what assessment he has made of the potential merits of introducing (a) proactive and (b) regular inspections to increase standards in the social housing sector.

Kit Malthouse Minister of State (Housing, Communities and Local Government)

The Ministry of Housing, Communities and Local Government has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

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18 JUN 2019

Male Suicide

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

Sharing information saves lives when it comes to suicide prevention, but families are too often unnecessarily excluded because clinicians may be unaware of or do not follow the consensus statement guidance on seeking consent and sharing information in the patient's best interests. I thank the Minister for meeting me and the National Suicide Prevention Alliance recently. She will know that the Matthew Elvidge Trust has highlighted the importance of how consent is sought, and it has suggested the following wording:

"In our experience, it is always much better to involve a family member, friend or colleague whom you trust in your treatment and recovery... This will result in you recovering much quicker. Would you like us to make contact with someone and would you like us to do this with you now?"

The Minister will agree that there is a huge difference between that and just asking someone whether their mum can be phoned. Will the Minister set out how she will raise awareness of the consensus statement?

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

I am grateful to the hon. Lady for her continued interest in this matter. She will recognise the cultural challenge of encouraging all practitioners in the NHS to embrace the change, because we quite rightly have a culture in which discretion is paramount. Practices are in place to encourage information sharing, and I highlight our support for the Zero Suicide Alliance—£2 million was provided last October—and central to its work will be spreading understanding of the consensus statement throughout the NHS.

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13 JUN 2019

Transport: Cycling

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

What steps he is taking to increase the uptake of cycling as a means of transport.

 

 

Michael Ellis Minister of State (Department for Transport)

The Government are committed to increasing cycling and walking, and to making our roads safer for cyclists and pedestrians. Spending per head on cycling and walking has more than trebled since 2010, and about £2 billion is now being invested in cycling and walking over the current Parliament. That is helping to fund new infrastructure in many towns and cities.

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

I am sure that the whole House will wish to join me in wishing the very best to Chris Froome.

I welcome the removal of the cap from the Cycle to Work scheme, but many of the people who could benefit most from e-bikes are not in work. What will the Minister do to support the use of e-bikes and non-standard pedal cycles by older people and those with disabilities? Will he meet me to discuss how we can create a safer infrastructure to encourage such use, particularly in my constituency, where there has been a long-standing block to the Littlehempston to Totnes cycleway?

Michael Ellis Minister of State (Department for Transport)

I shall be happy to meet the hon. Lady, and I extend similar sentiments to Chris Froome.

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12 JUN 2019

South Devon College

It was lovely to catch up with ⁦South Devon College Principal Stephen Criddle in Parliament today

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10 JUN 2019

Cystic Fibrosis Drugs: Orkambi

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

I thank my constituent, Cathy Meredith, who started this petition. I also thank Oli Rayner and the many others living with cystic fibrosis who, sadly, cannot be in the Public Gallery with us today because cystic fibrosis is such a curiously isolating condition—those suffering from it cannot be in the same room as others because of the risk of transmitting resistant infections.

I will start with some context on the cause of cystic fibrosis, which is a mutation in the cystic fibrosis transmembrane conductance regulator gene, affecting the production of a protein that in turn has consequences for the balance of salts and fluids moving across membranes, leading to an accumulation of thick, sticky mucus in the lungs and other organs. The point, however, is that although 10,000 people in the UK live with cystic fibrosis, it is not really a single condition: there are many mutations of the CFTR gene. That has consequences for the types of medication to which people will best respond. We need to think of cystic fibrosis not only as a rare genetic condition but as a series of much rarer conditions. That is important to note.

We now have some real hope for progress with the CFTR modulators, but we need to make that progress much more rapidly than we are. The negotiations between Vertex and NHS England have dragged on for far too long. The patients living with cystic fibrosis and their families, have been lost in those discussions. We need not only to return to thinking about them, but to bear in mind the implications that go far beyond those living with cystic fibrosis.

The NHS has a responsibility to consider the wider cost of drugs, including the opportunity costs—what we cannot treat if our NHS budget is consumed completely by the ever-rising cost of drugs. For the NHS to have that responsibility is a tough message for all of us, which is why we need bodies such as NICE to make the decisions to ensure fairness for all patients who rely on NHS resources. To put that in context, the drugs budget in 2017-18 was £18.2 billion. A little more than half of that was for hospital drugs and, over the past seven years, the costs of those drugs have increased by 119%. We therefore have to bear in mind the implications of taking a free-for-all approach to drugs costs, which the Minister will not want to do.

The Government are trying to get the parties around the table. Unfortunately, the gap is huge between what Vertex continues to demand for the drugs and what the NHS is offering based on recommendations from NICE. The gap is not small; it is considerable. Other companies have come to the table to negotiate their prices, so I call on Vertex to look again at what is happening. It is absolutely disgraceful that families have to resort to such things as buyers' clubs; the inequalities that that creates are horrific. We need Vertex to focus on what is happening.

I am also concerned about some of the points made during our Health and Social Care Committee inquiry into Vertex. For example, we asked the company directly whether drug supplies had been destroyed because they were going off date, and we were told that that was not the case and was very unlikely to happen—but it has been happening. That is wholly unacceptable.

To come back to the alternatives, Kerry McCarthy touched on the issue of Crown use licences, for example. One of the areas that our Committee considered was possible referral to the Competition and Markets Authority. In fact, we have now heard that that would take many years, so unfortunately the area does not look like one we can pursue further. However, given so little progress since our inquiry, the Committee wrote to all the parties involved in the negotiations—NHS England, Vertex and NICE—to ask where we are now.

The most promising idea that we should take forward to apply pressure is that of interim agreements, such as in Scotland. An interim price is agreed, further research is carried out and all parties agree to a review based on the outcomes of that further research. That is being managed in Scotland and other places, as we have heard from other speakers today, and I urge Vertex to do that here. We all recognise the need for a fair price to enable further research to take place. We all recognise that many other drugs are in the pipeline, particularly a very promising triple therapy, which NHS England has now agreed to take off the table so that it does not distort future pricing. That is a sensible thing to do at this stage, so that within the current offer we look just at the three existing treatments. At a later stage, we can come back to look at the triple therapy evidence. I urge all parties to come to an interim agreement at least, and to continue to put patients front and centre in everything they do.

Finally, I would like to touch on the political aspect, because both President Trump and US Secretary of State Azar have repeated referred to using their muscle in trade negotiations to increase the price that European countries would have to pay for their drugs. They have referred to the NHS "freeloading", for example. That is very worrying. We all need to be aware of the dangers of a future trade deal and the implications that it could have on negotiations for a range of other products. I hope that those points have contributed to the debate. All parties need to focus on the people at the heart of the issue: the patients who are living with cystic fibrosis.

.......

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

The Minister referred to the importance of Vertex engaging with NICE. Does she share my concern that when I wrote to Vertex and NICE about the failure to make progress, Vertex assured me that it had contributed "substantial new evidence" on the three products in question, yet I subsequently heard from NICE that it had received only

"an overview of the clinical evidence", rather than genuine engagement? Will she join me in calling on Vertex to properly engage with the process, so that we can get the full evidence base on which to make these decisions?

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06 JUN 2019

Department for Business, Energy and Industrial Strategy Post Offices

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

To ask the Secretary of State for Business, Energy and Industrial Strategy, what steps the Government is taking to support rural post office branches.

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

While the Government sets the strategic direction for the Post Office, it allows the company the commercial freedom to deliver this strategy as an independent business.

The Government recognises the critical role that post offices play in communities and for small businesses across the UK. This is why the Government committed to safeguard the post office network and protect existing rural services. Thanks to significant Government investment of over £2 billion since 2010 the overall number of post offices across the UK remains at its most stable in decades with over 11,500 branches.

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05 JUN 2019

Housing Estates: Playgrounds

Written Answer

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

To ask the Secretary of State for Housing, Communities and Local Government, what proportion of housing estate developments built in the last five years have outdoor children's play areas.

Kit Malthouse Minister of State (Housing, Communities and Local Government)

The Department does not hold the information requested

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28 MAY 2019

Department for Education

Written Answers

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

  • To ask the Secretary of State for Education, for what reasons children's play is not prioritized in the five foundations for building character.
  • To ask the Secretary of State for Education, whether the audit of out of school activities will include playing outside.

Nadhim Zahawi The Parliamentary Under-Secretary of State for Education

World-class education is not only about having the highest standards in academic and technical education, it also means ensuring that education builds character and resilience.

We want all children and young people to have opportunities to develop the key character traits of believing that they can achieve, being able to stick with the task in hand, seeing a link between effort today and reward in the future, and being able to bounce back from the knocks that life inevitably brings to all of us. Character must also be grounded in positive values such as kindness, generosity, fairness, tolerance and integrity.

The 5 Foundations for Building Character announced on 7 February by my right hon. Friend, the Secretary of State for Education are sport, creativity, performing, volunteering and membership, and the world of work. Each of these areas covers a very wide range of activities that children and young people can enjoy doing. In developing key character traits, research suggests that high-quality delivery of the 5 foundations should take a structured approach, occur over a sustained period of time, and be self-directed by the child or young person. Through the support of teachers, coaches or other professionals, children and young people are more likely to receive a higher level of challenge and develop the traits that can help them achieve their goals.

Play can provide benefits to children and young people through physical activity and promotion of wellbeing, but the audit of the availability of out-of-school activities across the country does not currently include playing outside as that activity does not provide the structured and high quality elements that are required in character building activities as proposed in the 5 Foundations for Building Character.

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

  • To ask the Secretary of State for Education, what estimate he has made of the number of children with autism spectrum condition who have been (a) excluded and (b) isolated in schools in the last 12 months.

Nick Gibb Minister of State (Education)

Permanent and fixed period exclusions in England: 2016-2017 can be found at: https://www.gov.uk/government/statistics/permanent-and-fixed-period-exclusions-in-england-2016-to-2017.

Permanent and fixed period exclusions by type of special educational need can be found in national table 6.

The information requested, on the number of children with autism spectrum condition who have been isolated in schools in the last 12 months, is not held centrally.

As part of Ofsted inspections, however, schools will be asked to provide records and analysis of any use of internal isolation. Ofsted inspectors will expect schools to have clear and effective behaviour policies that promote high standards of behaviour and are applied consistently and fairly. In reaching a judgement on pupils' personal development, behaviour and welfare, inspectors will take account of a range of information, including schools' use of internal isolation.

The Department's behaviour and discipline guidance to schools makes clear that schools must act lawfully, reasonably and proportionately when using isolation, and must take account of any special education needs or disabilities pupils placed in isolation may have.

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

  • To ask the Secretary of State for Education, what steps the Government is taking to ensure the effectiveness of cross-departmental work to tackle the referral of children and young people with (a) depression and (b) mental health issues.

Nick Gibb Minister of State (Education)

The Department for Education has a joint programme of work with the Department of Health and Social Care, NHS England and Health Education England to deliver the proposals set out in the green paper 'Transforming Children and Young People's Mental Health Provision'. This includes setting up and running Mental Health Support Teams linked to groups of schools and colleges. The teams will be made up of additional, trained, mental health workers, supervised by suitable NHS staff working closely with other professionals such as educational psychologists, school nurses, counsellors and social workers.

The first teams will be set up in 25 trailblazer areas this year, which will be evaluated to inform the subsequent roll-out. The Department has put in place a small regional implementation team to work alongside NHS England to support delivery of the green paper commitments and lead and model effective partnership working for education and health.

The Government is also taking action to support specific vulnerable groups of children. In May 2016, Ofsted and the Care Quality Commission began inspecting local areas on their effectiveness in fulfilling the new duties on education, health and social care services to provide for children and young people who have special educational needs and disabilities (SEND). All 152 local areas in England will be inspected over a period of five years. The inspections are identifying how effectively access to mental health provision is working as part of the SEND provision locally.

The Department is also piloting new mental health assessments for looked-after children to ensure young people are assessed at the right time to support more effective access to mental health provision, with a focus on meeting their individual needs as they enter care.

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23 MAY 2019

Business of the House

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

Brixham Trawler Agents in my constituency recently invested £107,000 in rooftop solar for the fish market. It applied in good faith and in advance of the deadline, but unfortunately fell the wrong side of the cap. It therefore faces considerable unexpected costs. Given that the House has now declared a climate and environment emergency, may we have a debate about how we can properly reward those who are doing the right thing by trying to reduce their carbon footprint and serve their communities?

Before I finish, I join others in thanking Philippa Helme for the remarkable work she has done. I thank her personally and on behalf of Select Committees for everything, and I wish her a long and happy retirement. Will the Minister also send my personal good wishes to the retiring Leader of the House? I thank her for the constructive work she has done to support Select Committees.

Mark Spencer Comptroller (HM Household) (Whip, House of Commons)

Of course I will pass on the hon. Lady's good wishes to the former Leader of the House. In January, the Government published a consultation, "The future for small-scale low-carbon generation", on a smart export guarantee to follow the feed-in tariff scheme, which closed to new products on 31 March, with some limited grace periods and extensions. The SEG will ensure that small-scale generators, including those using solar, can export to the grid and receive payment. We are analysing the results of the consultation and aim to publish the Government response in due course.

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23 MAY 2019

Whorlton Hall

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

Too many people are ending up in terrible institutional care hundreds of miles from home for the want of much more appropriate community care, including social care. The Minister has spoken about not wanting to delay the publication of reports, but she will know that the delay to the social care Green Paper has been unaccountably prolonged. Will she bring forward the social care Green Paper because this issue lies at the root of inappropriate admissions?

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

The hon. Lady knows that I listen very carefully to what she says. I completely share her frustration about the delays to the social care Green Paper, but I do not think that we should ever be held back from making progress on all the things that are wrong in society that we care very deeply about because we are awaiting the publication of such documents. We will therefore be pushing forward with all the work on a lot of the issues that I have spoken about today as a matter of great urgency.

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23 MAY 2019

Social Prescribing

Written Answer

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

To ask the Secretary of State for Health and Social Care, what his Department's policy is on social prescribing.

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

'Prevention is better than cure', published by the Department in November 2018, highlighted the important role social prescribing can play in reducing people's isolation and improving levels of activity.

As set out in the NHS Long Term Plan, NHS England has committed to deliver at least £4.5 billion of new investment in primary medical and community health services over the next five years. Part of this investment will support the recruitment of over 1,000 trained social prescribing link workers - in place by the end of 2020/21 rising further by 2023/24, with the aim that over 900,000 people are able to be referred to social prescribing schemes by then.

The Prevention document and the Long Term Plan can be found at the following links:

www.gov.uk/government/publications/prevention-is-better-than-cure-our-vision-to-help-you-live-well-for-longer

www.longtermplan.nhs.uk/publication/nhs-long-term-plan/

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22 MAY 2019

Leaving the European Union

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

I spent 24 years on the frontline of the NHS, and like the vast majority of clinicians, I am desperately worried about the impact of a no-deal Brexit—a WTO Brexit—on the NHS, social care, science and research, and public health. I really want to help the Prime Minister get her deal across the line if it is subject to a confirmatory vote, but I do not believe it has the consent of even the loudest voices among the Brexiteers, let alone of constituents across this nation. Will she please commit to ending all of this? Her deal would get across the line with the support of so many colleagues across this House if she would just agree to make sure that it was genuinely the will of the people?

Theresa May The Prime Minister, Leader of the Conservative Party

If the hon. Lady wants to ensure that we do not leave without a deal, and she wants to press the case for a second referendum, the way to do that is to vote for Second Reading of the withdrawal agreement Bill. Then, during the progress of that Bill, we will be able to have that debate about a second referendum and, indeed, about other issues on which there is disagreement across this House, and come to a determination on them. That is the proper process to follow; it is the process that enables this House to take that decision.

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21 MAY 2019

Parliamentary Buildings (Restoration and Renewal) Bill

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

On the point about legacy value, would it not be better to have a Chamber that we could use for more constructive purposes? Rather than this adversarial approach, we could have a circular or semi-circular Chamber, with electronic voting facilities, so that we do not build in obsolescence, and we could then use it afterwards—for example, for citizens' assemblies and other forums where we want to engage with the public.

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

I hope the hon. Lady will appreciate that the purpose of the Bill is merely to establish a Sponsor Body and Delivery Authority, which will give the best value for money against a professionally run project that seeks to restore the Palace of Westminster. The shape of the decant Chamber and parliamentary procedures for voting can be discussed any day of the week. All Members are encouraged to feed in their ideas and suggestions to the northern estate programme, which is separate from what we are talking about today, and I encourage her to do so.

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

I apologise for being absent for part of this debate because I have been chairing a Select Committee. It is on that point that I would like to ask the hon. Gentleman's advice. Does he agree that the public would be deeply shocked if we were seen to be building obsolescence into such an extraordinarily expensive project by not having the capacity for electronic voting posts in Select Committee Rooms on the northern estate redevelopment, so that at least, if this place got its act together with modern practices, we would not be interrupting repeatedly, and at length, Select Committee hearings by the way that we vote in this place?

Neil Gray Shadow SNP Spokesperson (Work and Pensions)

That is a very good point. It is clear from the hon. Lady's intervention, among others, that the majority view—in this debate, certainly, and in others—has been that we cannot return to a Parliament that is identical to the one that we leave. There have to be changes made; there has to be progress. I hope that that will be borne out in the passage of this Bill and the discussions that follow.

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21 MAY 2019

Treasury: NHS Pension Scheme

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

The workforce shortfall is the greatest challenge facing the NHS. What discussions has the Chancellor had with the Health Secretary about the combined impact of these changes together with the disastrous consequences for the NHS workforce that would follow a no-deal or WTO Brexit?

Philip Hammond The Chancellor of the Exchequer

As the hon. Lady says, recruitment and retention is one of the big challenges facing the NHS. Clearly, anything that were to impede the NHS's access to overseas workers coming into the UK to serve in our health service would have an impact on that. But I have also recognised and acknowledged today that the operation of the pension annual allowance charge does have a significant effect—particularly, it seems, on partners in GP practices.

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08 MAY 2019

Department of Health and Social Care: Preventive Medicine

Written Answers

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

To ask the Secretary of State for Health and Social Care, with reference to the Prevention is better than cure vision published by his Department in November 2018, whether the forthcoming prevention Green Paper will include oral health.

Seema Kennedy The Parliamentary Under-Secretary for Health and Social Care

We are considering a number of policy options for the prevention green paper and will be mindful of oral health opportunities.

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07 MAY 2019

Health and Social Care: NHS Workforce Vacancies

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

The workforce shortfall is not evenly distributed across the NHS either geographically or by specialty. The Minister will know that there are particularly serious nursing shortfalls in learning disability and community services. He will also know of the implications of shortfalls—for example, for the ambition to deliver 75% of cancer diagnoses at stages 1 and 2. Will he look again at the evidence on mature students and the impact of losing bursaries on that section of the workforce? Will he meet me to discuss that?

 

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

The Chair of the Select Committee is right: the vacancies are not evenly spread and are of particular concern in learning difficulties and a number of other areas. Of course we want to ensure that mature students come back to and stay within the health service. That is why a number of incentives are being put in place to encourage, recruit and retain mature students. I would, of course, be happy to meet her to discuss this matter in more depth.

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03 MAY 2019

Totnes

It was lovely to be in Totnes and Plymouth today. Thank you to everyone who stopped to meet the great Change UK candidates campaigning for the EU elections.

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02 MAY 2019

National Security Council Leak

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

How can this matter be closed as far as our security partners are concerned given that Gavin Williamson has said that he is innocent? Has he been interviewed under oath at any stage during the investigation, because I note that he is not here to set out his position on the Floor of the House and it is vital that our security partners now have confidence? If it was not the former Secretary of State for Defence, who was it?

 

David Lidington Chancellor of the Duchy of Lancaster, Minister of State (Cabinet Office)

I think our security partners can have confidence that the Prime Minister has acted swiftly and resolutely to uphold the essential integrity and security of National Security Council proceedings.

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02 MAY 2019

Transport: Cycling and Walking

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

We know from the international evidence what would work to boost us to continental levels of cycling: consistent, long-term funding, rather than stop-start funding, and for both capital and revenue projects. Will the Minister set out what he is planning to ask for? Will he press for cycling funding of £10 to £35 per head, to bring us up to continental levels?

 

Jesse Norman Minister of State (Department for Transport)

I am grateful to the hon. Lady. I actually spent two hours yesterday in front of the Transport Committee debating exactly that question and specifying in some detail some of my hopes and expectations for future work, including for the spending review. Of course the hon. Lady is right about the importance of consistency and longevity in funding—that is what our local cycling and walking investment plans are doing and why we welcome the work that has been done in Birmingham by Mayor Andy Street and in Manchester through the Chris Boardman and Brian Deegan project—but I remind her that in 2010 the level of funding for cycling and walking was £2.50 a head; it is now at more than £7, and I hope that that upward direction will continue.

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01 MAY 2019

Liaison Committee

Today the Prime Minister was questioned on Brexit by the Liaison Committee

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01 MAY 2019

Environment and Climate Change

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

I thank the right hon. Gentleman and fellow cyclist for giving way. Does he agree with the young people who are outside this building that it would be easier and better to tackle climate change if we remained full members of the European Union?

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30 APR 2019

APPG Great South West

I attend a Parliamentary reception of the launch of the Great South West All Party Parliamentary Group. There was a great turnout for this launch with local business leaders, councillors and MPs among those in attendance. I am sure this APPG can achieve great things by working cross party to find solutions to the issues that matter locally.

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30 APR 2019

APPG Cycling

This morning, I attend a meeting of the All Party Parliamentary Group on Cycling. This is one of my passions and I regularly make use of the fantastic cycle routes that we have across Devon. During this meeting, there was an informative presentation by Cycling UK about how we can push the Government into supporting increased cycling infrastructure and investment. We should take the lead from several European cities, whose specialised design and planning has resulted in a drastic uptake in cycling.

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30 APR 2019

Health and Social Care Committee

The Committee met today to discuss the NHS Long-term Plan: legislative proposals

This was a very relevant and interesting hearing where we discussed the use of medicinal cannabis. We considered the following questions: What does the current evidence base tell us about the efficacy of medicinal cannabis? What plans are there for research into the medicinal use of cannabis, and what challenges are faced by that research?

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29 APR 2019

Meeting with Cancer Charities

Thank you to representatives from across cancer charities for meeting in Parliament today to discuss the NHS Long Term Plan , workforce and early diagnosis and how ⁦the Health⁩ and Social Care Committee can help hold the  Government and NHS to account on delivery.

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25 APR 2019

Government Mandate for the NHS

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

The truth is that it is very difficult for the NHS to make plans without knowing what the Government's plans are for social care. We know, following a response to a question in yesterday's debate, that the Green Paper has actually been written. There is simply no excuse for the continued delay in its publication which would allow the House to scrutinise it and the NHS to be able to provide a truly integrated approach to health and social care. Just saying that it will be published soon is no longer acceptable. Will the Minister set out when we can expect to see this vital document, so that we can scrutinise the Government's plans?

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

The hon. Lady knows that the House and her Committee will have the fullest opportunity to scrutinise the document as and when it is published. She also knows that there is a commitment to publish it soon. She also rightly points out that it will deliver on the need to ensure that health and social care are integrated.

........

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

On a point of order, Mr Speaker. When the Secretary of State comes to the Dispatch Box and makes a clear commitment that the publication date of the Green Paper will be before Christmas, and we know that the document has been written, what are the consequences of an absolute failure to honour such a commitment made at the Dispatch Box by a Secretary of State?

John Bercow Speaker of the House of Commons,

The consequences are political more than anything else. Quite what form that political consequence takes, if there is to be any, very much depends upon the view of the House of Commons; so the matter is the property of the House. I do not wish to incite strong feeling on this matter and the Minister has answered questions fully—whether to the hon. Lady's satisfaction or not is another matter—and courteously. There are proceedings that can be brought to the House, but those are rarely brought and they would require a written communication with me. If, for example, a Member thought that the behaviour were contemptuous of the House, it is perfectly proper to bring that to my attention and I would have to consider it very carefully. But my instinctive reaction is that the consequence is a political consequence in terms of what might be considered a negative opinion of the failure to honour an earlier commitment. We shall leave it there for now.

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25 APR 2019

Electoral Registration: EU Citizens

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

Telling EU citizens to go home and vote is an absolute insult. This is their home and none of this shambles is any of their making. Will the Minister give an assurance that no EU citizens who turns up to vote will be turned away as a result of this shambles? Why can these forms and paperwork not be available at the point where they vote?

Brandon Lewis Minister without Portfolio , Party Chair, Conservative Party

Nobody is saying to EU citizens what the hon. Lady has just said we are saying. What we are saying is that EU citizens, as per 2014, should follow the process to register to vote so that they can use their vote if we hold these elections. It is about ensuring that people vote once in the European parliamentary elections, if they are held.

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24 APR 2019

Local Government and Social Care Funding

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

My right hon. Friend makes some really important points about the first 1,000 days of life, but equally there are similar arguments relating to the end of life. For example, too many people who need social care end up in a much more expensive place at the end of their life—in a hospital setting, where they do not want to be—for the want of the right investment in social care. Does he agree that we should apply the principle of investing to save across the whole of life?
..............

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

It is a pleasure to follow Anna Turley.

I start by thanking and paying tribute to all the frontline care staff around the country, and to all the family carers, informal carers and those working extremely hard in voluntary services in all our constituencies. In my constituency, I pay tribute to Dartmouth Caring, Totnes Caring, Brixham Does Care, South Brent and District Caring, and Kingsbridge and Saltstone Caring. I know that similar voluntary services are working across the country in tandem with the NHS to provide excellent care to our constituents, but they are under pressure as never before.

There is a devastating impact on those affected—those who are not getting the care services they need; not only working-age adults but older adults, and their families. There is also an impact on the NHS. If people cannot access care services, there is not only an impact on their dignity, mobility and wellbeing but they are much more likely to end up in hospital—a place they do not want to be and at much higher cost—sometimes with serious illnesses or injuries that could have been avoided by better prevention and early intervention.

We need to deal with this issue, and the House needs to appreciate the scale of the challenge. Let us look at the demographics. We know from the Office for National Statistics that, last year, 18% of our population nationally was aged over 65, but that in 14 years' time 23% of our population nationally will be over 65. Of course it is a good thing that people are living longer, but they are living longer with multiple disabilities and we need to be prepared for that. We need to be prepared not only for the scale of the shortfall we face right now but for what is coming in the future. When we talk about social care funding, we need not only to acknowledge the impact of the shortfall we have here and now, and how we are going to deal with it, but to plan seriously for what is coming down the track.

In my constituency, we are already there. My constituency has a much older population than in many parts of the country and, even when they can afford to pay for care, people cannot find the workforce to care for them. There is a real crisis in our social care workforce, which needs investment. We need to value and nurture that workforce. We know what works, but we also know it will require serious investment.

I am afraid that one of the features of such debates is that the blame bounces backwards and forwards when, in fact, cross-party working and consensus building is what is really needed. The funding choices we face are difficult. I agree with the hon. Member for Redcar, who highlighted why this cannot all be funded at a local level. Doing so just widens inequality, because the areas that are least able to pay have the greatest need. It is unrealistic for everything to come from a local level, so we need to work towards a national solution to the problem.

The Health and Social Care Committee, which I chair, has worked together with the Housing, Communities and Local Government Committee—I pay tribute to Mr Betts, who has also spoken about this—and we know what works. The tragedy is that we could deal with the problem. Our joint Committees looked at the options and achieved a cross-party consensus; we worked alongside a citizens' assembly, because we think it is really important to build consensus outside this House. There are some principles we should be following. I urge the Minister, in her response, to tell us when the social care Green Paper will be published and commit to ensuring that it looks at the work of our joint Select Committees and the citizens' assembly.

We can move forward, but if we have learned anything from the Brexit process, surely it has to be that we cannot build consensus at the end of a process; we have to build it in right from the start. I hope that the Green Paper will be designed to achieve that, and that it will set out the principle of fairness in the funding of social care. One statistic that we should all be aware of is that in the next 14 years, as our demographic changes and the percentage of our population aged over 65 increases to 23%, there will be 4.4 million more citizens aged over 65 but only 1.5 million extra citizens aged under 65. It is simply not sustainable to allow all the extra cost to fall on working-age, employed adults, so we must look at how to spread it fairly across the generations and between the employed and the self-employed.

I agree with Members who have talked this afternoon about reimagining national insurance as national health and care insurance. If we are truly to move towards a system that expands not only eligibility but quality, we need to bring more funding into the total system; the funding cannot just come from local sources. I urge the Minister to set out what she feels about the measures highlighted in the joint Select Committee report, and whether the Government will commit to coming up with a solution that can deliver real change, rather than kicking the issue down the line.

The wrong lesson to learn from the last general election campaign would be, "Don't ever set out who has to pay more." We all need to do that now, between elections. We must be realistic with our constituents about the fact that everybody needs to pay more, and we must build their trust in the idea that the increase will be delivered fairly. The consequences of doing nothing will be that more and more of our constituents will be left in desperate conditions, without carers to look after them; more and more of our care providers will go to the wall; and there will be no increase in the quality of care delivered on the ground, because there will not be the funding to support the workforce. We have to grasp the nettle with these difficult choices.

Before I close, I want to say something about Brexit. There is no version of Brexit that will deliver anything positive for health and social care, especially if we look at the impact on the workforce. The Minister will know that in parts of the south-east and London, in particular, social care is very heavily dependent on access to a workforce from the European Union. That is also the case in my constituency. Nationally, around 7% of the social care workforce are from the EU. If we cut off access to that workforce, not only will we miss out on an incredibly important and valued skilled workforce by making it more difficult for them to come here, but we will add costs. Many of the people who work in social care—in fact, the vast majority—will not meet the current proposed earnings thresholds that will allow them to come here easily on, for example, tier 2 visas.

We need a way to nurture our workforce and to make it easy for people to come here to work and to feel valued. I do not want to meet any more people in my constituency who work in the NHS and social care and tell me that after decades of dedicated service to this country, they no longer feel welcome.

.................

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

The Minister's reply suggests that the Green Paper already exists. There is a great deal of frustration about the delay. The Green Paper was supposed to follow hard on the heels of the 10-year plan, because the two were closely linked. The Secretary of Stategave a pledge from the Dispatch Box that it would be published before Christmas. Will the Minister at least set out the reasons for the delay, and give some indication of when we might expect it? It is such a crucial document.

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

As the hon. Lady will know, a version of the Green Paper already exists, but that does not mean that we are resting on our laurels while we are waiting for an opportunity to publish it. We are continuing to improve it and evolve it so that when we do publish it—as soon as possible—it will be in the best possible shape.

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11 APR 2019

Loan Charge

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

I thank the hon. Gentleman for making these excellent points. Like me, does he find that he has several constituents who had no option but to be self-employed and were required to enter such vehicles?

 

 

Stephen Metcalfe Conservative, South Basildon and East Thurrock

The hon. Lady makes an excellent point. For many there was no option. In many cases, as in the case of my constituent, people had to enter these schemes. My constituent even checked whether there were alternative options and checked the legitimacy of it, never thinking it would come back to haunt him.

I have to say that I do not like it. It feels wrong. I would like to think that I am a fairly reasonable chap, and when I feel that something is wrong or off and does not feel like natural justice, it tends to be true. Eventually, the Government will come round to my way of thinking, or I very much hope so.

As I said, I am not an expert on tax in general, but the charge is retrospective and HMRC failed to notify scheme users of the tax liability. Users sought professional advice or were advised to enter these schemes and, as in my constituent's case, annually declared what they were doing.

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10 APR 2019

World Health: 25-Year Environment Plan

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

Does my hon. Friend feel that there should be greater penalties for acts of environmental vandalism, where developers come in and clear wildlife corridors and later on we find that the tree survey, for example, shows that there are no trees because they have cut them all down? The current penalties for that are simply not sufficient. It has happened in my area in Dartmouth and caused great upset and loss to the environment.

Rebecca Pow Conservative, Taunton Deane

I thank my hon. Friend for mentioning that, because it leads me on, interestingly, to ancient woodland. I am pleased that this Government, through the all-party parliamentary group on ancient woodland and veteran trees and the Woodland Trust, and working with many colleagues, have managed to get extra protection for ancient woodland. In future, developers should not be able to bulldoze ancient trees down in the way they used to. Those trees are very precious, as is the soil underneath them. We must get teeth so that we can hold people's feet to the fire and ensure that those things do not happen.

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10 APR 2019

World Health: 25-Year Environment Plan

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

My hon. Friend is making important points about natural capital and health, and I agree with all that he has said so far. However, does he agree that the real elephant in the room is the issue of climate change and its impact on human health not only in this country, but globally? Would he like to see the Government go further and faster in planning for the long-term goals on carbon reduction targets? Although we are currently meeting our carbon budget for this period, we will not meet it for the fourth and fifth carbon budget.

Derek Thomas Conservative, St Ives

I am concerned now, because people have clearly read my speech. I was about to move on to that subject. I have the great honour of being a Cornish MP, as Members might have noticed. The Duchy of Cornwall was first to proclaim a climate change emergency. On Friday, my hon. Friend Sarah Newton and I worked with the council on its plans to be carbon-free by 2030.

It is right that we need to up our game. It is about caring for our environment, but it is also about spreading wealth around the country, improving the quality of our homes, improving attainment for young people, using whatever renewable means of energy we can and providing a healthier, happier environment for all of us who live on this great planet. We can be a global leader, because we have real influence to help support other countries to take this issue seriously.

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08 APR 2019

Women and Equalities

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

On a point of order, Mr Speaker. May I put it on record that today the Prime Minister has found time to meet the 1922 committee but, I regret to say, we still do not have a date for her to meet the Liaison Committee? I know that you have already pointed out to the House that that is part of the House's ability to hold the Prime Minister to account at this important time. Will you join me in hoping that the Government Front Bench will, again, pass on to the Prime Ministera formal request for her to set a date?

John Bercow Speaker of the House of Commons,

I am certainly very happy to join the hon. Lady in the expression of that request. I make no comment on the other gathering in front of which the Prime Minister may have appeared. Certainly, as far as the House is concerned, the point that the Chair of the Liaison Committee makes is of the highest importance. The role of the Liaison Committee in holding the Executive to account and, in particular, holding the Prime Minister to account can hardly be overstated. The Liaison Committee is a greatly respected body. The custom and practice whereby the Prime Minister regularly appears before it are now very well established. It would seem to me to be highly desirable that an appearance should take place sooner rather than later.

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08 APR 2019

Access to Medical Cannabis

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

I warmly welcome the measures announced by the Secretary of State today, but will he go further in discussing the importance of clinical trials and answer some of the many questions about striking the right balance between THC and CBD? We have heard in the Select Committee that some pharmaceutical companies are refusing to make their products available for clinical trials. Will he look specifically at that point? We need to ensure that safe and consistent products are regularly available and that they are of a predictable pharmaceutical grade, as we have heard.

 

Matthew Hancock Secretary of State for Health and Social Care

If I may, Mr Speaker, I would like to add to my previous answer by congratulating my hon. Friend the Member for Watford, the former Business Minister, on all that he did to support business, enterprise and the case for capitalism while he was in his former job. I regret his departing from the Government, because he was a brilliant Minister.

On the question ahead of me, so to speak, the Chair of the Select Committee, Dr Wollaston, is right to say that it is vital to bring forward these clinical trials, and that the pharmaceutical companies that provide the oils have not pushed forward the trials in the way that would normally happen. We have therefore stepped in to try to make them happen, but we do need the calls to be answered.

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04 APR 2019

NHS Confederation

Today I met with Niall Dickson, Chief Executive of the NHS Confederation to discuss amongst other issues, their Health for Care Campaign

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03 APR 2019

Business of the House

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

Does the right hon. Gentleman accept, however, that if the Government were to Whip for their own withdrawal agreement and future framework, and to combine that with the undoubted support for putting that deal to the people, that would be the simplest way for the Prime Minister to get her deal through Parliament with an absolute guarantee of showing whether it was the will of the people?

 

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

What the right hon. Gentleman seems to be confirming is that the withdrawal agreement and future framework does not represent the will of the people and is rather unpopular. In that circumstance, surely it would be better to check what the public support is, once we know what a known deal is. As he will know, if there were agreement to a confirmatory vote, a referendum would require an Act of Parliament, and during the passage of a referendum Bill it would be this House that determined what the questions would be. It would not be for us to set the question in advance of that; it would be open to debate.

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03 APR 2019

Points of Order

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

On a point of order, Mr Speaker. The Liaison Committee, which consists of all the Select Committee Chairs, is the only Committee that can call the Prime Minister. She has said on several occasions this afternoon that she is willing to sit down with Members from across the House, but I regret to say that, despite repeated requests, the Liaison Committee has been unable to secure a date for a hearing with the Prime Minister. Could I please seek your advice, Sir?

John Bercow Speaker of the House of Commons,

The hon. Lady can do and has done. I thank the hon. Lady, the Chair of the Liaison Committee, for giving notice that she intended to raise this matter on a point of order with me. I appreciate that the Prime Minister's diary will have been even busier than usual recently, but I am sure the Prime Ministerrecognises that her regular appearances before the Liaison Committee form an important part of her accountability to Parliament.

The hon. Lady asks how she can persuade the Prime Minister to confirm a date. I suggest that by raising the matter today, the hon. Lady may have helped to achieve that objective. If she is not immediately successful, I have no doubt that she will—following, perhaps, my repeated advice to colleagues—persist, persist and, if necessary, persist again until she accomplishes her objective. Those sessions matter. They are part of respect for, and the proper functioning of, the legislature.

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01 APR 2019

Leaving the European Union

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

It is a pleasure to serve under your chairmanship, Mr McCabe.

"If a democracy cannot change its mind, it ceases to be a democracy."

Those are not my words, but those of our first Brexit Secretary, Mr Davis, who is one of many. The ability to change one's mind is a beautiful thing and something that we should particularly value in parliamentarians. As Maynard Keynes said:

"When the facts change, I change my mind."

Having a sealed mind—the inability to change one's mind—is something that we should be very careful about. That is where we are at the moment, I am afraid. We are in a situation in which people seem incapable of changing their mind, but the public are not.

It is very difficult to quote a figure for the number of people who have signed the petition to revoke article 50, because it is changing. When we started the debate, it was 6,036,045, but the last time I checked—a couple of minutes ago—it was 6,037,286. Some 10,804 of those signatories are in my constituency, which is almost 16% of the electorate. I pay tribute to the 355 people who signed the petition to leave with or without a deal, because we should recognise their voices in the debate. I also pay tribute to the 496 people who signed the petition for the second referendum.

There are lots of reasons to change one's mind. A good reason to change one's mind is that the circumstances have changed. Another is that one has looked at the evidence. I come to this seeing both sides of the debate, because I started out—originally, when the referendum campaign was launched—as a soft-leave Eurosceptic. However, as Chair of the Health and Social Care Committee, I heard the evidence of harm week in, week out, and I came to the view that I was wrong. I was not afraid to say that. In fact, many colleagues said to me, "Don't tell people that you've changed your mind. Just put a cross in a different box. It will be very bad for your political career if you change your mind." It is astonishing that we have come to that—that parliamentarians are not honest and are not prepared to change their mind when they have looked at the evidence.

We focus on the idea that this is all about a WTO Brexit and trade, but from chairing the Health and Social Care Committee it became obvious to me that there is clear evidence of harm to social care, science and research from unpicking a close relationship that has brought enormous benefits for more than four decades. I looked at the harm that Brexit would cause to science and research. There is no version of Brexit that will benefit science and research, improve the situation for our health and social care workforce, or do anything positive for NHS funding.

Of course, the biggest, most remembered non-fact of all the referendum campaign was the £350 million a week for the NHS that never was. Those who led the leave campaign not only know that that was wrong, but valued the fact that people were quoting that figure and that there was a debate. I was in rooms with people who said to me, "Yes, we know the fact is wrong. It's not a fact. It's a gross figure, rather than a net figure," but they were prepared to keep saying it. Many of those people now sit on the Front Bench. It is quite extraordinary.

We must consider the big picture and the extent to which people were misled knowingly and deliberately during the referendum campaign. We must consider the very real evidence that has emerged in every area of the degree of harm. We must be honest about the fact that there were many different versions of Brexit. I am a former clinician—I have said this before—and it would be ridiculous to take someone into an operating theatre more than 1,000 days after they had signed a vague consent form for an operation of some sort. The surgeon would be struck off. The surgeon in this case, I am afraid, is our Prime Minister. Now that we know all the circumstances of Brexit, she has a duty, once we have settled on a version, to allow people to go back and weigh up the risks and benefits of a known deal. That is what is required to give consent.

That is particularly true for young people. We are taking people into the operating theatre kicking and screaming with a consent form signed by their grandparents. We owe it to the British people to check that we have their valid consent before we carry out this extraordinary act of constitutional, social and economic surgery on the population. We have time to do so. We should take that time, and revocation is one way we could do that. We should revoke and reflect. As Martin Whitfield said, that does not cancel Brexit altogether; it just gives us the chance to pause. This is a significant decision, and we should take the time to ensure we get it right.

There are many good reasons to change one's mind, but there are some that are less honourable, such as changing one's mind because it suits one's leadership ambition or because this has all become about the unity of the Conservative party. The country is looking on in horror; it does not see those as reasons to change one's mind or to stick rigidly to a point of view when all the evidence to the contrary is compelling. Many of my constituents have said to me over and over again, "Why is it that all of you get to change your mind so many times but none of us does?" They just want the ability to reflect the fact that many of them have changed their mind.

Last weekend, I was with the million people—an extraordinary, positive outpouring from all around the country, walking past the Prime Minister's door peacefully and asking her to put this to the people. I contrast that with the crowds that were outside the gate when I cycled out last Friday, screaming at me, "Traitor!" and "Bitch!", and referring to other parts of my anatomy in a disgusting outpouring of hostility.

I hear the Prime Minister and others say that we cannot put this back to the people because it will unleash dark forces and divisionin our society, but those dark forces and division are already out there. We counter the far right not by appeasing them but by standing firm. Since when did this country not have a democratic process because we were afraid of the far right? I and many colleagues in this House have had to face that blast full on. I will not be quiet; I will keep saying loud and clear that it is time we put this back to the people.

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

Will the hon. Lady clarify what Labour's position is tonight on voting in favour of the revoke motion?

 

Jenny Chapman Shadow Minister (Exiting the European Union)

Yes. We are treating tonight as the opportunity to vote for something—a way to find whether there is a majority in the House of Commons for a particular deal as a way forward. We do not necessarily disagree with the proposition made by Joanna Cherry, but we will abstain on it this evening, while acknowledging that it is something that we might need to confront in the future.

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

Is that a whipped abstention or advisory?

Jenny Chapman Shadow Minister (Exiting the European Union)

Gosh, the hon. Lady invites me to make comments way above my station. I am sure she will understand that what happens with whipping is a matter for my Chief Whip.

.........

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

Does the Minister agree that it was the publication of the manifesto that was the tipping point for the Conservatives, and it was all going quite well until then, when things fell off a cliff? That was my experience.

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27 MAR 2019

EU Exit Day Amendment: EU: Withdrawal and Future Relationship (Votes)

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

On a point of order, Mr Speaker. This is both a national tragedy and a national embarrassment. Is this situation not partly down to the fact that we tried to reduce a complex issue with very many possible versions of Brexit into a simple, binary choice? Does this evening not demonstrate that we must now set out clearly what the choice is and return it to the British people? Will you confirm, Mr Speaker, that the greatest number of votes cast today were for a confirmatory public vote on a defined choice?

John Bercow Speaker of the House of Commons

The factual record speaks for itself. The political point that the hon. Lady perfectly reasonably makes—it is not a party political point, of course—is not one for me, but she has made her point with her typical sincerity and sense of insistence on what she believes to be right, and I respect that. How these proceedings—in all the time I have known the hon. Lady, she has been concerned about this—are viewed by people outwith this place, I do not know. However, it seems to me, if I may say so, that it is a matter not just of the content of what is said but of how it is said that is of the foremost importance. In my experience, the hon. Lady plays the ball rather than the man or woman. If we can, albeit amid inflamed passions and strong conflicts of opinion, maintain that basic respect for each other and that civility of discourse, that has to be in our interests, both in respect of this issue and reputationally for the future.

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27 MAR 2019

Eu: Withdrawal and Future Relationship (Motions)

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

My hon. Friend is making a very powerful case for this being the least damaging form of Brexit. The trouble is that it will end up pleasing no one: neither the remainers who voted to remain, nor a very significant number of his colleagues who voted to leave. Would it not be best, if it does not have the consent of this House, at least to check that it has the consent of the people? Would he agree to link it to a public vote, so that we can check that it really is the will of the people?

Nicholas Boles Conservative, Grantham and Stamford

The hon. Lady makes a powerful argument, as she has done consistently. The funny thing about this position is what happened in Norway. It was meant to be temporary for Norway. It went into this thing on its way into the EU. All the Norwegian elite—both sides of Parliament, all the business elite and everybody else—want to get into the EU, but the Norwegian people consistently say, "No, thank you very much, we are quite happy where we are." Some 65% to 70% of the Norwegian people say, "Do you know what? This halfway house is absolutely perfect for us." My prediction is that that is what the British people would conclude, too.

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26 MAR 2019

HSCC Inquiry into Medicinal Cannabis

The Health and Social Care Committee explored issues around medicinal cannabis during a further evidence session today

We heard from the Government, practitioner organisations and NHS England.

You watch the session via the following link:-

https://www.parliamentlive.tv/Event/Index/954fe835-ca5f-4fed-9415-eeba45fe18ea

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25 MAR 2019

European Council

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

The Prime Minister has tested to destruction the possibility of getting the DUP and the right-wing ERG to get her deal through the House. She could, however, get it through if she agreed to check that it still is genuinely the will of the people. Instead of listening to the 14 men in fast cars who came to Chequers, will she listen to the 1 million people who walked past her door? Considering that she spoke earlier about "female multi-tasking", will she agree to meet a delegation of 14 women parliamentarians from across the House, so that we can really get things done?

Theresa May The Prime Minister, Leader of the Conservative Party

As I have indicated to others—and as she knows, because we have previously sat down and discussed these matters—I am always happy to reach out and talk to Members across the House. I have a different opinion from her on a second referendum, because I believe we should deliver on the first.

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20 MAR 2019

Destitution Domestic Violence Concession (Eligibility): Article 50 Extension

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

The Secretary of State will know that this House has rejected the Prime Minister's deal twice by historic margins now—it is neither the will of the House nor the will of the public—and it has also rejected very resoundingly leaving with no deal. However, we have not yet had in Government time an opportunity to do just what he asks, which is for the House to give an indication of what it would support. Will he support bringing forward the opportunity to give an opinion on indicative votes in the next week, preferably on Saturday?

Stephen Barclay The Secretary of State for Exiting the European Union

I am not sure that Saturday would be the most popular of responses with colleagues across the House, but we have given a commitment, as the hon. Lady knows, to a meaningful vote on Monday and, following that, there will obviously be opportunities for the House to have its say. Let me make some progress.

Any extension is the means, not the end, but any extension of whatever length does not allow this House to escape its responsibilities to decide where it stands: whether to keep its commitment to deliver on the decision it gave to the British people or to walk away from doing so. Nor should an extension mean that a guerrilla campaign can be run to overturn the result of the referendum and frustrate the will of those who voted to leave.

I disagree with the suggestion of the shadow Chancellor, who is not in his place, that any extension should be open ended. I think he said that it should be "as long as necessary". Indeed, he was at odds with other Labour Front Benchers. Emily Thornberry said only the day before that the Labour party would back an extension just to July because

"it would be inappropriate for us to stand for the European Parliament".

An open-ended delay would be likely to mean no Brexit and disregarding the votes of the 17.4 million people who voted to leave.

We now need to use any additional time to ensure that an orderly Brexit is delivered. The Leader of the Opposition has not said to date how long an extension he seeks. I do not know whether Labour Front Benchers wish to use the opportunity of this emergency debate to put on record exactly how long an extension they support.

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20 MAR 2019

No-Deal EU Exit Preparations

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

There is a good reason why this House has resoundingly objected to and rejected a no-deal Brexit: because Members here have looked at the evidence of the real-world harms. Just one such area of concern is the position of healthcare for British citizens who are pensioners who have retired to countries across the European Union. The Minister will know that a reciprocal arrangement could not be made with the EU as a whole but would have to be made with 27 individual countries. Can he set out in how many of those 27 countries our fellow citizens who have retired to the EU now have the absolute certainty that in nine days' time they will have reciprocal healthcare arrangements in place?

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

Actually, a whole host of countries are now enacting legislation through their processes to do exactly as the hon. Lady says. The hon. Lady is completely correct in the fact that health in general terms is tied up in social security policy in nearly all EU member states. This needs legislation in individual EU member states, and I believe—I will write to the hon. Lady later today to clarify this—that pretty much every member state has started that legislative framework process.

 

I received the following letter from Chris Heaton-Harris and you can read it here

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19 MAR 2019

Exiting the European Union (Agriculture): Foreign Affairs Committee

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

I thank my hon. Friend and neighbour for giving way on this point. I will, if I may, try to persuade him. Does he agree that Select Committees are at their best and acting on behalf of the public when their members can leave tribal politics at the door, focus on the evidence and work collaboratively to come up with solutions? That is what the public wants to see from this Parliament, as opposed to the often confrontational picture that they might see. This is the part of Parliament that often shows us at our best. My concern is that what we are seeing tonight will fundamentally undermine and degrade the important reforms that were brought in a decade ago, so I really hope that he will join me in the Lobby this evening.

Kevin Foster Conservative, Torbay

I thank my hon. Friend—and I mean that—for her intervention. She is right that the Select Committees are at their best when a member of the public attending a sitting would not be able to tell which party label applied to which Member of Parliament. I remember the time that I spent on the Public Accounts Committee, and the questions there were as fearless from Government Members as from Opposition Members. That is the strength of Select Committees. The fact that we work by consensus in most instances gives strength to our reports. If an inquiry was just an attack by an Opposition motivated by party politics, it would not get the support of Government Members. And ditto—if a report were trying to praise the Government too much, funnily enough Opposition Members would probably not sign up to it.

It is right that people do not take their party labels into Select Committees, but the conflict for me is the issue of the Opposition having certain protections in this place. In a situation where a Government had a significant majority, they could in theory start playing a game with these sorts of motion. I think it is safe to say that a game is being played this afternoon, but it is quite clear to me that there is a difference between Members on the Government payroll and other Members. Each Member can take their own view; I just feel a slight difficulty in choosing the Opposition Members on a Select Committee from my position.

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

Does my hon. Friend feel that it would undermine the system if we were in a position where members of a Select Committee were always having to look over their shoulder, because they might suddenly find that their place had been made unilaterally vacant on their behalf if they were not following the party line? In this case, there will still be the same number of OppositionMembers in the Foreign Affairs Committee.

Kevin Foster Conservative, Torbay

I accept that the balance of Opposition Members will be the same. This is not, for example, about someone having gone from the Government Benches to the Opposition Benches, and then a motion trying to flip back the balance. For me, though, this is about choosing the Opposition Members on a Select Committee. Let us be candid: there will be occasions when the Government might not particularly want certain individuals from the Opposition on a certain Committee. That is where the conflict lies. This is about Government Members —particularly those in the Government—choosing the Opposition Members on a Select Committee.

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18 MAR 2019

Brixham

I'm really pleased that ministers met with me and representatives from Brixham to discuss investing in our port and fishing and how Brixham in particular contributes to the strategic importance of the industry. This project could bring an extra £10m growth in the value of fish and £4m of shell-fish landed at Brixham and wider benefits to the whole of our local economy.

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18 MAR 2019

Integrated Care Regulations: Exiting the European Union

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

My hon. Friend rightly makes the point that we can unilaterally decide to be freer about letting goods come across our border. However, surely one issue is that a free-for-all and a lack of proper checking could put the organic sector at risk.

Neil Parish Chair, Environment, Food and Rural Affairs Committee

The hon. Lady raises a good point. Milk production is a good example. Organics is a selected market; although a good number of people buy organics, there is a ceiling of around 10% of people who actually buy organics overall. Therefore, exporting organic food is as important as importing it. On the dairy side of organics, the big milk co-operative Omsco trades very successfully into the United States, but that has to be maintained—and we must have the certification, and all these other things must work, in order for that to happen. That is why we have to be very careful to ensure that we can trade successfully in a no-deal situation.

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18 MAR 2019

Integrated Care Regulations

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

As my Committee has already been quoted, I think that it might assist the House if I were also to quote from the conclusions that we came to on this issue. The Committee said:

"We recognise the concern expressed by those who worry that ACOs could be taken over by private companies managing a very large budget, but we heard a clear message that this is unlikely to happen in practice. Rather than leading to increasing privatisation and charges for healthcare, we heard that using an ACO contract to form large integrated care organisations would be more likely to lead to less competition and a diminution of the internal market and private sector involvement."

Jon Ashworth Shadow Secretary of State for Health

The hon. Lady makes an interesting point. She is correct in as much as there is not currently a long queue of companies lining up to take control of whole health systems, but that could change if some new form of Transatlantic Trade and Investment Partnership is brought in by a post-Brexit deal. A number of these companies are becoming increasingly litigious in the courts, which is why Virgin Care took the NHS in Surrey to court. However, even if a private provider is not gifted a whole contract, which is the point that the hon. Lady is making, there is nothing to prevent it from buddying up with NHS bodies in joint ventures as a way of exercising influence over the way in which local health systems are configured. There is already evidence of private sector involvement in the establishment of the integrated care system, with Centene UK—an offshoot of an American health insurer—working with Capita in the Nottingham ICS.

.....

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

Will the Minister assure the House that only public statutory providers will hold these contracts? That would be reassuring, as the language on this is not completely clear. Will he also give some assurance regarding the Select Committee's other proposal, which is that the policy should be carefully piloted and evaluated? If it is done first in Dudley, followed by careful evaluation, I would be prepared to support it. If he cannot give reassurance on those points, it would be difficult for me to support the regulations.

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

I can give the Chair of the Select Committee the assurance that the ICP contract will be made available in a controlled and incremental way, conditional on the successful completion of NHS England and NHS Improvement assurance through the integrated support and assurance process. That incremental process is, I think, in line with what she and her Committee recommended.

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15 MAR 2019

Stalking Protection Bill Receives Royal Assent

I am delighted that the Stalking Protection Bill has received Royal Assent and is now an Act of Parliament. Stalking Protection Orders will soon be available to police so that they can intervene more rapidly to protect victims of this awful crime.

I am grateful to everyone who has helped with advice and support, especially those who have personal experience of stalking, MPs from all parties who have worked with me, and to the Minister Victoria Atkins MP and her team as well as Baroness Bertin for their commitment to making this important change to the law.

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14 MAR 2019

UK's Withdrawal from the European Union

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

I rise to speak to amendment (h) in my name and that of Dr Whitford. It seeks an extension to allow us to obtain the consent of the British people to whatever deal is approved by this House, with an option to remain.

Many of us believe that consent is at the heart of this argument. We are repeatedly told that the Prime Minister's deal is the will of the people. The truth of the matter is that it is not the will of Parliament. It has been voted down by this place by 230 at the first time of asking, and by 149 at the second time of asking. However, I would say that there is no evidence that it is the will of the public either. It is certainly not the will of the 48%, nor is it the will of a very significant number of those who voted to leave—both in this place and outside—because they write to tell me so very vigorously that they do not think that this is the Brexit they voted for.

The truth is that the great Brexit charlatans have been exposed for the lies they perpetrated during the campaign. This Brexit is nothing like the sunlit uplands that they were promised, and I would ask people how many of them would have voted for this dog's Brexit if it had been presented to them at that time.

Philippa Whitford Shadow SNP Spokesperson (Health and Social Care)

My hon. Friend is talking about consent, and there has been discussion about that. As a surgeon, I have always had to have explicit, signed, informed consent, and such a discussion is always based on risks and benefits. We did not have that debate before the referendum, and we have had it only now, so it is only now that people have had the chance to learn how this Brexit deal will affect them

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

I thank my hon. Friend for that, and she is absolutely right. For someone to be able to consent to something, they need to know what they are consenting to. Let us face it: the risks and benefits of the various versions of Brexit are very different. The risks and benefits of no deal, WTO, the Prime Minister's deal, Norway and Norway plus the customs union are very different procedures, if we talk about this in strictly clinical terms.

The other thing about consent is that nobody would seriously proceed on the basis of a consent form that was signed nearly three years ago. Furthermore, young people in this country face being wheeled into the operating theatre for major constitutional, social and economic surgery based on a consent form that was signed by their grandparents nearly three years ago. This is the point: given the sheer weight, significance and implications for all of their futures, what is the constitutional outrage or the democratic outrage about pausing to check that we have their consent?

I say to those on the Government Front Bench that they will never be forgiven for the consequences of Brexit, unless they have taken the time to pause and ask for explicit consent for their version of it. Even if the House were to approve a Norway-style Brexit, with or without a customs union, that will still not represent what many people out there thought Brexit should be. There is therefore a compelling case for all hon. Members to be honest about the way people feel about this issue, and to pause to ask for explicit consent. If the Prime Minister were a surgeon, she would be struck off if she proceeded without consent.

Tim Loughton Conservative, East Worthing and Shoreham

Perhaps I could butt in on this medical love-in. When making her diagnosis, the hon. Lady seems to ignore that the patient is the EU. Does she seriously think that the health of the EU has improved so much after the last three years that the view of the public in this country would be any more endeared to it, given that 75% of the eurozone is in recession? It is Europe that has changed, not us.

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

I thank the hon. Gentleman for his intervention—I still consider him a friend, even though I am on the Opposition Benches—but I gently point out that it is good he is not a surgeon if he cannot recognise who the patient is.

Many Members have made the point that now is not the time for this amendment and that we should table it later, but it has been a bit like "Waiting for Godot". "Now" will never be the right time, and we are just 15 days from falling off the cliff. I was there in the summer with 700,000 people who marched through the streets. Their call was: "We demand a people's vote". When did they want it? They wanted it now. They were not saying, "We want it when it is convenient for the Labour Front Bench".

I am sorry—I say this with great sincerity to Labour colleagues—but there was a clear promise to move to support a people's vote, and it is simply no good to keep backtracking on that. Today is the time for us to vote for this amendment. It may fail—I accept that—but there is nothing to stop us bringing it back and voting for it again.

 I urge all colleagues who know that they support a people's vote to vote for this amendment today, and again when they get the opportunity. If people never demonstrate that they supported a people's vote that will be their greatest regret, and I am afraid the chances are that those on the Labour Front Bench will never move to wholeheartedly and unequivocally support a people's vote, unless there is significant pressure to do so. Those of us, from many parties, who have come together to press for a people's vote will support the amendment today. We urge hon. Members to join us, and to support it again next week.

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13 MAR 2019

Uk's Withdrawal from the European Union

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

Can the hon. Gentleman think of any circumstance in which a consent form would be valid if it were signed 1,000 days beforehand without the signatories knowing the exact procedure to which they were giving their consent?

Stephen Gethins Shadow SNP Spokesperson (Foreign and Commonwealth Office)

The hon. Lady makes a valuable point, as she often does.

....

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

Does the hon. Lady also feel that hon. Members should read the letter that they have all received today from Professor Andrew Goddard, the president of the Royal College of Physicians, setting out his stark warning for the health of our patients and the NHS in the event of a no-deal Brexit?

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12 MAR 2019

European Union (Withdrawal) Act

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

Does the hon. Gentleman agree that had our constituents seen the reality of the actual Brexit deal, they too would have rejected it, and that they should have the opportunity to have the final say and a right to vote, not just MPs?

Sam Gyimah Conservative, East Surrey

The hon. Lady makes a powerful point, to which I shall return in a second.

We have this misleading cliché today that we just have to get on with it, as though the result is somehow immaterial so long as we do. That gives me cause for extreme concern about supporting the deal. Let me make two principal points. First, as far as I can understand it, the backstop is there to try to solve an impossible problem: we want to take control of our borders but we want the other side to have an open border. The back- stop exists now because after months and years of negotiation, we have not found a solution to that problem. If those who, like my right hon. Friend Nicky Morgan, say that alternative arrangements could solve the problem genuinely believe that such arrangements could, they need not fear the backstop.

The truth is that dealing with these alternative arrangements on their own will not address the need for the backstop. The side deal that the Prime Minister has come back with improves things to some extent, but the EU has no need to act in bad faith because it knows that, between now and 2020, we will keep going round the same loop, trying to find alternative arrangements. If we are not careful, we may still end up in that backstop, which is why there is such serious concern.

My second point is on the political declaration.

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11 MAR 2019

Exiting the European Union

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

Even if this monumental fudge is enough to satisfy the ERG and just about manages to scrape through the House tomorrow, what happens next if it is not ratified by the European Parliament?

David Lidington Chancellor of the Duchy of Lancaster, Minister of State (Cabinet Office)

It is for the European Parliament to take its decision on this, just as it is for the House of Commons to take our decisions on this matter. The Prime Minister is due to meet President Tajani of the European Parliament in Strasbourg this evening, so I am sure she will be wanting to explain to him what has been agreed with the Commission.

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07 MAR 2019

Availability of Orkambi on the NHS

Today the Health and Social Care Committee held an Oral Evidence Session on the availability of Orkambi on the NHS

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06 MAR 2019

End of Life Care

Thank you to Caroline Dinenage, Minister of State for Care, and the charities, Marie Curie, Macmillan Cancer and Sue Ryder for meeting today to discuss improving end of life care, the NHS Long Term Plan , workforce pressure and the Social Care Green Paper.

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06 MAR 2019

Stalking Protection Bill - 3rd Reading in the House of Lords

Baroness Bertin Conservative

My Lords, I pay tribute to the honourable Member for Totnes, Sarah Wollaston, for all her hard work in creating this Bill in the other place and for her determination to get this legislation on the statute book. Furthermore, the Bill would not be in existence without the many brave stalking victims speaking out and the dedication of campaigners such as the Suzy Lamplugh Trust. I sincerely hope that anyone currently suffering from this terrifying crime will take some comfort from today. More help and protection for them is on its way. I thank this House for its cross-party support, the Home Office—particularly Andrew Lewis and his team—the clerks and Ben Burgess in the Whips' Office, who deserves a medal for his patience with me. I have had the privilege of meeting many victims and grieving families, who have somehow found the strength to channel the pain of their trauma into changing the system to prevent others going through the same horror. I dedicate this Bill to them and to the ones they lost.

Bill passed.

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05 MAR 2019

NHS Parliamentary Awards

It was lovely to launch the NHS Parliamentary Awards with Simon Stevens, the Chief Executive of NHS England and Caroline Abrahams, Charity Director for Age UK who will be one of the judges. The Awards are an opportunity to celebrate the outstanding work done by health and care staff and volunteers across the country

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05 MAR 2019

Points of Order

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

On a point of order, Mr Speaker. My hon. Friend Luciana Berger is currently on maternity leave. She has served with great distinction as a member of the Select Committee on Health and as a spokesperson who is nationally recognised for her work on mental health. I am deeply concerned to hear that the Labour party has been seeking names to replace and oust her from her position on the Select Committee. Surely this is unacceptable and sends entirely the wrong message about how we value maternity leave in this place. I am very relieved that none of her former colleagues was prepared to be nominated in that way. May I seek your guidance, Mr Speaker, on that point and on the wider point that Select Committees are surely at their best when Members can leave their narrow party politics at the door rather than being a tool of the Whips Office?

John Bercow Speaker of the House of Commons, Chair, Speaker's Committee on the Electoral Commission, Chair, Speaker's Committee for the Independent Parliamentary Standards Authority, Chair, Commons Reference Group on Representation and Inclusion Committee

I am grateful to the hon. Lady for the point of order.

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05 MAR 2019

Brixham Fish Market

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

The port of Brixham in my constituency lands the most valuable catch in England, but it has now reached capacity and needs urgent infrastructure investment in order to expand opportunities. Will the Minister assure me that our strategically important fishing industry and processing sectors will be fully considered in future infrastructure plans, and will he meet me to discuss Brixham port’s exciting plans for development, which need only modest investment to help them get rapidly off the ground?

Robert Jenrick The Exchequer Secretary

I would be happy to meet the hon. Lady. We are investing in port infrastructure, as indeed in other infrastructure projects across the south-west. I believe it was she who asked the Chancellor in the lead-up to the Budget to make that national commitment to Dawlish, for example. We are keen to listen to her opinions in this respect, and I would be very happy to meet her.

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04 MAR 2019

Young Minds

I was delighted to host YoungMinds in Parliament, for an event where young people met with MPs discussed the benefits of whole school mental health and wellbeing approaches in supporting students' education. This was part of YoungMinds' #TellOfsted campaign, urging Ofsted to include mental health provision in schools as part of their assessments.
Many schools do excellent work when it comes to wellbeing approaches, however too often they do not receive any recognition for this. Similarly, school leaders feel that the lack of focus on wellbeing within the current Ofsted framework and inspections programme, acts as a disincentive for them to prioritise wellbeing approaches, particularly when under financial constraints.

The Health & Social Care Committee's report into transforming children and young people's mental health found that half of all mental health conditions first occur by age 14, and three quarters by age 24—often with exam pressures and social media reported as key contributing factor, underlining the importance of schools' role in this issue.

Tackling this threat to the happiness and wellbeing of young people, before it develops into a crisis, must see the Government focus on joining up services. Updating Ofsted's remit to include the work schools do to support the mental health of young people would be a welcome step in the right direction.

I will also continue to press for an increase in the funding our schools receive as I'm very concerned about the shrinking of school curricula especially for arts subjects and the loss of counselling services

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04 MAR 2019

Housing, Communities and Local Government: Adult Social Services

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

Has the Minister read the letter to the Prime Minister—it was sent last week but published over the weekend—from Health for Care, which is a new coalition of organisations that speak passionately about their view that social care is on the "brink of collapse"? Will he meet me to discuss the coalition's concerns, the report published by the Health and Social Care Committee, which I chair, and the Housing, Communities and Local Government Committee, our findings and the work that we did with the Citizens' Assembly?

Rishi Sunak Parliamentary Under-Secretary (Housing, Communities and Local Government)

I praise the work done by both Select Committees in producing some options for the social care Green Paper, and I know that they are being actively considered, as they should be. To the hon. Lady's broader point, her characterisation is perhaps a little unfair, because good things are happening in social care. The recent publication of the delayed transfer of care statistics showed that they have halved since the peak of a couple of years ago, which shows that good progress is being made.

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04 MAR 2019

Department for Exiting the European Union

Written Answers

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

To ask the Secretary of State for Exiting the European Union, what steps he is taking in negotiations with his EU counterparts to ensure the UK's continued membership of the European University Institute Convention.

Robin Walker The Parliamentary Under-Secretary of State for Exiting the European Union

The Government has made clear that it values international exchange and collaboration. Officials in the Department for Exiting the EU and the Department for Education have met with the EUI to hold discussions to explore options to provide continuity and ensure UK students at the EUI can complete their studies.

Should Parliament approve the deal the Prime Minister has negotiated with the EU, the UK will continue to apply the terms of the EUI Convention for the duration of the implementation period. The UK's rights and obligations under the Convention would continue during that period, in accordance with the Withdrawal Agreement. The Political Declaration sets out that we will establish general principles, terms and conditions for UK participation in EU programmes in areas of shared interest, and wider dialogues to allow us to share best practice and act together in our mutual interest. On this basis, we will explore with the European University Institute options for future participation in its activities and we will work to ensure that UK students at the EUI will be able to complete their studies.

Furthermore, UK universities will be able to continue to collaborate with the EUI in research projects even if the UK is no longer a member of the EUI Convention.

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

To ask the Secretary of State for Exiting the European Union, whether it remains the Government's assessment that the UK will automatically leave the European University Institute Convention on 29 March 2019.

Robin Walker The Parliamentary Under-Secretary of State for Exiting the European Union

The European University Institute Convention (EUIC) is an agreement between the Member States of the European Union. After 29 March 2019, the United Kingdom will cease to be a Member State of the European Union and, as such, the UK's membership of the EUIC will automatically cease. Should Parliament approve the deal the Prime Minister has negotiated with the EU, the UK will continue to apply the terms of the EUI Convention for the duration of the implementation period. The UK's rights and obligations under the Convention would continue during that period, in accordance with the Withdrawal Agreement.

Officials in my department and in the Department for Education have met with the EUI to explore options for future participation in its activities and we will work to ensure that UK students at the EUI will be able to complete their studies. Furthermore, UK universities will be able to continue to collaborate with the EUI in research projects even if the UK is no longer a member of the EUI Convention.

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04 MAR 2019

School Funding

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

We all recognise that supporting the higher needs budget is extraordinarily important because of the vulnerable children that it supports. However, does the hon. Lady agree that when there is just a compulsory virement away from other budgets, that exacerbates the problem and that what we need is higher needs properly funded as a bloc?

.......

 

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

Does the hon. Gentleman agree that wellbeing and mental health are also important? Would he support the campaign being run by YoungMinds, who are in Parliament today to tell Ofsted to count in mental health and wellbeing in our schools?

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28 FEB 2019

Health and Social Care Committee

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons), Chair, Liaison Committee Sub-committee on the effectiveness and influence of the select committee system

I pay tribute to the hon. Gentleman for his effective chairing of the inquiry, and for his powerful speech. I also pay tribute to the other Committee members and the wider Committee team for the excellent report. It is fantastic that it sets out effectively the importance of early intervention in the first 1,000 days if we are to make the greatest difference and have the greatest impact on reducing inequalities.

Will the hon. Gentleman join me in paying tribute to a group in my constituency, the Dartmouth Nurslings, for its work to support breastfeeding mothers through peer-to-peer support? Will he touch on the evidence about the important of breastfeeding in the first 1,000 days of life, and how effective it can be? Will he also join me in hoping that we can reduce some of the fragmentation that means there is not a consistent level of support across the country? I hope that such groups will receive the support they deserve.

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28 FEB 2019

UK's Withdrawal from the EU

Sarah Wollaston Chair, Health and Social Care Committee, Chair, Liaison Committee (Commons), Chair, Liaison Committee Sub-committee on the effectiveness and influence of the select committee system

I am glad that the Government have published at least the summary of the no-deal consequences, and hope that they will go much further and publish the detail. Has the Minister seen the detailed paper published in The Lancet this week about the health consequences of no deal? If he has not seen it, will he assure me that he will look in detail at those consequences? No responsible Government could inflict that kind of pain on their people.

 

David Lidington Chancellor of the Duchy of Lancaster, Minister of State (Cabinet Office)

I have not seen that particular paper but I will make sure that I look at it and draw it to the attention of my right hon. Friend the Secretary of State for Health and Social Care. I hope it is of some reassurance to the hon. Lady that the Secretary of State has been making these preparations one of this very top priorities. He wrote to the leaders of the healthcare and pharmaceutical sectors in December last year, and the NHS executive is working hard to make sure that contingency arrangements are in place to ensure that supplies of medicines continue to be available.

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19 FEB 2019

Health and Social Care: Topical Questions

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

Key parts of our NHS workforce are registered and regulated by the Health and Care Professions Council. Does the Minister share their concern about the steep rise in professional fees that they face—in particular, the loss of the 50% discount that applied to graduates within two years of qualifying—and will she look again at whether anything can be done to assist this key group of our workforce?

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

My hon. Friend is absolutely right about the need to support and enhance the protections for allied health professionals. One of the recent planned HCPC increases was to raise its annual fees by £16, but it would still remain one of the lowest of any of the UK-wide health and care regulators. It is also important to remember that regulation fees are tax deductible.

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19 FEB 2019

Health and Social Care: PrEP Impact Trial

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

Does the Secretary of State share the widespread concern about the variation in availability of PrEP treatment, which is surely an unacceptable situation?

Matthew Hancock Secretary of State for Health and Social Care

There is a variability in availability. Of course the current model of delivery is a trial—we have doubled the size of that trial but it is still a trial that runs until 2021. I am very happy to work with my hon. Friend as well as with Peter Kyle to try to make sure that it is as available as possible.

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14 FEB 2019

UK's Withdrawal from the EU

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

Is the right hon. and learned Gentleman able to clarify in plain English at what point the Leader of the Opposition will unequivocally back a people's vote?

Keir Starmer Shadow Secretary of State for Exiting the European Union

The policy we have adopted is clear about what the options are. What we are trying to do today is to put a hard stop to the running down of the clock. That will enable options to be considered in due course. I hope that will happen. When they are considered, we will take our position and we will see where the majority is in the House.

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13 FEB 2019

Education

I met with Nick Gibb MP, Minister of State at the Department for Education along with local head teachers in Westminster to discuss funding challenges and how we can use resources most effectively to give pupils the support they need to stay in school.

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12 FEB 2019

Mental Capacity (Amendment) Bill [Lords]: Extent, Commencement and Short Title (

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

I thank my hon. Friend for giving way and for listening to many of the concerns that have been expressed about the Bill, as shown in the Government amendments. How are we going to deal with the extraordinary backlog of cases, which has left over 125,000 people without protection? The safeguards she has set out will stop this being a rushed process, but will she say something about the backlog?

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

The backlog of 125,000 people without the safeguards they need, with their families lacking reassurance and with the people who care for them lacking legal protection, is an enormous concern. That is why, during the long period in which we will set out the code of practice, we will be supporting local authorities to go through those backlogs. From day one, when the system is implemented, any new applications and those still in the backlog will be processed using the new system.

With grateful thanks for your patience, Mr Deputy Speaker, I will now sit down. This new system puts individuals at its very heart, and it removes the one-size-fits-all, box-ticking exercise we have unfortunately come to live with under the current system.

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07 FEB 2019

Business of the House

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

It seems clear to me that we are simply not going to be able to get the primary and secondary legislation required through by 29 March. However, could we, as soon as time allows, have a debate on the operation of Home Office rules on TBcertification and access to approved testing clinics? A young family in my constituency are facing imminently being torn apart because of entirely illogical and unreasonable application of these rules. Despite my constituent having had an X-ray and obtained a TB certificate, at her expense, at a UK hospital, she has been told that it will not count because it is not an approved centre, but the Home Office is telling her that there are no approved centres within the United Kingdom. To add further illogicality, if she returned to her home country of Canada to reapply, she would not need a TB certificate because it is more than six months since she was in a TB-prone country. I am very grateful to a Home Office team for agreeing to meet me to look at this case in detail. However, I do think that it raises a wider issue about applications and access to TB centres in the United Kingdom.

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

My hon. Friend raises a very concerning case on her constituent's behalf, and I have great sympathy for her constituent in that situation. I understand that my hon. Friend has rightly written to my right hon. Friend the Minister for Immigration, asking her to look into the matter. I understand that my right hon. Friend is seeking an urgent clarification of the situation, and of course if I can be of any help, my hon. Friend can always write to me.

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30 JAN 2019

European Union (Requirements Relating to Withdrawal)

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

I beg to move,

That leave be given to bring in a Bill to establish requirements in connection to the United Kingdom's withdrawal from the European Union.

We do not have the luxury of time. Unless an alternative is in place, in 58 days—just 29 sitting days—we will leave the EU with no deal. My Bill looks ahead to what happens if, as looks likely, the Prime Minister returns empty-handed from her mission impossible to Brussels, and is based on the recommendations of the 11th report of the Select Committee on Exiting the European Union, so I start by paying tribute to its Chair, Hilary Benn, and all its members for that excellent report.

The Prime Minister has repeatedly commented that, while the House has said what it does not want, it needs to decide what it does. In the event of there being no agreement to change the backstop, we will be back to square one, but with one important difference: we will be much nearer the no-deal cliff edge. In a nutshell, my Bill would allow the House to express its view on what could command the support of the House through a serious of indicative votes on free-standing motions, and the Committee recommended that those be taken in order.

The motions would give the House an opportunity to vote first on the Prime Minister's negotiated withdrawal agreement and framework for the future relationship; secondly, on the option of leaving with no deal; thirdly, to instruct the Government to seek changes to the backstop—although I think by then we would have tested that to destruction; fourthly, to instruct the Government to seek a Canada-style deal, as set out in the report; fifthly, on seeking to join the European economic area through the pillar of the European Free Trade Association and remain in a customs union with the EU, or a variation of it; and finally, to return the decision to the British people by giving them the opportunity to decide in a public vote what kind of Brexit deal they want or whether they wish to remain in the EU on the current deal.

Last night, the House gave two instructions to the Government. Not for the first time, it rejected leaving the EU with no deal, but it also passed an amendment unilaterally requiring that the Northern Ireland backstop be replaced by unspecified "alternative arrangements" to avoid a hard border. It adds up, essentially, to tearing up the withdrawal agreement. Donald Tusk in his statement following the vote has made it clear that the backstop is part of the withdrawal agreement and that the withdrawal agreement is not open for renegotiation. Most people do not seriously feel that the EU will be prepared to renegotiate.

In the absence of meaningful changes to the withdrawal agreement, it is hard to see how the Government will secure support for a deal that we rejected so comprehensively, by a margin of 230 votes. If my Bill went ahead, the House would have the opportunity to express its view on where the Prime Minister should go from here by giving it the opportunity not only to reject no deal but to consider other alternatives.

I want to be clear about why the House rejected no deal. No Government could seriously, knowingly and deliberately inflict such pain on their people. We are talking about changes not just to the economy but to livelihoods and jobs. It is the real world crashing into Brexit fantasy. It would affect not only our economy but many other sectors, including health, transport links, security, food and farming—the list is very long. No responsible Government could inflict that kind of pain, but unfortunately, up until now, the Prime Minister has given the House a binary choice: "My deal or no deal." My Bill would allow the House to say there are other routes forward.

Some colleagues want to press forward with an EEA-EFTAarrangement and a customs union, while others would prefer a Canada-style arrangement. We should all have the opportunity to vote on the way forward. I and many of my colleagues have made it clear we favour returning the decision to the British people to give them the final say. The problem with the original referendum was that it did not set out which of these many options the public were voting for. Once we know that decision, we will see that it is far removed from the sunlit uplands promised during the referendum campaign.

We need to seek the informed, valid consent of the British people; otherwise, we are pressing forward with a deal that commands the respect of neither leavers nor remainers. Nobody could realistically claim it is the will of the people, but if we give it back to the people and tell them exactly what is involved, so that they can weigh up the risks and benefits themselves, we will get that informed, valid consent, and then we could proceed together.

It is quite possible that the British people would decide to proceed with Brexit—I accept that—and they would need the absolute guarantee that it would then be acted on as quickly as possible, but a second vote would also allow them to change their minds. Everybody deserves the opportunity to change their mind. Even our first Secretary of State for Exiting the European Union has famously commented that if people cannot change their minds in a democracy, it ceases to be a democracy.

I reject the notion sometimes put forward that it would be a betrayal of democracy to ask people again, and I particularly object to the assertion that it would cause civil unrest. We need to stop talking that up. Since when did this House bow or cave in to the concerns and demands of the far right? We should be standing up to them and making it absolutely clear that democracy does not stand still, and should never stand still, and that this House has a duty to give the public the right to vote and have the final say.

We must recognise that this call comes not from the EU but from the people—the hundreds of thousands of people who marched through the streets of London in the summer and the many hundreds of thousands beyond that who did not make it here but who have written to us and campaigned for the right to have the final say in a people's vote. The House owes it to them to debate and vote on that as part of a series of indicative votes, and I commend the Bill to the House.

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29 JAN 2019

Ministry of Defence: Navy: Deployment

Written Answers

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

To ask the Secretary of State for Defence, what steps he is taking to ensure the continued effective patrolling of the (a) North Sea, (b) English Channel, (c) Western Approaches, (d) Bristol Channel and (e) Irish Sea; and what plans he has to increase the number of vessels based at the South Atlantic station.

Mark Lancaster The Minister of State, Ministry of Defence

The Royal Navy has a range of vessels that contribute to patrolling the waters of the UK. Those vessels are tasked to reflect the day to day operational demand, including supporting and working with Other Government Departments.

Force levels in the South Atlantic are regularly kept under review, and will be adjusted to meet the operational demand.

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Hansard

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29 JAN 2019

Ministry of Defence: HMS Medway and HMS Trent

Written Answers

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

To ask the Secretary of State for Defence, when (a) HMS Medway and (b) HMS Trent will be completed for deployment.

Stuart Andrew Assistant Whip, The Parliamentary Under-Secretary of State for Defence

As announced by the Secretary of State for Defence onboard HMS TYNE on 22 November 2018, the Royal Navy is expected to have all the Batch 2 Offshore Patrol Vessels, which includes HMS MEDWAY and HMS TRENT, by the end of 2020.

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Hansard

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29 JAN 2019

Ministry of Defence: Fisheries: Protection

Written Answers

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

To ask the Secretary of State for Defence, what steps he is taking to ensure the continued effective operation of the Fisheries Protection patrol in the event of the UK leaving the EU without a deal.

Mark Lancaster The Minister of State, Ministry of Defence

Ministry of Defence (MOD) officials are working closely with colleagues from across Government to manage the consequences of exiting the EU under a 'no deal' scenario. We firmly believe it is in the interests of both the EU and the UKto strike a deal.

That remains the goal on both sides and we are confident that this will be achieved. But it is the job of a responsible Government to prepare for all scenarios, so we have already carried out significant 'no deal' preparations for the unlikely event that we reach March 2019 without agreeing a deal.

As part of the Department's 2018-19 EU exit allocation from Her Majesty's Treasury, funding was provided to sustain an enhanced number of Offshore Patrol Vessels to ensure that the MOD has the ability to meet the anticipated additional Fisheries Protection requests from the Department for Environment, Food and Rural Affairs following the UK departure from the EU.

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Hansard

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24 JAN 2019

EU Free Trade Agreements

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

We now know that we will not have 40 of these deals ready to roll over on the stroke of midnight. Some of these deals will be worth proportionately more than others, so it could be said that we have a majority ready to go, but they might be ones of very low value. Can the Minister give us more clarity about the most valuable of these trade deals?

George Hollingbery Minister of State (International Trade)

I can report to the House that we are making good progress on a whole range of these deals, including those of high value and those at the other end of the scale.

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23 JAN 2019

Local Heat Heroes Receive Awards

Two local Energy Advisors have been recognised for their energy advice work with vulnerable residents across the South Hams at an award ceremony in the House of Commons.

Lin Etherden from Citizens Advice South Hams and Sophie Phillips from South Dartmoor Community Energy (SDCE) were nominated by their colleagues and received a national Heat Hero Award at the House of Commons today.

The awards are organised by fuel poverty charity National Energy Action and recognise people for going above and beyond in helping their clients to reduce their fuel bills and to stay warm and healthy at home.

Lin and Sophie are both qualified Domestic Energy Assessors and help householders to sort out their fuel bills, reduce fuel debt, apply for grants for home improvements and link up with other support services.

Citizens Advice and SDCE both deliver fuel poverty projects across the South Hams and often work together to ensure residents receive all the support that's available to them. They run regular drop in advice sessions in community venues, can attend community groups and can undertake home visits for more vulnerable clients. Their energy advice is all free and impartial and is funded through small grants that they have to apply for every year. SDCE are delighted to have recently secured £2000 through the Tesco Bags of Help scheme towards their work.

To find out more about the energy advice offered in the South Hams please visit their websites https://southhamscab.org.uk/ or www.southdartmoorcommunityenergy.org or call them on CAB:01803 659733 SDCE:0800 112 3044.

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21 JAN 2019

Healthcare (International Arrangements) Bill

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

I do not intend to detain the House for long. I support this Bill, but only regret that it is necessary. I wish to tell the House about an email that I received from a friend recently. He told me about his 92-year-old father who was visiting France and had a fall. He phoned my friend, who dialled 999 in this country, and an hour later his father was in hospital—all of that at no cost to his father because he carried a European health insurance card. The close ties that we have involving our reciprocal healthcare are not just financial. They are also about those close links and data transfer. I profoundly regret that this is the kind of thing that people will not realise they have lost until it is gone. That is the great tragedy here. The point is that it is not people like us, who are relatively fit and healthy, who will necessarily lose out by having to spend an extra 10% to 20% on our health insurance costs; it is our constituents who are elderly, who have to have regular kidney dialysis or who have other complex medical conditions, who will simply find themselves uninsurable or having to face prohibitively expensive insurance costs, and who, if they run into difficulties while they are abroad, will find themselves really adrift.

I hope that the Minister will make it absolutely clear to our constituents that, 67 days from now—the chances are looking more likely that we could crash out with no deal—very, very many of our constituents will find themselves in a really dire situation should they fall into difficulties abroad. They need to be given clear and specific advice about their holiday plans. For those of our fellow citizens who have retired to the European Union and who find themselves in difficulties, I regret that this is a situation for which we will all have to take responsibility in years to come. I hope that the Government will rule out no deal because the consequences will be profound.

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16 JAN 2019

Oral Answers to Questions - Prime Minister: Engagements

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

Driving off a cliff never ends well, particularly if it results in a crash and burn Brexit with no deal in just 72 days' time, but there is a way to avoid this: to be realistic by extending article 50 to allow us to put a realistic negotiated Brexit direct to the British people, to ask if it has their consent and also to include an option to remain with the excellent deal we already have.

Theresa May The Prime Minister, Leader of the Conservative Party

My hon. Friend will not be surprised to hear, as I have said this already in today's Prime Minister's questions, that I believe we should deliver on the vote of the referendum in 2016: we should be delivering Brexit. As I indicated earlier to her, she and others have talked about extending article 50, but the European Union would extend it only under circumstances in which it was going to be possible to come to an agreement on a deal. The talks we will be having—the discussions I will be having with parliamentarians across this House—will be aimed at ensuring that we can find a way to secure a deal that will get the support of this House.

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15 JAN 2019

Health and Social Care: NHS Facilities

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

The maintenance backlog across the NHS is deeply worrying. It affects equipment as well as buildings. Two of the 10 operating theatres at Torbay Hospital remain out of action. Would the Secretary of State meet me to discuss the impact that that is having on patient care? It is increasing waiting lists and leading to very short-notice cancellations to make way for emergency cases. Torbay Hospital has a £34 million maintenance backlog. It is deeply worrying.

Matthew Hancock Secretary of State for Health and Social Care

I am very happy to meet my hon. Friend, who makes a very important point. Of course, future allocations of capital are for the spending review. I look forward to working with her to try to sort out the problems in Torbay and across the board.

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14 JAN 2019

Leaving the EU: European Union (Withdrawal) Act

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

This deal simply does not deliver on the will of the people—it cannot do so mathematically. It is unwanted by the 48% who wanted to remain, and it is unloved by a very significant proportion of the loudest voices for leave. More importantly, it does not have the valid consent of the people. To give consent to an operation, people need to understand and have set out for them what the procedure involves, so that they can weigh up the risks and benefits. I am afraid that it is only now that we truly know what Brexit looks like out of the very many versions of Brexit that were presented during the referendum campaign. And I am afraid that it looks very far from the sunlit uplands with which we were presented at that time.

We cannot say that there is valid consent until people have had the opportunity to weigh up the risks and benefits of this deal—of Brexit reality—and we should take the time to pause in order to give them the chance to give that consent. The Secretary of Statesaid that that would take a year, but that is not the case. This could be done in 24 weeks, and we know that the European Union is prepared to suspend article 50 to allow that process to go ahead. I do not agree with the often stated claim that this would somehow be a travesty that would somehow let down our democracy. Since when was democracy a single, one-off event? No one said it was a travesty when we had a further general election in 2017, just two years after the 2015 election. Surely the worst argument of all for refusing the British people the opportunity to give their valid consent would be to say that it might upset the far right—a group of thugs outside the gates of Parliament. Since when did this House give in to the demands of fascists?

We have heard powerful speeches by my hon. Friend Joseph Johnson and Mr Sheerman about the scale of the harms this deal will inflict on our constituents. All Members in this House have a duty to say it as it is. In an age of populism and fake news, we owe it to our constituents to tell them how it is and not to bow to that populism.

We should be very careful if we are going to ignore the very real concerns that have been set out regarding the conduct of the original referendum campaign—concerns that part of one of the biggest donations in British political history could have come as laundered money from abroad. We have also heard about the serious concerns and the fines imposed by the Electoral Commission for cheating; we are talking about more than half a million pounds diverted to support the murky activities of AggregateIQ. These are very serious concerns. If, in the years to come, there is a public inquiry looking back on the conduct of the campaign, it will ask why those concerns were not taken more seriously at the time.

Alec Shelbrooke Conservative, Elmet and Rothwell

I know that my hon. Friend is a supporter of a second referendum, so let me take this opportunity to ask her what she believes the question would be in a second referendum.

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

My hon. Friend makes a valid point, but the point is that if this House agreed to a referendum Bill, those decisions would be made by this House. My feeling is that it should be a choice between, "Is this what you meant by Brexit? Do you want to proceed on the terms of this deal—the only realistic deal on the table?" and "Do you want to remain?" It would be up to this House to decide whether a further option was included, but what would be wrong would be to deny people the opportunity to discuss that.

Angus MacNeil Chair, International Trade Committee

But effectively the deal will be dead tomorrow, so the premise of the people's vote will be dead tomorrow, leaving only a hard Brexit or revocation of article 50. That is what we are down to now.

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

As it happens, I do not agree, but I do not think that any of us should pretend that it is for us, right now, to decide what the referendum question would be. We now know what the deal is. This is the only realistic deal on the table. It would be unconscionable for members of the Government to impose no deal. We have heard what the consequences of no deal would be, and I am afraid that they would be highly damaging for all the people we represent. It would not be damaging so much for big interests; it would be the most disadvantaged in our society who would pay the highest price.

Angus MacNeil Chair, International Trade Committee

If Parliament voted down the deal tomorrow, the deal could be resurrected again for the people's vote. That is a perplexing situation.

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

If the deal does come back to this House—and once the Labour party has gone through its processology and is able to deliver on the wishes of its own members to back a people's vote—then many former clinicians, including me, will be bringing forward an amendment to make it conditional on informed consent and obtaining that through a people's vote. That would be the right thing to do, in recognition that, as we can all see, this House has reached an absolute impasse. That is the simple truth of the matter. There is no consent for any of the versions of Brexit. Now we have reached that point, absolutely the right thing to do, and the ethical thing to do, is to be honest about it and take the decision back to the people with a simple question: is this what you meant by Brexit or would you rather remain on the deal that we already have?

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08 JAN 2019

Seaborne Freight

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

I am glad to hear the Secretary of State confirm that no money will change hands, but there will undoubtedly be vast manpower and bureaucracy costs in no-deal planning, and we know that there are actual costs when it comes to commissioning refrigerated warehousing and special air freight. All that could be avoided if the Government ruled out no deal. No deal would be catastrophic, and no sensible Government should inflict that on their people.

Chris Grayling The Secretary of State for Transport

Of course, the best way of avoiding no deal is to ensure that the deal passes through this House, and I will vote for it next week.

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08 JAN 2019

Pubs Code

Today in the Commons I raised the '72 pints' campaign with pubs minister Kelly Tolhurst on behalf of a constituent who has long been campaigning for fair treatment for pub tenants. I share my constituent's concern that too often breweries and pub companies are not passing on accurate information to pubs about how much beer in the casks they sell is drinkable. The undrinkable sediment in cask beer can be as much as three pints, so a pub buying a 72 pint cask may only be able to sell 69 pints from it. This is unfair to both consumers and publicans.

In the case of tenanted pubs, where rent may be set based on volumes sold, this increase cost pressures because it assumes sales on the basis of the volume of casks rather than the volume that can actually be sold. This is not just a small technical detail, but one that matters at scale because it costs publicans and ultimately customers more.

I am pleased that the Minister has agreed to meet with me and publicans from the constituency to discuss this issue and to find a way forward to tackle a long standing grievance. Pubs are at the heart of our communities and I want to help them remain financially viable.

If this affects your business please do get in touch.

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07 JAN 2019

NHS Long-Term Plan

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

I warmly welcome this ambitious and wide-ranging long-term plan for the NHS. I agree with Dr Whitford that so much is dependent on social care, on public health and on the workforce through Health Education England budgets, but may I add to that the situation for capital budgets within the forthcoming spending review? So much of the success of transforming services depends on the upfront funding to get things going and sometimes double running so that we can get a new service up and running before an existing service closes down. Will the Secretary of State go further in talking about the role and importance of capital budgets?

I also really welcome the triple integration—not only between health and social care, but between mental and physical health and between primary and hospital services. Could the Secretary of State confirm and support the proposal in the long-term plan that the legislative tweaks that will support that much needed integration will come from the NHS itself? I confirm that the Health and Social Care Committee remains committed to subjecting those proposals to pre-legislative scrutiny. Will he meet me to see how we can take that forward?

Matthew Hancock Secretary of State for Health and Social Care

Yes, I would be very happy to meet my hon. Friend to discuss the legislative changes. These changes have been proposed by the NHS. The NHS wants the changes set out at a high level in the plan. Of course there is a lot of consequential work to do to turn them into a full legislative proposal. The NHS is working on that. If it does that alongside and working with the Select Committee, I would be very happy to meet with her to discuss how that might happen. This is very much the NHS's proposed legislation and I look forward to discussing it with her.

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19 DEC 2018

Engagements

Oral Answer to Question

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

Will the Prime Minister join me in thanking all NHS, social care and emergency services staff who will be working over Christmas and the new year? Imagine how many more of them could be employed if we were not haemorrhaging billions preparing for a disastrous no deal. Could the Prime Minister end the uncertainty by ruling out no deal and will she also end the uncertainty please by publishing the long-term 10-year plan for the NHS before we break for Christmas?

Theresa May The Prime Minister, Leader of the Conservative Party

My hon. Friend and indeed a number of others have raised this question of no deal and not wanting to have no deal. As I said earlier in answer to questions, there is a simple way to ensure that we do not leave with no deal, and that is to back the deal.

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17 DEC 2018

European Council

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

Here is what would do irreparable damage to the integrity of our politics: to run down the clock and end up forcing through a deal that 48% did not want because they did not want to leave the European Union, and that the majority of those who voted for Brexit do not want. The mathematics simply do not stack up. The majority, in this House and in the wider country, do not want this deal. Can I ask the Prime Minister to get on with it, so that we can vote on it and then look at practical alternatives?

Theresa May The Prime Minister, Leader of the Conservative Party

As I indicated in my statement, we will bring the vote back in the second week in January. It is our intention that the debate will start in the previous week, the first week of January. As I said earlier, I have listened to the House. Had I not listened to the House and started the work to try to get further assurances, I suspect hon. Members would have raised that issue. It is right that I and the Government are doing exactly what we said we would, which is work with the EU for those further political and legal assurances.

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13 DEC 2018

Local Government Funding Settlement

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

Devon has successfully piloted the 100% retention of business rates, and it has injected an additional £20 million into Devon to support local economic growth and public services, but the pilot is due to end in March. Surely the whole point is to continue pilots that are a success. Can the Secretary of State provide any reassurance for Devon as to whether it will be able to continue, because it was not in the list of counties that he mentioned?

James BrokenshireThe Secretary of State for Housing, Communities and Local Government

I recognise the challenges and issues over the business rates retention pilots. Not everyone has been successful in relation to the pilots for 2019-20. We are piloting on the basis of 75%. That is on the basis of the new system that is being introduced in 2020 so that we can properly understand how it will operate in practice. I will certainly highlight to my hon. Friend some of the other issues in relation to, for example, the rural services grant, and how that will be beneficial to her local community, but, obviously, we will look at the representations that are received through this provisional settlement.

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12 DEC 2018

UK Fishing Industry

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

I thank my hon. Friend for making that really important point. In Brixham, in my constituency, fishermen are very worried about choke species with cod, which they cannot avoid catching. I wonder whether she feels the same about cod fisheries?

.....

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

Does the hon. Gentleman share my concern about the catastrophic implications of our crashing out with no deal and no transition, particularly because of the extreme friction that would cause at the borders? It would certainly affect my fishermen and I wonder whether he feels the same.

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11 DEC 2018

European Union (Withdrawal) Act 2018: Statutory Obligations on Ministers

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

In 108 days we run out of road, and the only red line that has not been laid down is the one in front of the cliff's edge, over which we would fall into a chaotic no deal. I urge the Minister and the Government to bring forward the meaningful vote to next week, because by then at least we will know what cosmetic changes have been made in Brussels.

Robin Walker The Parliamentary Under-Secretary of State for Exiting the European Union

I say gently to my hon. Friend that we should make sure the Prime Minister has the opportunity that she seeks to get the best deal in front of this House, and that we have the assurances we need so that the whole House can get behind the deal. My hon. Friend is a great champion of working across party lines; we ought to be taking this matter forward in a cross-party manner that delivers for the whole country. I do not believe that it would be right to rush into having a vote of this nature before we had sought those assurances.

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10 DEC 2018

Exiting the European Union

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

The Prime Minister rightly talks about listening to young people and first-time voters. Does she accept that they voted overwhelmingly to remain? They look at what is happening in this House and they see that this deal is Brexit, warts and all—this is as good as it gets. Is it not time, now that we know what Brexit actually looks like as opposed to some fantasy version of Brexit, that those people get the chance to vote on Brexit reality rather than Brexit fantasy?

Theresa May The Prime Minister, Leader of the Conservative Party

I think my hon. Friend has heard my response in relation to a people's vote, a second referendum, before. I genuinely believe that we should recognise that the referendum in 2016 was the biggest exercise in democracy in our history. We should respect the many people who went out to vote, including many who had not voted before. I believe that if we then go back to people and say, "Have another think, think again," they will question the value of democracy and the value of the vote.

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05 DEC 2018

Immigration (Time Limit on Detention):

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

Further to the point made by my right hon. Friend Justine Greening, will the Home Secretary commit to looking at the extra costs and the bureaucracy that will fall on our health service and our care sector? As she has said, because of the salary threshold that applies, many of the key staff who enable our health service and care sector to function will fall below that salary threshold, and the extra costs that will fall on the care sector in particular are quite extraordinary. Will he commit to reducing bureaucracy and tackling that cost?

Sajid Javid The Secretary of State for the Home Department

Again, a very important point has been raised by one of my colleagues. I absolutely make that commitment. My hon. Friend is quite right to raise it, because we have to recognise that as we move from the current system of freedom of movement, in which there is virtually no bureaucracy to speak of, to a system under which we will require visas for every worker, we must keep an eye on the paperwork and bureaucratic requirements and keep the system as simple and light-touch as possible. That applies not just to larger employers, such as hospitals or NHS trusts, but to the smaller employers that may be looking for skills but perhaps taking only one or two people a year, and we should keep that in our minds as well.

.......

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

It is a pleasure to follow Mr Sharma, and I agree with him that we are stronger when we work with our neighbours. No one doubts the commitment of the Prime Minister to try to deliver on the wishes of the 52%. The trouble is that no one really knows which version of Brexit she was mandated to deliver. There are so many possible alternatives, with everything from Norway, the European Economic Area, the European Free Trade Association and Norway plus a customs union through to a Canada-style free trade agreement and Canada plus plus plus. There are so many options, but after two years of hard slog, we now know what this looks like. We know what the withdrawal agreement looks like, for example. It is a legally binding agreement with more than 500 pages, but worryingly, it has only 26 pages describing what will actually happen after the transition period. That is nothing more than a wish list of asks and it is very sketchy. We are heading for a blindfold Brexit.

I also fear that we are being forced into a binary false choice in which we accept either a bad deal or something even worse: no deal. Unfortunately, the Prime Minister has set down red lines all around herself for the various options. The one area in which she has not put down a red line is the worst deal of all, which is no deal. I am afraid that I do not agree with my right hon. Friend John Redwood when he talks about "Project Fear". I think that very shortly, possibly in as little as 114 days, we will be up against "Project Reality". In the context of no deal, "Project Reality" would be very serious indeed for patients who use our national health service. We are talking about major interruptions in the supply chain of vital medicines and medical supplies. We are talking about insecurity in the supply of vital diagnostic test materials such as medical radioisotopes, which cannot be stockpiled. We are talking about supply chain issues for complex biological drugs, including those that we use to stop transplant rejection and to treat cancers.

We are also talking about products that cannot easily be switched from one brand to another in cases of shortage, such as medication for epilepsy. We are talking about difficulty in guaranteeing sufficient refrigeration capacity for stockpiling. Nobody voted in the referendum because they wanted to see the stockpiling of medicines and the extra costs involved, or the difficulties that the NHS and our care services will face in providing the workforce that we need. The truth is that there is no version of Brexit that would be positive for our NHS, for our care services, for science and research or for public health, and we need to be honest with people about that.

We also need to be honest and have a reality check about what is happening in this place. It seems to me that even the dogs in the street know that the Prime Minister's deal is not going to pass this House next week. That is the truth of it. We should now be thinking about plan B, and we need to be honest about that. To my mind, plan B must not involve no deal. No responsible Government could inflict no deal on the United Kingdom in 114 days' time. We are absolutely not prepared for that. So what is the alternative? There is no majority in this House for any of the other options, so the alternative is to look at going back to the British people and saying to them, "This is what Brexit looks like. This is the best that could be negotiated. Is this the Brexit you voted for, or do you want to stick with the deal that we have?" I would say that there was no consent to being dragged into Brexit without asking the people.

Before coming to this place, I was privileged to work in the health service for 24 years, and to teach junior doctors and medical students. In medicine, there is the really important principle of informed consent. We should apply it to Brexit, because Brexit is major constitutional, economic and social surgery. To give informed consent, one has to know what the operation involves. Two years ago, there were many possible versions of that operation, but now that we know what the surgery involves, it is time for proper discussion about the risks and benefits, and to allow people to weigh them up for themselves.

James Heappey Conservative, Wells

My hon. Friend knows that I respect her enormously. I agree that being very candid with the electorate is the right thing to do right now. Should we also be candid with them about the mechanism for delivering a second referendum—about the fact that it would require an Act of Parliament; about the European Union (Withdrawal) Bill taking 348 days to get through the Houses of Parliament; and about there being absolutely no expectation that a Bill as controversial as a second referendum Bill would be able to progress through this place any quicker?

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

I ask my hon. Friend to have a look at the work of the Constitution Unit and others, who estimate that we could get a referendum Bill through the House in 22 weeks. We would first need to extend article 50. That is what I hope that the Prime Minister does. I hope that she looks at the reality of the situation, extends article 50, and asks the British people, "Is this the Brexit you voted for, or do you want to stay with the deal we have?"—the one that has served us well for decades. That question has to go back to the British people.

None of us in this House should be forced into a false choice—into choosing a bad deal because we are told that the only alternative is no deal. That is simply not the case, and I believe that the House will reject the deal. That is why I support the amendment in the name of Hilary Benn rejecting no deal, and urge colleagues to do the same. The House should ask to extend article 50, so that we have the time to consider where we go from here. Otherwise, in 114 days, we run out of road and fall off a cliff. What is needed now—this message is for the Opposition Front Benchers as well as ours—is a BFO: a blinding flash of the obvious. We need to think again. Delivering on a people's vote will require the Opposition Front Benchers not to cling to the idea that they will force a general election; we know that will not happen, either.

We do not have any time to waste. We need Members on both Front Benches to give a free vote, or deliver support for a people's vote. That is the way forward. This House would decide the exact question. I believe that the choice should be between this deal and remain; I know others feel that the question should be more complex. We do not have to decide that now—it is something that the House could decide later—but we must not run out of road; we must extend article 50.

............

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

Does the Secretary of State agree, however, that another option would be to extend article 50, and that it is incorrect to present the House with a false choice in which we would automatically fall out on 29 March?

Jeremy Hunt Secretary of State for Foreign and Commonwealth Affairs

I had a conversation with my hon. Friend earlier this evening about how lively things are in her constituency. I think that if any of us asked our own constituents whether the right solution to the dilemmas we face would be to extend the agony by postponing the article 50 due date, they would be absolutely horrified. They want to get this over with. They want to get it resolved.

I mentioned the risks of a no-deal situation to our security, which were recognised by my right hon. Friend Stephen Crabb and my hon. Friends the Members for Ludlow (Mr Dunne) and for Banbury (Victoria Prentis). They all alluded to that issue.

In conclusion, when it comes to defence and security, irrespective of our membership of the EU, the lesson of history is clear. When Britain and Europe stand together against common foes, our combined strength deters our adversaries and keeps the peace. If we did not do that, our common security would be placed at risk in a way that would be wholly unnecessary. So let us grasp this opportunity for a new and different partnership, post Brexit, based on the essential truth that British and European security are indivisible and, whether inside or outside the legal structures of the EU, our common interests are best served by working together to protect the values we all cherish.

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04 DEC 2018

Personal Independence Payment: Mental Illness

Written Answers

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

  • To ask the Secretary of State for Work and Pensions, what proportion of successful personal independence payment applicants have a diagnosed serious mental health condition.
  • To ask the Secretary of State for Work and Pensions, what proportion of personal independence payment claimants are diagnosed with schizophrenia.

Sarah Newton The Minister of State, Department for Work and Pensions

Statistics on Personal Independence Payment (PIP) claim outcomes (clearances) at disability level are not readily available and have not previously been published as Official Statistics. We are producing the statistics requested and issuing them in an Official Statistics release on 11th December 2018 in accordance with the Code of Practice for Official Statistics.

Statistics on the number of individuals in receipt of PIP payments broken down by disability are already available on Stat Xplore:

https://stat-xplore.dwp.gov.uk

Guidance for users is available at:

https://sw.stat-xplore.dwp.gov.uk/webapi/online-help/Getting-Started.html.

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04 DEC 2018

European Union (Withdrawal) Act

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

I welcome the Prime Minister's commitment to engage further with the Select Committees. When she came to the Liaison Committeelast week, she will have heard one Committee Chair after another pointing out to her the catastrophic consequences of no deal and asking whether she would rule that out, if and when the House rejects this deal, because we cannot inflict that kind of catastrophe on our people.

Theresa May The Prime Minister, Leader of the Conservative Party

If my hon. Friend is concerned about no deal, the way to ensure that there is a deal is to support the deal that is on the table.

.........

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

Does my right hon. Friend agree that this is exemplified in article 107 of the future framework document? It just says:

"The Parties should consider appropriate arrangements for cooperation on space"— and that is it.

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27 NOV 2018

Health and Social Care: Community Hospitals

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

Dartmouth has lost its much-loved community hospital. Unfortunately, that loss has been compounded by the closure of River View nursing home, which had been due to house some replacement facilities. The total loss of community beds in isolated coastal communities such as Dartmouth is causing a collapse of trust in such programmes. Will the Minister meet me to discuss the situation in Dartmouth and the loss of nursing home and community beds?

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

I will of course meet my hon. Friend. She is right that we need to keep such valuable local resources right in the community, where they are most needed and where they keep people out of acute hospital services and surrounded by their friends and family.

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26 NOV 2018

Green Nonprofit Organisations

Thanks to Devon representatives from Devon Wildlife Trust, RSPB South West, Woodland Trust and National Trust for coming to Parliament to discuss environmental issues, the Agriculture Bill and the Fisheries Bill.

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22 NOV 2018

Progress on EU Negotiations

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

Without informed consent, there is no valid consent. Following the publication of the withdrawal agreement and the political declaration, we now have a much clearer idea of what Brexit looks like, which allows people to weigh up the risks and the benefits. That is what informed consent is all about. Does the Prime Minister accept that we have reached an impasse in the House, and that now that we are in a position to ask people for their informed consent, it really is time for a people's vote on this final deal?

Theresa May The Prime Minister, Leader of the Conservative Party

As I have indicated to a number of Members—obviously I have answered the question about a people's vote before—I strongly believe that having asked people in this country to determine whether or not this country should remain in the European Union, we, as their elected representatives, should recognise the feeling that was expressed in that vote and should deliver for people on that vote, and that means delivering leaving the European Union.

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21 NOV 2018

Fisheries Bill

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

Further to the Secretary of State's earlier point about expanding fishing opportunities, I am happy to report that Brixham in my constituency has had another record year and in 2017 landed over £40 million-worth of fish, but it is now limited because it is at full stretch. Brixham is anxiously waiting to hear what my right hon. Friend will do to guarantee that it can have access to funds such as the European maritime and fisheries funds to allow it to expand. Brixham is really keen to get on with it.

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

My hon. Friend makes a good point. I congratulate her on championing her constituency so successfully, and I thank the fishermen of Brixham for their work. In the EU we have the EMFF, which provides support for individual fishing communities, and this Bill makes provision for a replacement so that grants and loans can be provided for just such investment.

.....

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

Further to the point about zonal attachment, does my hon. Friend agree with Brixham fishermen that sprats would be an ideal kind of species to look at, because 90% of them are caught within the 12-mile limit but we have only 52% of the total allowable catch? Does he agree that that would be a much more sensible way to proceed?

Neil Parish Chair, Environment, Food and Rural Affairs Committee

My hon. Friend makes an interesting point. By moving to a different system, we perhaps remove ourselves from some of the existing quota restrictions. Because those are historical, and because we did not necessarily get a good deal—far from it—when we went into the common fisheries policy, we have the opportunity to do this.

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21 NOV 2018

Gosport Independent Panel

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

I welcome the Secretary of State's statement and commitment to introduce legislation to compel trusts to report on how they handle staff complaints and concerns, but will he assure the House that trusts will not be penalised if they have more staff concerns raised, because it might be an indicator that they have introduced the culture change necessary for staff to feel able to come forward? Will he also clarify how rapidly we will be rolling out the very welcome introduction of medical examiners?

Matthew Hancock Secretary of State for Health and Social Care

My hon. Friend is absolutely right that the number of complaints and concerns raised is not the material factor. A complaint that is actively welcomed and then acted on by management is merely part of the improvement process of any organisation. We should be open to them, welcome them and see them as an important part of the continuous improvement of NHS trusts, which is how many successful organisations see them. As I set out in the statement, medical examiners will be introduced from next April, but I am happy to give her more details of that whole policy.

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20 NOV 2018

Road Safety and the Legal Framework

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

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

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

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

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

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20 NOV 2018

Health and Social Care Committee

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

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19 NOV 2018

Second Homes

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

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

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

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

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19 NOV 2018

Finance (No. 3) Bill: Carbon Emissions Tax

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

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

Chuka Umunna Labour, Streatham

I could not agree more with the hon. Lady.

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15 NOV 2018

EU Exit Negotiations

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

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

Theresa May The Prime Minister, Leader of the Conservative Party

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

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14 NOV 2018

Healthcare (International Arrangements) Bill

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

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

......

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

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

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

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

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

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

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

......

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

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

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

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

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

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

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

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

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12 NOV 2018

UK Statistics Authority

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

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12 NOV 2018

Epilepsy

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

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06 NOV 2018

National Guardian

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

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06 NOV 2018

Assessment and Treatment Units: Vulnerable People

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

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

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

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

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05 NOV 2018

Road Safety

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

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


Jesse Norman Parliamentary Under-Secretary (Department for Transport)

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

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

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

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05 NOV 2018

Bullying and Harassment: Cox Report

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

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

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

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

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

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

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05 NOV 2018

Universal Credit: Prevention of Ill Health: Government Vision

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

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

Matthew Hancock Secretary of State for Health and Social Care

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

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01 NOV 2018

Fixed Odds Betting Terminals

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

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

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

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

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01 NOV 2018

Shipping: Exhaust Emissions

Written Answers

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

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

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

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

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

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

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

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01 NOV 2018

Health and Social Care Committee

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

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

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

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

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

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01 NOV 2018

Prison Health

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

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

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

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

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

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

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

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

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

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31 OCT 2018

Shipping: Exhaust Emissions

Written Answers

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

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

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

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

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

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

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

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

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

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30 OCT 2018

DEFRA Fisheries

Written Answer

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

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

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

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

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

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

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30 OCT 2018

Budget Resolutions - Income Tax (Charge)

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

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

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

Jon Ashworth Shadow Secretary of State for Health

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

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

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

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

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

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

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

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

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

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

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26 OCT 2018

DEFRA Fisheries

Written Answer

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

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

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

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

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25 OCT 2018

Immigration: DNA Tests

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

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

Sajid Javid The Secretary of State for the Home Department

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

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24 OCT 2018

Northern Ireland (Executive Formation and Exercise of Functions) Bill

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

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

 

Fiona Bruce Conservative, Congleton

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

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23 OCT 2018

Health and Social Care: NHS Innovation

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

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

Matthew Hancock Secretary of State for Health and Social Care

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

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22 OCT 2018

Nick Hurd

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

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18 OCT 2018

Scallops: Fisheries

Written Answers

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

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

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

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

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17 OCT 2018

Social Care Funding

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

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

Barbara Keeley Shadow Minister (Mental Health and Social Care)

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

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

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

Barbara Keeley Shadow Minister (Mental Health and Social Care)

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

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17 OCT 2018

Universal Credit

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

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

Heidi Allen Conservative, South Cambridgeshire

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

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

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

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15 OCT 2018

EU Exit Negotiations

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

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

Theresa May The Prime Minister, Leader of the Conservative Party

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

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10 OCT 2018

Agriculture Bill

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

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

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

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

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09 OCT 2018

Government Overseas Aid Commitment: Private Investment: EU Exit Negotiations

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

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

Dominic Raab The Secretary of State for Exiting the European Union

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

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09 OCT 2018

Dangerous Waste and Body Parts Disposal

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

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

 

 

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

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

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13 SEP 2018

Scallop Fishing: Bay of Seine

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

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

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

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

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11 SEP 2018

Home Care Services: Living Wage

Written Answers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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10 SEP 2018

Ministry of Justice: Prisons: Staff

Written Answers

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

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

Rory Stewart The Minister of State, Ministry of Justice

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

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

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

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

Rory Stewart The Minister of State, Ministry of Justice

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

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

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

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

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06 SEP 2018

Integrated Care

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

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

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

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

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

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

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

.......

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

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

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

.......

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

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

........

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

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

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

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

.........

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

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

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

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

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

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

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

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

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

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

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

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

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

........

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

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

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

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06 SEP 2018

Cystic Fibrosis

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

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04 SEP 2018

Prisons: Health Services

Written Answer

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

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

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

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

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

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

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

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24 JUL 2018

Health and Social Care: NHS Services: Online Access

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

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

Matthew Hancock Secretary of State for Health and Social Care

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

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20 JUL 2018

Fracking: Health Hazards

Written Answers

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

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

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

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

Hansard

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19 JUL 2018

Exiting the European Union: Contingency Plans

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

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

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

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

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

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18 JUL 2018

Liaison Committee

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

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17 JUL 2018

Trade Bill: Transfer Schemes

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

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

Phillip Lee Conservative, Bracknell

I will be as brief as possible, Mr Speaker.

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

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

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

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17 JUL 2018

Electoral Commission Investigation: Vote Leave

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

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

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

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

Chloe Smith The Parliamentary Secretary, Cabinet Office, Assistant Whip

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

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12 JUL 2018

Eu: Future Relationship White Paper

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

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

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

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

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11 JUL 2018

The Treasury

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

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10 JUL 2018

Grammar Schools: Transport

Written Answer

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

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

Nick Gibb Minister of State (Education)

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

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

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

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

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

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09 JUL 2018

Stalking Protection Bill

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

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

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

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

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

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

Alex Chalk Conservative, Cheltenham

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

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

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

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

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

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

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

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

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

Emma Reynolds Labour, Wolverhampton North East

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

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

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

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

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

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

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

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05 JUL 2018

NHS 70

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

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04 JUL 2018

NHS70 Awards

It was a pleasure to host the NHS70 Awards in Parliament, celebrating the people and services which exemplify the everyday brilliance of those working in NHS and care services. Thank you to Jeremy_Hunt for speaking, and congratulations to the winners and those shortlisted

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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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26 JUN 2018

Devon Air Ambulance

Thank you to the Devon Air Ambulance⁩ for all you do for people across all our communities. Concerned to hear about impact of people filming with mobile phones though. So important for bystanders to respect the privacy of all those who need emergency care

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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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02 JUN 2018

Grow Gap

Just love the Grow Gap project at Blatchcombe transforming spaces, spreading happiness through gardening, impressive mangetout and other veg. Thank you to your amazing team of volunteers

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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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29 MAR 2018

Department of Health and Social Care: Death Certificates

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, what progress he has made on the implementation of his Department's proposals for reform of death certification by April 2019; and if he will make a statement.

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

The Government is committed to the introduction of medical examiners from April 2019, to provide a system of effective medical scrutiny of all non-coronial deaths. Following a public consultation on associated reforms, the Government plans to publish a response shortly, accompanied by an impact assessment which will set out the costs and benefits of the revised approach.

Hansard

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28 MAR 2018

Contaminated Blood

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

The victims of the contaminated blood scandal have waited decades for answers. Will my right hon. Friend update the House on progress on the inquiry? Is there any room to revisit the decision to deny victims and their families legal aid in order to prepare adequately for the inquiry?

David Lidington Chancellor of the Duchy of Lancaster, Minister of State (Cabinet Office)

The inquiry launched a consultation on its terms of reference on 2 March. Details are on its website. The deadline for responses is 26 April. Sir Brian Langstaff wants to hear from as many of those who were affected as possible. As with any such inquiry, it is for the inquiry to decide the level of financial support, including for legal representation for the inquiry proceedings. I am very happy to talk to my hon. Friend and other interested colleagues, or for the Parliamentary Secretary, Cabinet Office, my hon. Friend Chloe Smith, to do so, about how the terms of reference are being handled. Sir Brian wants this process to be as user-friendly as possible.

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27 MAR 2018

Liaison Committee

Watch the Prime Minister give evidence to the Liaison Committee.

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23 MAR 2018

Leaving the EU: NHS

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

I thank the Minister for giving way and apologise for not making a fuller contribution to this important debate; I had a long-standing commitment as Chair of the Health and Social Care Committee that could not be delayed.

On the workforce, will the Minister comment on a small area that the Committee highlighted in its report but many people are not aware of: the role of qualified persons? Those are the individuals who are legally responsible for batch-testing drugs before they are released on to the market or made available for clinical trials. Will he pay close attention to the problems that will arise and the impact on clinical trials and the safety of medicines if qualified persons are no longer recognised in the UK after it leaves the European Union? That workforce is in great demand, and there is clear evidence that many of them will have to leave to the EU if that happens, leaving Britain short.

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

I am very happy to recognise my hon. Friend's point, which is well made. As she knows, I am keen to have close discussions with her about such issues. However, through our adoption of the acquis into UK law, our desire for a transition deal, our protection of workers' rights and our clear signal to EU citizens, the Government have signalled that we are committed to working collaboratively with the European Union and to maintaining high standards. Indeed, science and healthcare is one of the areas where collaboration is best and where the EU has the strongest desire to maintain that collaboration. We work from firm foundations as we take on some of these specific issues, which the Department will continue to explore.

At the same time as attracting talent from overseas—from both the EU and beyond—we should not lose sight of the importance of growing our own workforce. Again, the Government have clearly signalled our intention in that regard, with a 25% expansion of undergraduate places for nursing and our announcement earlier this week of five new medical training centres, in Sunderland, Lincoln, Lancashire, Chelmsford and Canterbury. There is a clear desire to strengthen training for the existing workforce.

That sits alongside other initiatives, such as apprenticeships and ensuring that there are different pathways for people to progress in the NHS. That will ensure that people can develop their careers at different stages, so that someone who enters the system as a healthcare assistant, for example, is not trapped in that role but is able to progress through the nursing associate route and go on to be a qualified nurse. There are myriad ways in which we need to ensure that the NHS has the right skills.

.....................

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

Will the Minister comment on the need for contingency planning, which is one of the central themes of our report? As he knows, nothing is agreed until everything is agreed, and there is genuine concern that we could have a last-minute no-deal scenario, which would have major implications for supply chains in the life sciences industry. Will he confirm whether he will publish a detailed list of the areas in which contingency planning is taking place? Will he also publish the detailed contingency planning?

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

The Chair of the Health Committee is absolutely right about the importance of contingency planning. In the Scottish context, on the steps of No. 10 recently, a critic of the Government as fierce as the First Minister praised the level of discussion between the devolved Government in Scotland and the UK, and her discussions with the Prime Minister.

It may reassure my hon. Friend that the Department has secured additional funding from the Treasury—more than £20 million—as part of our preparation for Brexit. The right hon. Member for Exeter has previously asked in the House whether the Department's preparation and staff resource is at the level that he and other colleagues seek. That is a fair observation, and the situation is continually being improved. Alongside that, considerable work is going on within the wider NHS family—in NHS England, NHS Improvement and elsewhere.

Like the Prime Minister and the Secretary of State, I emphasise once again the importance of EU staff within the NHS. They are hugely valued and will continue to be so, and we are keen to protect their workers' rights. That is reflected in the agreements reached by the Prime Minister in December and those reached earlier this week by the Secretary of State for Exiting the European Union. Alongside that, considerable work is going on within the Department to address a number of these issues as part of our contingency planning. We continue to seek a very close co-operative deal with our partners in the European Union. In areas such as science, there is a long and strong tradition of working in such a collaborative manner. As part of continuing those preparations, this debate and the Health Committee's informed report provide much material on which we can work.

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21 MAR 2018

NHS Staff Pay

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

I warmly welcome today's announcement of a well-deserved pay rise for NHS staff and, in particular, that this will be additional funding of £4.2 billion over three years, rather than it coming out of existing resources. I particularly welcome the focus on staff health and wellbeing, which was raised by the recent Health Committee inquiry into the nursing workforce. In particular, I ask the Secretary of State to go further and talk about what will be done on continuing professional development for NHS staff, because this was identified as a key factor in retention. He referred to it partially in his comments, but I wonder whether he could go further.

Jeremy Hunt Secretary of State for Health and Social Care

I thank my hon. Friend for her comments. Underneath this agreement, there is a very important new partnership between NHS employers and the unions to improve the health and wellbeing of staff through mental health provision and the implementation of the Stevenson-Farmer review, taking on board a number of points raised by the Health Committee, and through improved support for people with musculoskeletal conditions, because a lot of NHS work is very physical. However, she is absolutely right: professional development is also very important. By reforming the increments system that we have been using for many years, we will give staff the chance to see their pay go up in a way that is linked to their skills going up as well. That is something that many staff will welcome.

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21 MAR 2018

Fisheries

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

Brixham in my constituency lands the most valuable catch in England. Will the Secretary of State visit Brixham to meet all parts of the sector to discuss their serious concerns that the terms of the transition could end up being reflected in the final deal?

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

My hon. Friend has privately been a persistent, effective lobbyist on the behalf of the fishermen of Brixham and all those associated with the industry, and I thank her for her work. The industry in Brixham has a highly effective and able advocate, and I will of course visit the fishermen in her constituency to explain to them how we intend to ensure that the opportunities available to them will be theirs to enjoy after the implementation period.

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14 MAR 2018

Women in Parliament

It was lovely to speak with Hilary Baxter about encouraging more women to stand for Parliament.

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07 MAR 2018

Slapton Line

Dr Sarah Wollaston (Totnes) (Con)

Storm Emma left a trail of destruction along the south coast of Devon, including washing away large stretches of the A379 along the Slapton line. Will the Prime Minister please assure my constituents that they will not be left isolated and their communities separated, and will she pledge funds to help rebuild this vital link? Will she also join me in thanking the emergency services, both in my constituency and around the United Kingdom, for their extraordinary work in desperately difficult circumstances?

The Prime Minister

I and, I am sure, everyone in the House will be happy to join my hon. Friend in praising the emergency services for the tireless work that they have been doing to help people during the severe winter weather that we have experienced. She is right to raise ​concerns about the A379 on the behalf of her constituents, and I am pleased to announce that my right hon. Friend the Transport Secretary will shortly confirm that we will provide financial assistance to ensure that repairs to the road are undertaken as quickly as possible.

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05 MAR 2018

Uk/EU Future Economic Partnership

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

The Prime Minister is rightly putting the needs of patients first in seeking associate membership of the European Medicines Agency. Will she go further in doing the same and commit to freedom of movement, both now and in future, for researchers and those in the health and care workforce who seek to work and study in each other's countries?

Theresa May The Prime Minister, Leader of the Conservative Party

When we leave the European Union, free movement, which has been one of the pillars of the EU, will end. However, as I said in my statement and in my speech on Friday, EU citizens will continue to want to work and study here, and UK citizens will continue to want to work and study in the EU27. We will be setting out our proposals for our immigration rules on that, and we will stand ready to discuss the arrangements that will be made in future.

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02 MAR 2018

Energy and Industrial Strategy

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 potential effect on employment of the projected (a) 17 sites by 2020, (b) 30-35 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)

BEIS has not made any estimates of the potential effect on employment from the future development of the shale gas industry.

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

To ask the Secretary of State for Business, Energy and Industrial Strategy, what estimate the Government has made of the number of jobs which will be created by the renewables industry over the next ten years.

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)

The Government does not produce forecasts for job creation over a future time period for the renewables industry.

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 extraction, what disposal method will be used for flowback waste from (a) the 17 sites by 2020, (b) the 30 to 35 sites by 2022 and (c) the 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)

It is up to the operator to agree disposal methods with the appropriate regulators as part of their planning application for any future shale gas development.

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01 MAR 2018

Seasonal Migrant Workers

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

Does my hon. Friend agree that, while we all support greater investment in technology within the agricultural sector, we are never going to be able to have a technological solution for harvesting in conditions such as those on hillsides in south Devon?

.........

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

It is a pleasure to follow Tom Brake and, like other colleagues, I congratulate my hon. Friend Kirstene Hair on securing this debate. Hon. Members have spoken compellingly about our need to address this issue here and now, and I will focus mostly on issues of time, because we do not have the luxury of that on our side.

I am sure that Members across the House will join me in paying tribute to our farmers and fishers. If we think it is cold here, imagine what it is like on a Dartmoor hill farm right now, or out on a Brixham trawler. We should pay tribute to all those who put food on our plates, and thank them for what they do. I particularly thank Riverford farm in my constituency, the National Farmers Union, and all those farmers who have written to me about this issue for the work they are doing to collect evidence for this debate.

As I have said, we do not have the luxury of time, and Riverford farm has made the point compellingly to me that this autumn it has to make crunch decisions about employing workers for the following year. There is still great uncertainty about the transition period, and as we have heard so compellingly from Members across the House, even if a transition period is in place, there is a shortage in our workforce here and now, and we could use the mechanism of a seasonal agricultural workers scheme to address that.

The Government have commissioned the Migration Advisory Committee to research the impact of leaving the European Union on the UK labour market, and to consider how to align immigration policy with a modern industrial strategy, but that is not due to report until autumn. It will then take time to implement such a scheme, and I do not think we have the luxury of that time.

Many nations across the EU already supplement their workforce with a seasonal agricultural workers scheme, so will the Minister give us some hope that the Home Office will take a decision on this issue sooner than we would expect under the current timetable, with a report coming forward in autumn? As we have heard, the uncertainty is delaying investment now for the future, and we need something to take back to our constituents who work in these important businesses. They are already making great efforts to recruit locally, but as we have heard, even with those efforts and schemes to encourage and retain a UK-based workforce, they are still dependent on a workforce that is supplemented from outside the country.

As the mother of someone who works in the robotics industry, I appreciate the investment going into those technological solutions. I am afraid, however, that it simply will not provide all the answers we need to make sure our crops are picked in a timely manner. There can be nothing more heartbreaking than seeing crops rotting in the fields, as I am sure the Minister will reflect in her closing remarks.

.....

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

I really think this is entirely in addition to it. I remain of the view that we should be focusing on the issues of frictionless trade and keeping very close links to our European Union partners as we exit the EU. I think these issues will arise irrespective of that, as we have heard. Whatever the situation with transition, I hope that the Minister will consider this as something we could use to supplement the arrangements we will have.

Most of all, I would like the Minister to give us some indication of when we are likely to see a decision. Farmers in my constituency here and now are starting to make decisions about their future plans and investment that will impact not only their businesses; remember that they also employ a local workforce in many other capacities, and their decisions will affect them. The implications for our industry are very far reaching and I hope the Minister will give some indication of when we are going to see an answer.

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27 FEB 2018

Royal College of Psychiatrists

I met with members of the Royal College of Psychiatrists to discuss the Mental Health agenda.

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26 FEB 2018

Children's Commissioner

Thank you to Anne Longfield, the Children's Commissioner for coming to Parliament today to discuss mental health

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26 FEB 2018

Home Department: Alcohol Abuse

Oral Answers to Questions

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

It has just been confirmed that all alcoholic drinks in Scotland must cost at least 50p per unit from May this year. Will the Minister now review our alcohol strategy to allow us to take up this evidence-based policy that will do so much to tackle the scourge of cheap, high-strength alcohol and reduce pressure on our emergency services?

Victoria Atkins The Parliamentary Under-Secretary of State for the Home Department, Minister for Women

We are of course aware of the Scottish Parliament's policy on this, and we are looking at it with interest. We set out our alcohol strategy in the 2016 strategy on dealing with modern crime, but we keep the issue under review.

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21 FEB 2018

Women NHS Leaders

It was inspiring to meet so many talented and passionate women fighting for 50:50 representation on NHS boards by 2020.

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21 FEB 2018

Medicines and Medical Devices Safety Review

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I welcome the Secretary of State's statement and his ongoing focus on patient safety, which has added so much to the patient experience. I also welcome the fact that he is clearly representing the voice of patients when learning lessons. Many of those who, courageously, have come forward, including many of my own constituents, have been harmed in the private sector. Will he confirm that all patients, wherever they were treated, will be included within the review and that there will be a focus on clinical governance, not only in the NHS but in the private sector?

Jeremy Hunt Secretary of State for Health and Social Care

I can absolutely give that assurance. We are considering how to strengthen oversight, because a tragedy is a tragedy wherever it happens, and we should be demanding the highest standards of care throughout our healthcare system. We are particularly considering the issue of data sharing, because often clinicians operate in both the NHS and the private sector, and we want to make sure that we do not have two datasets but that we share data in a way that makes patients safer.

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20 FEB 2018

Larwood

Thank you to all the teams & volunteers at the Larwood Practice and NHS Public Health and Local Authority leads from across England for meeting with the Health Select Committee today to share views on improving health and care. Great to hear about achievements and tackling challenges

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08 FEB 2018

Acute and Community Health

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I pay tribute to my colleague on the Health Committee, Rosie Cooper. She is a remarkable parliamentarian and advocate for patient safety. All of us on the Committee look forward to working alongside her to examine in full the Kirkup report's recommendations, and I welcome the Minister's commitment to a review of the fit and proper person test.

On the wider issues that the report raises, it is clear that when staff and funding continue to be cut from community services, there are terrible consequences for patient care. Will the Minister assure the House that he will work closely alongside the Care Quality Commission to identify other trusts in which issues such as this are likely to arise because of the workforce and funding pressures that are now being faced?

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

I am very happy to work with my hon. Friend on this. As she will be aware from reading the report, it is explicit that the finances were there for the existing service. That is stated at the outset of the report. What drove the problems was a wholly unrealistic attempt to seek foundation trust status, with a cost improvement plan that was simply undeliverable. There was a massive reduction, without any attempt to reconcile that with serious issues on staff levels and vacancies. As the report explicitly sets out, when staff raised those concerns, they were bullied, harassed and on occasion suspended without due cause. The culture has changed significantly, and measures have been put in place for how the regime involving NHS Improvement would address such issues and look at cost improvement plans.

On the extent to which the culture was driving the problems, I refer to the remarks I made in my statement. According to the report, the interim chief executive went in and found a significant underspend—£3 million—in the district nursing budget, at the same time as there were significant vacancies and patient harm. That culture was driving the issue, and that culture is what we need to put an end to.

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07 FEB 2018

Foster Care

Written Answers

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

  • To ask the Secretary of State for Education, how many children have been fostered in England in each of the last five years.
  • To ask the Secretary of State for Education, how many special guardianship orders have been issued in each of the last five years.

Nadhim Zahawi The Parliamentary Under-Secretary of State for Education

The numbers of children looked after in foster placements at any time during the year ending 31 March in each of the last five years were published in Table B1, in the statistical release Children looked after in England including adoption: 2016 to 2017 at: https://www.gov.uk/government/statistics/children-looked-after-in-england-including-adoption-2016-to-2017.

The numbers of children, who ceased to be looked after because of a special guardianship order during the year ending 31 March 2013 to 2017 in England, are shown in the following table.

  2013 2014 2015 2016 2017
Children who have ceased to be looked after because of a special guardianship order 2,770 3,360 3,550 3,860 3,690
  1. Numbers have been recorded to the nearest 10
  2. Only the last occasion on which a child ceased to be looked after in the year has been counted.
  3. Figures exclude children looked after under an agreed series of short term placements.
  4. Historical date may differ from older publications. This is mainly due to the implentation of amendments and corrections sent by some local authorities after the publicationdate od previous materials

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07 FEB 2018

General Practitioners: Migrant Workers

Written Answers

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of non-EU GP registrars who are currently on GP training schemes in England who will not be eligible for indefinite leave to remain when they finish their three-year training.

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

Currently there are 719 non-European Economic Area national general practitioner trainees working under a Tier 2 visa. On the completion of training, these trainees would be eligible to apply for indefinite leave to remain if they meet the requirements as set out by UK Visas and Immigration. Eligibility is based on individual circumstance and will be decided by UK Visas and Immigration.

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06 FEB 2018

Centenary of Voting Rights For Women

Truly wonderful to see all the Acts of Parliament that made it possible for women to vote and to take their seats.
It is thanks to the sacrifice, courage and determination of so many suffragettes and suffragists that there are now over 200 female MPs - our democracy is stronger as a result.

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06 FEB 2018

Sky Ocean Rescue



Today, I supported Sky Ocean Rescue and committed to #PassOnPlastic.

Launched in January 2017, Sky Ocean Rescue aims to shine a spotlight on the issues of ocean health, particularly single-use plastic, and inspire people to make small changes.

Sky Ocean Rescue's whale, Plasticus, which is made up of a quarter of a ton of plastic – the amount that enters our oceans every second, came to Parliament, to bring to life the scale of the problem.

Here are the top tips on how you can #PassOnPlastic

  • Drink out of a refillable water bottle
  • Use a bag for life
  • Avoid products that contain microbeads
  • Buy cotton buds with cardboard rather than plastic stems
  • Swop your wet wipe for a flannel
  • Use a metal or glass straw
  • Buy fruit and veg loose rather than in plastic packaging
  • Give up plastic cutlery
  • Bring your own travel mug to your favourite coffee shop

We all have a role to play in saving our oceans. Small changes = big difference!

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06 FEB 2018

Health and Social Care: Routes into Nursing

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

Following the recent inquiry by the Select Committee on Health into the nursing workforce, we absolutely welcome the new routes into nursing, including the new role of nursing associate. However, one of the issues highlighted strongly was the need to retain our existing nursing workforce as well as to recruit into it. Will the Secretary of State comment on that?

Jeremy Hunt Secretary of State for Health and Social Care

My hon. Friend speaks very wisely—we do need to be better at retaining our existing workforce. I think that is why the Treasury has given me extra latitude in negotiations on the pay rise—those discussions are currently happening—but we also need to be much better at flexible working and at recognising the challenges people have in their ordinary working lives.

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05 FEB 2018

NHS Winter Crisis

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

The Minister will know that pressures in the NHS cannot be viewed in isolation from pressures in the community. It is great to see that he is now part of a Department of Health and Social Care. Will he say what is being done about making beds available in the community, to free up pressures in the NHS?

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

My hon. Friend, the Chair of the Health Select Committee, makes a valid point about the need for much more integration in our approach to the NHS. That is reflected in the appointment of my hon. Friend Caroline Dinenage as the Minister for Care, to look at that exact point.

Part of it is also looking at how we address other areas to deliver better outcomes. For example, 43% of bed occupancy at present is from just 5% of patients—those staying over 21 days. One key issue is how we bring down the current average stay from 40 days to, say, 35 days. That alone would unlock around 5,000 beds. We are looking at a more integrated model to address the pathways that I know my hon. Friend has highlighted in the Health Committee as a key priority.

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01 FEB 2018

Proxy Voting for MPS

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

My right hon. Friend is making a very powerful speech and I absolutely support the motion. I agree with her in very much hoping that this is the thin end of the wedge, because on the centenary of the Representation of the People Act 1918, we must do more to fix the pipeline problem here so that we encourage more women at a younger age to think about putting themselves forward to become Members of Parliament.

Maria Miller Chair, Women and Equalities Committee

I thank my hon. Friend for that intervention because, 100 years since the first woman sat in this place, it still feels for many of us as though we are operating in an 18th-century model of work, and that really needs to change.

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29 JAN 2018

Mental Health

Thank you so much for coming to Parliament to share your views on mental health, education and CAMHS today

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19 JAN 2018

Stalking Protection Bill

Thank you to everyone for their support for the 2nd Reading of my Private Members Bill.

The Stalking Protection Bill can be found here

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15 JAN 2018

National Security Capability Review

Sarah WollastonChair, Health Committee, Chair, Liaison Committee (Commons)

The Liaison Committee was unanimous in supporting the request of the Chair of the Defence Committee, my right hon. Friend Dr Lewis, to have the National Security Adviser appear in front of the Committee. My right hon. Friend the Secretary of State will know that there are precedents for the National Security Adviser appearing in front of the Defence Committee, the Foreign Affairs Committee and elsewhere, and Parliament has never accepted the Osmotherly rules, so will he give permission for the National Security Adviser to appear?

Gavin Williamson The Secretary of State for Defence

I am afraid that my hon. Friend is asking me something I cannot deliver. I can offer the Chief of the Defence Staff if she would like him, but I cannot offer the National Security Adviser. However, I will certainly pass on her request to Mr Sedwill.

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08 JAN 2018

Office for Students: Appointment

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I am afraid that I feel Mr Young's comments do cross a line and are indicative of an underlying character. We are talking about the kind of person who would tweet comments to a woman about masturbating over images of refugees—this does just cross a line. I feel that he should withdraw. When we apply for jobs, we all say whether or not there is anything in our past that could cause embarrassment. If that question was asked and it was answered "no", there is clearly a case for the board revisiting this and asking him to step down.

Jo Johnson Minister of State (Department for Education) (Universities and Science) (Joint with the Department for Business, Energy and Industrial Strategy), Minister of State (Department for Business, Energy and Industrial Strategy) (Universities and Science) (Joint with the Department for Education)

I recognise that, as I have said, many of the tweets have been obnoxious and repellent in many ways—obviously, I have not seen all 40,000 of them—but it is also important to recognise that that tweet was probably eight or nine years old, since which time Mr Young has been on something of a developmental journey. It is possible that there is a capacity for reform, and we want to encourage Mr Young to develop the best sides of his personality—those that have led to him setting up good schools and to working with disadvantaged children in London so that they can make the most of their potential. It is for those reasons that he has been appointed to the board.

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08 JAN 2018

NHS Winter Crisis

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I join the Minister in thanking NHS staff and in commenting that there is nothing new about winter pressures in the NHS. What is different is that they are extending now into traditionally quieter months, and that the depth of those pressures is so much more profound over the current winter, because there has been a failure over successive Governments to plan sufficiently for the scale of the increased demand across both health and social care. Will the Minister think about the forthcoming Green Paper for social care and think about combining it with health, so that we can see this as a truly across-system approach? I would also like to reiterate the points made by Dr Whitford about the role of bed-occupancy levels. Can the Minister tell us what the current bed-occupancy levels are in the NHS in England?

Philip Dunne The Minister of State, Department of Health

On the last point, I can confirm to my hon. Friend that, at Christmas eve, the bed occupancy rate was 84.2%, below the target of 85% that we set going into this particular winter period. Of course the rate fluctuates daily and I do not have the figures for the most recent days. We did at least start this holiday period in that position, which is a great tribute to the work done in preparing for winter. I wish to reiterate to her, as I did to my right hon. and learned Friend, the importance of the integration work being done through the sustainability and transformation partnership process between NHS organisations and social care providers. It is part of the solution for the longer-term arrangements that we need to put in place to try to make sure that people who are living longer live better, more healthily and in a more independent way out of hospital.

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20 DEC 2017

Liaison Committee

The Liaison Committee takes Evidence from the Prime Minister

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18 DEC 2017

Harassment in Public Life

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

Sadly, abuse and intimidation are directed not just against those in public life, but against their families and those who work alongside them. I am sure the whole House will want to join me in paying tribute to our amazing teams in our constituency and parliamentary offices—in my case, Nina Smith, Lucy Mannion and Daragh Quinn—who deal with people with unfailing courtesy and respect. It is a great shame that, after I am targeted as a traitor by organisations such as the Daily Mail, the extent of the abusive calls is unfortunately so great that I have to ask them to work from home, and that when Members listen to this stuff—when we go in and work alongside them the next day—we find that it is truly shocking and unacceptable.

Amber Rudd The Secretary of State for the Home Department

I thank my hon. Friend for making such an important point. It is for us all to remember that our staff—they are the frontline—so often have to deal with these abusive phone calls, and they do such a fantastic job in usually protecting us from them, but they often have to deal with a torrent of abuse. Yes, I completely share her view, and I wholeheartedly endorse what she says about the people who work for her, as I do about everybody whose staff working for them put up with a level of abuse that we all have to endure.

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14 DEC 2017

Business of the House

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

On one of the busiest Saturdays in the run-up to Christmas in Totnes, local activists—including, sadly, the local Labour party—decided to parade with a real coffin and leave a large and carefully constructed model of a coffin at my constituency office. Does the Leader of the House feel, particularly in the light of the report on intimidation in public life that was published yesterday, that the line of decency was overstepped? There are real dangers in using the imagery of death and directing it against individuals to whip up hatred. Most importantly of all, this kind of thing deters really good candidates from applying for positions in public life.

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

I was disgusted, as I am sure all right hon. and hon. Members were, to hear about my hon. Friend's awful experience. I texted her at the time to say that I hoped she was okay. It must have been absolutely terrifying. It was truly horrible and we should all condemn this kind of behaviour and call it out wherever we see it. Lord Bew's report on the abuse and intimidation of candidates highlights that this is not a simple matter of holding politicians to account. It goes far beyond that and it will be a deterrent to diversity and the high calibre of candidates we want to see standing for Parliament. We all combine in condemning that action against my hon. Friend.

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14 DEC 2017

Topical Questions

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I recently booked an appointment in the Reading Room. I thought that it would be like an inner circle of hell, and that I would be trapped in there for days reading the sectoral analysis. Indeed, I was there with Mary Creagh. In fact, there were only nine pages on health and social care, and the documents relevant to my Select Committee took me less than an hour to read in their entirety. I believe that in the interests of transparency, these very straightforward documents should be in the public domain. Will the Secretary of State publish them?

Robin Walker The Parliamentary Under-Secretary of State for Exiting the European Union

The sectoral analysis has already been made available to the Select Committees, as per the motion of the House, and to all Members of this House through the Reading Room. The documents contain a range of information, including sector views, some of which would certainly be of great interest to the other side in these negotiations.

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13 DEC 2017

Implementing the withdrawal agreement

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I agree with many of the hon. Lady's points, but is it not vital that we send out the clear reassurance, which the Prime Minister gave at the Dispatch Box to all our NHS and care staff, that they and their families are welcome to stay, that we want them to stay and that their rights are now guaranteed?

Philippa Whitford Shadow SNP Spokesperson (Health)

I absolutely agree with the hon. Lady, but unfortunately it is not enough to come to the Dispatch Box every couple of months with warm words of welcome to EU staff, when in between women who are raising families here, with British partners or partners of EU origin, are being turned down for permanent residency because they have not taken out private comprehensive health insurance. We have had 100 EU nationals sent "prepare to leave" letters. Friends of ours tried to get citizenship for their three children, who were born and grew up in Scotland: the eldest and youngest were given passports; the middle child was refused. I am sorry but the experience of EU nationals on the ground over the past year and a half has been horrendous. If the phase 1 agreement last week is to mean anything, we must incorporate it into the immigration Bill to give them certainty now, instead of telling them they might have to wait another year before they find out what their future will be.

To exercise the right to live anywhere, access to healthcare and social security is crucial. It has made such a difference, not just to EU nationals here, but to our pensioners who have settled in the sunny uplands of the northern Mediterranean. What position will they be in if they cannot access healthcare? We must recognise that freedom of movement was not a one-way street; our young people and professionals have been able to take advantage of it for the past 40 years. We are taking that away from the next generation, which is something that I find terrible.

The Government say, and it is in the phase 1 agreement, that they accept keeping regulations 883 and 987, so let us bring that in. Let us get that down on paper and get it passed, because saying to EU nationals, "You're welcome to stay, but there might be no deal, which means you'll have no legal standing and you won't be able to use the NHS," is no use to anyone.

The other thing that the EU has brought us, as well as rights and opportunities, is co-operation. The agencies of which we are members are probably the prime example of that. Sadly, more than half of the EU agencies do not have a constitutional position for third countries. Twenty-one of them allow participation and 12 of those allow what is called co-operation, which does not involve payment in the way that participation would. It is therefore important that the Government utilise those and keep us in, or as close as possible to, the agencies that were bringing benefit to the UK. It is also important to recognise that this affects all constituent parts of the UK—all four nations. These decisions cannot be made by delegated legislation, down in an office, with no discussion with Parliament or the devolved nations, which will have to mitigate and face the ramifications.

With an airport and the northern air traffic control in my constituency, naturally I support amendments 245 and 246, on staying in the single European sky agreement, which is the reform of airspace, and the European common aviation agreement, which is what allowed the budget airlines to literally take off and people to travel cheaply. However, the European Aviation Safety Agency is also important, and that is a body of the EU and EFTA. It is important to recognise that there are things we can be in, there are things we cannot be in, and we lose these because we seem to have negotiated with ourselves to move to a hard Brexit instead of a soft Brexit. People here are saying , "Oh yes, this was all aired in the debate." I remember hearing leavers saying, "Of course we won't leave the single market. Don't be ridiculous." Yet that is the plan and that is where we are heading at the moment.

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13 DEC 2017

Prime Minister: Engagements

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

Will the Prime Minister join me in thanking all the wonderful staff from across the European Union who work in our NHS and social care? Will she give them her personal, unequivocal assurance that they and their families will have the right to remain after Britain leaves the European Union?

Theresa May The Prime Minister, Leader of the Conservative Party

I am very happy to join my hon. Friend in thanking all who work in our NHS and social care sector, including those from across the European Union. They do incredible work, and it is absolutely right that we recognise the contribution that EU nationals make in this sector but also across our economy and our society. That is why we want people to be able to stay and we want families to be able to stay together. I am very pleased that the arrangements that were published in the joint progress report between the United Kingdom and the European Union last Friday show very clearly, on citizens' rights, that where people have made the life choice to be here in the United Kingdom, we will support them and enable them to carry on living their lives as before.

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12 DEC 2017

European Union (Withdrawal) Bill

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I congratulate my hon. Friend and the Procedure Committee, and I really welcome its proposals. Does he think that this idea should be extended to all statutory instruments?

Charles Walker Chair, Procedure Committee

My hon. Friend tempts me so much. It is not my intention today to spook the Government, but I think the sifting committee will probably be so successful that the Government and the House will want to embrace it for all negative SIs going forward.

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07 DEC 2017

UK Fishing Industry

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I wish to start by paying tribute to Sean Hunter, a Brixham fisherman who sadly lost his life in the past week. He was deeply loved by his family and the whole community, and I know that the House will want to join me in sending our deepest condolences to his family.

I also pay tribute to the Fishermen's Mission, which does much to support fishermen, their families and our wider communities, and join other Members in paying tribute to the coastguard, the Royal National Lifeboat Institution, the National Coastwatch Institution and all the emergency services for their professionalism and courage. Most of all, however, I want to thank the fishers themselves, who do so much, in such challenging conditions, to put food on our plates and bring so much to our national and local economies. The value of the catch to the UK economy in 2016 was £936 million.

I am also delighted to say that Brixham has again been voted the No. 1 fishing port in the UK and lands the most valuable catch in England. In excess of £30 million has been sold through Brixham fish market in the last year, and that is providing jobs not just at sea but in the processing sector on land. We recognise the value of all those jobs.

I also pay tribute to the responsible actions of our fishers, who have done much in responding to scientific advice to improve the sustainability of many of our species. However, just as we expect our fishers to respond to that scientific advice and reduce the total allowable catch, in many cases, so I would ask the Minister to respond and recognise that we expect fairness when the scientific data shows we are fishing sustainably. In his negotiations, in which I wish him well, will he therefore look at the sole quotas in VIId and VIIe? There is a very strong case for their being increased further.

We need to look again at the value of the scientific evidence on which the quotas are based. In responding to the debate, will the Minister listen to the concerns of fishermen who are asking for greater access to fisheries science partnerships in co-operation with CEFAS? I am concerned to hear that too often these requests are turned down. For some years, the UK has agreed to adhere to the data collection framework, so it is of great concern to hear that the sprat stock, for example, is still described as "Data Deficient". In his response, will the Minister say what is going to happen about that in future?

Several colleagues have raised the issues of bass fisheries. As time is short, I will not dwell on them, except perhaps to thank the Devon and Severn inshore fisheries and conservation authority for meeting me to discuss the wrasse fisheries, and to hold that up as an example of where responsible but proportionate precautionary principles are being applied.

In my closing moments, I say to the Minister that as we now move to thinking about where we are with Brexit and beyond, fishing communities want to see fairness. We recognise that we need to avoid falling into an acrimonious Brexit, but to maintain good relations in order to trade with our neighbours in the future. I just hope that he will make sure that our fishing communities are not let down, as they were in 1973.

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07 DEC 2017

Social Care

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

The House of Lords Select Committee on the Long-term Sustainability of the NHS rapidly concluded that it would be impossible to carry out its task without investigating the interrelated nature of social care, and it changed its remit accordingly. The Committee changed the scope of its inquiry because it recognised that we will not see a long-term, sustainable solution unless we address both. I am afraid that a Green Paper that focuses entirely on social care will fail to rise to the challenge. Has the Minister read the Committee's findings, and as she listens to those she consults at an early stage, will she be prepared if the advice from them is to consider health and social care together—that has been the advice of all the commissions that have looked at this—to go back to the drawing board and start again by looking at both health and social care?

Jackie Doyle-Price The Parliamentary Under-Secretary of State for Health

To reassure my hon. Friend on the terms of reference for the Green Paper, let me say that part and parcel of getting a long-term, sustainable solution very much involves looking at care, and I pointed out in the statement that we need to look at holistic areas of policy to deliver it. Housing is one area, because if we get housing conditions right, we can obviously enable people to live for longer. The whole purpose of having a Green Paper and a debate is to make sure that we consider this issue not in a silo, but holistically, with a person-centred approach.

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28 NOV 2017

Nursing Workforce

The Health Committee heard from senior officials, including Minister of State for Health, Philip Dunne MP, about the challenges facing the nursing workforce in England and the actions Government and arms-length bodies are taking to address these problems.

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28 NOV 2017

Maternity Safety Strategy

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I warmly welcome the Secretary of State's announcements today, including the move to allow coroners to investigate full-term stillbirths. Will he set out the current waiting time for post-mortems for infants because, as he will be aware, there is a shortage of the very highly specialised pathologists who carry out this vital work?

Jeremy Hunt The Secretary of State for Health

I do not have that information to hand, but I will find out for my hon. Friend and let her know.

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23 NOV 2017

Universal Credits

Sarah WollastonChair, Health Committee, Chair, Liaison Committee (Commons)

I thank the Secretary of State for listening to colleagues on both sides of the House in this welcome package of changes to universal credit, and particularly for scrapping the seven waiting days, for improving the loans and advances that are available and for the changes to housing benefit. Will he join me in thanking Citizens Advice? Citizens Advice does so much to support all our constituents, and it also welcomes the changes.

David Gauke The Secretary of State for Work and Pensions

My hon. Friend is right to draw attention to Citizens Advice, with which we have strongly engaged. Indeed, I spoke to its chief executive yesterday, and I have a meeting with her—the chief executive—later today. We will continue to work closely with Citizens Advice, and I am keen to ensure that, when it comes to universal support, we continue to work closely with Citizens Advice because it provides people with a huge amount of practical support and help.

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14 NOV 2017

Paignton Community College

I met with Justine Greening today along with Kevin Foster to discuss our serious concerns about the condition of parts of Paignton Community & Sports Academy.

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14 NOV 2017

Nursing Home Beds

Sarah Wollaston Chair, Health Committee

In its annual “State of Care” report, the Care Quality Commission has highlighted that there are 4,000 fewer nursing home beds in England than there were in April 2015. What plans does the Secretary of State have to address the workforce and funding issues that lie behind this? Will he meet me to discuss the situation in my constituency and nationally?

Jeremy Hunt The Secretary of State for Health

I congratulate my hon. Friend on becoming Chair of the Liaison Committee. Of course, I am always happy to meet her, and the issue that she has raised is very important. Our figures show that the number of nursing home beds, as distinct from the number of nursing homes, is broadly stable. There is real pressure in the market, however, and there are real issues about market failure in some parts of the country, so I am more than happy to talk to her about that.

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13 NOV 2017

Ministry of Defence; Military Aircraft

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Defence, if his Department will give consideration to retaining UK aerospace design and manufacturing capability by taking into account supply chains when purchasing new aircraft.

Harriett BaldwinThe Parliamentary Under-Secretary of State for Defence

We recognise the important contribution the UK's Defence Aerospace Industry makes to the UK's national security and prosperity.

Through the Future Combat Air Strategy Technology Initiative (FCAS TI), announced as part of the 2015 Strategic Defence and Security Review settlement, we are pursuing a national programme to ensure the UK retains the skills and capabilities necessary to maintain our place as a global leader in this area including in the wider supply chain.

We continue to review the defence industrial landscape, including in the UK aerospace sector to better understand our longer-term requirements and delivery options including the potential for international partnering, industry's appetite to invest, adjacent civil investment and overall affordability. Our review process considers the broader supply chain and will be taken into consideration in future procurement decisions. In addition, the refreshed Defence Industrial Policy will further explain how our investment choices take account of factors contributing to a more dynamic and productive UK economy, in which the UK defence supply chain plays a crucial part.

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08 NOV 2017

Aerospace Industry

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Business, Energy and Industrial Strategy, what steps he is taking to strengthen and promote the British aerospace industry.

 

Richard HarringtonParliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)

The UK has the second largest aerospace industry globally, with strengths in some of the most technologically advanced parts of aircraft: wings, engines and advanced systems. The industry has annual turnover of around £32 billion, and exports some £30 billion.

Through the Aerospace Growth Partnership, Government is supporting action by industry to make sure the UK remains competitive, including a joint Industry/Government commitment of £3.9 billion for Research and Development activities through to 2026.

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07 NOV 2017

Presenting the 67 Petition

Today I presented a petition of over 1000 signatures to the House of Commons from the users of the No.67 bus service in Torbay, to urge Torbay Council to commit to providing a similar service to the previous No. 67 service for the sake of the local residents as soon as possible. This petition was collated by constituent Madge Forrester and assisted by Brixham Councillor David Giles

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07 NOV 2017

Health Select Committee

Today there was an oral evidence session on the Nursing workforce

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01 NOV 2017

Exiting the Eu: Sectoral Impact Assessments

Sarah Wollaston Chair, Health Committee

In response to the right hon. and learned Gentleman's point, may I formally request that these documents be released not only to the Exiting the European Union Committee, but to all relevant Select Committees, as requested by the Select Committee on Health yesterday?

Keir Starmer Shadow Secretary of State for Exiting the European Union

I will come to that, because we gave some thought to the process, and if the principle of disclosure is agreed, we are open to a discussion about exactly how that works. The Brexit Select Committee seemed the obvious Committee, but there is clearly interest in other Select Committees in the subject matter, not least medical services and social care, which I know will be of great interest to the hon. Lady.

Sarah Wollaston Chair, Health Committee

The Health Committee will shortly begin an inquiry entitled "Brexit—medicines, medical devices and substances of human origin". We will be considering, among other issues, how we can guarantee safe, effective and timely access to medicines and substances of human origin; the future of medical research and development; how we will co-operate and collaborate across Europe after we leave the European Union; and access to the appropriate workforce. The stakes could not be higher. The Committee does not want to damage the national interest; we want to do our job on behalf of patients, this House and the public.

We know that there are sectoral analyses of life sciences, pharmaceuticals, medical devices, medical services and social care. I did discuss with the Committee, in advance of our hearing yesterday, whether we wished to call for these papers, and we discussed many of the issues that have been raised in the House today. The Committee was unanimous in giving me the authority formally to request those papers from the Secretary of State, and I did so. Therefore, although there has been much comment this afternoon about there being a discourtesy in not raising this with the Committee, the Committee has considered it and would like the papers, on behalf of our patients, in order to allow us to do our job better.

I believe in transparency. I understand the concerns that have been raised and so would be prepared to see the documents in a private setting, if it is believed that that is the right way forward. But I and my Committee believe that we can do a better job on behalf of this House if we have access to the information. I therefore call on the Secretary of State to release it to us.

Sarah Wollaston Chair, Health Committee

On a point of order, Mr Speaker. Would it be helpful for you to inform the House what you feel a reasonable timeframe would be for the Government to respond?

John Bercow Speaker of the House of Commons,

I do not think I am obliged to do that, and I am not sure how much difference it would make. The issues are important but I do not think—I may be contradicted by senior procedural experts, to whose wisdom I should defer—that the matters are particularly complicated. One can take a view about this, one can consult "Erskine May" and one should reflect in a sober and considered fashion, but if the hon. Lady is asking me whether I envisage this being something that needs to be deliberated on over a period of several days, the answer is no.

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31 OCT 2017

Health Select Committee

Today the Committee took evidence from the Secretary of State for Health

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26 OCT 2017

Leaving the EU

Sarah Wollaston Chair, Health Committee

No deal would be a very bad deal indeed for this country. What if the House votes on the final deal and rejects it? Is the Secretary of State implying that those who voted against it would be saying that they would like to leave with no deal at all?


David Davis The Secretary of State for Exiting the European Union

All I was doing was repeating exactly the statement that was made at this Dispatch Box by the Minister during the debate on the relevant Bill.

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25 OCT 2017

Social Care

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow Dr Whitford and I particularly commend her comments on the importance of prevention, which we must not forget. I join the Minister in paying tribute to the wider care and health workforce, and of course the many unpaid family carers for all that they do. I would like to touch on the forthcoming consultation and some of the current and future challenges. If hon. Members will forgive me, I will take very few interventions because I know that many are waiting to speak.

On the consultation, the Health Committee yesterday had the pleasure of hearing from members of the House of LordsCommittee on the Long-term Sustainability of the NHS on the subject of the long-term sustainability of the NHS and social care. They started out with the remit of talking about the NHS, but rapidly realised that the two systems are completely inseparable and that we have to stop considering health and social care in separate silos. The Minister will hear overwhelmingly from the people who contribute to the consultation that we cannot keep thinking of these systems in isolation, so right from the outset will she make it a consultation on the sustainable future funding of both health and social care?

One thing that we heard loud and clear from members of the Lords Committee yesterday was that we need to do more about future planning and that the system for this has been dismal for decades. Their recommendation was that we should set up an office for health and care sustainability that gives us all good-quality, reliable data about not only the demographic challenges but the future needs of both systems so that we can plan ahead for the costs we face in a realistic manner.

Too often in this House we have very divisive debates on this issue, and the challenges in funding future health and care costs are so enormous that I fear the only way we will meet them is by those on both Front Benches and all Members across the House agreeing that we need to work jointly to reach solutions, because no political party has a monopoly on good ideas. Particularly in a hung Parliament, where it is very difficult for us to pass primary legislation, the only way we will move forward on behalf of the people we all represent—we all want the best for them—is if the solutions are worked towards jointly across the House. I hope all Members will move forward in this debate in a spirit of co-operation, because we have to fund this properly. I am afraid that there is a funding gap, although I absolutely welcome the £2 billion that has been pledged. There is consensus that by the time we reach 2019-20, we will face an estimated funding gap, despite the uplift, of more than £2 billion. That will have a real impact on all those we represent.

We must fund this properly not just now, in the short term, but in the long term, and we must come forward with solutions, but it is not just about funding. It is about staffing, and planning properly for a wider workforce across health and social care, so I very much hope that that will also be included in the consultation. Unless we plan ahead for our future workforce, we will always be playing catch-up, as we do at the moment. Of course, we have seen many important changes. In the future, for example, healthcare assistants will be able to train to move forward through the apprenticeship route to become nursing associates and on into degree nursing. We know from Camilla Cavendish's review that it is not just about pay in the sector but the lack of continuing professional development and training opportunities and, in particular, the inability to rotate through the NHS and social care community settings. That gives an example of how the Government are making some positive moves, which I welcome.

I hope that from the start the consultation will cover both health and social care and that the Minister will go further in covering not just the sleep-in crisis but some of the many other issues that affect my constituents. For example, some are having their assessments re-examined, and disabled young adults facing a change in the support that will be available to them. I hope that the Minister will meet me to discuss some of the issues raised by my constituents in Kingsbridge who face significant changes to their care.

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23 OCT 2017

European Council

Sarah Wollaston Chair, Health Committee

I welcome the Prime Minister's positive approach, and the news that we are within touching distance of a deal, because that is in everyone's best interests. However, in preparing for all eventualities, would the Prime Minister be willing to reinstate the seasonal agricultural workers scheme? Businesses in my constituency are keen to plan ahead for all eventualities.

Theresa May The Prime Minister

I was Home Secretary when the scheme ended, and at that stage the Migration Advisory Committee made it clear that it felt it was not necessary to reintroduce it, at least for a period of time. However, the current Home Secretary has asked the committee to look into immigration needs throughout the UK economy. I am sure that that will include consideration of the sector that my hon. Friend has spoken about, and of whether or not a seasonal agricultural workers scheme is necessary.


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23 OCT 2017

Defence

Sarah Wollaston Chair, Health Committee

On a point of order, Mr Speaker. It is now more than four months since the general election, but still the Liaison Committee cannot meet formally to carry out its functions on behalf of the House. Will you assist us, Mr Speaker, because I am afraid that repeated representations from across the House by Select Committee Chairs are not yet making a difference in ensuring that all Select Committees are properly constituted?

John Bercow Speaker of the House of Commons, Chair, Speaker's Committee for the Independent Parliamentary Standards Authority, Chair, Commons Reference Group on Representation and Inclusion Committee

I am grateful to the hon. Lady for her point of order. It is absurd and indefensible that more than four months after the state opening of Parliament, that Committee, which, of course, consists of the Chairs of the Select Committees, has yet to be constituted. I might add—almost in parentheses, because I am sure that the hon. Lady will feel empathy with other colleagues on this front—that the same situation, I think, applies to the European Scrutiny Committee, and also to another Committee which is not a Select Committee but which is a Committee of Parliament, and a very important Committee at that, namely the Intelligence and Security Committee. Those Committees are there to scrutinise the Executive branch.

I discussed this important matter in a most co-operative exchange with the Leader of the House at the start of the summer recess, and I know that she used her best endeavours, with others, to ensure the constitution of many of the Select Committees some little while ago. However, the fact that the remaining Committees are as yet unconstituted is simply not acceptable.

It would obviously be most unfortunate if it were necessary for Members to keep raising points of order day after day after day after day before those Committees were established, and, as I am sure the whole House would want to avoid such an embarrassing fate, I can only assume that proper action will now follow. However, the hon. Lady is always attentive to her responsibilities, and I am certain that, in the grisly event that it is necessary for her to raise a further point of order, she will not hesitate to do so.

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18 OCT 2017

Universal Credits

Sarah Wollaston Chair, Health Committee

I support the principles behind universal credit. My question is this: why are we undermining a policy with the potential to change lives for the better by not addressing a fundamental flaw at its heart?

We have heard many compelling cases today, and we cannot ignore them. Siobhain McDonagh set out one of the flaws, but we have seen that a policy of test, learn and rectify can work. Today there have been universal congratulations for the Government on the introduction of a free helpline, and the bringing forward of access to advances has also improved the policy, but that does not get us away from the fundamental problem of a minimum six-week wait. That means that our constituents who are living on the edge—we are talking about real people's lives here—are going to start this process in debt and in arrears, as we have heard.

It is possible to apply test, learn and rectify to this process. I want to hear from the Minister in the winding-up speech that Front Benchers recognise that and that they are going to address the six-week wait. The advance does not solve the issue; it does not cover the entire amount. Those of us who represent our constituents have a cushion and we would probably manage, but many of the people I used to look after when I was in clinical practice and the people I represent now who come to my constituency surgeries have no cushion whatever. This is devastating for them, and we cannot ignore the very real, compelling case histories that we have heard. We cannot allow those to continue.

There are things that we can do. Bringing forward the initial payment would mean that fewer people needed advances in the first place. That would save us a complicated bureaucracy, allowing people to say for themselves when they start universal credit, "Please would you pay my landlord direct, because I know I am going to find that complicated? Please would you give me payments every fortnight, because I don't currently receive monthly payments?" Once they are established on the system, give them, with their advisers, the option to transfer to taking over their own monthly payments for their rent.

Heidi Allen Conservative, South Cambridgeshire

Does my hon. Friend agree that that would be sensible not only from an administrative point of view, but because work coaches could be helping people get into work, rather than helping them to deal with debt, stress and mental health issues?

Sarah Wollaston Chair, Health Committee

I absolutely agree. I say to the Minister, please, can we hear an assurance at least that there is a recognition of this fundamental flaw and that it will be addressed?

I know that Members on this side of the House will be abstaining tonight. Personally, I do not agree with that. The House should have an opportunity to express its view, and there have been occasions on which these debates, even though they are advisory, have led to changes in policy. If there is no way for me to express my view, on behalf of my constituents, that I think this fundamental flaw must be addressed before the policy is rolled out to the Totnes constituency next year, I am afraid that I will have to vote against the Government. I do not wish to do that because I support the underlying policy of universal credit—we have heard about many of its benefits—but, I say again, we are undermining it by not addressing the fundamental flaw at its heart. I hope the Minister will give an assurance from the Dispatch Box so that I do not have to vote against the Government.

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18 OCT 2017

Surgical Mesh Implants

I attended a Westminster Hall Debate today on the risk of surgical mesh implants.

The following is a link to the reporting scheme for women wishing to notify the MHRA of mesh complications. Then click on the devices tab

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12 OCT 2017

Unauthorised Encampments

Sarah Wollaston Chair, Health Committee

I thank my hon. Friend for the measured tone that she has set for this debate. Does it surprise her that there are often examples of forced entry clearly having been used—for example, angle grinders on gates or huge boulders dragged to the side, sometimes in front of witnesses? Does she agree that the police need much greater powers to intervene and move people on where that is happening?

..........

Sarah Wollaston Chair, Health Committee

I am disappointed that Laura Pidcock dismisses the issue as a clash of cultural norms. That does a great disservice to the Gypsy and Traveller community. I do not believe that incidents of criminal damage, environmental degradation, intimidation, fly-tipping and, in some cases, violence are cultural norms for that community; we are talking about a very tiny minority. As we have heard repeatedly in the debate, this is about ensuring the same rights, responsibilities and respect for everybody.

In the short time available, I will not repeat the many points that have been made, but propose to the Minister a solution-focused approach. We need much greater clarity about the police's powers to deal with witnessed criminal damage, because they are sometimes unsure of their own powers when criminal damage is reported or even when it happens in their presence.

So much revolves around dialogue. As has been said, meeting people and talking to them is important, but it can sometimes be difficult to know who to liaise with. During the consultation, will the Minister consider introducing a responsibility for someone to be appointed to speak for groups of Travellers and to liaise with them directly? That would allow us not only to advance the dialogue more constructively, but to hold somebody genuinely accountable.

That is about holding people to account, just as we would expect members of the local community to be held to account vigorously for intimidation of, or disrespect towards, the Traveller community. We still expect someone to be responsible for a group of people involved in the kinds of incidents that we have heard about today, such as fly-tipping. At the moment, nobody can be held to account for such incidents, yet the local community has to pick up the bill. That is where we are heading: a vicious cycle of communities being so resentful about these encampments.

We are asking for the same laws to apply to everyone and to see something coming out of this consultation that results in genuine action to ensure that people are held to account, in the same way that I would expect all my other constituents to be held to account for the kinds of incidents that we have heard about today.

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10 OCT 2017

Health Select Committee

The Health Select Committe met today to discuss the Work of NHS England and NHS Improvement

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10 OCT 2017

Mental Health Workforce

Sarah Wollaston Chair, Health Committee

As someone who is married to an NHS psychiatrist, may I start by paying tribute to all those volunteers, carers and professionals working in mental health on World Mental Health Day? Has the Secretary of State seen today's briefing by the Children's Commissioner, highlighting the vital importance of prevention and early intervention? Will he set out what steps he is taking to support a growing workforce—volunteers and professionals—working in prevention and early intervention?

Jeremy Hunt The Secretary of State for Health

My hon. Friend is absolutely right. I am aware of the report that she talks about. We know that half of mental health conditions become established before the age of 14, which is why early intervention is so important. In July, I announced an expansion in the mental health workforce—another 21,000 posts. A number of those will be in children's mental health, to address the issues she raises.

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14 SEP 2017

Local Housing Need

Sarah Wollaston Chair, Health Committee

The South Hams has one of the highest house prices to earnings ratios in the country. I know that the Secretary of State wants to help young people to get on the housing ladder by introducing the earnings ratio, but that will be of no help to young people in my constituency if all the homes become second homes. Will he set out his plans to deal with areas of exceptionally high second home ownership?

Sajid Javid The Secretary of State for Communities and Local Government

My hon. Friend makes a good point. She will know that schemes are already in place to help people to get on the housing ladder, such as the Help to Buy scheme, which has helped more than 400,000 people. On her specific point about second homes, measures have already been introduced but, as she highlights, this issue needs to be considered carefully and kept under review to see what more we can do.

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13 SEP 2017

Higher Education (England) Regulations

Sarah Wollaston Chair, Health Committee

The Leader of the Opposition reneged on his clear pledge to deal with historic debt. Does the Secretary of State agree that that policy would have meant graduates repaying not only their own debt but the future debts of others?

 

Justine Greening Minister for Women and Equalities, The Secretary of State for Education

Indeed. The Labour party has a confused, muddled, counterproductive and anti-social mobility policy on student fees and student debt that would put at risk much of our higher education sector. It would be absolutely disastrous.

The bottom line is that, even now, across the border in Wales, the Labour colleagues of the hon. Member for Ashton-under-Lyne are implementing the very increases, in line with inflation, that she is opposing here today. That shows a level of hypocrisy that is becoming a hallmark of the current Labour Front Bench. The bottom line is that they are in—[Interruption.] I am taking no lectures from the hon. Lady about taking interventions when she was scared to take more than two. The bottom line is that Labour's student finance policy is a cold, calculating con trick on young people. It is shameless politics.

I have three serious questions for the Opposition on the policy of no fees, and they are questions that they need to answer. How many of the poorest children in this country are they going to prevent from going to university under that policy? How many world-class universities will shut down because they run out of money? If highly paid graduates do not have to pay to go to university to get their degrees, who is going to pay the bill? Those questions have never been answered. The Opposition have no answers, because having a sensible approach that has the best interests of students, universities and taxpayers at its heart is not their objective, is it? Driving social mobility is not Labour's objective. Enabling more disadvantaged young people to go to university is not their objective. Properly funded universities are not their objective. It is just a cynical con trick. That is Labour's objective. Far from Labour being the friend of students and universities, its policy would destroy opportunity and destroy our world-class universities. This House should see straight through it. Frankly, the motion is not even worth the paper it is written on.

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13 SEP 2017

NHS Pay

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow Dr Whitford. I pay tribute to her for her work on the Select Committee on Health in the previous Parliament. That work was inevitably full of expertise and always constructive; I thank her for that. I agree with her that the NHS is a team, but that team should also include the wider social care staff because we cannot continue to look at the two systems in isolation. I echo her point, thanking all our NHS and care staff for the contribution they make not just to our wider economy, but—most importantly—to patients. Those are the people we should keep at the heart of this debate.

I welcome this debate. I also welcome the relaxation of the cap because we need to give the NHS Pay Review Body greater flexibility to make recommendations about what we need to put in place for our NHS staff. I agree with the hon. Member for Central Ayrshire that we should look at the impact of pay on morale, recruitment and retention—this is an international workforce, as well as a national one—but we also need to look at pay across regions and within specialties because there is great variation. We should focus our efforts on ensuring that we are looking at the situation from the patients' perspective by, for example, looking at the greatest areas of deprivation, which very often have the lowest ratios of NHS and care staff and who are under the greater pressure.

Seven years of sustained pressure on NHS pay is taking a toll. Nobody anticipated that it would go on for this long, so it is time to relax the cap. We should look not just at the issue of pay, but at the wider pressures within the NHS. I am delighted to announce that the Health Committee, which held its first meeting just before Prime Minister's Question Time, has agreed that its first inquiry of the Parliament will be on the nursing workforce. We will look not just at pay, but at the wider workforce pressures, including the increased workload that comes from increasing demand across the system, morale and all the other non-pay issues that contribute to the pressures on nurses. We will also look at bursaries and the new routes into nursing, and at their impact on people entering the nursing workforce. We have heard about that already today. For example, we know that those who drop out of nursing courses are more likely to be in the younger age groups, whereas those who go into nursing as mature students are much more likely to stay. We need to look at all those wider impacts.

Maria Caulfield Conservative, Lewes

I really welcome the news that the Select Committee is going to do a review of nursing. Will the Committee look into pay structure? The current Agenda for Change structure is being used by some trusts, in hospitals and communities, as a way of downgrading nursing roles. For example, a senior sister in one place may be paid a band 7 salary, whereas someone in the same role somewhere not too far down the road may be paid a band 5 salary. There is inequity in the current system.

Sarah Wollaston Chair, Health Committee

That is an important point. I very much hope that my hon. Friend will contribute to the Committee's inquiry. As well as looking at the new routes into nursing, we will look at the skills mix, roles within health and social care more widely, the impact of Brexit and language testing, workload and morale. We will be seeking contributions from hon. Members across the House and from people outside.

As I said, we will miss something if we just look at the issue as one of pay. Pay restraint is estimated to contribute between £3.3 billion and £3.5 billion of the five year forward view efficiency savings up to 2019-20. If that goes, what will fill the gap? We have to be careful that there is no loss of services or losses in the workforce, because workforce pressures—probably more than any other issue—contribute to nursing staff leaving the profession. We have to look at the bigger picture.

Eleanor Smith Labour, Wolverhampton South West

I have been a nurse for 40 years, but this is not just about nursing. There are other groups as well, including occupational therapists and physiotherapists, who are also registered professionals. Along with everybody else, they are just as important as nurses.

Sarah Wollaston Chair, Health Committee

The hon. Lady is absolutely right. Look, for example, at the applications for nursing courses. Even though the number of applicants has gone down, it may not ultimately result in a loss of numbers entering nursing. Some of the applicants from that overall drop in numbers might have gone on to other courses, so we need to look at the bigger picture. In opting to look at the nursing workforce, the Health Committee is not saying in any way that other parts of the workforce are not important. The NHS is a team, but it would be difficult for us to report within a certain timeframe if we looked at the entire workforce. I have no doubt that we will look at other aspects of the workforce over the course of this Parliament. I assure the hon. Lady that we will not lose sight of the bigger picture and I hope that she will contribute to the inquiry.

We need to look at the big picture regarding the total budget for health and social care. Norman Lamb has long made this point, and we have both made it clear that it is time for us to take a cross-party approach to sustainable funding for health and social care in the long term. I look forward to working with him on that over the course of this Parliament.

Norman Lamb Liberal Democrat Spokesperson (Health), Chair, Science and Technology Committee (Commons)

I totally agree with the hon. Lady and I am keen to continue working with her. Did she see the Independent Age survey that showed that well over 80% of Members of Parliament on both sides of the House agree that there needs to be a cross-party settlement for the future of the NHS and the care system?

Sarah Wollaston Chair, Health Committee

I welcome that and I look forward to working with the right hon. Gentleman over the coming months to try to encourage colleagues on both sides of the House, including the Front Benches, to agree to the idea. Next year is the 70th anniversary of the NHS, and I cannot think of anything more constructive we could do than to work across political parties in order to deliver sustainable long-term funding for health and social care.

I will bring my remarks to a close because I know that many hon. Members wish to speak. I look forward to hearing suggestions from colleagues in the House and outside this place about the points they would like the Health Committee's inquiry into the nursing workforce to cover.

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13 SEP 2017

Education Finance

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what assessment she has made of the effect of maintaining current levels of core educational funding for 16 to 18 year olds on (a) educational outcomes and (b) further education provision; and what plans she has for (i) funding and (ii) resourcing further education in the next five years.

Anne Milton Minister of State (Department for Education)

The post-16 system is performing well and a record proportion of 16 to 18-year olds are now participating in education or apprenticeships. The results in the first of the reformed A levels were released last month, with students continuing to achieve effectively against the high standards of the qualification and demonstrating their readiness for the demands of higher education. Overall A level results this year were stable compared to last year.

A record number of 18-year olds applied for places in Higher Education this year and the entry rate for English 18-year olds from disadvantaged backgrounds is at a record high.

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13 SEP 2017

Medicine: Education

Written Questions

Sarah Wollaston Chair, Health Committee

  • To ask the Secretary of State for Health, what steps he is taking to support the development and growth of smaller and non-London medical schools
  • To ask the Secretary of State for Health, when he plans to announce the criteria and timetable for allocating additional undergraduate medical student places.
  • To ask the Secretary of State for Health, when allocating the 1000 additional undergraduate medical student places, what steps he plans to take to ensure that medical schools outside London receive a fair allocation of those places.

Philip Dunne The Minister of State, Department of Health

The Government has announced a historic expansion of medical school places in England, with an increase of 1,500 medical school places in England. The first 500 places have already been allocated and will be available to students in September 2018.

The Government response to the recent consultation was published on 9 August 2017, confirming that 1,000 additional medical school places would be available to medical schools in England via a competitive bidding process to be managed jointly by the Higher Education Funding Council for England (HEFCE) and Health Education England (HEE).

It also set out the priority areas bidding criteria would need to focus that include aligning the expansion to local National Health Service workforce need with an emphasis on priority geographical areas, including rural and coastal areas.

HEFCE and HEE are currently finalising the design of the bidding process and will publish details in the autumn.

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11 SEP 2017

EU Withdrawal Bill

Sarah Wollaston Chair, Health Committee

Without the Bill we cannot respect the will of the British people, as expressed in the referendum, and repeal the European Communities Act 1972. Without the Bill, as many Members have pointed out, we will see legal chaos. Given the sheer volume and complexity of the EU law that will have to be converted into UK law, I accept that the Government will need relatively wide delegated powers to amend legislation, but there is a distinction between necessary amendments as a consequence of our leaving the EU, many of which will be technical and minor, and those that implement entirely new policies. The delegated powers in the Bill will touch every aspect of our lives, as many colleagues have said—their use could be unprecedented in scale, scope and constitutional significance—so I am glad to hear that Ministers are in listening mode.

I will support the Bill tonight in the expectation that it will be amended in Committee and that there will be support for reforming the way delegated legislation is handled, so that Parliament, rather than the Government, can decide the appropriate level of scrutiny. Without that, we simply will not be able to bring control back to Parliament. It may be useful to those who are following the debate from outside this place if I explain how delegated legislation works and why it is important that we amend it.

I was first introduced to Delegated Legislation Committees when I was appointed to one dealing with draft double taxation relief and international tax enforcement orders. I thought there must have been a horrible mistake, so I sent a note to the Whip to ask about my duties. I received the following three instructions: “Turn up on time, say nothing and vote with the Government.”

People might argue that no one died as a result of my ignorance of international law on double taxation relief in Oman and Singapore, but what makes the system so absurd is that the very next Committee due to sit was a Delegated Legislation Committee examining the draft Medical Profession (Responsible Officers) Regulations 2010. It might be argued that, as someone who had just come to the House having been teaching junior doctors and medical students and having been an examiner for the Royal College of General Practitioners with an interest in doctors who were failing, I was better placed to be on the second Committee. It seems to me that there is an expectation that Members should not have any expertise at all. I think the general public would find that absolutely extraordinary; they expect Members to be able genuinely to scrutinise legislation.

There are many other reasons why the procedures should change. It is a great concern to people outside this place that many statutory instruments are subject to the negative procedure rather than the affirmative procedure and do not get any scrutiny at all—not even the current defective scrutiny. The power to change that does not necessarily need to come from legislation; we could use the Standing Orders. I commend the Hansard Society for the excellent work it did in advance of the Bill to set out how the procedures could be amended. Even though it is in our power as a House to put in place Standing Orders, for example to set up a Delegated Legislation Committee with the powers of sift and scrutiny that we have discussed today, it would help if Ministers indicated that they are in listening mode about that, too, and that they would support it happening over time. I genuinely feel that the Government do not want to obstruct sensible debate. All Members from across the House should work with Ministers to put in place something that genuinely works. We know that delegated legislation needs reform even without this Bill, so let use this as an opportunity. As we have heard, up to a thousand statutory instruments will be coming before the House, and we need the House to decide whether the procedure will be negative or affirmative. We need reform so that we can genuinely develop expertise along the lines suggested by the Hansard Society and so that MPs with a genuine interest scrutinise the proposals. The point is that a delegated legislation Select Committee could have the power to send a statutory instrument to a Committee of the whole House—not just a small Delegated Legislation Committee in a Committee Room, but with all of us here, similar to what we are doing today. It could also have the power to suggest sensible amendments that the Government would have to take away and consider.

I have said that I will support the Government tonight, but I do so only in the expectation that they will support sensible amendments.

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11 SEP 2017

Medicine: Education

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what estimate he has made of the number of extra UK medical school places that will be made available to international medical students after the removal of the cap on the number of such places.

To ask the Secretary of State for Health, what steps he plans to take to ensure that additional medical student places are fairly allocated to students from (a) the UK and (b) other EU countries.

Philip Dunne The Minister of State, Department of Health

The Government has announced a historic expansion in domestic supply of the medical workforce by funding an additional 1,500 medical school places in England available to domestic students from 2018-19. In addition, from 2019-20 English universities will not be limited in the number of international students they can recruit on a full fee paying basis.

For medical school intake targets, the only distinction that is made is between home or European Union students and those from outside the EU. As such, the additional 1,500 medical school places the Government is funding will be available to students from across the United Kingdom and all European Economic Area countries subject to the usual residency requirements.

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Hansard

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, for what reasons the Service Increment for Teaching funding allocation process is subject to the market forces factor; and what steps he plans to take to ensure that there is not an excessive regional disparity in allocations of that funding between London and non-London medical schools.

Philip Dunne The Minister of State, Department of Health

The funding for training placements in secondary care is allocated to placement providers by Health Education England using a tariff payment mechanism. These tariffs are calculated on the basis of average costs and do not take into account some features of cost that are likely to vary across the country. The tariffs are therefore adjusted by the Market Forces Factor in order to compensate for the cost differences of providing training placements in different parts of the country.

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19 JUL 2017

Department for Education: Vocational Guidance

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, when her Department plans to publish the careers strategy.

Anne Milton Minister of State (Department for Education)

We will publish a careers strategy in the Autumn. The strategy will have a clear focus on improving social mobility.

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12 JUL 2017

The Ambulance Service in Devon

Today I managed to secure a Westminster Hall debate on the Ambulance Service in Devon

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11 JUL 2017

The Future of the NHS

I delivered a lecture today in the Speaker's House on the future of the NHS

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06 JUL 2017

Adult Social Care Funding

Sarah Wollaston Conservative, Totnes

It is concerning to note from the CQC's state of adult care report that staff turnover rates have risen from 22.7% to 27.3% in the three years to 2015-16. Will the Minister meet me to discuss the important role that supporting skills and opportunities for career progression can play in reducing turnover, improving morale and, most importantly, improving the quality of care that people receive? Will he visit my constituency to see the excellent joint working that has been done by the trust and South Devon College towards just that?

Steve Brine The Parliamentary Under-Secretary of State for Health

I thank my hon. Friend for that. I think she knows that I will be in the vicinity of her constituency at some point over the next few months, and I would like to take her up on her offer. I wish her well in her current campaign.

The workforce is critical. Adult social care is a rapidly growing sector, and there are about 165,000 more adult social care jobs than there were in 2010. It is imperative that we get the right people into the right jobs, to deliver the improved quality of care and services that we all want to see. We are working closely with our delivery partner Skills for Care to improve the level of skills in the adult social care workforce, and we are making the profession more attractive with the introduction of the national living wage, from which up to 1.5 million people in the social care sector are expected to benefit. I might point out that that policy has come in only as a result of this Prime Minister and this Government.

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06 JUL 2017

International Trade: Food and Drink Sector

Sarah Wollaston Conservative, Totnes

More than £30 million-worth of fish was sold through Brixham fish market last year, the most valuable catch in England. Will the Minister meet me and industry representatives to discuss opportunities for expanding markets after we leave the European Union, as well as frictionless trade and smooth transfer across the border?

Mark Garnier Parliamentary Under-Secretary (Department for International Trade)

The Secretary of State is a Member of Parliament for the south-west, and he is happy to come and have that meeting, as am I as the departmental lead on the food and drink sector. Between the two of us, my hon. Friend Dr Wollaston may get twice as many meetings as she anticipates. We look forward to coming to help.

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06 JUL 2017

Brexit Agriculture and Fisheries

Written Answer

Sarah Wollaston Totnes
To ask the Secretary of State for Exiting the European Union, what steps he is taking to (a) engage with and (b) protect the interests of the South West's agricultural and fishing industries during future trade negotiations with the EU. (900263)

Mr Robin Walker:Under Secretary of State at the Department for Exiting the European Union

As part of our committment to hear from every sector and region in the UK, DExEU Ministers continue to engage closely with organisations across the agriculture and fishing industries, to enable us to understand issues for the sectors and to identify potential post-exit opportunities.

We have spoken to a range of organisations including the National Federation of Fishermen's Organisations, and the National Farmers' Union and will continue to listen to workers in the industry, trade organisations, producers and the public as negotiations progress.

Leaving the EU presents a major opportunity for the UK agriculture and fishing industries. The Government will be able to design new policies which specifically benefit British agriculture, the countryside and the fisheries, and provide better value for money to the British taxpayer.

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04 JUL 2017

Parliament's Education Service

This afternoon I spoke to teachers from across the country about my work as an MP and my experiences as a Chair of the Health Select Committee. This event was arranged by Parliament's Education Service

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04 JUL 2017

Health

Sarah Wollaston Conservative, Totnes

As a result of the capped expenditure process, the wider Devon sustainability and transformation plan is being asked to make £78 million of savings at short notice—within the next nine months. Does the Secretary of State share my concern about the impact on patients, the short timeframe and the undermining of savings already agreed by the STP? Will he meet me to discuss this matter and the wider CEP?

Jeremy Hunt The Secretary of State for Health

I am more than happy to meet my hon. Friend. The principle behind the capped expenditure process is that we should have fairness between patients in different parts of the country. We should not see patients in one part of the country disadvantaged because the NHS has overspent in their neighbouring area, but the way in which we implement the process must be sensitive and fair. We must ensure that we get it right.

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28 JUN 2017

Debate Queen's Speech

Sarah Wollaston Conservative, Totnes

It is a pleasure to follow Sir Edward Davey. When the national health service was launched in July 1948, it was launched on the basis of three core principles: that it should meet the needs of everyone, that it should be free at the point of delivery, and that it should be based on clinical need and not the ability to pay. Those principles continue to serve us very well; they are supported across the House, and they have been reinforced by the NHS constitution. The extraordinary success of the NHS and public health provision lies in its delivery of increased life expectancy. Many people who now survive into adulthood would not have done so when I qualified as a doctor, some years ago. However, that extraordinary success hands us the key responsibility and challenge of ensuring that we can continue to provide and to meet the needs of everyone in the coming decades. Yvette Cooper spoke of the importance of joint working across the House. Given that we now have a different parliamentary arithmetic, I agree with her, and I would extend that to the way we talk about funding of health and social care.

Gloria De Piero Labour, Ashfield

Last week I was told by Pauline that her mum, 79-year-old Sheila, who has dementia and heart failure, suffers from seizures and is unable to eat, go to the toilet or dress on her own, has been denied a funded place in a care home. Does the hon. Lady agree that that is a scandal that needs to be resolved?

Sarah Wollaston Conservative, Totnes

The hon. Lady has made a very important point. We will all see similar cases in our surgeries. However, we will not resolve the problem by having constant arguments about how we are going to do so. What we must do is agree, across the House, on how we are to provide long-term sustainable funding. I commend the House of Lords Select Committee on the Long-term Sustainability of the NHS for its work on the provision of long-term sustainable funding for health and social care. I welcome the commitment from Ministers in the Gracious Speech to seek sustainable social care solutions, but I call on the Government to extend that to health, because if we continue to view the two systems in isolation, we will fail exactly the patients, and others, to whom the hon. Lady has just referred.

The parliamentary arithmetic is such that there is an additional responsibility on all of us to ask what we can achieve by the end of this Parliament and what we can achieve when the NHS reaches its 70th birthday next year. I would say that by working together we could achieve something really remarkable, and I call on all Members from all parties to work to make that happen.

I also very much welcome the proposals in the draft patient safety Bill, but I put it to the Secretary of State that we need to get to grips with the impact of the workforce challenge across health and social care on patient safety. I agree with others that it is time for us to think again about the impact of the public sector pay cap. There is no doubt in my mind that seven years of the cap are now having a significant impact on morale in the health service and across our wider public sector. Again, I think that the change in the parliamentary arithmetic following the message that we have had from the electorate is very clear. People value our public services and they want to see this matter addressed.

One way in which we can address the issues of recruitment, retention and morale is to deliver a fair pay settlement, and I hope that we can make further progress on that. Again, however, we will achieve the funding that is required for that through realistic cross-party working. During the election campaign, and in the manifesto, we tried to address the issues of intergenerational fairness in funding these services, and it might be that, as we look realistically at how we are going to fund our public services, we need to take ideas from all parties in order to achieve our aims, so that we can do something about public sector pay and improve the retention rates in our health and social care workforce.

Another area of the Queen’s Speech that I want to touch on is mental health, and I should declare a personal interest, in that I am married to an NHS consultant psychiatrist who is also the registrar of the Royal College of Psychiatrists. I very much welcome the fact that we are the party that legislated for parity of esteem, but we now need to translate that into practice. It needs to be translated into ensuring that the welcome extra funding for mental health actually reaches the frontline and delivers.

I am pleased to see the proposals in the Gracious Speech for a Green Paper on children and young people’s mental health, and I hope that the Secretary of State will look at the joint work of the Select Committees on Health and Education in that area and take note of our proposals and suggestions. I also hope that he will look again at the work done by the Health Committee on suicide prevention. Suicide remains the single biggest cause of death in men under the age of 50 and in young people of both sexes. This is a core challenge, and one of the issues that we identified is now in the Government’s proposals—namely, how we involve the families of those with serious mental health challenges in their care and treatment. That does not involve riding roughshod over the important principles of confidentiality. Often, it can involve simple things such as ensuring that mental health professionals are aware of the consensus statement on how to achieve consent.

I welcome the progress that we have made on reducing the use of cells as a place of safety for those with serious mental health problems. Their use is wholly inappropriate and I hope that we can make further progress on that. There is much more that we can do to improve mental health care, but we have some excellent proposals in the five-year forward view. This is all about implementation, and I urge the Secretary of State to do everything he can to ensure that the money reaches the frontline, that there is transparency about that and that we make further progress on improving the mental health of young people and adults alike.

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27 JUN 2017

Education and Local Services

Sarah Wollaston Conservative, Totnes

Although we all recognise the need to address deprivation, does my right hon. Friend also recognise the need to address the historical injustices for underfunded areas? Will she confirm that she will increase the age-weighted pupil unit block in the funding formula and help to reduce the costs that some schools are facing through the apprenticeship levy?


Justine GreeningMinister for Women and Equalities, The Secretary of State for Education

As I said, we are committed to introducing fair funding. It is right that we hold all schools to the same standards and the same accountability framework, and it makes sense that we should ensure that children with comparable needs are funded comparably wherever in the country they are. I will set out shortly the details of how we will do that following the consultation.

I will finish my speech. [Hon. Members: "Hooray!"] In many respects I was just getting started, but I am sure the rest can wait for future debates. The Government have done sterling work in narrowing the gender pay gap and advocating having more women on boards, but those efforts cannot slacken and need to be stepped up. We will bring forward new approaches to supporting women in the workplace. The 30-hour childcare offer will help families with the cost of childcare, and our returnship pilots will explore new ways of supporting mothers—it is overwhelmingly mothers—to get back into work. We know from some of the work that is already under way how powerful they can be. Of course, inequality is not confined to gender, and the Government will bring a renewed focus to the ethnicity gap in our workplaces.

The Government have an ambitious agenda for this Parliament: creating world-class technical education, ensuring that there is a good school place for every single child, wherever they are growing up, and tackling inequality in educational opportunity in all its forms. To achieve those goals, we will be resolute in our pursuit of high standards. We are building on a firm foundation, although there is more to do and more to deliver. Our young people deserve nothing less. This nation contains a wealth of talent just waiting to be unlocked, which will create opportunity and success for individuals and a strong and prosperous country that can take on, and succeed in, any challenge.

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27 JUN 2017

NHS Shared Business Services

Sarah Wollaston Conservative, Totnes

While Members from across the House will be relieved that so far no patients are identified as having been harmed by this appalling incident, will the Secretary of State set out what steps he is taking to ensure that this can never happen again?


Jeremy Hunt The Secretary of State for Health

Absolutely. There is a short-term and long-term lesson. The short-term point is that it is unlikely this would happen again because it was paper correspondence, and we are increasingly moving all the transfer of correspondence to electronic systems. The longer-term point is exactly that—[Interruption.] An Opposition Member mentions cyber-attacks; they are absolutely right to do so, because of course we have different risks. This clearly indicates that we need better checks in place, so that when we trust an independent contractor with very important work, we know that the job is actually being done, and that did not happen in this case.

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19 JUN 2017

Devon and Somerset Fire Service

Thank you to Chief Officer Lee Howell and his team from the Devon and Somerset Fire Service for visiting Parliament today.

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27 APR 2017

Immigrants: Detainees

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for the Home Department, how much her Department has paid in compensation for unlawful immigration detention since figures on such compensation payments were published in 2014-15.

Robert Goodwill The Minister for Immigration

I refer the honourable member to my response to PQ 47658, submitted to Parliament on 19 October 2016.

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Hansard

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26 APR 2017

Immigrants: Detainees

Written Answer

Sarah WollastonChair, Health Committee

To ask the Secretary of State for the Home Department, whether procedures have changed as a result of recent successful prosecutions for unlawful immigration detention.

Robert GoodwillThe Minister for Immigration

The cross-system Detention Gatekeeper has now been introduced to scrutinise all proposed detentions independently of an arresting team. Individuals can now only enter immigration detention with the authority of the Detention Gatekeeper, who will ensure that there is no evidence of vulnerability which would be exacerbated by detention, that return will occur within a reasonable timeframe and check that any proposed detention is lawful.

Separately, Case Progression Panels have been introduced to review all cases within immigration detention by a peer-led panel. These panels focus on ensuring that there is progression toward return for all individuals detained, and that detention remains lawful.

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Hansard

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25 APR 2017

Immigration Enforcement Directorate

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for the Home Department, when she plans for the Immigration Enforcement Business Plan for 2016-17 to be published.

Robert Goodwill The Minister for Immigration

The Department's plans for immigration enforcement will be communicated in due course.

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Hansard

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25 APR 2017

Junior Doctors: Conditions of Employment

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what assessment was made prior to the implementation of the junior doctors' contract in 2016 of the additional financial and administrative cost associated with (a) pay protection, (b) additional hours payments, (c) guardian fines, (d) guardian of safe working hours role and (e) exception reporting management.

Philip Dunne The Minister of State, Department of Health

The contract will be recurrently cost-neutral with the exception of additional employer pension contributions arising from the increase in basic pay that was agreed with the British Medical Association as a condition for them entering negotiations in 2013 and was honoured by the Government. This is expected to rise to around £25 million per annum recurrently at the end of transition (circa 0.6% of total contract value).

In addition, there are limited non-recurrent costs of pay protection during transition. Upfront assessments of these costs are uncertain.

Additional hours payments and any fines reflect additional work carried out and are therefore outside the cost neutral funding envelope and will depend on how trusts manage juniors locally. Exception reporting is managed through rota management software. The role of the Guardian of safe working typically takes up a portion of the time of one consultant in each trust. This is seen as an investment in improving safe working for trainees.

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25 APR 2017

Affordable Housing

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, whether the Community Housing Fund will continue to be distributed through local authorities from 2017-18.

Gavin BarwellMinister of State (Department for Communities and Local Government) (Housing, Planning and London)

The first year of the Community Housing Fund was distributed through local authorities and used to build capacity within local groups. Funding for 2017/18 will be used to deliver housing on the ground for local people.

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Hansard

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24 APR 2017

Department of Health: Social Services: Finance

Written Answers

Sarah Wollaston Chair, Health Committee

  • To ask the Secretary of State for Health, whether the forthcoming Green Paper on adult social care funding will look at the needs of everyone who receives adult social care.
  • To ask the Secretary of State for Health, what assessment he has made of the needs of working-age users of disabled social care ahead of the publication of the forthcoming Green Paper on adult social care funding.
  • To ask the Secretary of State for Health, what consultation he has undertaken with organisations operating in the care sector ahead of the publication of the forthcoming Green Paper on adult social care funding.

David Mowat The Parliamentary Under-Secretary of State for Health

Following the announcement of the General Election on 8 June, decisions on the future reform and funding of adult social care will be taken by the new Government.

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24 APR 2017

Drugs: Misuse

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for the Home Department, when the Government's new Drug Strategy will be published.

Sarah NewtonThe Parliamentary Under-Secretary of State for the Home Department

We are currently developing the new Drug Strategy, working across government and with key partners. The new strategy will be published in due course.

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Hansard

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24 APR 2017

Air Quality Strategy

Sarah Wollaston Chair, Health Committee

The Secretary of State has clearly set out the reasons for the delay, but in the intervening time, may I encourage her to strengthen our policies to encourage people to get out of their cars altogether? May I also urge her to read an article in this week's edition of The BMJ that clearly sets out the growing evidence of the benefits of active commuting, particularly by bicycle? Will she encourage us to get Britain cycling?

Andrea LeadsomThe Secretary of State for Environment, Food and Rural Affairs

My hon. Friend is right to raise that issue. The Government are a huge supporter of sustainable transport projects. We have invested £224 million in cycling since 2013, and £600 million in the delivery of transport projects across 77 local authorities through the local sustainable transport fund. As my hon. Friend says, we must do everything that we can to protect the quality of the air in our cities, and that includes changing the way in which people travel.

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20 APR 2017

Environment, Food and Rural Affairs: Food and Drink Sector

Sarah Wollaston Chair, Health Committee

The fishing industry is vitally important to my constituency. Will the Minister update fishers there and around the UK about if, and when, the Government will trigger their intention to withdraw from the 1964 London fisheries convention?

 

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

My hon. Friend makes an important point: there is a 1964 London fisheries convention which has access arrangements for a number of countries. As we have made clear on numerous occasions, we are looking at this very closely, and, as the Prime Minister said just two weeks ago, we hope to be able to say something on this shortly.

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18 APR 2017

Syria and North Korea

Sarah Wollaston Chair, Health Committee

Given the vile propaganda role of Asma al-Assad in propping up a murderous and barbaric war criminal, will the Foreign Secretary update the House as to what discussions he has had with the Home Secretary so that we can send a very clear message that such a role is incompatible with British citizenship?

Boris JohnsonSecretary of State for Foreign and Commonwealth Affairs

We do not discuss individual citizenship cases, as I am sure my hon. Friend knows, although I understand the feelings she is expressing. What I can tell her is that Asma al-Assad, in common with her husband, is certainly on the sanctions list.

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29 MAR 2017

Article 50

Sarah Wollaston Chair, Health Committee

I welcome the Prime Minister's clear commitment to a positive, constructive and respectful approach to the negotiations that lie ahead. May I press her further on behalf of the fishing community in my constituency and around the United Kingdom? She will know that in the past these people have been badly let down during negotiations, so will she give an equally clear commitment that the fishing community will receive a sufficiently high priority during the negotiations ahead?

Theresa May The Prime Minister, Leader of the Conservative Party

I can confirm to my hon. Friend that we are very conscious of the needs of the fishing industry. The Department for Environment, Food and Rural Affairs has been talking to the fishing industry. The Secretary of State and others have been looking carefully at the arrangements that will need to be put in place in the interests of the fishing industry, and that will be an important part of our considerations in future.

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27 MAR 2017

NHS: Reorganisation

Written Answer

Sarah Wollaston MP for Totnes

To ask the Secretary of State for Health, which sustainability and transformation plans contain no mechanism for engaging schools and colleges as active stakeholders.

David Mowat Under Secretary of State at the Department of Health

This information is not held centrally. Local areas are responsible for engaging with the staff, patients and the public, as well as organisations which may include schools and colleges, to further develop their plans.

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24 MAR 2017

Soft Drinks Levy

Written Answer

Sarah Wollaston Chair of the Health Select Committee

To ask Mr Chancellor of the Exchequer, what assessment he has made of the potential merits of using money raised from the Soft Drinks Industry Levy to support (a) nursery schools and (b) private nurseries in accessing the Children's Food Trust accreditation scheme; and if he will make a statement.

This question was grouped with the following question for answer:

To ask Mr Chancellor of the Exchequer, whether he has assessed the potential merits of using money raised through the Soft Drinks Industry Levy to extend the free school meals scheme to (a) nursery schools and (b) private nurseries; and if he will make a statement.

Jane Ellison: Financial Secretary to the Treasury

The Government has already confirmed that, in England, we will invest the £1 billion revenue we originally forecast from the Soft Drinks Industry Levy during this parliament in giving school-aged children a better and healthier future, including through doubling the primary school PE and sport premium and expanding school breakfast clubs. The Secretary of State for Education recently set out further details on this, including £415m for a new healthy pupils capital programme. The Department for Education will set out more detail in due course.

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22 MAR 2017

NHS: Reorganisation

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, how many of the groups responsible for each of the 44 sustainability and transformation plans are consulting with schools and colleges in the development of those plans.

David Mowat The Parliamentary Under-Secretary of State for Health

Local areas are responsible for engaging with the staff, patients and the public, as well as organisations which may include schools and colleges. This information is not held centrally.

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Hansard

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21 MAR 2017

Education: Schools: Transport

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, if she will publish a list of school transport plans with no mechanism for engaging schools and colleges as active stakeholders.

Caroline DinenageThe Parliamentary Under-Secretary of State for Education

The statutory responsibility for transport to education and training for children of compulsory school age and for 16 to 19 year olds rests with local authorities, enabling them to make decisions which best match local needs and circumstances.

Local authorities are required to consult a range of stakeholders including schools and colleges about their post-16 transport policies. When developing transport policies for children of compulsory school age statutory guidance strongly encourages local authorities to consult.

Local authorities publish transport policies for school age children and post-16 young people on their websites. The department does not assess these to determine the extent to which local authorities meet these expectations for consultation. Links to post-16 transport policies can be found at www.gov.uk/subsidised-college-transport-16-19.

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21 MAR 2017

DVLA and Private Parking Companies

Sarah Wollaston Chair, Health Committee

It is a pleasure to serve under your chairmanship, Ms Dorries, and it is a real pleasure to follow my hon. Friend Mr Rees-Mogg and the compelling points he made. I thank my neighbour, my hon. Friend Kevin Foster, for securing the debate. In the short time left, I will touch on unreasonable practices and appeals and make a few further points following on from my hon. Friend the Member for North East Somerset.

There are highly unreasonable practices going on. We have heard many Members give examples. In my area, Premier Parking Solutions, to which my hon. Friend the Member for Torbay referred, has a particular problem with its machines, which is affecting many individuals, particularly when number plate recognition is used in combination with a requirement to enter the vehicle's number plate manually. In many cases, the machines do not record the first number of that registration plate.

The issue is that, because number plate recognition is being used, individuals do not receive a notification until about 10 days to two weeks later, by which time most reasonable people, having parked legally and paid the correct amount, will have discarded the clutter from their windscreen—I do not take much joy in tidying my car, so that would not affect me. Even if individuals have retained their ticket and can clearly prove that there has been an honest error, they find their appeals are not being upheld.

The other problem we have is the disincentive to appeal, because those who appeal have to pay a higher charge if their appeal fails—and fail it will. I have a series of clear cases from individuals who can demonstrate—I suggest to the Minister it is beyond any reasonable doubt—that they have legally parked, fully paid the correct amount and left within the required time, but who are still being hit. If they carry through the appeal process, they find they get nowhere. If they then refuse to pay, they are hit with a series of harassing letters and ultimately receive letters from debt recovery agents, which has an impact on their credit rating. That practice is wholly unacceptable, and intervention from Members of Parliament does not make any difference, either.

I am afraid that our constituents are being caught, and that has consequences. I will read from part of a letter from one of my constituents, which sums up the problem:

"I am an honest lady in my late 60s and I have never had an experience like this before. I live in rented accommodation on a limited income—I am not financially secure. It will cause me hardship to pay this fine when I fully believed I was doing everything legally and correctly."

The letters go on. Another pensioner wrote to me:

"I am a pensioner and all this angst really upsets me...I will do as everyone else has done and pay the £60 within the allotted time and try to forget it—but I have to say the injustice really riles me."

That is the injustice to which my hon. Friend the Member for North East Somerset referred. He is right that the role of Government is to stand up to help those who are powerless against such practices.

It is not just pensioners—I hear this from across a spectrum of individuals—but we should ensure that particularly those who may have difficulty in entering details via these machines have their interests protected. I agree with hon. Members who have said that at the root of the problem lies the DVLA and its complicity in the process. Will the Minister use every power he has to ensure that it takes its role and responsibility seriously? It has a responsibility to ensure that such practices are not allowed to continue. I hope that in responding he will inform all Members here, and constituents following the debate closely, what the Government will do to ensure that justice is done for all our constituents.

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21 MAR 2017

Health: Topical Questions

Oral Answers to Questions

Sarah Wollaston Chair, Health Committee

The NHS mandate was published yesterday, just days before coming into force. Can the Secretary of State set out the reason for the delay, because it allows very little time for scrutiny of this important document by this House? Will he also set out how he is going to prevent money being leached from mental health services and primary care to prop up provider deficits, so that we can meet objective 6 on improving community services?

Jeremy Hunt The Secretary of State for Health

My hon. Friend makes very important points. The reason for the delay was because about a month ago we had wind that we might be successful in securing extra money for social care in the Budget, and we needed to wait until the Budget was completed before we concluded discussions on the mandate. Our confidence as a result of what is in the Budget has enabled us to make the commitments we have made in the mandate, including making sure that we continue to invest in the transformation of out-of-hospital care.

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16 MAR 2017

Suicide Prevention Report

The Health Select Committee, which I chair, released it's report in to suicide prevention today and you may be interested to read it here.

I also spoke about this on the Today programme on BBC Radio 4 this morning and you may like to listen to this here. I spoke approximately 50 minutes in to the programme.

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15 MAR 2017

MHRA

I met with Dr Ian Hudson and Michael Rawlins from the Medicines and Healthcare Products Regulatory Agency (MHRA) to discuss the implications of Brexit in advance of the next stage of the Health Committee's inquiry into the implications of Brexit and health.

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14 MAR 2017

Georgia Shortman

Congratulations to Georgia Shortman, from the South Hams on being selected to represent Oxford Brookes University in Parliament celebrating excellence in undergraduate research. At Posters in Parliament, Georgia presented her dissertation on women in the wine industry considering the opportunities and obstacles, as well as different cultural attitudes to women in the industry.

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14 MAR 2017

Health and Social Care Budgets

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow Meg Hillier. I pay tribute to all the Select Committees and their members for the work that they done and to all those outside this House who made the compelling case that led to the announcements in the Budget. I say to the Minister that I unequivocally welcome those announcements, and I thank the Government for listening to the case that was made, not only about social care but about capital.

However, I would nuance some of that, because the point about social care is that we must not consider it "job done". The £2 billion over the next three years is very welcome—it is also welcome that it has been profiled to address the back-loading of the previous settlement. However, I would like the Minister to say how we will ensure that it gets to the frontline and is distributed fairly according to need, and also that that reflects the different abilities of councils to raise their own money through the social care precept, because that is important for public confidence about how the money is spent.

I also welcome the announcements on capital—the £325 million for the sustainability and transformation plans that are ahead of time is very welcome. I look forward to the announcements in the autumn Budget about further money, although the Minister will know that £1.2 billion has been transferred to revenue from capital. That is an ongoing issue that is hampering the ability of areas to put effective plans in place. Will he touch on that and say how quickly he thinks we will get to a position where we do not see these capital-to-revenue transfers as being necessary?

Another welcome announcement was about the capital improvements available to accident and emergency departments, although I would caution that this is being linked to putting general practitioners alongside casualty departments through co-location. This is not only about funding; it is about having a general practice workforce that can fund these co-located departments alongside out-of-hours departments and providing routine surgeries on Sundays. I am afraid that we simply do not have the workforce to sustain that activity. I know that there is a commitment to increase the workforce in primary care, but that is alongside a significant retirement bulge in primary care. Something will have to give. As things stand, I simply do not feel that we have the workforce to do that work.

Finally on the Budget, there was a very welcome announcement of a review and a Green Paper in the autumn, which we all look forward to. However, I call on the Government to stop and take stock, because next year will be the 70th birthday of the NHS, and it will come at a time when it is under unprecedented financial pressure. Over the last Parliament we saw a 1.1% annual uplift, against the background of uplifts of around 3.8% traditionally since the late '70s. This is a sustained financial squeeze, at the same time as an extraordinary demographic change and an increase in demand across the whole service. As welcome as the announcements were last week, I am afraid that they do not go far enough to address the scale of the generational challenge that we face. It is of course very welcome that more people are living longer, but that is happening alongside a shrinking base of our working population who are able to fund that demand.

We simply cannot carry on as we are. If the review focuses simply on social care, we will miss an extraordinary opportunity to address the issue in time for the 70th anniversary of the NHS. I would therefore ask the Minister to go back to colleagues and say, "Can we widen this Green Paper to take in health and social care, and can we try to do that on a consensual, cross-party basis?", as has been said by many across the House. Notwithstanding the issues about that in the past, the scale of the challenge is so great that we owe it to all our constituents to put that aside and to take nothing off the table in considering the scale of the challenge and the solutions ahead.

We have an opportunity to explain that to the public, because whenever I address public meetings and I ask people whether they would be prepared to pay more to fund our health and social care adequately, I find that the response is almost unanimous. People are ready for this. They understand the pressures, and they value health and social care immensely. That would be my big ask of the Minister: think again, widen the review, make it consensual and explain it to the public. Let us get the consent and move forward.

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14 MAR 2017

Ministry of Justice: Coroners

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Justice, what proportion of bodies were released by coroners within the Chief Coroner's target of three days in the most recent period for which figures are available.


Phillip Lee The Parliamentary Under-Secretary of State for Justice

The information requested is not held centrally.

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Hansard

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14 MAR 2017

Health Select Committee

The Health Select Committee met today to discuss Children and young people's mental health - role of education

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14 MAR 2017

Sex and Relationship Education

Thank you very much for taking the time to email me about personal, social, health and economic education (PSHE), and relationships education and relationships and sex education being included in the Children and Social Work Bill.

I also think that sex education should be compulsory. I believe that sex education has to be about more than 'plumbing and prevention' and I think that, once it becomes age appropriate, topics such as relationships and consent should also be discussed.

I am concerned about the extent to which young people are gathering information about sex from pornography, which is often violent and distorts understanding of what constitutes as consent. In addition, it is clearly of paramount importance that future generations understand the danger of sexually transmitted diseases and how they spread. After decades of highlighting this information to combat such diseases we do not want all the progress we have made to go to waste. I quite understand that many parents wish to broach these subjects with their children themselves. However, we should make sure all children receive the information they need. On the matter of reducing unplanned pregnancy at all ages, progress is being made on this and I do think that making sex education mandatory could be of further help.

I signed a letter to this effect to the Secretary of State for Education which you may be interested to view via the following link: http://www.parliament.uk/documents/commons-committees/Education/Correspondence/Chairs-letter-to-Secretary-of-State-re-PSHE-status-29-11-2016.PDF

I hope the following information on this topic from the Department of Education is of interest:

Schools should be providing all young people with a curriculum that equips them for success in adult life, and that also addresses modern issues like cyber-bullying and internet safety. Part of that responsibility is to ensure every child has access to relevant, factually accurate and age-appropriate PSHE and RSE.
The Secretary of State is personally committed to ensuring that progress in improving the availability and quality of PSHE and RSE is made a priority. The Government has introduced new clauses to the Children and Social Work Bill at Committee Stage which would require regulations to be made to require all secondary schools in England to teach relationships and sex education (RSE) and would introduce a new subject, 'relationships education' to be taught in all primary schools. Renaming the secondary school subject 'relationships and sex education' places emphasis on the intrinsic importance of healthy relationships and would deliver sex education within this context. The focus of relationships education in primary schools will be on building healthy relationships and staying safe.
The Department for Education intends to engage with key groups to develop age-appropriate subject content that includes teaching on mental wellbeing, consent, resilience and keeping safe online. The clauses would continue to allow parents a right to withdraw their children from sex education and schools would be required to publish a clear statement of their policy and teaching content to ensure parents are engaged in the teaching throughout.
It is important to make sure that our young people have the right information and right advice, and that what we teach them is fit for the world that children live in today. Starting at an early age so that children can understand relationships with one another, is sensible. However, the Government is not proposing that sex education be compulsory in primary schools beyond what is already covered in the science curriculum. Teaching must remain age-appropriate. The clauses emphasise that relationships education content should remain appropriate and the Department for Education intends to work with key groups to develop age-appropriate subject content.

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13 MAR 2017

Dr Henrietta Hughes

Dr Henrietta Hughes is the NHS National Guardian for speaking up freely and safely. Her role is to support whistleblowing and work with Trusts to be more transparent and to respond earlier to concerns raised by staff. We were able to discuss her initial findings and the experience of whistleblowers in my constituency.

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13 MAR 2017

Nuala Campbell and Alistair Johnstone

It was a pleasure to meet Nuala Campbell and Alistair Johnstone, who are the Guardians of Safe Working Hours for Torbay and South Devon and Bristol Hospital Trusts. We discussed junior doctors' workload and the problems of fatigue, stress and disillusionment. We agree on the importance of EU staff to the wider NHS, including here in South Devon.

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13 MAR 2017

Health Services and Social Services: Apprentices

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, how much the Government plans to spend on health and social care apprenticeships in each of the next five years.

 

Philip Dunne The Minister of State, Department of Health

The new Apprenticeship Levy comes into operation in April 2017 and is set at a rate of 0.5% of an employer's pay bill. Apprenticeship Levy contributions by National Health Service organisations are estimated as £200 million in 2017-18 and will change over the next five years as the NHS pay bill changes. Estimates are not available for social care.

Apprentices are employed and individual employers will decide which apprentices to employ to meet their workforce needs. The Department does not centrally collect the plans of how many apprentices each individual employer intends to recruit by the end of 2020.

The Department is working with a range of partner organisations, including Health Education England, NHS Improvement, Skills for Health and Skills for Care to ensure NHS and social care providers have access to the apprentice standards they need to develop their own workforce and to make full use of the apprentice levy.

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09 MAR 2017

Drugs: Misuse

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what assessment he has made of the effect of the abstinence based approach for the treatment of drug addiction on levels of deaths from drug misuse.



Nicola BlackwoodThe Parliamentary Under-Secretary of State for Health

The provision of both harm reduction and abstinence based interventions is essential to any drug treatment system. Each local authority is responsible for ensuring there is a full range of drug treatment services available in their area to meet the needs of their local population.

During the recent Public Health England led inquiry into the rise in drug-related deaths, analysis of the treatment population did not establish a direct relationship between a policy focus on abstinence and drug-related deaths.

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09 MAR 2017

Health Services and Social Services: Apprentices

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, whether the revenue raised by the Immigration Skills Charge applied to NHS and social care sponsors of Tier 2 visas will be hypothecated for investment in apprenticeships in health and social care; and if she will make a statement.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what estimate she has made of the cost of the Immigration Skills Charge to NHS and social care sponsors of Tier 2 visas in 2016-17; and if she will make a statement.

Robert HalfonThe Minister for Schools, Minister of State (Department of Education) (Apprenticeships and Skills)

The income raised from the Immigration Skills Charge will support the provision of skills for the resident population, to address the skills gaps that employers face. Further information will be set out in due course. We have not estimated the potential annual cost to NHS and social care sponsors. The cost will depend on employer use of the Tier 2 skilled worker route.

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08 MAR 2017

International Women's Day

March 8th marked International Women's Day, celebrating women worldwide and highlighting where more must be done in the fight for equality. It was the first IWD where the number of female MPs ever elected outnumbers the number of men currently sitting in Parliament. When I was sworn in after the 2010 General Election I became the 304th female MP ever elected. I was proud to join so many of my colleagues in Members' Lobby for a photo.

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07 MAR 2017

Gabriel Wikström

It was fascinating to meet with Gabriel Wikström, Minister for Public Health, Healthcare and Sports in the Swedish Government. We discussed our shared aims to reduce public health harm from smoking, obesity, excessive alcohol and improving air quality. For both Sweden and the UK Government, reducing health inequalities is a key goal. I shared the Health Committee's perspective on the Childhood Obesity Plan and learned of some of Sweden's forthcoming legislation designed to improve public health. We also discussed the funding and social care challenges facing all EU nations.

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06 MAR 2017

The Daily Mile

I  met Education Minister Ed Timpson and Elaine Wyllie, founder of the Daily Mile, to discuss physical activity and its importance to children and young people's wellbeing. Many schools around the UK now take time at the start of the day to run the daily mile and it was also promoted in the Childhood Obesity Plan last year. The Minister was very positive about this scheme and how we discussed how he could better enable schools to participate and take advantage. I have also discussed this locally and hope to see children across the constituency benefit in future. The results have been transformative and once implemented, schools are positive about the benefits. It's well worth a look at their website.

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06 MAR 2017

RNLI

The RNLI plays an important role in this constituency. I was pleased to meet with their Director of Operations George Rawlinson to discuss their priorities including the new National Drowning Prevention Strategy. Local authorities and coastguards continue to work closely to reduce risk and to provide education on the importance of enjoying the sea safely and responsibly. You can test your knowledge on what to do in an emergency on the Respect the Water website.

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28 FEB 2017

Baroness Tyler

It was a pleasure to catch up with Baroness Tyler, to discuss her recent report What Really Matters in Children and Young People's Mental Health. The report was produced with the Royal College of Psychiatrists and examines how we can best make the changes needed to improve children's mental wellbeing. The Health Committee is holding a joint inquiry with the Education Committee into the role of education in children and young people's access to mental health services, which you can read more about here.

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28 FEB 2017

Doctors of the World

I met with Doctors of the World, the National AIDs Trust and Liberty to discuss my concerns about the information sharing agreement between the Home Office and the Department of Health. We discussed the important principle that information shared between patients and their doctor is confidential except in exceptional circumstances. The extension through the agreement to share exact addresses for those who have overstayed visas or other immigration offences does erode that principle and could have unintended consequences for public health if people do not seek treatment for serious conditions as a result.

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28 FEB 2017

Health Select Committee

The Health Select Committee met today to discuss Brexit and health and social care

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27 FEB 2017

Health and Social Care

Sarah Wollaston Chair, Health Committee

Today's debate on the supplementary estimates and the financial position of health and social care matters, first and foremost, because of the impact of that financial position on patient care. I start by paying tribute to our health and care staff across the country and, at this particular time, by noting and thanking those who have come from across the European Union to work in this country.

The current financial position is of great concern. As a result of the wider economic downturn, we are now in the seventh year of the longest financial squeeze in the history of the NHS. Although the Department of Health's budget has been protected in relation to many others, we cannot escape the fact that over the previous Parliament the average annual increase in its budget was 1.1%, which is far lower than the increase in demand and, of course, far lower than the historical increase of 3.8% since the late 1970s. All that is in the context of an extremely challenging position for social care. Between 2009-10 and 2014-15, there was a 10% real-terms reduction in social care spending by local authorities.

All that has taken place in the face of an extraordinary increase in demand, because of not only a rising population but our changing demographics. To put that into context, over the decade to 2015 there was a 31% increase in the number of people living to 85 and beyond, and we estimate that over the next 20 years we will see a 60% increase in the number of individuals who rely on social care. Over the years there has been an abject failure of Governments to plan for that, although it was entirely predictable. We absolutely cannot just keep ducking the question. We need not only to address the immediate financial problems that face health and social care, but to come together as a House to address the problems for the future.

Bill Wiggin Chair, Committee of Selection

It occurs to me that this is not a uniquely British problem; it is in fact a global one. I have been trying to find out where in the world social care is best delivered and whether we can learn anything from those countries.

Sarah Wollaston Chair, Health Committee

My hon. Friend makes an important point. We are all looking forward to the publication of the House of Lords report on future sustainability, because of course we have much to learn from other systems. I pay tribute to the Public Accounts Committee, which today published its report on the financial sustainability of the NHS. We have also seen the final position of trusts at the end of the previous quarter, so we now know that 135 providers ended that quarter in deficit. We are on course for a financial deficit across trusts of between £750 million and £850 million at the end of the financial year.

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27 FEB 2017

NHS Shared Business Services

Sarah Wollaston Chair, Health Committee

This is undoubtedly a very serious incident, but I welcome the detailed and thorough steps that the Secretary of State has taken to protect patient safety. However, he will know that there are ongoing problems with the transfer of patient records. GPs and hospitals spend endless hours chasing up results, investigations and letters on a daily basis. Is it not time that patients were given direct control of their own records, and will the Secretary of State provide an update on that to the House?

Jeremy Hunt The Secretary of State for Health

I thank my hon. Friend for her sensible contribution. She is right that, although the process of sending on these particular documents has been taken in-house, other parts of the contract were taken on by a company called Capita—[Interruption.] Jonathan Ashworth cannot stop, can he? Let me repeat that the work in question has been taken in-house. The other work, which is being done by Capita, has had some teething problems, of which we are very aware. We know it has been causing problems for GPs. The Under-Secretary of State for Health, my hon. Friend Nicola Blackwood has been meeting Capita and people relating to that contract on a fortnightly basis to try to identify the problems.

My hon. Friend Dr Wollaston is right that the aim in the long run is to give people control of their records. I am proud that, under this Government, we have become the first country in the world to give every patient access to their own records online. From September, people will be able to do that without having to go to their GP's surgery.

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27 FEB 2017

Fisheries: Treaties

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Environment, Food and Rural Affairs, if the Government will consider invoking Articles 15 and 11 of the 1964 London Fisheries Convention after triggering Article 50 of the Lisbon Treaty.

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

The Government is considering this issue very carefully.

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22 FEB 2017

Royal College of Radiologists

I was grateful to Dr Nicola Strickland, President of the Royal College of Radiologists for coming to Parliament to discuss the shortage in radiologists and the impact this is having on diagnosis and treatment of cancer and other serious conditions in the UK. An average of 9% of consultant posts are unfilled in the UK, with over 40% of these vacant for over a year. We need a clearer strategy for training, recruiting and retaining radiologists and radiographers.

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22 FEB 2017

Britvic

Following up on the Childhood Obesity Plan, I met with Paul Graham and Victoria McKenzie-Gould from Britvic to discuss the company's work on reformulation. The new sugary drinks levy has encouraged soft drinks companies to reduce the sugar content in their products but the effect of the levy will be increased if there is a price difference at point of sale. It would be wrong for customers choosing a low or no sugar brand to be subsidising those choosing high sugar alternatives. There is strong evidence that the various nutritional information on packaging is confusing consumers – simplifying labelling is one of the opportunities from Brexit which will allow us to set our own standards for example allowing us to show how many teaspoons of sugar are in a surgery drink.

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22 FEB 2017

General Medical Council

I met the General Medical Council's new Chief Executive, Charlie Massey, along with its chair Terence Stephenson. We discussed upcoming reforms to professional regulation and some of the challenges facing doctors, particularly in terms of revalidation and the concerns about the impact on the NHS and care workforce over Brexit. This is the subject of a current Health Select Committee inquiry.

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22 FEB 2017

Police Grant

Sarah Wollaston Chair, Health Committee

Does my hon. Friend agree that the assumption is often made that rural areas are wealthy? In fact, rural deprivation is significant, but it often needs to be measured in different ways. Those in rural areas are often on below-average incomes, but they have higher costs. I think that that needs to be stressed.


Sarah Wollaston Chair, Health Committee

I join the hon. Gentleman in commending the police forces on the work they do, particularly for those suffering from mental health problems. Does he agree that the funding formula needs to include not only that, but wider issues of vulnerability, particularly among the elderly population, which is higher in rural areas, especially in areas such as Devon?

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22 FEB 2017

Local Government Finance

Sarah Wollaston Chair, Health Committee

I would like to put on record the fact that my constituency covers part of Torbay, which has both a national and an international reputation for integration of health and social care. Despite that, it is now under extraordinary pressure from a number of sources, and it is very important that Ministers are aware of the strain that social care is under.

Gareth ThomasParty Chair, Co-operative Party, Shadow Minister (Communities and Local Government)

I commend the hon. Lady, who has been a brave voice on the Government side in raising this issue.

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21 FEB 2017

Health Select Committee

The Committee met today to discuss Brexit and health and social care.

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21 FEB 2017

South West Water

It was good to catch up with Dr Stephen Bird, Chief Executive of South West Water. Household bills are higher here in the South West and I was pleased to learn that South West Water's prices for 2017-18 will be kept below inflation. Those needing further support with costs may be eligible for a social tariff, discounting energy to those most vulnerable to fuel poverty. Some customers may also benefit from a water meter. We also discussed South West Water's work with apprentices. SW Water is a Top 100 apprenticeship employer and you can find out more about their projects here.

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20 FEB 2017

The Chancellor

This evening I met with the Chancellor to raise concerns about the business rates revaluation and the potential impact on local businesses in our high streets like Salcombe, Dartmouth Totnes and Kingsbridge. I hope to see some mitigation for worst-hit areas in the Budget on 8 March.

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13 FEB 2017

Health Services: Directors

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, by what metrics the effectiveness of Regulation 5: Fit and proper persons: directors is measured; and if he will make a statement.

Philip Dunne The Minister of State, Department of Health

Regulation 5 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, The Fit and Proper Persons Requirement (FPPR) for Directors came into effect for National Health Service bodies on 27 November 2014 and was extended to cover all providers regulated by the Care Quality Commission (CQC) on 1 April 2015.

The regulations include a requirement that they must be reviewed every five years, beginning five years after 1 April 2015. As yet the Department has not undertaken a review of regulation 5. Any such review would be completed with input from the CQC.

The CQC has advised that it is the provider's responsibility to ensure that all directors appointed are fit and proper for their role. The CQC's responsibility is to check whether providers have the right systems and processes in place to assure themselves of fitness.

The CQC has not yet conducted a thorough assessment of the regulations' effectiveness. However, in the first years of implementation, the CQC has received feedback on how the regulation is applied, often driven by an assumption that it is CQC's role to assess fitness directly rather than to assess providers' systems and processes.

In response to this feedback, the CQC has considered whether its current approach is in line with what can be reasonably expected of the CQC within the current regulations. The CQC has therefore begun a programme of work to improve its internal systems and processes for handling referrals under FPPR. There are three areas of CQC's guidance and processes that it is strengthening:

- Passing on all details of FPPR concerns raised with the CQC to providers

Presently the CQC does not pass on all concerns raised with it to providers to ask for an explanation. Instead the CQC assesses whether there are concerns that a reasonable employer should be expected to investigate and if the CQC does not think there is a substantive concern it does not pass the material on. When the CQC does share concerns, it initially summarises the information and will later send on the full material if requested.

CQC's intention is to change both of these steps so providers are notified of all concerns and receive all of the information immediately. The CQC will set out more clearly the type of investigation it expects providers to undertake, following notification.

- Interpretation of "serious mismanagement"

CQC believes there would be benefit in developing a clearer understanding of what type of behaviour constitutes 'serious management'. The CQC has prepared some draft guidance that characterises serious mismanagement and will shortly be publishing this for consultation. The CQC will develop the finalised draft into internal and external guidance as to how it interprets and applies this element of the regulation.

- The way CQC manages and records information regarding FPPR

It is recognised internally that CQC needs to improve the data available to itself about CQC's application of FPPR. The CQC is developing an approach to better enable it to track the volume of FPPR concerns shared with CQC by sector and the actions that result from these.

The CQC aims that, by undertaking the programme of improvements described above, CQC will be better placed to monitor the effectiveness of Regulation 5: Fit and Proper Persons in future.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, in how many instances the Care Quality Commission has asked service providers to instigate fit and proper persons requirement (FPPR) investigations for each year since the FPPR came into force; and how many of those FPPR investigations resulted in a director being discharged from duty.

Philip Dunne The Minister of State, Department of Health

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England.

The CQC has provided the following information:

The following actions have been taken in relation to Regulation 5 Fit and Proper Persons Requirement:

- CQC management reviews enable the CQC to reach a decision about the next course of action to take in response to a trigger for review, for example when we identify concerns around non-compliance with the regulations during an inspection, at the point of registration, or when we receive a safeguarding alert or concern. As at 8 February 2017 there have been 38 Adult Social Care (ASC), 14 Hospital, 5 Primary Medical Services and 37 Registration management reviews held regarding regulation 5.

There have been 28 enforcement actions under this regulation:

- 21 have been triggered by an enquiry, 16 of which were during the registration process.

- Seven were triggered by an inspection, four at ASC locations and three at Hospital locations.

- In seven cases registration was refused. In five cases registration was cancelled and in a further eight cases the providers were registered with agreed actions. The remainder included recommended fixed penalty notices, urgent and non-urgent imposition of conditions and warning notices.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, for what reasons the Care Quality Commission closed its fit and proper persons requirement process on Paula Vasco-Knight, then Chief Executive of South Devon NHS Foundation Trust.

Philip Dunne The Minister of State, Department of Health

The Care Quality Commission (CQC) has advised that in October 2015 the CQC received information of concern regarding the appointment of Paula Vasco-Knight as Acting Chief Executive at St George's University Hospital NHS Foundation Trust. These concerns related to Paula Vasco-Knight's conduct whilst she was Chief Executive at South Devon Foundation Trust. The CQC followed this up directly with the trust to review whether they had followed appropriate recruitment processes and carried out robust checks to determine Paula Vasco-Knight's fitness prior to her employment.

Based on the extensive evidence supplied by the trust and information provided separately from the Nursing and Midwifery Council the CQC concluded that the trust had not breached the fit and proper persons regulation at that time in relation to that appointment. The CQC informed the trust of this decision in February 2016 but reserved the right to reopen the case in light of any further information received. At the time of this decision, neither CQC nor the trust was aware of the fraud charges.

In April 2016 CQC received new information that led it to re-open the case. In early May 2016 both CQC and St George's became aware for the first time of the criminal investigation and fraud charges being brought against Paula Vasco-Knight. The CQC were subsequently asked by NHS Protect to put the case on hold pending their criminal investigation. St George's University Hospital NHS Foundation Trust suspended Paula Vasco-Knight at this time. These are matters of public record.

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08 FEB 2017

EU Nationals

I raised the question about the rights of EU Nationals in the UK at today's Prime Minister's Question Time

I am not alone in hearing from families long-settled here in Britain who are deeply worried that they could be separated after we leave the European Union. I know the Prime Minister will not want that to happen. Will she reassure all our constituents today that those who were born elsewhere in the European Union but settled here in the UK, married or in partnerships with British citizens will have the right to remain?

Theresa May The Prime Minister, Leader of the Conservative Party

My hon. Friend obviously raises an issue that is of concern all across this House. As she says, it is of concern to many individuals outside the House who want reassurance about their future. As I have said, I want to be able to give, and I expect to be able to give, that reassurance, but I want to see the same reassurance for UK citizens living in the EU. What I can say to her is that when I trigger article 50, I intend to make it clear that I want this to be a priority for an early stage of the negotiations, so we can address this issue and give reassurance to the people concerned.

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07 FEB 2017

Foreign Nationals: NHS Treatment

Sarah Wollaston Chair, Health Committee

Given the Government's stated objective of reducing health inequalities, will the Secretary of State set out how he will guarantee that those who are, for example, homeless or who have severe enduring mental illness—the most disadvantaged in our society, who are unlikely to have the required documentation—will receive the treatment they need?


Jeremy Hunt The Secretary of State for Health

I can absolutely reassure my hon. Friend. What we are doing is based on good evidence from hospitals such as Peterborough hospital, which has introduced ID checks for elective care and has seen absolutely no evidence that anyone who needs care has been denied it. This is not about denying anyone the care they need in urgent or emergency situations; it is about ensuring that we abide by the fundamental principle of fairness so that people who do not pay for the NHS through their taxes should pay for the care we provide.

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07 FEB 2017

Health Select Committee

The Health Committee met to discuss Childhood Obesity and whether this was a 'plan for action' or a 'plan for inaction and missed opportunities'

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06 FEB 2017

Parliamentary oversight of negotiations

Sarah Wollaston Chair, Health Committee

My right hon. Friend is absolutely right to be concerned about the fate of British citizens living in the European Union, but I agree with others who have said that, surely, a goodwill gesture would be a really positive thing for this Government to make. Two of my constituents are a married couple who have been living together in this country for 30 years, and I consider the wife to be as British as anybody else. We should make it absolutely clear that it is inconceivable that this couple should be separated, and that their children should be left with separated parents.

.....

Sarah Wollaston Chair, Health Committee

I wish to start by reading something from a letter I have received from a constituent. He talks about his wife, who was born in the Netherlands. He writes:

"She has lived in this country for over 30 years, brought up three British children and is completely integrated into the life of her local town. She is not part of any 'immigrant community'. She just lives here and is fully at home here. Until now, she has never seen herself as an outsider and has been able to participate fully in local life, thanks to her rights as an EU citizen. In two years' time, she will lose those rights and be a foreigner, dependent on the good will of the Government of the day."

I have written back to and met my constituent, because I think it is inconceivable that our Prime Minister would separate this family. However, many people are not reassured, and he and his wife sought for her to have permanent residency. This involved dealing with an 85-page document, including an English language test and a test about life in Britain, which is insulting to someone who has lived here most of her life and brought up three children here. This process is also very expensive, but the final sting in the tail is that she finds she is not eligible, because she has been self-employed and has not taken out comprehensive sickness insurance. This situation is unacceptable. We need to keep our compassion and keep this simple. It is inconceivable that families such as this would be separated, so we should be absolutely clear in saying so, up front.

Julian Knight Conservative, Solihull

I understand what my hon. Friend is saying about her constituency surgeries. I have had a similar experience and it is deeply upsetting in many respects, but will she join me in reflecting that the EU and Chancellor Merkel could have come to a deal on this earlier? The reality is that they have point-blank refused to discuss it before we trigger article 50.

Sarah Wollaston Chair, Health Committee

I agree with that, and I have also heard from constituents of mine who are British citizens now living in the EU. But my point is that, come what may, it is inconceivable that we would seek to separate families such as this one. There is no doubt that many people are sleepless and sick with worry about this, and we have all seen them in our surgeries. [Interruption.] It is true. I am seeing these people in my surgery. We also need to consider the tsunami of paperwork that we will have to deal with in settling the rights of these citizens if we do not get on with this quickly. We need to keep this simple. There is no way that families such as this should be subjected to a vast bureaucracy and vast expense. We all know that this needs to be settled, so in negotiating, surely, making a bold, open offer as a gesture of good will can do nothing but good in this situation.

Richard Fuller Conservative, Bedford

I agree with my hon. Friend, but my question to her is: can she cast any thought on why the Chancellor of Germany refused the offer?

Sarah Wollaston Chair, Health Committee

I have no idea why this is happening, but I am saying, as an important point to the Chancellor of Germany, that making this clear unilateral offer is the right thing to do, and we should get on and do it. There is no reason not to do so. Even if other countries were to take an obstructive and unreasonable line, it would still be inconceivable that our Prime Minister would separate families such as my constituents. So let us get on with this.

Anna Soubry Conservative, Broxtowe

Does my hon. Friend not agree that the Prime Minister as given her word that this will be a priority and she clearly hears the compassion that my hon. Friend reflects for her constituent, as we all do for all our constituents? We must, as I certainly do, accept the word of the Prime Minister that this will be her priority and that she will sort it.

Sarah Wollaston Chair, Health Committee

I thank my hon. Friend for that. Like her, I do trust the Prime Minister, and that is why I have taken a very reassuring line with my constituents. However, there is no substitute for a clear statement from our Prime Minister that, come what may, families such as this will not be separated, because that is the reassurance they seek. I hear what my hon. Friend says, but I think we should get on and make that offer, because it can be nothing but good to do so.

I also hope the Prime Minister will take further action on the issue of those who work in our NHS and social care. One in 10 of the doctors who works in our NHS comes from elsewhere in the EU, and I would like to say thank you, on behalf of the whole House, to all those workers and to all those who are working in social care. It would also be very much a positive move if we could say, up front, that those who are working here will be welcome to stay and make it very clear that we will continue to make it easy to welcome people from across the EU to work in social care and in our NHS.

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01 FEB 2017

Developing Countries: Family Planning

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for International Development, what estimate her Department has made of the potential shortfall in funding to charities and non-governmental organisations as a result of the revocation in the US of the Presidential Memorandum of 23 January 2009 Mexico City Policy and Assistance for Voluntary Population Planning and the reinstatement of the Presidential Memorandum of 22 January 2001 Restoration of Mexico City Policy; and what plans her Department has to ensure continued access to (a) family planning advice and (b) safe termination and contraception through its programmes.

James Wharton The Parliamentary Under-Secretary of State for International Development

It is too early to put an exact figure on the financial impact of the restoration of the Mexico City Policy.

The UK firmly believes that supporting comprehensive sexual and reproductive health and rights of women and girls, through proven, evidence-based public health interventions, saves lives and supports prosperity. We will continue to work with all our partners, including governments, UNFPA and civil society partners, to deliver this.

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31 JAN 2017

Post Offices: Rural Areas

Written Answers

Dr Sarah Wollaston Totnes

To ask the Secretary of State for Business, Energy and Industrial Strategy, what the implications for his policies are of the call by the Association of Convenience Stores for the Government to review the costs, income and viability of rural post offices on its Rural Shop Report 2017, published in January 2017.


Margot James Under Secretary of State for Small Business, Consumers and Corporate Responsibility

The Government entrusts the Post Office's management to keep the health of the network under review in order to meet the commitment we have set to maintain the network at over 11,500 branches. The commercial agreements it has with subpostmasters, rural and urban, covering costs and revenue form a key part of ensuring the health of the network. While these arrangements are commercially sensitive between both parties the evidence of their success is in the fact that that the network is at its most stable in decades.

Dr Sarah Wollaston Totnes

To ask the Secretary of State for Business, Energy and Industrial Strategy, whether his Department plans for the increase in Post Office outreach services in rural communities over the last five years to continue; and if he will make a statement.

Margot James Under Secretary of State for Small Business, Consumers and Corporate Responsibility

The Department for Business, Energy and Industrial Strategy keeps the state of the network under review including the provision of rural services through outreaches. Outreaches are provided so Post Office can maintain access to communities, most often in rural areas, where the old post office has closed. These provide a regular part time service, with hours tailored to the levels of demand in the community. They provide a welcomed link to the network for many isolated communities.

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31 JAN 2017

Energy and Industrial Strategy: Topical Questions

Sarah Wollaston Chair, Health Committee

It is 100 years since the destruction of Hallsands village following an act of environmental destruction and vandalism that saw the removal of protective shingle from the shoreline. Communities around our entire coast, including in Start Bay, face an even greater threat from climate change. Will the Minister assure me that he will protect us from an act of environmental vandalism —withdrawal from the Paris agreement?

Nick Hurd The Minister of State, Department for Business, Energy and Industrial Strategy

As the Prime Minister said in Prime Minister's questions last week, this country is fully committed to the Paris climate change agreement—as are all the countries that endorsed the Marrakech proclamation—and we hope that all parties will continue to ensure that it is put into practice.

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31 JAN 2017

Science Funding

Sarah Wollaston Chair, Health Committee

There is great concern about the future of fusion research after Britain pulls out of the EU and Euratom. Will the Secretary of State reassure us that he will continue to support and fully fund the Joint European Torus project and other joint research projects such as ITER—the international thermonuclear experimental reactor—after Britain leaves the EU?

Greg Clark The Secretary of State for Business, Energy and Industrial Strategy

The collaboration between scientists and those in the nuclear sector is one of the important aspects of the continued co-operation that we want and intend to see continue.

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31 JAN 2017

National Assembly of Korea

It was a privilege to meet with Na Kyung-won, chair of the Special Committee on Low Birthrate and Aging Society in the National Assembly of Korea and some of her colleagues. Korea and the UK share many similar demographic challenges as our populations' age and we must find sustainable long term funding and systemic solutions which enable older people to live independently and with dignity for as long as they can.

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30 JAN 2017

Public Accounts Committee

I joined Meg Hillier, chair of the Public Accounts Committee, for a seminar on NHS and social care funding in England. Joined by Members of Parliament and Peers, representatives of hospitals, doctors, local government, health policy and the NHS offered a comprehensive and effective briefing of the pressures in the system, as well as reflecting on possible solutions. It is vital that the Government bring forward a long term, sustainable funding solution reflecting that health and social care are part of a single system. I will continue to work with colleagues across the House to call for such a debate.

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26 JAN 2017

Junior Doctors

It was a pleasure to meet the BMA Junior Doctors Committee interim co-chair Dr Jeeves Wijesuriya and Harry Carter and Charlie Bell from the Medical Students Committee. We spoke of the challenges faced by junior doctors. It is incredibly frustrating for junior doctors who decide to spend a year working abroad in Australia are not able to arrange a Skype interview at hospitals in the UK, or even obtain a confirmed date for an interview. We must make it easier for doctors to return to the NHS and ensure that they are properly supported when they are here.

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26 JAN 2017

Post Offices: Rural Areas

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Business, Energy and Industrial Strategy, what assessment his Department has made of progress in securing the future of rural post offices; and if he will make a statement.

Margot James Parliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)

The Government understands the important role post offices play in communities across the country, especially in the more remote, rural areas. This is why in our manifesto we committed to secure the future of 3,000 rural post offices.

Thanks to Government investment the UK's network of 11,600 branches is at its most stable in decades, with over 98% of the UK population in rural areas within 3 miles of a post office. The investment is offering real improvements to customers, including an extra 200,000 opening hours every week and over 4,200 post offices open on a Sunday.

The Government's recent consultation will help us understand what the public and businesses expect from the Post Office and to understand more fully what subsidy is needed and what it should be used for.

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25 JAN 2017

Cancer Research UK

I met with Sarah and Emma from Cancer Research UK to discuss cancer diagnosis and treatment in the UK. Tackling obesity, poor diet and lack of exercise is an important strand of reducing cancer rates in the UK and we spoke about how cuts to public health budgets are storing up problems for the future. We must also tackle the ongoing challenges in recruitment and retention of vital clinical staff in this part of the workforce.

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24 JAN 2017

Cancer: Health Services

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, with reference to the National Audit Office's report, Progress in improving cancer services and outcomes in England, published in January 2015, what the total spend on cancer care in the NHS per newly diagnosed patient was for the most recent period for which figures are available.

David Mowat The Parliamentary Under-Secretary of State for Health

The National Audit Office published an estimate of the total amount spent on cancer care in the National Health Service to show the relative scale of the cost of cancer services to the NHS. The NHS does not routinely publish estimates of the total amount spent on cancer patients as the large scale and highly complex range of services that cancer patients interact with makes this very difficult. Many of the services used by people with cancer, in particular diagnostic and rehabilitation services, but also some treatment services, are not specific to cancer patients.

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24 JAN 2017

Health Select Committee

Today the Health Select Committee took evidence from the Secretary of State for Health on the impact of Brexit on health and social care.

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23 JAN 2017

Local Government Finance Bill

Sarah Wollaston Chair, Health Committee

I thank the Minister for giving way. He will know that the better care fund is an important redistribution mechanism, given the variable amounts that councils will be able to raise through the precept, which the Institute for Fiscal Studies estimates will raise £700 million over the next three years. Can the Minister give any encouragement on whether the better care fund will reflect the serious concerns around the problems with social care?

Marcus Jones Parliamentary Under-Secretary of State (Department for Communities and Local Government) (Local Government)

I think my hon. Friend is referring to what we term the improved better care fund, which will go directly to local authorities. That funding has been brought forward as part of the spending review 2015. She will probably know that that funding effectively was obtained by changing the way in which the new homes bonus operates, and sharpening the incentive in relation to the way in which that system operates. As such, therefore, that additional money is not freed up quickly enough to do what she says. Although this year £105 million comes into the system, next year it will be £800 million and the year after that—the last year of the Parliament—it will be £1.5 billion. Alongside that, in this financial year we have also put an additional £240 million into the social care system as a dedicated social care grant, which again has been realised from additional savings made through the new homes bonus.

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23 JAN 2017

Life Expectancy

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Minister for the Cabinet Office, what assessment he has made of the change to the life expectancy of (a) men and (b) women at age (i) 75 and (ii) 85 in each of the last five years.


Chris Skidmore Parliamentary Under-Secretary (Cabinet Office)

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the Authority to reply.

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23 JAN 2017

Mortality Rates

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Minister for the Cabinet Office, what assessment he has made of trends in death rates for people aged 75 and over in each of the last five years; and what steps his Department has taken to investigate the reasons for any change in such death rates.


Chris Skidmore Parliamentary Under-Secretary (Cabinet Office)

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the Authority to reply.

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20 JAN 2017

Doctors: Training

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, with reference to his announcement of 4 October 2016, that up to 1,500 extra medical training places will be made available from September 2018, what increased Service Increment for Teaching funding will be provided to support the training of those additional medical students.

To ask the Secretary of State for Health, with reference to his announcement of 4 October 2016, that up to 1,500 extra medical training places will be made available from September 2018, whether those additional students will be supported by the same (a) undergraduate fee and (b) Higher Education Funding Council for England banding payments as existing medical students.

Philip Dunne The Minister of State, Department of Health

National Health Service providers will receive clinical placement funding for the minimum number of students that Health Education England forecast are required to meet the longer-term workforce needs of the NHS.

In early 2017, the Department plans to run a public consultation on its proposals to expand domestic undergraduate medical training places by up to 1,500 per year, from the academic year 2018-19.

For the 2017-18 academic year, undergraduate medical students undertaking the first four years of their courses will qualify for the same tuition fee loan and living costs support package from the Student Loans Company as other full-time undergraduate students. For years five and six of their courses, these students will continue to qualify for NHS bursaries and an additional reduced rate non-means tested loan for living costs from the Student Loans Company.

Teaching grants for medical students will also continue under the Office for Students (which is expected to assume Higher Education Funding Council for England's funding responsibility from April 2018) reflecting the high-cost of the subject.

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20 JAN 2017

Physician Associates

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, when the consultation on the role of Physician Associates announced in his keynote speech to the NHS Providers conference on 30 November 2016 will be launched.

 

Philip Dunne The Minister of State, Department of Health

The Department is currently considering options for a consultation on the regulation of Physician Associates, which will be published in due course.

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18 JAN 2017

Epilepsy Nurses

I was privileged to meet my constituent Helen Skinner, an epilepsy specialist nurse who spoke compellingly from both her own family's personal experience and her professional experience about the need to prevent avoidable deaths as a result of seizures. We discussed the need to improve the recording of epilepsy related deaths because clear and accurate data plays an important role in driving effective change. We also discussed the impact of discrimination in the workplace on those living with epilepsy.

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17 JAN 2017

Royal College of GPs

It was a pleasure to meet Professor Helen Stokes-Lampard, the new President of the Royal College of GPs, to discuss pressures on primary care and the important role GPs and primary care teams play in supporting patients and alleviating pressures on the health system, We also discussed the RCGP's recent report into multimorbidity, which is where a patient lives with two or more long term chronic conditions – an increasingly important aspect of a GP's role. The GP Forward View is the long term plan for improving funding of and wider support for primary care and we discussed how this can be supported to make sure that funding reaches the front line.

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17 JAN 2017

End Violence Against Women

I met with the End Violence Against Women coalition, who spoke compellingly of the importance of integrating awareness of and training for health professionals to work with victims and perpetrators of domestic violence. Domestic violence costs the health service £1.7bn a year but is still viewed largely as simply a criminal justice problem. With two women a week being killed by a current or former partner, visits to the GP or A&E are vital opportunities to make contact and prevent escalation or continued abuse.

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16 JAN 2017

BMA Council

I met with Mark Porter, Chair of the BMA Council. We discussed the impact of Brexit on recruitment and retention of our vital EU workforce across the NHS. The Health Committee has launched an inquiry into the effects of Brexit and will be considering its impact on people and the wider health and social care workforce – keep up with the progress of the inquiry and all of the Committee's ongoing work here. Mark and I also spoke about the challenges facing junior doctors, morale, NHS funding and the ongoing issues around seven day working.

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16 JAN 2017

Independent Midwives

I met with my constituent Elizabeth, an independent midwife, and representatives of Independent Midwives UK to discuss the work of independent midwives and in particular the threats to their ability to practice as a result of rulings on their professional indemnity from the Nursing and Midwifery Council. These issues were subsequently raised at the Health Select Committee hearing and are the subject of ongoing discussions.

 

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13 JAN 2017

Broadcasting (Radio Multiplex Services) Bill

Sarah Wollaston Chair, Health Committee

I congratulate my hon. Friend on bringing forward this excellent Bill to broaden choice for community providers. Will he join me in paying tribute to the volunteers who work in community radio stations throughout the country? I very much welcome the opportunity to expand the role that they play in our communities.

 

Kevin Foster Conservative, Torbay

I thank my hon. Friend and neighbour for that intervention. Hospital radio absolutely provides an opportunity for volunteers to be part of delivering something to patients, and it also develops skills and talents that may well sustain them in a future paid career. There will be stories of people who have started off presenting a hospital or community radio show as a volunteer, but displayed talent that they could take much further. My hon. Friend will know Torbay Hospital Radio, which regularly provides the outside broadcast system for community events and fairs. The image of hospital radio is just someone sat in a broom cupboard at the bottom of the hospital, playing requests, but they actually get out in the community and do interviews, and they look to be more than just a station that people listen to in their hospital beds; they really want to make a contribution.

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11 JAN 2017

NHS and Social Care Funding

Sarah Wollaston Chair, Health Committee

I will try to be mindful of those comments, Madam Deputy Speaker, as I follow Dr Whitford, my colleague on the Health Committee. As always, she made thoughtful and thought-provoking comments, and I would like to endorse her points and expand on some of them.

First, I thank NHS and care staff. We have heard that they are facing unprecedented demand over the winter, but it is not just winter pressures that they face now—the pressures extend into the summer. As we have heard, that is not just about numbers but about the complexity of conditions and the frailty of those presenting in our accident and emergency departments. The Health Committee heard in its recent inquiry that the trusts that are most successful in getting close to the four-hour target are those that see it as an entire-system issue, and in which both health and care staff contribute to the effort, not as a tick-box exercise but because they recognise that it is fundamentally about patient safety and the quality of patients' experiences. That is why the four-hour target matters, and the Secretary of State is right to endorse it.

The Secretary of State is also right that we sometimes need to be more nuanced about our targets, and that he needs to be open to listening to what clinicians are telling him about how we can improve the way in which targets are applied. It would be a great shame if we in this House prevented those sensible discussions from taking place because of political furore. I urge him to continue to have them, and to take advice and listen to clinicians about how we can improve the use of targets, but he is absolutely right in being clear that he will keep the four-hour target.

We must talk about this as a whole-system issue. Accident and emergency is a barometer of wider system pressures, as has been pointed out, and I want to focus my remarks on the integration of health and social care.

I agree with colleagues throughout the House who have called for a convention on reviewing funding as a whole-system issue. We have heard that next year is the 70th birthday of the NHS, and what could be a better present than politicians changing the debate and the way in which we talk about the funding of health and social care, so that we do so in a collaborative manner that works towards the right solution for our patients? The consequences of our not doing that would be profound for our constituents, who would not thank us for not being prepared to put aside party differences and work towards the right solution.

Ultimately, this issue is about a demographic change that we are simply not preparing for adequately. In the case of the pension age, we recognised that there had to be a different debate given the change in longevity. Over the decade to 2015, we saw a 31% increase in the number of people living to 85 and older. Of course, that is a cause for celebration, but there has not been a matching increase in disease-free life expectancy.

I welcome the Prime Minister's focus on tackling inequality, but unfortunately we are not making sufficient progress on that, either. In her very first speech in the job, she talked about tackling the "burning injustice" of health inequality. We in this House have a role in doing that together in a consensual manner.

Norman Lamb Liberal Democrat Spokesperson (Health)

I very much agree with the hon. Lady. Does she share my welcome for the Prime Minister's response today in which she stated that she was prepared to meet us and other Members of Parliament from across the House, and my hope that it might start a more constructive approach?

Sarah Wollaston Chair, Health Committee

Absolutely. It was extraordinarily encouraging to hear the Prime Minister say that she was prepared to consider that and to meet Members from across the House. I urge colleagues who feel that this is a better way forward to sign up to it, speak to their party Whips and make it clear that it has widespread support.

Barbara Keeley Shadow Minister (Mental Health and Social Care)

I wonder, on this vital issue, whether the hon. Lady wants to say something about what her own party did on the two previous times we tried to get important cross-party working on health and social care: it made it an election issue, producing posters about a "death tax"; and on the second occasion the Secretary of State just walked away from the talks.

Sarah Wollaston Chair, Health Committee

I am afraid that that intervention is exactly not the kind of debate we want to be having. Let us look to the future. We are in a different part of the electoral cycle. I accept the hon. Lady's comments—I was still an NHS clinician when that happened and, like many of those working in health or social care, I looked at the yah-boo debate in this place and thought that surely there had to be a better way—but I ask her to put them aside and to look to the future rather than backwards, otherwise we will not get anywhere. I think our constituents want us, as politicians, to recognise the scale of the challenge and to get to grips with it.

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10 JAN 2017

Soft Drinks Industry Levy: Funding for Sport in Schools

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow John Mc Nally and my fellow Health Committee member, my hon. Friend Maggie Throup. I am very grateful to my hon. Friend Justin Tomlinson for bringing this very important debate to the House.

I realise that this is not a debate about the sugar levy per se, but I would like to state at the outset that I fully support the levy. In fact, if anything, I would like it to be extended to include milk-based sugary drinks. It addresses a very important issue, and it is worth reminding ourselves of the data on health inequality from obesity. Now, in the most disadvantaged areas, 26% of the most deprived children are leaving year 6 not just overweight but obese, with extraordinary long-term consequences for both their mental and physical health, so we should remain focused on what the purpose of the measure is.

Let me also stress that we should not think about tackling obesity as just about sport; it is also about nutrition. We should not lose sight of that in the debate. Reducing calories has to be the mainstay of addressing childhood obesity. That said, we should also have a message that exercise and physical activity matters, whatever one's age and weight, and has extraordinary benefits. I fully support the words of my hon. Friend the Member for North Swindon about how we can incorporate sport as part of the anti-obesity strategy and about the importance of hypothecating the money raised by the sugary drinks levy so that it goes to these types of project and is focused on the most disadvantaged groups.

Julie Elliott Labour, Sunderland Central

Does the hon. Lady agree that the 26% in the most deprived areas are probably children from the families who are least able to afford some of the things that have been mentioned, such as the £12.50 a day for sports activities, and that the cost of things should not rule out children who probably need that activity more than others?

Sarah Wollaston Chair, Health Committee

I thank the hon. Lady for her intervention. I absolutely agree. It is essential, if we are to address some of the accusations that this is a regressive tax, that we ensure that it becomes progressive in the way the money and the resources are allocated. I think there has been a commitment to that. We can look at how the Government have stated they will spend the money—providing up to £285 million a year to give 25% of secondary schools in the most disadvantaged areas the opportunity to extend their school day, and £10 million of funding to expand breakfast clubs in the most disadvantaged areas. I absolutely agree with the hon. Members who have already commented that that could be extended into holiday periods. I am talking about how we look at nutrition, and expanding nutritional education and, in particular, targeting that on the most disadvantaged areas. We know that Mexico's experience is that those on the lowest incomes end up spending more of their income on products such as sugary drinks, so we must be absolutely clear that the benefit returns primarily to the most disadvantaged, and of course it is the most disadvantaged areas that have the highest levels of childhood obesity, so I absolutely agree with what Julie Elliott has said.

This is primarily about school sport and how we hypothecate the money for activities in the most disadvantaged areas, although not just in the most disadvantaged areas. We have already heard the hon. Member for Falkirk pay tribute to Elaine Wyllie, and I add my tribute to her extraordinary achievements. She told me when I met her recently that if directors of public health take this initiative on board, that gives it much a greater impetus. She has looked at where it has been most successfully rolled out, and it is where directors of public health work together with education to push for it and see the benefits. Of course, the benefits are not just for children. The initiative is now being rolled out to families and staff in schools, so there is a whole-community approach to changing attitudes to mobility.

I would also like to make a point about active travel. The all-party parliamentary group on cycling, of which I am a member, held an inquiry in the last Parliament, "Get Britain Cycling". One issue that was very clear from that was that active travel is one of the forms of activity that people are most likely to engage in over the long term. I therefore urge my hon. Friend the Minister to consider how schools can engage with the programme and get children cycling to school and college. My hon. Friend the Member for Erewash pointed out that the cost of a bike can sometimes be a deterrent, but there are many things we can do about rolling out Bikeability to all ages across schools and ensuring that we focus on active travel, because that is the form of activity that people are most likely to sustain throughout their life.

I would also like to pick out the importance of play. I pay tribute to Play Torbay, in my constituency, and the work it is doing. That has been pointed out by the all-party parliamentary group on a fit and healthy childhood. I do not know whether the Minister has had the chance to read its excellent report, which considered how we can use the money effectively. I agree with my hon. Friend the Member for Erewash that evaluation is critical. We need to see what delivers results in the long term, particularly because, if the tax is effective in the way we hope it will be, the revenues raised from it will decrease as a result of behavioural change. We need to ensure that the money available is targeted in the most effective ways.

We should also look at the difference in activity rates between girls and boys. Girls are not as physically active; particularly as they go through the school years, activity levels decline. I urge the Minister to continue to support Sport England's "This Girl Can" programme, which has already been referred to. We need to look across the piece and make sure we engage children at every level in a way that they are most likely to continue to keep active. I have a concern that if we just talk about sport, we risk taking our eye off the ball. Tackling obesity first and foremost has to involve calorie reduction. We must take empty, wasted calories out of children's diets. There are other harms; obesity is not just about sugar levels. The biggest single cause of admission to hospital for primary school children is to remove their rotten teeth. The benefits of reducing sugar in children's diets go beyond tackling obesity.

Will the Minister liaise with his colleagues on the rest of the money from the sugary drinks levy that we are raising? As it stands, the Government have indicated that a significant proportion will go towards the academisation programme, but now that there has been a change to the policy objective of forced academisation, I think the sugary drinks levy would command far greater public support if every penny of it was hypothecated to public health measures to support children, particularly at a time when public health grants are being cut and measures to support children who are already obese are being cut back in local authorities. I hope to see even more of the sugary drinks levy being hypothecated to progressive measures to target children who are already obese and to help prevent children from becoming obese in the first place. I support my hon. Friend the Member for North Swindon in saying that sport is a key part of that, and that matters whatever a child's weight and whatever a child's age.

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09 JAN 2017

Mental Health and NHS Performance

Sarah Wollaston Chair, Health Committee

I welcome the Secretary of State's statement and the Prime Minister's focus on mental health in her speech today. She spoke of holding the NHS leadership to account for the extra £1 billion that we will be investing in mental health. Will the Secretary of State set out in further detail how clinical commissioning groups will be held to account for ensuring that that money gets to the frontline so that we can deliver progress on parity of esteem?

Jeremy Hunt The Secretary of State for Health

Yes, I can do that. It is a very important point. We have had a patchy record in the NHS of ensuring that money promised for mental health actually reaches the frontline. The way that we intend to address this is by creating independently compiled Ofsted-style ratings for every CCG in the country that highlight where mental health provision is inadequate. Those ratings are decided by an independent committee chaired by Paul Farmer, who is responsible for the independent taskforce report, so he is able to check up on progress towards his recommendations. I am confident that, by doing that, we will be able to shine a light on those areas that are not delivering on the promises that this Government have made to the country.

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22 DEC 2016

Neuromuscular Disorders: Ambulance Services

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what discussions his Department has had with National Ambulance Service medical directors on ensuring that the best practice system of flagging people with muscle-wasting conditions to ambulance crews in London, North West and North East Ambulance Services is used across all ambulance services.

Philip Dunne The Minister of State, Department of Health

The Department has not had any recent discussions with National Ambulance Service Medical Directors on this subject.

NHS England has advised that it is working with all ambulance services in England to ensure the right resource is allocated to the right 999 call at the right time.

Currently the flagging of patients with long term conditions or longer term care needs is not used universally. However the development of technology to allow real-time searching of the National Health Service number as a unique patient identifier will significantly increase the value of placing 'flags' on patients with specific clinical needs. This will then reliably allow any attending healthcare professional to access care plans and special patient notes to help inform individual patient management. This is a component of the 2017/19 ambulance service national Commissioning Quality and Innovation framework.

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21 DEC 2016

Health Professions: Training

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what assessment he has made of the effect of including the market forces factor as a criterion for allocation of Service Increment for Teaching (SIFT) funding on the amounts allocated for each Local Education and Training Board (LETB) in England; and what estimate he has made of the proportion of SIFT funding spent on salaries in (a) London and (b) each other LETB in England.

Philip Dunne The Minister of State, Department of Health

The market forces factor (MFF) index used in the allocation of funding for clinical placements (formerly known as service increment for training) is consistent with the approach taken by NHS Improvement in adjusting service tariffs to reflect unavoidable cost differences between health care providers, based on their geographical location. This is considered the most appropriate method to adjust resource allocations in the National Health Service in proportion to these cost differences.

The MFF is applied to all three education and training tariffs, however it is not applied to the contribution to salary for postgraduate doctors in training, which instead are based on national pay scales and amended for inner and outer London weighting.

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21 DEC 2016

Dentistry: Training

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if he will publish the rates at which the NHS market forces factor is applied to the dental service increment for teaching.

Philip Dunne The Minister of State, Department of Health

Payments for dental undergraduate clinical placements (formerly known as dental service increment for teaching) are outside the scope of the medical undergraduate clinical placement tariff and subject to local arrangements between the placement provider and Health Education England.

There is no nationally mandated market forces factor rate applied to these locally agreed payments.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, how much dental and medical service increment for teaching funding was allocated to each dental school by (a) student and (b) in total for each of the last three years.

Philip Dunne The Minister of State, Department of Health

The table below shows the total funding allocated by Health Education England (HEE) for dental placements in England in each of the last three years.

Year  Funding Allocated £ million
 2014/15  £98.5
 2015/16  £97.7
 2016/17  £99.7

Source: HEE

Information relating to the funding allocated to individual dental schools is not held centrally.

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20 DEC 2016

Health Topical Questions

Sarah Wollaston Chair, Health Committee

The Health Committee has just published its interim report on preventing suicide. I thank all those who gave evidence to our inquiry and all members of the Department of Health advisory group. We support the strategy, but the clear message that we heard was that implementation needs to be strengthened. Will the Secretary of State meet me to discuss our report's recommendations, and will he join me in thanking members of the Samaritans and other voluntary groups around the country who will be working tirelessly over Christmas, as they do every day, to support those in crisis?

Jeremy Hunt The Secretary of State for Health

My hon. Friend speaks wisely. Christmas can be a very lonely time for a number of people, so we all commend the work of voluntary organisations that do so well. I would be delighted to meet her.

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19 DEC 2016

Physician Associates: Training

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if he will publish the funding provided through Health Education England for the training in NHS providers of Physician Associate students for each programme supported per student (a) per year and (b) over the course of the training.

Philip Dunne The Minister of State, Department of Health

The total funding provided by Health Education England for the training of Physician Associate students for each programme supported is:

- £15,655 per student per year; and

- £31,310 per student over the duration of the two year course.

The cost per student consists of tuition, maintenance and clinical placement funding as outlined in the table below.

  Clinical Placement
Tuition
Maintenance
Cost per student  £2,156  £7,310  £6,189

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19 DEC 2016

Medicine: Education

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps his Department is taking to ensure that students of private medical schools receiving training in NHS settings do not pay less than the cost of providing that training.

Philip Dunne The Minister of State, Department of Health

The arrangements for students of private medical schools to receive training in National Health Service settings are a matter for agreement between the medical school and the NHS organisation. Funding for placements commissioned by Health Education England and its local offices should not be used to subsidise any element of the cost of placements for non-NHS funded students or trainees.

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16 DEC 2016

Department for Transport: Rolling Stock

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Transport, what assessment he has made of the economic effect on the (a) South West region and (b) UK of the lack of new rolling stock available to train companies; and if he will make a statement.


Paul Maynard Parliamentary Under-Secretary (Department for Transport)

The Government and the private sector has continued to invest in new rolling stock in the South West and in other regions to provide improved services for passengers.

The market for new rolling stock in the UK has become increasingly vibrant in recent years, with a number of manufacturers competing to provide new rolling stock to the UK's train operating companies.

Train operators are not seeing a shortage of train manufacturing companies or financiers offering new rolling stock for the UK's rail network.

Over 1,900 new vehicles were ordered in 2016 alone.

Great Western Railway are acquiring 29 brand new bi-mode trains to operate services to the South West of England.

Nationally passengers will see over 5,000 new vehicles delivered to operators between now and the end of 2020.

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15 DEC 2016

Local Government Finance Settlement

Sarah Wollaston Chair, Health Committee

It is good news that people are living longer—in the decade to 2015, there has been a 31% increase in the number of people living to 85 and over—but already, more than a million people have unmet care needs. Although I welcome the fact that some of this money will be brought forward, I do not feel as though we are going far enough in this House to address the scale of the increase in demand and allow people to be cared for with dignity in their old age. May I join the Chair of the Communities and Local Government Committee in asking the Government to start cross-party talks urgently to ensure that we have a long-term, fair, sustainable settlement for both health and social care?

Sajid Javid The Secretary of State for Communities and Local Government

My hon. Friend speaks with experience. I know that she has spent a great deal of time looking into this issue, especially in her work as Chair of the Select Committee on Health, and I take what she has to say very seriously. I think I am correct in saying that my hon. Friend used the words "bring forward spending". Today's announcement on adult social care does more than just bring it forward; it is a real, significant increase in spending of £900 million. To be clear, that is an additional £900 million over the next two years where there are some of the biggest short-term pressures. That would not have happened had these changes not been announced. It is, significantly, new money, not just bringing forward spending. I know that she will welcome that clarification.

My hon. Friend referred to the need to talk widely, including with members of the Opposition. I would include in that local leaders, health professionals and social care professionals, and that is certainly what I intend to do over the coming months, to make sure that we keep this always under review.

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14 DEC 2016

Prime Minister Question Time

Sarah Wollaston Chair, Health Committee

One of my constituents has just had to move to residential care because no carers could be found to support her in her own home. She is at the sharp end of a crisis in social care that is as much about inadequate funding as it is about a shortfall in our very valued social care workforce. I am looking forward to hearing what immediate further support will be provided for social care, but is it not time that rather than having confrontational dialogues about social care funding, all parties work together, across this House, to look for a sustainable long-term solution for the funding of both integrated health and social care?

Theresa May The Prime Minister, Leader of the Conservative Party

My hon. Friend is right to raise the issue of looking at a sustainable way in which we can support integrated health and social care, and a sustainable way for people to know that in the future they are going to be able to have the social care that they require. As I said earlier in response to the Leader of the Opposition, we recognise the short-term pressures that there are on the system, but it is important for us to look at those medium-term and longer-term solutions if we are going to be able to address this issue. I was very pleased to be able to have a meeting with my hon. Friend to discuss this last week, and I look forward to further such meetings

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13 DEC 2016

Department for Transport: Rolling Stock

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Transport, what steps his Department is taking to accelerate access for train-operating companies delivering services (a) to the South West and (b) nationally to new passenger rolling stock.


Paul MaynardParliamentary Under-Secretary (Department for Transport)

Improvements in rolling stock are part of the Government's investment in the railways that will deliver better journeys for passengers.

In relation to the South West of England specifically, in July 2015the Department announced that Great Western Railway would be acquiring 29 brand new Hitachi AT300 bi-mode trains for longer distance services between London and the South West of England.

Nationally, new train procurements including Thameslink, Crossrail and the Great Western/East Coast Intercity Express Programme will see over 5000 new carriages delivered to operators between now and the end of 2020.

In 2016 alone we have announced that over 1900 new carriages will be delivered by the franchising programme over the next five years, including over 500 into the Northern and TransPennine franchises, 211 for Great Western, 150 for Great Northern and 1043 for East Anglia.

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06 DEC 2016

Care Quality Commission

The Health Committee held an accountability hearing with the Care Quality Commission (CQC) today. The hearing follows the regular series of accountability hearings held by the Committee in the last Parliament, and the reports on the CQC by the National Audit Office in July 2015 and the Committee of Public Accounts in December 2015.

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29 NOV 2016

Cross Country Trains

The Managing Director of Cross Country trains, Andy Cooper, came to meet local MPs in response to our concerns about proposals to change the timetable which would involve axing important services. A number of trains which run directly from Newton Abbot, Paignton and Torbay to Birmingham, and on to Manchester, would be lost each weekday. A shortage of new train carriages for the network means Cross Country has chosen to reduce services for this region to relieve overcrowding elsewhere.
Cross Country apologised unreservedly for the lack of publicity given to the consultation, which will impose such drastic cuts to services for us in the South West. The proposed changes will hit our tourism sector and other businesses, as well as cause increased overcrowding and inconvenience for an area of the country already disadvantaged by low investment in rail services. I am totally opposed to the company trying to relieve overcrowding elsewhere in the system at our expense. I urge all constituents to sign the Herald's 'Save our trains' petition, and I will continue to work with colleagues to call on the Department for Transport and the train operator to find a fairer way of tackling overcrowding and improving rolling stock.

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29 NOV 2016

Health Select Committee

Today was the last evidence session on suicide prevention where we questioned Jeremy Hunt and others

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29 NOV 2016

Second Homes

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, with reference to paragraph 6.6 of the Autumn Statement 2015, if he will publish the application process for applying for extra funding for local authorities in areas affected by high levels of second home ownership.

 

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, with reference to paragraph 6.6 of the Autumn Statement 2015, when his Department plans to make available the proposed extra funding for communities affected by high levels of second home ownership.

Gavin Barwell Comptroller (HM Household) (Deputy Chief Whip, House of Commons), Minister of State (Department for Communities and Local Government) (Housing, Planning and London)

The Department for Communities and Local Government remains committed to providing the funding indicated at Budget 2016 to support community led housing in areas affected by high levels of second home ownership. We will announce the allocation process for this funding shortly.

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24 NOV 2016

Reducing Health Inequality

 

Back Bench Debate: Reducing Health Inequality

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23 NOV 2016

Nurses: Training

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if the Nursing and Midwifery Council will include mandatory bowel and bladder care training for pre- and post-registration nurses in the new revised curriculum.

 

Philip Dunne The Minister of State, Department of Health

The Nursing and Midwifery Council (NMC) is the independent body responsible for the regulation of nurses and midwives in the United Kingdom. It is responsible for the way it discharges its statutory duties including setting standards of education, training, conduct and performance, so that nurses and midwives can deliver high quality healthcare throughout their careers. Accordingly, it is for the NMC to decide what it will include in its standards of proficiency. Its role as a professional regulator does not include developing or revising a curriculum. That is the role of education institutions.

The Code for nurses and midwives requires that they must prioritise people, practise effectively, preserve safety and promote professionalism and trust. This includes practising in line with the best available evidence. The Code also states that nurses and midwives must treat people as individuals and uphold their dignity by delivering the fundamentals of care effectively. The fundamentals of care include nutrition, hydration, bladder and bowel care, physical handling and making sure that those receiving care are kept in clean and hygienic conditions.

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23 NOV 2016

Autumn Statement

Sarah Wollaston Chair, Health Committee

The Care Quality Commission has warned that social care is at a tipping point and vulnerable people across the country are being left without the care and support that they need, which is adding hugely to costs for the NHS. I am disappointed that the better care fund has not yet been brought forward, but encouraged to hear that that is actively under discussion. Will the Chancellor confirm that we should try to get away from this divisive debate in the House about how we are going to fund our health and social care, and that all parties should work together for a new, sustainable, long-term settlement?

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22 NOV 2016

Incontinence: Health Services

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, which Clinical Commissioning Groups have put into practice the NHS EnglandExcellence in continence care guidelines published in November 2015.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps NHS Englandhas taken to promote the Excellence in continence care guidelines to (a) clinical commissioning groups, (b) patient groups and (c) the general public.

David Mowat The Parliamentary Under-Secretary of State for Health

Excellence in Continence Care is best practice guidance and NHS England does not currently hold information on which clinical commissioning groups (CCGs) have put the guidance into practice. However it anticipates auditing CCGs in future in order to capture this information.

NHS England issued a press release and secured significant media coverage to launch the guidance in 2015 and has promoted it to a range of audiences including special interest groups, professional societies and provider organisations.

In addition to media work, NHS England has engaged with key stakeholders who form part of the Excellence in Continence Care Board. The Board membership has evolved over time and has included clinical experts working in National Health Serviceorganisations, patient advocates and representatives. Board members support NHS England to raise awareness of the guidance to special interest groups, patients groups, professionals within their extended networks which recently included the Association of Continence Advisors Conference.

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22 NOV 2016

National Health Service Funding

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow my hon. Friend Dr Whitford.

I want to touch briefly on the importance of clear data, the current financial position, and the need to agree on a settlement for the future in this House rather than continuing to have such confrontational debates.

I can see how the £10 billion figure has been arrived at: by adding an extra year, starting from 2014-15, and by transferring budgets to NHS England. When the Secretary of State refers to the NHS, he is actually referring to NHS England. He is not including public health. He is not, for example, including Health Education England. However, it is crucial that they are considered. As my hon. Friend the Member for Central Ayrshire said, when we talk about transferring money from public health to the NHS England budget, we are cutting off our ability to control the increase in future demand. We face significant challenges, which we will not address unless we invest in those future services.

We sometimes talk about public health as if it were not front-line care, but it is. We are talking about, for instance, services to help people with addictions and sexual health services—really important costs for the NHS. There is also the challenge of the reduction in Health Education England's £5 billion budget, £3.5 billion of which is spent directly on the wages of health service doctors who are undergoing training, but also delivering front-line services. Cuts to Health Education England cut us off from future sustainability, because that is the budget that trains, retains and sustains our existing workforce. This is all crucial to front-line services.

The other way in which the £10 billion figure has been arrived at is by changing the baseline from which we calculate real-terms increases. I would say that it has never been more important than it is now for the public to have confidence in the data that we use. Trying to return us to talking about total health spending is not trying to be awkward; it is trying to be honest with the public. It is difficult to argue that more funding for health and social care is necessary if a £10 billion increase has been claimed. It is important that we continue to use the same consistent baselines that have been used in the past, so that the public can see what has happened to total health spending.

I welcome the front-loading of the settlement, and I welcome the fact that the NHS has been relatively protected in comparison with other departments, but the scale of the increase in demand is extraordinary. When Simon Stevens talked about welcoming the increase that had been granted, he made it clear that it was dependent on a fair settlement for social care and a radical upgrade in public health, and those two aspects are lacking.

I think that both sides are correct. I can see how the Secretary of State has arrived at the £10 billion figure, but whenever that figure is used we should also present a figure that refers to total health spending in the way in which it has always been referred to in the past. I think that that would help to build the Secretary of State's case for an increase in funding as we go forward.

Like others, I hope that we shall see an uplift for social care in the autumn statement, because the impact of social care on the NHS is now profound. There cannot be a Member in the House to whom it has not been made clear by people who come to his or her surgery that the state of the care system is in collapse and providers are in retreat. Even those who can afford to pay are finding it difficult to gain access to care.

..............

Sarah Wollaston Chair, Health Committee

We know it does, and the CQC report describes social care as being at a tipping-point; it is in a very fragile state and we owe it to all our constituents to try to come together to agree where we go from here. Many have proposed a royal commission to look at future sustainability, but we have had commissions: the Barker commission set out the options, and the House of Lords is looking at future sustainability and the range of options.

I urge colleagues across the House to try to agree, rather than having this continual confrontational debate. The best way forward would be for all parties in this House to agree that this is an enormous challenge. My personal belief is that we should stick with our current very equitable system of state funding of our NHS, look at the various options and agree between us that we need to address this. We cannot keep ducking it; we owe it to all our constituents to adopt a much more constructive tone to our debate.

We know that the current position is unsustainable, and that was reiterated in today's National Audit Office report. We can continue to shout across the Chamber about how much is spent, but we know this will be a challenge whoever is in power, and I urge all colleagues to focus instead on a different approach. Yes, more can be done within the NHS, but I am afraid that the elastic is stretched far too tight for social care to make any more efficiencies. We now need to work together to see how we can fund this going forward.

............

Sarah Wollaston Chair, Health Committee

All I clarified was that the way it had been arrived at is not a way that the public would understand health spending, so I think the Minister is perhaps taking my words out of context, if he will forgive me.

Philip Dunne The Minister of State, Department of Health

We never claimed that we were increasing the Department of Health's budget; we were talking about the increases to the NHS. For complete clarity, in 2014-15 the NHS budget was £98.1 billion; in 2020-21, it will be £119.9 billion. For Opposition Members who cannot do the maths, that is a £21.8 billion increase in cash terms to NHS England, or £10 billion in real terms. We promised £8 billion; we are delivering £10 billion.

We also listened to NHS leaders' requests for a front-loaded settlement and delivered on that—it was welcomed by hon. Members in today's debate—with £6 billion of the £10 billion increase coming by the end of this year, including a £3.8 billion real-terms increase in this year alone.

We have also created a £1.8 billion sustainability and transformation fund for the current year to help providers to move to a sustainable financial footing. This fund will mainly be allocated to emergency care provision, which faces some of the greatest demand growth and financial pressures within the system.

This brings me to the next important point I want to address. While more funding is obviously welcomed, hon. Members have drawn attention to rising deficits in the budgets of NHS providers. We recognise that stronger financial management is required to turn this situation around, and we have introduced robust governance arrangements to get things back on track. There are four main elements to this plan: extra investment in the spending review, as I have discussed, and freeing up local government to spend more on adult social care; restoring financial discipline in the short term, through the measures set out by NHS England and NHS Improvement in July, with a wide-ranging set of actions; reducing demand for acute care in the longer term; and driving efficiency and productivity across the provider sector, building on the work of Lord Carter, who has identified large variations in efficiency across non-specialist English acute hospitals, and controlling cost pressures. The need to reduce variations was raised by my hon. Friend Andrew Selous in his very constructive contribution, and by Jim Shannon. We agree that we need to reduce the variability in the poorly performing trusts and bring them up to at least the average standard, if not higher.

We are now beginning to see the first fruits of the plan, with the publication last Friday of the figures for the second quarter deficit, which has been reduced to £648 million, down from £1.6 billion in the same period last year, representing a £968 million improvement. Progress halfway through the financial year is therefore encouraging, but there is no room for complacency. That is why the system needs to stick to its strong financial plan, supported by our investment and by a series of measures set out to help hospitals to become more efficient and to reduce the use of expensive agency staff.

Several hon. Members talked about the sustainability and transformation plans, 28 of which have now been published. The remainder will be published by the end of next month. Half of the Labour Members who spoke in the debate talked specifically about the STP covering Cheshire and Merseyside. It was disappointing that only one of those three Members was able to attend the Westminster Hall debate earlier today in which we discussed conditions in Cheshire and Merseyside. I remind Labour Members that that STP was led by the chief executive of Alder Hey hospital in Liverpool, with whom I would strongly encourage hon. Members who are complaining about a lack of engagement to have a conversation.

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22 NOV 2016

Peninsula Task Force

I joined MPs from Devon, Cornwall and Somerset, as well as Councillors from across the South West, to the launch of the Peninsula Rail Taskforce's report 'Closing the Gap'. The report sets out a 20 year strategic blueprint for upgrading the South West's rail network and its connections towards London, Bristol and the North. We highlighted the report's key themes to Rail Minister Paul Maynard, underlining the importance of making the line more resilient, as well as improving the speed and quality of the journey. The Minister reaffirmed the Government's commitment to improving rail links to the South West, including the Transport Secretary's announcement last week of a further £10 million in funding to improve resilience at Dawlish.

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21 NOV 2016

The Health Gap

Today I chaired an event with Professor Sir Michael Marmot, Director of the Institute Of Health Equity and the author of the new book 'The Health Gap: The Challenge of an unequal world". It was an enlightening talk about the problems around health inequality.

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17 NOV 2016

English Wine Industry

Sarah Wollaston Chair, Health Committee

Further to that point, will my hon. Friend join me in congratulating Sharpham Wine and Cheese, which does just that? It is not only producing fantastic wines but fantastic cheeses and is providing a welcome tourist centre for tours, sharing expertise and creating valuable local employment.

Neil Parish Chair, Environment, Food and Rural Affairs Committee, Chair, Environment, Food and Rural Affairs Sub-Committee

I very much commend the Sharpham vineyard, because, once again, it is reaching out. It is producing a good wine, and then we can have good local food and bring more and more tourists down to the south-west, provided that we dual the A30 into Honiton while we are it and along the A358 to Taunton—that was not part of my speech.

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16 NOV 2016

Social Care

Sarah Wollaston Chair, Health Committee

I agree with Norman Lamb on the need for cross-party working to achieve sustainable funding for both health and social care. As the hon. Lady will know, I have set out my concerns about the underfunding of social care in a letter to the Chancellor. Does she agree that it is not just about funding, however, but also about how we support and train our social care staff? Would she like to see further progress made on the recommendations of Camilla Cavendish about how we train and support our care staff to help to retain them as well as recruit them?

Barbara Keeley Shadow Minister (Mental Health and Social Care)

I agree, and that is why I started my speech by saying we should value the job our care staff do and we should train them properly; it should be a proper job with a proper career path. The care staff I met today were reduced to worrying about what they were being paid, however, simply because they were paid less than the minimum wage.

This is what six years of funding cuts to social care actually mean for people who need care and their carers: unmet needs for care; patients stuck in hospital, increasingly because they have to wait for a care home or a nursing home place; poor quality care in care homes, with one quarter of "inadequate" services unable to improve; poor quality home care, with more complaints being upheld by the ombudsman; more unpaid family carers having to step in to care; more unpaid family carers having to provide increased levels of care; and, without the right support, those family carers becoming isolated, burnt-out and unable to look after their own health. That is a disturbing deterioration in the state of social care. I want the Secretary of State to tell us whether he recognises the scale and seriousness of the issues I have outlined.

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15 NOV 2016

All Party Parliamentary Cycling Group

Today I met with the All Party Parliamentary Cycling Group, which promotes all forms of cycling i to discuss priorities for our future programmes to get Britain cycling and to improve safety.

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15 NOV 2016

The Shelford Group

I met with The Shelford Group, which comprises ten leading NHS multi-specialty academic healthcare organisations, to discuss health funding and the importance of free movement of NHS and research staff.

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15 NOV 2016

Professor Sneyd

Great to catch up with Professor Sneyd from Plymouth University to talk about medical student training, primary care and the terrific opportunities at Plymouth University

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15 NOV 2016

Care England

I met with Care England today to discuss the challenges facing social care.

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14 NOV 2016

Health Select Committee Visit

Thank you to Everton Football Club charity EITC and State of Mind for meeting the House of Commons Health Committee and for your work supporting mental and physical health and fitness.

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11 NOV 2016

Nurses: Pay

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what estimate he has made of NHS England payroll expenditure excluding VAT on (a) permanent nursing staff and (b) agency nursing staff in 2016-17.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what the value was of NHS Englandpayroll expenditure excluding VAT on (a) permanent nursing staff and (b) agency nursing staff in (i) 2014-15 and (ii) 2015-16.

Philip Dunne The Minister of State, Department of Health

The Department is able to provide payroll expenditure for all Qualified Nursing, Midwifery and Health Visiting Staff on employment contracts with the National Health Service. This information for 2014-15 and 2015-16 is tabled below. VAT costs do not apply to staff on NHS Employment contracts.

The requested information for 2016-17 is not yet available.

Year               
 Payroll costs for Qualified Nursing, Midwifery and Health Visiting Staff in NHS Hospital
and Community Health Services in England. (£)
 2014-15   
 13.3 billion
 2015-16  13.5 billion

The Department does not hold national data on agency staff that is broken down by staff group.

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08 NOV 2016

Grammar and Faith Schools

Sarah Wollaston Chair, Health Committee

My hon. Friend is making a powerful speech. Does he agree that the third issue should also be about social cohesion? Does he share my concern about some of the proposals on faith schools? I recognise the contribution that they make, but can he think of a single reason why the child of an atheist parent like myself should be excluded from a school because of their parents' lack of faith? Does he also share my concern that 100% selection by faith risks driving communities into further segregation and does nothing to improve social cohesion?

Neil Carmichael Chair, Education Committee, Chair, Education, Skills and the Economy Sub-Committee

I thank my hon. Friend for that instructive intervention. It goes off the issue of grammar schools, which I was hoping to talk about, but she is right that the issue of faith schools should be addressed. I say two things. First, we must have an inclusive society; we cannot parcel people up in that sector and say, "That's you—off you go!" That is not acceptable. We must make sure that our faith schools do not do that and instead are all embracing. It is the outward-looking school, of whatever faith, that will do a good job.

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08 NOV 2016

Health Select Committee

The Health Select Committee today held an oral evidence session with a number of experts on suicide prevention.

Representatives from Network Rail, the RNLI, Devon Suicide Prevention Alliance, the 'If U Care Share' Foundation, The James Wentworth-Stanley Memorial Fund, the Matthew Elvidge Trust, the MindEd Trust, Young Minds, and Suicide Crisis discussed this important issue

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07 NOV 2016

UK Statistics Authority

Thanks to Ed Humpherson, the UK Statistics Authority's Director General for Regulation, for coming to Parliament today.

We had a good, wide ranging discussion about the importance of facts and evidence in politics and decision-making.

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07 NOV 2016

Royal College of Anaesthetists

Today I met with Liam Brennan, the President of the Royal College of Anaesthetists. We had the chance to discuss the workforce in the NHS, anaesthetics safety, and more.

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03 NOV 2016

Community Pharmacies

Sarah Wollaston Chair, Health Committee

Further to that point, the Minister knows that our pharmacists are a highly skilled and professional resource that has long been underused in the NHS. He has mentioned the ongoing Murray review, and a sustainability and transformation plan process is also going on around the country. My concern is that the closures will come about in a random way, rather than through a planned process based on identifying skills in particular areas. Will he consider delaying them until we have all the reports in place and we can consider the matter on an area-by-area basis?

David Mowat The Parliamentary Under-Secretary of State for Health

The access scheme is the device that will ensure that pharmacies are not closed in a random way. I want to address the point about closures head on. It is my belief that there will be a minimal amount of closures. The impact analysis talks about 100 and it models 100. The average pharmacy has a margin of 15%, and the amount of efficiency savings that we are asking pharmacies to make over two years is 7%. In addition, the average pharmacy is trading for £750,000 when it closes or merges, even after we announced these efficiency savings a year ago. That value is being retained.

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02 NOV 2016

Health Select Committee

You can read the Health Select Committee report on winter pressure in accident and emergency departments here

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02 NOV 2016

Sierra Leone's Health Committee

It was an honour to meet with Dr Sesay MP, chair and colleagues from Sierra Leone's Health Committee to discuss improving health and sanitation.

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01 NOV 2016

Health Select Committee Suicide Prevention

The Health Committee held the first evidence session as part of its inquiry into the action which is necessary to improve suicide prevention in England.

If you are in need of confidential emotional support, you can contact Samaritans 24 hours a day by calling free on 116123, or emailing jo@samaritans.org

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01 NOV 2016

Pharmacovigilance

I met this morning with Dr Brian Edwards, Ms. Nimisha Kotecha and Mr Colin Knight, to discuss pharmacovigilance and the impact of Brexit on the industry

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01 NOV 2016

Sense About Science

Thank you to Sense about Science for coming to Parliament to talk about why evidence matters in public policy.

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01 NOV 2016

Mental Health Policy Group

It was great to catch up with the Mental Health Policy Group in Parliament today. I met with experts in understanding mental health from the Royal College of Psychiatrists, the Centre for Mental Health, Rethink Mental Illness, MIND, and the Mental Health Foundation.

We talked at length about the work of the Mental Health taskforce and what the NHS can be doing to improve mental-wellbeing across the United Kingdom. You can read more about the task force's work here

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31 OCT 2016

Advertising Standards Authority

I met with Guy Parker, Chief Executive of Advertising Standards Authority to talk about the importance of challenging misleading claims on medicines and alternative treatments, which can be dangerous and risky to health if they encourage people not to use traditional, evidence-based treatments.
A recent example is the ASA ruling on a company promoting thermal mammography, a medically unproven process of diagnosis.
We also discussed concerns over the marketing of unhealthy foods to children. In its recent Childhood obesity: brave and bold action report, the Health Committee made a number of recommendations aimed at protecting children from unsuitable advertising and to promote healthier family choices.

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31 OCT 2016

NHS Funding

Sarah Wollaston Chair, Health Committee

I agree with the Secretary of State that prevention is better than cure, but he will know that achieving the aims of the five year forward view was dependent on a radical upgrade in public health and prevention. He will know that it was also dependent on adequate funding for adult social care. In addition, there are continuing raids on the NHS capital budget, and we need to put in place the kind of transformation that he and our sustainability and transformation partnerships wish to achieve.

Will the Secretary of State therefore confirm that he recognises the serious crisis in social care and the effect it is having on the NHS, and the effect that taking money from public health budgets is having? Although I accept that he does not agree with the Health Committee's appraisal of the £10 billion figure, I am afraid I stick by those figures.

Jeremy Hunt The Secretary of State for Health

I have enormous respect for my hon. Friend. I respect her passion for the NHS, her knowledge of it and her background in it, so I will always listen carefully to anything she says. I hope she will understand that just as she speaks plainly today, I need to speak plainly back and say that I do not agree with the letter she wrote today, and I am afraid I do think that her calculations are wrong.

The use of the £10 billion figure was not, as she said in her letter, incorrect. The Government have never claimed that there was an extra £10 billion increase in the Department of Health budget. Indeed, the basis of that number has not even come from the Government; it has come from NHS England and its calculations as to what it needs to implement the forward view. As I told the Select Committee, I have always accepted that painful and difficult economies in central budgets will be needed to fund that plan. What NHS England asked for was money to implement the forward view. It asked for £8 billion over five years; in fact, it got £10 billion over six years, or £9 billion over five years—whichever one we take, it is either £1 billion or £2 billion more than the minimum it said it needed.

I think my hon. Friend quoted Simon Stevens as saying that NHS England had not got what it asked for. He was talking not about the request in the forward view, but in terms of the negotiations over the profile of the funding we have with the Treasury. The reason that the funding increases are so small in the second and third year of the Parliament is precisely that we listened to him when he said that he wanted the amount to be front- loaded. That is why we put £6 billion of the £10 billion up front in the first two years of the programme.

I fully accept that what happens in the social care system and in public health have a big impact on the NHS, but on social care we have introduced a precept for local authorities combined with an increase in the better care fund—[Interruption.] This is a precept, which 144 of 152 local authorities are taking advantage of. That means that a great number of them are increasing spending on social care. It will come on top of the deeper, faster integration of the health and social care systems that we know needs to happen.

On public health, I accept that difficult economies need to be made, but it is not just about public spending. This Government have a proud record of banning the display sale of tobacco, introducing standardised packaging for tobacco, introducing a sugary drinks tax and putting more money into school sports. There are lots of things that we can do on public health that make a big difference.

On capital, I agree with my hon. Friend about the pressure on the capital budget, but hospitals have a big opportunity to make use of the land they sit on, which they often do not use to its fullest extent, as a way to bridge that difficult gap.

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26 OCT 2016

Letter to the Chancellor

Use the following link to read the letter in full of the key requests to the Chancellor on the funding of health & social care.

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26 OCT 2016

BBC 5 Live Daily

This morning I was on BBC 5 Live with Emma Barnett, Clive Lewis and Tasmina Ahmed-Sheikh to talk about the Heathrow runway, party politics, and the NHS. You can listen to me on BBC iPlayer here.

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25 OCT 2016

NHS Clinical Commissioners

I met with Julie Wood from NHS Clinical Commissioners. The Clinical Commissioners represent clinical commissioning groups (groups of GPs who manage health spending locally). We discussed some of the issues facing the health service, including funding pressures and the importance of different bodies in the NHS and the social care sector working well together in the interest of patients.

North, East & West Devon CCG is currently consulting its Success Regime. You can have your say on the CCG website here.

NEW Devon is also consulting on continuing to prescribe gluten free foods. If this is something which would affect you, you can complete the survey on the CCG website.

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25 OCT 2016

Unplanned Admissions

I attended a reception hosted by Henry Smith MP at the Palace of Westminster to show my support for reducing unplanned admissions to hospital as a result of urinary incontinence. The event coincided with the launching of an updated version of a Best Practice Guide on improving continence care published by the Unplanned Admissions Consensus Committee. Thank you to Tracey Cunningham, Matron of Totnes and Dartmouth Hospital for attending and Ward Sister Michelle Thomas.

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25 OCT 2016

Private Members' Bills

Sarah Wollaston Chair, Health Committee

I fully support my hon. Friend the Chair of the Procedure Committee. Will theLeader of the House respond to the question he has been asked as to whether he accepts that the existing arrangements bring this House into disrepute? I believe that they do.

 

David Lidington Lord President of the Council and Leader of the House of Commons

We will respond in full to the Committee's report. Over the years, many criticisms of the private Members' Bill procedure have been made from different quarters. I will take seriously the proposals the Committee has made. However, we also need to ensure that under our procedures, legislation does not reach the statute book, perhaps even creating criminal offences affecting our constituents, unless there is clear demonstrable support within Parliament among a majority of Members for it to be enacted.

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24 OCT 2016

Health Service Medical Supplies (Costs) Bill

Sarah Wollaston Chair, Health Committee

Further to that important point about biosimilars, and in welcoming this legislation and the opportunity to create savings for the NHS, will the Secretary of State also address the long-standing issues around Lucentis and Avastin?George Freeman updated the House about the barriers in both domestic and European legislation that prevent the use of Avastin—it is not licensed for wet age-related macular degeneration—but the scale of savings could be so vast that there is a case for introducing measures in the Bill to allow for such issues to be addressed.

Jeremy Hunt The Secretary of State for Health

I am happy to look into that—some of my own constituents have been affected by that issue. I am not aware that there is scope to consider that important point in the Bill, but we should reflect on what we can do to deal with some of the anomalies in the drug licensing regime that lead to the unintended consequences that my hon. Friend talks about.

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19 OCT 2016

Baroness Floella Benjamin

Baroness Floella Benjamin chaired a meeting today to discuss the role of Physical Education as part of a health, wellbeing and confidence-boosting matrix and how to ensure involvement of the family in a physical activity relationship alongside schools/early years' settings.

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19 OCT 2016

Agriculture and Fishing

Sarah Wollaston Chair, Health Committee

Time is short, so I will congratulate my hon. Friend Scott Mann on bringing forward this debate, and endorse the many comments he and others have made about the importance of our farming industry. I would like to touch on: issues for our fishing industry, particularly fairness, markets, support and sustainability; our coastal communities—the Minister, whom I welcome to her post, will understand that, as she represents a coastal community—marine science; and the importance of talking to fishermen and farmers as policies go forward.

First is the issue of fairness—that is what fishermen are looking for. When 73 million of the channel fishing quota goes to British fishermen and 211 million goes to French fishermen, clearly that is out of balance. Fishermen tell me that they are unable to access waters within France's 12-mile limit, but others are able to access waters within our 12-mile limit, so that again is an area in which we have an opportunity to make significant changes. Also, will the Minister also comment on the issue of quota hopping? That has long been a source of concern to our fishermen.

This is not just about our fishing communities and fishermen; it is about the onshore sector, markets and access to those markets. Will the Minister join me in congratulating Brixham market and Brixham Trawler Agents? Last week, Mike Shaw and his team topped the £1 million-mark for the value of the catch landed through Brixham market. That market was worth more than £23 million to our local economy in the past year. However, the majority of the produce that goes through that market is for export, principally to the European Union. Clearly, it is absolutely vital that we protect those markets, and that we do not drive the producer sector away from Brixham and other areas in the south-west to the European Union. I hope that the Minister will focus on that, as well as access for the important workers in that industry.

Many hon. Members have touched on support for our coastal communities, our fishermen and, indeed, for Brixham market and others. Although many grants have come from the European Union, we all accept that the money is recycled from our own resources. It will be terrific if we have more flexibility to use that money in a way that is right for our businesses and communities. Will the Minister comment on whether those processes will speed up, and become more transparent and less bureaucratic? We have a huge opportunity to do that.

There is also the important issue of sustainability. We will exit the common fisheries policy at a time when it finally seems to be getting its act together; the 2014 reforms have really started to make a difference. Continuing to look at this by sea basin area will be important. Clearly, under the United Nations arrangements, we will still rightly be bound to liaise with our neighbours when coming to these agreements; we cannot just unilaterally make changes. It is important that the Minister acknowledges the importance of having a commitment to a maximum sustainable yield and to protecting our marine environment.

We must also look at pollution controls and safety at sea. Those who put their lives on the line for us to put fish on our plate deserve an absolute assurance that safety will be foremost in the Government's mind going forward.

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18 OCT 2016

Health Select Committee

The Health Committee questioned the Secretary of State for Health and NHS Chief Executives as part of the inquiry on the current state of NHS finances.

http://www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/news-parliament-20151/healt-finances-evidence2-16-17/

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13 OCT 2016

South West Royal College of General Practitioners

I met with Richard Pratt of the South West Royal College of General Practitioners to discuss the GP Forward View. You can find out more about the GP Forward View here:

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13 OCT 2016

Barnardos

It was fantastic to meet  with Debbie and Alison from Barnardo's to talk about their new project, 'Believe In Me' which aims to show off the incredible things that children who may not have had the best start in life can do.

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13 OCT 2016

Hospital Consultants

I met with members of the Hospital Consultants and Specialists Association to talk about the pressures facing the NHS and how to deal with the challenges the NHS faces. It was a pleasure to meet with Claudia, John, Ross, and Eddie from the Association.

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13 OCT 2016

Tobacco Control Plan

Sarah Wollaston Chair, Health Committee

It is a pleasure to serve under your chairmanship, Mr Brady. I commend Alex Cunningham for his tireless campaign on tobacco control and for introducing the debate.

In 1974, 46% of adults smoked, but that figure has now fallen to 16.9%. That is not an accident; it has been because of the concerted action of campaigners, cross-party working and Government support over the years. It has all been about price, marketing, availability, smoke-free environments, education, targeted support to help people to cut down and quit, and the availability of less harmful alternatives.

I also commend the Government and the Conservative-led coalition Government for their action over the past six years. We have seen an end to point-of-sale displays—the last refuge of advertising and marketing—and, finally, the introduction of standardised or what we might call "truth" packaging, which allows people to see the product and what it does to them. We have also seen further protection for children, with bans on proxy sales and on smoking in cars with children present.

The evidence shows that intervention saves lives, and in the case of smoking it saves lives very quickly. It can have a real effect in the same year on foetal, maternal and child health and on reducing cardiovascular disease and complications in surgery. It is definitely worth doing, both in the short and the long term. It should set a template for other public health measures, because it shows that they really make a difference and are definitely worthwhile.

As the hon. Member for Stockton North so clearly stated, however, these improvements do not mean we should be complacent. There are still 76,000 preventable and premature deaths a year as a result of smoking. Not only does that have a devastating impact on individuals and their families, it has other implications, not just for mortality but for the disease burden and the lives lived in very poor health. In my 24 years on the frontline in the NHS I saw that at first hand. Living with COPD and end-stage COPD is a dreadful burden on individuals.

There is also the cost to the NHS and the issue of health inequality, which we have heard about already. The cost to the NHS is about £2 billion a year. If we are to look at the long-term sustainability of our NHS, we must tackle that. Things can be done. Almost a quarter of hospital admissions for lung disease are attributable to smoking; we can do better on that.

As the hon. Member for Stockton North pointed out, the Prime Minister spoke in her first speech on the steps of Downing Streetabout the "burning injustice" of the life expectancy gap between rich and poor. I absolutely support her determination to tackle that; we also need to tackle the gap between rich and poor in healthy lives lived, which is also very important. The stark reality is that those who earn less than £10,000 a year are twice as likely to smoke as those who earn more than £40,000 a year. If the Government are serious about tackling health inequality, they have to have an effective tobacco control plan.

Of course, health inequality is a multi-factor problem. It is not just about issues such as smoking and obesity—there are many other important issues, such as education, poverty and housing—but we can make a difference both quickly and in the long term by continuing to tackle smoking. I really hope the Minister will acknowledge that it is about preventing new smokers from coming on board, helping existing smokers to cut down and quit, and imposing greater responsibility and accountability on the industry. The five year forward view rightly calls for a radical upgrade in prevention and public health, which is essential for the long-term sustainability of the NHS. Now is not the time to cut back on the services that deliver prevention and help for people to cut down and quit, but sadly that is what is happening.

I am afraid a lot comes down to budgets. In 2015, we saw a £200 million in-year cut to public health budgets, and that is set to continue. The Health Committee's recent inquiry into public health, which has now reported, found that there will be a real-terms reduction in public health budgets from £3.47 billion in 2015 to £3 billion by 2021. That will hit front-line services. Around 4.1% of total health spending is currently in public health, and that percentage is definitely set to decline, which is absolutely a false economy. We should be investing now to make the savings we need for the future—not just for individuals, though of course they should be the priority, but for the long-term sustainability of the NHS. That would be cost-effective.

We are already seeing the impact on front-line services: local authority stop smoking services have been decommissioned in Manchester, for example, and in Worcestershire they are now available only to pregnant women. We also need to look at how CCGs are withdrawing their support for GPs to prescribe nicotine replacement therapy. That is worrying, because there is a very clear evidence base for such services, as we have heard—I will not repeat what the hon. Member for Stockton North set out so eloquently. Cutting them is the worst example of poor value for money and letting people down. I really hope that when devising an effective strategy the Minister will look at that and make sure that those services are available, both within local authorities and at the frontline of NHS services.

As a former GP, I know the role GPs can play in persuading those who are in the most danger, because they see people when they are suffering the complications of smoking and their intervention at that point is often the trigger for people to quit effectively. But GPs are now left in a position where they cannot prescribe the products that we know might help patients. We absolutely must not abandon one of the most cost-effective measures in healthcare, and we must not add extra cost to the future.

Members in the main Chamber of the House of Commons are discussing baby loss this afternoon, and I am sorry that none of us can be in two places at once. However, it is essential to remember that if the Government are to succeed in their aim to reduce neonatal stillbirths and maternal deaths by 50% by 2030, we have to consider maternal smoking. Sadly, around 300 perinatal deaths every year are attributable to smoking. There are very important reasons across the board for tackling this.

Finally, I will touch on the issue of e-cigarettes, because there is some controversy around them. Some people fear that the industry will take over and that e-cigarettes will become a gateway into smoking, but the evidence so far does not support that. Of course we need to be vigilant and make sure that these products are not being marketed to children to push nicotine addiction, which then steps on to smoking, but so far the evidence is not there. Nevertheless, we need to watch the marketing side of things.

There is no doubt that for many people e-cigarettes are a gateway out of smoking or a way to reduce the amount that they use. It is estimated that in 2015 around 18,000 long-term smokers were helped to cut down and quit by such products. We should be encouraging their use, because the evidence supports that. We are currently members of the European Union and so subject to the tobacco directive, which will mean further restrictions on the use of e-cigarettes. Will the Minister confirm that she will look carefully at the emerging evidence to see where we want to fit in with and adopt that directive and, perhaps, where we feel that it might not be appropriate for the UK? It is an emerging picture, but the overall message should be that we should encourage the use of e-cigarettes and make them available to people when they need to use them.

I know that other Members wish to speak, so I shall not detain the House any further, other than to say that, like the hon. Member for Stockton North, I hope the Minister will be able to confirm today the timetable for the introduction of the tobacco control plan. I know that she will be personally determined to ensure it is effective.

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12 OCT 2016

Devon and Cornwall Business Council

It was a pleasure meeting the CEO of Devon and Cornwall Business Council, Ben Rhodes again in Parliament last Wednesday. We talked about how Devon businesses are going to be affected by Brexit, about Local Enterprise Partnership schemes in my constituency, and more.

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12 OCT 2016

President of the Syrian British Medical Society

It was a delight to meet with Dr Ayman Juni, the President of the Syrian British Medical Society about support for Syrian Doctors. We also talked extensively about the great work of Syria Relief, Britain's largest Syria focussed charity.

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12 OCT 2016

Obesity Health Alliance

A big thank you to the Obesity Health Alliance (OBA) for taking time to meet with me today. The OBA is a coalition of 30+ organisations working together to tackle obesity in Britain. We talked extensively about why the government's obesity plan needs to go further and about what we need to do as a nation to fight obesity in the United Kingdom.

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12 OCT 2016

Elaine Wyllie

It was an absolute delight to meet Elaine Wyllie the founder of the Daily Mile.  Elaine wanted to tackle the obesity and poor levels of fitness of the children in her school. The scheme is now spreading across the UK. The aim of The Daily Mile is simple – to get children fit by running for 15 minutes a day. The daily exercise is not timetabled. Teachers take their classes out at a time of their choosing. The children walk, jog or run with their classmates in the safety of their own playground. You can read more about this inspiring change that is really making a difference via the following link.

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12 OCT 2016

European Medicines Agency

Sarah Wollaston Chair, Health Committee

The hon. Gentleman is making a powerful case. These points were raised with the Select Committee on Health in the run-up to the referendum. Will he join me in calling for people to submit further evidence to the Health Committee, now that we have launched our inquiry into what the Government's priorities should be during their negotiations on the terms of our withdrawal?

Daniel Zeichner Shadow Minister (Transport)

I thank the Chair of the Health Committee for her intervention. I certainly encourage those in my area and others to take up that offer. We will be doing so.

Let me come to the most tangible issue of all: the future physical location of the European Medicines Agency. Just last month, the Government said in a written answer to my hon. Friend Andrew Gwynne:

"The future arrangements which apply in relation to European Union institutions based in the United Kingdom should be determined once the United Kingdom has left the EU. It is too early to speculate on the future location of the European Medicines Agency."

Early or not, speculation is intense, and others are moving fast to gain advantage. The EMA stated in July that it

"welcomes the interest expressed by some Member States to host the Agency in future", while stressing that the decision will be taken

"by common agreement among the representatives of the Member States."

Various member states are already vying to host the EMA. The Danish Prime Minister has said he is looking at it. The Irish HealthMinister has said that attracting the EMA to Dublin is one of the "more interesting" opportunities afforded by Brexit. Italy, Sweden and Spain are also reportedly expressing an interest.

The EMA employs some 900 people. What will happen to their jobs? Will those people move with the agency? Inevitably, there is concern that, should the EMA relocate outside the UK, there will be a knock-on effect on the wider pharmaceuticals and life sciences industries. When they next decide where to locate and invest, does losing the EMA hinder or help? In my view, the answer is fairly clear, but I would welcome the Minister's view.

We risk losing jobs. We risk losing influence. On a practical level, any company that sells to the European economic area has to have a qualified person for pharmacovigilance—an experienced, senior person based in the European economic area. If we are outside that area, QPPVs would have to move out of the UK or lose their jobs. There are 1,299 QPPVs currently in the UK. That is another potential loss, and of course, every highly-skilled job lost has a multiplier effect.

Perhaps the Minister can give us an estimate of how much all this will cost us. When I asked the Secretary of State for Exiting the European Union that question in the House on Monday, he had no answer. I appreciate that the Minister, following the lead given by the Brexit Ministers, is unlikely to be able to provide detailed, concrete information at this stage. I have some sympathy; if you do not have a plan, it is probably best to say as little as possible. However, I hope that the Government understand just how important it is for the UK to retain the closest relationship possible with the European Medicines Agency. It is important for patients. It is important for businesses. It is important for innovation, and it is important for our economy as a whole.

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Sarah Wollaston Chair, Health Committee

Does the Minister agree that the reason why we have such world-class expertise is the workforce? We must be absolutely clear and send a message to the world that, within our science and research community, we will not be maintaining a list of who is here from the EU and who is a British scientist. We must unequivocally send a message that Britain is open to scientists, researchers and the medical and healthcare workforce from around the world and the EU, not just from Britain.

David Mowat The Parliamentary Under-Secretary of State for Health

That last intervention—I say "last" somewhat hopefully—unites us all. It would be ridiculous if the world-class science that we must continue to do compromised on matters like that. I completely agree with my hon. Friend's point, and there is agreement across Government about that. If we need to make that clearer, we should.

I will finish now, as nobody is springing to their feet. I thank all hon. Members, particularly the hon. Member for Cambridge, for putting the issue on the agenda. It is right and important that the topic is at the forefront of our negotiations, and that we get the right answer in the end.

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11 OCT 2016

Health and Social Care

Sarah Wollaston Chair, Health Committee

I welcome greater integration, but the Minister will be aware that there are grave concerns about the effect of cuts to social care on the NHS. More and more patients are spending greater time in more expensive settings in hospital when they could be better looked after in their own homes or in the community, but cuts to social care make that impossible. Will the Minister set out what appraisal the Government are making of the effect and the damage to the NHS of cuts to social care?

David Mowat The Parliamentary Under-Secretary of State for Health

My hon. Friend is right: social care funding is tight. It is also true to say that those parts of the country that do the best in this regard—there are some that do considerably better than others—have integrated social care and health most effectively. On the budget itself, there is some disparity among different local authorities. About a quarter of local authorities have increased their adult social care budget by 5% or more this year.

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10 OCT 2016

Broadband

I met today with the Minister for Digital and Culture, Matt Hancock MP to directly make representations about the way that rural Devon has been disadvantaged by relatively slow progress of broadband compared to some other areas.

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10 OCT 2016

Calais Jungle

Sarah Wollaston Chair, Health Committee

I welcome the Home Secretary’s statement and the sense of urgency that she brings to this important issue. These are deeply traumatised children. Can she update the House on not only what mental health provision will be available for them when they come to this country, but what is being done to identify families who will have the specialist skills to help and support those children coming here under the Dubs amendment?

Amber Rudd The Secretary of State for the Home Department

My hon. Friend raises a very important point: once we have them over here, how will we best look after children who have been traumatised, and families who are feeling vulnerable? We are working closely with the local authorities to ensure that they can provide the necessary support, and we can assist them.

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14 SEP 2016

British Farming Day

I met with the NFU at the Back British Farming event in Westminster to celebrate farming's contribution to Britain's economy and food security. British farming accounts for 3.9m agri-food jobs in the UK.
I discussed issues ranging from Brexit to tackling bovine TB with Matt Ware the NFU's head of government affairs and also met with Gemma Harvey, whose family runs a dairy farm in the South Hams, and who has recently joined the NFU as a graduate.

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13 SEP 2016

Hospitality and Tourism Day

I met today with  Graham Grose and Edward Bence as part of the Hospitality and Tourism Day in Parliament. We discussed a range of issues facing the industry, including tourism VAT, Brexit and seasonal workers, the National Living Wage and training and apprenticeships.

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12 SEP 2016

Department of Health: Migrant Workers

Written Answers
Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if he will discuss with theGeneral Dental Council steps to address the disparity in acceptable scores on the International English Language Testing System achieved by dentists and dental hygienists and the scores accepted in such tests by the General Medical Council for doctors from outside the UK who are able to practise in the UK.

Philip Dunne The Minister of State, Department of Health

Both the General Medical Council (GMC) and the General Dental Council (GDC) are able to apply a language test to international applicants wishing to practise in the United Kingdom. Proportionate language controls can also be applied by the GMC and GDC on all applicants from the European Economic Area wishing to practise in theUK to ensure that doctors and dentists have the necessary English language skills to practise safely in the UK.

It is for the GMC and GDC as independent regulatory bodies to decide what constitutes an acceptable knowledge of English to practise safely in the UK including an acceptable score in the International English Language Test.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether his Department plans to respond to the policy briefing from the Royal College of Surgeons on English language testing of EEA healthcare professionals, dated 17August 2016; and what plans he has to introduce clinical language tests for EEA healthcare professionals working in the UK.

Philip Dunne The Minister of State, Department of Health

Changes to United Kingdom law introduced in April 2014 and March 2015, allow the General Medical Council (GMC), Nursing Midwifery Council, General Dental Council (GDC), General Pharmaceutical Council and the Pharmaceutical Society of Northern Ireland to carry out language controls for European Economic Area (EEA) doctors, dentists, nurses, midwives, pharmacists and pharmacy technicians in Britain. The regulators are now able to apply proportionate language controls for EEA professionals before registration and admission onto the register ensuring that only those healthcare professionals who have the necessary knowledge of the English language to do their job in a safe and competent manner are able to practise in the UK.

Under the Mutual Recognition of Professional Qualifications Directive (MRPQ) regulatory healthcare bodies, including the GMC and GDC, are required to recognise primary and specialist medical qualifications gained in an EEA healthcare professional's home member state.

The people of the UK have voted to leave the European Union, however until exit negotiations are concluded the UK remains a full member of the EU and all the rights and obligations of EU membership remain in force. This includes implementation of the MRPQ Directive.

A number of concerns have been raised about the constraints that the Directive places on the ability of UK regulators of health professionals to carry out robust checks of both the clinical and language skills of medical professionals from the EEA seeking to practice in the UK. The Government shares these concerns and will review the checks that UK regulators are able to apply in light of the EU exit negotiations.

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12 SEP 2016

Asylum: Children

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for the Home Department, what steps she is taking to accelerate the process of family reunification for unaccompanied refugee children in Europe.


Robert Goodwill The Minister for Immigration

The Government began work to implement the 'Dubs amendment' immediately after the Immigration Bill gained Royal Assent. Over 30 children who meet the criteria in the Immigration Act have been accepted for transfer since it received Royal Assent in May, the majorityof these have already arrived in the UK.

We continue to work with the French, Greek and Italian authorities and others to speed up existing family reunification processes or implement new processes where necessary for unaccompanied children. We have seconded a UK official to Greece, we have a long-standing secondee working in Italy and will shortly be seconding another official to the French Interior Ministry to support these efforts.

We have established a dedicated team in the Home Office Dublin Unit to lead on family reunion cases for unaccompanied children. Transfer requests under the Dublin Regulation are now generally processed within 10 days and children transferred within weeks. Over 120 children have been accepted for transfer this year from Europe.

We also continue to consult local authorities about the transfer unaccompanied refugee children from Europe to the UK, where it is in their best interests.

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08 SEP 2016

Soft Drinks: Taxation

Written Answers

Sarah Wollaston Chair, Health Committee

To ask Mr Chancellor of the Exchequer, what the Government's plans are for the implementation of the soft drinks industry levy; and if he will publish a timetable for the implementation of that levy.

 

 

Jane Ellison The Financial Secretary to the Treasury

The Soft Drinks Industry Levy consultation was launched on 18th August 2016. At the Budget in March, the Government announced that it would consult on the Levy during the summer and legislate in Finance Bill 2017, for implementation from April 2018. This timetable remains in place.

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08 SEP 2016

Scamming: Vulnerable Individuals

Sarah Wollaston Chair, Health Committee

Has my hon. Friend also considered the risk and actual harm caused when scammers market fake medicines online? That is a particular problem. Operation Pangea has been seizing many such products as they come into the UK, but people need to be aware of the danger of buying from online pharmacies. They need to be sure that they are buying from a reputable agent of the pharmacy industry in the UK, and people can look at logos to check that they are doing so.


Sarah Wollaston Chair, Health Committee

I wonder whether the Minister in the legislation will also address the fines that are meted out when people breach the rules. She may be familiar with the case of Pharmacy2U, which, disgracefully, sold the details of more than 20,000 of its customers, many of them very vulnerable, to marketing companies. The fine of £130,000 is derisory and no meaningful deterrent.

Sarah Newton The Parliamentary Under-Secretary of State for the Home Department

As always, the Chairman of the Health Committee makes a powerful point, and I am sure those responsible for drafting these measures will take them into careful consideration, ensuring that the scope of the measures captures some of the very harmful behaviour of scammers and fraudsters and that there is sufficient deterrent to those considering undertaking these crimes from the regime of punishments put in place, including fines.

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07 SEP 2016

Badger Cull and Bovine TB

Sarah Wollaston Chair, Health Committee

I support further research into vaccination, but is the hon. Gentleman aware that there is a global shortage of bovine TB vaccine? It is the same vaccine as is used in humans, it needs 10 times the dose, and it needs to be repeated every five years. There is no possibility of an injectable vaccine roll-out at this time, and the programme has even been suspended in Wales.

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05 SEP 2016

Junior Doctors: Industrial Action

Sarah Wollaston Chair, Health Committee

I welcome the BMA's suspension of next week's damaging industrial action. It is clear from its statement that thousands of doctors had been in touch to say that they wanted to keep their patients safe. Doctors know that they cannot do so with full, rolling, five-day walkouts. Will the Secretary of Statetherefore join me in asking the BMA to ballot its members to hear their views before they proceed with the other proposed, damaging, five-day walkouts?

 

Jeremy Hunt The Secretary of State for Health

The BMA should talk to its members much more because, as far as I could tell, the consultation over the summer showed that only a minority actually wanted this extreme series of rolling one-week suspensions of labour that the BMA supported in the end. Most junior doctors are perplexed and worried about the situation and would love to find a solution. There was a bitter industrial dispute, but we actually started a process through which trust was being rebuilt on both sides. In a series of meetings, I met the junior doctors' leader to talk through the areas of her greatest concern and we made progress in addressing two of those four outstanding areas. Building that trust means actually sitting around the table and talking, not having confrontational strikes. I think that that is what most junior doctors want.

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05 SEP 2016

Exiting the European Union

Sarah Wollaston Chair, Health Committee

I warmly welcome my right hon. Friend and the whole Front Bench team to their important new roles in making a success of Brexit. Will the Secretary of State set out what discussions he has had with the EU Trade Commissioner, who has taken a much tougher line on article 50? We all agree it is in everyone's interest to get on and negotiate before we exit, but in a recent interview she indicated that that will not be the case.

David Davis The Secretary of State for Exiting the European Union

Yes, but the commissioner is not in a position, frankly, to tell the Secretary of State for International Trade what he can do, subject to meeting European law. European law in this case means not putting a free trade agreement into effect until we leave. That is the limit. In terms of other discussions and negotiations, commissioners have tried to say that we cannot speak to other members of the European Union, which is sort of silly. We are an ongoing member of the European Union and we take our responsibilities seriously. It is implausible that, in our conversations with member states, we will not talk about what is coming next.

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19 JUL 2016

Impact of the Spending Review on health and social care

The Health Select Committee report released today, covers the NHS funding challenge and calls for clarity, workforce and training, public health and inequality, social care and transformation.

To read the report click here

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13 JUL 2016

Health Professions: Training

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether legislative changes will be required to remove the NHS bursary for healthcare students by September 2017; and if he will make a statement.

 

Ben GummerThe Parliamentary Under-Secretary of State for Health

The proposed reforms to healthcare education funding for introduction on 1 August 2017 will not require amendments to the legislation under which the National Health Servicebursary is provided.

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13 JUL 2016

Health Services

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether his Department plans to publish and keep updated a public resource for identifying and assisting contact with (a) chairs of clinical commissioning groups, (b) chairs of health and wellbeing boards and (c) sustainability and transformation leads.

George FreemanThe Parliamentary Under-Secretary of State for Business, Innovation and Skills, The Parliamentary Under-Secretary of State for Health

There are currently no plans to publish a central resource of contact details. Contact details for each clinical commissioning group are publicly available on their websites. The table below shows where this and other relevant information is publically available:

Chairs of clinical commissioning groups

https://www.england.nhs.uk/ccg-details/

Chairs of health and wellbeing boards

http://www.kingsfund.org.uk/projects/health-and-wellbeing-boards/hwb-map

Sustainability and transformation leads

https://www.england.nhs.uk/2016/03/leaders-confirmed/

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13 JUL 2016

Clinical Commissioning Groups

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, when clinical commissioning groups will be required to update their local transformation plans; and what plans he has for such plans to interact with sustainability and transformation plans.

George FreemanThe Parliamentary Under-Secretary of State for Business, Innovation and Skills, The Parliamentary Under-Secretary of State for Health

Health economies have come together to develop Sustainability and Transformation Plans (STPs) for their footprints until 2020/21. As with the current arrangements for planning and delivery, there are layers of plans which can sit below STPs, with shared links and dependencies. STPs do not replace the existing system architecture. Rather STPs act as an umbrella, holding underneath them a number of different specific plans to address key local issues.

Clinical commissioning groups (CCGs) have operational plans for 2016/17 in place. Operational plans for 2017/18 will reflect the contribution of the CCG to the overall STP. The timelines for the development of the 2017/18 operational plans are being finalised.

The March guidance stressed the importance of responding to 10 key priority areas which included mental health. Footprints are at different starting points, and so the degree of detail that has been provided in the 30 June STP checkpoint varies. However, final STPs will be expected to set out how Mandate priorities will be delivered, including the oversight of locally led transformation plans for children and young people's mental health, before being agreed.

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12 JUL 2016

Neuromuscular Disorders

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what recent discussions his Department has had with NHS ambulance trusts to encourage them to work with Muscular Dystrophy UK to increase health professionals' knowledge of care for people with muscular dystrophy and neuromuscular conditions.

 

Jane EllisonThe Parliamentary Under-Secretary of State for Health

NHS England is responsible for commissioning specialised neurological services, including some services for patients with neuromuscular disorders. NHS England has published a service specification for neurological care that includes an exemplar service specification for neuromuscular conditions that sets out what providers must have in place to offer evidence-based, safe and effective services.

The specification can be found at the following link:

www.england.nhs.uk/wp-content/uploads/2013/06/d04-neurosci-spec-neuro.pdf

National Health Service providers, working with local area teams, may establish neuromuscular networks if they consider it would benefit service provision; such decisions are a local matter.

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11 JUL 2016

Great Western Railway's Bicycle Policy

Sarah Wollaston Chair, Health Committee

I thank the right hon. Gentleman for securing the debate and absolutely agree with everything he has said so far. Does he agree that it was clear from the Get Britain Cycling inquiry that he and I served on in the previous Parliament that active travel to work is a key aspect of encouraging people to get cycling, and that the health benefits that that brings are not in dispute?

Ben Bradshaw Labour, Exeter

Yes, I completely agree. I have described the system as Orwellian partly because of the confusion and the contradictory messages that are being given to the public, but the hon. Lady is exactly right that this is a moment in our history when we should be encouraging people to use sustainable transport and to take their bikes on trains. If there is space on trains, people should be allowed to put their bikes on to them.

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08 JUL 2016

Health Services

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether NHS England has met the key deliverable in the 2014-15 NHS England business plan to ensure that more than 70 per cent of all scientific and diagnostic services are part of accreditation programmes.

 

George Freeman The Parliamentary Under-Secretary of State for Health

The measurement of scientific and diagnostic services was more complex than originally envisaged which meant that the 70% target for these services to be part of an accreditation programme was difficult to quantify. NHS England continues to lead a programme of work to increase the number of scientific and diagnostic services that are part of accreditation programmes and demonstrate robust quality assurance measures.

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06 JUL 2016

Paediatrics: Audiology

Written Answers

 

 

Sarah Wollaston Chair, Health Committee

  • To ask the Secretary of State for Health, how many paediatric audiology services have registered for the Improving Quality in Physiological Services accreditation scheme to date.
  • To ask the Secretary of State for Health, how many paediatric audiology services have (a) been allocated a date and are awaiting an assessment visit by UKAS inspectors under the Improving Quality in Physiological Services accreditation scheme and (b) failed to gain accreditation after their initial assessment visit, since the accreditation began in 2012.
  • To ask the Secretary of State for Health, how many paediatric audiology services have reached the level required, using theSelf-Assessment and Improvement Tool, to be eligible to apply for accreditation under the Improving Quality in Physiological Services scheme.

Alistair Burt The Minister of State, Department of Health

As of July 2016, 74 services are currently registered – covering all stages of gaining and holding Improving Quality in Physiological Services accreditation.

NHS England does not hold information on the number of services that have been allocated a date and are awaiting an assessment visit by United Kingdom Accreditation Serviceassessors, or the number of services that failed to gain accreditation after their initial assessment.

NHS England does not hold information on how many paediatric audiology services have reached the level required, using the Self-Assessment and Improvement Tool, to be eligible to apply for Improving Quality in Physiological Services accreditation.

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06 JUL 2016

Junior Doctors Contract

Sarah Wollaston Chair, Health Committee

I welcome today's statement and thank the Secretary of State for dealing with many of the extra-contractual issues that have blighted the lives of junior doctors. I join him in regretting the outcome of the ballot. Like my right hon. Friend, I welcome Doctor Ellen McCourt to her post. I know that my right hon. Friend will work constructively with the junior doctors committee to try to resolve the outstanding issues. In proceeding in a careful, measured way with the imposition of the contract, will he work to reassure the public that if patient safety issues arise during that process, he will deal with them?

Jeremy Hunt The Secretary of State for Health

I thank my hon. Friend for her measured tone and for being an independent voice throughout the dispute. I spoke to Dr Ellen McCourt earlier this afternoon. I appreciate that she is in a very difficult situation, but I wanted to stress to her that, as I told the House this afternoon, my door remains open for talks about absolutely anything and that I am keen to find a way forward through dialogue. I had lots of discussions with Dr McCourt when we were negotiating the agreement in May, and I know that she approached those negotiations in a positive spirit.

We have set in place processes, and that is one of the reasons why Professor Bailey recommended phased implementation—so that if there are any safety concerns, we can address them as we go along. The Minister with responsibility for care quality, my hon. Friend the Member for Ipswich, is leading a process that will keep looking at the issues to do with the quality of life of junior doctors. NHS Employers is leading a process that will look in detail at how the contract is implemented. Absolutely, the point of the changes is to make care safer for patients; we will continue to keep an eye on this to make sure that it does so.

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05 JUL 2016

Health Select Committee

Today the Health Select Committee met to discuss the Professional Standards Authority.

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05 JUL 2016

Department of Health Nurses

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps he plans to take to ensure that UK nursing is effectively represented at (a) the World Health Assembly and (b) other EU and international fora.

 

Ben GummerThe Parliamentary Under-Secretary of State for Health

The World Health Assembly (WHA) is usually attended by theChief Medical Officer and senior health officials. In the past the Chief Nursing Officer has attended the WHA, though in recent years has not been part of the Department's delegation. However, the World Health Organization (WHO) is largely focussed on public health and the Chief Nurse atPublic Health England works with and contributes to international nursing development with the WHO, including attendance at the WHO Nursing Forum, and also contributes to other global programmes.

There is a European Chief Nursing Officers forum which Government chief nurse advisors attend. It is for the Chief Nursing Officer for England to attend this meeting. In her absence one of the other United Kingdom Chief Nursing Officers should attend.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps he plans to take to ensure nurses are consulted on his Department's future policies after the proposed closure of the Nursing, Midwifery and Allied Health Professions policy unit in his Department.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether (a) staff and (b) external stakeholders were consulted on the proposal to close the Nursing, Midwifery and Allied Health Professions policy unit in his Department.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what mechanisms he plans to put in place to ensure ministers receive impartial nursing advice after the proposed closure of the Nursing, Midwifery and Allied Health Professions policy unit in his Department.

Ben Gummer The Parliamentary Under-Secretary of State for Health

The Department leads the health and care system in England, working closely with a range of organisations on whose expertise it draws, including the nursing and midwifery expertise in NHS England and Public Health England. The Department's approach to ensuring that nurses are consulted about future policies is to flexibly access professional advice from a wide range of sources, including arms-length bodies, regulators, stakeholders and professional bodies.

The Department's policy teams will establish new networks and relationships with stakeholders and partners and collaborate with the Chief Nursing Officer (CNO) to ensure systems are in place to secure advice when developing evidence based policy. These changes do not affect the role of the CNO, who as CNO of the Department already advises, and will continue to advise all Ministers and the Department on the range of nursing and midwifery issues.

The Department is changing the way it works to deliver its essential work for the Government while achieving efficiency savings. All of the changes we are making through the resulting DH2020 programme are being done transparently and communicated to staff.

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01 JUL 2016

Cervical Cancer: Screening

Written Answers

Sarah Wollaston Chair, Health Committee

  1. To ask the Secretary of State for Health, what steps he is taking to address the decline in cervical screening uptake in the 25 to 29 age group.
  2. To ask the Secretary of State for Health, what recent assessment his Department has made of the barriers that prevent women from attending cervical screening.
  3. To ask the Secretary of State for Health, what steps his Department is taking to increase cervical screening rates among (a) women with learning disabilities and (b) women in deprived communities.

Jane Ellison The Parliamentary Under-Secretary of State for Health

There is a range of work going on to understand the reasons for the decline in cervical screening uptake amongst women aged 25 to 29 and to try to address them. They include:

a) Data and information – access to data, cleansing, benchmarking for providers, timely and useful information for commissioners; b) Behavioural insight – communication with commissioners, providers, patients and public; c) Commissioning levers – commissioning contracts in public health (S7a) and primary care; d) Partnership work – relationships with commissioners and providers; and e) Sharing best practice – what works well, evaluation and how to embed quality improvement

Public Health England (PHE) is working with colleagues in NHS England and Health and Social Care Information Centre to implement the Accessible Information Standard which is intended to improve access to services for vulnerable and disadvantaged groups. Through the re-development of cervical Information Technology systems opportunities will arise to review how to help improve uptake.

PHE supports providers to help meet the Accessible Information Standard through the provision of high quality information for people with learning disabilities or sensory loss. A national group of experts and service users has been set up to oversee this work and will be updating the existing easy read leaflets and developing new materials over the next 18 months.

PHE is aware that there are a range of factors which may act as barriers in hindering women from attending cervical screening. It is hoped that through the STRATEGIC (Strategies to Increase Cervical screening uptake at first invitation) interventions will be identified to help minimise barriers and assist women to attend screening whilst increasing uptake across all quintiles. The STRATEGIC trial was completed in 2015 and researchers are expected to publish findings later this year.

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07 JUN 2016

Health Select Committee

Today the Health Select Committee met to discuss Public Health post-2013, structures, organisation, funding and delivery.

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01 JUN 2016

Breastfeeding: Obesity

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if he will ensure that the benefits of breastfeeding will be included in the upcoming obesity strategy.

Jane EllisonThe Parliamentary Under-Secretary of State