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?
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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.

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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.

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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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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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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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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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