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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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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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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