19 JUN 2018

Health and Social Care: Life Sciences and Medical Research

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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18 JUN 2018

NHS Long-Term Plan

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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

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13 JUN 2018

European Union (Withdrawal) Bill:

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

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

Robert Buckland The Solicitor-General

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

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12 JUN 2018

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

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

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


Phillip Lee The Parliamentary Under-Secretary of State for Justice

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

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11 JUN 2018

G7

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

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

Theresa May The Prime Minister, Leader of the Conservative Party

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

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07 JUN 2018

Tuberculosis

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

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

 

Nick Herbert Conservative, Arundel and South Downs

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

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

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07 JUN 2018

Bill Presented: Privilege

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

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

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

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

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

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

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

 I thank my hon. Friend for that point.

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

 

 

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07 JUN 2018

Leaving the EU: Fishing Industry

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

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


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

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

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05 JUN 2018

Offences Against the Person Act 1861

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Yvette Cooper Chair, Home Affairs Committee

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

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

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

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

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04 JUN 2018

Home Department: Topical Questions

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

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

Sajid Javid The Secretary of State for the Home Department

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

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24 MAY 2018

Porton Down

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

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23 MAY 2018

Social Services: Minimum Wage

Written Answers

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

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

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

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

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

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

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

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

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

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

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

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22 MAY 2018

Transport Emissions: Urban Areas

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

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

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

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

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21 MAY 2018

Miles Briggs

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

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21 MAY 2018

NHS Clinical Commissioners

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

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21 MAY 2018

Care Quality Commissioner

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

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21 MAY 2018

Community Buses

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

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19 MAY 2018

Citizens' Assembly

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

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17 MAY 2018

Gaming Machines

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

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

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

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

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13 MAY 2018

Amsterdam

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

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09 MAY 2018

Education (Student Support)

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

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

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

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

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09 MAY 2018

Data Protection Bill [Lords]: Information Orders

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

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

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

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

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

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

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

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

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

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

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

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

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08 MAY 2018

Learning Disabilities Mortality Review

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

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

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

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

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08 MAY 2018

Health and Social Care: Topical Questions

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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08 MAY 2018

Health and Social Care: Access to Social Care

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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02 MAY 2018

Breast Cancer Screening

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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01 MAY 2018

Health Select Committee

Today the Health Select Committee discussed childhood obesity.

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30 APR 2018

Windrush

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

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

Sajid Javid

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

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26 APR 2018

Customs and Borders

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

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

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

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

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

Ben Bradshaw Labour, Exeter

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

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

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

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

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

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

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25 APR 2018

School Funding: Social Care

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

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

Kelvin Hopkins Labour, Luton North

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

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24 APR 2018

Energy and Industrial Strategy: Fracking: Methane

Written Answers

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

To ask the Secretary of State for Business, Energy and Industrial Strategy, with reference to the Implementation Unit Report on Shale Gas, what estimate the Government has made of the amount of unintended methane emissions at the projected (a) 17 sites by 2020, (b) 30 to 35 sites by 2022 and (c) 155 sites by 2025.

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

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

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

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

Methane emissions from shale gas production minimised and monitored.

Gas consumption remains within carbon budget limits

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

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

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

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

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

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

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

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23 APR 2018

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

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

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

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

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

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

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19 APR 2018

Surgical Mesh

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

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

.....

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

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

......

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

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

.....

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

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

.....

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

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

......

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

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

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16 APR 2018

Syria

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

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

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

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

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

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

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16 APR 2018

Syria

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

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

Theresa May The Prime Minister, Leader of the Conservative Party

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

They Work For You

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29 MAR 2018

Autism

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

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

Lisa Cameron Shadow SNP Spokesperson (Mental Health)

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

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

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

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29 MAR 2018

Department of Health and Social Care: Death Certificates

Written Answers

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

To ask the Secretary of State for Health and Social Care, what progress he has made on the implementation of his Department's proposals for reform of death certification by April 2019; and if he will make a statement.

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

The Government is committed to the introduction of medical examiners from April 2019, to provide a system of effective medical scrutiny of all non-coronial deaths. Following a public consultation on associated reforms, the Government plans to publish a response shortly, accompanied by an impact assessment which will set out the costs and benefits of the revised approach.

Hansard

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28 MAR 2018

Contaminated Blood

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

The victims of the contaminated blood scandal have waited decades for answers. Will my right hon. Friend update the House on progress on the inquiry? Is there any room to revisit the decision to deny victims and their families legal aid in order to prepare adequately for the inquiry?

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

The inquiry launched a consultation on its terms of reference on 2 March. Details are on its website. The deadline for responses is 26 April. Sir Brian Langstaff wants to hear from as many of those who were affected as possible. As with any such inquiry, it is for the inquiry to decide the level of financial support, including for legal representation for the inquiry proceedings. I am very happy to talk to my hon. Friend and other interested colleagues, or for the Parliamentary Secretary, Cabinet Office, my hon. Friend Chloe Smith, to do so, about how the terms of reference are being handled. Sir Brian wants this process to be as user-friendly as possible.

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27 MAR 2018

Liaison Committee

Watch the Prime Minister give evidence to the Liaison Committee.

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23 MAR 2018

Leaving the EU: NHS

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

I thank the Minister for giving way and apologise for not making a fuller contribution to this important debate; I had a long-standing commitment as Chair of the Health and Social Care Committee that could not be delayed.

On the workforce, will the Minister comment on a small area that the Committee highlighted in its report but many people are not aware of: the role of qualified persons? Those are the individuals who are legally responsible for batch-testing drugs before they are released on to the market or made available for clinical trials. Will he pay close attention to the problems that will arise and the impact on clinical trials and the safety of medicines if qualified persons are no longer recognised in the UK after it leaves the European Union? That workforce is in great demand, and there is clear evidence that many of them will have to leave to the EU if that happens, leaving Britain short.

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

I am very happy to recognise my hon. Friend's point, which is well made. As she knows, I am keen to have close discussions with her about such issues. However, through our adoption of the acquis into UK law, our desire for a transition deal, our protection of workers' rights and our clear signal to EU citizens, the Government have signalled that we are committed to working collaboratively with the European Union and to maintaining high standards. Indeed, science and healthcare is one of the areas where collaboration is best and where the EU has the strongest desire to maintain that collaboration. We work from firm foundations as we take on some of these specific issues, which the Department will continue to explore.

At the same time as attracting talent from overseas—from both the EU and beyond—we should not lose sight of the importance of growing our own workforce. Again, the Government have clearly signalled our intention in that regard, with a 25% expansion of undergraduate places for nursing and our announcement earlier this week of five new medical training centres, in Sunderland, Lincoln, Lancashire, Chelmsford and Canterbury. There is a clear desire to strengthen training for the existing workforce.

That sits alongside other initiatives, such as apprenticeships and ensuring that there are different pathways for people to progress in the NHS. That will ensure that people can develop their careers at different stages, so that someone who enters the system as a healthcare assistant, for example, is not trapped in that role but is able to progress through the nursing associate route and go on to be a qualified nurse. There are myriad ways in which we need to ensure that the NHS has the right skills.

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

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

Will the Minister comment on the need for contingency planning, which is one of the central themes of our report? As he knows, nothing is agreed until everything is agreed, and there is genuine concern that we could have a last-minute no-deal scenario, which would have major implications for supply chains in the life sciences industry. Will he confirm whether he will publish a detailed list of the areas in which contingency planning is taking place? Will he also publish the detailed contingency planning?

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

The Chair of the Health Committee is absolutely right about the importance of contingency planning. In the Scottish context, on the steps of No. 10 recently, a critic of the Government as fierce as the First Minister praised the level of discussion between the devolved Government in Scotland and the UK, and her discussions with the Prime Minister.

It may reassure my hon. Friend that the Department has secured additional funding from the Treasury—more than £20 million—as part of our preparation for Brexit. The right hon. Member for Exeter has previously asked in the House whether the Department's preparation and staff resource is at the level that he and other colleagues seek. That is a fair observation, and the situation is continually being improved. Alongside that, considerable work is going on within the wider NHS family—in NHS England, NHS Improvement and elsewhere.

Like the Prime Minister and the Secretary of State, I emphasise once again the importance of EU staff within the NHS. They are hugely valued and will continue to be so, and we are keen to protect their workers' rights. That is reflected in the agreements reached by the Prime Minister in December and those reached earlier this week by the Secretary of State for Exiting the European Union. Alongside that, considerable work is going on within the Department to address a number of these issues as part of our contingency planning. We continue to seek a very close co-operative deal with our partners in the European Union. In areas such as science, there is a long and strong tradition of working in such a collaborative manner. As part of continuing those preparations, this debate and the Health Committee's informed report provide much material on which we can work.

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21 MAR 2018

NHS Staff Pay

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

I warmly welcome today's announcement of a well-deserved pay rise for NHS staff and, in particular, that this will be additional funding of £4.2 billion over three years, rather than it coming out of existing resources. I particularly welcome the focus on staff health and wellbeing, which was raised by the recent Health Committee inquiry into the nursing workforce. In particular, I ask the Secretary of State to go further and talk about what will be done on continuing professional development for NHS staff, because this was identified as a key factor in retention. He referred to it partially in his comments, but I wonder whether he could go further.

Jeremy Hunt Secretary of State for Health and Social Care

I thank my hon. Friend for her comments. Underneath this agreement, there is a very important new partnership between NHS employers and the unions to improve the health and wellbeing of staff through mental health provision and the implementation of the Stevenson-Farmer review, taking on board a number of points raised by the Health Committee, and through improved support for people with musculoskeletal conditions, because a lot of NHS work is very physical. However, she is absolutely right: professional development is also very important. By reforming the increments system that we have been using for many years, we will give staff the chance to see their pay go up in a way that is linked to their skills going up as well. That is something that many staff will welcome.

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21 MAR 2018

Fisheries

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

Brixham in my constituency lands the most valuable catch in England. Will the Secretary of State visit Brixham to meet all parts of the sector to discuss their serious concerns that the terms of the transition could end up being reflected in the final deal?

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

My hon. Friend has privately been a persistent, effective lobbyist on the behalf of the fishermen of Brixham and all those associated with the industry, and I thank her for her work. The industry in Brixham has a highly effective and able advocate, and I will of course visit the fishermen in her constituency to explain to them how we intend to ensure that the opportunities available to them will be theirs to enjoy after the implementation period.

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14 MAR 2018

Women in Parliament

It was lovely to speak with Hilary Baxter about encouraging more women to stand for Parliament.

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05 MAR 2018

Uk/EU Future Economic Partnership

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

The Prime Minister is rightly putting the needs of patients first in seeking associate membership of the European Medicines Agency. Will she go further in doing the same and commit to freedom of movement, both now and in future, for researchers and those in the health and care workforce who seek to work and study in each other's countries?

Theresa May The Prime Minister, Leader of the Conservative Party

When we leave the European Union, free movement, which has been one of the pillars of the EU, will end. However, as I said in my statement and in my speech on Friday, EU citizens will continue to want to work and study here, and UK citizens will continue to want to work and study in the EU27. We will be setting out our proposals for our immigration rules on that, and we will stand ready to discuss the arrangements that will be made in future.

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02 MAR 2018

Energy and Industrial Strategy

Written Answers

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

To ask the Secretary of State for Business, Energy and Industrial Strategy, with reference to the Implementation Unit Report on Shale Gas, what estimate the Government has made of the potential effect on employment of the projected (a) 17 sites by 2020, (b) 30-35 sites by 2022 and (c) 155 sites by 2025.

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

BEIS has not made any estimates of the potential effect on employment from the future development of the shale gas industry.

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

To ask the Secretary of State for Business, Energy and Industrial Strategy, what estimate the Government has made of the number of jobs which will be created by the renewables industry over the next ten years.

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

The Government does not produce forecasts for job creation over a future time period for the renewables industry.

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

To ask the Secretary of State for Business, Energy and Industrial Strategy, with reference to the implementation unit report on shale gas extraction, what disposal method will be used for flowback waste from (a) the 17 sites by 2020, (b) the 30 to 35 sites by 2022 and (c) the 155 sites by 2025.

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

It is up to the operator to agree disposal methods with the appropriate regulators as part of their planning application for any future shale gas development.

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01 MAR 2018

Seasonal Migrant Workers

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

Does my hon. Friend agree that, while we all support greater investment in technology within the agricultural sector, we are never going to be able to have a technological solution for harvesting in conditions such as those on hillsides in south Devon?

.........

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

It is a pleasure to follow Tom Brake and, like other colleagues, I congratulate my hon. Friend Kirstene Hair on securing this debate. Hon. Members have spoken compellingly about our need to address this issue here and now, and I will focus mostly on issues of time, because we do not have the luxury of that on our side.

I am sure that Members across the House will join me in paying tribute to our farmers and fishers. If we think it is cold here, imagine what it is like on a Dartmoor hill farm right now, or out on a Brixham trawler. We should pay tribute to all those who put food on our plates, and thank them for what they do. I particularly thank Riverford farm in my constituency, the National Farmers Union, and all those farmers who have written to me about this issue for the work they are doing to collect evidence for this debate.

As I have said, we do not have the luxury of time, and Riverford farm has made the point compellingly to me that this autumn it has to make crunch decisions about employing workers for the following year. There is still great uncertainty about the transition period, and as we have heard so compellingly from Members across the House, even if a transition period is in place, there is a shortage in our workforce here and now, and we could use the mechanism of a seasonal agricultural workers scheme to address that.

The Government have commissioned the Migration Advisory Committee to research the impact of leaving the European Union on the UK labour market, and to consider how to align immigration policy with a modern industrial strategy, but that is not due to report until autumn. It will then take time to implement such a scheme, and I do not think we have the luxury of that time.

Many nations across the EU already supplement their workforce with a seasonal agricultural workers scheme, so will the Minister give us some hope that the Home Office will take a decision on this issue sooner than we would expect under the current timetable, with a report coming forward in autumn? As we have heard, the uncertainty is delaying investment now for the future, and we need something to take back to our constituents who work in these important businesses. They are already making great efforts to recruit locally, but as we have heard, even with those efforts and schemes to encourage and retain a UK-based workforce, they are still dependent on a workforce that is supplemented from outside the country.

As the mother of someone who works in the robotics industry, I appreciate the investment going into those technological solutions. I am afraid, however, that it simply will not provide all the answers we need to make sure our crops are picked in a timely manner. There can be nothing more heartbreaking than seeing crops rotting in the fields, as I am sure the Minister will reflect in her closing remarks.

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

I really think this is entirely in addition to it. I remain of the view that we should be focusing on the issues of frictionless trade and keeping very close links to our European Union partners as we exit the EU. I think these issues will arise irrespective of that, as we have heard. Whatever the situation with transition, I hope that the Minister will consider this as something we could use to supplement the arrangements we will have.

Most of all, I would like the Minister to give us some indication of when we are likely to see a decision. Farmers in my constituency here and now are starting to make decisions about their future plans and investment that will impact not only their businesses; remember that they also employ a local workforce in many other capacities, and their decisions will affect them. The implications for our industry are very far reaching and I hope the Minister will give some indication of when we are going to see an answer.

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27 FEB 2018

Royal College of Psychiatrists

I met with members of the Royal College of Psychiatrists to discuss the Mental Health agenda.

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26 FEB 2018

Children's Commissioner

Thank you to Anne Longfield, the Children's Commissioner for coming to Parliament today to discuss mental health

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26 FEB 2018

Home Department: Alcohol Abuse

Oral Answers to Questions

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

It has just been confirmed that all alcoholic drinks in Scotland must cost at least 50p per unit from May this year. Will the Minister now review our alcohol strategy to allow us to take up this evidence-based policy that will do so much to tackle the scourge of cheap, high-strength alcohol and reduce pressure on our emergency services?

Victoria Atkins The Parliamentary Under-Secretary of State for the Home Department, Minister for Women

We are of course aware of the Scottish Parliament's policy on this, and we are looking at it with interest. We set out our alcohol strategy in the 2016 strategy on dealing with modern crime, but we keep the issue under review.

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